Plaque rupture,platelet aggregation,and thrombogenesis are the main mechanisms of acute coronary syndrome (ACS),and inflammation factors play key roles in plaque unstability.Psychological stress promotes acute inflammatory response,leading to increased circulating levels of C-reactive protein (CRP),IL-6,and serum intercellular adhesion molecule (sICAM)-1.But it is not clear that whether psychological stress has a direct effect on atherosclerotic plaque stability.The purpose of this study was to investigate effects of chronic psychological stress on inflammatory marker (ICAM-1 ) in atherosclerotic plaque,and inflammatory markers in peripheral blood.Materials and methods Sixty male rabbits were randomized into 2 groups:the control group (n =10) and the atherosclerotic group (n =50).The latter were fed on high fatty diet and were given a large dose of vitamin D3 (3 600 000IU/kg) via intraperitoneal injection.After 8 weeks,the atherosclerotic model was estaslished.Then the 50 atherosclerotic model rabbits were divided into 3 subgroups:no-stress subgroup (n = 16),physiological stress subgroup (n = 16) and psychological stress subgroup (n =18).In physiological stress subgroup and psychological stress subgroup,drinking was cut from twice a day to once a day.At the same time,psychological stress subgroup was given empty bottle stress,and this process lasted for 2 weeks.One hour after the last stress,the blood samples were collected and the serum levels of CRP,IL-6 amd ICAM-1 were tested by radioimmunoassay or enzyme linked immunosorbent assay.The aorta and heart were extracted for pathology examination,and the express of ICAM-1 was tested by immunohistochemical examination.Results (1) After effective atherosclerotic animal model construction,the expression of ICAM-1 in aorta was higher in atherosclerotic group than that in control group (P＜0.01),and was notably higher in psychological stress subgroup than that in no-stress subgroup or in physiological stress subgroup (2.18±0.17 vs 1.58±0.22,1.22±0.15,P＜0.001,respectively).The expression in physiological stress subgroup was higher than that in no-stress subgroup (584±0.22 vs 1.22±0.15,P=0.001).(2) The serum level of IL-6 (51.80±4.60 pg/ml vs 27.60±4.19 pg/ml,8.01±1.39 pg/ml,7.83±1.37 pg/ml),sICAM-1 ( 1.24±0.25 vs 0.85±0.09,0.62±0.17,0.57±0.11),CRP ( 1.004±0.37 vs 0.90±0.29,1.01±0.22,0.71±0.13) in psychological stress group were significantly higher than that in other groups (All P＜0.05).There was a positive relationship between the serum level of CRP,IL-6 and ICAM-1 and the expression of ICAM-1 in aorta wall ( r =0.59,r =0.75,r =0.87,P＜0.01,respectively).Conclusions Psychological stress induces an increased expression of ICAM-1 in aortic atherosclerotic plaque,a higher serum level of CRP,IL-6,and sICAM-1 expression.Psychologial stress has a direct effect on the transition from stability to unstability through in-plaque and out-plaque inflammation.The serum level of CRP,IL-6 and ICAM-1 can reflex the inflammatory degree in atherosclerotic plaque.(J Geriatr Cardiol 2008;5:235-242)

Objective To analyze the severity of coronary artery lesions and the prognosis in patients with low levels of free triiodothyronine (fT3)undergoing coronary angiography (CAG). Methods From August 2011 to August 2012, 600 consecutive suspected patients with coronary heart disease (CHD) who undergone CAG were selected. The patients were divided into two groups based on thyroid function prior to CAG:euthyroidism group (450 patients) and low T3 group (150 patients). All the patients underwent elective coronary angiography, then the severity of coronary artery lesions was assessed by the Gensini scores , and the patients were followed up for cardiovascular events. Results The incidence rate of CHD in low T3 group was significantly higher than that in euthyroidism group (P=0.01). Multiple variables logistic regression analysis showed that fT3 was a protective factor for CHD (OR = 0.351,P < 0.001); The severity of coronary artery lesions was greater in low T3 group than in euthyroidism group (P < 0.001). The mean duration of follow-up was (15.4 ± 3.6) months; the incidence of the composite end-point (death, non-fatal myocardial infarction and target vessel revascularization ) was significantly higher in low T3 group than in euthyroidism group (P=0.023). Conclusions Patients with a decreased T3 level has a higher incidence rate of CHD , an increase in the severity of coronary artery lesions , and a poorer prognosis.

Objective To evaluate the value of magnetic resonance imaging(MRI) in diagnosing ligament injury of the knee.Methods MRI manifestations of ligament injury of the knee confirmed by operation or joint-screen examination in 32 cases were retrospectively analyzed. All cases underwent routine MR scanning. The cases with suspicious anterior cruciate ligament injury undenwent oblique saqittal section fast spin echo-T_2 weight (FSE-T_2WI )and the cases with suspicious medical accessory ligament injury underwent coronal section fat suppressed-fast spin echo-T_2 weight(FS-FSE-T_2W).Results 36 ligaments were found having injury in all cases, including 16 anterior cruciare ligaments, 14 posterior cruciate ligaments, 5 medical accessory ligaments and 1 lateral accessory ligament. The ligaments injuries included tear completely and part.Conclusion MRI is the ideal non-invasive method for studying ligament injury of the knee.

Objective To evalute the accuracy of stroke volume variation (SVV) in monitoring blood volume in patients undergoing off-pump coronary artery bypass grafting.Methods Twenty-one ASA Ⅱ or Ⅲ patients of both sexes aged 44-77 yr undergoing off-pump coronary artery bypass grafting were enrolled in this study.Anesthesia was induced with midazolam,etomidate,fentanyl,rocuronium and dolicaine and maintained with target-controlled infusion of propofol,infusion of remifentanil,intermittent iv injetion of atracurium and inhalation of sevoflurane.The patients were mechanically ventilated (VT 8 ml/kg,RR 12 bpm,I:E 1:2,PEEP 0,FiO2 80％ ).PEr CO2 was maintained at 35-44 mm Hg.Radial artery was cannulated and connected to FloTrac pressure transducer and Vigileo monitor.6％ hydroxyethyl starch 130/0.4 sodium chloride solution 7 ml/kg was infused at a rate of 0.25 ml· kg- 1 1· min- 1 at 5 min of haemodynamics stabilization after pericardiotomy (T1).HR,MAP,CVP,systemic vascular resistance (SVR),systemic vascular nesistance index (SVRI),SVV,stroke volume index (SVI)and CI were recorded at T1 and at 10 min after loading dose (T2).The change rate of HR(△HR),MAP(△MAP),CVP(△CVP),SVR(△SVR),SVV(△SVV),SVI(△SVI) and CI(△CI) were calculated.△SVI≥25％ was considered effective volume expansion.The ROC curves for HR,MAP,CVP,SVR and SVV in determining the volume expansion efficacy were plotted.The area under the curves and 95 ％ confidence interval were calculated.Results Compared with T1,CVP,SVI,CO and CI were significantly increased,SVRI and SVV decreased at T2 (P ＜ 0.01).There was no significant difference in MAP and HR between T1 and T2(P ＞0.05).△SVI was negatively correlated with △HR and △SVR ( r =- 0.737,r =- 0.480,P ＜ 0.05).△SVI was not correlated with △CVP,△MAP and( P ＞ 0.05).The change in SVI was determined by SVV 8.8％ (sensitivity =52.6％,specificity =100.0％ ).The area under the curve for SVV and 95％ confidence interval were 0.579(0.346-0.812).Conclusion SVV can not be used to accuratelymonitor the changes in blood volume in patients undergoing off-pump coronary artery bypass grafting.

Objective To evaluate the efficacy of intracoronary,antologous bone marrow mononuclear cell transplantation on the patients with chronic heart failure.Methods Eighty patients with chronic heart failure were assigned into bone marrow cell transplantation group (n=48) and control group (n=32),with intmcomnary delivery of autologous bone marrow mononuclear cell suspension or not respectively,in addifion to conventional treatment.The left venlrieular ejection fractions (LVEF),the level of plasma brain natriuretic peptide (BNP),and the siges of myocardial perfusion defect were measured and compared with useing single photom emission computed tomography (SPECT) and echocardiography before and after the treatment.Results The one year follow-up results showed that LVEF increased from base-line (42.1±5.8)%,(43.9±6.7)% to (54.1±4.8)%,(49.8±7.7)% by echocardiography.The plasma levels of BNP decreased from base-line (699±101)ng/L,(687±95)ng/L to (305±78)ng/L,(399±89)ng/L,and the size of myocardial perfusion defect decreased from bese-line (26.8±8.6)%,(26.3±6.5)% to (15.8±4.3)%,(20.5±7.8)% in bone marrow cell transplantation group and control group respectively,the absolute changes were statistically significant.During and after the procedure of bone marrow cell transplantation group,there was no complication occurring. Conclusion Intmcoronary autologous bone marrow mononuclear cell transplantation for treating patients with chronic heart failure results in improvement in left ventricular systolic function and myocardial perfusion,and this therapy is safe and feasible.

OBJECTIVETo evaluate the efficacy of combined interleukin (IL)-2 gene and IL-12 gene therapy in murine model with head and neck squamous cell carcinoma (HNSCC).

METHODSHNSCC model was established in the mouth floor of C3H/HeJ mice with SCCVII cell line. Lipid-IL2 and lipid-IL12 plasmid complexes were introduced either alone or in combination into the tumor by direct intratumor gene injection. Tumor size was measured before and after the treatment to evaluate the response of the different treatment and control groups. Enzyme-linked immunosorbent assay (ELISA) was used to measure the IL-2 and IL-12 expression. Lactic dehydrogenase (LDH) assay was used to evaluate the activity of Cytotoxic T-Lymphocyte (CTL) and natural killer (NK) cells.

RESULTSGrowth of HNSCC was significantly inhibited in combined IL-2 and IL-12 gene therapy group as compared with the other groups (P < 0.01). Increased level of IL-2 and IL-12 protein expression was found in both combined and single treatment groups. Greater activity of CTL and NK was also observed in these two groups as compared with the controls.

CONCLUSIONBoth IL-2 and IL-12 gene therapy is able to inhibit the growth of HNSCC and induce the host antitumor immune response efficiently in the murine model. Combination of the two in gene therapy may be additive or synergistic in antitumor effect.

Animals ; Carcinoma, Squamous Cell ; immunology ; physiopathology ; therapy ; Disease Models, Animal ; Female ; Genetic Therapy ; methods ; Head and Neck Neoplasms ; immunology ; physiopathology ; therapy ; Interleukin-12 ; genetics ; Interleukin-2 ; genetics ; Killer Cells, Natural ; immunology ; Mice ; Mice, Inbred C3H ; T-Lymphocytes, Cytotoxic ; immunology

OBJECTIVE To investigate the expression of cycloxygenase-2(COX-2)and matrix metalloproteinase-7(MMP-7)in laryngeal squamous cell carcinoma(LSCC)and their clinical significance. METHODS The expression of COX-2 and MMP-7 in 65 LSCC tissues and 34 adjacent non-neoplastic tissues were studied by immunohistochemical SP method. RESULTS The expression of COX-2 and MMP-7 was observed in 72.3% and 75.4% of the LSCC tissues and in 20.6% and 23.5% of the adjacent non- neoplastic tissues respectively,which had a significant difference(P

Objective To explore the management model of chronic disease like myocardial infarction through the effect of collaborative work pattern of doctors and nurses on acute myocardial infarction patients with percutaneous coronary intervention(PCI) after 1 year follow up.Methods A total of 852 patients from October 1,2011 to September 30,2013 with collaborative work pattern of doctors and nurses were as collaborative work pattern group,and 734 patients without collaborative work pattern of doctors and nurses at the same time were as control group.The patients were followed up for 1 year.The differences of treatment compliance,risk factors control,and the incidence of cardiovasc~ar events were compared between collaborative work pattern group and control group.Results The improvement of treatment compliance in collaborative work pattern group was better than that in control group.The improvement rate of improve lifestyle initiatively,completely medication,check regularly were 83.3％(710/852),97.9％(834/852),75.4％(642/852) in collaborative work pattern group and 63.5％(466/734),93.7％(688/734),59.0％(433/734) in control group,x2=81.02,17.57,26.22,P＜0.01.The control rate of risk factors including hypertension,diabetic mellitus,high blood low density lipoprotein cholesterol were 78.5％ (252/321),68.4％ (214/313),84.8％ (491/579) in collaborative work pattern group and 55.8％ (168/301),58.1％ (168/289),79.9％ (381/477) in control group,x2=36.47,6.79,4.41,P＜0.01 or ＜0.05.The incidence of treatment compliance and total cardiovascular events in collaborative work pattern group were better than those in control group.There were significant differences in the above indices,P＜0.05.Conclusions Collaborative work pattern of doctors and nurses is an effective method and supplement for patients with myocardial infarction after PCI to improve treatment compliance and control risk factors.The prognosis of patients can be improved and this pattern is an effective exploration of chronic disease management.

Objective To determine the optimum harvest time of Scutellaria barbata D.Don with flavonoids contents as the index. Methods The content of total flavonoids in Scutellaria barbata D. Don was determined by ultraviolet-visible spectrophotometry with scutellarin as standard control, and scutellarin and cosmosiin in Scutellaria barbata D. Don were determined by HPLC. Results The contents of total flavonoids and scutellarin in Scutellaria barbata D.Don of different harvest time were complied with the quality standards in the China Pharma Copoeia, and reached the peakin blossom . The contents of total flavonoids, scutellarin and cosmosiin were (45.74±0.95) ,(5.58±0.16 ) and (17.39±0.42) mg?g-1 , respectively. Conclusion The Scutellaria Barbata D.Don may be collected at the flowering time with luxuriant foliage.

Objective To analyze the mammographic findings of triple-negative breast cancer [TNBC,which is estrogen receptor (ER) negative,progesterone receptor (PR) negative,and human epidermal growth factor receptor 2 ( HER2 ) negative ] and triple-positive breast cancer ( TPBC,which is ER positive,PR positive,and HER2 positive ),and to evaluate the relationship of immunohistochemologic receptor status and mammographic findings.MethodsThe immunohistochemistry results of 631 cases with breast cancers were reviewed,including 117 cases of TNBC and 44 cases of TPBC.All of the patients took mammography at initial diagnosis.We retrospectively evaluated the visibility,morphology,distribution and size of the lesion (masses and calcifications) and breast density on mammography of TNBC,and compared them with those of TPBC.The age onset and tumor sizes of TNBC and TPBC were compared by using Chi-square test and t test.ResultsThe visibility rate of TNBC and TPBC on mammography were 88.0％(103/117) and 90.9％ (40/44),and the difference between them was insignificant ( x2 =0.055,P ＞0.05).TNBC was more frequently associated with merely a mass (56/103) than TPBC (12/40) (x2 =6.860,P＜0.01 ),and the mean diameter of the mass of TNBC [ ( 2.6 ± 1.4 ) cm ] was larger than that of TPBC [(2.0 ± 0.6) cm](t =2.087,P ＜ 0.05). TNBC were less frequently associated with microcalcifications (37/103) than TPBC ( 24/40 ) ( x2 =7.423,P ＜ 0.01 ).Mammographic density and lesion visibility were similar between the two different immunophenotypes of breast cancers.The mean age of TNBC (52±9) was more than that of TPBC (48 ±8) (t =2.759,P ＜0.01).Infiltrating ductal carcinoma was the main pathologic type of both groups.Basal-like breast cancer accounted for 49％ (57/117 ) of TNBC while none happened in TPBC.ConclusionsTNBC shows merely a mass with indistinct margins,lager size and is less associated with microcalcifications.These mammographic features might be useful in diagnosing triple negative breast cancer.