Effect of the integration pattern of hospital-community on the grade-based management for hypertension in elders / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of the integration pattern of hospital-community on the grade-based management for hypertension in elders.
@*METHODS@#We randomly chosen 218 (male, n=121; female, n=97) primary senile hypertension patients from a Community Health Service Center of District in Changsha City, from June, 2013 to December, 2013. Based on the risky factors, the subjects were divided into three groups and every group received grade-based management on blood pressure with a integration pattern of hospital-community for six months. According to the HILL-BONE high blood pressure compliance scale and the self- designed blood pressure monitoring form, we assessed the effect of compliance and blood pressure control on senile hypertension patient. 
@*RESULTS@#Hypertension treatment rate for the elders ranged from 22.9% to 88.1% (P<0.01). The levels of blood pressure of the subjects were significantly decreased compared with baseline. The level of diastolic blood pressure in the low, average, high and very high-risk group was decreased by 17, 20 and 23 mmHg, respectively (P<0.01). The level of systolic blood in the low, average, high and very high-risk group was decreased by 6, 5 and 7 mmHg, respectively (P<0.01). The compliance rate of HILL-BONE hypertension rose from 54.5% to 87.4% (P<0.01).
@*CONCLUSION@#The integration pattern of hospital-community with the grade-based management for hypertension significantly improved the senile hypertension control rate and compliance of drug treatment. The rational for drug usage rate rose obviously. The integration pattern of hospital-community with the grade-based management for elders deserves to spread.

Correlation between plasma asymmetric dimethylarginine and different types of coronary heart disease / 中南大学学报(医学版)

OBJECTIVE@#To monitor the changes of plasma asymmetric dimethylarginine (ADMA), nitric oxide (NO), and von Willebrand factor (vWF) levels in patients with stable angina pectoris (SAP) or acute coronary syndrome (ACS) and to evaluate the correlation between ADMA and different types of coronary heart disease.@*METHODS@#A total of 143 subjects were divided into a non-CHD group, a SAP group and an ACS group. Plasma levels of ADMA, NO and vWF were examined and their correlation with SAP or ACS was analyzed.@*RESULTS@#Compared with the non-CHO or the SAP group, ADMA level was elevated in the ACS group (P0.05). Compared with the non-CHD group, NO level was decreased in both the SAP and ACS group (P0.05).@*CONCLUSION@#The change of plasma ADMA level is closely correlated with acute coronary syndrome. ADMA might be a clinical marker for acute coronary syndrome.

Linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation guided by non-contact 3-dimensional mapping system / 中南大学学报(医学版)

OBJECTIVE@#To study the feasibility, safety, effectiveness of linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system.@*METHODS@#Twenty-eight consecutive patients with drug refractory paroxysmal and persistent AF were included in this study. Real-time 3-dimensional left atrial (LA) and pulmonary veins (PVs) maps were constructed through 3-dimensional mapping system (Ensite NavX) in all patients. Pulmonary vein isolation was performed by encircling the left and right sides of PVs at 1 to 2 cm away from the ostium of PVs. The endpoint of ablation included: All circum PVs ablation lines finished; all PVs were isolated; and non-inducibility of AF was observed.@*RESULTS@#All 28 patients reached the endpoint of ablation completely. The mean procedure time and fluoroscopy time was (161.3+/-23.2) min and (38.0+/-6.8) min, respectively. During the 6 approximately 17 month follow-up, 20 patients (71%) were free of AF without any antiarrhythmic drugs. Recurrence of AF was found in the other 8 patients (29%): Two were treated with amiodarone and 6 repeated ablation. After the second ablation, 4 were free of AF and 2 recurrence were treated with amiodarone. No complications occurred during the procedure and the follow-up.@*CONCLUSION@#Linear ablation and circumferential isolation of pulmonary veins for atrial fibrillation (AF) guided by 3-dimensional mapping system is effective and safe. But the long-term outcome remains to be investigated.

Myeloperoxidase in the plasma of patients with acute coronary syndrome / 中南大学学报(医学版)

OBJECTIVE@#To determine the diagnostic value and efficacy for risk stratification of myeloperoxidase (MPO) levels in patients with acute coronary syndrome (ACS).@*METHODS@#One hundred and sixty-two patients were enrolled in this study. All patients underwent coronary angiography. They were divided into 3 groups: ACS group (n=54), SAP group (n=54) and control group (n=54). Blood samples were taken from the artery before angiography in all patients and the concentrations of MPO, hsCRP and cTnI were measured. Each subject was asked details of history of hypertension, hyperlipidemia, diabetes and smoking habits. The efficacy of therapy, the cardiovascular events (myocardial infarction, the need for revascularization, or death) were recorded after 6 months of follow-up.@*RESULTS@#The plasma MPO level in ACS group (30.98 ng/mL) was significantly higher than those in the SAP group (14.67 ng/mL) and the control group(14.23 ng/mL)(P<0.01), and the plasma MPO levels in patients of the SAP group and the control group were not significantly different (P=0.74). There was no obvious correlation between the levels of plasma MPO and the serum levels of cTnI, hsCRP,the prevalence of the 4 major risk factors for CHD. Multivariate logistic regression analysis showed that plasma MPO level, free plasma glucose and sex were the significant variables. The risk for subsequent cardiovascular events was higher in the patients with elevated level of MPO.@*CONCLUSION@#Plasma MPO may be a new risk biomarker for ACS and may predict the incidence of subsequent cardiovascular events.

Proatherogenic effects of immune complexes of human oxLDL in vitro / 中南大学学报(医学版)

OBJECTIVE@#To observe the effects of immune complexes (IC) prepared from human oxidized density lipoprotein (oxLDL) antibodies and human oxLDL on the foam cell forming and the macrophage activation, and to further uncover the possible mechanisms of immune complexes contributing to the atherosclerosis occurrence.@*METHODS@#The immune complexes of human oxLDL and purified human oxLDL antibodies were added to culture U937 cells by protocols: polyethylene glycol-precipitated insoluble IC (PEG-IC) and IC immobilized by absorption to red blood cells (RBC-IC). With oxLDL as controls and heat-aggregated gamma globulin as an inhibitor of Fc gamma receptor, we measured the cholesterol ester, total cholesterol of the cellular extracts, and quantified the secreted MMP-1 of supernatants from U937 cells.@*RESULTS@#A significant increase of MMP-1 release [(0.769 +/- 0.030) ng/ml vs (0.513 +/- 0.034) ng/ml, P < 0.01] and a higher level of cholesterol ester accumulation [(20.271 +/- 1.668) microg/mg protein vs (17. 226 +/- 1.298 ) microg/mg protein, P < 0.05] in U937 cells incubated with RBC-IC were observed, compared with those incubated with RBC-oxLDL. However, the above quantative difference between the cholesterol ester accumulation induced by oxLDL and insoluble PEG-IC was even more striking, and cholesterol ester accumulation was dosage-dependent. Heat-aggregated gamma globulin (10 mg/ml) as an inhibitor of Fc gamma receptors competitively inhibited cholesterol ester accumulation and decreased PEG-IC stimulating MMP-1 secretion to 71%.@*CONCLUSION@#Immune complexe of ox-LDL can transform macrophages into foam cells and activted macrophages. The immunological function of oxLDL is involved in the process of atherosclerosis occurrence.