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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 clinical effects and safety of bevacizumab combined with S-1 as the second-line treatment of recurrent and/or metastatic esophageal cancer after chemoradiation. Methods Patients with recurrent or metastatic esophageal cancer after chemoradiation were treated with bevacizumab and S-1. Bevacizumab was used by intravenous infusion, 7.5mg/kg body weight on day 1; S-1 was used by oral at 80mg/m·d on day 1-14, 21 days as a cycle of treatment and repeated until either pro- gressive disease or intolerable toxicity occurred. Chest CT were performed and RECIST 1.1 was used for response evaluation. Kaplan-Meier method was used for survival analysis. Side effects were recorded and analyzed. Results Totally 78 patients were enrolled in the study, including 67 squamous cell carcinoma and 11 adenocarcinoma histologically. The overall response (CR+PR) rate was 22.4% (17/76) and disease control (CR+PR+SD) rate was 61.8% (47/76) respectively. The median follow-up time was 20 months (range from 9 to 44 months). The median progression-free survival (PFS) was 4.9 months (95% CI 4.4-5.5) and the median overall survival (OS) was 8.1 months (95% CI 7.6-9.2). The median PFS and OS of patients with metastasis diseases were 6.2 months (95% CI 3.3 to 6.3) and 8.5 months (95% CI 5.8 to 11.2), where PFS was longer than that of patients with local regional recurrence (median 5.0 months, 95% CI 3.0 to 5.5, P=0.017) and OS was longer than that of patients with regional disease and metastasis (median 8.0 months, 95% CI 4.6 to 9.5, P=0.010). The common adverse effects were mild to moderate neutropenia (84.2%), grade I-II hand and foot syndrome (51.3%), grade I-II nausea (48.7%), mild epistaxis (30.1%) and mild vomiting (14.5%). Esophageal bleeding occurred in 7.9% of patients. One patient (1.3%) died from massive bleeding which was caused by esophageal perforation. Conclusion Bevacizumab combined with S-1 was effective and safe for esophageal cancer patients who had recurrent or metastatic diseases after chemoradiation.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Bevacizumab , Drug Combinations , Esophageal Neoplasms , Drug Therapy , Mortality , Pathology , Oxonic Acid , TegafurABSTRACT
Objective: To explore the clinical response on cardiac resynchronization therapy (CRT) in patients of chronic heart failure (CHF) with different QRS wave morphology. Methods: A total of 52 CHF patients received CRT in our hospital and the Seventh People's Hospital of Zhengzhou City from 2010-03 to 2013-07 were retrospectively studied. The patients were divided into 3 groups: True-complete left bundle branch block (t-CLBBB) group,n=20, Classic LBBB (CLBBB) group,n=15 and IVCD group,n=17. The general clinical condition, the indexes of echocardiography at 6 months of follow-up study including left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), NYHA classiifcation and 6-MWT were examined and compared among different groups. Results: In general clinical condition, the ratio of non-ischemic heart disease patients in t-CLBBB group was higher than those in CLBBB group and IVCD group, allP<0.05. By 6 months follow-up study, LVEDD in t-CLBBB group (62.6 ± 8.9) mm was lower than those in CLBBB group (70.0 ± 8.9) mm and IVCD group (72.8 ± 8.0) mm, LVEF was higher in t-CLBBB group (38.5 ± 6.2) % than those in CLBBB group (31.7 ± 6.7) % and IVCD group (30.1 ± 6.7) %. NYHA classiifcation in t-CLBBB group (2.00 ± 0.45) grade was lower than those in CLBBB group (2.73 ± 0.80) grade and IVCD group (3.12 ± 0.78) grade . 6-MWT in t-CLBBB group (302.0 ± 57.9) m was longer than those in CLBBB group (257.3 ± 59.0) m and IVCD group (220.2 ± 57.9) m, allP<0.05. Conclusion: CRT is an effective method for treating CHD patients, different QRS morphology may have different response, the patients with t-CLBBB would make better response.
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Objective: To evaluate the short-term effect of thrombus aspiration catheters combining tiroifban medication for myocardial tissue reperfusion recovery in patients with acute ST-elevation myocardial infarction (STEMI). Methods: A total of 105 STEMI patients with percutaneous coronary intervention (PCI) in our hospital from 2011-05 to 2013-05 were studied, there were 73 male and 32 female with the mean age of (58.39 ± 10.37) years. The patients were randomly divided into 2 groups, Group A, the patients received thrombus aspiration catheters with intravenous tiroifban, n=53 and Group B, the patients received tiroifban and PCI, n=52. The basic clinical features, myocardial tissue perfusion level, major adverse cardiovascular events (MACE) at post operative and in-hospital period were recorded, the cardiac function was examined by echocardiography at 6 months after PCI in both groups. Results: The basic clinical features were similar between 2 groups. The thrombolysis in myocardial infarction trial (TIMI) 3 lfow rate was higher in Group A than that in Group B (92.45% vs 55.77%), P=0.000. TIMI 2 and TIMI 0~1 lfow rates were lower in Group A than that in Group B (7.55%vs 26.92%), P=0.008 and (0%vs 17.31%), P=0.002. The adjusted TIMI frame was lower in Group A (27.26±5.50) vs (38.98±5.42), P0.05. Conclusion:Thrombus aspiration catheters combining tiroifban medication may obviously improve the myocardial tissue reperfusion and the short-term cardiac function in STEMI patients after PCI, it could reduce the incidence of no-relfow without increasing MACE.
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Sall4, a member of sall4 gene family, plays important roles in embryo development; organogenesis as well as pluripotency maintenance and re-establishment. There are two isoforms of Sall4, Sall4A and Sall4B. The sequence of porcine sall4 gene is still not reported. Because of its distinct role in maintaining the pluripotent state of stem cells, we cloned and sequenced porcine sall4 gene and assessed its expression in pig tissues and embryos. One 2 372 bp nucleotide sequence representing the full-length cDNA of pig sall4 was obtained by 5'and 3'RACE. Analyses of putative protein sequence showed a 70% to 80% identity with isoform Sall4B of human and mouse. Comparing with Sall4A, the identity reduced to 30% to 55% because of the loss of a zinc-finger domain-rich fragment. Assessment of sall4b expression in porcine tissues by Real-time PCR showed that it expressed most strongly in ovary and stronger in spleen, lung, heart and testis. For preimplantation embryos, the expression level was lower in 4-cell embryos compared with other stages. Immuno-fluorescence analysis of Sall4 on porcine preimplantation embryos indicated that it expressed in all the preimplantation embryos and located in nucleus, in blastocyst it preferentially limited in ICM cells. Expression pattern in early embryos suggest that pig sall4b is associated with pluripotency and might be a new and useful reprogramming factor for establishing pig induced pluripotent stem cell lines.