Clinical Characteristics, Pathogenic Distribution, Treatment and Prognosis of 300 Patients With Infective Endocarditis Hospitalized in Fuwai Hospital / 中国循环杂志

Objectives: To analyze the clinical features, pathogenic distribution, treatment and prognosis of patients with infective endocarditis (IE) hospitalized in Fuwai Hospital during the latest 4 years, and to improve the diagnosis and treatment of this disease. Methods: This retrospective study included a cohort of 300 IE patients hospitalized in Fuwai Hospital from 2013 to 2016. Predisposing cardiac disease,pathogenic distribution and clinical outcomes were analyzed.Clinical and epidemiological features of patients treated with medications or surgery were compared. Results: There were 228 male and 72 female patients in this cohort; the mean age was (40.0±15.7) years old. Among the IE patients, 35.3% patients had congenital heart diseases, 22.3% had non-rheumatic valve diseases, and 10.3% had history of PCI or heart surgery. Only 4.3% patients suffered from rheumatic heart diseases. Cardiac murmur (93.3%) and fever (84.3%) were the most common clinical presentations. Congestive heart failure was the most common complication (75.3%), followed by systemic and pulmonary embolism (16.7%). Incidence of positive blood culture was 52.4%.Streptococcus (76.3%) were the most common causative organisms, followed by Staphylococcus (11.0%). 91.3% IE was detected by echocardiography. In-hospital mortality rate was 3.0%. Subgroup analysis showed that the cure rate of surgical treatment group was significantly higher than that of the medical treatment group (96.6% vs 48.6%, P<0.001). Conclusion: Congenital heart disease is the main underlying disease related to IE.Streptococcus is still the primary pathogen of IE. Due to the 1ower positive rate of blood culture, echocardiography serves as the most important diagnostic tool for infective endocarditis.Early, effective and regular antibiotic therapy is still the cornerstone of the treatment of IE. Cardiac surgery treatment can reduce the mortality rate of IE.

History of pregnancy induced hypertension is linked with increased risk of cardio-cerebral vascular events / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the incidence of cardio-cerebral vascular events between pregnancy induced hypertension (PIH) women and non-PIH(NPIH) women.</p><p><b>METHODS</b>Ambispective cohort study method was used and 4630 pregnant women giving birth during October 1976 to December 2008 in our hospital and participated the healthy examination between July 2006 and October 2007 at Kailuan medical group were included and divided into PIH group (n = 694) and NPIH group (n = 3936) by the history of PIH. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.</p><p><b>RESULTS</b>(1) The follow-up time was 2 to 34 (15.32 ± 7.94) years. (2) The childbearing age, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while gestational weeks and weight of newborn were significantly less in PIH group than in NPIH group (all P < 0.01). Levels of systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol and fasting blood glucose during healthy examination between July 2006 and October 2007 were significantly higher in PIH group than in NPIH group (P < 0.05 or P < 0.01). (3) There were 71 cardio-cerebral vascular events during the follow-up. In PIH group, the incidence rate of cardio-cerebral vascular events, myocardial infarction and cerebral infarction was 20.64%, 11.08% and 8.67%, respectively, while the corresponding incidence rate was 7.82%, 4.02% and 2.67% in NPIH group (all P < 0.01). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction and cerebral infarction in PIH group was 2.99 fold (95%CI: 1.80 - 4.95), 3.91 fold (95%CI: 1.71 - 8.91) and 3.96 fold (95%CI: 1.95 - 8.05) higher than in NPIH group.</p><p><b>CONCLUSION</b>PIH is an independent risk factor for cardio-cerebral vascular events.</p>

Preparation of brain targeted immunoliposomes / 药学学报

To prepare a kind of effective non-viral transduction vector, which can deliver exogenous gene into the brain, this vector can be injected through vein system and has the ability to penetrate blood brain barrier. Several groups of materials proportion, type of oil phase, water-oil ratio, phosphatides-cholesterol ratio, temperature of steaming, ultrasonic temperature and time were compared for optimization. Well-constructed immunoliposomes encapsuling LacZ gene were infused into rats through tail vein. 48 h after injection, expression product beta-galactosidase of LacZ gene was detected by histochemistry staining to convince the validity of immunoliposomes as non-viral vectors. The best proportion of synthesis immunoliposomes is as following: phosphatides-cholesterol ratio is 1:1, lipids/drug is 100:1, the type of oil phrase is dichloromethane, oil-water ratio is 4:1, temperature of steaming is 30 degrees C, ultrasonic temperature and time is 10 degrees C and 5 min. At last, 10% trehalose was added as a stabilizer. The entrapment rate is 87.24% and antibody coupling rate is 69%. When immunoliposomes were infused into rats, the expression of LacZ gene could be observed in the brain and periphery organs. Through the best proportion of materials, gene delivering immunoliposomes had been synthesized successfully. This non-viral vector can deliver exogenous gene penetrating blood brain barrier and express in the brain, and will be well-used in the field of gene therapy of cerebral diseases.