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Objective:To investigate the effect of exercise rehabilitation combined with psychotherapy and exercise rehabilitationn alone in elderly patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:A total of 150 elderly patients(≥65 years)admitted to our hospital with CHD after primary PCI were enrolled and randomly divided into the group A(conventional drug therapy), group B(conventional drug therapy+ exercise rehabilitation)and group C(conventional drug therapy + exercise rehabilitation+ psychotherapy), with 50 patients in each group.Patients in groups B and C were intervened at two weeks after PCI, once a week for 12 weeks.Changes of Hamilton anxiety scale(HAMD)scores, Hamilton depression scale(HAMA)score, 6 min walking test, left ventricular ejection fraction(LVEF)and metabolic equivalents(METs)were compared among the three groups.Results:Before treatment, the METs were significantly lower in the group B(3.58±0.14)compared with the groups A(3.69±0.18)and C(3.68±0.15), and were similar between groups A and C. After 12 weeks of treatment, compared with the indicators before treatment, the HAMA scores were similar in the group A(12.98±2.51 vs. 12.16±2.91, P>0.05), and were significantly decreased in groups B(12.90±2.12 vs.8.06±2.11, P<0.05)and C(13.03±2.52 vs.6.96±2.13, P<0.05); HAMD scores were all markedly decreased in all three groups(group A: 22.38±2.52 vs.20.87±2.12; group B: 22.58±2.57 vs.17.25±2.32; group C: 22.23±2.35 vs.13.39±2.25), and were decreased most in the group B, followed by groups A and B( P<0.05). Furthermore, the LVEF group A: (49.08±1.59)% vs.(52.15±1.91)%; group B: (48.99±2.11)% vs.(57.56±2.13)%; group C: (49.04±2.02)% vs.(59.92±1.93)%, 6 min walking distance test(m)(group A: 360.78±12.50 vs.370.16±12.41; group B: 359.21±10.54 vs.394.19±15.56; group C: 363.12±15.28 vs.413.29±18.15)and METs(group A: 3.69±0.18 vs.3.91±0.21; group B: 3.58±0.14 vs.4.89±0.09; group C: 3.68±0.15 vs.5.77±0.13)were significantly improved in all groups after the treatment.Among them, group C was improved most, followed by groups B and A(all P<0.05). Conclusions:Exercise rehabilitation combined with psychotherapy is of great significance to improve the physical condition of elderly patients with CHD after PCI, and it is better than the routine exercise rehabilitation alone.
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Objectives To explore the correlation between the heteroplasmy level of mt5178C＞A mutation in ND2 gene of mitochondria DNA and essential hypertension(EH)in middle-aged and elderly adults.Methods EH patients and normotensive controls were recruited consecutively from 2014-2015 from general population.Demographics,clinical characteristics and blood leukocytes were collected.The mt5178C＞A mutation heteroplasmy level was quantified by the rapid and sensitive realtime polymerase chain reaction(PCR) method for each participant.Results A total of 108 EH patients and 109 controls were recruited.The mt5178C＞A mutation heteroplasmy level was(42 ± 11％)in EH patients and (54± 13)％ in control subjects,with statistically significant difference between the two groups(P＜0.01).Using a two-step cluster analysis,the mt5178C＞A heteroplasmy level exceeding 44％ was associated with a decreased risk of EH(OR=0.18,95％,CI:0.10-0.31,P＜0.01).Correlation analysis showed mt5178C＞ A heteroplasmy level was significantly negatively correlated with both systolic blood pressure (r =-0.38,P＜ 0.001) and diastolic blood pressure (r =-0.49,P＜ 0.01)in 109 controls.Logistic regression analysis demonstrated that in single-factor analysis,mt5178C ＞ A heteroplasmy level (OR =0.82,95 ％ CI:0.77 0.87,P ＜ 0.01) was protective factor for EH,however,BMI(OR=1.30,95％CI:1.12-1.45,P＜0.01),total cholesterol(OR=2.13,95％CI:1.39-3.28,P=0.00),triglyceride(OR=7.62,95％CI:3.45-16.84,P＜0.01)and blood urea nitrogen(OR =1.35,95 ％ CI,P =0.03) were risk factors for EH.And a multiple logistic regression analysis showed that mt5178C＞ A heteroplasmy level (OR =0.83,95 ％ CI:0.78-0.89,P＜ 0.01) was independent protective factor for E H,however,only total cholesterol (OR =2.17,95 ％ CI:1.58-2.98,P =0.02) and low density lipoprotein cholesterol (OR =0.06,95％ CI:0.01-0.83,P =0.04) were independent risk factors for EH,and the P at critical 0.05 value.Conclusions Mitochondrial ND2 gene 5178C＞ A mutation heteroplasmy level exerts protective role against EH in middle-aged and elderly adults in Chinese population.
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Xingnaojing injection has been widely used in the treatment of cerebral vascular diseases, through the following mechanisms: improving the blood-brain barrier (BBB) permeability, anti-oxidant free radical damage, inhibition of excitatory amino acids (EAA) toxicity and calcium overload, inhibition of apoptosis, reducing cerebral edema and inhibition of autophagy. Thus, the paper summarized its progress.
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Objective To observe the effects of Fuzheng Huayu Capsule on the expressions of the main roles, Rock1 and Rock2, in RhoA/Rock signal transduction pathway in rats with myocardial infarction (MI);To explore the possible mechanism of Fuzheng Huayu Capsule to improve ventricular remodeling in myocardial fibrosis. Methods The MI model was induced by ligation of the left coronary artery. Rats with MI were randomly divided into the model group, Fuzheng Huayu group and Fasudil hydrochloride group. A sham-operation group threading without ligation was setting as a control group, with eight rats in each group. The rats were treated with corresponding medicine for 4 weeks from the second day after modeling. The expression of Rock1, Rock2 and its mRNA were detected by immunohistochemical and real-time PCR method. Results The protein expression of Rock1 and Rock2 in model group were significantly higher than those in the sham-operation group (P<0.05). The protein expression of Rock1 and Rock2 in the Fuzheng Huayu group and Fasudil hydrochloride group were lower than those in the model group. The mRNA expression of Rock2 was significantly higher in the model group than that in the sham-operation group (P<0.05). The mRNA expression of Rock1 in the Fasudil hydrochloride group was lower than that in the model group (P<0.05). The mRNA expression of Rock2 in the Fuzheng Huayu group and Fasudil hydrochloride group was lower than that in the model group (P<0.05). Conclusion Fuzheng Huayu Capsule can decrease the expression of Rock1, Rock2 and Rock2 in the marginal zone of myocardial infarction in rats with MI. The anti ventricular remodeling mechanism of Fuzheng Huayu Capsule maybe related with this.
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Objective To study the effects of Panax Notoginseng Saponins (PNS) on the damaged expression of ZO-1 of brain microvascular endothelial cells caused by Aβ42.MethodsBrain microvascular endothelial cells were divided into normal control group, model group, PNS low-, medium- and high concentration groups. They were incubated for 24h in 5% CO2 incubator at 37℃ . Then cell vitality was detected by MTT colorimetric method and ZO-1 protein expression was tested by Western blot.Results Stimulation of Aβ42 reduced the activity of microvascular endothelial cells (P<0.01) and suppressed the expression of ZO-1 protein (P<0.01). Compared with the model group, the activity of microvascular endothelial cells of PNS groups, especially the high and medium dose groups (P<0.05), and increased the ZO-1 protein expression. Conclusion PNS can partly recover the barrier function of blood brain barrier through inhibiting the decrease of the activity of microvascular endothelial cells caused by Aβ42.
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Objective To observe the influence of Qizhi Yifei containing serum on the expression of MMP-9 and TIMP-1 mRNA in lung fibroblasts, and explore its mechanism. Methods Trypsin digestion method was used to extract fibroblasts from lung tissue in rats. All fibroblasts were cultured and trained to the fourth generation. Then they were randomly divided into control group, model group and drug serum group. The model group and drug serum group were firstly treated by DMEM with 0.002 5 μg/mL TGF-β1. The control group was treated by DMEM only. The control group and model group were then treated by DMEM with blank drug serum in concentration of 5%, and the drug serum group was treated by DEME with Qiahi Yifei containing serum in same concentration. After 48 and 72 hours, RT-PCR was performed to test the expression of MMP-9 mRNA and TIMP-1 mRNA of each group. Results After 48 hours, MMP-9 and TIMP-1 mRNA were significantly increased in model group and drug serum group compared with control group. There was no difference between model group and drug serum group. After 72 hours, MMP-9 mRNA was up-regulated in model group and was decreased in drug serum group compared with control group. There was no significant difference among the three groups on the expression of TIMP-1 mRNA. Conclusion Qizhi Yifei containing serum can decrease the up-regulated expression of MMP-9 mRNA in lung fibroblasts stimulated by TGF-β1.
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Objective To investigate the effects of treatment of proximal humeral fracture in the elderly with anatomical plate internal fixation.Methods Twenty-seven cases of proximal humeral fractures received operative treatment with anatomical plate.According to Neer classification,there were 18 patients with three-part fractures of the bone,there were 9 patients with four-part fractures of the bone.Results Twenty-seven patients were followed up for 6-24 months.According to the evaluation of Herscovici scales,the result were excellent in 17 cases,and good in 8,92.6％ (25/27) of all reductions were excellent or good.The excellent and good rate of Constant-Murley score was 88.9％(24/27 ).Conclusion It is an ideal way to treat the displaced proximal humeral fracture with anatomical plate,which can provide rigid fixation,it allows early functional treating.
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To establish an ischemia-reperfusion injury model of rat cerebral microvascular endothelial cells (MVECs) in vitro, and to explore the relationship between nuclear factor-kappa B (NF-kappaB) and the protective effects of Qingkailing effective components (hyocholic acid, taurocholic acid, baicalin, jasminoidin, Pinctada martensii) on MVECs.
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Objective: To determine the appropriate time of early administration of dopamine (DA) before nitroglycerin (GTN) for establishing rat model with vasomotor abnormalities. Methods: Rats were divided into 5 groups: normal group, DA Group and other 3 groups in accordance with DA at different time points (10, 30, 45 min) plus GTN .Common carotid artery (CCA) blood flow velocity was dynamically measured with pulsed Doppler flow probe to evaluate the influence of DA, GTN on blood flow velocity rate(BFVR). Results:The blood flow velocity rate induced by DA of All medication administration was different from the normal group within 10 minutes(P 0.05). The BFVR of 10min interval group had differences with the DA group at 45min, 50min, 55min, 60min, 65min and 70min(P 0.05). Conclusion: Subcutaneous injection of DA, 45m in after injection of GTN can induce vasomotor abnormalities in rat with phase characters. The model may be useful for vasoactive screening of anti-migraine drugs.
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OBJECTIVE: To study the characteristics of coronary arteriography and traditional Chinese medicine syndrome of 1,069 patients with coronary artery disease (CAD). METHODS: One thousand and sixty-nine patients with CAD were investigated by epidemiological method. The patients were divided into young patients (n=82, aged 45 years or younger) and middle-aged and old patients (n=987, older than 45 years). The characteristics of the two groups were analyzed, including clinical data, coronary arteriography and traditional Chinese medicine syndrome. RESULTS: Compared with middle-aged and old patients, proportion of male, triglyceride, total cholesterol, smoking patients, acute myocardial infarction and family history of CAD in young patients were significantly higher (P<0.05). Patients accompanying with hypertension and diabetes in middle-aged and old patients were more than those in young patients (P<0.05). Occurrence rates of morbidity of left circumflex coronary artery, left main coronary artery and multi-branch were higher in middle-aged and old patients (P<0.05), however, the occurrence rates of morbidity of single and double-branch were higher in young patients (P<0.05). The occurrence rates of syndromes of qi stagnation and phlegm turbidity in young patients were higher than those in middle-aged and old patients (P<0.05). But the proportions of cold coagulation, yin deficiency, yang deficiency and kidney deficiency in middle-aged and old patients were obviously higher (P<0.05). CONCLUSION: The traditional Chinese medicine syndrome and pathological changes of CAD in young patients are different from those in old patients.
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BACKGROUND: As a multifunctional cell growth factor, vascular endothelial cell growth factor (VEGF) plays various biological roles under some physiologic and pathologic conditions. OBJECTIVE: To summarize molecular structure and biological effects of VEGF. RETRIEVAL STRATEGY: A computer-based online search of PubMed database was undertaken to identify related English articles dated from January 1989 to December 2007 with keywords"VEGF, molecular structure, biological effect, diabetes, diabetic macroangiopathy". 934 articles were firstly collected, including 38 about molecular structure and biological effects of VEGF, and 896 about diabetes and diabetic macroangiopathy. After the first trial, only articles about ①molecular structure and biological characteristics of VEGF, and ②diabetes and diabetes complicated by coronary heart disease or limb vascular disease were selected. 897 repetitive, outdated and unrelated articles were excluded. Finally, 35 articles were included. LITERATURE EVALUATION: Of 35 articles, there were 17 ones about animal trials, and in vivo, in vitro and cytological studies, 8 of review articles and comments, and 10 clinical studies. All articles were individual evaluation. DATA SYNTHESIS: Human VEGF genes consist of 8 exons and 7 introns, and are located in 6p21.3 region. VEGF encodes several isoforms with different biological characteristics. Two VEGF receptors display different biological effects. VEGF and its receptors are regulated by various factors. The receptors interact with ligand and play biological effect. In diabetic patients complicated by coronary heart disease, myocardial VEGF mRNA and protein expressions are increased but the expressions of two kinds of receptors are decreased compared with non-diabetic patients. Compared to patients with non-severe lower limb ischemia, VEGF production is more in diabetic patients complicated by severe lower limb ischemia. It is demonstrated that VEGF can restore injured neovascularization. However, VEGF therapy for diabetes still needs further study. CONCLUSION: VEGF can restore impaired neovascularization. VEGF expression shows diversity under diabetic macroangiopathy. Further study should be made focusing on the prevention value of VEGF to diabetic macroangiopathy.
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Objective To study whether myeloperoxidase (MPO) can provide prognostic information in patients with acute coronary syndromes (ACS). Methods The study population consisted of 274 consecutive patients with ACS. All patients underwent coronary angiography which showed significant coronary artery disease and blood samples were collected at admission. Follow-ups were scheduled at 1, 3, and 6 months.The end point included cardiac death, acute myocardial infarction (MI), percutaneous or surgical revascularization. Results Patients with elevated MPO serum levels (MPO ≥ 72.2 AUU/L) were more likely to have diabetics and had a history of coronary events. Kaplan-Meier event rate curves with accumulative incidence of end point at 6-month follow-up in the MPO ≥ 72.2 AUU/L group was significantly higher than in MPO＜72.2 AUU/L group. Conclusions MPO may be a powerful predictor of adverse outcome in patients with ACS.
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Objective To study characters of TCM syndrome and pathological changes of coronary artery in patients of coronary artery disease combined with diabetes(CAD-DIA).Method By epidemiological way,patients with CAD-DIA were collected and compared with CAD without DIA,including clinical characters,characters of pathological changes of coronary artery,characters of syndrome.Result Compared with CAD without DIA group,history of hypertension and blood vessel rebuilt in CAD-DIA group had significant difference(P
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Objective To research the effects and mechanism of gastrodin against migraine and on single amine neurotransmitter. Methods The model of nitroglycerin migraine was made after rat treated by gastrodin for 5 days, the time points of ear rubescence and the times of scratch head were observed to take as evaluation index of pharmacodynamic action, the concentration of 5-HT, NE and DA were measured in the brain with HPLC. Results Gastrodin could obviously prevent the attack of migraine and increase the concentration of 5-HT, DA and NE in the brain. Conclusions The effects of gastrodin against migraine is related with the concentration of 5-HT, DA and NE in the brain, gastrodin can regulate neurosystematic functions and enhance the secretion and metabolism of neurotransmitters.
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Objective: To observe the expression of cell adhesion molecules ICAM-1 and VCAM-1of cultured rat brain microvascular endothelial cells(MVEC),expecting to explore the mechanisms of new QingKaiLing injection protecting brain from injury of inflammatory cascade in cerebral ischemia diseases.Methods: Rat cerebral MVEC were extracted by separating microvessel sections and collagenase enzymatic digesting,an in vitro ischemia reperfusion model was established(Kreb,95%N2+5%CO2),the protein and mRNA expression of ICAM-1 and VCAM-1 were detected by using immunocytochemical stain and RT-PCR method.Results:The expression of adhesion molecules of model group were significantly higher than those of noral group(P
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The paper briefly summarizes the chief manifestations of moral degradation on the part of medical personnel and then makes a preliminary analysis of the causes. On the basis of this, it discusses at some length some major measures to be adopted in reconstructing medical personnels morality. These include: ① carrying forward traditional Chinese medical ethics and using medical codes of ethics from Western countries for reference; ②strengthening the education and training of medical personnel in ethics; ③perfecting the codes of ethics for medical personnel; ④speeding up reform in the personnel and distribution systems; ⑤reinforcing supervision and setting up corresponding evaluation mechanisms; ⑥selecting personnel combining ability with political integrity to engage in the medical profession; ⑦strengthening the construction of social morals.