The impact of image quality on the diagnostic performance of CT-derived fractional flow reserve / 中华放射学杂志

Objective:To explore the impact of coronary CT angiography (CCTA) image quality and related factors on the diagnostic performance of CT-derived fractional flow reserve (CT-FFR).Methods:Based on the CT-FFR CHINA trial, the prospective multicenter trial enrolled patients with suspected coronary artery disease who underwent CCTA, CT-FFR and FFR measurement. The subjective and objective assessments of CCTA image were performed on a per-vessel level. The objective assessments included the enhancement degree of coronary artery, the signal-to-noise ratio (SNR) of the aortic root. We used χ 2 test and DeLong test to compare the diagnostic performance of CT-FFR with FFR as the reference standard in different subjective groups (non-artifact vs. artifact), enhancement degree of coronary artery groups (≤400 vs. 401-500 vs.>500 HU), SNR of the aortic root groups (≤16.9 vs.>16.9), body mass index (BMI) groups (<25 kg/m 2 vs.≥25 kg/m 2) and heart rate groups (<75 bpm vs.≥75 bpm). FFR and CT-FFR values≤0.80 was identified as myocardial ischemia. Results:The study enrolled 317 patients with 366 vessels. All target vessels in CCTA images were successfully analyzed by CT-FFR. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of the non-artifact group were 90.45%, 86.75%, 93.10%, 90.00%, 90.76% and 0.928, respectively, and those of the artifact group were 83.23%, 87.21%, 79.01%, 81.52%, 85.33% and 0.869, respectively. The differences in accuracy and specificity were statistically significant (χ 2=4.23, P=0.040; χ 2=8.55, P=0.003). The diagnostic efficacy of CT-FFR had no statistically significant differences among different objective groups (all P>0.05). Conclusions:The artifact of CCTA image has an effect on CT-FFR in the diagnosis of myocardial ischemia. The degree of vascular enhancement, SNR, BMI, and heart rate have no significant effect on the diagnostic performance of CT-FFR.

Incidence, mortality and trends of drowning among children aged 0-14 years in China, 1990-2019 / 中国学校卫生

Objective@#To understand the incidence and mortality of drowning and secular trend among children aged 0-14 from 1990 to 2019 in China, so as to provide reference for drowning intervention among children in China.@*Methods@#Based on data of drowning incidence and death in 0-14 years old children in China in 1990-2019 years Global Burden of Disease (GBD 2019) database, the standardized rate was calculated by the world standard population, and the trend of incidence rate and mortality rate was fitted by Joinpoint regression model respectively.@*Results@#From 1990 to 2019, the overall incidence of drowning among children aged 0-14 years in China decreased from 37.17/100 000 to 12.54/100 000, a relative decrease of 66.26%; the standardized incidence rate decreased from 21.78/100 000 to 14.98/100 000, a relative decrease of 31.22%. The incidence rate and standardized incidence rate of drowning in children showed an increasing after decreasing trend, with decreasing mortality and standardized mortality rate. Joinpoint regression showed that the incidence rate of standardized AAPC for child drowning was -1.3, -2.5 for males and 0 for females. The overall standardized mortality rate of drowning was -3.9, male was -3.6, female was about -4.5 , the trend changes were statistically significant ( P <0.05). The incidence rate and mortality rate of male were higher than that of female, and there was significant difference between male and female groups ( P <0.05).@*Conclusion@#Significant progress has been made in child drowning prevention and control, with substantial decreasing in the incidence rate of child drowning. However, considering recent slight increase in drowning incidence, effective measures should be developmed including risk factors, vulnerable population to further control the incidence and mortality of child drowning.

Pneumonia mortality in children aged 0-14 years in China during 2005 to 2019 / 中国学校卫生

Objective@#To understand pneumonia mortality in children aged 0-14 years in China in recent 15 years, and to provide reference for child pneumonia prevention and treatment.@*Methods@#Based on the death data from China Statistical Yearbook 2005-2019, pneumonia mortality in urban and rural children aged 0-14 was extracted and the standardized mortality was calculated, and the trend of mortality was fitted by Joinpoint regression model.@*Results@#The crude mortality rate of child pneumonia in urban and rural areas showed an increasing trend, while the standardized mortality rate showed a fluctuating downward trend. Joinpoint regression showed that the mortality rate of pneumonia in urban and rural children showed a monotonous downward trend, and there was no turning point. The overall APC of pneumonia mortality of urban children was -3.4, that of boys and girls were both -3.5. Trend for annual changes in urban areas were found significant among total sample and boys (both P <0.05). The overall APC of pneumonia mortality in rural children was -7.8, that of boys and girls were -7.1 and -7.8, respectively. Trend for annual changes in rural areas were found significant among total sample and boys(both P <0.05). There was no significant differences in the trend of mortality between urban and rural groups.@*Conclusion@#During 2005 to 2019, child pneumonia mortality in urban and rural areas in China shows a downward trend, which is relatively balanced in urban and rural areas. Further strengthened pediatric pneumonia treatment and management are expected to reduce the pneumonia mortality.

The value of combined analysis of plaque characteristics and stenosis based on coronary CT angiography in improving CT diagnostic performance for lesion-specific myocardial ischemia / 中华放射学杂志

Objective:To probe the diagnostic performance of the combined evaluation of stenosis and plaque characteristics based on coronary computed tomography angiography (CCTA) in identification of myocardial ischemic lesions, using the invasive coronary angiography (ICA)-based fractional flow reserve (FFR) as the gold standard.Methods:From November 2018 to March 2020, the patients with suspected or known coronary artery disease and scheduled for ICA at 5 clinical trials centers were enrolled in this study. All the patients underwent CCTA, ICA and FFR in turn in one week. The luminal stenosis and plaque characteristics were measured and assessed including plaque burden, volume ratios of calcification and non-calcification, lesion length and CT vulnerable features. All culprit vessels were divided into FFR≤0.8 and FFR>0.8 groups, and the parameters of plaque characteristics were compared. The correlation of ischemic lesions with CCTA stenosis and plaque characteristics was analyzed by the logistic regression analysis. The ROC curve was used to evaluate the sensitivity and specificity of CCTA stenosis rate and plaque characteristics, meanwhile the area under curve (AUC) of each parameter was compared by Delong test.Results:Three hundred and sixty-six culprit vessels in 317 patients were analyzed in this study (169 vessels in ischemia group and 197 in nonischemia group). The plaque burden [34.3% (30.3%, 38.8%) vs. 32.4% (28.5%, 37.9%); Z=-2.622, P=0.009], proportion of CT vulnerable features [26.9% (45/169) vs.11.7% (23/197); χ 2=15.311, P<0.001] and lesion length [22.1 (14.4, 35.0) mm vs. 17.6 (11.0, 26.0) mm; Z=-4.388, P<0.001] in FFR≤0.8 group were higher than those in FFR>0.8 group. The results of logistic regression analysis revealed that CCTA stenosis, lesion length, and CT vulnerable features were significant predictors for myocardial ischemia (OR values: 3.794, 2.461, 1.027; P<0.001, P=0.002, P=0.002). The diagnostic performance of CCTA ≥50% stenosis alone in identification of ischemic lesions was low (AUC=0.625). When it combined high-risk plaque characteristics and lesion length, the AUC was improved to 0.714 with a statistical significance. Conclusions:CCTA stenosis, lesion length, and CT vulnerable features are major predictors in identification of myocardial ischemic lesions, and the combination will significantly improve the diagnostic performance of CCTA ≥50% stenosis.

Explosion on the core outcome set (COS) in the clinical evaluation in the TCM clinical studies / 国际中医中药杂志

Recently, more systemic reviews and randomized controlled trials were published to prove the effectiveness of TCM,and some of those were included by Cochrane Library. But due to the potential selective reporting bias and publication bias, few trials were included in the meta analysis, which failed to prove the evidence for the TCM treatment. The difference of reported outcomes comes to the big problem of the comparison between interventions. Such problem of difference was gradually brought to the attention. Therefore, Core Outcome Sets(COS), which stands for that the minimum standardized outcome set that must be repoted, may be the solusion to that problem. In this research we've introduced the formation and development of core outcome sets in TCM.

Effect analysis of Naokang Ⅱ combined with aniracetam for patients with vascular cognitive impairment of none dementia after cerebral infarction / 中国脑血管病杂志

Objective To observe the clinical efficacy of Naokang Ⅱ in patients with vascular cognitive impairment of none dementia after cerebral infarction.Methods A total of 100 consecutive patients with vascular cognitive impairment of none dementia after cerebral infarction diagnosed at the Neurology Clinic,Beijing Xuanwu Hospital,Capital Medical University from October 2012 to February 2014 were enrolled prospectively.Six of them did not complete a return visit because of not returning to the hospital in time,2 withdrew automatically,and finally,92 patients were enrolled in the study.According to the random number table method,they were divided into either an observation group (n=48) or a control group (n=44).The control group was treated with aniracetam,while the observation group was treated with aniracetam plus Naokang Ⅱ (Radix Polygoni Multiflori Preparata,Radix Rehmanniae Preparata,Radix Notoginseng,Acorus Calamus L.and Radix Polygalae) for 12 weeks.The differences of traditional Chinese medicine syndrome integral before and after treatment in both groups were compared.The effective rate and cognitive function improvement rate of traditional Chinese medicine syndromes before and after treatment in both groups were compared.Results The scores of traditional Chinese medicine syndrome integral before and after treatment in patients of the observation group were 28±5 and 15±4,respectively,those of the control group before and after treatment were 26±5 and 18±5,respectively.There were significant differences before and after treatment (the t values were 15.02 and 14.73,respectively,all P0.05).The total effective rate in the observation group (75.0% [36/48]) was higher than that in the control group (45.5% [20/44]).There was significant difference between two groups (χ2=7.023,P=0.008).The improvement rates of memory,orientation,judgment,and problem solving skills in the observation group (29.2% [14/48],27.1% [13/48],and 31.2% [15/48]) were higher than those in the control group (11.4% [5/44],9.1% [4/44],and 13.6% [6/44]).There were significant differences between the two groups (all P<0.05).No adverse reactions were observed in the two groups during the observation period.Conclusion Naokang Ⅱ combined with aniracetam for patients with vascular cognitive impairment of none dementia after cerebral infarction had a synergistic effect.

Smac playing vital role in enhancing the sensitivity of cyclophosphamide and doxorubicin in breast cancer MCF-7 cell line / 国际肿瘤学杂志

Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) ％,(53.35 ± 6.29) ％ and (34.19 ± 5.43) ％,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.

Effect of paired using tangerine peel and ternate pinellia tuber on the expressions of phosphatidylinositol 3-kinase and phosphorylation of protein kinase B/Akt in rabbits with carotid atherosclerosis / 中国脑血管病杂志

Objective To investigate paired using tangerine peel and ternate pinellia tuber to regulate phosphatidylinositol 3-kinase (PI3K)and protein kinase B (p-Akt)signal pathways in rabbits in order to treat carotid atherosclerosis. Methods According to a random number table,20 rabbits were divided into 4 groups:a control,a model,a tangerine peel and ternate pinellia tuber,and a tangerine peel and ternate pinellia tuber+LY294002 (a PI3K/Akt signal pathway specific inhibitor)group (n=5 in each group). The rabbits in the control group were fed with basal diet,while those in other groups were given high-cholesterol diet and air drying of carotid artery intima were performed. After procedure,the rabbits in the tangerine peel and ternate pinellia tuber group and the tangerine peel and ternate pinellia tuber +LY294002 group were treated with the decoction of traditional Chinese medicine. Carotid atherosclerosis was observed via HE staining;the effect of tangerine peel and ternate pinellia tuber on the expressions of PI3K and p-Akt in rabbits with carotid atherosclerosis was observed by western blot. Results (1)the expressions of PI3K and p-Akt in carotid in the model group were 107. 0 ± 2. 6 and 113. 0 ± 1. 7,and those in the tangerine peel and ternate pinellia tuber group were 174. 7 ± 14. 5 and 186. 3 ± 18. 3. There were significant differences between the two groups (P <0. 01). After using PI3K/Akt signal pathway specific inhibitor LY294002,the expressions of PI3K and p-Akt (117. 0 ± 4. 0,127. 3 ± 4. 7)were lower than the tangerine peel and ternate pinellia tuber group. There were significant differences between the two groups (P <0. 01). (2)The tangerine peel and ternate pinellia tuber group had mild intimal hyperplasia and foam cell formation under the artery intima,however,they were better than those of the model group and the tangerine peel and ternate pinellia tuber+LY294002 group. Conclusion Tangerine peel and ternate pinellia tuber may play a role in the treatment of carotid atherosclerosis by upregulating the expressions of PI3K and p-Akt in vascular endothelial cells.

Antibiotic resistance patterns of uropathogens in 141 children hospitalized with complicated urinary tract infection / 中国医师进修杂志

Objective To investigate the distribution and antibiotic resistance patterns of uropathogens in children with complicated urinary tract infection to guide the empirical antimicrobial treatment.Methods Retrospective analysis of isolated bacteria from 141 children hospitalized with complicated urinary tract infection was performed from January 2011 to January 2013.Results Gram-negative bacillus were the main pathogens [56.6％(81/143)],and Escherichia coli was the leading cause (41.3％,59/143).Gram-positive bacillus accounted for 38.5％ (55/143),including Enterococcus faecium (17.5％,25/143) and Enterococcus faecalis (14.7％,21/143).Fungi caused 4.9％ (7/143) of the infections.The resistance of Escherichia coli to amoxicillin was the highest [92.0％ (23/25)] and resistance to imipenem (4.3％,2/47),amikacin (6.8％,4/59) and nitrofurantoin (6.8％,4/59) was lower.It was observed resistance of Enterococcus faecium to linezolid,quinupristin,vancomycin and nitrofurantoin was significantly lower than other common antibiotics.The resistance of Enterococcus faecalis to quinupristin,tetracycline,erythromycin,rifampicin was significantly higher than other common antibiotics.Concluusions Escherichia coli,Enterococcus faecium and Enterococcus faecalis are the common uropathogens.These pathogens have a high antibiotic resistance to many common antibiotics.The selection of empirical treatment of children with complicated urinary tract infection should be adjusted by antimicrobial susceptibility test.

Correlation Between Gastrointestinal System and Brain in Acute Cerebrovascular Disease / 中国中医药信息杂志

Cerebrovascular disease, also known as a cerebral vascular accident, is named “stroke” in traditional Chinese medicine, there is close correlation between acute cerebrovascular disease and gastrointestinal system. In this paper, we discussed 3 parts about the relationship between the gastrointestinal system and brain. First, in the traditional Chinese medicine theory, there is close relationship between gastrointestinal system and brain from the physiological function and Meridian theory. Secondly, clinical practice indicated that heat phlegm fu-organ syndrome is the main syndrome of acute cerebrovascular disease. The main symptom of this syndrome is the constipation, which is an important part of the disease transition. Furthermore, in acute cerebrovascular disease, the brain-gut peptide esp. CCK and surface colonic electrical physiological changes are the material and electrophysiological basic on the relationship between gastrointestinal system and brain.

Effects of NaokangⅡon cognitive function and neurogenesis in rats with cerebral ischemia WANG / 中国脑血管病杂志

Objective ToobservetheeffectsofNaokangⅡ,atraditionalChinesemedicineon spatial learning and memory abilities and hippocampal neurogenesis in rats with cerebral ischemia. Methods Atotalof54SDratsweredividedinto6groupsaccordingtothedigitalrandommethod:a control,a sham operation,a model,a low-dose,a medium-dose,and a high-dose NaokangⅡ group (the low-,medium-,and high-dose groups were 5,10,and 20 times of adults (n=9 in each group). A rat model was induced by ligate the bilateral common carotid arteries permanently. The bilateral common carotid arteries were only isolated but not ligated in rats of the sham operation group. The rats in the control group were not given any treatment. After modeling,the rats in the treatment groups were treated with NaokangⅡ. The rats in the control,sham operation,and model groups were given equal volume of isotonic saline (2 ml). Morris water maze test and space search experiment were used to evaluate the learning and memory abilities in rats 9 weeks after modeling. Immunofluorescence staining and immunohistochemical methods were used to observe proliferation and differentiation of neural stem cells (NSCs). Western blot was used to detect the expression of autophagy related protein Beclin-1 and LC-3Ⅱ. Results (1 )The escape latencies of the model group from 1 to 5 days were 100 ± 13,98 ± 13,82 ± 14,72 ± 15,and 46 ± 7 s,respectively. They were significantly longer than those of the sham operation group and the control group (all P<0. 05). The search distances were 1239 ± 127,1011 ± 122,959 ± 123,553 ± 66,and 407 ± 29 cm,respectively. They were significantly increased as compared with those of the sham operation group and control group (all P<0. 01). Both the escape latencies and search distances of the rats in the Naokang Ⅱ low-,medium-,and high-dose groups were significantly shorter than those of the model group (P<0. 05). The escape latencies on the fifth day were 20 ± 6,19 ± 8,and 15 ± 6 s,respectively,and the search distances were 234 ± 38, 297 ± 23,and 99 ± 22 cm,respectively. Nine weeks after modeling,the quadrant search time on the original platform in the rats of the model group was 30 ± 9 s,it was significantly shorter than that of the sham operation group (P<0. 01). The quadrant search time on the original platform of the Naokang Ⅱ low-, medium-,and high-dose groups were 34 ± 6,38 ± 8,and 40 ± 10 s,respectively. They were significantly longer than those of the model group (P <0. 01). (2)Nine weeks after modeling,the results of immunofluorescence and immunohistochemistry showed that the number of BrdU-positive cells and the Nestin positive cells in hippocampal dentate gyrus of the model group were higher than those of the control group and the sham operation group (P<0. 05). The number of BrdU-positive cells and Nestin positive cells of Naokang Ⅱ each dose group were significantly higher than those of the model group (P<0. 05). The expression of LC-3Ⅱand Beclin-1 in the model group was significantly higher than those in the control and sham operation groups (P<0. 01). The expression of LC-3Ⅱ in the medium- and high-dose groups was 143 ± 9 and 129 ± 9 respectively,and the expression of Beclin-1 was 139 ± 10 and 124 ± 7 respectively, andtheyweresignificantlylowerthanthemodelgroup(P<0.01).Conclusion NaokangⅡcanimprove the cognitive function in rats with cerebral ischemia,promote neurogenesis in the dentate gyrus,and inhibit autophagic cell death.

Effect of Tenuigenin on Differentiation of Neural Stem Cells from Hippocampus of Newborn Rats / 中国康复理论与实践

Objective To observe the effect of tenuigenin on differentiation of hippocampal neural stem cells (NSCs). Methods NSCs isolated from newborn (within 24 h) Wistar rats hippocampus were cultivated in vitro with serum free and clone culturing technology. Tenui-genin of different doses (0, 1, 2, 4μg/ml) were added in the medium, and the proliferation and differentiation of the cells were identified with immunofluorescence staining. Results The neural spheres obtained from the hippocampi of newborn rats were positive for Nestin ex-pression, with the potential for further cloning and differentiation into neurons or glial cells. The incidence of neuron specific enolase and glial fibrillary acidic protein positive cells increased in all the tenuigenin groups compared to the control (P<0.05), while the Nestin positive cells decreased (P<0.05). Conclusion Tenuigenin may promote the differentiation of neural stem cell into nerve cell.

An Application Study of Quality Control Circle in Clinical Probation of the Course of Traditional Chinese Medicine in Western Medicine Colleges and Universities / 中国中医药信息杂志

Objective To study the application effect of quality management tool“quality control circle” in clinical probation of the course of traditional Chinese medicine (TCM) in western medicine colleges and universities. Methods The students of grade 2009 and grade 2010 majoring in clinical specialty in Capital Medical University were classified into the control group and the test group. The control group received traditional teaching methods and the test group received quality control circle activities in clinical probation of TCM. The statistical analysis about comprehensive quality and academic achievement of two groups were made after the clinical probation period. Results Both the theoretical and practical achievements in the test group were better than those in the control group (P<0.05). The students of the test group showed greater improvements in the learning enthusiasm, joy, confidence, communication and coordination, team cohesion and the ability of problem-solving than the control group (P<0.05). Conclusion The application of quality management tool “quality control circle” in clinical probation of TCM teaching can effectively improve students’ academic performance and learning ability, as well as their comprehensive quality.

Roles of high mobility group box-1 protein and myeloperoxidase deficiency in evaluating coronary stenosis and predicting vulnerability of atherosclerotic plaques / 中华老年医学杂志

Objective To elucidate the roles of high mobility group box-1 protein (HMGB1) and myeloperoxidase (MPO) deficiency in evaluating coronary stenosis and the vulnerability of atherosclerotic plaques in patients with coronary heart disease.Methods Totally 50 patients with acute myocardial infarction (AMI),50 patients with unstable angina pectoris (UAP),50 patients with stable angina pectoris (SAP) and 30 patients without coronary heart disease underwent the study.Coronary arteriography (CAG) and intravascular ultrasound (IVUS) were performed to analyze coronary stenosis and plaque characteristics and then gensini score was calculated.Concentrations of HMGB1,MPO and hypersensitive C reactive protein (hsC-RP) were measured by means of enzymelinked-immonosorbent assay (ELISA).Results Concentrations of HMGB1,MPO and hsC-RP were significantly higher in AMI and UAP patients than in SAP paticnts (all P＜ 0.01).IVUS showed that 51.3 ％ (20/39) AMI patients,46.7％ (43/92) UAP patients had soft lipid-rich plaqucs,while 52.9％(46/87) SAP patients had fibrous plaques,only 17.2％(15/87) had soft plaques.AMI and UAP patients had larger plaque burden and vascular remodeling index than did the SAP patients (both P＜0.01).In AMI group,HMGB1 and MPO levels were correlated well with gensini score and remodeling index measured by IVUS,respectively(r=0.54,0.48,allP＜0.05),while in UAP group,HMGB1 and MPO levels were correlated well with gensini score and plaque burden measured by IVUS,respectively(r=0.43,0.56,all P＜0.05).Conclusions HMGB1 and MPO are positively correlated with coronary stenosis,which can be used to predict the severity of ACS.HMGB1 and MPO are associated closely with plaque vulnerability and rupture.

Effect of Tangerine Peel and Pinellia Ternata on Expression of VCAM-1 and MMP-9 in Carotid Atherosclerosis Rabbits / 中国中医药信息杂志

Objective To research the influence of tangerine peel and pinellia ternata on the expression of VCAM-1 and MMP-9 in carotid atherosclerosis rabbits, and explore its mechanism. Methods Totally 25 male rabbits were divided into control group, model group and Chinese medicine group. Control group was treated with basic diet, model group and Chinese medicine group were treated with both high-fat diet and carotid artery intima-air drying technique. Chinese medicine decoction group was treated with tangerine peel and pinellia ternata decoction, as 10, 8, 6 mL/kg, for 4 weeks. Then the right carotid was cut and fixed, and pathological changes were observed by HE staining. The expressions of VCAM-1 and MMP-9 were observed by immunol histochemistry SABC method. Results Compared with control group, the expression of VCAM-1 and MMP-9 in model group was significantly increased (P<0.01). And compared with model group, tangerine peel and pinellia ternata decoction significantly restrained VCAM-1 and MMP-9 expression (P<0.05). Conclusion Tangerine peel and pinellia ternata could restrained VCAM-1 and MMP-9 expression in carotid atherosclerosis rabbits, suggesting that its mechanism may be related with inhibiting vascular inflammatory reaction and stabilizing plaques.

Intravascular ultrasound features of intermediate coronary arterial lesions and the relationship of fractalkine,CD36 and LP-PLA2 with coronary artery stenosis / 中华超声影像学杂志

ObjectiveTo elucidate the clinical application value of intravascular ultrasound(IVUS) in assessing intermediate lesions and the relationship between serum levels of fractalkine,CD36 and LP-PLA2and severity of coronary artery atherosclerosis.MethodsOne hundred and twenty patients with unstable angina underwent coronary angiography.Then the patients were divided into two groups:severe lesion group (lumen diameter stenosis greater than 70％,including 40 patients),and the intermediate lesion group lumen diameter stenosis(50％～70％,80 patients).IVUS were performed in all patients to analysis the coronary lesions.Concentrations of CD36,fractalkine and LP-PLA2 were measured by means of ELISA.Results IVUS found that 74％ intermediate lesion patients had soft lipid plaques,while 48％ severe lesion patients had lipid plaques ( P＜0.01 ).Patients with severe lesion had larger plaque burden and vascular remodeling index than those of patients with intermediate lesions(P＜0.05～0.01).There were 59 patients(74％) in the intermediate lesion group underwent PCI.IVUS also found the PCI patients had larger plaque burden and vascular remodeling index.Concentration of CD36 was significantly higher in severe lesion group than that of intermediate lesion group (P＜0.05).ConclusionsIVUS could further clarify the characteristics of the intermediate and severe lesions,and provide guidance for PCI treatment.Plasma CD36 level could be used to predict pathological severity of coronary atherosclerosis.

Oral rapamycin prevents artery restenosis after stent implantation by inhibiting mammalian target of rapamycin ( mTOR ) / 中华超声影像学杂志

Objective To identify the mechanisms of oral administered rapamycin on the prevention of restenosis after stent implantation with intravascular ultrasound (IVUS) and pathology.Methods Twenty-four New Zealand white rabbits underwent balloon-induced abdominal aortic wall injury and were given a diet of 1 ％ cholesterol for 8 weeks.Then,the rabbits were divided into three groups:the bare metal stent group(BMS group),the bare metal stent with oral rapamycin group(BMS + RAPA group) and the rapamycin eluting stent group(DES group).Rabbits in the RAPA and BMS + RAPA groups received a daily oral dose of rapamycin(0.5 mg/kg),whereas rabbits in the DES group received no drugs.All the rabbits were euthanized after the 4-week intervention.Serum lipids were measured.IVUS and pathologic studies were performed.The minimal luminal diameter (MLD),external elastic membrane (EEM) area,lumen area (LA),and plaque area(PA),plaque burden(PB) were measured.Mammalian target of rapamycin(mTOR) expression level was examined by immunohistochemistry.Results After the 4-week intervention,there was no significant difference of serum lipid levels among the three groups.IVUS showed that oral administration of rapamycin in the BMS + RAPA groups showed similar effects in reducing PA and PB as the DES group,which all were better than the BMS group.The BMS + RAPA and DES groups showed much more MLD and less lumen reduction,compared with the BMS group( P ＜0.05).Level of mTOR expression of the BMS + RAPA group and DES group was significantly lower than that of BMS group.Conclusions Oral administration of rapamycin demonstrates the same effect in the reduction of plaque burden and stent restenosis as the rapamycin eluting stent.Inhibition of mTOR by rapamycin involves in the stent restenosis.

Effects of naokang erhao decoction on cognitive ability and hippocampal apoptosis-related proteins in diabetic rats / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effects of Naokang Erhao decoction on the cognitive ability and the expression of Caspase-3, Bax and Bcl-2 proteins in hippocampus of type 2 diabetic rats.</p><p><b>METHOD</b>The diabetes mellitus (DM) rat model was produced by intraperitoneal injection of streptozotocin and fed with high fat and sucrose diet. The Naokang Erhao-treated rats were intragastrically given different doses of Naokang Erhao, whereas the control and DM model groups were given double distilled water for 4 consecutive weeks. Learning and memory abilities of rats were tested with the Morris water maze. The expression of Caspase-3, Bax and Bcl-2 proteins in hippocampal CA1 region was measured by immunohistochemistry.</p><p><b>RESULT</b>Both escape latency and swimming distance of type 2 DM rats were significantly prolonged in comparison of those in normal control (P < 0.01), and swimming time in the platform of previous quadrant was significantly shorter in model group (P < 0.01). Furthermore, the expression of Bcl-2 protein was decreased, while Caspase-3 and Bax in the hippocampus were increased compared with the control group (P < 0.01). Four weeks of treatment with Naokang Erhao decoction remarkably improved the learning and memory abilities of DM rats, increased the expression of Bcl-2 and decreased the expression of Caspase-3 and Bax in hippocampal CA1 region of model rats (P < 0.01 or P < 0.05).</p><p><b>CONCLUSION</b>Naokang Erhao decoction may inhibit apoptosis by increasing the expression of Bcl-2 and reducing the expression of Caspase-3 and Bax in the hippocampus, and this may be one of the mechanisms by which Naokang Erhao decoction improves cognitive ability in DM rats.</p>

The characteristics of sleep disturbance in patients with comorbid anxiety and depression after cerebral infarction and their related factors / 中华物理医学与康复杂志

Objective To investigate the factors influencing sleep disturbance and comorbid anxiety and depression after cerebral infarction.Methods A total of 216 patients with first onset of cerebral infarction were enrolled and divided into a post-stroke comorbid anxiety and depression (PSCAD) group, a pure anxiety group, a pure depression group and a non-anxiety and no-depression group. Smoking, alcohol intake, educational background, life or work pressure and exercise frequency were compared among the four groups along with ultrasound images of the carotid artery and brain blood vessels. The subjects' sleep quality was evaluated with the Pittsburgh sleep quality index (PSQI).Results The conditions studied showed no significant difference among the four groups. There were significant differences among the four groups in HAMA and HAMD scores. HAMD overall scores were higher in the PSCAD group than in the other three groups. HAMA overall scores were higher in the PSCAD group than in the pure depression group or the non-anxiety and no-depression groups. The PSCAD group showed significantly higher scores on all the dimensions and in their overall scores than those in the non-anxiety and no-depression group. Subjective sleep quality, sleep latency, sleep duration, sleep efficiency, day-time dysfunction and the overall PSQI score were all significantly higher in the PSCAD group than in the pure anxiety group. Sleep latency, sleep duration, day-time dysfunction and the overall PSQI scores were significantly higher in the PSCAD group than in the pure depression group. Age, life or work pressure, smoking, alcohol intake were the main factors influencing sleep quality in the PSCAD group.Conclusions The sleep quality of anxious and depressed patients after cerebral infarction is worse than that of those suffering only anxiety or depression alone, especially in terms of subjective sleep quality, sleep latency, sleep duration, sleep efficiency and day-time dysfunction. Age, life or work pressure, smoking and alcohol intake are the main factors influencing sleep quality in such comorbid individuals after cerebral infarction.

Anxiety of Cerebral Infarction Patients with Sleep-disordered Breathing and Correlated with Sleep Quality / 中国康复理论与实践

@#ObjectiveTo investigate the anxiety and its effect on the sleep quality in patients with cerebral infarction and sleep-disordered breathing. Methods149 cerebral infarction patients were divided as 95 without sleep-disordered breathing and 54 with sleep-disordered breathing. They were evaluated with Hamilton Anxiety scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI). ResultsPatients with sleep-disordered breathing showed higher HAMA overall score and factor scores of somatic anxiety and psychic anxiety（P<0.001）. In the factors of somatic anxiety, the scores of sensing, cardiovascular, gastrointestinal and autonomic nerve system were higher in patients with sleep-disordered breathing than those without sleep-disordered breathing （P<0.05）. In the factors of psychic anxiety, the scores of anxious mood, tension, fears, insomnia, depressed mood were higher in patients with sleep-disordered breathing（P<0.05）. PSQI overall score and all factor scores were also higher in patients with sleep-disordered breathing（P<0.001）. HAMA overall score as well as psychic anxiety and somatic anxiety scores were closely correlated with the PSQI overall score （P<0.001）. Somatic anxiety score was correlated with subjective sleep quality, sleep latency, sleep disturbance and daily dysfunction scores （P<0.05）. Psychic anxiety score was correlated with all the dimension scores of PSQI （P<0.01）. ConclusionCerebral infarction patients with sleep-disordered breathing appeared anxiety and worse sleep quality than patients without sleep-disordered breathing. Anxiety is closely related with sleep quality.