Objective To observe the promoting effect of hypoxia on proliferation of human bone marrow mesenchymal stem cells (BMMSCs) and maintaining their potential of multi-directional differentiation in vitro.Methods BMMSCs were isolated from bone marrow blood samples of patients with bone fracture, and cultured under hypoxic (group A) or normoxic (group B) conditions.The morphology, proliferation and osteogenic and adipogenic potential of the BMMSCs were observed.Results BMMSCs in the group A showed a long spindle shape and a fish shoal-like distribution, and were well-grown, while the morphology of cells in the group B appeared polygonal or flat.The quantity and growth rate of BMMSCs in the group A were increased compared with the group B (P< 0.05), with an osteogenic and adipogenic potential.Conclusions Hypoxia can promote the proliferation of BMMSCs in vitro and maintain their multi-directional differentiation potential.

Objective To evaluate short-term and long-term prognosis of revascularization in patients with acute coronary syndrome. Methods A total of 6005 patients who received coronary revascularization in our institution between July 2003 and September 2005 were enrolled. The patients were followed up in clinic or by telephone after discharge between September 2006 and November 2006. The clinical and prognosis data of all-cause mortality, neo-myocardial infarction, nonfatal stroke, and rerevascularization of ST-segment elevation myocardial infarction ( STEMI ) , non ST-segment elevation myocardial infarction ( NSTEMI) and major adverse cardiovascular and cerebrovascular events ( MACCE) were analyzed. Results Among 4865 acute coronary syndrome patients, 955 cases were STEMI; 263 cases were NSTEMI; and 3647 cases were unstable angina ( UA) pectoris. There were no significant difference for in-hospital mortality and late mortality ( 18 month survival 96% , 98% and 98% ) between patients with STEMI, NSTEMI and UA. Patients with UA had lower MACCE rate (18 month non-MACCE survival of STEMI, NSTEMI and UA group were 86% , 86% , and 89% respectively). Conclusions Despite different clinical characteristics, patients with STEMI, NSTEMI and UA undergoing revascularization had similar short-term and long-term mortality. Patients with UA had lower MACCE rate.

Objective To investigate the expression and genetic alterations of KLF6 in hepatocellular carcinoma (HCC) and explore their functional mechanisms in the oncogenesis and development of HCC. Methods Real-time quantitative-PCR, direct sequencing and LOH approaches were used to detect KLF6 genetic abnormalities in HCC. The experiment had 2 groups, an experimental group and a control group. In the experimental group, the transfected plasmid pcDNA3.0 was recombined with KLF6 and tranfected into HCC HepG2 cells. MTT, flow cytometry and Western blotting were used to observe the effect of anti-oncogene wild type KLF6 on HepG2 cells by transgenic method for 48 h.Results Expression levels of KLF6 were significantly downregulated in HCCs(P＜0. 01), as detected by qRT-PCR. LOH occurred in 11 (52%) of the 21 tumors, and all the samples with LOH showed KLF6 down-regulation. The mutational frequency was 29%, and sequence changes located in activation domain of KLF6. Meanwhile, MTT assay showed a significant antiproliferative effect of the transfected wtKLF6 on HepG2 cells(42.7%, P＜0.05). Fluorescence-activated cell sorting analysis revealed that KLF6 induced apoptosis. Conclusion The deregulation of KLF6 together with genetic abnormalities of allelic imbalance and mutations may play an important role in HCC pathogenesis.

Objective To evaluate the short-term and long-term outcomes of patients with ST-segment elevation myocardial infarction (STEMI) compared with those with non-STEMI after percutaneous coronary intervention (PCI). Method The DESIRE Ⅱ (Drug-Eluting Stent Impact on Revascularization Ⅱ) was a single-center registered retrospective study of coronary revascularization in our institution between July 2003 and September 2009.Data of demographics, clinical features and revascularization record of STEMI and non-STEMI patients from the DESIRE Ⅱ trial were analyzed. The patients were followed up in OPD or by telephone after discharge. MACCE (major adverse cardiocerebral events) including death, neo-myocardial infarction, stroke and revascularization were recorded. The clinical outcomes of patients of two types were evaluated. Results There were 6005 patients studied with a median follow-up of 566 days. A total of 1009 STEMI and non-STEMI patients were analyzed. The patients with non-STEMI ( n = 206) had higher prevalence of hypertension and history of higher frequency of myocardial infarction as well as revascularization compared with patients with STEMI ( n = 803). The patients with non-STEMI had higher ratio of treatment for multivessel disease (43.7% vs. 34.4%, P = 0.039). There were no significant differences in in-hospital mortality and long-term outcomes (one year survival rate: 96% vs. 98%)between patients with STEMI and non-STEMI. The predictors of 1-year mortality were LVEF and blood creatine.Conclusions Despite different chnical features, patients with STEMI and non-STEMI after PCI had similar both short-term and long-term outcomes.

Objective To assess the prevalence, and characteristics, and in-hospital and long-term prognosis of coronary artery disease (CAD) with metabolic syndrome, and to determine the factors affecting the prognosis of CAD most. Method The DESIRE (drug-eluting stent impact on revascularization) registry covered a database of 2368 patients with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in a period between July 2003 and September 2004. The median long-term follow-up time was 3.5 years ranged from 293 to 1855 days. The metabolic syndrome (MS) was diagnosed on the Definition of the Metabolic Syndrome modified by the Adult Treatment Panel (ATP) Ⅲ in 2005, by using the body mass index (BMI) instead of waist circumference. The relationship between metabolic syndrome (MS) and the incidences of major adverse cardiac as well as cerebral events (MACCE) in a large cohort of patients treated for revascularization was analyzed by using logistic analysis and Cox regression with SPSS 11.0 software. Results The Ms was present in 45.6% patients (high fast glucose (FG) in 44.5% patients, high triglycerides (TG) in 45.0% patients, low high density lipoprotein (HDL) in 50.8% patients, high BP in 61.4% patients, high BMI in60.7% patients). After follow-up, the ratio of MACCE in CAD patients with metabolic syndrome increased significantly (18.9% vs. 15.6%, P <0.036). The most dangerous factors of MS were high FG, hypertension and obesity (OR=1.787, 95%CI=1.132-2.845, P =0.014). Conclusions The MS contributes the high risk factors of MACCE in CAD patients with or without diabetes. The most dangerous combination of risk factors in MS is the combination of high FG, hypertension and obesity.

Objective To understand the application of drug eluting stent (DES) in renal functional insufficient patients, and to assess its safety and effectiveness, especially the occurrence of stent thrombosis(ST) after DES implantation and its related factors. Methods The subjects were all the patients underwent percutaneous coronary intervention (PCI) as well as at least one DES admitted to Beijing Anzhen Hospital consecutively from July 2003 to June 2005. All patients were divided into 2 groups: Group Ⅰ with normal or mild renal insufficiency (Ccr≥60 ml/min),and Group Ⅱ with moderate to severe renal functional insufficiency (Ccr ＜ 60 ml/min). All of the clinical, angiography and intervention data were recorded. ST was adjudicated by the definition of ARC Dublin. The rates of MACCE in hospital and during the follow-up between the 2 groups were compared. Results There were 2377 patients enrolled in the study, of which 2020 ( 85.0% ) patients presented Ccr ≥ 60 ml/min, and 357( 15.0% ) presented Ccr ＜ 60ml/min. The case fatality during follow-up in group Ⅰ was significantly higher than that in group Ⅱ (4. 5% vs. 1.2%, P ＜ 0. 001 ). However, the incidences of ST were not significantly different between each stage of disease( P ＞0. 05 ). The results from Cox regression showed that renal functional insufficiency was not a risk factor of death,whereas multivessel coronary artery disease [OR = 1. 929(95% CI: 1. 178 -3. 157),P =0. 009] ,diabetes [OR = 1. 914(95% CI:1. 055 -3. 470) ,P =0. 033] and age [OR = 1. 051 (95% CI:1. 005 -1. 099 ) ,P = 0. 030] were independent risk factor of death after DES implantation in patients with moderate to severe renal functional insufficiency. Conclusions Compared with normal renal function or mild renal patients, the longterm case fatality is higher in moderate and severe renal functional insufficiency patients. However, the higher case fatality does not due to the increase of ST.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combination use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively analyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some previous studies were not reliable.

Kruppel-like factor 6 (KLF6) was reported as tumor suppressor in multiple cancers. However, loss of chromosomal locus spanning KLF6 is relatively infrequent in previous published studies. To explore the role of KLF6 in hepatocellular carcinoma (HCC), we examined the gene for expression change, loss of heterozygosity (LOH) and mutation in 26 HCC samples. The expression levels of KLF6 were significantly down-regulated in HCCs, as detected by qRT-PCR. LOH occurred in 11 (52%) of 21 tumors, and all the samples with LOH showed KLF6 down-regulation. The mutational frequency was 24%, and sequence changes located in activation domain of KLF6. Furthermore, MTT assay showed a significant antiproliferative effect of the wt KLF6 transfected in HepG2 hepatoblastoma cells. Fluorescence-activated cell sorting analysis revealed that KLF6 could induce apoptosis. These findings indicate that deregulation of KLF6, together with genetic abnormalities of allelic imbalance and mutations, may play a role in HCC pathogenesis.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.

Kruppel-like factor 6 (KLF6) was reported as tumor suppressor in multiple cancers.However,loss of chromosomal locus spanning KLF6 is relatively infrequent in previous published studies.To explore the role of KLF6 in hepatocellular carcinoma (HCC),we examined the gene for expression change,loss of heterozygosity (LOH) and mutation in 26 HCC samples.The expression levels of KLF6 were significantly down-regulated in HCCs,as detected by qRT-PCR.LOH occurred in 11 (52%) of 21 tumors,and all the samples with LOH showed KLF6 down-regulation.The mutational frequency was 24%,and sequence changes located in activation domain of KLF6.Furthermore,MTT assay showed a significant antiproliferative effect of the wt KLF6 transfected in HepG2 hepatoblastoma cells.Fluorescence-activated cell sorting analysis revealed that KLF6 could induce apoptosis.These findings indicate that deregulation of KLF6,together with genetic abnormalities of allelic imbalance and mutations,may play a role in HCC pathogenesis.