Table of Content

21 August 2012, Volume 33 Issue 4

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心脏病学专题

Genetic association of ADIPOQ gene polymorphisms with type 2 diabetes mellitus with coronary artery disease

NAN Nan;JIN Ze-ning;YANG Ze

2012, 33(4):  421-426.  doi:10.3969/j.issn.1006-7795.2012.02.001

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Objective To investigate the genetic association of adiponectin gene (ADIPOQ) with coronary artery disease in type 2 diabetes mellitus. Methods A 2-step study was conducted. Firstly, the pilot study included bio-information analysis, sequencing the 2^nd exon regions in 20 T2DM complicated with CAD patients and contrasting to reference database to screen the candidate single nucleotide polymorphisms(SNPs). Secondly, the replication study was based on case-control study design. Of 680 type 2 diabetes mellitus patients, 213 individuals with coronary artery disease(CAD) from Beijing Anzhen Hospital and 467 controls from Beijing Hospital were recruited in our study. The polymerase chain reaction-high resolution melting(PCR-HRM) assay was carried out to genotype all the subjects for the candidate SNPs in ADIPOQ gene. Results In pilot study, 5 SNPs were screened, including 17366568G/A, 9882205G/A, 2241767A/G, 1501299G/T, 2241766T/G. Polymorphisms of rs2241766T/G(+45T/G) and rs9882205G/A were associated with risk of CAD[OR and 95% CI were 2.78(1.20~8.65) and 3.9(1.78~13.61), P<0.05]. In replication study, rs2241766 polymorphism was not associated with CAD in type 2 diabetes mellitus patients. Conclusion rs2241766 polymorphism may not be associated with coronary artery disease in type 2 diabetes mellitus.

Altered whole genomic methylation in chronic heart failure patients

WANG Jian-long;LI Hai-tao;SU Pi-xiong;GU Song;LIU Yan;ZHANG Xi-tao;YAN Jun;AN Xiang-gang;GAO Jie;XIN Yue;CAI Jun

2012, 33(4):  427-431.  doi:10.3969/j.issn.1006-7795.2012.04.002

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Objective To explore the relationship between the change of whole genome methylation and heart failure. Methods Methylated DNA Immunoprecipitation-chip(MeDIP-chip) and microarray hybridization, mRNA amplification and microarray, and the bisulfite sequencing(BS)-PCR-sequencing strategy were used in this study. Differential methylation genes and differential expression genes from mRNA amplication and microarray analysis were compared. Then 13 differential methylation genes were selected for further analysis with BS-PCR. Results abca4 gene promoter methylation in heart failure group and healthy group was 85.5% and 91.2%, respectively. While 5.7% difference in methylation between two groups correlated with 2.05 fold increase in mRNA expression in heart failure group, cd200 gene promoter methylation in heart failure group and healthy group was 50.5% and 57.1% respectively. And 6.6% difference in methylation between two groups corresponded to 2.18 fold increase in mRNA expression in heart failure group. Conclusion abca4 and cd200 DNA methylation may significantly influence the expression of these genes. And it is suggested that the alteration in DNA methylation may lead to the initiation and development of heart failure.

A prediction model for no-reflow in female patients treated with primary percutaneous coronary intervention

WANG Chang-hua;CHEN Yun-dai;YANG Xin-chun;WANG Le-feng;WANG Hong-shi;SUN Zhi-jun;LIU Hong-bin;CHEN Lian

2012, 33(4):  432-436.  doi:10.3969/j.issn.1006-7795.2012.04.003

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Objective To identify independent no-reflow predictors during primary percutaneous coronary intervention(PPCI) in female patients with ST-segment elevation acute myocardial infarction(STEMI) after various contemporary interventional strategies, thus to establish a model for predicting no-reflow status. Methods Totally 320 female patients with STEMI successfully treated with PPCI were divided into no-reflow group and normal reflow group. Results The no-reflow status was found in 81(25.3%) of 320 female patients. Univariate and multivariate logistic regression identified that low systolic blood pressure(SBP) on admission(<100 mm Hg, OR=1.991, 95% CI: 1.018~3.896; P=0.004), target lesion length(>20 mm, OR=1.948, 95% CI: 1.908~1.990; P=0.016), collateral circulation(0-1, OR=1.952, 95% CI: 1.914~1.992; P=0.019), pre-PPCI thrombus score(≥4, OR=4.184, 95% CI: 1.482~11.813; P=0.007), and intra-aortic balloon pulsation(IABP) use before PPCI(OR=1.949, 95% CI: 1.168~3.253; P=0.011) were independent no-reflow predictors. The no-reflow incidence rate significantly increased as the numbers of independent predictors increased[0%(0/2), 10.8%(9/84), 14.5%(17/117), 37.7%(29/77), 56.7%(17/30), and 81.8%(9/11) in female patients with 0, 1, 2, 3, 4, and 5 independent predictors, respectively; P=0.000]. Conclusion The 5 no-reflow predictor variables were low SBP on admission <100 mm Hg, target lesion length >20 mm, collateral circulation 0-1, pre-PPCI thrombus score ≥4, and IABP use before PPCI in female patients with STEMI and PPCI. The prediction model provides a basis for therapeutic decision making.

Comparison of mortality, myocardial infarction, and stent thrombosis following drug eluting versus bare metal stenting in unselected diabetic patients at long-term followup

QIAO Yan;MA Chang-sheng;NIE Shao-ping;LIU Xiao-hui;DU Xin;KANG Jun-ping;Lü Qiang;JIA Chang-qi;ZHANG Yin

2012, 33(4):  437-445.  doi:10.3969/j.issn.1006-7795.2012.04.004

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Objective This observational study compared the rates of death, myocardial infarction(MI), repeat revascularization and stent thrombosis after implantation of drug eluting stents(DES) versus bare metal stents(BMS) in unselected patients with diabetes mellitus to evaluate the long-term efficacy and safety of DES. Methods We consecutively included 834 diabetic patients who underwent either DES(n=583) or BMS(n=251) in our institution from July 2003 to December 2005. The primary end point was all-cause mortality at 24 months, the secondary end points were the occurrence of nonfatal MI, cerebrovascular events and repeat revascularization and major adverse cardiac events(MACE) at 24 months. Results After adjusting with Cox regression, the risk of mortality in the DES group was significantly lower than that in the BMS group (3.2% vs 5.1%, hazard ratio of DES vs BMS 0.58, 95% confidence interval 0.12 to 0.94, P=0.038), similar outcome had also been found in the adjusted risk of cardiac mortality(2.2% vs 4.4%, HR=0.29, 95% CI: 0.13~0.87, P=0.027) at 24 months, although the adjusted risk of nonfatal MI and the composite of the cardiac mortality and nonfatal MI was similar. DESs was not associated with increased risk of stent thrombosis(2.7% vs 3.2%, HR=0.61, 95% CI: 0.17~1.32, P=0.144). The MACE rate was also lower in the DES group(15.8% vs 27.9%, HR=0.19, 95% CI: 0.09~0.85, P<0.001) due to less mortality and less repeat revascularization with DES(10.5% vs 20.7%, HR=0.24, 95% CI: 0.11~0.78, P<0.001). Conclusion In a real-world diabetic patient population, DES was related to reduced mortality, repeat revascularization and MACE rates at long-term follow-up compared with BMS without increased risk of stent thrombosis, or nonfatal MI. The survival benefits of DES resulted from reducing revascularization procedures for restenosis which could account for the reduction in mortality and MI, higher rate of complete revascularization and no additional risk of stent thrombosis.

One-year follow-up results of transcatheter intervention for complex patent ductus arteriosus in adults

ZHOU Yu-jie;YANG Shi-wei;GUO Yong-he;LIU Yu-yang;WANG Jian-long

2012, 33(4):  446-450.  doi:10.3969/j.issn.1006-7795.2012.04.005

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Objective To evaluate one-year follow-up results of transcatheter intervention for complex patent ductus arteriosus(PDA) in adults. Methods From Jan. 2004 to April 2008, 112 adult patients〔43 male, 69 female, mean age(34±19)years〕 with complex PDA underwent transcatheter intervention in Beijing Anzhen Hospital. Coils were used for patients with small PDA(minimal ductal diameter<3.0 mm), and Amplatzer duct occluders or China-made mushroom shape occluders were used for patients with moderate-to-large PDA(minimal ductal diameter≥3.0 mm). If the conventional technique could not establish the delivery railway, retrograde technique was alternative. In addition to the common practice, all kinds of special tricks were used for the complex PDA patients. Follow-up with color Doppler ultrasound were given at 1 week, 1, 3, 6 and 12 months after the successful interventions. Results The total successful rate was 93.8%, and the rate of residual shunts was 1.8% at the end of 12 months follow-up. All the residual shunts were minimal and no special treatment were needed. The peak systolic pulmonary pressures decreased by 35 mmHg(1 mmHg=0.133 kPa) significantly〔pre-intervention(94±21)mmHg vs post-intervention(58±20)mmHg, P<0.001〕. No procedure-related severe complications (including deaths, recanalization, dislocation of occluders, stenosis of aorta or pulmonary artery) occurred. Some patients developed hemolysis or arterial complications, and all were cured by conservative therapy. Conclusion Transcatheter intervention is an effective and safe treatment for adults PDA patients with complex anatomic or hemodynamic conditions.

Importance of platelet function monitoring

LV Shu-zheng;XU Feng

2012, 33(4):  451-456.  doi:10.3969/j.issn.1006-7795.2012.04.006

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Antiplatelet therapy is widely used to treat and prevent thrombosis in patients with atherosclerosis. However, sufficient no sufficient attention has been paid to the monitoring of antiplatelets. Thrombosis and bleeding event is not rare in clinical practice due to inappropriate antiplatelet therapy. This review describes the necessity and method of platelet function monitoring during antiplatelet treatment.

Protective effect of trimetazidine on myocardial injury and recurrent angina after percutaneous coronary intervention

XU Xiao-han;ZHANG Wei-Jun;ZHOU Yu-jie;ZHOU Zhi-ming;MA Han-ying;HU Bin;KANG Yun-peng;LUO Fang-fang

2012, 33(4):  457-461.  doi:10.3969/j.issn.1006-7795.2012.04.007

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Objective To explore the effect of trimetazidine(TMZ) on the level of cardiac troponin Ic(cTnI) in patients with coronary heart disease after percutaneous coronary intervention(PCI) and investigate the effect of trimetazidine on symptoms of recurrent angina after PCI. Methods A total of 93 patients with unstable angina pectoris admitted for elective PCI were randomly assigned to 2 groups to receive or not an acute loading dose of 60 mg of TMZ prior to the intervention and routine dose of 20 mg Tid after it. The frequency of and the increase in the level of cTnI after successful PCI were measured before and 16~18 h after PCI. Recurrent angina and major adverse cardiac events(MACE, including death, re-infarction and target vessel revascularization) at 9 months after the procedure were also compared. Results Totally 79 patients who were successfully undergoing elective PCI were finally enrolled, 35 were assigned into TMA group and 44 into control group. Post-procedural cTnI levels were significantly reduced in the TMZ group at 16~18 h(P<0.05). The frequency of patients with an increase in cTnI over 2 times the upper limit of the control range(0.05 ng/mL) was significantly decreased in the TMZ group(P<0.05). At 9 months follow-up, symptoms of recurrent angina after PCI were significantly relieved in the TMZ group(P<0.05). Conclusion Trimetazidine can limit the post-PCI cTnI release and relieve the symptoms of recurrent angina after PCI.

Transesophageal echocardiography to detect right-to-left shunt in neurosurgical patients in the sitting position

GAO Jing;HUA Qi;LI Xiao-hui;WANG Cai-rong;MA Ting;YE Xin

2012, 33(4):  462-464.  doi:10.3969/j.issn.1006-7795.2012.04.008

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Objective To evaluate the efficacy of intraoperative transesophageal echocardiography(TEE) to detect right-to-left shunting in patients undergoing neurosurgical procedures while in the sitting position. Methods six patients scheduled for neurosurgery in the sitting position were investigated. venous air embolism(VAE) and paradoxical air embolism(PAE) were continuously monitored by cardiac two-dimensional 4-chamber view using transesophageal echocardiography(TEE). Results Microbubbles in the right atrium appeared in all patients. In 3 patents, air appearance in all cavities of the heart was found. Conclusion TEE would be one of the most important monitoring methods not only in cardiac surgery, but also in neurosurgical procedures in the sitting position.

糖尿病研究与临床诊疗

Variants in KCNQ1, AP3S1, MAN2A1 and ALDH7A1 and the risk of type 2 diabetes in the Chinese northern Han population

ZHOU Jian-bo;XIN Zhong;FENG Jian-ping;YANG Jin-kui

2012, 33(4):  468-471.  doi:10.3969/j.issn.1006-7795.2012.04.010

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Objective The recent studies have explored several novel type 2 diabetes susceptibility variants in KCNQ1(rs2237892), AP3S1(rs3756555), MAN2A1(rs2015698) and ALDH7A1(rs2306617) genes. This study aimed to evaluate the contribution of these variants in the four genes to predisposition of type 2 diabetes in the Chinese northern Han population. Methods Four candidate single nucleotide polymorphisms, rs2237892, rs2306617, rs2015698 and rs3756555 were selected, and genotyped them in 537 unrelated individuals with type 2 diabetes and 510 normal controls. Results The C risk allele in rs2237892 and rs3756555 conferred a significantly increased susceptibility to type 2 diabetes(P=0.002, P=0.003). The significant association remains after adjusting the age, sex and BMI(OR=1.51, 95% CI: 1.17~1.95, P=0.002; OR=1.48, 95%CI: 1.14~1.92, P=0.003). No association was observed in recessive genetic models for rs2015698 and rs2306617. Further investigation in the control subjects showed that fasting plasma glucose was significantly higher for the individuals with CC genotype of rs2237892 than for those with the other two genotypes after adjusting for age, sex and BMI(P=0.020). The SNP of rs3756555 was marginally associated with BMI in recessive model(P=0.050). Conclusion In this study the effects of KCNQ1 and AP3S1 variants on the susceptibility to type 2 diabetes in the Chinese northern Han population were confirmed.

Effect of blood pressure control on nephropathic end-point in type 2 diabetes mellitus in an observational cohort

WANG Yan;ZHAO Xia;FAN Bin;FENG Jian-ping;Yang Jin-kui

2012, 33(4):  472-476.  doi:10.3969/j.issn.1006-7795.2012.04.011

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Objective To investigate the effect of blood pressure control on nephropathic end-point in patients with type 2 diabetes. Methods Totally 210 type 2 diabetic inpatient without renal function decline at the starting point participated in the follow up study. Clinical data and results of laboratory tests were collected. The end point event was defined as eGFR<60 mL^-1·min^-1·1.73m^-2. The subjects were divided into 2 groups based on the level of blood pressure, and survival curves were made. Results Renal function was initially normal for all 210 patients, but by the completion of follow-up, 23 patients(10.95%) progressed to renal function decline(eGFR<60 mL^-1·min^-1·1.73m^-2). The subjects were divided into 2 groups based on the level of SBP. By comparing the survival curves in 2 groups, SBP<140 mmHg(1 mmHg=0.133 kPa) group showed a significantly higher survival rate and longer survival time than SBP≥140 mmHg group(P=0.047 5). The subjects were divided into 2 groups based on the level of DBP. By comparing the survival curves in 2 groups, DBP<90 mmHg group showed a significantly higher survival rate and longer survival time than DBP≥90 mmHg group(P=0.000 4). Conclusion It was found that both SBP and DBP are strong predictors of renal function decline. The study documented a strong association between blood pressure level and renal function decline in type 2 diabetic patients without renal function deline(eGFR>70 mL^-1·min^-1·1.73m^-2) at baseline. The patients with blood pressure under 140/90 mmHg showed a statistically significantly higher survival rate and longer survival time than those with blood pressure>140/90 mmHg.

Comparison for Association of Fasting and 2-hour Glucose and HbA1c with Diabetic Retinopathy

XIN Zhong;YUAN Ming-xia;FENG Jian-ping;SHI Jing;ZHU Xiao-rong;YANG Jin-kui

2012, 33(4):  477-480.  doi:10.3969/j.issn.1006-7795.2012.04.012

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Objective To compare the association of fasting plasma glucose(FPG), 2-h plasma glucose(2hPG) and hemoglobin A1c(HbA1c) levels with diabetic retinopathy(DR) and to evaluate the best way to diagnose diabetes. Methods A cross-sectional, population-based survey on chronic diseases and risk factors was conducted in Changping; in 2 551 subjects, the three glycemic measures in oral glucose tolerance tests(OGTT), and DR was assessed by digital retinal images. Receiver operating characteristic(ROC) curves were calculated and compared the areas beneath them to compare the ability of FPG, 2hPG and HbA1c measurements to detect DR. Results Patients with DR were rated significantly higher in FPG, 2hPG, HbA1c, blood pressure and subjects suffered from hypertension compared with subjects without DR(P<0.05 or P<0.001). The area under the ROC curve for 2hPG was 86.9%(95% CI: 82.2~91.7) and was not significantly larger than that for FPG 85.4%(95% CI: 80.0~90.7; P=0.501) and that for HbA1c 86.4%(95% CI: 80.8~92.0; P=0.796). After excluding individuals receiving antihyperglycemic medication, all three measures of glycemia also showed no significant differences for detecting DR. Conclusion Measuring FPG or HbA1c are equally reliable methods in measuring 2hPG for the diagnosis of diabetes in the Chinese population.

Relationship between serum bilirubin and diabetic retinopathy in patients with type 2 diabetes

FENG Wei;YANG Jin-kui

2012, 33(4):  481-484.  doi:10.3969/j.issn.1006-7795.2012.04.013

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Objective To investigate the difference of serum bilirubin between non-diabetic retinopathy(NDR) in long-standing type-2 diabetes mellitus and proliferative diabetic retinopathy(PDR). Methods Type-2 diabetic patients who were out-patient or who attended the department of endocrinology at Capital Medical University affiliated Tongren Hospital between March 2010 and December 2011 were recruited. Of all the patients, 253 had diabetic duration longer than 10 years and non-diabetic retinopathy(NDR)(male female ratio: 136/117), and 218 had proliferative diabetic retinopathy(PDR) and diabetic duration was not restricted(male female ratio: 98/120). Comparing the level of serum bilibubin between the two groups and the significant parameters were taken to the logistic regression formula. Results Both total bilirubin and indirect bilirubin were not significantly different between the two groups(P>0.05), however, patients with NDR had higher direct bilirubin than those with PDR(P<0.05). Concerning sex, male patients in NDR group had higher direct bilirubin than those with PDR. But in female patients, no significant diffenence was found. In the logistic regression analysis about diabetic retinopathy risk factors, age and direct bilirubin were protective factors; and systolic blood pressure, HbA1c were risk factors. Conclusion The level of direct bilirubin between the NDR group with diabetic duration longer than 10 years and PDR was different. Bilirubin is a natural anti-oxidant, and can play a protective role in the onset and development of diabetic retinopathy.

Analysis of distribution characteristics of glycolipids and relationship among them in the young people

GENG Ya-hui;MA Na-min;YU Shi-lin;YUAN Mei-ying

2012, 33(4):  485-487.  doi:10.3969/j.issn.1006-7795.2012.04.014

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Objective To investigate glycolipid distribution and variation characteristics year after year in the young people, and analyze their correlation. Methods Data of plasma glucose, blood lipids measurements of 282 heathy young persons in Haidian district were collected and analyzed for three consecutive years. Results Plasma glucose and blood lipids increased year by year, and there was a positive correlation between plasma glucose and blood lipids. Conclusion Triglyceride had a close relationship with plasma glucose, it can reflect plasma glucose level, and it may be one of the factors which induced abnormal glucose metabolism.

基础研究

Influence of soluble form of receptor for advanced glycation end products(sRAGE) on hypoxia/reoxygenation myocardial oxidative stress

ZHANG Min;GUO Cai-xia;ZENG Xiang-jun;WANG Hong-xia;ZHANG Li-ke;DU Feng-he

2012, 33(4):  488-493.  doi:10.3969/j.issn.1006-7795.2012.04.015

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Objective To elucidate the influence of soluble form of receptor for advanced glycation end products (sRAGE) on hypoxia/reoxygenation myocardial oxidative stress. Methods Cardiac myocytes were isolated from neonatal rats with the modified 2-step collagenase digest method and were subjected to Primary culture for 48 hours. Hypoxia 3 h/reoxygenation 2 h injury model was produced. The cells were randomly divided into four groups: normoxic control group (Con), normoxia + sRAGE group(Con-sRAGE), hypoxia/reoxygenation (H/R) group(model group), hypoxia/reoxygenation + sRAGE (H/R-sRAGE) group (experimental group). The viability of myocardial cells was detected by MTT; The leakage of lactate dehydrogenase in culture medium (LDH); the activity of superoxide dismutase (SOD) were detected by xanthine oxidase; The content of malondialdehyde (MDA) was detected by thiobarbituric acid color method; The intensity of fluorescence was detected by DCFH-DA fluorescent probe combined flow cytometry-Reactive oxygen species (ROS) levels in response; nitrate reductase determination of nitric oxide (NO) levels. Results Compared with H/R group, H/R-sRAGE group could improve the myocardial viability, reduce the amount of LDH leakage, increase SOD activity, lower MDA and ROS levels (P<0.05). Conclusion sRAGE may act directly on myocardial cells and antagonize the hypoxia/reoxygenation injury, the protective role is related to inhibition of oxidative stress.

Synthesis and antiangiogenic activity of oleanolic acid and deoxycholic acid derivatives

WANG Peng-long;CHENG Ya-tao;WANG Lin;XU Shi-xun;WANG Yan-hui;LI Qiang;LEI Hai-min

2012, 33(4):  494-497.  doi:10.3969/j.issn.1006-7795.2012.04.016

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Objective Two oleanolic acid and deoxycholic acid-acetonyl derivatives were synthesized; and the angiogenetic activities of the two compounds were aslo evaluated. Methods In the acetone/K₂CO₃ reaction system, TMP-Br took place nucleophilic substitution reaction with oleanolic acid and deoxycholic acid, respectively. And two novel oleanolic acid and deoxycholic acid-acetonyl derivatives were obtained. The two compounds’ angiogenic activity was evaluated on chick chorioallantoic membrane(CAM) model. Results The oleanolic acid and deoxycholic acid-acetonyl derivatives’ structure were confirmed by ¹H-NMR, ¹³C-NMR and IR spectra. Both of the two compounds could suppress normal angiogenesis in CAM. Conclusion In the acetone/K₂CO₃/TMP-Br reaction system, we got oleanolic acid and deoxycholic acid-acetonyl derivatives, respectively. Moreover deoxycholic acid-acetonyl derivatives showed well anti-angiogenic activity on CAM assay.

Influence of Jiawei Xiaoke Kang on expression of fibronectin laminin and collagen Ⅳ expression in rats with diabetic nephropathy

ZHANG Cheng;LI Feng-ting;LI Meng;YUE Shun-qing;GENG Jian-guo;ZHANG Jiu-hong

2012, 33(4):  498-502.  doi:10.3969/j.issn.1006-7795.2012.04.017

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Objective To observe the effects of Jiawei Xiaoke Kang on the expression of fibronectin(FN), laminin(LN) and collagen Ⅳ in renal tissue of rats with diabetic nephropathy. Methods Diabetic nephropathy was induced after unilateral nephrectomy by streptozocin(STZ) and the DN rats were randomly divided into normal control group, DN model group, western medicine treated group and Chinese traditional medicine group. The rats in Chinese traditional medicine group were perfused with Jiawei Xiaoke Kang. The rats in the western medicine group were perfused with Losartan. And the normal control group and model group rats were perfused with the same amount of distilled water. All the rats were perfused for 12 weeks. The rats were sacrificed at the end of 12 week. Immunohistochemistry was adopted to detect the expression of FN,LN and collagen Ⅳ in renal tissues. Results The Jiawei Xiaoke Kang can reduced FN, LN and collagen Ⅳ expression. Conclusion Jiawei Xiaoke Kang has therapeutic effect on DN rates.

临床研究

Treatment of multiple level lumbar disc protrusion

KANG Nan;HAI Yong;SU Qing-jun

2012, 33(4):  503-507.  doi:10.3969/j.issn.1006-7795.2012.04.018

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Objective To study the characteristic of multi-level lumbar disc protrusion treatment. Methods 68 patients who suffered from multi-level lumbar disc protrusion were reviewed retrospectively from Jan 2002 to Jun 2010. male: 42, femaie: 26.age: 30~78,average: 51±12, history: 1~15 years, average: 3±1 years.58 patients(33 patients, 68 discs) accept posterior disectomy(double side: 7, single side: 26); 25 patients with 54 disc underwent spinal fusion; 10 patients 20 discs underwent artificial disc replacement. Results All patients were followed up for 1 to 9 years(mean 46 months). The average preoperative JOA was 9.6±2.0(range: 6 to 17), while postoperative JOA was 24±2.0(range: 20 to 29). The Chi-square test, Z=-7.276, P<0.01, indicate the significant difference. The average preoperative VAS was 8.2±1.0(range: 6 to 10), while postoperative VAS was 1.4±1.0(range: 0 to 2). The Chi-square test, Z=-7.210, P<0.01, indicate the significant difference. Conclusion To define the "pain-relative disc" take important role in multi-level lumbar disc protrusion treatment, and discography take an important role in operative segmental selection in multi-level lumbar disc protrusion.

Application of acupuncture in the treatment of chronic headache: A meta-analysis

SUN Yan-xia;WANG Nan;LI Tian-zuo

2012, 33(4):  508-512.  doi:10.3969/j.issn.1006-7795.2012.04.019

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Objective To evaluate the efficacy of acupuncture for treatment of chronic headache.Methods The following databases were searched for randomized controlled trials on the use of acupuncture for chronic headache: Medline(1966~2011), CINAHL, Cochrane Central Register of Controlled Trials and Scopus. Studies were included if they enrolled adults with chronic headache and were randomized to receive needling acupuncture treatment or sham acupuncture. The data on headache intensity, frequency and response rate were extracted for analysis. Results Seventeen trials were included in this review. The majority of included trials showed a trend in favor of acupuncture. The combined response rate in the acupuncture group was significantly higher as compared with sham acupuncture either at the early follow-up period〔risk ratio(RR)=1.19, 95% confidence interval(CI):1.08~1.30〕 or late follow-up period(RR=1.22, 95% CI: 1.04~1.43). Conclusion Needling acupuncture was superior to sham acupuncture in management of chronic headache.

Clinical effects of Stronger Neo-Miaophagen C in combination with ribavirin in treatment of severe measles

JIAN Xi-yao;JIAN Rong;LI Xu-hui;LIAO Xiao-hui;GUO Ning-ning

2012, 33(4):  513-515.  doi:10.3969/j.issn.1006-7795.2012.04.020

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Objective To evaluate the clinical effect of Ribavirin in combination with Stronger Neo-Miaophagen C in treatment of patients with severe measles. Methods A total of 103 cases with clinical diagnosis of severe measles from June 2009 to May 2012 were randomly divided into two groups, including 51 cases in control group and 52 cases in treatment group. The patients in the control group were treated with ribavirin intravenous infusion alone, while those in the treatment group were treated with Stronger Neo-Miaophagen C in combination with ribavirin intravenous infusion. After the end of treatment for 7 to 10 days, the results of both groups were compared. Results The total effective rate(94.23%) of the treatment group was significantly higher than that of the control group(74.51%)(P<0.05). Conclusion The therapeutic effects of Stronger Neo-Miaophagen C in combination with ribavirin was better than ribavirin alone in the treatment of patients with severe measles.

新视角

Analysis of research front and evolution path of translational medicine

HUANG Fang

2012, 33(4):  516-522.  doi:10.3969/j.issn.1006-7795.2012.04.021

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Employing Citespace software, mapping of translational research papers(from 2006~2012) were performed, and country, institutions, cited references were analyzed. Then attempts were made to depict the transformation of the translational research.

Information visualization analysis of the research and hot spots in the early diagnosis of Alzheimer’s disease 1992~2011

GONG Jia-jian;LIU Yu-ting

2012, 33(4):  523-529.  doi:10.3969/j.issn.1006-7795.2012.04.022

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A literature search was made on early diagnosis of Alzheimer’s Disease at SC-EXPANDED, and 3 453 articles were retrieved. Based on bibliometric statistics, the word co-occurrence of social network analysis methods, using tools of bibexcel, Ucinet, Vosviewer, visual analysis of the literature in the field of time, countries, research institutions, authors, journals, and hot spots was performed.

综述

Progress in studies on resistance to direct-acting antiviral agents in patients with chronic hepatitis C virus infection

CHENG Jun

2012, 33(4):  530-533.  doi:10.3969/j.issn.1006-7795.2012.04.023

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Hepatitis C virus infection is one of the leading causes of cirrhosis, hepatocellular carcinoma and liver failure. The current standard of care, a combination of Peg-IFN and ribavirin, eradicates the virus in only about 50% of patients. Direct-acting antiviral agents(DAAs) are in phase Ⅰ, Ⅱ and Ⅲ trials, which target the nonstructural 3 protease, the NS5A protein, the RNA-dependent RNA-polymerase NS5B. They directly inhibit HCV replication through interaction with host cell protein. Because of the high genetic heterogeneity of HCV and its rapid replication, monotherapy with DAAs possess a high risk for selection of resistant variants. This article reviews the progress in the research, resistance profiles and parameters of DAAs.

HEY gene family in mammalian cardiovascular development

HUA Bing;YANG Meng-han;CHI Ya-fei;WANG Chao

2012, 33(4):  534-537.  doi:10.3969/j.issn.1006-7795.2012.04.024

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Mammalian HEY gene family and drosophila Hairy genes have similar helix-loop-helix structure, both of which are transcription factors, and they are one of the few target genes found in the Notch signaling pathway. This paper aims at analyzing the characteristics of HEY gene family in its structure and function, clarifying their important effect in cardiovascular development, so as to provide a theoretical basis to reveal the mechanism and molecular regulatory mechanisms of HEY gene family on the cardiovascular development.

Recent advances in pyrrolidine derivatives as dipeptidyl peptidase-Ⅳ

FU Wen-zhuo;WU Ying-ting;ZHANG Jin-lu

2012, 33(4):  538-543.  doi:10.3969/j.issn.1006-7795.2012.04.025

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Type Ⅱ diabetes is one of the most common chronic diseases. The drugs which have pyrrolidine derivatives as dipeptidyl peptidase-Ⅳ have some effect in the treatment of type Ⅱ diabetes. Therefore intense interest has risen towards pyrrolidine derivatives as dipeptidyl peptidase-Ⅳ inhibitors recently. In this review, we summarized the mechanism, characteristic structure, structure-activity relationship and progress of pyrrolidine derivatives as dipeptidyl peptidase-Ⅳ, to provide a basis for structure-based drug design to the dipeptidyl peptidase-Ⅳ.

New advances of laser therapy in hair removal

LIN Guan-ting;DUAN Xiao-han;CUI Yu-li

2012, 33(4):  544-548.  doi:10.3969/j.issn.1006-7795.2012.04.026

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From adolescence people begin growing some unwanted hair on the skin under the changes of the hormones level. How to remove unwanted body hair which affect our appearance has become an increasingly prevalent trend recently. Laser hair removal is an advanced way to remove unwanted hair, and laser technology continuous to grow very fast in recent years. This article is a review which includes the promising progress of laser hair removal, and the factors that affect the efficiency.