Objective　To observe the influence of pre-infarction angina on ventricular function and prognosis of first acute myocardial infarction in old people. Methods　76 first acute myocardial infarction old patients was divided into two groups: angina pectoris group (n=42); no angina pectoris group (n=34). Global left ventricular function was assessed by echocardiography, arrhythmia, cardiogenic shock, heart failure, post-infarction angina and mortality was observed in hospital. Results　The rate of cardiogenic shock and heart failure and mortality was lower in angina pectoris group (33.3% vs 58.8%; 2.4% vs 23.5%), LVEF and E/A was higher in angina pectoris group (0.52±0.056 vs 0.45±0.03,0.86±0.29 vs 0.54±0.35), P<0.05. Conclusion　pre-infarction angina possesses the protecting effects on ventricular function of first acute myocardial infarction in old people, and can improve the prognosis of first acute myocardial infarction in old people.

SUMMARY Here we report a case of cervical spondylosis misdiagnosed as cerebral infarction .The pa-tient was a 55-year-old man with a one-day history of weakness in his right extremities .Brain magnetic resonance imaging ( MRI) showed no acute abnormality , cerevical MRI showed that cervical spondylisis , C4/5 , C5/6 disc herniation , spinal canal stenosis and compression of the spinal cord .Then the patient was transferred to the Department of Orthopaedics and underwent surgical treatment of cervical spondylo -sis.Followed-up for six months , the weakness of his right extremities returned to normal .

Atrial fibrillation ( AF) is the most common sustained arrhythmia in clinical practice and it is associated with an in-creased thromboembolism risk , due mainly to embolism from the left atrial appendage ( LAA) .Percutaneous left atrial appendage clo-sure ( PLAAC) provides a valid alternative to oral anticoagulation ( OAC) mainly in patients who cannot tolerate this therapy due to a high bleeding risk .Recent studies showed PLAAC can substantially reduce stroke incidence .This article reviews the safety and efficacy of PLAAC preventing thromboembolism by retrospectively analyzing related studies of PLAAC .

Objective To evaluate the effect of tranilast on neointimal proliferation and remodeling of rabbit iliac artery after balloon injury.Methods Twenty four rabbits were randomly divided into 3 groups including sham-operated group, control group, and treatment group. Balloon catheter was used to induce injury to the iliac artery of rabbits in control group and treatment group. Tranilast was given to the rabbits in treatment group (300 mg?kg -1) once a day from 3 days before operation to 28 days after operation, and then local vessels were harvested for pathological analysis and immunohistochemical staining. Automatic image analysis system was used to detect the changes of intimal thickness, medial thickness, luminal area, external elastic lamina (EEL) cross-sectional area and the proliferation index of proliferating cell nuclear antigen (PCNA). Results The intimal thickness was decreased in treatment group compared with control group. The luminal area and EEL cross-sectional area were significantly larger in treatment group than those in control group. No significant difference was found between treatment group and control group in medial thickness. The proliferation index of PCNA was significantly reduced in treatment group compared with control group. Conclusions Tranilast signifcantly inhibited neointimal hyperplasia and prompted compensatory artery dilation during remodeling of rabbit iliac artery after balloon injury. The effect on neointimal hyperplasia may be partly attributed to the inhibition of vascular smooth muscle cell proliferation.

Objective To determine whether the raised serum uric acid(UA)level is the independent risk factor for coronary artery disease(CAD).Methods A retrospective study was performed including 118 consecutive CAD patients(male 94,female 24)with average age of(65.79?10.03)and 67 normal angiography patients(male 43,female 24)with average age of(60.75?11.98).All the patients were performed coronary angiography from September 2003 to March 2004.In CAD group,36 cases were stable angina pectoris,28 were unstable angina and 54 were acute myocardial infarction.A fasting blood samples were collected for measurement of serum UA,blood cholesterol,and so on.And all patients were carefully inquired for their history including smoking and hypertension.Results Although raised serum UA was observed in CAD patients(372.31?100.28)mmol/L vs(340.08?81.58)mmol/L(P=0.028),logistic analysis suggested serum UA was not an independent risk factor for CAD.And there was no difference of UA among subgroups in CAD patients.Conclusion The raised serum UA may be a marker of atherosclerosis and is not an independent predictor for CAD.

Objective To study the characteristics of MRI Lesions in posterior circulation cerebral infarction and the correlation of the syndrome types of traditional Chinese medicine.Methods 82 patients with posterior circulation cerebral infarction from May 2012 to May 2015 were recruited, two observers estimated cranial MRI infarct size, location, and TCM syndrome type in the hospital medical records of the patients separately.Results Of all patients with posterior circulation cerebral infarction, patients with meridians involved infarction in the distant part of posterior circulation is far more than other parts of the posterior circulation(21 patient,P=0.006), nevertheless,patients with apoplexy involving Zang-fu organs,cerebral infarction volume is larger (14.78 ± 5.68 mlvs. 9.12 ± 6.67 ml,P=0.001).Conclusion Of all patients with posterior cerebral infarction, patients with meridians be involved, infarction in the distant part of posterior circulation is far more than other parts of the posterior circulation, nevertheless, in patients with apoplexy involving Zang-fu Organs, cerebral infarction volume is larger.

Objective: To observe the effect of electroacupuncture (EA) of "concurrent treatment of the brain and heart" on angiogenesis and cortical vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF) in rats with focal cerebral ischemia, and to explore the mechanism of EA in cerebral ischemia treatment. Methods: A total of 108 Sprague-Dawley rats, 27 rats were randomly selected as the sham-operation group, and the rest rats received the right middle cerebral artery occlusion operation for model preparation firstly, and then were divided into a model group, a traditional acupoint group, and a concurrent treatment of the brain and heart group, with 27 rats in each group. In the sham-operation group, only the carotid artery was isolated. EA at Shuigou (CV26), Quchi (LI11), Hegu (LI4), and Zusanli (ST36) in the traditional acupoint group, and EA at Fengfu (GV16), Baihui (GV20), Xinshu (BL15), and Neiguan (PC6) in the concurrent treatment of the brain and heart group were performed 4 h after the operation, once a day, for 14 consecutive days. Rats in the sham-operation group and the model group were identically fixed without any treatment. Before and after treatment, the modified neurological severity score (mNSS), regional cerebral blood flow (rCBF), and CD34 positive expression by immunohistochemistry were measured. The positive protein expression levels of VEGF and BDNF were detected by immunofluorescence, and the mRNA expression levels of VEGF and BDNF were detected by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Results: Compared with the sham-operation group, the mNSS, rCBF, and ischemic side cortical micro-vessel density (MVD) decreased, and the protein and mRNA expression levels of VEGF and BDNF increased in the model group (P<0.01). Compared with the model group, the mNSS of the two EA groups decreased, and the mNSS of the concurrent treatment of the brain and heart group was lower than that of the traditional acupoint group on the 14th day (P<0.05). Compared with the model group, the rCBF in the two EA groups increased, and the rCBF reached the highest on the 14th day (P<0.05 or P<0.01), and the rCBF in the concurrent treatment of the brain and heart group was higher than that in the traditional acupoint group (P<0.05); the MVD of the two EA groups was higher than that of the model group, and the MVD of the concurrent treatment of the brain and heart group was higher than that of the traditional acupoint group on the 7th and 14th days (P<0.05 or P<0.01). Compared with the model group, the protein and mRNA expression levels of VEGF and BDNF in the two EA groups increased (P<0.01). The VEGF expression level was the highest on the 7th day in the concurrent treatment of the brain and heart group (P<0.05), and the BDNF expression level was higher on the 7th and 14th days than on the 3rd day (P<0.05). The mRNA expression levels of VEGF and BDNF in both EA groups reached the highest on the 7th day (P<0.05 or P<0.01). Conclusion: EA therapy can up-regulate the VEGF and BDNF expression levels and increase the rCBF in the cortex of rats with focal cerebral ischemia, which may be one mechanism of EA in the cerebral ischemia treatment. The therapeutic effect is accumulated with the effective time, and the concurrent treatment of the brain and heart group is superior to the traditional acupoint group in promoting angiogenesis.

Objective To study the current status of catheter - related thrombosis(CRT)in Chinese children through a retrospective analysis of the inpatients in the Department of Medicine,Beijing Children's Hospital Affiliated to Capital Medical University. Methods The clinical data of the inpatients with CRT from November 2010 to November 2013 were collected retrospectively,and the causes,clinical symptoms,diagnosis,treatment and prognosis were ana-lyzed. Results There were 42 cases of children with CRT in Beijing Children's Hospital Affiliated to Capital Medical University. Among the cases,the male to female ratio was 1. 0:0. 5;the median age of onset was 88(2 - 186)months with ﹤ 1 year old counted for 16. 7%(7 / 42 cases)and 13 - 14 years old counted for 11. 9%(5 / 42 cases);the distri-bution differences between the male and the female age were not significant(P = 0. 826). The median time from cathe-terization to CRT onset was 9(1 - 81)days,0 - 10 days after catheterization was the peak of onset(52. 5% ,21 / 40 ca-ses)followed by 10 - 20 days(35. 0% ,14 / 40 cases). The protopathy was usually hematologic tumor,kidney disease or deep fungal infection. Slightly more cases developed CRT on the right side(57. 1% ,24 / 42 cases)than on the left side (38. 1% ,18 / 42 cases). All cases were diagnosed by using B - ultrasound,of whom 28. 6%(12 / 42 cases)were symp-tom - free. After being diagnosed,7. 1%(3 / 42 cases)were treated with conservative methods such as immobilization of the affected limbs and hot compress;7. 1%(3 / 42 cases)had catheter removed;anticoagulant and/ or thrombolytics after catheter removal used in 33. 3% patients(14 / 42 cases). After 1 week,22 cases were reviewed,of whom 54. 5%(12 / 22 cases)had thrombosis reduced(all with intervention),thrombosis growing in 22. 7% patients(5 / 22 cases), and thrombosis did not change in 22. 7% patients(5 / 22 cases). Three cases needed re - catheterization after catheter removal,and all of 3 cases had CRT recurrences(100% ). Conclusions CRT is more common among infants and senior children. CRT usually develops within 20 days after catheterization. Children with hematologic tumor,kidney disease or deep fungal infection are more likely to have CRT. Routine ultrasound test should be conducted to monitor CRT in catheterized children. Once CRT is diagnosed,patients need to be treated with anticoagulants and/ or thrombo-lytics. Catheter should also be removed if necessary. Recatheterization can result in CRT recurrence.

The clinical data of 13 patients diagnosed as Takayasu's arteritis with cardiomyopathy in Peking Union Hospital were reviewed.Echocardiography showed cardiomegaly (left chambers mainly),diffuse weakened myocardial wall movement and reduced left ventricular ejection fraction.Dilated cardiomyopathy was diagnosed in two patients.Glucocorticoid and cyclophosphamide were the essential medication for treatment.One patient died,1 patient was aggravated and the disease condition in remaining 11 patients was stable or improved.Takayasu's arteritis with cardiomyopathy is a rare disease and it attacks younger people.It is difficult to identify at onset,and the disease deteriorates rapidly.Echocardiography should be performed earlier to evaluate the heart function for early diagnosis and treatment.Administration of large dose of glucocorticoid and cyclophosphamide at early stage may improve the prognosis.

Notoginseng Radix et Rhizoma has the efficacy of dissolving stasis and hemostasis and reducing swelling and easing pain. Panax notoginseng saponins (PNS) is the main active component of Notoginseng Radix et Rhizoma, and the main components include ginsenoside Rb1, Rg1, Re, Rd and notoginsenoside R1. Injections with PNS as the medicinal material basis have become main TCM injections for the treatment of cerebral vascular diseases, with confirmed clinical efficacy. This article reviewed the research progress in pharmacological effects, clinical application and adverse reactions of PNS in treatment of cerebral vascular disease, with a purpose to provide references for further research and clinical application.