Objective To observe the changes of growth hormone axis(GH axis) and to study the mechanism of acquired growth hormone resistance in aged patients with congestive heart failure (CHF). Methods Ninety-five patients with congestive heart failure were divided into three groups (Grade Ⅱ , n = 28; Grade Ⅲ , n = 36;and Grade Ⅳ , n = 31) according to New York Heart Association criterion. Another 30 healthy people were used as controls. The concentrations of plasma GH , insulin growth factor 1 (IGF-1) and insulin growth factor binding protein 3 (IGFBP-3) were measured by radioimmunoassay, and growth hormone sensitivity was assessed by log(IGF-1 /GH). Results Plasma concentration of GHC[(5. 83 ? 1. 41) mlU/L vs (1. 56 ? 0. 97) mlU/L were higher in grade Ⅳ group than those in normal subjects ( P

0.05). Flow cytometry analysis by diff erent gates showed the transfection ratio was high in BMSCs in the period of pro d uctive metabolism. The mRNA expression of CAR in P3, P6 and P8 was similar, and the same change was observed in the protein expression of CAR in P3 and P8 BMSCs . CONCLUSION: Ad-CMV-GFP is transferred to BMSC effectively and sustained about 28 days. It is suspected that BMSCs in mitotic phase are easy to be transferred by Ad-CMV-GFP and different passages of BMSCs from P3 to P8 BMSCs can be as high-effectively g ene vehicle.

Objective To explore the operative timing and cause of death in the patients with acute cholangitis of severe type(ACST). Methods The clinical data on the treatment and the prognosis of 116 patients with ACST were analyzed retrospectively. Results 10 cases died during perioperative period.The patients who received operation within 6 hours after toxic shock all survived.Of 8 cases who received operation after 24 hours,7cases died from toxic shock and multiple organ deficiency of function (MODF) within 4 days of post-operation. Conclusion Operation should be performed before toxic shock or mental symptom occurred in the patients with ACST. The earlier the operation was performed, and the better the prognosis was. The main causes of death were delayed operative time,severe complications and senility.

Objective To investigate the etiology clinical diagnosis and treatment of pediatric neurogenic pulmonary edema(NPE).Methods The clinical data of 18 hospitalized children with NPE were retrospectively analyzed.Results 18 cases of NPE children with traumatic brain injury 2 cases( 11.1％ ),cervical spinal cord injury 1 case(5.5％ ) and,subarachnoid hemorrhage 2 cases( 11.1％ ),and epilepticus states 2 cases( 11.1％ ),non-HFMD caused encephalitis 3 cases( 16.6％ ),NPE caused hand,foot and mouth disease 8 cases(45.6％ ),survival 6 cases (33.3％) and 12 patients died (66.7％)in 18 hospitalized children with NPE.Conclusion The common cause of pediatric NPE was central nervous system infections and poor prognosis,early diagnosis and early treatment could improve the efficacy and prognosis.

The prevalence of atrial fibrillation (AF) is high in both community- and hospital-based studies in the Far East and South East Asia. Hypertension is the most common risk factor, but coronary heart disease and diabetes mellitus are other important co-morbidities in these countries. Anticoagulant therapy use was low, being 0.5%–28% in Malaysia, Singapore, and China. The reported rate of stroke related to AF was 13.0%–15.4% based on community studies in those countries and was 3.1%–24.2% of stroke rate in hospital-based cohorts. Better assessment of thromboembolic and bleeding risks is important. International guidelines now recommend the use of the CHA2DS2-VASc score to identify the ‘‘truly low-risk’’ AF patients, who do not need antithrombotic therapy, whilst those with ≥ 1 stroke risk factors can be offered oral anticoagulation. Aspirin is ineffective and may not be any safer than oral anticoagulants, especially in the elderly. It is anticipated that the availability of the new oral anticoagulant drugs would improve our efforts for stroke prevention in the Far East and South East Asia, especially where anticoagulation monitoring for warfarin is suboptimal.

Objective To evaluate the additional efficiency of aldosterone blockers (AB) during angiotensin Ⅱ receptor blockers (ARB) treatment on hypertensive left ventricle hypertrophy in the elderly. Methods Forty-five cases of hypertensive left ventricular hypertrophy detected by Doppler ultrasonic cardiogram examination were enrolled,and were randomized to receive treatment with ARB plus AB (Group A) or ARB plus diuretics (Group B) for 48 weeks. The indicators of left ventricle hypertrophy were checked before and after the treatment. Results The both regimens could significantly decrease the blood pressure,and there was significant difference in the effects on lowering blood pressure between the regimens. Both regimens could alleviate left ventricle hypertrophy,but the regimen of ARB plus AB was superior to the regimen in Group B. Conclusion The addition of AB treatment during the ARB treatment was a good antihypertensive regimen for reducing left ventricle hypertrophy.

Objective To investigate the correlation between the serum resistin level and carotid artery atherosclerosis in elderly Chinese males. Methods The study enrolled 235 elderly Chinese males [median age 76 (range 60-97) years] scheduled for ultrasound examination of carotid artery plaque and determination of carotid artery intima-media thickness (CIMT). They were divided into carotid atherosclerotic plaque (CAP) and carotid atherosclerotic plaque-free (CAP-free) groups according to the ultrasound results. Their clinical profiles were col-lected, and the serum resistin and other blood biochemistry levels were determined.Results The CAP group was older and had a thicker mean CIMT than the CAP-free group. However, there was no difference in the serum resistin level between the groups. CIMT was positively correlated with age (r = 0.299,P< 0.001). The serum resistin level was not correlated with CIMT, even after controlling for age. Multiple linear regression analysis revealed that age (β = 0.001,P< 0.001) and body mass index (β = 0.002,P= 0.015) were significantly and posi-tively correlated with the mean CIMT. Only age [odds ratio (OR): 1.159; 95% confidence interval (CI): 1.078-1.183,P< 0.001] was associ-ated with the presence of carotid artery atherosclerotic plaque. The serum resistin level was not correlated with the mean CIMT or associated with the presence of carotid artery atherosclerotic plaque.Conclusion The results suggest that resistin might not be a risk factor for atherosclerosis in elderly Chinese males.

Objective To evaluate the efficacy of lung volum ereduction surgery(LVRS) on severe chronic obstrutive pulmonary emphysema (COPE).Methods Fifteen patients with COPE with LVRS were retrospectively analyzed.The lung volume was reduced with GIA by a degree of 20％-30％.The activity and the lung function indexes of patients before LVRS,half a year and 1 year after LVRS were analyzed.Results Fifteen patients recovered and were discharged in 8-54 (14.7 ± 8.8) days after LVRS.The forced expiratory volume in one second (FEV1),total lung capacity (TLC),residual volume (RV),and 6-minute walk distance (6MWD) of patients with LVRS were significantly improved after operation (P ＜ 0.05).Conclusion The lung volume reduction surgery provides a quite new and effective treatment for some cases of severe chronic obstructive pulmonary disease.

Objective To investigate the expression of connexin43 (Cx43) protein and mRNA in human adenocarcinoma of lung and its clinical significance.Methods One hundred and forty-eight human adenocarcinoma of lung tissues were detected by immunohistochemistry for Cx43 expression and fluorescence in situ hybridization for mRNA.The relationship between Cx43 expression and clinicopathologcal factors was analyzed.Results The positive rates of Cx43 expression in well/moderately differentiated and poorlydifferemiated/indififerentiated lung cancer tissues were 48.7 ％ (38/78) and 30.0 ％ (21/70),respectively (P ＜ 0.05).The positive rates of Cx43 expression in negative lymph node metastasis and positive lymphnode metastasis lung cancer tissues were 56.3 ％ (18/32) and 34.5 ％ (40/116),respectively (P ＜ 0.05).The positive rates of Cx43 expression in stage Ⅰ-Ⅱ and Ⅲ-Ⅳ lung cancer tissues were 51.5 ％ (49/95) and 34.0 ％(18/53),respectively (P ＜ 0.05).The positive rates of Cx43 mRNA expression in adenocarcinoma of lung adenocarcinoma and normal lung tissues were 32.4 ％ (48/148) and 60.0 ％ (12/20) (P ＜ 0.05).Conclusion The expression of Cx43 is closely related with well differentiation,invasion,status of lymphnode,clinical stage and prognosis of human lung adenocarcinoma.It may participate in the development and progression of human lung adenocarcinoma,and may be used to predict the prognosis of human lung adenocarcinoma.

BACKGROUND: The content of type Ⅰ and Ⅲ collagen and the ratio of both are crucial factors to promote heart geometric morphology change,and ventricular systolic and diastolic myocardial performance.Matrix metalloproteinase 2 (MMP-2) and tissue inhibitor of metalloproteinase 1 (TIMP1) are primary regulatory substances of collagen metabolism.After myocardial infarction,chronic heart failure rats were subjected to bone marrow meseuchymal stem cell transplantation.What changes in MMP-2 and TIMPI would occur?OBJECTIVE: To observe the content of type Ⅰ and Ⅲcollagen and the ratio between both,as well as expression levels of MMP-2 and TIMP1 in the left ventricular tissue of rats with myocardial infarction-caused chronic heart failure following bone marrow mesenchymal stem cell (MSC) transplantation.DESIGN: A randomized controlled experiment.SETTING: Department of Senile Angiocardiopathy,General Hospital of Chinese PLA & Department of Biochemistry,Peking University Health Science Center.MATERIALS: This study was performed at the laboratory of Department of Biochemistry,Peking University Health Science Center between July 2004 and December 2005.Male Sprage Dawley rats of clean grade,aged 4 weeks old,were provided by the Laboratory Animal Center,Beijing Medical University and used for preparation of MSCs.Fourteen female rats,weighing 200-250g,were developed into models of heart failure-caused by myocardial infarction.METHODS: MSCs were isolated and,purified by gradient centrifugation and adherent cells were allowed to proliferate.Female rats underwent coronary artery ligation to induce chronic ischemic heart failure.Four weeks later,the rats were randomly divided into 2 groups: (1) experimental group (n=7),rats received transplantation of MSCs harvested from male rats [5×106 in 50 μL phosphate buffered saline(PBS)]by injection into the ischemic myocardium; (2) control group (n=7),rats received the same volume of PBS.MAIN OUTCOME MEASURES: Twenty-one days after therapy,(1) left ventricular fusion was tested by hematoxylin-eosinstaining and Masson staining; (2) Expression of MMP-2 and 1TMPI as well as contents of type I and llI collagen was analyzed by immunohistochemistry; (3) MMP-2 and TIMP1 expression levels were examined by Western blot.RESULTS: Fourteen rats were included in the final analysis.Type Ⅰ collagen expression in the scar area was much higher in theexperimental group than in the control group,while type Ⅲ collagen expression was much lower in the experimental group.MMP-2 expression was reduced and TIMPI expression was increased in the experimental group compared with the control group.Together,ventricular wall was thickened,ventricular chamber was reduced,and heart function was strengthened in the experimental group compared with the control group.CONCLUSION: MSC transplantation alleviated left ventricular remodeling in chronic ischemie heart failure,which results from dynamic regulation of MMP-2/TIMP1.