OBJECTIVETo observe the effects of Bushen Qianggu decoction proliferation and PCNA and Bcl-2 expression.

METHODSSerum containing BQD was made and synovial fibroblasts were separated and cultured and passaged in vitro. Four groups were divided as 20% blank control group, serum containing 20% Tripterygium wilfordii multi-glycosides drug (TWMD), 20% of serum containing high and low of BQD, respectively. Serum containing drugs of different concentration were added into the synovial fibroblasts of the third generation, and then the synovial fibroblasts were cultured continued. The effects of different drugs on synovial fibroblasts and PCNA and Bcl-2 expression were observed.

RESULTSCompared with the control serum, BQD-containing serum promoted the apoptosis of synovial fibroblasts (P < 0.000 1); especially, high dose could inhibit proliferation. The expression of PCNA and Bcl-2 was significantly lower in BQD-containing serum (P < 0.000 1 vs control group).

CONCLUSIONBQD can promote the apoptosis of synovial fibroblasts by improving of expression of PCNA and Bcl-2, which may be one of the mechanisms of BQD in preventing and treating osteoporosis of rheumatoid arthritis.

Animals ; Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Female ; Fibroblasts ; drug effects ; physiology ; Proliferating Cell Nuclear Antigen ; analysis ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Rats ; Rats, Wistar ; Synovial Membrane ; chemistry ; cytology ; drug effects

OBJECTIVETo investigate the effects of a new anticoagulant, annexin V derivative (AND) on anticoagulation and antithrombosis.

METHODSHigh and low doses of AND were given to rabbits (groups 1 and 2 respectively) by intravenous (iv) bolus injections followed by half the respective AND doses by iv infusion over 2 hours. Control groups were iv given heparin (group 3) and saline (group 4) of the same volume and procedure as that in group 1 and 2. Blood cell count, activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT) and fibrinogen level were examined before and 15, 30 and 60 min after iv bolus and 2 hours after the end of iv infusion. A 3.0 mm x 15 mm balloon was put into femoral artery to induce endothelial denudation 15 min after IV bolus and the blood pressure of femoral artery was monitored until the pulse pressure recorded 0 mm Hg when the vessel was occluded completely by a thrombus. The femoral arteries were collected and the thrombi were stripped off for measuring their lengths, wet and dry weights.

RESULTSAnticoagulation parameters: APTT at 15 min after iv bolus in AND group was significantly longer than that in group 4 (P < 0.05) but shorter than that in group 3 (P < 0.05); APTT and TT in group 3 were significantly longer than those in groups 1, 2 and 4. Fibrinogen: 0.70 mg/kg AND may decrease fibrinogen. Antithrombosis values: the wet and dry weights in AND groups were significantly lighter than those in group 3 and 4 (P < 0.05). The dry weight in high-dose AND group was remarkably lighter than that in low-dose group (P = 0.029). The length of thrombus in low-dose AND group was remarkably shorter than that in group 4 (P = 0.013), but not for group 3 (P > 0.05). It was remarkably shorter in high-dose AND group than in both group 3 (P < 0.001) and 4 (P = 0.015). The time when pulse pressure equaled to 0 was longer in AND group than in group 4 (P < 0.05), but not in 3.

CONCLUSIONAND is an effective anticoagulant and antithrombosis agent, the highest anticoagulation effect occurs at 15 min after IV bolus. Its anticoagulation effect is not more potent than that of standard heparin, while antithrombosis capacity is more effective. AND in treating thrombosis clinically might be promising.

Animals ; Annexin A5 ; administration & dosage ; pharmacology ; Anticoagulants ; administration & dosage ; pharmacology ; Blood Coagulation ; drug effects ; Disease Models, Animal ; Fibrinogen ; analysis ; Humans ; Injections, Intravenous ; Male ; Partial Thromboplastin Time ; Prothrombin Time ; Rabbits ; Random Allocation ; Thrombin Time ; Thrombosis ; prevention & control

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

Objective To investigate the current status and influencing factors regarding quality of life among patients with Alzheimer' s disease (AD).Methods Through stratified cluster sampling method,two hundred patients with AD and their caregivers were chosen and interviewed.AD patients were assessed by questionnaires,Montreal Cognitive Assessment,and Quality of LifeAlzheimer' s Disease (QOL-AD),in order to compare the reports from patients and caregivers on QOL-AD and to analyze related influencing factors.Descriptive analysis,paired t-test,analysis of variance (ANOVA),Pearson' s correlation and multiple linear regression were performed using the Statistical Package for Social Science (SPSS).Results The scores of reports from patients (28.78 ±4.30) were lower than that from the caregivers' (30.05 ± 6.05).The difference was statistically significant (t=2.122,P＜0.05) and was positively correlated (r=0.312,P＜0.001).Data from multivariate analysis showed that cognitive level (t=3.465,P=0.001),marriage relationship (t=3.062,P=0.003 ),having public activities (t =2.581,P=0.011 ),personal characters (t =2.254,P =0.026),restricted diet pattern (t=3.614,P＜0.001),regularly drinking tea (t=2.652,P=0.009) and doing housework (t=3.180,P=0.002) were predictive factors.Conclusion Scores from the caregiver' s report on QOL-AD were higher than that from the patients'.Many factors influenced the quality of life on AD patients.Strategies on improving the quality of life among AD patients can be developed based on the findings of this study.

BACKGROUNDTotally laparoscopic aortic surgery is still in its infancy in China. One of the factors preventing adoption of this technique is its steep learning curve. The objective of this study was to evaluate the feasibility and safety of laparoscopic surgery for aortoiliac occlusive disease (AIOD).

METHODSFrom November 2008 to November 2012, 12 patients were treated for severe AIOD with a totally laparoscopic bypass surgery at our university hospital. The demographic data, operative data, postoperative recovery data, morbidity and mortality were analyzed and compared with those of conventional open approach.

RESULTSTwelve totally laparoscopic aortic surgery procedures, including two iliofemoral bypasses (IFB), three unilateral aortofemoral bypasses (UAFB), and seven aortobifemoral bypasses (ABFB), were performed. Conversion to open procedures was required in three patients. The mean operation time was 518 (range, 325-840) minutes, mean blood loss was 962 (range, 400-2500) ml, and mean aortic anastomosis time was 75 (range, 40-150) minutes. Compared with conventional open approach for aortofemoral bypasses performed concomitantly during this period, laparoscopic patients required fewer narcotics and a shorter in-hospital stay and earlier recovery. Postoperative complications developed in four patients, including a single patient with transient left hydronephrosis, ischemic colonic fistula and pneumonia, residual aortic stenosis proximal to the anastomotic site, and asymptomatic partial left renal infarction. All patients recovered and were discharged on postoperative Days 7-14 except one patient that died of respiratory failure on Day 46. All grafts were patent with follow-up imaging performed by Duplex examination, with a mean follow-up time of 10.7 (range, 2-61) months.

CONCLUSIONTotally laparoscopic bypass surgery is a feasible and safe procedure for AIOD, but attention needs to be paid to improve laparoscopic skills of vascular surgery in order to minimize morbidity during the learning curve of this advanced procedure.

Adult ; Aged ; Aortic Diseases ; surgery ; Arterial Occlusive Diseases ; surgery ; Female ; Humans ; Iliac Artery ; surgery ; Laparoscopy ; adverse effects ; methods ; Male ; Middle Aged ; Postoperative Complications ; etiology

OBJECTIVETo study the expression and pathological implication of transforming growth factor-1 (TGF-1) and endothelin-1 (ET-1) in intraacinar pulmonary arterioles of children with congenital heart disease and pulmonary hypertension (HP).

METHODSForty-one children with left-to-right shunt congenital heart disease were studied including 25 cases of HP (group A), 16 cases without HP (group B) and 10 children without congenital heart disease as the contols (group C). Expression of TGF-beta1 mRNA and ET-1 mRNA in intraacinar pulmonary arteriolar (IAPA) was studied using in-situ hybridization and image pattern analysis of their absorption values (A value). Changes of the intraacinar arterioles and lung tissue were studied by elastic fiber staining and electronic microscopy respectively.

RESULTS(1) There was a significant difference in the amount of intraacinar pulmonary arterioles (partial-muscular and muscular) counted in either group A or B in comparing with that of group C (F values 149.96 and 142.01 respectively, P < 0.01); (2) Electronic microscopy demonstrated endothelial proliferation of the small arteries, thickening of arteriolar wall, increased density of collagen fibers at adventitia and increased thickness of the capillary basal membrane; (3) The A value of TGF-beta1 mRNA expressed in the pulmonary arterioles of groups A and B by in-situ hybridization were 0.1988 +/- 0.0498 and 0.1098 +/- 0.0428 respectively, however, the expression was weak in group C (A value: 0.0578 +/- 0.0096). There were all significant between each two groups (F = 45.95, P < 0.01). The expression of ET-1 mRNA was markedly increased as well in the endothelial cells of pulmonary arterioles in both groups A and B, with A values of 0.1692 +/- 0.0205 and 0.1004 +/- 0.0140 respectively, whereas the expression was weak in group C (A value of 0.0746 +/- 0.0119). There were all significant between each two groups (F = 139.996, P < 0.01).

CONCLUSIONSThe number of intraacinar pulmonary partial-muscular and muscular arterioles in patients with left-to-right shunt congenital heart defect is drastically increased, along with marked restructuring of the pulmonary vasculatures. In addition, there seems a correlation present between the overexpression of TGF-beta1 mRNA and ET-1 mRNA in intraacinar pulmonary arterioles and the occurrence of pulmonary hypertension in patients with congenital heart disease.

Child ; Child, Preschool ; Endothelin-1 ; biosynthesis ; genetics ; Female ; Heart Defects, Congenital ; complications ; metabolism ; pathology ; Humans ; Hypertension, Pulmonary ; complications ; metabolism ; pathology ; Infant ; Lung ; pathology ; ultrastructure ; Male ; Pulmonary Artery ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Transforming Growth Factor beta1 ; biosynthesis ; genetics

OBJECTIVETo examine the associations between physical activity measures [metabolic equivalents of energy expenditure (MET) per hour per day] and ischemic cardiovascular diseases (ICVD) in Chinese population.

METHODSA survey on cardiovascular risk factors was conducted in different areas of China in fall 1998. People aged 35 to 59 but without a history of coronary heart and stroke at baseline were prospectively followed and 11 849 subjects whose information were complete at the end of second follow-up were valid. Cox regression was used to estimate the hazard ratios (HRs) for incident ischemic cardiovascular diseases and the different measures of physical activity.

RESULTSDuring a mean follow-up period of 5.9 years, 84 incident ischemic cardiovascular events were ascertained. We examined the HRs of ischemic cardiovascular events for a 1-unit change in METs value, which were included in the models as continuous variable. There were negative association of METs values found with ischemic cardiovascular events in total, urban, rural, male and female subjects, and statistical significance in the urban (HRs = 0.22, 95% CI: 0.05-0.95) but the association was weakened after adjustment for demographic factors. When further adjustment for other intermediate factors, the significance in the urban was again attenuated. When the urban males and females, rural males and females were divided into 3 groups according to their respective tertiles and the combination of different population groups, the factors of male/female and urban/ rural were equally distributed in different groups, and no more adjustment in the Cox model. The multivariate - adjusted (age and education attainment) HRs associated with the tertiles, from lowest to highest, were: 1, 1.03 and 0.65 (P(trend) = 0.170) for the total, 1, 0.72 and 0.64 for the urban, 1, 1.49 and 0.72 for the rural, 1, 1.05 and 0.59 for men, 1, 0.90 and 0.84 for women.

CONCLUSIONThe totality of our findings pointed to METs per hour per day seemed to be weakly associated with a reduction in ischemic cardiovascular events incidence among urban middle-aged adults.

China ; epidemiology ; Energy Metabolism ; Female ; Humans ; Male ; Myocardial Ischemia ; epidemiology ; Risk Factors ; Rural Health ; Urban Health

OBJECTIVETo evaluate medium-long term patency of below-knee bypass on patients who suffered from diabetic lower limb ischemia.

METHODSClinical and follow-up data of 51 patients was retrospectively analyzed who underwent 56 below-knee bypass because of diabetes from November 2001 to December 2006. There were 35 male and 16 female with an average age of 68 years. They endured 26 months ischemic time lag in average, and had suffered from diabetes for 11 years. All of the patients were performed bypass to below-knee (posterior tibial, anterior tibial or peroneal) arteries. Kaplan-meier method was applied. The subgroups of different operative methods and different out-flow vessels were compared by Log-rank tests.

RESULTSAn average follow-up time of 23 months was achieved, and lost-follow-up rate was 15%. The total 1- and 5-year primary patent rates were 68% and 54% respectively, secondary patent rate were 70% and 60% respectively, limb salvage rates were 69% and 65%, survival rates were 82% and 60%. One year (3 years) of patent rate(s) of operative method subgroups of femoral-popliteal-infrageniculate bypass with composite grafts, femoral/popliteal-infrageniculate bypass with artificial grafts and femoral/popliteal-infrageniculate bypass with autologous veins were 70% (50%), 33% (33%) and 70% (70%) respectively. One year (4 years) of patent rate(s) of out-flow vessel subgroups of posterior tibial artery, anterior tibial artery and peroneal artery were 65% (60%), 80% (53%) and 77% (66%) respectively. However, both subgroups did not show any statistic differences by log-rank tests.

CONCLUSIONSPartial or whole autologous veins as bypass grafts should be chosen when infrageniculate bypass is considered in diabetic patients. Considerable patent rates are acceptable no matter what kinds of out-flow vessels are chosen.

Aged ; Diabetic Angiopathies ; surgery ; Female ; Femoral Artery ; surgery ; Follow-Up Studies ; Humans ; Ischemia ; etiology ; surgery ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Popliteal Artery ; surgery ; Retrospective Studies ; Saphenous Vein ; transplantation ; Tibial Arteries ; surgery ; Vascular Surgical Procedures ; methods

OBJECTIVETo explore the management of cerebral ischemia caused by Takayasu's arteritis.

METHODSOne hundred and three cases treated from 1984 to 2003 were reviewed including 92 females. Seven cases underwent ascending aorta to bilateral internal carotid artery (ICA) bypass, 38 cases to the axillary artery with graft to single ICA bypass. Six cases underwent ascending aorta to axillary bypass with 3 graft to single ICA bypasses as the second stage surgery. Three cases underwent ascending aorta to right ICA bypass with 2 graft to left ICA bypasses as well as 6 subclavian to carotid bypass, PTA in 5 and stenting in 3 cases, etc.

RESULTSTwenty-seven patients with less clinical severity received conservative therapy, 9 of them had mostly temporarily improvement, 15 had slight improvement or basically no change, 1 had hemiplegia and 2 died of stroke and myocardial infarction respectively. Surgically, the short-term effective rate was 87% and operative death 7.8%. Fifty-five patients were followed up, a mean follow-up time was 48 months, and the follow-up rate was 80.9%. The excellently, good, fair, no change and death rate were 36.4%, 38.2%, 20.0%, 3.6% and 1.8% respectively. All patients with PTA or stent had an immediate good response and all recurred within 3 to 5 months.

CONCLUSIONSFor treating severe cerebral ischemia caused by Takayasu's arteritis, the ascending aorta to axillary and single ICA reconstruction or the ascending aorta-bilateral axillary bypass for patients with subclavian steal syndrome is advocated; second stage operation from graft to contralateral ICA can be carried out if necessary.

Adolescent ; Adult ; Angioplasty, Balloon ; Brain Ischemia ; etiology ; therapy ; Carotid Artery, Internal ; surgery ; Cerebral Revascularization ; methods ; Child ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Takayasu Arteritis ; complications ; Treatment Outcome ; Vascular Surgical Procedures