[Preliminary application of CPC/PMMA composite bone cement in kyphoplasty for the elderly].

OBJECTIVE: From the perspective of clinical application to analyze the effectiveness and reliability of CPC/PMMA bone cement in percutaneous kyphoplasty (PKP) for the treatment of elderly patients with osteoporotic thoracolumbar fractures. METHODS: A retrospective analysis was performed on 62 patients with osteoporotic compression fracture of single-vertebral thoracic or lumbar segment who underwent PKP surgery and had a bone density less than or equal to -3.0 SD from February 2016 to December 2016. Among them, 23 patients were in CPC/PMMA group, with an average age of (77.6±2.2) years old, 39 patients in PMMA group, with an average age of (77.1±1.1) years old. The indexes between two groups were compared, including the visual analogue scale (VAS), height ratio of anterior vertebra (AVHR), local Cobb angle, cement leakage, new adjacent vertebral fracture(NAVF). RESULTS: There were no significant difference in gender, age, follow-up time and preoperative VAS, AVHR, local Cobb angle between two groups (P>0.05), at the 1 day after operation, VAS, AVHR, local Cobb angle in all patients got obvious improvement (P<0.05), which was no significant difference at 1 day after operation and final follow-up (P>0.05). At the same time, there was no statistically significant difference in the incidence of new adjacent vertebral fracture and cement leakage (P>0.05). The pain in both groups continued to improve at follow up after operation (P<0.05), the local Cobb angle increased (P<0.05) and AVHR decreased slightly (P<0.05). However, the images of conventional methods (X-ray or CT) could not find signs about CPC degeneration and new bone ingrowth. CONCLUSION: CPC/PMMA composite bone cement is safe and reliablein PKP for treatment of elderly patients with osteoporotic thoracolumbar fractures, which can effectively relieve pain and maintain vertebral body stability. It has the same curative effect as PMMA bone cement. It was worthy to research more in future, although no direct evidences support the CPC/PMMA composite bone cement can reduce the incidence of adjacent vertebral fracture, CPC degeneration or new bone ingrowth.

Pitavastatin-attenuated cardiac dysfunction in mice with dilated cardiomyopathy via regulation of myocardial calcium handling proteins.

C57BL/6 mice with dilated cardiomyopathy (DCM) were randomly divided to receive placebo or pitavastatin at a dose of 1 or 3 mg kg-1d-1. After 8 weeks treatment, mice with dilated cardiomyopathy developed serious cardiac dysfunction characterized by significantly enhanced left ventricular end-diastolic diameter (LVIDd), decreased left ventricular ejection fraction (LVEF) as well as left ventricular short axis fractional shortening (LVFS), accompanied with enlarged cardiomyocytes, and increased plasma levels of N-terminal pro-B type natriuretic peptide (NT-proBNP) and plasma angiotensin II (AngII) concentration. Moreover, myocardium sarcoplasmic reticulum Ca2+ pump (SERCA-2) activity was decreased. The ratio of phosphorylated phospholamban (PLB) to total PLB decreased significantly with the down-regulation of SERCA- -2a and ryanodine receptor (RyR2) expression. Pitavastatin was found to ameliorate the cardiac dysfunction in mice with dilated cardiomyopathy by reversing the changes in the ratios of phosphorylated PLB to total PLB, SERCA-2a and RyR2 via reducing the plasma AngII concentration and the expressions of myocardium angiotensin II type 1 receptor (AT1R) and protein kinase C (PKC)b2. The possible underlying mechanism might be the regulation of myocardial AT1R-PKCb2-Ca2+ handling proteins.

Meta-analysis of effectiveness of first-generation drug-eluting stents versus coronary artery bypass grafting for unprotected left main coronary disease.

It is controversial whether drug-eluting stents (DESs) are safe and effective when generalized to "real-world" patients with unprotected left main coronary artery disease. This meta-analysis compared the safety and efficacy of DESs to coronary artery bypass grafting (CABG) in real-world patients with unprotected left main coronary artery. We identified comparative, observational, DES versus CABG studies published from January 2000 through May 2012. All studies included ≥100 patients and reported end points with follow-ups ≥6 months. We included adjusted risk estimates and, when no adjusted estimate was available, crude estimates. Data were grouped according to follow-up times of ≤2, ≤3, and >3 years. We included data from 25 observational studies representing 7,230 patients. No differences were detected between CABG and DES in overall mortality (≤2 years, adjusted risk ratio [RR], 0.83, 95% confidence interval [CI] 0.53 to 1.28; ≤3 years, adjusted RR 0.60, 95% CI 0.20 to 1.66; >3 years, adjusted RR 0.58, 95% CI 0.29 to 1.17) or in major adverse cardiac and cerebrovascular events (≤2 years, adjusted RR 1.22, 95% CI 0.86 to 1.73; ≤3 years, adjusted RR 1.70, 95% CI 1.35 to 2.15; >3 years, adjusted RR 1.23, 95% CI 0.87 to 1.73). Compared to DESs, CABG showed a significant decrease in target vessel revascularization (≤2 years, adjusted RR 3.72, 95% CI 2.50 to 5.52; ≤3 years, adjusted RR 3.92, 95% CI 2.54 to 6.04; >3 years, adjusted RR 3.45, 95% CI 2.14 to 5.57). In conclusion, DESs and CABG were not significantly different in short- and long-term rates of death or major cardiovascular/cerebrovascular events, but DESs showed a higher risk of target vessel revascularization compared to CABG.

[Elevated serum secretory type II phospholipase A2 in patients with coronary heart disease].

OBJECTIVE: To measure the serum level of secretory type II phospholipase A2 (sPLA2) in patients with coronary heart disease and investigate the possible relationship with IL-8 and LPA. METHODS: A total of 110 patients with acute coronary syndrome (ACS), 63 patients with stable coronary heart disease (SCHD) group and 89 non-CHD control patients were studied. Serum levels of sPLA2, IL-8, LPA and hs-CRP were measured and the correlation among these parameters was observed. RESULTS: The levels of serum sPLA2 [(68 +/- 17) U/ml], IL-8 [(182 +/- 80) pg/ml] and LPA [(2.85 +/- 0.36) micromol/L] were significantly higher in CHD patients than those in controls [sPLA2: (55 +/- 12) U/ml; IL-8: (119 +/- 33) pg/ml; LPA: (2.34 +/- 0.36) micromol/L, all P < 0.01], and sPLA2 and IL-8 were also significantly higher in ACS patients [sPLA2: (71 +/- 18) U/ml; IL-8: (195 +/- 78) pg/ml] than those in SCHD patients [sPLA2: (63 +/- 12) U/ml; IL-8: (159 +/- 79) pg/ml, both P < 0.01]. Serum sPLA2 level was positively correlated with hs-CRP, IL-8 and LPA (r = 0.203, P = 0.007; r = 0.658, P < 0.01; r = 0.231, P = 0.005, respectively). The relative risk of having CHD is 6.248 (P < 0.01) with the sPLA2 level above 63.75 U/ml. CONCLUSION: Elevated serum sPLA2 level is a risk factor for CHD.