Objective:To study the expression of angiotensin-converting enzyme(ACE),extracellular signal-regulated kinase(ERK),and the changes of atrial fibrosis in patients with rheumatic heart disease(RHD) and atrial fibrillation(AF) treated with angiotensin-converting enzyme inhibitor(ACEI).Methods:Atrial tissues were obtained from the right appendage during open surgery in 35 patients with RHD.The mRNA of ACE and ERK2 were semi-qualified by reverse transcription-ploymerase chain reaction(RT-PCR) and normalized to the glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Western blotting analysis was employed to examine the expressions of ACE and phosphorylated ERK(pERK).Atrial collagen volume fraction(CVF) was detected by Masson's stain.Results:The mRNA of ACE and ERK2 or the protein of ACE and pERK were significantly increased,and CVF was significantly increased in patients with chronic atrial fibrillation(CAF) compared with sinus rhythm group(SR)( P 0.05).Conclusion:The expressions of ACE,ERK2 and pERK increase,and fibrosis is more severe in RHD patients with CAF as compared with those with SR.Compared with CAF patients treated without ACEI,the expressions of ERK2 and pERK significantly decrease( P 0.05)in CAF patients treated with ACEI.This suggests that the increasing expression of ERK2 and pERK resulting from local renal angiotensin-converting enzyme system activation mediates the development of atrial fibrosis,and ACEI may contribute to lesser atrial fibrosis in RHD patients with AF.

According to the sera aquaporin-4 antibody (AQP4), neuromyelitis optica (NMO) can be classified into two types as AQP4 antibody positive (AQP4+) and negative (AQP4-). However, the NMO patients with AQP4- are prone to delayed treatment, and may have a different pathogenesis compared to that in patients with AQP4+. Scientific researches and the clinical trials on NMO with AQP4- will deepen the understanding of NMO pathogenesis and help to make an early accurate diagnosis and rational therapy for NMO with AQP4-. This review aims to summarize the progress in clinic diagnosis for NMO patients with AQP4-.

Pulmonary hypertension (PH) is a progressive disorder characterized by abnormally elevated blood pressure of the pulmonary circulation. PH progresses rapidly to right ventricular (RV) failure and even death without treatment. Cardiac magnetic resonance (CMR) is an accurate and reproducible tool for the assessment of RV morphology and function, which plays an important role in the prognosis of patients with PH. The aim of this study is to review the clinical application and research progress of CMR in evaluation of PH.

The acupuncture medical literature during the Republic of China is divided into four categories, including theoretical literature, acupuncture channels and acupoints drawing literature, translations, and teaching materials and medical cases. It is found that the theoretical literature focuses on inheriting the traditional theories as well as combining traditional Chinese and Western medicine. The drawings are becoming more and more precise, and in these drawing works anatomy begins to appear at that time. Translations are the achievements of communication between TCM and Western medicine, which promote the scientization of acupuncture greatly. Teaching materials are also influenced by Western medicine, presenting a rough frame of modern acupuncture disciplinary system. As important clinic data, medical cases have great clinical value. Overall, acupuncture medical literature during the Republic of China is widely published, which is influenced greatly by the Western medicine and presents a significant tendency of scientization.
Acupuncture Points ; Acupuncture Therapy ; history ; Books ; history ; China ; History, 20th Century ; Humans ; Translations

Objective: China Heart Failure Registry Study (China-HF) is aimed to understand the etiology, clinical features and treatment of in-hospital heart failure (HF) patients in China. Methods: Based on geographic region and economic condition, we prospectively recruited the in-hospital patients with primarily diagnosed HF, and the demographic information, etiology, clinical features and treatment condition were collected by electronic case report form in all patients. Results: A total of 8516 HF patients from 88 participating hospitals between 2012-01 and 2014-12 were analyzed. The average age of patients was at 66 years with 54.5% male. There were 6777/7997 (84.7%) patients with NYHA functional classiifcation at III-IV, 4207/8516 (49.4%) with coronary artery disease (CAD), 4649 (54.6%) with hypertension, 2109/7102 (29.7%) with chronic kidney disease and 2478/6608 (37.5%) with left ventricular ejection fraction (LVEF) < 40%. The patients with infection 3909/8516 (45.9%) and exertion or stress 2214 (26.0%) and myocardial ischemia 1967 (23.1%) were the major cause of HF worsening. There were 6165/8516 (72.4%) patients treated by intravenous diuretics during hospitalization, and after discharge, 5722 (67.2%) patients received oral loop diuretics, 2563 (30.1%) received angiotensin converting enzyme inhibitor, 2095 (24.6%) received angiotensin II receptor antagonist. The median length of in-hospital stay was 11 days and the in-hospital mortality was 5.3% (451/8516). Conclusion: China-HF provides a comprehensive insight of clinical features for the in-hospital HF patients in China. There is still a gap for medications between our current condition and the guideline, it is important to educate both patients and physicians in clinical practice.

Long non-coding RNAs (lncRNAs) , which are closely related with human critical illness, can regulate gene expression and involve the physiological and pathological processes on epigenetic, transcriptional and post-transcriptional levels through several mechanisms. LncRNAs also play important regulation roles in the maturation and differentiation process of hematopoietic cell. Besides, in-depth exploration of their mechanism will provide new ideas for the diagnosis and treatment of blood diseases.

OBJECTIVE:To establish a method for the simultaneous determination of lithospermic acid and rosmarinic acid in Guanxin danshen capsule. METHODS:UPLC was performed on the column of ACQUITY UPLC-BEH C18 with mobile phase of 0.1% formic acid-methanol solution (gradient elution) at a flow rate of 0.3 ml/min,detection wavelength was 280 nm,column temperature was 30 ℃,and the injection volume was 5 μl. RESULTS:The linear range was 0.019-0.76 mg/ml for lithospermic ac-id(r=0.999 9)and 0.005-0.2 mg/ml for rosmarinic acid(r=0.999 7);RSDs of precision,stability and reproducibility tests were lower than 2%;recoveries were 97.34%-101.24%(RSD=1.57%,n=6) and 98.30%-100.39%(RSD=0.86%,n=6). CONCLU-SIONS:The method is simple,accurate and reproducible,and can be used for the contents determination of lithospermic acid and rosmarinic acid in Guanxin danshen capsule.

Objective:To explore the main influencing factors for cardiopulmonary resuscitation (CPR ) in patients with perioperative cardiac arrest .Methods:A total of 168 patients ,who received surgery and suffered from cardiac arrest during perioperative period in our hospital from Jun 2012 to Jun 2014 ,were selected .According to recovery outcome of spontaneous circulation ,they were divided into success group (n=67) and failure group (n=101) .Case information were retrospectively analyzed in two groups ,including American Society of Anesthesiologists (ASA) class at hospitalization ,surgical sites ,monitor before cardiac arrest ,location when cardiac arrest occurred , dose of amiodarone ,volumes of bleeding and blood transfusion ,time of cardiac arrest during surgery ,CPR duration and timing etc .,and they were statistically analyzed between two groups .Results:There were significant difference in ASA class ,location when cardiac arrest occurred ,baseline ECG rhythm ,shock before cardiac arrest ,adrenaline dose ,CPR duration and timing between two groups ,P<0.05 or <0.01. Multifactor Logistic regression analysis in‐dicated that being outside operating room when cardiac arrest occurred (OR=9.72 ,95% CI=3.16~67.33) ,non-shockable rhythm (OR=8.33 ,95% CI=2.77~22.87) ,shock before cardiac arrest (OR=5.17 ,95% CI=3.23~16.13) ,adrenaline dose (OR=6.84 ,95% CI=2.61~44.75) ,CPR duration (OR=6.14 ,95% CI=1.77~17.21) and CPR timing >1min (OR=7.51 ,95% CI=2.57~41.93) were independent risk factors for prognosis of periop‐erative CPR , P< 0.05 or < 0.01. Conclusion:Being outside operating room when cardiac arrest occurs , non -shockable rhythm ,shock before cardiac arrest ,adrenaline dose ,CPR duration and CPR timing > 1min are inde‐pendent risk factors for prognosis of perioperative CPR . Cardioc arrest calls for instant CPR .

Objective To investigate the correlation between mechanical ventilation (MV) initiation time during cardiopulmonary resuscitation (CPR) and the prognosis of patients with in-hospital cardiac arrest (IHCA) in emergency . Methods Retrospective analysis of clinical records of patients with IHCA in emergency from January 2011 to April 2016 treated in Zhangye People's Hospital of Hexi University was performed. Patients with restoration of spontaneous circulation (ROSC) and were on MV with aged over 18 years were divided into early treated group (≤ 10 minutes) and later treated group (> 10 minutes) according to the initiation time of MV. Corneal reflex, pupillary reflex, pain-avoidance responses and motor response 24 hours after CPR, neurological function and cure rate of the two groups were analyzed. Results 210 patients were selected into our study including 130 males and 80 females (mean age: 60.24±13.17 years). There were no significant differences in gender, age, type of heart rate and etiological factor of cardiac arrest (CA) between the MV early stage group (124 cases) and the MV late stage group (86 cases). The restoration of corneal reflex, pupillary reflex, pain-avoidance responses, motor response and achievement ratio of CPR in early group were higher than those of later group (respectively, 59.68% vs. 31.40%, 59.68% vs. 31.40%, 54.84% vs. 24.42%, 54.84% vs. 24.42%, 70.16% vs. 51.16%, all P < 0.01); The D-dimer levels in the early group patients were significantly lower than those in the later group (μg/L: 478.39±57.21 vs. 510.05±62.83, P < 0.01). However, no statistical difference was observed between the two groups with respect to pH (7.24±0.72 vs.7.13±0.67, P > 0.05); The average hospitalized day of the early group was significantly shorter than that of the later group (days: 24.15±3.04 vs. 30.28±4.17, P < 0.01); Besides, the early group showed a higher survival rate at discharge and had more cases with neurologic level of grade 1-2 than those of the later group (Respectively, 41.94% vs. 26.74%, P < 0.05; 44.35% vs. 15.12%, P < 0.01). Conclusion Initiation MV on IHCA patients in the early stage of CPR (≤ 10 minutes) could help improve the hypoxic condition and prognosis of neurological function, and increase the achievement ratio of CPR.

Objective To evaluate the effect and safety of ultrasound-guided pereutaneous thrombin injection for the treatment of iatrogenic femoral arterial pseudoaneurysm.Methods Thirty patients [6 male,24 female,age range 45-82 years,mean (63 ± 10) years] were found to have pseudoaneurysms confirmed by ultrasound between 1 and 7 days following femoral arterial puncture from July 2011 through July 2014.Results All patient had pseudoaneurysm thrombosis after the first procedure.Thrombin 200-1000 U (50 U/mL)was injected into the pseudoaneurysm under ultrasound-guidance,performed.One patient showed acute allergy 5 min after thrombin injection,which was relieved by anti-allergic therapy.No thromboembolic complications or infections occurred.Conclusions Ultrasound-guided pereutaneous thrombin injection is a safe and effective noninvasive method for the treatment of iatrogenic femoral pseudoaneurysm and should be considered as first-line therapy.