Table of Content

24 August 2007, Volume 28 Issue 4

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The Impact of Nonmyocytes on the Expression of α-and β-Myosin Heavy Chain mRNA of Myocytes

Xie Miaorong;Shen Luhua

2007, 28(4):  427-429,433. 

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Objective To study the impact of nonmyocytes conditioned media(NMCM) on the expression of α-and β-myosin heavy chain(MHC) mRNA of myocytes.Methods One to three-day-old SD rats were used.Cells were separated to myocytes and nonmyocytes(NMC) and the suspension of NMC was used as nonmyocyte conditioned media(NMCM).After 96 hours' culture,the myocytes were divided into 8 groups: group M: MC+new media;group C: MC+70% new media+30% NMCM;group L: MC+new media +Losartan(10^-6mol/L);group CL: MC+70% new media +30% NMCM+Losartan;group P: MC+ new media+ PD123319(10^-6mol/L);group CP: MC+ 70% new media +30% NMCM +PD123319;group LP: MC+new media+Losartan+PD123319;group CLP: MC+ 70% new media+30%NMCM+ Losartan+ PD123319.After 24 hours treatment,The expression of α-and β-myosin heavy chain(MHC) mRNA of myocytes were measured.Results The expression of α-MHC were lower in group C and CP than that in other groups.Losartan can inhibit the changing from α-to β-myosin heavy chain(MHC) mRNA.Conclusion NMCM can cause α-MHC changing to β-MHC.The changes could be inhibited by Losartan.

The Impact of Nonmyocytes Conditioned Media on the Biological Process of Apoptosis in Myocytes

Xie Miaorong;Shen Luhua

2007, 28(4):  430-433. 

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Objective To study the impact of nonmyocytes conditioned media(NMCM) on the biological process of apoptosis in myocytes(MC) and the relationship with the angiotensin Ⅱ receptors.Methods 1～3 day-old SD rats were used for our experiment.The single cells were separated to myocytes(MC) and nonmyocytes(NMC) and the suspension of NMC was used as nonmyocyte conditioned media(NMCM).After 96 hours culture,the myocytes were divided into 8 groups: group M: MC+new media;group C: MC+70% new media+30% NMCM;group L: MC+new media +Losartan(10^-6mol/L);group CL: MC+70% new media +30% NMCM+Losartan;group P: MC+ new media+ PD123319(10^-6mol/L);group CP: MC+ 70% new media +30% NMCM +PD123319;group LP: MC+new media+Losartan+PD123319;group CLP: MC+ 70% new media+30%NMCM+ Losartan+ PD123319.Results 1)The area of myocytes,RNA and protien of group C,CP and CLP were greater than those of group M;2)The rates of apoptosis of group C and CP were higher than those of other groups.Conclusion NMCM made myocytes of rats hypertrophy,but not proliferation.Losartan can inhibit both NMCM-induced hypertrophy of myocytes partly and NMCM-induced apoptosis of myocytes.It is suggest that AT1 receptor can promote apoptosis of myocytes.

Continuous Cardiac Output Measurements with Transesophageal Doppler Echocardiography Versus Swan-Ganz Catheterization

Yin Wenpeng;Li Chunsheng

2007, 28(4):  434-436,459. 

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Objective To compare the results of CCO measurements by echocardiography through transesophageal Doppler route with that of Swan-Ganz catheterization method in anesthetized dog models.Methods Cardiogenic shock model of canine was established by ligating the left anterior descending(LAD) of coronary artery.The transesophageal Doppler sensor was placed into the esophagus at the level of T5-6 vertebra of in 18 anesthetized dogs.The hemodynamic parameters,including CCO were recorded with HemosonicTm100;The Swan-Ganz Catheterization performed through right femoral vein.The CCO variables of both group were analyzed with linear regression procedure.Results Continuous cardiac output measured with transesophageal Doppler echocardiography was highly correlated with that measured with thermodilution technique(R=0.965,P<0.01,n=108).Conclusion Transesophageal Doppler echocardiography allows reliable continuous measurements of CCO,both easily and safely.The invasive technique of hemodynamic measurement can be replaced by non-invasive one.

Study on the Effect of Acute Cerebral Hemorrhage on Left Ventricular Function and the Relationship between Acute Cerebral Hemorrhage and Plasma Brain Natriuretic Peptide

Zhang Longyou;Li Chunsheng;Yu Dongming

2007, 28(4):  437-441. 

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Objective The purpose of this study is to investigate the alterations of left ventricular function in patients with acute cerebral hemorrhage and the relationship between acute cerebral hemorrhage and plasma brain natreuretic peptide(BNP) by way of echocardiography and plasma BNP concentration determination and to bring to light the mechanism and to provide the basics for preventing and treating cardiac impairment caused by acute cerebral hemorrhage.Methods Thirty patients with acute cerebral hemorrhage within 24h having been diagnosed by clinical manifestations and head computed tomography were recruited.All enrolled patients had no history of heart diseases and no complications such as cardiac insufficiency and arrhythmia.And concurrently twenty sex and age matched patients with essential hypertension,and twenty-one sex and age matched healthy persons were selected as control groups.All patients and controls underwent echocardiographic investigation and at the same time blood was drawn for the quantitative determination of plasma BNP concentration.Results 1) The mean of LVEF in acute cerebral hemorrhage group was much lower than those in hypertension group and healthy control group((41.33±15.03)% vs(59.20±15.03)%,P<0.01;(41.33±15.03)% vs(67.71±8.02)%,P<0.01,respectively);There was no significant difference in the mean of LVEF between hypertension and healthy control groups(P>0.05).The mean E/A ratio in acute cerebral hemorrhage group was lower than those in hypertension group and healthy control groups.There was no significant difference in the mean E/A ratio between acute cerebral hemorrhage group and hypertension group(P>0.05),but there was significant difference between acute hemorrhage group and healthy control group(1.00±0.46 vs 1.47±0.23,P<0.01).The mean E/A ratio in hypertension group was lower than that in healthy control group, the difference was significant(1.09±0.37 vs 1.47±0.23,P<0.01).2) The plasma BNP concentration in acute cerebral hemorrhage group was higher than that in healthy control group((49.62 ng/L,(17.18～85.25)ng/L vs(1.90 ng/L,(0.15～21.50)ng/L,P<0.01).3) The correlation coefficient between volume of cerebral hemorrhage and plasma BNP concentration was 0.13(P>0.05).There was no correlation between volume of cerebral hemorrhage and all cardiac functional parameters in acute cerebral hemorrhage group(P>0.05).There was no correlation between plasma BNP concentration in acute hemorrhage group and cardiac structural and functional parameters(P>0.05).Conclusion Acute cerebral hemorrhage can cause left ventricular systolic dys function.Acute cerebral hemorrhage may cause left ventricular diastolic dys function as well.There was no correlation between the volume of cerebral hemorrhage and all cardiac functional parameters in acute cerebral hemorrhage group.The plasma BNP concentration increases after the onset of acute hemorrhage,but there was no correlation between the BNP concentration and changes in cardiac structural and functional parameters.The rise of plasma BNP concentration may be caused by the pathophysiologic mechanism of acute hemorrhage.

Clinical Study on Early Risk Stratification in Non-ST-segment Elevation Acute Myocardial Infarction

Wang Yong;Fu Yan;Zhang Jing

2007, 28(4):  442-444. 

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Objective To investigate the influential factors of early risk stratification in non-ST-segment elevation acute myocardial infarction(NSTEMI).Methods QT dispersion(QTd),cardiac troponin I(cTNI),C-reactive protein(CRP),presence of ST-segment depression were measured and coronary angiography(CAG) undertaken in 102 patients with NSTEMI.According to the results of CAG(single-vessel,two-vessel and triple-vessel changes in CAG),the 102 patients were divided into three groups(groups 1,2 and 3).Results Although there was no significant difference in the basic characters among the three groups,the percentage of male was higher than that of the female(P<0.001).Patients in group 1 had lower QTd,cTNI,CRP and fewer presence of ST-segment depression than the others.The percentage of diabetes mellitus in the group 2 and group 3 was higher than that in group 1(P<0.05).Multivariable logistic regression analysis suggested that aging、history of diabetes、elevated QTd、cTNI and CRP、presence of ST-segment depression were predictors of early risk stratification(OR:1.401,1.632,2.041,2.322,2.102 and 1.310 respectively).Reinfarction,recurrent angina and congestive heart failure were more frequently seen in patients with 4 factors than those with one factor only(P<0.05);but there were no significant difference in the occurrence of cardiogenic shock and mortality.Conclusion Aging,History of diabetes,elevated QTd,cTNI and CRP,presence of ST-segment depression are independent predictors of early risk stratification in NSTEMI,which are associated with severe ischemia and multivessel coronary artery disease and indicate a poor prognosis.

Acute Coronary Syndrome and Detection of Unstable Plaque

He Yu;Fu Yan

2007, 28(4):  445-449. 

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Objective The aim of the present study is to assess the value of hs-CRP,PAPP-A and MMP-9 in diagnosis and to evaluate the short-term prognosis of ACS.Methods Sixty patients with ACS and 30 patients without ACS were enrolled in this study.The hs-CRP PAPP-A MMP-9 levels were measured.Patients with ACS were followed up for 30 days after admission.The relation between these three factors and the 30 days prognosis were observed.Results Blood hs-CRP levels showed significant differences between control and unstable angina(UA) groups(P<0.05),control and acute myocardial infarction(AMI) groups)P<0.01),as well as UA and AMI groups(P<0.01).There were very significant differences in blood PAPP-A and MMP-9 levels(P<0.01).Blood hs-CRP was positively correlated with blood PAPP-A and MMP-9.Single factor analysis showed all the three levels were higher in MACE patients(P<0.01).Logistic regression analysis showed that blood PAPP-A and MMP-9 were correlated with MACE in 30 days(P<0.05).Conclusion Because the hs-CRP,PAPP-A and MMP-9 might decrease the stability of the plaque,they are important risk factors of ACS.Inflammation affected the development and changes of ACS by decreasing the stability of the plaque.The levels of hs-CRP PAPP-A and MMP-9 are correlated with the short-term prognosis of ACS.PAPP-A and MMP-9 levels are independent risk factors of short-term prognosis in ACS patients.PAPP-A and MMP-9 could be better predictors than hs-CRP.

The Value of Dynamic Observation on C-reactive Protein and Clinical Pulmonary Infection Score in Evaluation of the Prognosis of Aged Patients with Community Acquired Pneumonia

Zhao Jing;Qin Jian;Yang Shufang

2007, 28(4):  450-453. 

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Objective To study the changes on C-reactive protein(CRP) and clinical pulmonary infection score(CPIS) in aged patients with community acquired pneumonia(CAP) and the value in evaluation of the prognosis.Methods Ninety-eight elderly CAP cases were analysed retrospectively CRP,CPIS,white blood cell(WBC),neutrophil percentage(N),albumin(ALB) and prealbumin(PA) were measured on the 1st and the 7th days after admission.Data were compared with those of 30 aged patients without infection.CAP patients were divided into fatal group and surviaval group.ROC curve was used to determine the optimal limit value.Cases were divided into two groups by taking the decline of CRP less or more than 70% and CPIS less or more than 0.5 as the landmark.Statistical comparison was carried out on the results.Results On the 1st day after admission,the levels of CRP(77.87±69.97)mg/L in survival group and CRP(71.10±71.75)mg/L in the fatal group were much higher than that in the control group(4.30±3.91)mg/L,(P<0.01).The levels of CRP and CPIS were not significantly different between the fatal group and the survival group.After one-week treatment,compared with 1st day,the levels of CRP(22.44±22.83)mg/L and CPIS(2.34±2.15) declined significantly in the survival group.While the levels of CRP(61.28±40.37)mg/L and CPIS(6.04±2.23) were not significantly different in the fatal group.The levels of CRP and CPIS of the fatal group were much higher than those of the survival group(P<0.01).Through comparing AUC,the CRP decline ratio was better than that of the CPIS in predicting prognosis.According to the ROC curve,the optimal limit value in CRPdecline ratio was 70.33% and in CPIS 0.5 Using the two parameters together,the evaluation of treatment success had a specificity of82.4% and positive predictive value of 58.1%.In the regression analysis of the CAP cases,the regression equation is Y^= 0.551+0.064 CPIS2+0.064CPR2-0.205ALB1,the Coefficient is 0.603.Conclusion Dynamic observation of CRP and CPIS provides an important means in evaluating the prognosis of CAP in aged patients,especially when symptoms were atypical.It is recommended to use them jointly.

The Role of BNP in Diagnosis of Congestive Heart Failure and Its Advantages over UCG

Chen Fei;Zheng Yaan

2007, 28(4):  454-456. 

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Objective To investigate the clinical significance of the B-type natriuretic peptide(BNP) in the differential diagnosis of acute dyspnea,its role and contribution to staging of the congestive heart failure(CHF),and its advantages for the CHF diagnosis compared with the ultrasonic cardiography(UCG).Methods The plasma BNP levels in 86 patients with dyspnea were determined and the left ventricular ejection fraction(LVEF) measured by UCG,taking BNP>100 ng/L and LVEF<50% as the diagnostic criteria of CHF.The cardiac functions of patients clinically diagnosed as CHF were divided into four stages based on the New York Heart Association(NYHA) criteria.Comparison was performed between the clinical diagnoses and BNP levels.Results The BNP levels were significantly different between the non-CHF group and CHF group,and among CHF groups at different stages.In each of which the P value was less than 0.001.BNP had high sensitivity(98.5%), positive predictive value(94.4%),and negative predictive value(93.3%).The specificity of BNP(77.8%) was slightly lower than that of UCG(94.4%);the positive predictive values were almost equal,being 94.4% and 97.8% respectively.BNP,however,had absolute advantages in terms of sensitivity and negative predictive value as compared with those of UCG which were 64.7% and 41.5%,respectively.Conclusion BNP is a rapid,accurate,and quantitative index in the diagnosis of CHF and in differential diagnosis as compared with UCG,especially in terms of the sensitivity and the negative predictive value.

The Direct Thrombin Inhibitors and Their Clinical Application

Guan Jian;Wang Guogan;Zhu Jun

2007, 28(4):  462-466. 

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Direct thrombin inhibitors are newly emerging decoagulant.They inhibit thrombin,and also inhibits factor Ⅴ,Ⅷ,ⅩⅢ and fibrinogen.All of which are mediated by thrombin.Direct thrombin inhibitors not only have anticoagulant function,but also have anti-platelet aggregation function.So,they have a good perspective in treatment of some diseases related to thrombus formation.In the treatment and prevention of some diseases such as acute coronary syndromes,atrial fibrillation,venous thromboembolism,heparin induced thrombocytopenia, ischemic cerebrovascular diseases,peripheral arterial occlusion,as well as during percutaneous coronary intervention,the direct thrombin inhibitor plays a role.This paper reviews the role of direct thrombin inhibitors in different aspects such as biologic activity,and safety and their clinical applications.

基础研究

Effects of Recombinant Pro-urokinase on Expression of Urokinase Type Plasminogen Activator System in Human Pulmonary Arterial Endothelial Cells

Liu Yi;Wang Chen;Yang Yuanhua;Pang Baosen;Huang Xiuxia;Xin Ping;Hou Xiaoli;Wang Jun

2007, 28(4):  467-470. 

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Objective Pro-urokinase,a new thrombolytic agent that is currently being evaluated for the treatment of myocardial infarction,stroke and pulmonary embolism.However little research has been done about the effects of recombinant pro-urokinase on endothelial cells.The purpose of this article is to study the effects of pro-urokinase on the expression and release of urokinase type plasminogen activator receptor(u-PAR) and plasminogen activator inhibitor1(PAI-1) and to study the effects of pro-urokinase on the mRNA expression of urokinase type plasminogen activator(u-PA) in human pulmonary arterial endothelial cells(HPAECs).Methods The HPAECs were cultured in M200 medium with low serum growth supplement until became confluent.Then the HPAECs were starvated for 12 h,and ready to be used in different experiments.(1) HPAECs were incubated with pro-urokinase(0 or 150 IU/mL) for 8 h,then the medium was centrifuged for 10 min at 1 000 r/min and expression of u-PAR or PAI-1 in the medium detected with ELISA kits.(2) HPAECs was incubated with pro-urokinase 150 IU/mL for 0,4,8,12 and 24 hours.In each group,the total RNA of HPAECs was extracted by Trizol reagent and the gene expression of u-PA mRNA detected with RT-PCR and compared with that of GAPDH mRNA.All cells in these experiments were of 3 to 6 passages.Results The cells were flat with round or oval nuclei containing several prominent nucleoli.Six to seven days after plating,the cultured HPAECs formed a monolayer.In the ELISA tests,the u-PAR content in pro-urokinase treated cell was statistically increased as compared with the control ones((0.51±0.04)μg/L vs(0.58±0.05)μg/L,P=0.005);the PAI-1 content in serum was statistically decreased in pro-urokinase treated cells as compared with control ones((66.75±7.92)μg/L vs(53.38±12.18)μg/L,P=0.009).In RT-PCR experiments,after incubation with pro-urokinase 150 IU/mL for increasing hours(0,4,8,12 and 24 hours),the u-PA bd/GAPDH band ratio was(0.34±0.11),(0.51±0.12),(0.58±0.12),(0.50±0.18) and(0.35±0.10) respectively.Pro-urokinase(150 IU/mL) incubation could up-regulate the expression of u-PA mRNA in HPAECs in a time-dependent manner and the highest expression was shown at 8 hours.Conclusion Under normal conditions,HPAECs cue could express or release u-PA,u-PAR,and PAI-1.Pro-urokinase could inhibit the release of PAI-1 and enhance the release of u-PAR from cell surface.Pro-urokinase could enhance the expression of u-PA mRNA in HPAECs in a time-dependent manner.Pro-urokinase has direct effects on the expression of u-PA system in HPAECs,which may thus enhance thrombolytic process.

The Relation of Insertion Elements IS861 and IS1548 to Genotype and Phenotype of Group B Streptococci

Yang Ming;Yang Yonghong;Dmitriev Alexander;Shen Adong;Tong Yuejuan;Fan Xunmei

2007, 28(4):  471-475. 

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Objective To observe the presence pattern of two insertion elements,IS 861 and IS 1548 in the genome of Group B streptococci(GBS);to study the relationship between the insertion elements in the genome and the phenotypes of GBS(virulence,drug resistance,and serotype);and to access the value of insertion elements in genotyping.Methods IS861 and IS1548 were studied with PCR-restriction fragment length polymorphism(RPLP),nucleic acid probe and Southern blot in 113 strains isolated in Beijing,Guangzhou and St.Petersburg.Results Of the 113 GBS strains,67(59.3%) and 13(11.5%) possessed IS861 and IS1548 respectively.There was no significant difference in positive insertion rate of the two elements among the strains isolated in the three cities.Thirteen strains with IS1548 additionally possessed IS861 and all belonged to serotype Ⅲ.Relatively larger number of insertion element copies were discovered in the genome of these strains.The GBS strains possessing insertion element(s) showed a significantly higher erythromycin resistance rate.Nine HindⅢ restriction patterns,hybridized with gene probe IS861 were found in 67 insertion element positive strains,and the copy numbers varied from 1～9;while 6 EcoRⅠrestriction patterns,hybridized with IS 1548 gene probe,were found in 13 strains with the copy number varied form 8～9.Conclusion The insertion of insertion element(s) is common in the genome of GBS.IS861 and IS1548 are closely related to the special properties of GBS serotype Ⅲ.Most of the strains of serotype Ⅲ were believed to be from a same pathogenic clone,and clinical attention should be paid to the women and neonates carrying GBS serotype III.IS861 and IS1548 may modulate the erythromycin susceptibility of GBS by affecting the expression of erythromycin resistant genes.The comparative study of different typing method suggest that the combination of genotyping by insertion elements PCR-RFLP and serotyping demonstrate a good discriminative value in epidemiological study of GBS.

Expression of Vascular Endothelial Growth Factor in the Granulated Metrial Gland Cells

Wei Jingbo;Weng Jing

2007, 28(4):  476-478. 

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Objective To investigate the expression of vascular endothelial growth factor(VEGF) in the granulated metrial gland(GMG) cells.Methods Metrial glands were taken from pregnant Kunming mice at 13～15th gravid day.GMG cells were got and purified by tissue culture.Expression of VEGF in the GMG cells was shown with immunohistochemical staining and Western blot.Results GMG cells migrated from the tissue culture blots and grew well.Expression of VEGF was shown in these cells by immunohistochemical staining and Western blot.Moreover VEGF was also shown in GMG cells culture medium.Conclusion The GMG cells can express and excrete VEGF.

Modulation of GFP Expression by Chicken α-Globin Gene 5 MAR in COS7 Cells

Sun Licui;He Junqi;Zheng Junfang;Wang Yamei;Zhang Song;Zhang Yuguo;Zhong Fei;Liu Pengpeng;Qi Shunzhang

2007, 28(4):  479-483. 

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Objective Recently,it has reported that gene expression and regulation in eukaryotic cells were closely related to matrix attachment regions(MARs).MARs,also known as scaffold/matrix attachment regions(S/MARs),are critical for stabilization of transgene expression.MARs are located in close proximity to cis-acting regulatory DNA elements identified either genetically or functionally.MARs mediate structural organization of the chromatin within the nucleus.Also MARs can affect formation of eukaryotic DNA loop,maintain stability of DNA and participate in gene regulation via interaction with nuclear matrix by MAR-binding proteins.In recent years more researches have demonstrated that 5' MARs of some genes,such as chicken lysozyme gene,human β-interferon and β-globin gene,have transcriptional enhancer activity and can enhance the expression of foreign gene.5' MAR(1 600 bp) of chicken α-Globin gene is located at the boundaries of the "active" chromatin region which includes replication initiation region and nuclear matrix association region.It also contains binding sites of many transcription factors,such as SP-1,DTF-1,CTF and AP-1 et al,a long GC-rich inverse-repeated sequence GCTGCTGGCCAGCAGC and many A-boxes and T-boxes downstream of sequence.These structures are favor of the binding of nuclear matrix with MAR.GFP(green fluorescent protein) gene is a reporter gene.GFP,as expression product of GFP gene,is not only easy to observe but also easy to accurately quantify in eukaryotic expression system.So in this study GFP gene was used as a reporter gene to study the regulating effect of chicken α-globin gene 5' 1600 bp MAR on gene expression.Methods First PCR method was used to amplify 1 600 bp chicken α-Globin gene 5' MAR sequence.Then eukaryotic expression vector pGFP/2MAR was constructed by adding MAR in the upstream of CMV promoter and downstream of GFP reporter gene.Thirdly,vector pGFP/2MAR was transfected into COS7 cell line with liposome method.Finally,fluorescent microscope and flow cytometry(FCM) were used to assess GFP expression.Results From fluorescence microscope,we observed that the expression level of GFP in pGFP/2MAR transfected cells was much higher than that of pCMV/GFP transfected cells at 48 h after transfection.FCM analysis showed that the number of percentage of GFP positive cells are 17.9%(pCMV/GFP) and 33.6%(pGFP/2MAR) respectively in COS7 cells,demonstrating that MAR could significantly enhance the expression of GFP.Conclusion MAR can enhance the expression of GFP in COS7 cells, which suggests thatMAR can be further applied to improve expression efficiency of foreign gene in eukaryotic cells.But in our experiment the extent of enhancing expression of MAR is lower than those reported elsewhere.Whether this expression system has selectivity on cell line,promoter or other factors needs further study.

Determination of Percutaneous Absorption in Mice of Borneol After External Application of Compound Chinese Medicine with Gas Chromatography

He Yumei;He Min;Li Peiwen

2007, 28(4):  484-487. 

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Objective Ointment of compound Chinese medicine having definite effect on treating tumor effusion was formulated for external application.The characteristics of percutaneous absorption of borneol,which is one of the effective ingredients in the compound prescription was quantitatively investigated.Gas chromatography was used to determine borneol in ointment and in biological sample,the ascites of ascites line(H22) mice in vivo.Methods In this study,the concentration of borneol in model mouse ascites was detected as a sign of this prescription permeating skin after external application.H22 mice were given the external ointment of compound Chinese medicine on abdominal skin,and then,the ascites of mice were drawn at different time intervals since external application.The concentration of borneol in mice ascites were separately determined by gas chromatography.Results The chromatograms showed that borneol in the ascites samples of mice can not be determined at 15 min after being given externally,but at 30 min,the average concentration of borneol in ascites was 1.707 mg/L.It reached its peak value(9.588 mg/L) at 4 h after being given the ointment.Then it declined 4 h later,the average concentration of borneol in ascites decreased suddenly at 6 h,the average concentration of borneol in ascites further declined copiously after 6 h,and then it declined slowly,the average concentration of borneol in ascites was 4.935 mg/L at 8 h after the external application of ointment.Conclusion The results shows that borneol,the main effective ingredients of the external ointment of compound Chinese medicine can be determined in H22 mice ascites after external application.This indicates that the effective ingredients of the ointment can be absorbed through mice skin,and it can have effect on reaching the target organ.The percutaneous absorption takes place slowly and keeps effective long.Gas chromatography can be used to determine borneol in biological sample,and the method used in this test was efficient and accurate.This method is better than the commonly used,radioisotope scanner,it avoids pollution and the operation is easy.

Studies on the Pathophysiological Performance of the Artificial Liver Support System in the Treatment of Acute Liver Failure

Zhang Shijie;Jia Cuiyu

2007, 28(4):  488-491. 

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Objective To study the therapeutic effects of artificial liver support system treatment for in acute liver failure.Methods Eleven miniature pigs were divided into the therapeutic and control groups.Pigs were given D-galactosamine to build models of acute liver failure.Pigs in the therapeutic group were treated after 48 h with plasma exchange and hemofiltration of the artificial liver support system(ALSS).Four parameters were observed: survival time,common condition,biochemical assay,changes in liver pathology.Results The survival time(128.7±11.3) h in the therapeutic group were remarkably different from those in the control group(67.9±9.4)h in terms of improvements in the common condition,as well as ALT,TBil and PT levels(P<0.01).Area of necrosis was obviously reduced in the therapeutic group,and cholestasis was not found.Conclusion Treatment of acute liver failure by ALSS in pig model is very effective.

Screening Analysis and Preventive Measures of Tubercle Bacillus Infection in Undergraduates Clinic Attached to Capital Medical University

Zhu Xian

2007, 28(4):  492-494. 

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Objective To analyze the results of tuberculosis(TB) screening for undergraduate freshmen in Grade 1 classes of 2005 and 2006.Capital Medical University and to discuss the preventive measures of TB infection in undergraduates.Methods Chest X-ray(with 500 mA X-ray machine) and Purified Protein Derivative(PPD) tests were carried out among 2410 undergraduate freshmen in Grade 1 classes of 2005 and 2006 of Capital Medical University.Results PPD tests were carried out among 1504 undergraduate freshmen in Grade 1 class of 2005 with 20 positive cases accounting for 1.33% and among 906 undergraduate freshmen in Grade 1 class of 2006 with 11 positive cases accounting for 1.21%.Chest X-ray for TB was carried out among 1504 undergraduate freshmen in Grade 1 class of 2005 with 6 cases infected with TB accounting for 0.399% and among 906 undergraduate freshmen in Grade 1 class of 2006 with 3 cases infected accounting for 0.331%.Conclusion The prevalence rates of TB among undergraduate freshmen are not lower than that of the national basic TB control index.PPD test is an effective screening method.College students are highly vulnerable to TB.Measures should be taken to improve the resistance to TB and to prevent and reduce the infection of TB,by strengthening health education,building up constitution and developing good personal hygienic habits.Regular physical checkup should be carried out among college students on campus in order to detect early TB cases and take active preventive and control measures.

The Development of a Computer-based Evaluating System for the Elderly's Physical Fitness

Chen Ruifang;Xiong Kaiyu

2007, 28(4):  495-500. 

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Objective As one important part of the national fitness camping,the physical fitness of the old people is paid more and more attention to by the people.The studying confine of the old people's physical fitness is more extended.Large area and repeating more frequently fitness test need more simple and efficient evaluating method.Methods In this study,we consulted a lot of literature and data.On the basis of the standards made by national fitness monitor and ECG test experiment and exercise suggestion,Design and preparation procedures for the evaluation of the physical fitness test with the commonly used programming language Visual Basic.Results We made the exercise suggestion for old people,so that they can exercise in lots of ways easily.We worked out a program for the whole physical fitness test evaluating.In this system,we can input the data of the subject,and evaluate their fitness.We can modify,delete,and query their fitness condition.We even can query the subjects who in some common.In the last,we can give them the exercise suggestion individually.It is easy for the old people to exercise themselves.Conclusion The efficiency of physical fitness test evaluating process would be greatly improved and it was well suited for the need of today's physical fitness test.In the same time,from the design process and method,we can exerted to the child and young,or adult or other age colony.

临床研究

The Application of Intraoperative Angiography in the Surgical Treatment of Patients with Acute Hemorrhagic Stroke

Yuan Ge;Wang Shuo;Xu Jun;Xin Yu;Zhao Jizong

2007, 28(4):  501-504. 

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Objective To evaluate the clinical value of intraoperative angiography during emergency operation for cerebrovascular diseases of the hemorrhagic type.Methods From July 2003 to February 2006,15 consecutive patients with acute hemorrhagic stroke(7 female and 8 male patients,mean age 36 years) underwent emergency operation assisted with intraoperative angiography in our institute.Of these patients,there were 10 cases of AVMs with nidus diameter from 2 cm to 7 cm,including 2 cases with of large AVMs(diameter≥6 cm);the other 5 cases were aneurysms including 1 case of giant aneurysm(diameter≥2.5 cm).The preoperative Hunt-Hess grading in these patients was grade 1 in 1,grade 2 in 2 and grade 3 in 2.After intubation was achieved and general anesthesia administrated,the patient's right femoral artery was catheterized successfully with the catheter reaching the intracranial artery,which would be involved during the surgery.After the lesion had been treated,such as AVMs being resected or the aneurysm being clipped,the intraoperative angiography was performed.Results All of these 15 patients underwent emergency operation for acute intracranial hemorrhage without preoperative angiography.Ten patients were estimated to have AVMs as assisted with intraoperative angiography,while the other 5 patients revealed aneurysms.Thirteen of 15(86.7%) patients had been treated successfully,1 patient(6.7%) with ophthalmic artery aneurysm was estimated to have residual aneurysm and being undergone clip adjustment.One patient(6.7%) had motor dominant zone residual AVMs,which was noted and resected.There was no operation mortality,no unexpected major artery occlusion.No complication attributable to angiography noted.Intraoperative angiography took 60 to 145 min with a mean time of 83 minutes.Conclusion Intraoperative angiography detects the position of unexpected residual aneurysms or AVMs nidus and occlusion of major artery,helps surgeons to modify technical faults to prevent from reoperation,and can decrease complication of cerebrovascular surgery.

The Pharmacokinetics of High-dose Chemotherapy with Presperative Methotrexate for Osteosarcoma and the Clinical Analysis

Wang Difan;Niu Xiaohui;Zhang Qing;Hao Lin;Ding Yi;Cai Youbo

2007, 28(4):  505-509. 

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Objective To evaluate the pharmacokinetics and clinical results in preoperative osteosarcoma patients with HDMTX chemotherapy.Methods The methotrexate pharmacokinetics of 32 osteosarcoma patients who were treated with 37 courses of preoperative HDMTX chemotherapy were analyzed.Chemotherapy protocol: all patients received HDMTX(at the dose of 8～12 g/m²) intravenously with folinic acid rescue(at the dose of 9～15 mg).Patients received hydration and alkalinization fluids starting 24 hr before the MTX administration and continuing 24 hrs after HDMTX administration was completed.Serial blood samples were obtained at 0,1,6,12,24,48 and 72 hours after the MTX infusion.The serum MTX concentrations were measured subsequently.The MTX data were treated with NCA(non-compartment analysis) model.The event free survival time(EFS),change of MR image and the adverse effects of the patients were recorded.Results AUC=4 853.53±1581.53 μmol/(L·h^-1),Cmax=947.79±333.45 μmol/(L·h^-1),EFS=(41.47±16.07)month.EFS has a close correlation with AUC and has none close correlation with the Cmax.Significant differences were detected in EFS considering the AUC of 4 000 μmol/(L·h^-1) as the cut-off point.According to the change of MRI,the cases are divided into two groups: good response group and poor response group,their AUCs and Cmaxs had significant differences.Eleven cases demonstrate marrow inhibition and their AUCs were significantly difference from those without.Four cases demonstrated hepatic impairment.One case complicated oral ulcer.Conclusion AUC has close correlations with the short and long term clinical results.AUC>4000 μmol/(L·h^-1) can be a criterion.Marrow inhibition is related to higher AUC or Cmax.

Time Delay Distribution from Symptom Onset to Treatment in Patients with Acute ST Elevated Myocardial Infarction

Guo Jincheng;Hua Qi;Li Dongbao;Liu Dongxia;Wen Yumei;Chen Hailing;Xu Ji

2007, 28(4):  510-512,521. 

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Objective To investigate the time delay in different phases from symptom onset to arrival at the hospital and time to treatment in patients with acute ST-segment elevated myocardial infarction(STEMI).Methods In this prospective,study,412 consecutive patients with confirmed STEMI were encolled in the(LuHe Hospital and Xuanwu Hospital) study from September 2003 to November 2004.The data were collected from patients' interviews and medical records.The following median times were recorded: patient's delay(PD),transportation delay(TD),prehospital delay(PHD),door to CCU(DTC),CCU to informed consent of reperfusion therapy,door to needling(DTN) and door to the first ballooning(DTB).Results A total of 412 patients with STEMI were enrolled.The following median times were recorded: PD 75 min;TD 50 min,PHD 170 min;door to CCU 30 min;252 patients received reperfusion therapy within 12 h after symptom onset,of which 145 patients received thrombolytic therapy,the remaining 107 patients performed primary angioplasty.Written informed consent in thrombolytic therapy and primary angioplasty was obtained in median times of 15 min and 46.5 min,respectively.Door to needling and door to ballooning times were 65 min and 135 min,respectively.Door to needling time of less than or equal to 60 min is achieved in 48.3% of patients,Door to ballooning time of less than 90 min and 120 min in 23.4% and 43.9%,respectively.Conclusion PD is the main cause of prehospital delay.The time of obtaining informed consent plays an important role in treatment delay.In-hospital delay is still higher than the guideline-recommended door-to-ballooning times.

临床研究

Clinical Analysis of the Hepatic Stress Injury in Early Stage after Traumatic Brain Injury in Adults

Meng Qingying;Zhu Yuqun

2007, 28(4):  513-515. 

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Objective To investigate the incidence,the risk factors and prognosis of the hepatic stress injury in early stage after traumatic brain injury in adults.Methods Total 329 cases with traumatic brain injury admitted and treated in our department from January 2005 to September 2005 were analyzed retrospectively.Results Forty-nine patients were diagnosed hepatic stress injury(14.9%).There is no difference in age,sex,injury type and site,between Group HSI and the control group.The degree of injury(GCS) in HSI is significantly more severe than the control(P<0.001).The mortality in HSI is increased(P<0.05).Conclusion HSI may appear in early stage after traumatic brain injury.There is close correlation between HSI and the degree of injury.The prognosis is not good,the total mortality is 30.6%.HSI needs more attention and active treatment.

The Clinical Study of the Relationship between Serum Levels of MMP-9 and the Biological Behaviors of NSCLC

Liu Xiaofang;Chen Dongning;Zhang Husheng

2007, 28(4):  516-518. 

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Objective To evaluate the clinical application of MMP-9 and other four tumor markers in serum for the diagnosis of non-small cell lung cancer(NSCLC) and the correlation with the clinical staging of NSCLC.Methods Using the ELISA method and tumor markers protein chip,the serum levels of MMP-9,CEA,NSE,CA125 and CA19-9 in 73 cases of NSCLC,21 cases of benign pulmonary diseases and 16 cases of normal controls were measured,and compared with the clinical features of pathol-physiology of NSCLC.Results The concentrations of serum MMP-9,CEA,NSE,CA125 and CA19-9 in patients with NSCLC were significantly higher than those in the group with benign pulmonary disease and in the control group(P<0.01),furthermore,the levels of MMP-9 remarkably went up in NSCLC with increase in tumor size,lymph node metastasis and advance in clinical staging(P<0.01).Conclusion The serum levels of MMP-9,CEA,NSE,CA125 and CA19-9 were of some value in the diagnosis of NSCLC.Being a good marker associated with the biological behaviors,the serum MMP-9 is of greater clinical significance for the diagnosis of NSCLC.

The Characteristics of Blood Pressure Variability in Patients with Hypertension and Obstructive Sleep Apnea

Liu Zhi;Hua Qi;Zhu Hongxu;Li Dongbao

2007, 28(4):  519-521. 

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Objective To study the characteristics of blood pressure variability in the hypertensive patients with moderate or severe obstructive sleep apnea syndrom,which will help to reveal the causes of high morbidity of cardio-cerebral vasuclar events.Methods Ninety-four patients were divided into the control group(hypertension with mild obstructive sleep apnea,n=58,mean age(52±2.7)y, body mass index(27.3±0.98)kg/m² and OSAS group(hypertension with moderate or severe OSAS,mean age(46±1.6)y,body mass index(28.2±0.48)kg/m² according to the results of clinical blood pressure,24 h ambulatory blood pressure monitoring(ABP) and polysomnography(PSG).Results 1) The two groups are age,sex and body mass index matched.The rate of non-dipper profile in OSAS group(55.6%) is significantly higher than that of the control group(22.4%).2) Mean pulse pressure(PP) in 24 h,daytime and nighttime,in OSAS group((49.57±13.27)mmHg,(49.53±12.92)mmHg,(50.31±16.86)mmHg) is significantly higher than that of the control group((44.69±7.12)mmHg,(45.12±7.50)mmHg,(42.69±6.28)mmHg respectively)(P<0.05).Conclusion Moderate and severe OSAS affects the rhythm of blood pressure variability as well as does the pulse pressure.

Clinical Study on Improving Quality of Life in Adult Patients with Epilepsy by Enhancing the Standardization of Diagnosis and Treatment

Zhao Yongqing;Ding Chengyun;Li Zhimei;Cao Jing;Zhou Yong;Huang Yuming;Shao Xiaoqiu;Wang Yongjun

2007, 28(4):  522-527. 

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Objective To study the effects on improving quality of life(QOL) in adult patients with epilepsy by enhancing the standardization of diagnosis and treatment.Methods Eighty adult patients with epilepsy under nonstandard diagnosis and treatment,whose disease course was at least one year and seizure frequency more than four times a month were enrolled standardization with strict procedure of diagnosis and treatment was then adopted.After three months' standard AEDs treatment,the QOL for these patients were evaluated by quality of life in epilepsy inventory-31(QOLIE-31,Chinese version).Results All aspects of QOL for patients with uncontrolled seizures had been decreased,among which the values of worry about seizure and effects of medication were lowest.At the same time gender,education background,occupation,economic status and living condition also affected the overall QOL and various scales of QOL.After standard treatment overall QOL and all scales were significantly improved,meanwhile the influence of the above factors on QOL were largely eliminated or obviously diminished.Conclusion Enhancing the standardization of diagnosis and treatment was the key to controlling seizure and improving QOL in adult patients with epilepsy.

Clinical Analysis of the Haemorrhagic Type Moyamoya Disease

Yang Mingqi;Ni Ming;Wang Shuo;Zhao Jizong

2007, 28(4):  528-531. 

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Objective To analyse cases of haemorrhagic type moyamoya disease during 15 years period and elucidate the clinical features of this disease.Methods Eighty-two patients with haemorrhagic type moyamoya disease,50 males and 32 females,with average aged of 36.6 years,diagnosed with digital subtraction angiography,were divided into 3 groups according to CT scan: Group A consisted of 10 cases(12%) with aneurysms;Group B consisted of 38 cases(46%) with intracerebral haemorrhage(ICH) without aneurysms;Group C consisted of 34 cases(42%) with intraventricular haemorrhage(IVH) without aneurysms or ICH.Surgical treatment was performed in 49 patients and conservative treatment was done in 33 patients.Results Sixty-four patients were followed up from 1990 to 2005 over a period ranging from 0.6 to 15 years(mean 5.8 years).The outcomes were excellent in 46,good in 9,poor in 1 case,and 8 deaths.During the follow-up period,recurrent bleeding occurred in 10 cases.The interval to recurrent bleeding ranged from 0.3～8 years.The rate of recurrent bleeding was 12%.Two patients died of the initial intracranial hemorrhage,The rate of death was 2.4%.Six patients died of recurrent bleeding.The mortality of which was 60%.Conclusion Intracerebral haemorrhage is the important cause of death in patients with moyamoya disease,and recurrent bleeding is the most common cause of death in patients with the haemorrhagic type moyamoya disease.Long-term preventive measures against recurrent bleeding is necessary and a long-term prospective study with a large number of patients with haemorrhagic moyamoya disease is required to determine whether bypass surgery will prevent recurrent bleeding of haemorrhagic type moyamoya disease.

Clinical Analysis of 396 Fatal Patients with HCC in Beijing

Dong Jinling;Ding Huiguo;Zhao Long;Li Xia;Liu Binchen;Wang Ying

2007, 28(4):  532-535. 

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Objective Hepatocellular carcinoma(HCC) is the fourth most common cancer worldwide.Also,it is the second most common malignant tumor in China,and it is often found in the middle-aged male.The aim of this study is to elucidate the clinical characteristics and common causes of death in patients with HCC in Beijing,and to provide reasonable bases for prevention,screening and treatment of HCC.Methods A total of 26,416 hospitalized patients who had liver diseases in our hospital from Jan 2002 to Dec 2005 were analysed retrospectivly.Of these patients,the number of fatal cases was 895,and 412 patients were died of hepatocellular carcinoma,among which,16 cases were excluded because of incomplete clinical material,so altogether 396 fatal with HCC were enrolled in this study in which patients the 373 patients were diagnosed as primary hepatocellular carcinoma,and 23 secondary hepatocellular carcinoma.Results During the recent 4 years in Beijing area,the mortality rate of liver diseases was 3.38%,in which liver cancer patients accounted for 46.82% and cirrhosis of liver patients accounted for 29.32%.hepatocellular carcinoma increased significantly(from 37.9% in 2002 to 44.5% in 2005).The pure HBV infected persons accounted for 77.02%,the pure HCV infected accounted for 4.55%,the AFP positive rate(>500 μg/L) in primary hepatocellular carcinoma accounted for 49.4%,the CA199 positive rate(>100 kU/L) accounted for 55%.In 396 fatal patients with the concurrent upper gastrointestinal hemorrhage occurred 49.49%;in which esophageal hemorrhage was the primary cause;the abdominal hemorrhage occurred in 10.10%.Because of the digestive tract hemorrhages the hemorrhagic shock accounted for 46.2% as the direct cause of death.Hepatic encephalopathy accounted for 55.30%.The ascites formation in 92.42%.The spontaneous bacterial peritonitis merged shock accounted for 3.28%.The hepatorenal syndrome rate was 37.88%,which was responsible for 14.65% of the direct cause of death.Liver failure accounted for 63.64%.Conclusion During recent years,the mortality rate of hepatocellular carcinoma is increasing.Primary liver cancer has become the maincause of liver disease deaths.Coexistence of multiple omplications s the leading cause of death for patients with hepatocellular carcinoma.Joint examination of AFP and CA199 may improve the early diagnosis of liver cancer.

Laser Peripheral Iridoplasty Combined with Iridotomy for Acute Angle-closure Alaucoma

Chen Ping;Dai Weijia;Zhao Wei;Wang Nan;Xiao Li

2007, 28(4):  536-537. 

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Objective To investigate the efficacy and safety of laser peripheral iridoplasty combined with iridotomy for acute angle-closure glaucoma.Methods Twenty-six patients with acute primary angle-closure glaucoma(PACG)were recruited into the study.Each patient received the following IOP-lowering drugs: 1% pilocarpine,topical β-blocker,acetazolamide,mannitol.The IOP of each patient were controlled below 22 mmHg(1 mmHg=0.133 kPa).Then 26 cases(26 eyes) underwent laser peripheral iridoplasty at the iris root in all 360 degrees and had 30 laser spots.Then all cases were treated by laser iridotomy using Nd:YAG laser.Results Two hours after laser treatment,the intraocular pressure(IOP) was ≤21 mmHg and angle of anterior chamber opened again in all cases.Conclusion Laser peripheral iridoplasty combined with iridotomy can effectively reopen the closed anterior chamber angle and relieve pupil block in PACG patients who are experiencing acute attacks.

Expression of bcl-2,p53,P504S and 34βE12 Proteins in Prostatic Carcinoma

Xu Miaosheng;He Yanjiao;Liu Zhaoxia;Li Guang

2007, 28(4):  538-541. 

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Objective To study the expression of bcl-2,p53,P504S and 34βE12 proteins in patients with prostatic carcinoma and the relationship between these gene products and the pathogenesis of prostatic carcinoma.Methods Expression of bcl-2,p53,P504S and 34βE12 proteins in fifty-four cases of prostatic carcinoma and twenty cases of benign hyperplasia of prostate was determined with immunohistochemical SP assay.Results It was found that positive rates of bcl-2 and p53 in prostatic carcinoma were 44.4% and 33.3% respectively,both were not significantly higher than those in benign hyperplasia of prostate statistically,but a tendency of their increasing expression in prostatic carcinoma could be seen.The expression of bcl-2 in the group of poor differentiated was significantly higher than that in the well-differentiated group(P<0.05).When compared in terms of clinical stages,it was observed that bcl-2 expression at stage D was significantly higher than that at stage B or C(P<0.05).There existed a tendency of increase in p53 expression in prostatic carcinoma,but it was not significantly higher than that in benign hyperplasia of prostate.The tumor cells displayed positive reaction for P504S and negative for 34βE12.P504S can be used to differentiate the benign prostate gland from the prostatic carcinoma.Conclusion It is suggested that bcl-2 and P504S protein expressions increase in prostate carcinoma and is,to some extent,involved in the pathogenesis and development of the disease.It is important to use immunohistochemical staining for bcl-2,P504S and 34βE12 protein in the pathologic diagnosis of prostatic carcinoma.

Analysis of Lung Function in Patients with Chronic Obstrctive Pulmonary Disease Combined with Diabetes Mellitus

Li Dongyi;Chen Ying

2007, 28(4):  542-544. 

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Objective Through determination of levels of VC、FEV1、FEV1/FVC、DLCO and DLCO/VA,to investigate the change of lung function in patients with chronic obstructive pulmonary disease(COPD) Combined with diabetes mellitus(DM).Methods Thirty patients with COPD and thirty eight patients with COPD combined with DM were examined and the thirty eight patients with COPD and DM were further divided into 2 groups,22 with DM complication and 16 without. The levels of VC、FEV1、FEV1/FVC、DLCO and DLCO/VA were determined and analysed.Results The levels of VC、DLCO and DLCO/VA were lower in patients with COPD combined with DM with complications than in those with COPD only(P<0.05).The level of DLCO and DLCO/VA were lower in patients with DM complications than in those without(P<0.05).Conclusion In patients with COPD combined with DM,especially with DM complications restrictive ventilatory and diffusion dysfunctions are more aggravated than in those with COPD only.

综述

Inflammatory Factors Related to Acute Coronary Syndrome

Fan Zhenxing;Hua Qi

2007, 28(4):  547-550. 

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Inflammatory plays an important role in the pathogenesis of atherosclerosis and coronary artery diseases.Recent studies have revealed that inflammatory factors such as C-reactive protein,cell adhesion molecules,matrix metalloproteinases and cytokines offer a great value in the risk stratification and prediction of acute coronary syndrome.