TCM understanding and treatment strategy of hypertension complicated with sexual dysfunction / 中国中药杂志

Hypertension and its target organ damage have become a major public health problem. Sexual dysfunction is a new problem in the treatment of modern hypertension. Modern pathophysiological studies have shown that hypertension can lead to sexual dysfunction. In addition, three major hypotensive drugs represented by diuretics can also lead to sexual dysfunction. In traditional Chinese medicine(TCM), hypertension belongs to "vertigo" "headache" "head wind", etc. In the past, the understanding of the TCM pathogenesis of hypertension was mainly from the perspectives of "liver wind" and "Yang hyperactivity". However, based on the in-depth research on ancient and modern literature and medical records and many years of clinical practice, it has been identified that kidney deficiency was the key pathogenesis. Hypertension complicated with sexual dysfunction belongs to the category of kidney deficiency syndrome in TCM, especially the deficiency of kidney Yin. Previous studies by other research groups showed that Yin-enriching and kidney-tonifying method could effectively reduce blood pressure, improve sexual dysfunction, reverse risk factors, and protect target organs. This article systematically discussed the TCM understanding, modern pathophysiological mechanism, and the clinical treatment strategy of kidney-tonifying drugs(single drugs and compounds) in the treatment of hypertension complicated with sexual dysfunction in order to provide a scientific basis for kidney-tonifying method in the treatment of hypertension complicated with sexual dysfunction.

Research ideas of core formulas-syndromes based on disease-syndrome-treatment combination / 中国中药杂志

The relationship between disease and syndrome is a research focus in integrated traditional Chinese and western medicine. Depending on the focus, the disease-syndrome combination for treatment is manifested as the different treatment methods for the same disease and the same treatment method for different diseases based on the syndrome, and different treatment methods for the same syndrome and the same treatment method for different syndromes based on the disease. The mainstream model is the combination of di-sease identification in modern medicine with syndrome identification and core pathogenesis in traditional Chinese medicine. However, current research on the combination of disease and syndrome and core pathogenesis tends to focus on the heterogeneity between disease and syndrome and the separation of syndrome and treatment. Therefore, the study proposed the research idea and model of core formulas-syndromes(CFS). According to the theory of formula-syndrome correspondence, the research idea of CFS deepens the research on core pathogenesis, which aims to summarize the core formulas and syndromes for diseases. The research fields include diagnostic criteria for the indications of formulas, distribution patterns of formulas and syndromes for diseases, the evolution of medicinal-syndrome based on formulas-syndromes, formula combination law based on formulas-syndromes, and the dynamic evolution of formulas-syndromes. Through the summary of ancient classics, clinical experience, and medical records, and with the methods of expert consultation, factor analysis, and clustering analysis, research on the diagnostic criteria for the indications of formulas aims to explore the diagnosis information such as the diseases, symptoms, signs, and pathophysiology. The research on the distribution patterns of formulas and syndromes for diseases tends to summarize the specific types of formulas and syndromes for the diseases through literature research and clinical cross-sectional studies based on the establishment of diagnostic criteria for the indications of formulas. The research on the evolution of medicinal-syndrome aims to clarify the medicinal-syndrome law through literature and clinical research. The formula combination law refers to the fact that the core prescriptions for a disease often appear in combination with other prescriptions on a regular basis. The dynamic evolution of formulas-syndromes refers to the continuous transformation and change of formulas and syndromes in the process of disease development with changes in time and space. The CFS is conducive to the unification of disease, syndrome and treatment and to the deepening of the research model of disease and syndrome integration.

Clinical application of Chaihu Jia Longgu Muli Decoction based on modern pathophysiology mechanism / 中国中药杂志

Chaihu Jia Longgu Muli Decoction was firstly recorded in Treatise on Cold Damage(ZHANG Zhong-jing, Eastern Han dynasty). According to this medical classic, it is originally used in the treatment of the Shaoyang and Yangming syndrome. Based on the modern pathophysiological mechanism, this study interpreted the classic provisions of Chaihu Jia Longgu Muli Decoction. Original records of "chest fullness" "annoyance" "shock" "difficult urination" "delirium" "heavy body and failing to turn over" all have profound pathophysiological basis, involving disorders in cardiovascular, respiratory, nervous, and mental systems. This formula is widely used, which can be applied to treat epilepsy, cerebral arteriosclerosis, cerebral infarction, and other cerebrovascular diseases, hypertension, arrhythmia, and other cardiovascular diseases, insomnia, constipation, anxiety, depression, cardiac neurosis and other acute and chronic diseases as well as diseases in psychosomatic medicine. The clinical indications include Bupleuri Radix-targeted syndrome such as fullness and discomfort in chest and hypochondrium, bitter taste mouth, dry throat, and dizziness, the insomnia, anxiety, depression, susceptibility to fright, upset, dreamfulness and other psychiatric symptoms, red tongue, thick and yellow tongue coating, and wiry hard and powerful pulse. This formula was found to be used in combination with other formulas, such as Gualou Xiebai Decoction, Wendan Decoction, Zhizhu Pills, Juzhijiang Decoction, Suanzaoren Decoction, and Banxia Baizhu Tianma Decoction.

Arrhythmia:innovative understanding from traditional Chinese medicine and treatment by classic herbal formulas / 中国中药杂志

Arrhythmia, a common and frequently occurring cardiovascular disease, causes a heavy burden on the public health of China. Approximately 20 million patients are suffering from this disease in China and treated by pharmacological and surgical therapies. However, antiarrhythmic drugs can cause arrhythmia and surgical treatment has the risks of failure and recurrence. Therefore, the clinical outcome of arrhythmia remains to be improved. According to the traditional Chinese medicine(TCM) theory, arrhythmia is a disease of palpitation induced by 7 conditions: liver depression and Qi stagnation, accumulation of turbid phlegm, fluid retention attacking the heart, fire-heat disturbing the heart, stasis obstruction of heart vessel, cold congealing in heart vessel, and the deficiency of Qi, blood, Yin, and Yang. Therefore, this study concisely proposed 7 TCM syndromes of arrhythmia, including the palpitation due to depression, phlegm, fluid retention, fire, blood stasis, cold, and deficiency. The corresponding treatment strategies were recommended as follows: Chaihu Longgu Muli Decoction for the palpitation due to depression, Wendan Decoction for the palpitation due to phlegm, Linggui Zhugan Decoction for the palpitation due to fluid retention, Sanhuang Xiexin Decoction for the palpitation due to fire, Xuefu Zhuyu Decoction for the palpitation due to blood stasis, and Mahuang Fuzi Xixin Decoction for the palpitation due to cold, and Guizhi Gancao Decoction, Guizhi Gancao Longgu Muli Decoction, Huanglian Ejiao Decoction, Zhigancao Decoction, and Guipi Decoction for the palpitation due to the deficiency of Qi, blood, Yin, and Yang. Multiple formulas should be combined if the patient presents several TCM syndromes simultaneously. According to the principles of the correspondence between formula and syndrome and the treatment with consideration to both pathogenesis and pathology and both herbal nature and pharmacology, this study proposed an integrated treatment model of "pathogenesis-pathology-nature-pharmacology" to enhance the clinical efficacy of classic herbal formulas in the treatment of arrhythmia.

Somatotype characteristics of Lisu and Dulong adolescents aged 13-18 in Nujiang Lisu autonomous prefecture of Yunnan Province / 解剖学报

Objective To explore the somatotype characteristics and rules of Lisu and Dulong adolescents aged 13-18 years, and to analyze their annual somatotype differences. Methods According to the method of human bod)' measurement, through the measurement of 10 related indexes, using Heath-Carter bod)' type evaluation method, 634 cases (328 boys, 306 girls) Lisu and Dulong teenagers bod)' type evaluation. Results The average bod)' size of male and female students of Lisu ethnic group was of balanced mesoderm type (2. 9-4. 8-3. 3) and endoderm type (4. 7-4. 8-2. 8) . The average body size of male and female students of Dulong nationality is mesoderm type (3 . 1-3. 9-2. 1) and mesoderm type (5 . 2 - 4 . 6 - 1 . 6) . Among the 10 test indexes, there were significant differences in height, body weight, intercondylar diameter of humerus and intercondylar diameter of femur (P < 0. 01) . There were significant differences in height, intercondylar diameter of humerus and intercondylar diameter of femur among female students (P<0. 0 1) . Conclusion In Yunnan Province, adolescents of Lisu and Dulong ethnic groups generally have the body type characteristics of southern ethnic groups, but the body type difference between the two ethnic groups is great, and only has the characteristics of similar stage, age and body type.

Efficacy of Evolocumab in Patients with Hypercholesterolemia / 고신대학교의과대학학술지

Objectives@#The FOURIER trial reported that inhibition of PCSK9 with evolocumab on a background of statin therapy lowered low-density lipoprotein (LDL) cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. Here, we report data from a single center focusing on the effect of a PCSK9 inhibitor antibody on hyperlipidemia. @*Methods@#We enrolled 29 hypercholesterolemia patients who had LDL cholesterol levels ≥ 70 mg per deciliter or nonHDL cholesterol ≥ 100 mg per deciliter and were divided into two groups (placebo n = 14, evolocumab n = 15), and participated in a 72 - 96 week, randomized, double-blind, placebo-controlled trial with statin therapy. Patients were randomly assigned to receive evolocumab (140 mg every 2 weeks or 420 mg monthly) or matched placebo via subcutaneous injection. Lipid changes during follow-up were analyzed. @*Results@#The median LDL cholesterol level at baseline was 88 mg per deciliter, and the average LDL cholesterol level was 101.8 ± 20.0 mg per deciliter. At 4 weeks, the median LDL cholesterol level was 39 mg per deciliter, and the average LDL cholesterol level was 34.8 ± 51.8 mg per deciliter. Compared to placebo group, the LDL cholesterol levels were significantly reduced after treatment (P < 0.001), as well as total cholesterol, ApoB, and ApoB / ApoA1 levels. During follow-up, no discomfort was reported at local injection sites, and no cases of abnormal liver function were observed. @*Conclusions@#Evolocumab significantly reduced LDL cholesterol levels and was well tolerated.

Efficacy of Evolocumab in Patients with Hypercholesterolemia / 고신대학교의과대학학술지

Objectives@#The FOURIER trial reported that inhibition of PCSK9 with evolocumab on a background of statin therapy lowered low-density lipoprotein (LDL) cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. Here, we report data from a single center focusing on the effect of a PCSK9 inhibitor antibody on hyperlipidemia. @*Methods@#We enrolled 29 hypercholesterolemia patients who had LDL cholesterol levels ≥ 70 mg per deciliter or nonHDL cholesterol ≥ 100 mg per deciliter and were divided into two groups (placebo n = 14, evolocumab n = 15), and participated in a 72 - 96 week, randomized, double-blind, placebo-controlled trial with statin therapy. Patients were randomly assigned to receive evolocumab (140 mg every 2 weeks or 420 mg monthly) or matched placebo via subcutaneous injection. Lipid changes during follow-up were analyzed. @*Results@#The median LDL cholesterol level at baseline was 88 mg per deciliter, and the average LDL cholesterol level was 101.8 ± 20.0 mg per deciliter. At 4 weeks, the median LDL cholesterol level was 39 mg per deciliter, and the average LDL cholesterol level was 34.8 ± 51.8 mg per deciliter. Compared to placebo group, the LDL cholesterol levels were significantly reduced after treatment (P < 0.001), as well as total cholesterol, ApoB, and ApoB / ApoA1 levels. During follow-up, no discomfort was reported at local injection sites, and no cases of abnormal liver function were observed. @*Conclusions@#Evolocumab significantly reduced LDL cholesterol levels and was well tolerated.

Comparative Analysis of Two Different Fixation Methods for Treatment of the Intercondylar Eminence Fractures of Tibia / 昆明医科大学学报

Objective To compare the effect of hollow screw and double suture anchors for the treatment of the intercondylar eminence fractures of tibia.Methods The data of 68 patients with intercondylar eminence fractures of tibia from January 2006 to January 2012 were retrospectively reviewed.33 patients of them received treatment of hollow screw,35 patients received double suture anchors.All patients had X-ray films before operation.After follow-up of 3,6,12 and 36 months,they all were examined by X-ray eminence in an appropriate position.Union time was from 6 to 12 weeks and evaluated by Lysholm system.Results After a follow-up for 24 to 43 months and the average period was 36 months.A total of 68 patients turned up.The outcome of treatment was evaluated on the basis of X-ray and clinical findings in hollow screw group and double suture anchors group.Union and average time was 8 weeks.During the follow-up time,clinical evaluation included the range of motion and knee joint stability was examined and no knee joint instability and abnormal activity were found.During the 3 months and 6 months,there were significant differences between hollow screw group and double suture anchors group (P ＞ 0.05).But during the follow-up from 12 to 24 months,there were significant differences between hollow screw group and double suture anchors group (P＞0.05) according to Lysholm system,clinical evaluation including range of motion and knee pain was examined and knee pain and abnormal activity were found in this two groups.Conclusion Clinical characteristics of patients and individual requirement should be considered comprehensively before an individual treatment choice is made for the treatment of the intercondylar eminence fractures of tibia.

Effect of body mass index on outcomes of in vitrofertilization for infertile females at different ages / 中国组织工程研究

BACKGROUND:The effect of body mass index (BMI) on the outcomes ofin vitrofertilization (IVF) is controversial. Some scholars suggested that the higher BMI, the lower rate of pregnancy, and the higher rate of abortion. However, some others got the different results. To data, the effects of BMI on the pregnancy outcomes in females at different ages are rarely reported. OBJECTIVE:To explore the effect of BMI on the pregnancy outcomes of IVF for infertile women atdifferent ages. METHODS:A total of 902 cycles undergoing IVF were divided into two groups according to the age:≤ or> 35 years old groups. The patients in each group were then divided into four subgroups according to BMI: low weight, normal weight, excess weight, and obesity subgroups, respectively. RESULTS AND CONCLUSION: With increasing BMI, the average dosage of gonadotropins was increased gradualy in two both of age groups (P 35 years old group, the empty folicle rate in obesity subgroup was significantly higher than that in normal weight subgroup (P 0.05). These findings suggest that in the females at the younger age, BMI not only affects the quality of folicles and fertilization rate; but with increasing BMI, clinical pregnancy rate is decreased obviously. However in the females at the older age, BMI only affects the folicular quality, embryo quality and fertilization rates; there are no significant differences in the outcomes of pregnancy in the four subgroups. BMI have effects on pregnancy outcomes of IVF, and the effects are much greater in the younger female group.

Clinical effect of neovascular glaucoma treated by vitrectomy and cyclophotocoagulation / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To observe the postoperative intraocular pressure ( lOP) and operation safety in the eyes of the neovascular glaucoma pateints treated by intraocular cyclophotocoagulation which needed vitrectomy at the same time. METHODS: A total of 12 neovascular glaucoma cases ( 14 eyes ) secondary to diabetic retinopathy, retinal detachment surgery and trauma were reviewed in our study. This procedure mainly used intraocular photocoagulation catheter to highlight the ciliary processes until the ciliary became white atrophy or plosion after vitreous surgery treatment. The intraocular photocoagulation catheter was performed at a power of 300-500mW, for a duration of 0. 1-0. 2ms. Postoperative follow-up was at least for 6mo. The observation of 14 postoperative neovascular glaucoma was performed at 1wk, 1, 6mo observing the lOP and complications. RESULTS:lOP of the 11 eyes was significantly declined and controlled in normal. After cyclophotocoagulation, average lOP at 1wk was 16. 7±14. 4mmHg, 15. 7±8. 8mmHg at 1mo and 12. 9±4. 5mmHg at 6mo, which compared with untreatment ( 39. 6 ± 10. 0mmHg ) was statistically significant different (P CONCLUSlON: The intraocular cyclophotocoagulation and vitrectomy simultaneously can deal with the primary disease and secondary neovascular glaucoma. The operation can be accurately performed under direct cyclophotocoagulation and it is a safe and effective way for neovascular glaucoma which needs vitreous surgery.

Research advances of antibody-dependent cell-mediated cytotoxicity in the resistance of rituximab / 白血病·淋巴瘤

Rituximab,a chimeric monoclonal antibody targeted against the pan-B-cell marker CD20,comparing with chemotherapy has significantly improved the treatment outcome of all subgroups of B-cell lymphoma patients.However,not all patients respond to rituximab plus chemotherapy or relapse in a short time after response,which suggests the existence of resistance mechanisms.Antibody-dependent cell-mediated cytotoxicity (ADCC) is one of the main mechanisms of rituximab,so any abnormalities in ADCC pathway may affect the efficacy of rituximab.With the widely application of rituximab,its resistance mechanisms are attracting more attention.This review will summarize the factors within ADCC pathway that may affect the antitumor effect of rituximab.

Clinical significance of tumor budding detection in stage II colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association of tumor budding with recurrence and survival of patients with stage II colon cancer, in order to identify patients with high-risk recurrence who may benefit from adjuvant therapy.</p><p><b>METHODS</b>Clinical data of 112 stage II colon cancer patients in Guangzhou Red Cross Hospital between 1998 and 2007 were analyzed retrospectively. The degree of tumor budding was assessed by two observers and classified according to the number of tumor buds in the area with the greatest budding intensity on HE stain slides, as high-grade budding (≥10, n=30) and low-grade budding (≤9, n=82). Progression-free and cancer-specific survival were analyzed using the Kaplan-Meier method and Cox regression.</p><p><b>RESULTS</b>All the patients were followed up and the median follow-up was 78 months. The 5-year progression-free survival rates for patients with high-grade and low-grade budding were 65.3% and 90.7% respectively (P=0.008). The 5-year cancer-specific survival rates were 72.1% and 93.8% respectively (P=0.001). Cox regression analysis demonstrated tumor budding was an independent predictor of disease progression (RR=4.572, 95%CI:2.218-11.746, P=0.002) and cancer-related death (RR=4.116, 95%CI:1.657-10.384, P=0.012).</p><p><b>CONCLUSION</b>Tumor budding is a strong prognostic index for adverse outcome in stage II colon cancer patients,which may serve as a prognostic marker to identify patients with high risk of recurrence who may benefit from adjuvant therapy.</p>

Y Haplogroup Distribution in Korean and Other Populations / 대한법의학회지

With globalization, international exchange has increased. Accordingly, the necessity for individual identification using genetic polymorphism has also increased. Paternal lineages are distributed differently, and different distribution patterns can be used to predict ancestry. We studied the distribution pattern of different paternal lineages in Korea and compared them with other populations. All 30 SNPs on the Y chromosome were selected for paternal lineage confirmation. Loci that could subclassify haplogroup O, the most frequent in the East Asian population, were added. After multiplex amplification for the target loci, SBE reactions were set up for each SNP site. One hundred Korean men as well as 60 Chinese, 60 Japanese, 19 African-American, 48 Caucasian, and 47 Mexican American were tested and compared. Five Y haplogroups [C (C3), D (D2), NO, O, Q (Q1a1)] were found in Koreans, with haplogroup O being the most frequent. Haplogroup O sub-classified into O* (24%), O1 (6%), O2b (39%), O3a3c (4%), O3a3c1 (13%), and O3a3b(1%). This distribution pattern was similar to that of Chinese or Japanese, but minor differences were noted. With Fst, the Korean and Japanese patterns were close (0.01757) when using 6 SNPs. There were significant differences between Koreans and African Americans, Caucasians and Mexican Americans, and they were easily discernible without requiring haplogroup O sub-classification. Sub-classification of haplogroup O is likely to be useful for East Asia group comparisons. Additional studies in populations from different areas of China or Japan or studies of mtDNA or autosomes may enhance the discrimatory power of genetic polymorphism in different Asian populations.

Factors affecting thrombolysis in myocardial infarction myocardial perfusion frame count: insights of myocardial tissue-level reperfusion from a novel index for assessing myocardial perfusion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Myocardial tissue-level perfusion failure is associated with adverse outcomes following ST-elevation myocardial infarction (STEMI) despite successful epicardial recanalization. We have developed a new quantitative index-thrombolysis in myocardial infarction (TIMI) myocardial perfusion frame count (TMPFC)--for assessing myocardial tissue level perfusion. However, factors affecting this novel index of myocardial perfusion are currently unknown.</p><p><b>METHODS</b>A total of 255 consecutive STEMI patients undergoing primary angioplasty were enrolled. Myocardial tissue level perfusion was assessed by TMPFC, which measures the filling and clearance of contrast in the myocardium using cine-angiographic frame counting. We differentiate three groups with two cut off values for TMPFC: a TMPFC of 90 frames was the upper boundary of the 95% confidence interval (CI) for the TMPFC observed in normal arteries, and a TMPFC of 130 was the 75th percentile of TMPFC.</p><p><b>RESULTS</b>STEMI patients with TMPFC > 130 frames (68 patients, 26.7%) had higher clinical and angiographic risk factor profiles as well as a higher 30-day MACE rate compared with those with TMPFC ≤ 90 frames and those with TMPFC > 90 and ≤ 130 frames. Multivariable analysis identified that the independent predictors of TMPFC > 130 frames were age ≥ 75 years (OR 2.08, 95%CI 1.21 to 3.58, P = 0.007), diabetes (OR 1.37, 95%CI 1.01 to 1.86, P = 0.042), Killip class ≥ 2 (OR 1.52, 95%CI 1.05 to 2.21, P = 0.027), and prolonged pain-to-balloon time (OR 1.73, 95%CI 1.07 to 2.79, P = 0.013). TMPFC > 130 frames was identified as the strongest independent predictor of 30-day major adverse cardiac event (MACE) (OR 2.77, 95%CI 1.21 to 6.31, P = 0.008), along with age ≥ 75 years (OR 2.19, 95%CI 1.11 to 4.33, P = 0.016), female gender (OR 1.67, 95%CI 1.03 to 2.70, P = 0.038), and Killip class ≥ 2 (OR 1.83, 95%CI 1.07 to 3.14, P = 0.021).</p><p><b>CONCLUSIONS</b>STEMI patients with poor myocardial perfusion assessed by TMPFC had higher risk factor profiles. Advanced age, diabetes, higher Killip class, and longer ischemia time were independent predictors of impaired TMPFC after primary percutaneous coronary intervention. These results emphasize that particular attention should be paid on myocardial microvascular reperfusion in STEMI patients with these risk factors.</p>

Activation of extracellular signal-related kinases 1 and 2 in Sertoli cells in experimentally cryptorchid rhesus monkeys / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To assess the spatiotemporal changes in the expression of extracellular signal-regulated kinases 1 and 2 (ERK1/2), c-Jun N-terminal kinases (JNK) and p38 mitogen-activated protein kinases (MAPK) in response to heat stress in the cryptorchid testis, and to investigate a possible relation to Sertoli cell dedifferentiation.</p><p><b>METHODS</b>Immunohistochemistry and western blot were used to examine the expression and activation of ERK1/2, p38 and JNK in the cryptorchid testis at various stages after experimental cryptorchidism.</p><p><b>RESULTS</b>The abdominal temperature did not obviously change the total ERK1/2 expression but significantly activated phospho-ERK1/2 in the Sertoli cells of the cryptorchid testis. Heat stress increased total JNK expression in the Sertoli cells of the cryptorchid testis but did not activate phospho-JNK. Neither total p38 nor phospho-p38 was induced by heat stress in the Sertoli cells of the cryptorchid testis. Changes in the spatiotemporal expression of cytokeratin 18 (CK18), a marker of immature or undifferentiated Sertoli cells, were induced in the cryptorchid testis in a pattern similar to the activation of ERK1/2.</p><p><b>CONCLUSION</b>The activation of ERK1/2 in the testis may be related to dedifferentiation of Sertoli cells under heat stress induced by experimental cryptorchidism.</p>

Effects of acupuncture on blood-lipid levels in the patient of cerebral infarction with hyperlipidemia / 中国针灸

<p><b>OBJECTIVE</b>To observe therapeutic effect of acupuncture method for consciousness-restoring resuscitation on cerebral infarction with hyperlipidemia.</p><p><b>METHODS</b>Sixty cases of apoplexy with hyperlipidemia were randomly divided into a consciousness-restoring resuscitation acupuncture group (treatment group) and a Chinese medicine control group (control group), 30 cases in each group. TCM symptomatic scores and indexes of blood lipids were detected before and after treatment in the two groups.</p><p><b>RESULTS</b>The total effective rate for improvement of blood lipids was 72.4% in the treatment group, which was not different from that (65.5%) in the control group (P> 0.05); the total effective rate for clinical symptoms was 89.7% in the treatment group, which was better than that (62.1%) in the control group (P < 0.05). The treatment group was superior to the control group in improvement of numbness and twinge in extremities, dizziness, distention and oppressed feeling in chest and hypochondrium, anorexia, sleepy and weakness (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture method for consciousness-restoring resuscitation can regulate metabolic disorder of lipids and improve main clinical symptoms in the patient of cerebral infarction with hyperlipidemia.</p>

Prognostic value of plasma brain natriuretic peptide and C-reactive protein in patients with acute coronary syndromes underwent percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the prognostic value of plasma brain natriuretic peptide (BNP) and C-reactive protein (CRP) in patients with acute coronary syndromes (ACS) underwent percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Patients with ACS underwent PCI in our hospital from December 2004 to September 2005 were included in this study. Plasma BNP (n = 189) and CRP (n = 141) were measured at a median of (34.2 +/- 16.3) hours from symptom onset, total mortality and the risk for major adverse cardiac events (MACE, including death, recurrent MI, recurrent angina, heart failure, readmission for any reason) at 30 days and at 3 months was analyzed.</p><p><b>RESULTS</b>Patients were divided into 4 groups according to their BNP levels (BNP <or= 100 ng/L, BNP > 100 ng/L to <or= 300 ng/L, BNP > 300 ng/L to <or= 600 ng/L and BNP > 600 ng/L) and the 3-month mortality was 0%, 1.4%, 7.7%, 48.3% and 3-month incidence of MACE was 7.9%, 17.1%, 57.7%, 79.3% respectively. Multivariate logistic regression analyses showed that the plasma BNP level predicted 30-day (r = 0.8515, P < 0.01) and 3-month (r = 0.9201, P < 0.01) mortality and 30-day (r = 0.7066, P < 0.01) and 3-month (r = 0.7090, P < 0.01) incidence of MACE independent of other known prognostic factors such as age, gender, family heredity, hypercholesterolemia diabetes, hypertension, smoking and LVEF. Patients were divided into 3 groups according to their CRP levels (CRP <or= 8.0 mg/L, CRP > 8.0 mg/L to <or= 32.0 mg/L, CRP > 32.0 mg/L) and 3-month mortality was 2.7%, 7.7% and 28.6% and 3-month incidence of MACE was 28.4%, 41.0% and 60.7% respectively. CRP predicted 30-day (r = 0.5882, P = 0.0044) and 3-month (r = 0.5235, P = 0.0038) mortality independent of traditional risk factors, and predicted 30-day (r = 0.2705, P = 0.0380) and 3-month (r = 0.2290, P = 0.0429) incidence of MACE after adjustment for patient age. CRP lost its predictive value after BNP was introduced into the model, while BNP was still an independent predictor for mortality and incidence of MACE at 30 days and 3 months in ACS patients underwent PCI.</p><p><b>CONCLUSION</b>Both plasma BNP and CRP are good predictors for early mortality and MACE incidence in ACS patients underwent PCI.</p>

The clinical value of sixteen-detector row computed tomography angiography for the assessment of coronary artery bypass graft / 中华心血管病杂志

<p><b>OBJECTIVE</b>The aim of this study was to evaluate the value of sixteen-detector row computed tomography angiography (CTA) for the assessment of coronary artery bypass graft (CABG).</p><p><b>METHODS</b>Sixty-two consecutive patients undergoing coronary artery bypass grafting were recruited. Among them, 6 patients were excluded from the study due to unfavorable control of heart rate. A total of 56 patients with 152 coronary artery bypass grafts (internal mammary artery, n = 48; saphenous venous grafts, n = 104) were examined by computed tomography angiography (CTA) with sixteen-detector row CT and by conventional invasive coronary angiography (CAG). All CT procedures were performed with retrospective electrocardiogram gating method. The patients' mean heart rate was 58 +/- 6 beats/minute. 120 ml of Visipaque 320 were continuously injected with the rate of 4.0 ml/sec during the procedure. The patency and the stenosis of coronary artery bypass grafts were evaluated by two experienced readers.</p><p><b>RESULTS</b>All the coronary artery bypass grafts were visualized by CTA, and all the proximal bypass anastomoses and 71% of the distal bypass anastomoses were also visualized by CTA. Furthermore, 29 occlusions and 13 significant stenoses of coronary artery bypass grafts were detected by CTA. The comparison of the results between CTA and CAG showed that among all the 42 occluded and stenosed coronary artery bypass grafts detected by CTA, 34 were confirmed by CAG; among all the 110 normal coronary artery bypass grafts detected by CTA, 108 were confirmed by CAG. There were 8 false positive and 2 false negative findings, resulting in a sensitivity of 94%, a specificity of 95%, a positive predictive value of 86%, and a negative predictive value of 99%.</p><p><b>CONCLUSION</b>Sixteen-detector row CTA technology may provide a reliable visualization and higher diagnostic accuracy of coronary artery bypass grafts lesions. This technique can be used as a noninvasive procedure for the diagnosis of suspected coronary artery bypass grafts dysfunction.</p>