Objective To investigate the effect of smoking status after vascular construction on the long term prognosis in the patients with coronary heart disease(CHD).Methods Totally 893 patients with CHD were divided into 3 groups according to the smoking status before and after vascular construction,non-smoking group(n=458),quiting smoking group(n=287) and smoking group(n=148).The occurrence situation of major adverse cardiovascular and cerebrovascular events(MACCE) during follow-up period were recorded in detail.The postoperative cumulative survival rate was described by using Kaplan-Meier survival analysis.The effect of smoking status on the all-cause death and MACCE was compared.The Cox stepwise regression analysis was used to analyze the all-cause death and the influence factors of MACCE.Results The average follow up time was about 27 months,the postoperative smoking rate was significantly lower than the preoperative multivariable smoking rate(16.57 ％ vs.48.71％),the patients in the smoking group were younger (P＜0.01);the patients in the non-smoking group were mainly female (P＜0.01),the body mass index (BMI) was smaller(P＜0.01).The all-cause death in the smoking group was higher (1.53％ vs.1.05％ vs.6.76％,P=0.002) and the occurrence rate of MACCE was higher (4.37％ vs.5.23％ vs.15.54％,P=0.001).The Cox multivariable stepwise regression analysis showed that postoperative persistent smoking was an important risk factor leading to the all-cause death[HR=2.753,95％CI(1.695-4.473),P＜0.01] and MACCE[HR=1.552,95％CI(1.049-1.754),P=0.001].Conclusion Persistent smoking is an independent risk factor leading to all-cause death and MACCE occurrence in CHD patients after vascular construction.

Objective: To investigate the compliance of smoking cessation and the effect of smoking status on long-term clinical prognosis in male patients with acute coronary syndrome (ACS) after drug-eluting stent (DES) therapy. Methods: A total of 656 ACS patients after DES therapy were studied, according to the post-operative smoking status, the patients were divided into 3 groups: Non-smoking group,n=226, Quit smoking group,n=283 and Persistent smoking group, n=147. The patients were followed-up for the average of 27 months, the major adverse cardio-/cerebral-vascular events (MACCE) were recorded in detail, and the effect of smoking status for MACCE occurrence were evaluated by multivariable Cox regression analysis. Results: The pre-operative smoking rate was 65.5% (430/656) of patients and post-operative smoking rate was 22.4% (147/656). Compared with Non-smoking group and Quit smoking group, the patients in Persistent smoking group had the younger age (P<0.001), more patients with abnormal blood lipids (P=0.005) and having lower level of education (P<0.001). The all cause death rates in Non-smoking group, Quit smoking group and Persistent smoking group were at 1.8%, 1.1% and 6.1% respectively,P=0.004; the MACCE occurrence rates were at 7.1%, 5.3% and 15.0% respectively,P=0.002. Multivariable Cox regression analysis showed that post-operative smoking was the independent risk factor for MACCE occurrence, HR =1.404, 95% CI (1.206-1.793),P=0.008. Conclusion: Smoking is the independent risk factor for MACCE occurrence in male ACS patients after DES therapy.

BACKGROUNDThe pain caused by orthodontic treatment has been considered as tough problems in orthodontic practice. There is substantial literature on pain which has exactly effected on learning and memory; orthodontic tooth movement affected the emotional status has been showed positive outcomes. Danggui-Shaoyao-San (DSS) is a Traditional Chinese Medicine prescription that has been used for pain treatment and analgesic effect for orthodontic pain via inhibiting the activations of neuron and glia. We raised the hypothesis that DSS could restore the impaired abilities of spatial learning and memory via regulating neuron or glia expression in the hippocampus.

METHODSA total of 36 rats were randomly divided into three groups: (1) Sham group (n = 12), rats underwent all the operation procedure except for the placement of orthodontic forces and received saline treatment; (2) experimental tooth movement (ETM) group (n = 12), rats received saline treatment and ETM; (3) DSS + ETM (DETM) group (n = 12), rats received DSS treatment and ETM. All DETM group animals were administered with DSS at a dose of 150 mg/kg. Morris water maze test was evaluated; immunofluorescent histochemistry was used to identify astrocytes activation, and immunofluorescent dendritic spine analysis was used to identify the dendritic spines morphological characteristics expression levels in hippocampus.

RESULTSMaze training sessions during the 5 successive days revealed that ETM significantly deficits in progressive learning in rats, DSS that was given from day 5 prior to ETM enhanced progressive learning. The ETM group rats took longer to cross target quadrant during the probe trial and got less times to cross-platform than DETM group. The spine density in hippocampus in ETM group was significantly decreased compared to the sham group. In addition, thin and mature spine density were decreased too. However, the DSS administration could reverse the dendritic shrinkage and increase the spine density compared to the ETM group. Astrocytes activation showed the opposite trend in hippocampus dentate gyrus (DG).

CONCLUSIONSTreatment with DSS could restore the impaired abilities on ETM-induced decrease of learning and memory behavior. The decreased spines density in the hippocampus and astrocytes activation in DG of hippocampus in the ETM group rats may be related with the decline of the ability of learning and memory. The ability to change the synaptic plasticity in hippocampus after DSS administration may be correlated with the alleviation of impairment of learn and memory after ETM treatment.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Hippocampus ; drug effects ; physiology ; Male ; Memory ; drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spatial Learning ; drug effects ; Tooth Movement Techniques ; adverse effects

The interaction between atrial fibrillation (AF) and heart failure (HF) and following poor prognosis re-ceive more and more attention.Currently,there are four kinds of new oral anticoagulants (NOACs) that can pre-vent thromboembolism caused by AF.More and more evidence support that they can be used in AF + HF patients,including valvular,non-valvular AF or patients undergoing direct current cardioversion.The present article aimed at discussing possibility of NOACs application in AF + HF patients.

Pulmonary embolism (PE)remains a major contributor to global disease burden.In recent years,it has made great progress in treatment of PE,including new oral anticoagulant,primary systemic fibrinolysis and cathe-ter-directed techniques,but there are still some remaining areas of uncertainty to be studied.The present article made a review on progress in therapeutic methods of PE in recent years.

Pathological mechanism of aortic valve stenosis(AVS)is still poorly understood,especially effective med-ication or control of disease progress.Many studies have proved that a lot of coagulant markers,such as microparti-cles,phosphatidylserine,tissue factor,thrombin and thromboplastin,fibrin etc.,exist in stenotic valve.The pres-ent article made a review on interaction among coagulation,inflammation and calcification in aortic valve stenosis.

Neutrophil extracellular traps (NETs) is a new found mechanism of neutrophil killing pathogen .Some re-searches have confirmed that NETs possess promote coagulation and thrombosis also .Recent researches indicated that in acute coronary syndrome ,NETs burden of lesion sites of infarct related artery was positively correlated with infarct size .The present article made a review on NETs and its role in coronary heart disease .

OBJECTIVETo evaluate the changes in the expressions of endothelial nitric oxide synthase (eNOS) and plasminogen activator inhibitor-1 (PAI-1) and the alterations of nitric oxide (NO) concentration in atrial endocardium in atrial fibrillation (AF) in order to investigate the mechanisms that contribute to thrombosis.

METHODSIn canine AF was produced with rapid atrial pacing at 400 bpm for 6 weeks, whereas the controls had no atrial pacing. NO production was measured by NO-specific microelectrode. The expression of endocardial eNOS and PAI-1 protein were determined by Western blot analysis and immunohistochemical Staining. Plasma levels of PAI-1 were analysed by Enzyme-linked immunoadsorbent assay.

RESULTSLeft atrial NO concentration was decreased in AF than that in controls [(23.4 +/- 5.8)nmol/L vs (63.8 +/- 16.1)nmol/L, P < 0.01]. Endocardial eNOS expression was also significantly decreased (855 +/- 217 vs 2320 +/- 694, P < 0.05), whereas the expression of the PAI-1 was increased (3164 +/- 827 vs 1371 +/- 352, P < 0.01). Neither NO concentration, nor PAI-1, eNOS expression were altered in the right atria at the same time. A significant increase for plasma levels of PAI-1 was also detected in AF group. No correlation was found between eNOS and PAI-1 protein expression (r = 0.217, P > 0.05).

CONCLUSIONIn the canine model AF was associated with a marked decrease in endocardial NOS expression and NO concentration and with an increase in PAI-1 expression in the left atrium, which may contribute to the thrombosis in AF.

Animals ; Atrial Fibrillation ; complications ; metabolism ; pathology ; Disease Models, Animal ; Dogs ; Female ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Plasminogen Activator Inhibitor 1 ; metabolism ; Thrombosis ; etiology ; metabolism ; pathology

Microparticles are vesicle-like structures with a diameter of 0.1 to 1.0 μm.It′s produced after cell activa-tion or apoptosis,which possesses physiological and pathological effects.Microparticle level rises in many cardiovas-cular diseases.Its elevation in plasma is thought to be a biomarker of vascular function change.The present article aimed at summarizing and providing newest research progress for microparticles playing role in atherosclerotic in-flammation.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.