Objective To explore the effect and safety of calcium dibutyryl adenosine cyclophosphate(dbcAMP-Ca)combined with metoprolol in the treatment of older adults with heart failure combined with arrhythmia.Methods A total of 102 elderly patients with heart failure combined with arrhythmia were enrolled in our hospital between February 2021 and April 2023.The list of patients enrolled was entered into a random database by independent staffs not involved in the study and random assignment sequences were generated by the SAS9.4 software.Then,the 102 elderly patients were divided into a control group(n=51)and an experimental group(n=51).Patients in the control group were given metoprolol at an initial dose of 6.25 mg/d,which was gradually increased to the target dose of 25 mg/d.Patients in the experimental group were given 40 mg of dbcAMP-Ca once a day via intravenous drip in addition to the treatment given to the control group.Both groups were treated for 4 weeks.The rate of effective response to clinical treatment(the number of cases achieving significant effects and those achieving some effects divided by the total number of cases in the group)was defined as the main outcome index.Secondary indexes included cardiac function,heart rate variability,exercise ability,hemorheology,myocardial injury indexes,inflammatory indexes,and the occurrence of adverse reactions.Results The rate of effective response to clinical treatment was higher in the experimental group than that in the control group(94.12%[48/51]vs.78.43%[40/51],P<0.05).After treatment,the left ventricular end-diastolic and end-systolic dimensions(LVEDD and LVESD)and the interventricular septal thickness(IVS)were lower in the experimental group than those in the control group,while the left ventricular ejection fraction(LVEF)and the stroke volume(SV)were higher in the experimental group than those in the control group(P<0.05).In terms of heart rate variability after treatment,the standard deviation of all the normal-to-normal intervals/the average of all the normal-to-normal intervals(SDNN/SDANN),the percentage of NN50 in the total number of normal-to-normal intervals(PNN50% ),and the root mean square of the differences between adjacent normal-to-normal intervals/root mean square differences of successive R-R intervals(RMSSD)were higher in the experimental group than those in the control group(P<0.05).In terms of exercise capacity after treatment,the subjects in the experimental group covered more distance in the 6-min walk test than those in the control group did(P<0.05).In terms of the hemorheology indexes after treatment,the levels of platelet aggregation rate(PAgT),fibrinogen(FIB),erythrocyte sedimentation rate(ESR),and whole blood viscosity(ηb)were lower in the experimental group than those in the control group(P<0.05).In terms of the myocardial injury indexes after treatment,the levels of serum N-terminal pro-brain natriuretic peptide(NT-pro BNP)and cardiac troponin I(cTnI)were lower in the experimental group than those in the control group,while the levels of insulin-like growth factor 1(IGF-1)and cardiotrophin 1(CT-1)were higher in the experimental group than those in the control group(P<0.05).In terms of the inflammatory indexes after treatment,the levels of interleukin-6(IL-6),high-sensitive C-reactive protein(hs-CRP),and tumor necrosis factor-α(TNF-α)were lower in the experimental group than those in the control group(P<0.05).The incidence of adverse reactions in the experimental group(9.80% )and that in the control group(7.84% )were comparable(P>0.05).Conclusion The use of dbcAMP-Ca in addition to metoprolol can effectively improve cardiac function,heart rate variability,and exercise tolerance,while inhibiting inflammatory response in elderly patients with heart failure combined with arrhythmia,with high medication safety.The combination medication shows better safety and therapeutic effects than those of metoprolol used alone.

Objective To analyze characteristics and prophylaxis of pulmonary embolism (PE) after greater saphenous vein ligation and stripping.Methods We retrospectively analyzed the clinical characteristics and treatment of 11 inpatients with postoperative PE in Anhui Provincial Hospital and other hospitals from January 2008 to June 2013.Results In this group 6 patients died after failed cardiopulmonary resuscitation (CPR) and other treatments,the mortality was 54.5％.5 patients recovered after anticoagulation,thrombolysis and other treatments.During the process of thrombolysis,floating thrombus was found within the femoral vein in 2 patients and inferior vena cava filter was implanted.After 8-25 months follow-up,all 5 patients were free of difficulty of breathing,chest tightness,chest pain and other symptoms.Among many clinical manifestations,dyspnea (90.9％) was the most common,other clinical manifestations included chest pain (27.3％),syncope (18.2％),sudden death (18.2％).There was no typical triad of dyspnea,chest pain and hemoptysis in these patients.Conclusions Early diagnosis and early treatment of PE are most important to decrease mortality and to improve the prognosis of patients suffering from postoperative PE.

Objective To review the complications after endovascular aneurysm repair (EVAR) of high-risk abdominal aortic aneurysms in our medical center.Methods Fifty eight elective high-risk EVAR cases from January 2008 to December 2013 were analyzed retrospectively.Results The technical success rate was 96.6％ (56 of 58 patients).The overall complication rate in perioperative period was 32.8％ (19/58).Eleven systemic complications (19.0％),16 primary endoleaks (27.6％),7 access of site complications(12.1％) were observed.The follow-up rate was 86.2％ (51/58).During the follow up period,the mortality was 7.8％ (4/51),the re-intervention rate was 7.8％ (4/51).The overall complication rate was 29.4％ (15/51),including systemic complications (2/51),secondary endoleak (9.8％) and graft-related complications (11.8％,6/51).Conclusions Endoleak,graft-related complications continue to be the main causes of re-intervention in high-risk aneurysm patients after EVAR.

Atherosclerosis is a chronic inflammatory immune disease,which is one of the causes of human lower limb disability.Dendritic cells are the most powerful professional antigen presenting cell in immune system,and dendritic cells have the dual role of immunogenicity and tolerability.As a professional antigen presenting cell,the immunogenicity of dendritic cells present self abnormal antigen and course immune system disorder,which may be one role of dendritic cells participate in atherosclerosis.However,the tolerability of dendritic cells can course the generation of immune tolerance,which makes dendritic cells exert a regulatory role in atherosclerosis.This paper makes an introduction about how dendritic cells are involved and play a regulatory role in the pathogenesis of atherosderosis.

Subintimal angioplasty had been widely used in the intervention of lower extremity arterial obliterans disease in recent years.True lumen re-entry is the key to subintimal angioplasty.This comprehensive exposition of the true lumen re-entry can improve the chances of ultrasound and subintimal arterial flossing with antegraderetrograde intervention and catheter systems and other emerging technologies in the application of subintimal angioplasty,and various types of technology advantages and disadvantages.

Cardiovascular disease is a frequently-occurring disease of human society, each year many patients in need of vascular graft surgery. The emergency and application of tissue engineered blood vessels, in particular the application of nanomaterials, will hopefully solve the problem of vascular sources. Here this article reviews the research contents and performance evaluation of tissue engineered blood vessels.

Objective To explore the effect of stromal cell-derived factor-1 ( SDF-1 ) in combination with transplantation of peripheral blood endothelial progenitor cells (EPCs) for the treatment of nude mice hindlimb ischemia. Methods Hindlimb ischemia model was established in nude mice, mice were then divided into five groups randomly: ischemic control group, peripheral blood EPCs transplantation group, SDF-1 local application group, SDF-1 combined with EPCs group, SDF-1 combined with AMD3100 treated EPCs group. Local CD34+VEGFR+ cells in the hind gastrocnemius were detected at day 3,7 after transplantation. The intensity of neovasculorization were evaluated at day 28. Results The double-positive cells number of control group, EPCs group, SDF-1 group, SDF-1 + EPCs group, SDF-1 + AMD3100 EPCs group were 0.00 ±0.00,5. 30 ±0.65,0.00 ±0.00,10. 31 ±0. 63,1. 86 ±0. 17 at day 3 and 0. 00 ±0. 00, 7.05 ±0. 18,0. 00 ±0. 00,11. 81 ±0. 53,2. 83 ±0. 48 at day 7. The number of new capillaries were 3. 00 ± 0.13,6.15 ± 0. 04,6. 20 ± 0. 10,10. 65 ± 0.08,6. 21 ±0. 08 at day 28. SDF-1 increased the CD34 + VEGFR+ cells (P ＜0. 05) and the number of new vessels (P ＜0.05). SDF-1 combined EPCs further increased the number of new vessels (P ＜ 0. 05 ). Conclusions SDF-1 enhances blood vessel formation and promotes angiogenesis by promoting EPCs homing, which could be blocked by AMD3100.

With the population aging, diet changing and incveasing risk factors on vascular disease, the lower extremity ischemic disease has become a frequently occurring disease of older person, and it is the main reason for amputation disability. In the 21st century the stem cells transplantation is one of the most advanced technologies and has been applied quickly to clinical therapy, regarded as a radical treatment of lower extremity ischemic disease. Endothelial progenitor cells have gradually become a new direction and a new research focus because of its unique biological characteristics in the treatment of this disease. This article focuses on endothelial progenitor cells in treating extremity ischemia lesions on the theoretical basis and research developments.

Restenosis after interventional treatment is the major factor infheneing the result of percutaneous transluminal angioplasty, and it is a hot and difficult research in recent years. Endothelial progenitor cells are a class of proliferation and able to differentiate into vascular endothelial precursor cells, and take part in the repair and angiogenesis after endothelial injury-intimate. It is expected to play an important role in the prevention of vascular restenosis after interventional treatment. In this article, we reviewed the endothelial progenitor cell research overview and advances of prevention of restenosis after interventional therapy in recent years.

Background and purpose: TFPI-2 is a new serine proteinase inhibitor,it is related to many tumors.In this study,the effect of TFPI-2 gene on cell proliferation and apoptosis of human pancreatic cancer cell line Panc-1 were investigated.Methods:The growth curve was drawn for the 3 groups,Panc-1-TFPI-2、Panc-1-V and Panc-1.DNA strand breaks were used to detect the apoptosis of the 3 groups,and the change of cell cycle and apoptosis index was evaluated by flow cytometry.Results:Compared with nontransfected cells,the growth of Panc-1 cell transfected with TFPI-2 was inhibited significantly.The transfected cells showed a significant increase in G1/G0 phase.The apoptosis of Panc-1-TFPI-2 cell could be identified by DNA strand breaks and flow cytometry in comparison with the control group.The apoptosis index of the Panc-1-TFPI-2 cell(6.9?0.5)% was higher than the group Panc-1-V and group Panc-1[(3.0?0.4)% and(3.5?0.4)%]P