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As a pattern of manifestation of cerebral small vessel disease,cerebral microinfarct(CMI) is a very common neuropathological change in old people. It is significantly correlated w ith cognitive decline and dementia. This article review s the meuropathology, neuroimaging and clinical significance of CMI.
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Objective To investigate the use of cardiopulmonary auscultation model in clinical skills teaching, and students' feeling about this teaching form. On the basis of this teaching model, we have reflected on the teaching mode. Methods Through the questionnaire survey, 145 medical stu-dents of grade 2009 were asked to investigate their learning experience about cardiopulmonary aus-cultation model and other aspects of it. Results There are 71.7% students liking cardiopulmonary auscultation model in teaching; 96.5% students can establish contacting abnormal cardiopulmonary auscultation signs with cardiovascular diseases after the training; There are 91.7% students thinking teaching hours about auscultation model is not enough. For the open question “what do you think is the difficulty of cardiopulmonary auscultation learning?” The representative answer is: I think car-diopulmonary auscultation is unable to recognize visual things. Conclusion Cardiopulmonary aus-cultation model can successfully improve the students' clinical skills and achieve good teaching effect. Students have a positive and supportive attitude to it.
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Objective To investigate the intervention of Amlodipine combined with alanine aminotransferase(ALT)-711 on blood pressure and preventing of target organ remodels of Spontaneously Hypertensive Rats(SHR),and to explore an optimized treatment design.Methods A total of 24 SHRs at 12-Week-old male were randomly divided into 4 groups,with 6 SHRs in each group.In the control group(Group A)the SHR were given normal saline 1 ml/(kg · d)via intragastric administration; the SHRs in Group B were treated with Amlodipine 1 mg/(kg · d) via ntragastric administration; the SHRs in Group C were treated with ALT-711 10 mg/(kg · d)via ntragastric administration;the SHRs were treated with Amlodipine 1 mg/(kg · d)combined with ALT-711 10 mg/(kg · d)via ntragastric administration in Group D.All groups were treated for 8 weeks,and the blood pressure in mouse tail were monitored.After 8 weeks,all SHRs were executed in the condition of anaesthedia.Right cervical artery,heart and kidney were measured through immunohistochemistry,histological stain and imagine analysis.The remodeling of vascular,heart,kidney were compared,and collagen volume fraction,advanced glycation end products (AGEs) and fibronectin (FN) expression were measured.Results (1) After treatment for 8 weeks,blood pressure of SHRs in the 4 groups were (184.72 + 15.14),(108.00 ±10.19),(155.64±10.03)and (99.83 ± 12.27) nun Hg in Group A,B,C and D,respectively.The blood pressure in Group D was the lowest in the 4 groups (F =14.6702,P ＜ 0.05),whereas it is not significantly different from Group B (P ＞ 0.05).(2) The mean thickness of carotid arteries were (0.450 ± 0.023),(0.380 ±0.021),(0.420 ±0.019) and (0.320 ±0.020) mm in Group A,B,C and D,respectively.The mean thickness of carotid arteries in Group D was the lowest in the 4 groups(F =4.1463,P ＜0.05).(3).The mean intimal area of carotid arteries were (19.0 + 1.3) × 105,(25.0 ± 1.4) × 105,(29.8 + 1.5) × 105 and (21.3 ±1.3) × l05 μm2 in Group A,B,C and D,respectively.The mean intimal area of carotid arteries in Group D was significantly smallest than the other 3 groups(F =4.4305,P ＜0.05).(4) The collagen content in different organs in the 4 groups after treatment 8 weeks:in carotid arteries,they were (6.25 ± 0.19)％,(3.56 ± 0.03) ％,(4.25 ± 0.12) ％ and (1.32 ± 0.05) ％ in Group A,B,C and D,respectively.The collagen content in Group D were significantly lower than the other 3 groups (F =4.9316,P ＜ 0.01).In myocardia:collagen content in Group A,B,C and D were (6.02 ± 0.21)％,(4.08 ± 0.14)％,(4.44 ± 0.11)％ and (1.13 ± 0.08) ％ respectively,and it was the lowest in Group D (F =4.2469,P ＜ 0.01).In kidney,the collagen content in Group A,B,C and D were (13.23 ±0.51)％,(7.28 ±0.35)％,(8.33 ±0.22)％ and (5.66 ±0.13)％ respectively,and it was the lowest in Group D(F=8.1038,P ＜0.01).(5).Express rate of AGEs in carotid arteries in Group A,B,C and D were (31.48 ±7.30)％,(20.55 ±5.91)％,(10.48 ±0.98)％ and (7.56 ± 0.68) ％ respectively,with the lowest expression in Group D (F =11.4537,P ＜ 0.01).Express rate of FN in carotid arteries in Group A,B,C and D group were (28.18 ±5.66)％,(17.26 ±5.83)％,(18.20 ±1.44) ％ and (15.12 ± 1.03) ％ respectively,with the lowest expression in Group D (F =9.0036,P ＜ 0.01).Conclusion Amlodipine combined with ALT-711 decreased blood pressure more effectively and prevented the remodel of target organ in SHRs than Amlodipine or ALT-711 alone.
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Objective To detect the micro flow signals of carotid plaque by ultrasound B-flow imaging (BFI) and elucidate its relationship with acute cerebral infarction.Methods A total of 63 patients with carotid plaques were divided into 2 groups.acute cerebral infarction (ACI,n =48) and control (n =15).BFI was used to detect the micro flow signals of plaques and comparisons were made with the categorizing results of contrast enhanced ultrasound (CEU).The data were analyzed between two methods.Results The micro flow signals were detected in 15.7％ (22/140)patients in the ACI group vs.2.3％(1/44) in the control group.There were more signals in hypoechoic plaques.The detection percentage of micro flow in grade Ⅲ was significantly higher than that in grades Ⅰ and Ⅱ with CEU (P =0.005,P =0.027).No significant differences existed between grades Ⅲ and Ⅳ (P =1.000).Conclusion BFI can detect effectively the micro flow signals of carotid plaques and this characteristic is correlated with the symptoms of ACI.
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ObjectiveTo explore the appropriate teaching methods for medical international students.MethodsTotally 84 students in grade 2005 and 63 students in grade 2006 took part in clinical skills training in 2010 and 2011.The traditional method was employed in grade 2005 and interactive teaching and imagery training was applied in grade 2006 combined with the traditional methods.ResultsThe scores of clinical skill tests ( posterior thorax puncture test,abdomen puncture test,bone puncture,catheterization test) were significantly higher in grade 2006 than in grade 2005 with statistical differences,P ＜ 0.01.The clinical skill test scores were not statistically different between grade 2005 and 2006 before training,P ＞ 0.05,but the scores were statistically different between grade 2005and 2006 after training,P ＜ 0.05.Conclusion Using polynary teaching methods synthetically is helpful to improve the clinical skill training effect for medical international students.
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Objective To evaluate the relation of circadian blood pressure rhythm with vascular status in elderly patients with isolated systolic hypertension.MethodsAnkle-brachial index (ABI),brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were measured in 74 elderly patients with non-dipper hypertension (non-dipper group)、78 elderly patients with dipper hypertension ( dipper group),and 72 healthy controls ( control group).Results In comparison with the dipper group,baPWV and IMT of the non-dipper group were significantly increased [ baPWV (1801.61± 314.27) vs (1658.67±274.80) (cm/s)],P＜0.01; IMT:(0.96 ±0.22) vs (0.87 +0.19) (mm),(P＜0.05),while ABI of the non-dipper group was decreased (1.03 ±0.17 vs1.12 ±0.18,P＜0.01).Identification rate was significantly different among 3 groups when baPWV ＞1400 cm/s (x2 =12.57,P ＜0.01) or ABI ＜0.9 ( x2 =9.74,P ＜0.01).The detection of carotid plaques was also significantly different ( x2 =16.49,P ＜ 0.01).Conclusions These findings suggest that vascular damage could be found in elderly patients with isolated systolic hypertension,especially in those with non-dipper hypertension.ABI,baPWV and IMT measurement may be helpful for the assessment of vascular status.
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Objective To evaluate periphery artery and renal injury in elderly patients with dipper and non-dipper isolated systolic hypertension(ISH). Methods Totally 187 elderly cases were divided into 51 patients with non-dipper hypertension,70 patients with dipper hypertension aged (72.4±5.6) years and 66 cases with normal blood pressure as control according to results of dynamic blood pressure recorder. Ankle-brachial index (ABI),brachial ankle artery pulse wave velocity (baPWV),retinol-binding protein (RBP) and Cystatin C were assessed. ABI and baPWV were determined by a non-invasive automatic waveform analyzer. Results The baPWV value in nondipper group was higher than dipper group [(1869.3±285.6)cm/s vs.(1703.1±235.2)cm/s,q=4.73,P＜0.01],while the value of ABI in non-dipper group was lower than dipper group (1.0 ±0.2vs.1.1±0.2,q=4.74,P＜0.01).The level of Cystatin C was elevated in non-dipper group versus dipper group [(1.4±0.5) mg/L vs. (1.0±0.5)mg/L,q=6.92,P＜0.01]. There were no differences in RBP concentration among the three groups (F=2.39,P＞0.05).At baPWV＞ 1400cm/s,the level of Cystatin C was increased in 47 cases with non-dipper hypertension as compared with 64 cases with dipper hypertension [(1.4±0.5)mg/L vs.(1.1±0.5)mg/L,q=5.59,P＜0.01].Conclusions The elderly patients with non-dipper hypertension may be more easily suffered from periphery artery and renal injury in comparison with dipper hypertension.
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Objective To study the relationship between plasma level of tissue factor(TF)and severity of coronary heart disease(CHD).Methods Coronary angiography was performed in 237 patients with suspected CHD,with 149 diagnosed as CHD and 88 excluded.Seventy of stenosis of coronary arteries (CA)was evaluated by modified Gensini score on the basis of angiographic imaging.Blood glucose,serum levels of total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],uric acid,high sensitivity C-reactive protein(Hs-CRP),fibrinogen(FIB)and plasma level of TF were determined for all the subjects.Relationship between plasma level of TF and severity of pathological changes in CA was evaluated by linear correlation and multiple regression analyses for controlling other relevant factors.Results Plasma level of TF in patients with CHD[(138±39)ng/L]was significantly higher than that in controls[(61±19)ng/L](P＜0.01).Plasma level of TF obviously correlated with severity of pathological changes in CA(r=0.710,P＜0.01).Partial correlation analysis showed a positive correlation between plasma TF and severity of pathological changes in CA,independent of other potential influential factors,with a partial coefficient of correlation of 0.509(P＜0.01).Multiple stepwise regression analysis indicated that plasma level of TF associated with severity of pathological changes in CA,as well as with diabetes,LDL-C,Lp(a),Hs-CRP and FIB,with coefficients of correlation of 0.172,0.180,0.147,0.308 and 0.175,respectively(P＜0.05).Conclusion Elevated plasma level of TF may be one of important risk factors for CHD,which reflects severity of pathological changes in CA.
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BACKGROUND: Peroxisome proliferation-activated receptor-gamma (PPARγ) is the member of nuclear receptor superfamily, and closely related with the formation of atherosclerosis.OBJECTIVE: To investigate the relationship between PPARγ C161→T gene polymorphism and coronary atherosclerotic heart disease (CAHD).DESIGN: Randomized controlled experiment SETTING: Department of Cardiology, Tonai Hospital of Huazhong University of Science and Technology; Department of Cardiology, Zhongnan Hospital of Wuhan University; Center for Human Genome Research,Huazhong University of Science and Technology; Department of Internal Medicine, Affiliated Hospital of Hubei University of Traditional Chinese Medicine; Institute of Geriatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine PARTICIPANTS: Totally 203 CAHD patients aged (65±11) years, including 129 males and 74 females, were the inpatients and outpatients of Zhongnan Hospital of Wuhan University and Tonai Hospital of Huazhong University of Science and Technology from June 2002 to December 2005.And 156 cases of them were diagnosed by coronary arteriongraphy, among which 43 patients without coronary artery affection or with coronary stricture ＜ 50%, and 113 patients with coronary stricture ＞ 50 %. While 89 healthy physical examinees of Han race and mean (59±9) years old were enrolled as control group, including 56 males and 33 females. There was no blood relationship between controls and patients.METHODS: The experiment was conducted at Tongji Hospital of Huazhong University of Science and Technology from June 2002 to December 2005. PPARγ C161→T gene polymorphism was determined by polymerase chain reaction and restriction endonuclease fragment length polymorphisms. The radio-immunity technique, coronary angiography and clinical routine biochemical index were applied to analyze the genotypic frequency and allele frequency distributions as well as the relation between clinical data, biochemical index and different genotypes. The risk factors of CAHD were estimated in the patients of different genotypes.MAIN OUTCOME MEASURES: The genotypic frequency and allele frequency distributions, the relation between clinical data, biochemical index and different genotypes, along with the blood lipid, blood glucose, fasting insulin and body mass index (BMI).RESULTS: Totally 103 CAHD patients and 89 controls were involved in the result analysis of gene polymorphism and yielded different gene distribution frequencies.① In control group, "T" allele frequency was 0.213 and "C" allele frequency was 0.787, and in CAHD group, "T" allele frequency was 0.192 and "C" allele frequency was 0.808. There was no significant difference in the genotypic frequency and C, T allele frequencies between two groups (P ＞ 0.05).② The CC genotype was dominant in CAHD patients with coronary artery lesions, and showed significant differences from "T"allele carriers (CT+TT) (P ＜ 0.05). The CAHD risk in the "T" allele carries (OR: 0.56, 95% CI: 0.24-0.63) was much lower than that in the CC homozygote (OR: 1.92, 95% CI: 1.09-2.54).③ Apolipoprotein B in patients with CC genotype was obviously higher than that in patients with "T" allele (CT+TT) (P ＜ 0.05), and there was insignificant difference in the insulin resistance index (P ＞ 0.05).CONCLUSION: There is an important correlation between the substitution of PPARγ C161→T and CAHD, and "T" allele carriers demonstrate a lower risk of CAHD.
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Objective To investigate the relationship of peroxisome proliferator activated receptor gamma ( PPAR?)C161T gene polymorphism with related diseases of metabolic syndrome. To disscuss the mechanism of the elderly diseases from gene level and the relation between the gene polymorphism and lipid metabolism. Methods Three hundred seventy one non-sibship subjects of Han nationality were investigated in this study, including 69 old healthy subjects, 302 elderly cases diagnosed as metabolic syndrome. PPAR? C161T gene polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphism, and radioimmunoassay was used to detect serum insulin. The insulin resistance was obtained from homeostasis model assessment (HOMA), and blood glucose, blood lipoprotein, height, weight and so on were tested. The frequencies of PPAR? C161T genotypes and the allele were compared with the clinical data. Results (1) In the groups of old normal health and metabolic syndrome, "T" allele frequency was 0.217,0.201, and "C" allele frequency was 0.783, 0.798 . There was no significant difference between the groups. (2)The triglyceride in CC genotypes of the metabolic syndrome was significantly higher than that in "T" allele carriers. Conclusions (1) The distributing trend of PPAR ? C161T gene polymorphism of the Han nationality in Wuhan in the elderly normal healthy group was in accord with that in the group of the elderly metabolic syndrome. (2) PPAR ? C161T substitution can influence metabolic syndrome, especially in liporprotain metabolism. "T" allele is associated with lower level of triglyceride.
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AIM: To explore the effect and mechanism of endothelin receptor antagonist on local angiotensin system of hypertrophic myocardial tissue. METHODS: Twenty four rats were randomly divided into 3 groups, control group (CG), hypertrophy group (HG) and endothelin receptor antagonist group (EG). The ratios of left ventricle weight to body weight (LVW/BW) and left ventricle weight to heart weight (LVW/HW) were measured to reflect myocardial hypertrophy. Protein expression of AT1R was detected by immunohistochemistry. The concentration of Ang Ⅱ was determined by ria. Activity of ACE was examined by spectrophotometry. A piece of myocardial tissue was observed in light microscope after HE or VG dyeing. RESULTS:(1) In comparison to CG, LVW/BW, LVW/HW, ACE activity, the concentration of Ang Ⅱ and the expression of AT1R of HG were increased significantly (P
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AIM: To observe the effect of diammonii glycyrrhizinatis (DG) on collagen synthesis induced by angioplasty in rabbits. METHODS: The right common carotid artery of male rabbits were injured with 3.5F balloon catheter. Four weeks after operation, arterial tissure collagen content, serum procollagen type I(PCI)， procollagen type Ⅲ(PCⅢ) concentration, neointimal thickness and the rate of stenosis were measured.RESULTS: Arterial tissue collagen content, serum PCI, PCⅢ concentration, neointimal thickness and the rate of stenosis of low and high dose DG group is lower than those of injured group.CONCLUSION: DG could inhibit collagen synthesis and neointimal proliferation of rabbits carotid artery induced by angioplasty. It suggests that DG might have clinical potential prespective in prevention and therapy of restenosis.
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AIM: To evaluate the effects of interfer ?-2b (IFN ?-2b ) on atherosclerosis(AS).METHODS: Thirty normal male rabbits were randomly divided into five groups:normal control group(NC group, n= 6), atherosclerosis group(AS group, n =6),virus (herpesvirus Ⅰ,HSV-Ⅰ)infected atherosclerosis group(V group, n= 6), interferon (interferon ?-2b) intervented atherosclerosis group (IFN-Ⅰgroup, n= 6),interferon intervented and virus infected atherosclerosis group (IFN-Ⅱ group, n= 6). Serum lipids were measured and the thoracic aortas were sampled for histopathological, immunohistochemical and in situ hybridization study. RESULTS: The aorta atherosclerosis areas of NC, IFN-Ⅰ and IFN-Ⅱ groups were lower than that of AS group significantly, respectively, and the area of AS group was lower than that of V group ( P
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AIM: To observe the effect of diammonii glycyrrhizinatis (DG) on collagen synthesis induced by angioplasty in rabbits. METHODS: The right common carotid artery of male rabbits were injured with 3.5F balloon catheter. Four weeks after operation, arterial tissure collagen content, serum procollagen type I(PCI), procollagen type Ⅲ(PCⅢ) concentration, neointimal thickness and the rate of stenosis were measured.RESULTS: Arterial tissue collagen content, serum PCI, PCⅢ concentration, neointimal thickness and the rate of stenosis of low and high dose DG group is lower than those of injured group.CONCLUSION: DG could inhibit collagen synthesis and neointimal proliferation of rabbits carotid artery induced by angioplasty. It suggests that DG might have clinical potential prespective in prevention and therapy of restenosis.
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The hemodynamic effects of dextran and nitroprusside on acute pericardialtamponade were investigated on dogs. The result showed that dextran increased CO andMSAP significantly (all P