Objective To analyze the impact of extent of mitral valve stenosis on the short and longterm outcome of percutaneous balloon mitral valvuloplasty (PBMV) in patients with mitral valve stenosis.Methods Two hundred and eighty-four patients with mitral valve stenosis were divided into two groups according to the Wilkins scoring system,and 191 cases whose score ≤8 were classified as group A,while the rest were classified as group B.All the patients were using the modified Inoue balloon method.Patients of successful PBMV were followed up at least 48 months and the efficiency was compared between two groups.Results The success rate of PBMV was 97.9％(187/191) and 92.5％(86/93) in group A and group B,there was significant difference between two groups (P ＜ 0.05).Echocardiography parameters improved significantly in both groups at 6 months after PBMV compared with those before PBMV (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(14.31 ± 4.79) mm Hg (1 mm Hg =0.133 kPa) vs.(15.42 ± 5.14) mm Hg],across the valve pressure difference [(9.18 ± 4.66) mm Hg vs.(10.21 ± 4.38)mm Hg],pulmonary arterial systolic pressure [(26.21 ± 8.76) mm Hg vs.(32.04 ± 9.58) mm Hg],mitral valve orifice area [(1.01 ±0.16) cm2 vs.(1.21 ±0.18) cm2] after PBMV in group B were less (P＜0.05).Long-term follow-up (48-92 months) was completed in 273 successful cases and echocardiography parameters after PBMV improved significantly in both groups compared with those before PBMV during follow-up (P＜ 0.05).Compared with those in group A,the changes of left atrial mean pressure [(12.91 ±5.00) mm Hg vs.(15.1 7 ± 5.14) mm Hg],across the valve pressure difference [(7.26 ± 4.58) mm Hg vs.(9.63 ± 4.22) mm Hg],pulmonary arterial systolic pressure [(20.54 ± 7.68) mm Hg vs.(29.11 ± 8.53)mm Hg],mitral valve orifice area [(0.92 ±0.15) cm2 vs.(1.09 ±0.18) cm2] after PBMV in group B were less (P＜ 0.05).The incidence of mitral restenosis was also significantly higher in group B than that in group A [19.8％(17/86) vs.8.0％(15/187)],and there was significant difference (P ＜ 0.05).Conclusions The extent of mitral valve stenosis plays a key role on the outcome of PBMV in patients with mitral valve stenosis.Patients with lower echocardiography scores benefit more from PBMV than patients with higher echocardiography scores.

OBJECTIVE: To study the preventive effect of Breviscapus Injection on the chronic hypoxic myocardium injury in rats and its mechanism. METHODS: Transmission electron microscope and biochemical analysis were used to assay the therapeutic effect of Breviscapus Injection in rat model induced by 4 week's hypoxia. RESULTS: The contents of malondialdehyde (MDA) and Ca(2+) in the homogenate of myocardial tissue of the hypoxic rats were significantly higher than those of the control rats. The activities of superoxide dismutase (SOD), nitric oxide synthase (NOS) in the homogenate of myocardial tissue and the plasmic NO levels of the hypoxic rats were significantly lower than those of the control rats. Breviscapus Injection reduced the contents of MDA and Ca(2+), and increased the levels of SOD, NOS and NO. Ultrastructural examination revealed that the injuries of the ultrastructure of heart in hypoxic rats were improved by treatment with Breviscapus Injection. CONCLUSION: Breviscapus Injection can effectively prevent and treat the hypoxia-induced myocardial damage. One of its mechanisms may relate to its adjusting NO level, anti-damaging of free radicals and inhibiting calcium overload.

Aneurysm ; diagnosis ; Carotid Artery, Internal ; pathology ; Diagnostic Errors ; Female ; Humans ; Hypertrophy ; diagnosis ; Middle Aged ; Palatine Tonsil ; pathology

Objective To explore the invading mechanism of amebae in lamina porpria and observe the interaction between the cysteine proteinase (CP) of Entamoeba histolytica and laminin. Methods CP was identified by laminin-sepharose affinity chromatography, followed by isolation, purification and inhibitor experiment. The hydrolytic activity was measured by gelatin electrophoresis. Results Purified CP of E.histolytica showed a strong affinity with laminin. The molecular weight of CP is 27 kDa. It can be inhibited by EC-64 and exhibited a protein hydrolytic activity. Conclusion The specific affinity and hydrolytic activity of CP might play an important role in its invasion to the basement membrane of intestinal mucosa.

Objective To study the effect of candesartan (Can) on the LPS‐induced proinflammatory cytokines release in VSMCs ,and to explore the role of TLR4‐mediated signaling pathway in this process .Methods Rat VSMCs were primarily cul‐tured ,and the effect of different concentrations of Can on VSMCs activity was observed by M TT assay .The cells were divided into 5 groups :A(control) ,B(LPS intervention) ,C(LPS + 10 - 7 mol/L Can) ,D(LPS + 10 - 7 mol/L Can ) and E (LPS + Can 10 - 5 mol/L Can) .mRNA and protein levels of Toll‐like receptor‐4(TLR4) ,myeloid differentiation primary response gene 88(Myd88)and nu‐clear factor‐κB(NF‐κB) nuclear translocation were determined by real‐time PCR and Western blot ,respectively ;IL‐1β and TNF‐αconcentration were detected by ELISA .The production of intercellular reactive oxygen species(iROS) was measured by the DCFH‐DA assay .Pretreating VSMCs with the inhibitors against TLR4 ,NADPH oxidase ,and NF‐κB ,or a combination with candesartan and these inhibitors ,and then the expression of IL‐1β and TNF‐α was measured by ELISA .Results Can in the concentration range of 10 - 8 - 10 - 3 mol/L had no significant effect onVSMCs activity .Compared with th control group ,Can could effectively inhibit LPS‐induced VSMCs ,IL‐1β and TNF‐α release ,decreased the mRNA and protein expression of TLR4 ,Myd88 ,reduced the produc‐tion of iROS ,inhibited the NF‐κB(p65) nuclear translocation with a concentration‐dependent manner(P< 0 .05) .Anti‐TLR4 anti‐body ,DPI ,and PDTC all inhibited LPS‐induced inflammatory cytokines release in VSMCs ,and the combination of Can and these blockers showed stronger anti‐inflammatory effect .Conclusion Can can decrease the releaseof inflammatory cytokines IL‐1β and TNF‐α in VSMCs stimulated by LPS ,which is realized by inhibiting the signaling pathway of TLR4/Myd88‐iROS‐NF‐κB .

Epilepsy ; etiology ; Female ; Humans ; Infant ; Tuberous Sclerosis ; complications ; diagnosis ; genetics

ObjectiveTo investigate the efficacy and toxicity of postoperative radiochemotherapy compared with chemotherapy alone in the treatment of locally advanced gastric cancer.MethodsA total of 83 patients with resected adenocarcinoma of the stomach were randomly assigned to postoperative radiochemotherapy group (RCT) ( n =43 ) or chemotherapy alone group (CT) ( n =40 ).Patients in RCT group received radiotherapy concurrent with capecitabine chemotherapy then followed by 4 - 6 cycles of FOLFOX4 chemotherapy.The total dose of radiation was 45 Gy.The dose of capecitabine was 1600 mg/m2per day.In the CT group,patients received 6 - 8 cycles FOLFOX4 chemotherapy.Survival was analyzed using Kaplan-Meier method and Logrank test. Results The follow-up rate was 96％. The number of patients who had a minimum of 2-,3-year follow-up time were 37,12 in the RCT group and 31,10 in the CT group.The 1-,2-,3-year local control rates for RCT and CT groups were 100％,97％,94％ and 95％,87％,73％ (x2 =4.54,P =0.033),respectively.The 1-,2-,3-year survival rates were 98％,86％,81％ in the RCT group,with 93％,80％,64％ in the CT group ( x2 =3.96,P =0.047 ).The incidence of grade 3hematological toxicity in the RCT and CT group was 23％ vs 15％ ( x2 =0.93,P =0.630 ),and grade 3gastrointestinal toxicity was 16％ vs 10％ ( x2 =0.95,P =0.624 ). Conclusions Compared with chemotherapy alone,postoperative radiochemotherapy can improve survival of locally advanced gastric cancer patients with acceptable toxicities.

Objective To explore the effect and mechanism of stent implantation on the quality of sexual activity in middle and old age male patients with exertional angina pectoris.Methods One hundred and seventy-two male patients with exertional angina pectoris were enrolled in this study,and they were divided into control group (94 patients) and percutaneous coronary intervention group (78 patients).The patients in control group were given routine pharmacotherapy and the patients in percutaneous coronary intervention group were given drug-eluting stent implantation and routine pharmacotherapy.The sexual activity function was evaluated by international index of erectile function (IIEF)-5 scale before treatment and 3 months after treatment.The times of sexual intercourse was added up.The evaluation of angina pectoris was performed by the grade of Canadian cardiovascular society (CCS).At the same time,the walking distance and heart rate were measured through 6-minute walking test.The left ventricular ejection fraction(LVEF) was detected by echocardiogram.Results After treatment for 3 months,the scores of IIEF-5,the degree of sexual satisfaction,the times of sexual intercourse and the grade of CCS in percutaneous coronary intervention group were significantly improved compared with those in control group [(20.58 ± 7.36) scores vs.(16.38 ± 6.35) scores,(4.32 ± 1.38) scores vs.(2.51 ± 1.89) scores,(6.3 ± 3.2) times/month vs.(3.5 ± 1.6) times/month,(1.10 ± 0.43) grades vs.(2.50 ± 1.1 0) grades] (P ＜ 0.05).The walking distance and heart rate after 6-minute walking test and LVEF in percutaneous coronary intervention group were significant improved compared with those in control group [(386 ± 82) m vs.(281 ± 86) m,(95 ± 18) times/minute vs.(122 ± 25) times/minute,(65.2 ± 11.2)％ vs.(55.6 ± 13.8)％] (P ＜ 0.05).Conclusions Stent implantation can significandy improve the quality of sexual activity in middle and old age male patients with exertional angina pectoris.The mechanisms are associated with the exercise capacity increasing and the frequency of angina pectoris attacks decreasing during sexual intercourse.

Objective To investigate the influence of proton pump inhibitors (lansoprazole and rabeprazole) on dual-antiplatelet therapy (DAPT) in patients with coronary heart disease.Methods One hundred and eighty-one cases of coronary heart disease with DAPT were selected,and they were divided into control group (66 cases,no proton pump inhibitors administered),lansoprazole group (65 cases,lansoprazole administered) and rabeprazole group (50 cases,rabeprazole administered).100 mg/day of aspirin and 75 mg/day of clopidogrel were concomitantly used in all patients.Platelet aggregation rate,platelet aggregation threshold index (PATI) and adenosine diphosphate (ADP) was measured.Results The ADP-PATI in control group was (3.47 ± 0.96) μ mol/L,lansoprazole group was (3.28 ± 1.05) μ mol/L,rabeprazole group was (3.32 ±0.83) μ mol/L,and there was no statistically significant difference among three groups (P＞0.05).There was also no statistically significant difference in platelet aggregation rate and collagen-PATI among three groups (P ＞ 0.05).Conclusion In patients with coronary artery disease,the concomitant use of lansoprazole or rabeprazole does not affect antiplatelet action during DAPT.