Analysis of the nail microbiome in patients with onychomycosis by high-throughput sequencing of 16S rDNA and internal transcribed spacer regions / 中华皮肤科杂志

Objective:To investigate differences in bacterial and fungal microbiome between infected nails and healthy nails among patients with onychomycosis.Methods:Nail scraping samples were collected from infected nails and healthy nails of 31 patients with onychomycosis, who visited Dalian Dermatosis Hospital from August 2020 to July 2021. The total DNA of nail microbiota was extracted, and the V3-V4 regions of the bacterial 16S rDNA gene and the fungal internal transcribed spacer (ITS) region were amplified and sequenced using Illumina technology. The USEARCH and mothur softwares were used for data cluster analysis to obtain the operational taxonomic units (OTUs) , Wilcoxon rank sum test was used to analyze α diversity, analysis of similarities (ANOSIM) was performed to analyze β diversity, linear discriminant analysis of effect size (LEfSe) was performed to evaluate the species difference.Results:Among the 31 patients with onychomycosis, 16 were males and 15 were females. According to the age, they were divided into young group (18 - 35 years old, 10 cases) , middle-aged group (36 - 60 years old, 11 cases) , and elderly group (over 60 years old, 10 cases) . As the α-diversity analysis revealed, the infected nail group showed significantly decreased Shannon index ( W = 290, P = 0.007) , but significantly increased Simpson index ( W = 663, P = 0.010) compared with the healthy nail group, suggesting that the diversity and evenness of bacterial communities were lower in the infected nail group than in the healthy nail group; however, there was no significant difference in the diversity of fungal communities between the infected nail group and healthy nail group. The β-diversity analysis based on the unweighted-UniFrac distance matrix showed no significant difference in the fungal or bacterial community composition between the infected nail group and healthy nail group (bacterial communities: R = 0.0052, P = 0.331; fungal communities: R = 0.0036, P = 0.337) ; the β-diversity analysis based on the weighted-UniFrac distance matrix showed significant differences in the abundance of bacterial and fungal communities between the two groups (both P = 0.001) . In terms of the species composition, the bacterial flora with significantly decreased abundance in the infected nail group compared with the healthy nail group included Bacteroidetes, Proteobacteria, Betaproteobacteria, Burkholderiales, Ralstonia, Sphingomonas and Streptococcus, while the abundance of Bacilli, Bacillales and Staphylococcus was significantly higher in the infected nail group than in the healthy nail group. Compared with the healthy nail group, the fungal flora with significantly increased abundance in the infected nail group included Eurotiomycetes, Onygenales, Leotiomycetes-ord-incertae-sedis, Arthrodermataceae, Periconia, Erysiphe, Tilletiopsis, Trichophyton, Erysiphe cruciferarum, Trichophyton rubrum, Malassezia sympodialis, while the abundance of Saccharomycetes, Saccharomycetales, Saccharomycetaceae, Dothioraceae, Candida and Alternaria was significantly lower in the infected nail group than in the healthy nail group. Conclusion:The diversity and abundance of bacterial communities significantly differed between infected nails and healthy nails among patients with onychomycosis, while only the abundance of fungal communities differed between the two groups, and perhaps there was correlations between some bacterial and fungal communities.

A multi-center survey of medical staffs′ cognition and management of prolonged mechanical ventilation in pediatric intensive care unit / 中国小儿急救医学

Objective:To investigate the status of cognition and clinical management of prolonged mechanical ventilation(PMV) among medical staffs in pediatric intensive care unit(PICU) in China, and in order to improve the awareness of PICU medical staffs on PMV and standardize the management of PMV.Methods:The cross-sectional study was conducted with doctors and nurses in PICUs of the collaborative group as the survey objects from July 12 to September 12, 2020.The questionnaire was issued, collected and checked by the Children′s Hospital of Fudan University.Results:(1) PMV related settings: Nine out of eleven hospitals had established PMV multidisciplinary teams, respiratory techniques such as diaphragm ultrasound and airway peak flow monitoring could be respectively executed in 72.7% and 36.4% of PICU.Pulmonary rehabilitation techniques such as airway clearance techniques, induced spirometer exercise, external diaphragm pacemaker stimulation, transfer bed exercise, balloon blowing, hyperbaric oxygen therapy could be respectively executed in 100.0%, 9.1%, 9.1%, 9.1%, 27.3% and 27.3% of PICU, respectively.(2) The cognitive status quo of children′s PMV: The most medical staffs agreed with the view that PMV referred to the children′s continuous mechanical ventilation for more than two weeks.Sixty percent of medical staffs believed that children with PMV had basic central nervous system diseases, and 62.7% of medical staffs believed that the most common causes of difficulty in PMV weaning was abnormal brain function.(3) The cognitive status quo of the children′s PMV management in PICU: Respondents believed that the most commonly used mechanical ventilation mode was synchronized intermittent mandatory ventilation+ pressure support ventilation in children′s PMV during stable disease.Ninety-two percent of medical staffs performed the spontaneous breathing test when weaning.And 58.7% of the respondents agreed to perform tracheotomy for the children during 3 to 4 weeks of mechanical ventilation.More than half of medical staffs would execute diaphragm function assessment, bedside rehabilitation training, nutritional assessment, analgesia and sedation assessment for children with PMV.(4) The cognitive status quo of the children′s PMV management of transition from hospital to family: 54.5% of PICU provided family care training to the family members before the children were discharged from the hospital.One center established the PMV specialized outpatient clinic.45.5% of PICU would follow up these discharged children one month later.Conclusion:At present, PICU medical staffs have different awareness of children′s PMV related problems in China.And children′s PMV lacks a systematic plan regarding diagnosis, treatment and management.

The diagnostic value of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio in severe Mycoplasma pneumoniae pneumonia / 中华实用儿科临床杂志

Objective:To study the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diagnosing severe Mycoplasma pneumoniae pneumonia (MPP).Methods:A total of 616 cases of MPP patients in the Children′s Hospital of Soochow University from January 2015 to December 2017 were retrospectively analyzed.During the same period, 100 healthy children were selected as the healthy control group.NLR and PLR between MPP group and healthy control group, and those between severe MPP group and ordinary MPP group were compared by t test or rank sum test.Risk factors for severe MPP were identified.Receiver operating characteristic(ROC) curves were plotted to identify the cut-off point of NLR and PLR in distinguishing MPP from healthy subjects. Results:(1)The median of white blood cell count (WBC), neutrophil count (N), platelet count (PLT), NLR, PLR, immunoglobulin M (IgM) and the median percentage of CD3 -CD 19+ , CD 19+ CD 23+ in MPP group were significantly higher than those in healthy control group(8.36×10 9/L vs.7.49×10 9/L, 4.41×10 9/L vs.3.11×10 9/L, 340.92×10 9/L vs.234.00×10 9/L, 1.70 vs.0.91, 112.99 vs.70.34, 1.33 g/L vs.1.29 g/L, 20.95% vs.17.10%, 11.25% vs.9.70%), whereas the median of lymphocyte count (L), IgA and the median percentage of CD3 + , CD3 + CD8 + , and CD3 -CD +(16+ 56) were significantly lower(2.64×10 9/L vs.3.37×10 9/L, 0.86 g/L vs.1.30 g/L, 64.55% vs.68.00%, 23.65% vs.24.90%, 10.50% vs.12.20%)( Z=-3.074, -2.413, -2.972, -1.357, -1.863, -2.251, -4.282, -3.420, -2.221, -4.181, -2.784, -2.024, -2.791, all P<0.05). (2)The median of N, NLR, PLR, IgA, IgG, IgM and the average of percentage of CD3 + , CD3 + CD8 + in severe MPP group were significantly higher than those in ordinary MPP group[5.18×10 9/L vs.3.52×10 9/L, 2.39 vs.1.03, 149.32 vs.94.23, 1.29 g/L vs.0.71 g/L, 9.63 g/L vs.8.19 g/L, 1.40 g/L vs.1.29 g/L, (65.53±9.75)% vs.(62.81±9.89)%, (25.35±6.65)% vs.(23.38±6.91)%], whereas the median of L, the median percentage of CD3 -CD 19+ , and CD 19+ CD 23+ were significantly lower than those of ordinary MPP group(2.02×10 9/L vs.3.25×10 9/L, 17.40% vs.21.50%, 9.00% vs.11.70%)( Z/ t=-7.807, -11.313, -10.452, -8.819, -6.162, -3.047, -3.128, -3.270, -9.402, -5.191, -5.214, all P<0.05). (3)Univariate and multivariate Logistic regression analysis showed that CD3 -CD 19+ was the protective factor for severe MPP, while N, NLR and PLR were the risk factors for severe MPP (all P<0.05), with the risk sequence of NLR>PLR>N.(4)Area under ROC curve analysis of NLR and PLR in the diagnosis of severe MPP: NLR: AUC=0.789, 95% CI: 0.754~0.823, P<0.001; PLR: AUC=0.767, 95% CI: 0.730~0.804, P<0.001; when the critical value of NLR was 1.09, the sensitivity was 98.9%, and the specificity was 70.6%.When the critical value of PLR was 97.47, the sensitivity and specificity were 88.5% and 69.4%. Conclusions:NLR and PLR can be served as independent influencing factors for severe MPP, showing the diagnostic potential in severe MPP.

Subcellular localization of serine hydrolases 1 protein in Microsporum canis / 中华皮肤科杂志

Objective:To analyze the subcellular localization of family of serine hydrolases 1 (FSH1) protein in Microsporum canis. Methods:The FSH1 and enhanced green fluorescent protein (EGFP) genes were amplified by PCR using the previously constructed plasmid containing the FSH1 gene and the recombinant plasmid pCAMBIA-LRP-EGFP as the template; the vector DNA was obtained by double-enzyme digestion of the recombinant plasmid pCAMBIA-LRP-EGFP with SnaBI/KpnI. Then, the EGFP expression plasmid and Ptrcp-FSH1-EGHP-Ttrcp fusion plasmid were constructed by inserting the amplified EGFP gene and EGFP-FSH1 gene into the vector DNA respectively, and identified by PCR and sequencing. The two recombinant plasmids were transformed into Microsporum canis by an Agrobacterium tumefaciens-mediated method, and the gene EGFP and fusion gene FSH1-EGFP were expressed integratedly in Microsporum canis under the regulation by the fungal universal promoter Ptrpc and terminator Ttrpc. The cellular localization of the fusion protein was observed by laser scanning confocal microscopy. Results:The Agrobacterium tumefaciens-mediated transformation system and EGFP expression vector in Microsporum canis were successfully constructed; the fusion gene FSH1-EGFP was expressed integratedly in Microsporum canis. Laser confocal microscopy showed that fluorescence signals of the FSH1-EGFP fusion protein were concentrated in the cytoplasm and nuclei of Microsporum canis, with a granular or cluster-like appearance. Conclusion:The FSH1-EGFP fusion protein was successfully localized in the cytoplasm and nuclei of Microsporum canis, providing a basis for further clarifying the function and pathogenic mechanisms of the FSH1 gene in Microsporum canis.

Localization of PQ-LRP protein in Microsporum canis / 中华皮肤科杂志

Objective To determine the location of PQ-LRP protein in Microsporum canis using the enhanced green fluorescent protein(EGFP)as a marker.Methods The total RNA was extracted from Microsporum canis,and reversely transcribed into cDNA.The PQ-LRP gene was amplified by PCR using the above cDNA as the template.The fusion gene of PQ-LRP gene and EGFP gene was linked to the plasmid pCAMBIA 1300.Microsporum canis was subjected to Agrobacterium tumefaciens-mediated transformation,in order to achieve the integrated expression of the fusion gene LRP-EGFP in Microsporum canis under the regulation by the fungal universal promoter Ptrpc and terminator Ttrpc.Laser-scanning confocal microscopy was conducted to determine the cellular localization of the fusion protein.Results The expression vector pCAMBIA-LRP-EGFP was successfully constructed,and the fusion gene LRP-EGFP was expressed integratedly in Microsporum canis.Laser-scanning confocal microscopy showed that fluorescence signals of LRP-EGFP were concentrated on the cell membrane of Microsporum canis,giving a granular or cluster-like appearance.Conclusion The infusion gene LRP-EGFP can be successfully expressed in Microsporum canis,and PQ-LRP protein is located on the cell membrane of Microsporum canis.

Tai Chi therapy for elderly patients with type 2 diabetes mellitus: a randomized controlled trial / 国际中医中药杂志

Objective@#To observe the effect of Tai Chi combined with conventional western medicine therapy for elderly patients with type2 diabetes mellitus.@*Methods@#According to randomized controlled design, 108 patients were divided into two groups ,with 54 in each group. Patients in control group were treated with conventional western medicine therapy and regular walk (three times per week), while the patients in the observation group were treated with conventional western medicine therapy and Tai Chi (three times per week), both groups were treated for 12 weeks. Before and after treatments, diabetes symptoms scale was used to assess disease conditions, FPG and HbA1c were detected separately by methods of HK (hexokinase) and High Performance Liquid Chromatography (HPLC), Diabetes mellitus Specific Quality of Life scale (DSQL) were used to assess the quality of life, Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G) was used to assess patients’ self-management ability, and Geriatric Depression Scale was used to assess patients' depression emotions.@*Results@#After treatments, the clinical symptoms scores (1.79 ± 1.21 vs. 2.86 ± 1.66, t=-3.401), the DSQL scores (50.40 ± 10.88 vs. 56.00 ± 10.85, t=-2.156), the GDS scores (5.63 ± 0.71 vs. 6.08 ±0.91, t=-2.515) of observation group were significantly lower than that of control group (P<0.01 or P<0.05), and the SES6G scores (7.54 ± 0.59 vs. 6.89 ± 0.39, t=-5.987) of observation group were significantly higher than that of control group (P<0.01); after treatments, the D-value of FPG (-0.97 ± 1.54 mmol/L vs. -0.28 ± 1.74 mmol/L, t=-2.092) was significantly higher than that of control group (P<0.05).@*Conclusions@#The Tai Chi combined with conventional western medicine therapy could alleviate clinical symptoms and negative emotions, improve disease management and quality of life, regulate blood glucose of elderly patients with type 2 diabetes mellitus.

Tai Chi therapy for elderly patients with type 2 diabetes mellitus: a randomized controlled trial / 国际中医中药杂志

Objective To observe the effect of Tai Chi combined with conventional western medicine therapy for elderly patients with type2 diabetes mellitus. Methods According to randomized controlled design, 108 patients were divided into two groups ,with 54 in each group. Patients in control group were treated with conventional western medicine therapy and regular walk (three times per week), while the patients in the observation group were treated with conventional western medicine therapy and Tai Chi (three times per week), both groups were treated for 12 weeks. Before and after treatments, diabetes symptoms scale was used to assess disease conditions, FPG and HbA1c were detected separately by methods of HK (hexokinase) and High Performance Liquid Chromatography (HPLC), Diabetes mellitus Specific Quality of Life scale (DSQL) were used to assess the quality of life, Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G) was used to assess patients’ self-management ability, and Geriatric Depression Scale was used to assess patients' depression emotions. Results After treatments, the clinical symptoms scores (1.79 ± 1.21 vs. 2.86 ± 1.66, t=-3.401), the DSQL scores (50.40 ± 10.88 vs. 56.00 ± 10.85, t=-2.156), the GDS scores (5.63 ± 0.71 vs. 6.08 ±0.91, t=-2.515) of observation group were significantly lower than that of control group (P<0.01 or P<0.05), and the SES6G scores (7.54 ± 0.59 vs. 6.89 ± 0.39, t=-5.987) of observation group were significantly higher than that of control group (P<0.01); after treatments, the D-value of FPG (-0.97 ± 1.54 mmol/L vs.-0.28 ± 1.74 mmol/L, t=-2.092) was significantly higher than that of control group (P<0.05). Conclusions The Tai Chi combined with conventional western medicine therapy could alleviate clinical symptoms and negative emotions, improve disease management and quality of life, regulate blood glucose of elderly patients with type 2 diabetes mellitus.

Advance in Ultrasound Elastography for Evaluation of Spasticity (review) / 中国康复理论与实践

@#Spasticity is one of common manifestations of upper motor neuron injury, and often evaluated with semi-quantitative scales. Ultrasound elastography (UE) can provide elastic information for muscle tissue, and can be used for the evaluation of muscle tension after cerebral palsy and stroke, as well as the efficacy of treatment. It correlates well with clinical spasm rating scales. However, UE may also be used for assessment of spasticity after spinal cord injury and multiple sclerosis, etc.

The Association of SNP on Chromosome 9p21 with Myocardial Infarction in Yunnan Yi nationality / 中国生化药物杂志

Objective To investigate the relationship between 9p21 single nucleotide polymorphism (SNP) and myocardial infarction(MI) in Yunnan Yi nationality. Methods One hundred and ten patients with MI and 110 controls were enrolled. DNA sequencing was used to detect 9p21 gene locus and SNP typing and analysis. Results Hardy-Weinberg equilibrium was found in 9 sites of chromosome 9p21 in myocardial infarction group and control group.The frequency of rs1333049 GG genotype was 30.91% and 18.18% in case group and control group respectively, G The frequencies of rs2383206 GG genotype were 31.82% and 18.18%, respectively, and the frequencies of G allele were 55.3% and 41.1%, respectively. There were significant differences between the two groups 58.3% and 44.9%, The difference between the two groups was statistically significant(P<0.05). Conclusion This study demonstrates an association of rs1333049 polymorphism locus on chromosome 9p21 with risk for MI in in Yunnan Yi nationality.

Therapeutic Observation of Acupuncture with Elongate Needle plus Red Light Radiation for Post-herpetic Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture with elongate needle plus red light radiation in treating post-herpetic neuralgia.Method Seventy patients with post-herpetic neuralgia were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by acupuncture with elongate needle plus red light radiation, while the control group was by orally taking Pregabalin capsules. Visual Analogue Scale (VAS) and Quality of Life (QOL) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate was 97.1% in the treatment group, versus 71.4% in the control group, and the difference was statistically significant (P<0.05). After treatment, VAS and QOL scores were significantly changed in both groups (P<0.05). The VAS and QOL scores in the treatment group were significantly different from that in the control group after treatment (P<0.05).Conclusion Acupuncture with elongate needle plus red light radiation is effective in relieving post-herpetic neuralgia.

Relationship between postoperative anemia and short-term outcome after hip arthroplasty in elderly patients in high-altitude regions / 中华麻醉学杂志

One hundred fifty-three patients with hypoxia of both sexes,underwent hip arthroplasty from January 2012 to January 2014,aged 65-97 yr,weighing 41-80 kg,living in areas at altitude above 1800 m,of American Society of Anesthesiologists physical status Ⅱ-Ⅵ,were selected.The hemoglobin (Hb) at 3-4 days after operation was collected,and the patients were divided into 3 groups depending on whether or not postoperative anemia occurred:no anemia group (Hb＞ 110 g/L);mild anemia group (90 g/L≤ Hb≤ 110 g/L);moderate anemia group (70 g/L ≤ H b＜ 90 g/L).The 36-item Short-Form Health Survey score and Harris Hip Score at 28 days after operation were collected.There was no significant difference between the three groups in the postoperative 36-item Short-Form Health Survey score and Harris Hip Score (P＞0.05).Postoperative mild and moderate anemia did not affect the short-term outcome after hip arthroplasty in elderly patients in high-altitude regions.

Fever,poor response, convulsions, and hepatomegaly / 中华实用儿科临床杂志

Objective To investigate the differential diagnosis of Reye syndrome and the characteristics of primary carnitine deficiency,and to provide diagnostic strategy for similar cases.Methods There was a case presented with fever,poor response,convulsions and hepatomegaly hospitalized in Wuhan Children's Hospital,and the clinical manifestations were described,the physical examination was comprehensively conducted,the auxiliary examination results were recorded,some pediatric specialists from ICU,neurology department,genetic metabolic department,digestive system department were invited to discuss the case.The treatment was adjusted according to the suggested opinions;the treatment effects and the final diagnosis were tracked.Results The primary diagnosis of the case was central nervous system infection or toxic encephalopathy at the time of admission,but Reye syndrome could not be excluded.Although the cerebrospinal fluid test and brain MRI examination detected nothing abnormal,liver function suggested alanine aminotrans ferase ALT increase,blood sugar decrease,the liver volume increase,which was detected by liver ultrasound.Blood amino acids examination revealed the carnitine level decreased,and it was confirmed as primary carnitine deficiency in the end.L-carnitine was used to treat the disease,and its effect was good.Conclusions Great importance should be attached to children with onset age,physical check-up,and multidisciplinary cooperation.Use monism to explain the illness and the auxiliary inspection as far as possible,so that it can get early diagnosis and treatment,and the outcome is good.

The study of efficacy of subarachnoid bupivacaine in elderly patients undergoing total hip arthroplasty in high altitude area / 临床麻醉学杂志

Objective To investigate the ED50 and ED9 5 of subarachnoid 0.375% bupivacaine in elderly patients undergoing elective total hip arthroplasty (THA ) in high altitude area. Methods Twenty-three elderly patients,aged 73-99 years old,ASA Ⅱ or Ⅲ,selected for total hip ar-throplasty (THA)under combined spinal-epidural (CSE)anesthesia were enrolled in this study and predose of 3.0 mg,0.375% (m/v)bupivacaine administered in subarachnoid,following dosage in-creased by ratio of 0.8.Calculate the ED50 and ED9 5 of subarachnoid 0.375% bupivacaine and 95%CI.Results Twenty of 23 underwent the test completely.The ED50 (95%CI)and ED9 5 (95%CI)of 0.375% (m/v)bupivacaine were 4.81 mg (3.98-5.81 )and 7.29 mg (6.03-8.81 ),respectively. Conclusion Subarachnoid 0.375% bupivacaine (7.5 mg)can be used effectively and safely in elderly patients undergoing total hip arthroplasty in high altitudes area.

Effects of large dose of Astragalus membranaceus on the dendritic cell induction of peripheral mononuclear cell and antigen presenting ability of dendritic cells in children with acute leukemia / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effects of large dose of Astragalus membranaceus (Astragalus) on the dentritic cell (DC) induction in vitro and augumentation by peripheral mononuclear cell (MNC) and on antigen presenting ability of DC in children with acute leukemia.</p><p><b>METHODS</b>Forty-four children with acute leukemia in complete remission stage were divided into two groups. Twenty patients in the Astragalus (90 g daily) group were treated with large dose of Astragalus (90 g daily) based on conventional chemotherapy for one month, while 24 patients in the control group received chemotherapy alone. MNC were extracted from peripheral blood by wall-sticking method and cultured with such cell factors as interleukin-4, gramulocyte macrophage colony stimulating factor, tumor necrosis factor-alpha for 7-8 days. Phenotype of DC was assayed by flow cytometry and antigen presenting ability of them was assayed by mixed lymphocyte reaction.</p><p><b>RESULTS</b>There was no morphological difference in MNC induced DC between the two groups. The average number of DC in Astragalus group and control group was 4.4 x 10(6) / 2.5 x 10(6) MNC and 2.6 x 10(6) / 2.5 x 10(6) MNC, respectively, showing significant difference (P < 0.001). DC in Astragalus group could stimulate the proliferation of allogeneic lymphocytes strongly, showing significant difference when compared with that in the control group (P < 0.001). Conclusion Large dose of Astragalus could increase the DC induction of MNC and enhance the antigen presenting ability of DC in acute leukemia patients.</p>

Effects of diltiazem on platelet activation and cytosolic calcium during percutaneous transluminal coronary angioplasty / 中国病理生理杂志

AIM: To evaluate effects of diltiazem on platelet hyperreactivity in situations associated with endothelial injury and their possible relationship to cytosolic calcium concentration. METHODS: Blood samples were collected at 7 time points from 35 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) who received combined diltiazem and aspirin/ticlopidine therapy or aspirin/ticlopidine therapy alone. Platelet expression of glycoprotein Ⅱb/Ⅲa and cytosolic calcium concentration were measured, respectively, by whole blood flow cytometry and fluorospectrophotometry. The effects of diltiazem of different concentrations on expression of glycoprotein Ⅱb/Ⅲa were also studied in vitro in blood samples from patients with chronic stable angina. RESULTS: Of the two treatments, aspirin/ticlopidine therapy did not prevent an acute increase of expression of glycoprotein Ⅱb/Ⅲa 5 minutes and 10 minutes after first inflation and 10 minutes after PTCA, whereas combined diltiazem and aspirin/ticlopidine therapy had a significant inhibitory effect. In the group receiving aspirin/ticlopidine therapy, there was a short-term elevation of platelet [Ca~(2+)]i immediately following PTCA which was significantly reduced by diltiazem treatment. Expression of glycoprotein Ⅱb/Ⅲa was significantly inhibited in vitro by diltiazem in the concentration of 200 ?g/L or higher, but not 50 ?g/L. CONCLUSIONS: Combined diltiazem and aspirin/ticlopidine therapy significantly inhibited platelet activation that continued in the presence of conventional aspirin/ticlopidine treatment. Antiplatelet effects of diltiazem were probably a consequence of reduction of platelet [Ca~(2+)]i and may only be achieved in higher than therapeutic concentrations. [

Effects of hydrogen peroxide on cell proliferation and expression of gelatinase A and its inhibitor in vascular smooth muscle cells / 中国病理生理杂志

AIM: To study the effects of hydrogen peroxied (H 2O 2) on cell proliferation and transcription of gelatinase A (MMP-2) and its inhibitor (TIMP-2) in vascular smooth muscle cells (VSMC). METHODS: Cell proliferation and toxicity by H 2O 2 were tested through MTT. The expression of MMP-2 mRNA and TIMP-2 mRNA in VSMC were evaluated by RT-PCR. RESULTS: The present study showed that H 2O 2 (more than 300 ?mol/L)was lethal to VSMC. 0 01-50 ?mol/L H 2O 2 promoted proliferation of VSMC in a time-dependant manner. A value (optical density) was reached to peak at 24 h after continuing stimulation of 10 ?mol/L H 2O 2. MMP-2/?-actin mRNA ratio significantly increased after stimulation with 1 ?mol/L?10 ?mol/L H 2O 2. TIMP-2/?-actin mRNA ratio was not significantly fluctuated at 12 h?24 h?36 h?48 h after continuing stimulation with 1 ?mol/L, 10 ?mol/L, and 50 ?mol/L H 2O 2.CONCLUSION: H 2O 2 at suitable concentrations stimulated proliferation of VSMC and induced transcription of MMP-2 gene in VSMC. There was no effect of H 2O 2 on transcription of TIMP-2 gene in VSMC. These results imply that H 2O 2 takes part in the pathological course of vascular remodeling through VSMC.

Clinical application of percutaneous balloon mitral valvuloplasty in patients with rheumatic mitral stenosis and left atrial thrombi / 介入放射学杂志

Objective To evaluate safety and effect of percutaneous balloon mitral valvuloplasty(PBMV) for patients with rheumatic mitral stenosis and left atrial thrombi.Methods PBMV was performed in 27 patients with rheumatic mitral stenosis and left atrial thrombi. 19 cases of left atrial fresh thrombi revealed by transesophageal echocardiography (TEE) received warfarin orally for 3-6 months before PBMV. Results PBMV was successful in all cases of mitral stenosis and left atrial thrombi. Left atrial fresh thrombi was completely resolved in 9 cases and became smaller chronic organized thrombi in 10 cases after warfarin anticoagulation treatment among 19 cases of left atrial fresh thrombi revealed by TEE. In 5 cases of left atrial chronic organized thrombi shown only transthoracic echocardiography and without anticoagulation treatment, one case had cerebral embolism. No complication occurred in other cases.Conclusions The study showed that patients with rheumatic mitral stenosis and atrial fibrillation should have routine TEE. PBMV for rheumatic mitral stenosis with left atrial thrombi after anticoagulation treatment is safe and effective.

Effect of HOE642 on myocardial ischemia/reperfusion injury and apoptosis / 中国病理生理杂志

AIM: To clarify the effect of the specific sodium-hydrogen antiporter HOE642 on ischemia/reperfusion(I/R) injury including apoptosis, and the relationship between its effect and the time of HOE642 administration. METHODS: The isolated rat heart model were randomly divided into group A and B. Furthermore, the rat hearts in group A were divided into four subgroups including I/R, HOE-Pr+I/R, HOE-Is+I/R and HOE-Re, also the rat hearts in group B were divided into the following subgroups including control, I/R and HOE642+I/R. The LVDP, LVEDP, arrythmia coronary flow and the enzymatic activity in myocardium were measured in group A, and TUNEL method was applied to probe apoptosis in group B. RESLUTS: It was found that the LVEDP, arrythmias and the enzymatic activity including CK-MB and LDH were significantly lower in group HOE-Pr+I/R than that in group I/R, while the LVDP was obviously higher in HOE-Pr+I/R than that in I/R. The administration of HOE642 during ischemia could decrease LVEDP, arrythmias and enzymatic activity in myocardium, but not the LVDP. Furthermore, the results showed that HOE642 could inhibit apoptosis induced by ischemic/reperfusion injury. CONCLUSIONS: HOE642 is an effective cardio-protector in case of ischemic/reperfusion injury especially when it is applied before ischemia. The inhibition of apoptosis might be involved in the mechanisms underlying the protective effect of HOE642.