ABSTRACT
Reactive oxygen species(ROS) in the cardiac muscle are increased in cardiovascular diseases such as hypertension,coronary heart disease and heart failure.Oxidative stress mediates myocyte hypertrophy,myocyte apoptosis and interstitial fibrosis.And these changes are particularly pronounced in elderly patients or senescent animal disease models.The major sources of ROS in myocardium are mitochondria and the reduced nicotinamide adenine dinucleotide phosphate(NADPH) oxidase.Specific ROS such as hydrogen peroxide play an important role in myocardial remodeling in heart failure.Oxidative modifications of calcium handling proteins result in reduction of their activities,leading to decreased myocardial contractility.Reduction of oxidant levels and inhibition of oxidative modifications of specific proteins through inhibiting ROS sources may provide new strategies for the treatment of myocardial remodeling.
ABSTRACT
Objective To compare the curative effects between recombinant human brain natriuretic peptide (rhBNP) and sodium nitroprusside in treatment of the acute attack of elderly patients with chronic heart failure (CHF), and probe the impacts of rhBNP on the heart function,serum B-type natriuretic peptide (BNP), norepinephrine (NE), endothelin 1 (ET-1) and antidiuretic hormone (ADH) levels. Methods The 89 patients aged 65-85 years at acute attack stage of CHF were randomized into two therapy groups: rhBNP group (n= 47) and sodium nitroprusside group (n=42). The clinical effects, heart function, serum BNP, NE, ET-1 and ADH changes were observed before and after the treatment. Results After 24 hours of treatment, the efficacy rate and total effective rate were higher in rhBNP group than in sodium nitroprusside group (51.1% vs. 26.2 %,95.7% vs. 66. 7%, respectively, P＜0. 05 and P＜0. 01), and non-efficacy rate in rhBNP group was lower (4.3% vs. 33. 3%, P＜0. 01). There was one death case in rhBNP group and three in sodium nitroprusside group. In rhBNP group, left ventricular ejection fraction values increased after 2 weeks of treatment [(46.2± 9.5)% vs. (38.1 ±6.0)%], P＜0.05. Serum BNP level significantly decreased in rhlBNP group than in sodium nitroprusside group after 2 weeks of treatment (P＜0.05).In rhBNP group, serum BNP and NE levels decreased 24 hours and 2 weeks after treatment (P＜0. 01) and the levels furtherly reduced after 2 weeks (P＜0.01). Serum ET-1 level decreased in rhBNP group than in sodium nitroprusside group 2 weeks after treatment (P＜0.05). In rhBNP group, there was no significant difference in serum ET-1 level between baseline and 24 hours after treatment (P＞ 0. 05), but the ET-1 level decreased 2 weeks after treatment as compared with 24 hours after treatment (P＜0.01). There were no significant differences between the two groups before and after treatment (P＞0.05). Incidences of headache and hypotension were lower in rhBNP group than in sodium nitroprusside group (4.3% vs. 19.0%, 14.9% vs. 23.8%, both P＜0.05),Conclusions RhBNP can be safely and effectively used for acute attack of CHF.
ABSTRACT
Objective Introducing a technique of quantitative eschar shaving with great sheet of epidermal grafting for deep Ⅱdegree burns in hands.Method 148 hands from 112 patients were treated with this methods.From Jan.2001 to Jane 2004,patients who suffered from deep Ⅱdegree burn injuries was quantitatively eschar shaving using electrical or air power dermatome which was fixed at scale mark from 0.012 inc 、0.016 inc to 0.02inc(from 0.3mm 、0.4mm to 0.5mm) according to the burn injury extents,the wounds were divided into three groups just depends on the injury extents,also the wounds was covered with the different thickness of great sheet of epidermal grafting,which was obtained using the electric or air dermatomes.Results There were 148 hands of 112 cases were treated with this technique within 2h.to 72h after injury.The scar thickness was ranged from 0.4mm to 0.8mm,the function of these hands was good,and the shape of hands looks good.Conclusion Good results was obtained with this methods,the wounds covered with the large sheet of epidermal grafting harvested by the quantitative eschar shaving is recovered uneventful.The thickness of the grafting was according to the increasing skin thickness after burns.