To evaluate the cardioprotection of remote ischemic postconditioning (RIPostC) in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).Methods：Forty-six STEMI patients undergoing primary PCI at Peking University Third Hospital from January to April 2014 were randomized to RIPostC group (n=23) and control group (n=23).The RIPostC protocol was started within 1 min after reflow by thrombus aspiration or balloon inflation and consisted of 3 cycles of 5 min/5 min ischemia/reperfusion by cuff inflation/deflation of the lower left limb. The enzymatic infarct size, rate of complete ST segment resolution, corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) in infarct-related artery (IRA) and plasma levels of malondialdehyde(MDA), endothelin-1(ET-1), tumor necrosis factor α (TNFα) of the two groups were compared. Results：There was no significant difference in enzymatic infarct size between the two groups (P＞0.05). The rate of complete ST-segment resolution was significantly higher in RIPostC group than in control group (60.9%vs. 30.4%，P=0.04). There was a trend toward lower CTFC in RIPostC group than that in control group, but the difference was not statistically significant(28 ± 11 vs. 33 ± 11, P = 0.10). However, in the subgroup of anterior wall myocardial infarction CTFC in RIPostC group was significantly lower, compared with control group (25±9 vs. 39±10, P=0.01).There were lower plasma levels of MDA,ET-1,TNFα in RIPostC group than in control group at different time points after primary PCI (P<0.05). Conclusion：In STEMI patients undergoing primary PCI, RIPostC may improve myocardial perfusion and attenuate ischemia reperfusion injury with the underlying mechanisms involving reduction of oxidative stress, protection of endothelial function and inhibition of inflammatory response.

Objective：To compare the consistency of angiography-guided and fractional flow reserve (FFR)-guided management strategy for intermediate coronary lesions. Methods: The patients whose coronary intermediate lesions were assessed by measuring FFR from November 2012 to August 2014. The stenosis percentage and value of FFR during the procedure were collected. All the image data were collected and four experienced interventional cardiologists were invited to assess the target lesions and make a management strategy independently. The consistency of angiographyguided and fractional flow reserve-guided management strategy were analyzed. Results: In the study, 151 patients were included, of whom, 70.2% were male, the average age was (62.7±9.6) years, 169 vessels were assessed by measuring FFR, 1 being left main, 116 left anterior descending, 27 left circumflex branch, and 25 right coronary artery. There were some correlationship between the stenosis percentage judged by four interventional cardiologists and the stenosis percentage judged during the procedure (r=0.29－0.38, P<0.001), but the difference was significant. When 0.80 was used as FFR threshold value, the consistency rates of angiography-guided management strategy decision made by the four cardiologists with fractional flow reserve-guided management strategy were 72.78%, 71.60%, 75.15%, and 72.78%, respectively. Conclusion: Angiography-guided management strategy decision is unreliable, FFR is recommended for management strategy decision for intermediate coronary lesions.

Objective：To assess whether epicardial adipose tissue (EAT) thickness is associated with coronary flow reserve (CFR) and could be used to detect coronary microvascular dysfunction. Methods: We enrolled 62 nondiabetic patients who underwent computed tomography angiography or invasive coronary angiography and had no obstructive coronary artery disease. CFR and EAT thickness were measured by transthoracic Doppler echocardiography (TTDE). Results: In the study, a total of 62 patients were enrolled, echocardiographic coronary flow reserve were obtained in 61 of the patients with a mean age of (59±10) years. 34 patients (56%) had reduced CFR (CFR＜3, 2.52±0.32) suggesting microvascular dysfunction and 27 patients (44%) had normal CFR (CFR≥3, 3.56±0.52). EAT thickness was significantly increased in the patients with microvascular dysfunction as compared with those without ［(3.4±0.8) mm vs. (2.3±0.6) mm, P＜0.001］. EAT thickness was strongly related to CFR (r=-0.668, P＜0.001). By Logistic regression analysis, EAT thickness was the independent predictor of coronary microvascular dysfunction (OR=7.78, 95%CI: 2.44-24.79). EAT thickness＞2.9 mm had 82.4% sensitivity and 92.3% specificity to detect CFR＜3 (area under ROC curve 0.860, P＜0.001). Conclusion: EAT thickness was significantly increased in patients with coronary microvascular dysfunction. EAT thickness was independently associated with impaired CFR. EAT＞2.9 mm had high sensitivity and specificity to detect coronary microvascular dysfunction.

Objective：To provide the evidence for more accurately assessing the patient’s body composition, predicting exercise capacity and guiding rehabilitation exercise by analyzing the body compositions in patients with coronary heart disease, and to study the correlation between body compositions and exercise capacity. Methods: The study enrolled 663 patients with coronary heart disease in NYHA Ⅰ-Ⅱ stages, who underwent coronary intervention therapy between December 2013 and August 2014. Between 15^th and 20^th days of the onset, cardiopulmonary exercising testing (CPET, Bruce Protocol) was conducted, and the body composition was measured with the Inboby720 body composition analyzer before CPET. Results: All the patients completed the body composition evaluation and the CPET. According to the three indicators of body mass index (BMI), percentage of body fat (PBF), waisthip ratio (WHR), the diagnostic rate of obesity was 22.8%, 63.3%, and 72.7%, respectively. There was a good negative correlation between PBF and exercise capacity (r=-0.306, P<0.001). Compared with non-obesity patients, the exercise capacity of obesity group decreased according to PBF (P<0.01). The patients were divided into low, moderate and high exercise capacity groups according to METs, and the difference was only the PBF among the three groups (P<0.05). Conclusion: PBF, measured by body composition, is a more accurate diagnosis of obesity and has a good negative correlation with exercise capacity, which can be used as an important indicator to predict the exercise capacity in patients with coronary heart disease and guide the rehabilitation exercise.

Objective：To investigate current situation of blood pressure control in patients with hypertension in 22 community health centers of Shenzhen Futian District, and to find out related factors which affect blood pressure control. Methods: In the study, 10 020 cases with essential hypertension that had been registered in 22 Community Health Centers were selected as cases for the survey. The questionnaires, physical examinations, and laboratory tests were used to obtain the patients’ baseline data. Results: The mean blood pressure (median) levels were 142/86 mmHg (1 mmHg=0.133 kPa). Those of the males were higher than those of the females (142/86 mmHg vs. 140/85 mmHg, Z_SBP=-6.14，Z_DBP=-9.93，P<0.001), the systolic blood pressure increased with age. The overall blood pressure control rate was 40.2%. The blood control rates were different with different gender, body mass index (BMI) and waist circumference. The majority of the patients took single antihypertensive drug, and the proportion accounted to 54.4%. Regression analysis showed that gender, age, hyperlipidemia, smoking, and waist circumference were the main factors that affected blood pressure control. Conclusion: The blood control rate was low in these communities. Patients with high blood pressure often merge a variety of factors that affect blood pressure control, and at the same time of antihypertensive therapy for the patients, we should pay attention to the control of these factors.
Hypertension; Crosssectional studies; Community health centers; Risk factors

Objective：To investigate the value of myocardial performance index （MPI) in assessing LV function in patients with primary hypertension (HP). Methods: We studied 130 patients with HP （mean age 54.9±13.3 years)and 155 healthy control subjects （mean age 52.4±11.6 years). MPI was determined by tissue doppler imaging using the following formula: MPI=（isovolumic contraction time + isovolumic relaxation time)/ ejection time. The HP group was divided into hypertrophy subgroup（ LVMI≥115 g/m² in males, or ≥95 g/m² in females) and normal mass subgroup（LVMI <115 g/m² in males, or<95 g/m² in females). Results: MPI was significantly different in control group, normal mass subgroup and hypertrophy subgroup（0.72±0.23 vs. 0.54±0.17 vs.  0.45±0.11, P<0.001). Hypertrophy subgroup had significant higher MPI than normal mass subgroup（P =0.046), and both the groups had significant higher MPI than control group（all P<0.001). MPI was positively associated with age（r=0.369,P<0.001), Left ventricular end diastolic diameter（r=0.169, P<0.05), Sm（r=－0.211, P<0.001) and Em（r=－0.383, P<0.001) in control group. In multiple linear regression analysis, MPI was independently related to age （β=0.492, t=7.222,P<0.001) in control group. Among the HP patients, MPI was positively associated with left atrial area （r=0.293, P<0.001),intra ventricular septum（IVS) diameter （r=0.453, P<0.001), LVMI （r=0.453, P<0.001), relative wall thickness（r=0.458, P<0.001), and negatively associated with Sm（r=－0.414, P<0.001), Em（r=－0.508, P<0.001), left ventricular ejection fraction （r=－0.305, P<0.001) in bivariate analysis. In the multiple linear regression analysis, MPI was independently related to Em （β=0.401, t=4.256,P<0.001) and IVS diameter （β=－0.365, t=－3.878,P<0.001) in the HP patients. Conclusion: The HP patients had elevated MPI, especially in the ones with LV hypertrophy. Tissue doppler imaging (TDI) derived MPI could be a useful index to evaluate the overall cardiac function in HP patients.

Objective：To study microRNA profile alteration in unstable angina (UA) patients and its functional network via nerve growth factor (NGF) signaling pathway. Methods: Whole blood microRNAs were isolated from individuals with angiographically negative report (n=6) and UA patients (n=6), Taqman lowdensity microRNA array was performed to detect the microRNA profile, and SAM tool was conducted to calculate the differential expressed microRNA. Bioinformatic prediction tools (Targetsan, Miranda, DianamicroT) were used to obtain microRNA target genes. Targets’enriched pathways were analyzed by DAVID and biological function clusters were figured out by Panther database. The functional network of microRNAs by Cytoscape was costructed. Results: In the study, 20 microRNAs were significantly upregulated in the UA group were observed. Their main target signaling pathways were NGF, their target genes’ functional clusters were in signal transduction, cell proliferation and differentiation, cell cycles, immunity and inflammation, neurogenesis, neuronal activity and apoptosis. Conclusion: To upregulate microRNAs in UA patients is a major way to inhibit NGF signaling pathways, whose function is to suppress cell proliferation and differentiation, immunity and inflammation, neuronal growth, etc., and to stabilize the vulnerable atherosclerotic plaque.

Objective：To investigate the dynamic changes in serum histamine levels and their association with ST-segment resolution in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Methods: A total of 84 consecutive STEMI patients who received primary PCI were enrolled in this study. The dynamic changes in serum histamine levels were observed from before PCI to 1 week after PCI. Factors associated with ST-segment resolution were identified by multivariate regression analysis. Results: The serum histamine levels of STEMI patients decreased during the first week after PCI. Multivariate regression analysis showed that the factors associated with ST-segment resolution 2 h after PCI were: the histamine level 2 h after PCI (r=-0.361, P=0.001), pain to balloon time, infarct related artery, and thrombolysis in myocardial infarction (TIMI) flow grade after PCI. Conclusion: The higher histamine level 2 h after PCI was independently associated with poor myocardial reperfusion in STEMI patients.

Objective：To evaluate long-term effect of different right ventricular apex pacing ratio for heart structure and function of patients with dual chamber pacemakers. Methods: Patients who were implanted with dual chamber pacemakers at Department of Cardiology, Peking University Third Hospital were collected. The electrodes were put in right ventricular apex. All the patients, last pacemaker programming control and echocardiography results were followed up and collected.Patients with 10%-40% pacing ratio were rejected. Results: The total of 83 patients were enrolled in this study. The mean duration of the followup was (38±23) months. The morbility rates of moderate-severe mitral regurgitation (MR) and tricuspid regurgitation (TR) all significantly increased after implantation compared with those before implantation (6.2% vs. 2.6%, 11.1% vs. 4.9%, all P<0.01). There were 9 patients with moderate-severe TR after pacemaker implantation. They had higher pulmonary artery systolic pressure (PASP) and mitral diastolic early flow peak velocity/lateral mitral annulus diastolic early velocity (E/Em) ［(49.6±10.5) mmHg vs. (33.8±12.0) mmHg, P<0.01, 1 mmHg=0.133 kPa; and 11±5 vs.9±3, P<0.05］. And 52 patients had less than 10% pacing ratio (group A) and 31 patients had more than 40% pacing ratio (group B). The right atrium area and right ventricular diastolic diameter were bigger after implantation than those before implantation in group B ［(17.7±4.0) cm² vs. (15.6±3.2) cm², (21.5±4.4) mm vs. (19.9±3.4) mm, all P<0.05］. The morbility of pulmonary artery systolic pressure (PASP) ≥50 mmHg was higher after implantation than that before implantation in group B (9.7% vs. 3.2%, P<0.05). The left atrium area and right atrium area were bigger in group B than those in group A ［(21.8±5.5) cm² vs. (20.2±4.6) cm², (17.7±4.0) cm² vs. (16.1±3.8) cm², all the P<0.05］ after implantation, and lower left ventricular ejection fraction (LVEF) in group B than that in group A (68%±6% vs. 70%±6%, P<0.05). Conclusion: Patients with higher right ventricular apex pacing ratio have bigger left atrium, right atrium and right ventricular, higher PASP and lower LVEF in the long term.

Objective：To investigate the effects of liposomal formulation on simvastatin nano-liposomes (SMV-liposome) promoting the osteogenic differentiation of mice bone marrow stromal cells (BMSC) analyzed by the expressions of bone morphogenetic protein 2 (BMP-2) and alkaline phosphatase (ALP). Methods: Primary BMDC were cultured in vitro using adherence and culture of whole bone marrow method. SMV dosage was set as control group and had two different dosages in this group on the basis of the concentration of SMV. 1 μmol/L and 2 μmol/L SMV concentration were represented by SMV low dosage group (S1) and SMV high dosage group (S2), respectively. Similarly, SMV-liposome dosage was set as experimental group including two different dosages, 1 μmol/L SMV capsuled concentration as SMV-liposome low dosage group (SL1) and 2 μmol/L SMV capsuled concentration as SMV-liposome high dosage group (SL2). Besides, groups with no drug intervention in the experiments were set as blank. BMSC were treated with different concentrations of SMV and SMV-liposome for 48 h, the activity of ALP was measured using p-nitropheny-phosate method, and ALP expression in the BMSC cells was stained by BCIP/NBT alkaline phosphatase color development kit (BCIP/NBT Kit). Furthermore, BMP-2 expression in the BMSC was determined by Western Blot. Results: MTT assay showed, after incubated with different concentrations of SMV and SMV-liposome, the cell viabilities of BMSC were all above 85% and had no significant difference in the groups. Compared with the same dosage of SMV in these groups, control group and experimental group had significantly elevated the specific activity of ALP, the staining of BCIP/NBTKit as well as the protein expression of BMP-2. Besides, the data showed dosedependent elevation in the control group and experimental group, namely the high dose group had better results than the low dose group. Conclusion: Nano-liposomal formulation significantly enhanced SMV effects on the osteogenetic differentiation of BMSC.

Objective：To establish a model of cardiac fibrosis induced by isoproterenol (ISO), the non-selective β adrenoceptor agonist, injected subcutaneously for 7 days in rats, and to observe changes of transcription factor NF-κB in the model.Methods: Male SD rats weighing 280-320 g were injected with ISO ［0.25 mg/(kg·d)］ subcutaneously for 7 days to induce cardiac fibrosis. The collagen volume fraction was determined by quantitative morphometry of picrosirius red stained left ventricular sections. Collagen types Ⅰ/Ⅲ and IL-6 mRNA expressions were analyzed by real time PCR. The pathological changes of the heart were investigated by Hematoxylin and Eosin staining. NF-κB was localized by immunohistochemistry (IHC) and phosphorylated NF-κB levels were assessed by Western blot analysis.Results: Compared with the controls, ISO significantly elevated the sirius red stained area and collagen volume fraction (12.01±1.644 vs. 0.95±0.067, P＜0.001). Similarly, ISO increased the mRNA expressions of collagen Ⅰand collagen Ⅲ of the heart compared with the controls (10.51±0.47 vs. 0.98±0.02，P＜0.001 for collagen I; 9.58±1.33 vs. 1.02±0.02, P＜0.001 for collagen Ⅲ). The number of nuclei was increased and nuclear accumulation was presented in myocardial tissue induced by ISO. The mRNA expression of IL-6 increased in ISO group (1.64±0.18 vs. 1.04±0.07, P<0.01). ISO induced NF-κB nuclear translocation, accompanied by an increase in phosphorylation of NF-κB  (10.83±2.05 vs. 1.05±0.27, P＜0.001).Conclusion: We conclude that the model of cardiac fibrosis can be successfully induced by ISO injected subcutaneously for 7 days in rats and the activation of nuclear factor NF- κB increased by β-adrenoceptor stimulation.

Objective：To investigate the role of microRNAs (miRNAs) in mediating intercellular signaling. Methods: Microparticles (MP) from HUVEC and 293T were isolated by sequential centrifugation. THP-1 was co-cultured with microparticles. And then the migration of THP-1 was measured by transwell. Real-time PCR and Western blotting were used to study the related mechanisms. Results: Compared with the microparticles from 293T, MP from HUVEC could promote the migration of monocytes (P<0.05) and upregulate the expression of CXCR4 mRNA and protein (P<0.05). MiRNA-126 deficient MP could downregulate the migration of monocytes (P<0.05) and the expression of CXCR4 mRNA and protein (P<0.05) compared with miRNA-126 abundant MP. Conclusion: Microparticles from HUVEC could promote the migration of monocytes. As carriers, microparticles could mediate intercellular signaling.

Objective：To examine the cholesterol efflux and the expressions of ATP-binding cassette transporter G1 (ABCG1) in macrophages of diabetic patients and the roles of liver-X receptor (LXR) in regulation of ABCG1 expressions. Methods: Blood was collected from patients with type 2 diabetes mellitus and healthy controls. The peripheral blood monocytes were differentiated into macrophages with macrophage colony stimulating factor (M-CSF). The cells were radio labeled with ［3H］ cholesterol and were performed with cholesterol efflux assays. Quantitative real-time PCR (qRT PCR) and Western blot were performed to measure the mRNA and protein expressions of ABCA1 and ABCG1. To test the effects of LXR on ABCG1 expressions, inhibition of LXRα and LXRβ by siRNA were performed. The DNA-protein complex of LXR and LXR element (LXRE) located in the promoter region of ABCG1 gene were detected with electrophery mobility supershift assay (EMSA). Results: Macrophage ABCG1 expressions and high-density lipoprotein (HDL) induced cholesterol efflux were significantly reduced (19.0%±1.2% vs. 12.8%±3.6%, t=2.532, P=0.016) in the diabetic subjects whereas ABCA1 expressions and apolipoprotein A1 (ApoA1) induced cholesterol efflux were comparable (12.0%±1.2% vs. 10.2%±2.3%, t=1.771, P=0.109) between the diabetic patients and healthy subjects. The mRNA expressions of LXRα and LXRβ had no changes between the diabetes subjects and healthy controls (t=1.025, P=0.315; t=-0.531, P=0.600). The LXR-LXRE DNA-protein complex detected by EMSA were also similar between the diabetes subjects and healthy controls (t=1.483, P=0.164). Moreover, ABCG1 expressions were not altered by inhibition of LXRα/β siRNA (t=2.143, P=0.061). Conclusion: Our data indicated that expression of ABCG1 and HDL induced cholesterol efflux were reduced in type 2 diabetic patients. However, the LXR mRNA expression and binding complex of LXR and ABCG1 promoter were not changed. The impairment of cholesterol efflux and ABCG1 gene expressions might be regulated via an LXR-independent pathway.

Objective： To investigate the condition of isoprenaline (ISO)induced cardiac hypertrophy in the FVB/N mouse. Methods: ISO ［30 mg/(kg·d)］ was administered either by daily subcutaneous injection, or by continuous infusion via an implanted osmotic minipump. The mice in each mode of administration were randomly divided into two groups. For subcutaneous injection: the mice received ISO or saline through daily subcutaneous injection for 2 weeks. The mice for minipump: the mice received continuous infusion of ISO via an implanted osmotic minipump for 2 weeks, or received sham operation as the control to mimipump. The ratio of heart weight to tibia length (HW/TI), the diastolic left ventricular posterior wall thickness (dLVPW) were used to indicate cardiac hypertrophy. Interstitial fibrosis was examined with picrosirius red staining. Results: ISO ［30 mg/(kg·d)］ administered by daily subcutaneous injection did not lead to cardiac hypertrophy or fibrosis in the FVB/N mice, and 50% of the mice died before the end point. The mice receiving ISO via minipumps showed significant increase in HW/TI ［(10.60±0.40 ) mg/mm vs. (7.93±0.19) mg/mm，P<0.001］ and dLVPW ［（0.87±0.03）mm vs. （0.68±0.06）mm，P=0.0116］. ISO administered via minipumps did not induce cardiac fibrosis. All the mice in this group survived to the end point. Conclusion: ISO ［30 mg/(kg·d)］ administered by continuous infusion via a minipump for 2 weeks can lead to significant cardiac hypertrophy.

Objective：To analyze the risk factors involved in the weaning from mechanical ventilation in critical patients who underwent major abdominal surgery. Methods: This retrospective study was conducted at Department of Critical Care Medicine in Peking University People’s Hospital. The subjects included all critical ill patients who underwent major abdominal surgery from January 2011 to December 2013. Clinical and laboratory parameters in perioperative period were investigated for the risk factors involved in the weaning from mechanical ventilation. Results: In this study, 381 patients were included, of whom, 274 were successfully weaned. We found old age, lower left ventricular ejection fraction (LVEF) before surgery, with the complication of myocardial injury after noncardiac surgery (MINS) and lower serum albumin level after surgery were the independent risk factors of weaning from mechanical ventilation. And the days of intensive care unit and 28-day mortality of patients who successfully weaned were better than patients who failed to wean. Conclusion: Old age, lower LVEF before surgery, with the complication of MINS and lower serum albumin level after surgery were independent risk factors of weaning in critical patients who underwent major abdominal surgery.

Objective：To study the importance of the internal iliac artery (IIA) during the endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Methods: Forty-six consecutive cases of AAA treated by EVAR were retrospectively analyzed. The complications after exclusion of the IIA were analyzed. Results: The bilateral IIAs were reserved in 18 cases, in which the follow-up was achieved in 16 cases and no complication was observed. The IIAs were excluded in 28 (60.9%) cases, in which the bilateral, right and left IIAs were excluded in 7 (15.2%), 14 (30.4%) and 7 (15.2%) cases respectively. The follow-up was achieved in 26 cases. Buttock claudication was observed in 12 (46.2%) cases, altered bowel habit was observed in 8 (32.0%) cases, erectile dysfunction was observed in 3 (12.0%) cases, and bloody stool was observed in 2 (8.0%) cases. Comparing the bilateral and unilateral IIA exclusions, the rates of buttock claudication were 50.0% vs. 45.0%, altered bowel habit 33.3% vs. 31.6%, and erectile dysfunction 33.3% vs. 5.3% respectively. And the average duration of buttock claudication of bilateral IIAs exclusion (8.3 months) was longer than that of unilateral exclusion (4.7 months). Moreover, comparing the left and right IIA exclusions, the rates of buttock claudication were 57.1% vs. 38.5%, altered bowel habit 57.1% vs. 16.7%, and bloody stool 28.6% vs. 0 respectively. And the average duration of buttock claudication of left IIA exclusion (6.0 months) was longer than that of right exclusion (3.7 months). Conclusion: The IIAs, especially the left IIA, should be reserved during the EVAR for AAA.

Objective：To investigate the clinical value of urinary sediment analysis, a non-invasive diagnostic means, in the evaluation of pathological patterns of renal diseases. Methods: A total of 1 140 pairs of matched renal biopsies and fresh fasting morning urine specimens were collected from hospitalized patients in Peking University First Hospital. Their urinary sediments were examined with phase-contrast microscopy; the 24 h urine proteins were measured. Based on urinary sediment features combined with urine protein amount, the spectra of the urine sediments were classified into four types, Type Ⅰ: hematuria-dominant, with multiple cells and casts; Type Ⅱ: proteinuria-dominant, with hyaline or fine-granular casts but scanty cells; Type Ⅲ: renal tubular epithelial cell(RTEC)-dominant, minor proteinuria; Type Ⅳ: non-specificurine sediments，minor proteinuria. According to the pathological lesions detected in renal biopsies, the renal diseases were classified into three patterns: proliferative glomerulopathy(P-GP), non-proliferative glomerulopathy (NP-GP) and tubulointerstitial nephropathy(TIN). The urinary sediment spectra of different pathological patterns and the correlation between urinary sediment types and pathological patterns were analyzed. Statistical analyses were performed using kappa test, and χ² test, and significance was accepted at P<0.05. Results: (1) Of the 840 cases of matched urine samples and renal biopsies, 419 cases were diagnosed with P-GP; 375 cases with NP-GP; 46 cases with TIN respectively. (2) The spectra of urine sediments were associated with pathological patterns of the renal biopsies, and 84.0% of the patients with P-GP manifested type Ⅰ urine sediments; 93.1% of the patients with NP-GP had type Ⅱ urine sediments; 67.4% of the patients with TIN had type Ⅲ urine sediments. (3) The correlation between the urinary sediment types and renal pathological patterns was validated in an additional 300 matched samples. The positive predictive values of urinary sediment spectra in predicting renal pathological lesions were 84.8% for typeⅠ to P-GP, 86.0% for type Ⅱ to NPGP and 73.7% for type Ⅲ to TIN, respectively. Conclusion: As a non-invasive diagnostic means, the urinary sediment analysis is valuable in the evaluation of pathological patterns of renal diseases.

Objective：To investigate the expression and significance of ubiquitously transcribed TPR gene on the X chromosome (UTX) in renal cell carcinoma (RCC) tissues, then to explore the relationship between UTX expression and renal cancer pathologic characteristics. Methods: In the study, 45 patients with dignosed renal cell carcinoma clinical samples were collected in Peking University Shenzhen Hospital. Total RNA and protein were extracted from the cancer tissues and adjacent normal tissues. UTX expression of cancer tissues and adjacent normal tissues was detected on both mRNA and protein levels using real time-PCR and IHC, respectively. And the relationship between UTX expression and the 45 patients’ clinical characteristics was analyzed. Results: The mRNA level of UTX in cancer tissues(C) was 4.4 folds, higher than that of the adjacent normal tissues(N) ［ 0.883 2±0.703 8 vs. 0.199 7±0.140 0, P<0.05］. The protein expression of UTX in cancer tissues was up-regulated, and the protein score of cancer tissues was 4 folds, change compared with adjacent normal tissues［12±4 vs. 3±3, P<0.05］.The expression of UTX was associated with pathological grade（P=0.004）but without gender, age, tumor size and TNM stage. Conclusion: UTX is upregulated in RCC tissues and the expression of UTX is associated with pathological grade, illustrating that UTX may play an important role in renal cancer progression.

Objective： To study whether the assisted reproductive technology ［ in vitro fertilization and embryo transfer (IVF-ET)］ has influence on the physical and intellectual development of the children at the preschool age. Methods: The study group included 50 IVF-ET children, and the control group was a match cohort of 48 children born after being naturally conceived. A matched retrospective cohort study was performed on physical and intellectual development of the two children groups. The control group was matched according to home economics situation, parents’ educational level, etc. Results:In the adjusted analysis, the differences of the physical and the intellectual development between the two groups were not statistically significant (P>0.05). In the language test, the scores of the IVF-ET group was 1.35, 1.05, 1.32, 1.32 higher than those of the control group in the subject of general knowledge, words, synonyms, understanding ability. The IVF-ET group was 1.21 lower than that of the control group in the subject of arithmetics, 1.91 lower than that of the control group in the language subject, 5.5 higher than that of the control group in the operation subject, and 0.40, 0.38 higher than those of the control group in the subject of the maze and geometry. The scores of the control group were 1.04, 0.54, and 0.68 higher than those of the IVF-ET group in the animal house, drawing of vacancy, and block pattern, respectively. The final results of the IVF-ET group and the control group was 115.8 and 114.6, respectively. The ratio of the above medium height of the IVF-ET group and the control group was 30% and 31%, respectively. The ratio of the above medium weight was 30% and 23%, respectively. The IVF-ET group was a little fatter. There was no statistical difference between the two groups in the body development. Conclusion: The assisted reproduction technology is not associated with poorer physical and intellectual development. The family pay more attention to the children may promote their development.

Objective：To assess the control level of 4-11 years old children with asthma and to explore the correlative factors affecting the control level of asthma. Methods: One cross-sectional study was conducted of the 4-11 years old children with asthma from Pediatrics Outpatient Department of Peking University Third Hospital from October 2013 to February 2014. According to asthma control test (ACT), the control levels of asthma children could be divided into three levels: fully controlled, partly controlled and non-controlled. The partly controlled group and the non-controlled group were merged into the non-full controlled group. Life quality was compared between the full controlled group and the non-full controlled group. The correlative factors affecting the controlled level of asthma were analyzed by Logistic regression. The correlative case information was collected and the data were entered with EpiData software and analyzed with SPSS 17.0 software. Results: Ninety asthma children were enrolled.The children from the full controlled group and the non-full controlled group accounted for 61.1% (55/90) and 38.9% (35/90), respectively. Life quality of the full controlled group was higher than that of the non-fully controlled group. There was no significant difference between the two groups on body mass index (BMI), education level of parents,  parents or relative smoking, times of respiratory tract infection within 3 months, using asthma control drugs within 4 weeks before seeing a doctor and regularly taking medicine according to the doctor’s advice (P＞0.05). The binary Logistic regression analysis obtained three correlative factors affecting the control level of asthma: non-regular follow-up (OR=8.364, 95%CI: 1.816-38.532, P＜0.05), being diagnosed with or suffering from allergic rhinitis (OR=6.728, 95%CI: 1.699-26.644, P＜0.05) and accompanying with other allergic diseases (OR=3.926, 95%CI: 1.210-12.744, P＜0.05). Conclusion: The results from the single center have shown that the asthma full-controlled rate of 4-11 years old children with asthma is not high. The higher control level, the better the life quality. Non-regular follow-up and being diagnosed with or suffering from allergic rhinitis are the correlative factors affecting the control level of 4-11 years old children with asthma. Meanwhile, accompanying with other allergic diseases, such as atopic dermatitis and food allergy is the protective factor for asthma control. The data from the multi-center and further study will be needed to demonstrate the results of this study.

Objective：To evaluate the effect of the viral load on the red blood cell parameters in chro-nic hepatitis B patients and its clinical significance. Methods: In the study, 373 chronic hepatitis B patients were recruited, including 123 alanine transaminase (ALT) normal patients (ALT<40 U/L),128 ALT greater than or equal to the upper limit of normal, and less than 2 times higher than the upper limit of normal patients(40 U/L ≤ALT<80 U/L), and 122 ALT greater than or equal to 2 times higher than the upper limit of normal patients (ALT≥80 U/L). The blood routine parameters were measured by automatic blood cell counter. The liver function parameters were measured by automatic biochemical analyzer, the hepatitis B virus loads were measured by quantitative PCR analyzer and the results were analyzed by covariance analysis. Results: In the ALT normal chronic hepatitis B patients group, the viral load had minor effects on the red blood cell parameters.But in the ALT abnormal chronic hepatitis B patients group, the viral load had a significant effect on the red blood cell parameters, and the effect was most manifest in the ALT≥ double upper limit of normal group. The specific performance was that with the viral load increasing,   the red blood cell ［low copies group (4.10±0.67)×1012/L，medium copies group (3.92±0.69)×1012/L，high copies group (3.54±0.90)×1012/L］, the hemoglobin［low co-pies group (129.66±21.12 ) g/L, medium copies group (126.23±23.38) g/L, high copies group (112.98±27.77) g/L］, the hematocrit (low copies group 37.66±5.68, medium copies group 37.03±6.03, high copies group 33.34±8.15) decreased（P=0.006，0.007，0.010)，the mean corpuscular volume ［low copies group (92.17±6.53) fL, medium copies group (94.85±7.95) fL, high copies group (101.63±11.33) fL］, the mean corpuscular hemoglobin ［low copies group (31.70±2.22) pg, medium copies group (33.11±3.62) pg, high copies group (34.65±3.13) pg］, the mean corpuscular hemoglobin concentration ［low copies group (344.28±17.17) g/L, medium copies group (351.33±16.90) g/L, high copies group (358.12±15.67) g/L］, and the red blood cell distribution widthstandard deviation ［low copies group (52.49±9.04) fL, medium copies group (56.96±7.19) fL, high copies group (61.23±7.23) fL］ increased（P=0.000，0.000，0.002，0.000). Conclusion: Observing the effect of the viral load on the red blood cell parameters in chronic hepatitis B patients can reflect the effect of hepatitis B virus on the immune response and liver function in the different pathological stages, providing theoretical support for the clinical antiviral treatment.

Objective：To establish bisphosphonate-related osteonecrosis of the jaw (BRONJ) model in rats and to make preliminary analysis of its etiological mechanisms. Methods: A BRONJ model was established in rats using pamidronate, dexamethasone combined with alveolar bone trauma (tooth extraction) method, and the ratios of CD4+ and CD90+ lymphocytes in splenocytes were also analyzed by flow cytometry in each group. For in vitro studies, the effects of pamidronate and dexamethasone on the proliferation of human osteosarcoma cell line MG-63 and mouse preosteoclasts cell line Raw 264.7 were investigated using CCK-8 assay. Results: The rat BRONJ model was successfully established using the method described above. Flow cytometry results showed that the ratios of CD4+ and CD90+ lymphocytes in splenocytes were much lower in the pamidronate and dexamethasonetreated rats than those in either pamidronte alone- or dexamethasone alone-treated rats. CCK-8 assay results showed that pami-dronate could inhibit the proliferation of both MG-63 and Raw 264.7 cell lines, while dexamethasone could enhance the inhibitory effect of pamidronate on Raw 264.7 cells. Conclusion: This study successfully established the BRONJ model in rats and verified that dexamethasone could enhance the inhibitory effect of pamidronate on preosteoclasts in vitro. At least three factors including alveolar bone trauma, infection and immune response induced by dexamethasone could be involved in the process of BRONJ.

Objective： To evaluate the soft tissue esthetic outcome of implant restored anterior teeth lost from periodontal destruction. Methods: In the present study, 20 teeth extracted for severe periodontal destruction from 15 patients were involved. All the recruited patients received initial periodontal therapy. The implants were inserted with routine flap surgery 2-3 months after teeth extraction, and the guided bone regeneration technique was used when indicated. The extent of alveolar bone deficiency and the depth of implant placement (the distance from implant shoulder to the line connecting cemento-enamel junction of mesial and distal neighbor teeth) were recorded. The second-stage exposure and restoration were conducted after 3-month sub-mucosal healing. Pink esthetic score (PES) was used to evaluate the soft tissue esthetic outcome 1-3 months after final restoration. Results: All the implants obtained osseointegration successfully. The mean PES value was 9.6±2.4, ranging from 5 to 13. The PES values of the 3 prostheses were lower than 7. The mean PES value of the 13 sites with only horizontal bone defect was 10.5±1.9, and was significantly higher than that of the 7 sites with combined horizontal and vertical bone defect (7.9±2.3, P<0.05). The negative correlation was observed between the PES value and depth of implant placement (r=-0.608, P<0.01). Conclusion: High esthetic risk exists when restoring missing teeth lost from periodontal destruction by implant treatment. Alveolar bone defect especially vertical bone loss may mainly contribute to the soft tissue esthetic outcome deficiency.

Objective： To observe the gingival contour and its variation following application of implant-supported temporary crowns on gingival contour in maxillary single tooth implant procedure after loading 1 year and to explore the reliability of soft tissue intervention using temporary crowns. Methods: In 78 (37 males and 41 females) patients with anterior maxillary single tooth loss from the Department of Second Dental Center, Peking University School and Hospital of Stomatology, the gingival contour was induced by using implant-supported temporary crowns prior to maxillary tooth implant till permanent restoration from March 2010 to November 2011. The gingival papilla height and labial gingival margin level were measured immediately after the permanent restoration and 1 year later. Results: In all the cases after loading 1 year, the average mesial and distal gingival papilla heights in the implant area increased by (0.16±0.58) mm and (0.10±0.53) mm, respectively. The labial gingival margin level was changed by (0.10±0.41) mm averagely. The difference in gingival contour shaped by temporary crown was not statistically significant after 1 year (P>0.05). Conclusion: The soft tissue shaping technique on aesthetic rehabilitation in maxillary single tooth implant is clinically feasible with a good recent aesthetic effect under the condition that the complications are controlled stringently.

Objective：To investigate the root and canal morphology of maxillary first and second molars by using cone-beam computed tomography (CBCT).  Methods:The data of patients who underwent the CBCT scan for dental or periodontal diseases between May and September 2012 were analyzed retrospectively. In the study, 630 maxillary first molars, 519 maxillary second molars which were well-developed and without treatment were included. The number of roots, the number of root canals, and the canal configuration according to Vertucci’s classification were determined. The vertucci type I was regarded as the conventional form. Other types were the variation forms and the mutation rate was calculated. Results:2.38% of the maxillary first molars and 15.22% of the maxillary second molars had 2 separated roots; 97.14% of the maxillary first molars and 73.60% of the maxillary second molars had 3 roots; 10.41% of the maxillary second molars had one single root; 0.77% of the maxillary second molars had 4 roots. In 612 3-rooted maxillary first molars, additional canals were found in 30.88% of the mesiobuccal (MB) roots. In 519 3-rooted maxillary second molars, additional canals were found in 13.87% of the MB roots. Conclusion:CBCT scans show the root and canal anatomy accurately, with the potential of improving the outcome of endodontic treatment.

Objective：To develop a new kind of dental radiographic image quality indicator (IQI) for internal quality of casting metallic restoration to influence on its usage life. Methods: Radiographic image quality indicator method was used to evaluate the depth of the defects region and internal quality of 127 casting metallic restoration and the accuracy was compared with that of conventional callipers me-thod. Results: In the 127 cases of casting metallic restoration, 9 were found the thickness less than 0.7 mm and the thinnest thickness only 0.2 mm in 26 casting metallic crowns or bridges’ occlusal defects region. The data measured by image quality indicator were consistent with those measured by conventional gauging. Two metal inner crowns were found the thickness less than 0.3 mm in 56 porcelain crowns or bridges. The thickness of casting removable partial denture was more than 1.0 mm, but thinner regions were not found. It was found that in a titanium partial denture, the Xray image of clasp was not uniform and there were internal porosity defects in the clasp. Conclusion: Special dental image quality indicator can solve the visual error problems caused by different observing backgrounds and estimate the depth of the defects region in the casting.

Objective：To evaluate the effect of midpalatal mini-implant anchorage system in fixed appliance treatment. Methods:In this study, 14 adolescents who had skeletal class Ⅰ or Ⅱ malocclusions were involved. Maximal anchorage was required during orthodontic treatment. Maxillary first premolars of the selected individuals were extracted and the individuals were treated by fixed appliance. One mini-implant was inserted in the midpalatal suture region and a transpalatal arch (TPA) made of 0.019  inch×0.022  inch(1  inch=2.54 cm) stainless steel was adhered to the mini-implant and upper first molars. Cephalometric radiographs taken after mini-implants inserted (T0) and before mini-implants removing (T1) were traced and measured. SN-7 plane and PP plane were used as reference planes. Student’s t-test was used.Results: The successful rate of midpalatal mini-implant was 73.9%. All the items measured were found with no significant difference  between the two groups.Conclusion: This mini-implant system as orthodontic anchorage in midpalatal region can be an alternative method of maximal anchorage during orthodontic treatment.

Objective： To evaluate the accuracy of cone beam computed tomography (CBCT) in assessing furcation involvements of mandibular molars. Methods: In the study, 38 furcation involvements of 22 mandibular molars which would accept furcation surgery were included. Pre-surgical examination, CBCT and periapical radiograph were performed. Then, intra-surgical furcation assessments were compared with those data. Results: Intra-surgical findings confirmed 86.8% of the CBCT data, with a weighed kappa of 0.976. Of the four parameters tested of detailed root anatomy and furcation morphology, the vertical bone loss, the mesial-distal bone loss and the length of the root trunk revealed by CBCT were consistent with their respective intra-surgical values (P>0.05): about vertical bone loss, CBCT was (4.03±2.27) mm, but in surgery was (4.32±2.31) mm; about mesial-distal bone loss, CBCT was (2.05±0.89) mm, but in surgery was (2.07±0.97) mm; about length of the root trunk, CBCT was (2.35±0.88) mm, but in surgery was (2.24±0.75) mm. The horizontal bone loss revealed by CBCT ［(3.40±1.27) mm］ was significantly smaller than that by surgery ［(3.72±1.19) mm］. However, the mean difference was only 0.32 mm. Periapical radiograph could only obtain vertical bone loss ［(2.17±1.32) mm］ and mesial-distal bone loss ［(1.46±0.88) mm］, which was significantly different from that obtained in surgery. Conclusion: CBCT proved high accuracy in assessing the furcation involvement of mandibular molars.

Hyperkalemia may induce serious cardiac arrhythmia, with possible life-threatening effects. It may cause cardiac pacemaker (PMK) malfunctioning due to a reduction of the electronegativity of the resting myocardial potential. We report the case of a 71-year-old woman who had a previous history of chronic heart failure, chronic renal failure and DDI pacemaker. She was admitted for disturbance of consciousness. During hospitalization, she was observed for extreme hypotension, acute hyperkalemia, ventricular escape rhythm, associated with failure of pacemaker capture and sensing. She was treated with calcium chloride injection, followed by insulin/glucose and sodium bicarbonate infusions; the electrocardiogram recordings showed an correction of the PMK malfunctioning and serial improvement of the intraventricular conduction. This case supports that hyperkalemia should be closely monitored in the chronic heart failure patients combined with chronic renal failure.

Therapeutic hypothermia is an important treatment for cerebral resuscitation in patients after cardiac arrest. But it is rarely used for comatose survivor post cardiac arrest in China. The patient was the first case who was in coma post cardiac arrest caused by acute myocardial infarction and given hypothermia therapy in our hospital. After coronary reperfusion and therapeutic hypothermia, the patient’s sneurologic function was recovered to normal. The paper discussed the indications, contraindications, cooling methods and complications of therapeutic hypothermia.

Objective： To investigate the clinical presentation, diagnosis and treatment of the Eisenmenger’s syndrome in pregnancy.  Methods:  One case of Eisenmenger’s syndrome in pregnancy in our hospital was retrospectively analyzed and the literature reviewed.  Results: This patient who received antenatal care irregularly in other hospital was diagnosed with Eisenmenger’s syndrome with the symptoms of chest distress. The other hospital suggested her to terminate pregnancy, but the patient refused. She was admitted to our hospital in her late pregnancy, received the treatment of rest, oxygen, blood gas and pulmonary artery pressure monitoring. Considering perioperative pulmonary hypertension crisis likely to occur, pulmonary artery catheter was placed preoperatively. In general anesthesia, the cesarean was performed. After operation, the patient was transferred to the intensive care unit, with the treatment of expanding blood vessels, reducing pulmonary artery pressure, administering anticoagulation and preventing infection. One week later, the patient was discharged from hospital with smooth condition.  Conclusion:  Eisenmenger’s syndrome in pregnancy is associated with extremely poor maternal and fetal outcome. Termination of pregnancy should be offered to such patients. When interruption of pregnancy is refused, the early hospital admission is needed. The patients should be managed in a highrisk pregnancy unit by a multidisciplinary team from obstetrics, cardiology, anesthesia and pediatrics for improving pregnancy outcomes.

Cardiovascular disease is one of the major threats to human. Air pollution, which, as it become a problem too serious to be ignored in China, is known to be an important risk factor for cardiovascular disease. Among all pollutants, ultrafine particles (UFPs), defined as particles with their diameter less than 0.1 μm, are a specific composition. They are very small in size, large in quantity and surface area, and most important, capable of passing through the airblood barrier. These unique features of UFPs make them special in their impact on cardiovascular system. Nowadays, the influence of UFPs on the cardiovascular system has become a hot topic. On the one side, studies have shown that UFPs can cause inflammation and oxidative stress in the lung, and then induce systemic inflammation by releasing cytokine and reactive oxygen species into the circulation. On the other side, UFPs themselves can “spillout” into the circulation and interact with their targets. By this way, UFPs directly affect endothelial cells, myocardial cells and the autonomic nervous system, which ultimately result in increased cardiovascular events. We intend to make an overview about the recent progress about the influence of UFPs on human cardiovascular disease and the related mechanisms, and argue for more attention to this issue.

Sympathetic nervous system is excessively activated under strong stress, which leads to a significant rise of plasma catecholamine concentration, then activates the βadrenoceptors (βARs) in the heart and mediates the development of cardiac remodeling and heart failure. Meanwhile, chronic βARs activation has been proved to be involved in cardiac sterile inflammation by mediating the synthesis and secretion of cytokines, which subsequently mediates cardiac fibrosis and dysfunction. This review summarizes a number of important proinflammatory cytokines involved in the process of cardiac pathological remodeling under chronic adrenergic stimulation and the application of neutralizing antibodies on specifically targeting cytokines in the treatment of cardiovascular diseases.