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Objective To investigate the changes in serum matrix metalloproteinase(MMP)-2 and MMP-9 and their relationship with serum B-type brain natriuretic peptide(BNP)in patients with chronic heart failure.Methods MMP-2,MMP-9 and serum BNP levels were measured in 184 patients with chronic heart failure and 61 healthy controls.The relationship between changes in MMP-2 and-9 and serum BNP was analyzed.Results Chronic heart failure was categorized into grade Ⅱ,Ⅲ and Ⅳ according to NYHA.In grade Ⅱ,Ⅲ and Ⅳ and the control group,the levels of MMP-2 were(309.1±60.1)nmol/L,(422.6±89.6)nmol/L,(694.8±126.2)nmol/L and(217.2±26.3)nmol/L respectively,and the levels of MMP-9 were (321.2±63.2)nmol/L,(454.4±96.3)nmol/L,(634.1±51.2)nmol/L and(210.8±23.6)nmol/L respectively.The levels of MMP-2 and MMP-9 were significantly higher in chronic heart failure subgroups than in the control group(F=3.65,12.52;P=0.000,0.000).According to the pairwise comparison among the chronic heart failure subgroups,the levels of serum MMP-2 and MMP-9 were significantly higher in NYHA Ⅳ grade than in NYHA Ⅲ grade,and higher in NYHA Ⅲ grade than in NYHA Ⅱ grade(all P<0.05).In patients with chronic heart failure groups,MMP-2 was positively correlated with serum BNP(r=0.866,P=0.000),and with MMP-9(r=0.516,P=0.001).Conclusions MMP-2 and MMP-9 levels might be closely correlated with chronic heart failure and show an upward trend with the progression of chronic heart failure.The levels of MMP-2 and MMP-9 are associated with BNP,which indicates that clinical monitoring of the serum level changes can provide a certain reference for diagnosis,treatment and prognosis in patients with chronic heart failure.
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Objective To investigate the relationship between the systolic/diastolic orthostatic hypotension(OH S/OH-D) and myocardial infarction (MI) in the elderly.Methods 200 subjects without myocardial infarction (MI) aged 60 years and over in our urban district were selected.The orthostatic and supine blood pressure and heart rate were measured in supine position after resting for more than 5 minutes and at 0 and 2 minutes after standing.All eases were divided into systolic orthostatic hypotension(OH-S)or diastolic orthostatic hypotension(OH-D)groups based on the results of orthostatic hypotension,and followed up by telephone with mean period of 325 days.The primary endpoint was MI occurrence for analyzing the correlation between OH-S/OH-D and MI incidence.Results The prevalence rate of OH in this cohort was 38％,with OH-S 20％ and OH-D 18％.In the very elderly group(≥80 years)versus the elderly group,the occurrences of 0H and OH-S were(27％ vs.21 ％,P =0.036;22 ％ vs.15 ％,P =0.020),respectively,while no significant difference was found in OH-D between the two groups.After 325 day follow up,the prevalence of MI was significantly(P＜ 0.05)higher in the OH positive subjects than in the 0H negative subjects,which result was the same as the prevalence of MI in OH-S or and OH-D group.After adjusting for age,supine blood pressure,creatinine and cerebrovascular history,logistic regression analysis showed that MI was correlated with OH(HR 15.72,95％CI 3.29～74.23,P=0.002),OH-S(HR 8.552,95％CI 2.51～30.21,P=0.004)and OH-D(HR 3.80,95 ％CI 1.14～13.80,P=0.042).Compared with OH-D,OH-S had more significant correlation with MI.Conclusions Orthostatic hypotension,particularly systolic orthostatic hypotension,is common in elderly patients.The OH-S and OH-D have a significant correlation with MI.
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Objective To investigate the correlation of blood glucose,blood pressure and body weight with pancreatic cancer.Methods From January 2011 to December 2013,110 patients diagnosed with pancreatic cancer in our hospital were selected as the observation group and 110 agematched cases without cancer during the same period were selected as the control group.The percentages of patients with diabetes,hypertension and elevated body mass index (BMI) were analyzed in both groups.Results The number of patients with diabetes was higher in the observation group than in the control group (32 cases or 29.1％ vs.16 cases or 14.6％,P＜0.05).The proportions of pancreatic cancer patients with diabetes duration ≤ 2 years,2～5 years and 5～10 years were higher in the observation group than in the control group (P＜0.05).The proportion of subjects with increased BMI was higher in the observation group than in the control group (24.6％ or 27cases vs.10.9％ or 12 cases,P＜0.05).The proportions of patients with diabetes combined with increased BMI and of patients with hypertension and increased BMI were higher in the observation group than in the control group (17.3％ or 19 cases vs.2.7％ or 3 cases,10.9％ or 12 cases vs.2.7％ or 3 cases,respectively,P＜ 0.05 for both).Conclusions Diabetes,hypertension,and elevated BMI can be considered as risk factors for pancreatic cancer,and it is possible that these factors are involved in the development of pancreatic cancer.
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To observe whether HMGB1could enhance the paracrine effect of MSCs when the Mesenchymal stem cells [Mesenchymal stem cells, MSCs] are pre-proccessed by High Mobility Group Box-1 [High Mobility Group Box-1, HMGB1]. And to observe whether it can further increase the quantity of local angiogenesis in myocardial infarcts on the rat model with acute myocardial infarction, HMGB1 was combined with MSCs transplantation. MSCs in rats were cultivated with adherence and centrifugation method. Receptors of TLR4and RAGE in HMGB1 were tested. The MSCs were interfered by HMGB1 with different concentration gradient respectively, then the expression of VEGF was tested with ELISA method. SD male rats were divided into four groups: the model group, the MSCs transplantation group, the HMGB1 injection group, the HMGB1 injection plus MSCs transplantation group [n = 24], preparing rat model with acute myocardial infarction. The serum VEGF concentration levels were detected on the 3[rd] day, 7th and 28th day with ELISA method. On the 28th day after post operation the density of angiogenesis in infarction area was detected by immunohistochemal. [1] MSCs owned the expression of TLR4 and RAGE. [2] the secretion of VEGF increased significantly after the intervention of HMGB1 with concentration of 12.5 ng/mL, 25 ng/mL, 50 ng/mL, 100 ng/mL and 200ng/ml on MSCs compared with the control group. While the concentration was 400ng/ml or 800ng/ml, the secretion of VEGF decreased compared with the control group [P < 0.05]. [3] detection of the serum VEGF on the 3[rd] or7th day after post operation was arranged: The results showed that: HMGB1 injection plus MSCs transplantation group > MSCs transplantation group >HMGB1 injection group >model group [P < 0.05]. [4] the quantity of CD31 stained angiogenesis in HMGB1 injection plus MSCs transplantation group increased obviously. Combining MSCs transplantation, contributed to new angiogenesis of rats with acute myocardial infarction in myocardial infarction area and its near area in rats with acute myocardial infarction
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Objective To investigate the effect and possible mechanism of oxytocin on the expression of NO and ET-1 in precon-ditioning myocardium of rats with ischemia .Methods The rats were randomly divided into ischemic reperfusion group(I/R) ,ische-mic reperfusion + oxytocin pretreatment group(I/R+OT) ,sham operation group(SH) and nomal control group(N) .The myocar-dial ischemia-reperfusion model was induced by 25 min coronary occlusion and 120 min reperfusion in opened-chest anesthetized rats ,rats of SH group were not conducted with ligation but threading only .Group I/R+ OT were administered oxytocin(0 .03 g/kg ,i .p)25 min prior to ischemia ,the other three groups were given the same amount normal saline .After reperfusion ,nitric oxide (NO) ,endothelin-1(ET-1) ,creatin kinase isoenzyme(CK-MB)and lactate dehydrogenase(LDH)in blood serum were measured .At the end of reperfusion ,HE stain was used to observe the morphology of the cardiac muscular tissue .Results Pathological observa-tion showed that the myocardial cell in group SH and in X ranged in order ,with no fibers fractured ,myocardial fibers in I/R group were fractured and disorganized ,interstitial edema ,neutrophil infiltration were also observed .It was more serious in group I/R than in group I/R+OT .Compared with SH group ,the CK-MB ,LDH ,ET-1 of the I/R group and I/R+OT group increased ,the NO de-creased(P0 .05) Compared with the I/R group ,in I/R+OT group the expression of CK-MB ,LDH ,ET-1 were decreased ,the level of NO increased(P<0 .05) .There was a negative correlation be-tween NO and ET-1 in group I/R and I/R+ OT (P< 0 .05) .Conclusion Oxytocin pretreatment on rat myocardial ischemia and reperfusion has protective effect ,and its action mechanisms maybe associated with the increase of the content of NO and the de-crease of the content of ET-1 in blood serum .
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Objective To evaluate the value of mean platelet volume (MPV) in identifying the location of infarct at left circumflex artery (LCX) in patients with non-ST-elevation myocardial infarction (NSTEMI).Methods In this retrospective study,184 consecutive patients with NSTEMI were eligible to be enrolled from January 1,2009 to June 30,2011 and laboratory examinations including platelet count,B-type natriuretic peptide (BNP),troponins test (TnI),C-reactive protein and serum creatinine (SCr) were done.The demographics and detailed history of patients were documented.In addition,left ventricular ejection fraction (LVEF) test and coronary angiography to determine the culprit vessel implicating in infarction were carried out in all enrolled patients.The patients were categorized into LCX group and N-LCX group according to culprit vessel.Results Of 184 patients,68 patients were in LCX group and 116 patients had left anterior descending artery (LAD) lesion or right coronary artery (RCA) lesion.High percent of LCX infarction were found in patients with high MPV level and low BNP level,and in smokers.And lower proportion of those patients had previous percutaneous coronary artery intervention.The results showed that MPV was larger in patients with LCX infarction than that in patients with LAD or RCA.Receiver operating characteristic curve showed the area under curve was 0.75 (95％ CI:0.675-0.826).An optimized cut off point at 9.15 fL of MPV showed 83.8％ sensitivity and 63.8％ specificity for prediction of LCX infarction.Multivariate analysis also showed that MPV was the only independent predictor of a LCX infarction in patients with NSTEMI [OR=1.32,(95％ CI:1.031-1.688),P＜0.05].Conclusions MPV was the only independent factor associated with LCX infarction in patients with NSTEMI.