Dalian, China
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Han Y.,General Hospital of Shenyang Military Command | Guo J.,Capital Medical University | Zheng Y.,Jilin University | Zang H.,No 463 Hospital Of Pla | And 20 more authors.
JAMA - Journal of the American Medical Association | Year: 2015

Importance: The safety and efficacy of bivalirudin compared with heparin with or without glycoprotein IIb/IIIa inhibitors in patients with acutemyocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are uncertain. OBJECTIVE To determine if bivalirudin is superior to heparin alone and to heparin plus tirofiban during primary PCI. Design, Setting, and Participants: Multicenter, open-label trial involving 2194 patients with AMI undergoing primary PCI at 82 centers in China between August 2012 and June 2013. Interventions: Patients were randomly assigned to receive bivalirudin with a post-PCI infusion (n = 735), heparin alone (n = 729), or heparin plus tirofiban with a post-PCI infusion (n = 730). Among patients treated with bivalirudin, a postprocedure 1.75mg/kg/h infusion was administered for a median of 180 minutes (IQR, 148-240 minutes). Main outcomes and Measures: The primary end pointwas 30-day net adverse clinical events, a composite of major adverse cardiac or cerebral events (all-cause death, reinfarction, ischemia-driven target vessel revascularization, or stroke) or bleeding. Additional prespecified safety end points included the rates of acquired thrombocytopenia at 30 days, and stent thrombosis at 30 days and 1 year. Results: Net adverse clinical events at 30 days occurred in 65 patients (8.8%) of 735 who were treated with bivalirudin compared with 96 patients (13.2%) of 729 treated with heparin (relative risk [RR], 0.67; 95%CI, 0.50-0.90; difference, -4.3%, 95%CI, -7.5%to -1.1%; P = .008); and 124 patients (17.0%) of 730 treated with heparin plus tirofiban (RR for bivalirudin vs heparin plus tirofiban, 0.52; 95%CI, 0.39-0.69; difference, -8.1%, 95%CI, -11.6%to -4.7%; P < .001). The 30-day bleeding rate was 4.1%for bivalirudin, 7.5%for heparin, and 12.3%for heparin plus tirofiban (P < .001). There were no statistically significant differences between treatments in the 30-day rates of major adverse cardiac or cerebral events (5.0%for bivalirudin, 5.8% for heparin, and 4.9% for heparin plus tirofiban, P = .74), stent thrombosis (0.6%vs 0.9%vs 0.7%, respectively, P = .77), acquired thrombocytopenia (0.1%vs 0.7%vs 1.1%; P = .07), or in acute (<24-hour) stent thrombosis (0.3%in each group). At the 1-year follow-up, the results remained similar. Conclusions and Relevance: Among patients with AMI undergoing primary PCI, the use of bivalirudin with a median 3-hour postprocedure PCI-dose infusion resulted in a decrease in net adverse clinical events compared with both heparin alone and heparin plus tirofiban. This finding was primarily due to a reduction in bleeding events with bivalirudin, without significant differences in major adverse cardiac or cerebral events or stent thrombosis.


PubMed | Bayi Brain Diseases Hospital Affiliated to General Hospital of Beijing Military Command, Dalian Medical University, No 210 Hospital Of Pla and General Hospital of Beijing Military Command
Type: Journal Article | Journal: International journal of molecular sciences | Year: 2016

We previously reported that arsenic (As) impaired learning and memory by down-regulating calmodulin-dependent protein kinase IV (CaMK IV) in mouse cerebellum. It has been documented that the thyroid hormone receptor (TR)/retinoid X receptor (RXR) heterodimer and thyroid hormone (TH) may be involved in the regulation of CaMK IV. To investigate whether As affects the TR/RXR heterodimer and TH, we determined As concentration in serum and cerebellum, 3,5,3-triiodothyronine (T3) and thyroxin (T4) levels in serum, and expression of CaMK IV, TR and RXR in cerebellum of mice exposed to As. Cognition function was examined by the step-down passive avoidance task and Morris water maze (MWM) tests. Morphology of the cerebellum was observed by Hematoxylin-Eosin staining under light microscope. Our results showed that the concentrations of As in the serum and cerebellum of mice both increased with increasing As-exposure level. A significant positive correlation was found between the two processes. Adeficit in learning and memory was found in the exposed mice. Abnormal morphologic changes of Purkinje cells were observed in cerebellum of the exposed mice. Moreover, the cerebellar expressions of CaMK IV protein and the TR gene, and TR1 protein were significantly lower in As-exposed mice than those in controls. Subchronic exposure to As appears to increase its level in serum and cerebella of mice, impairing learning and memory and down-regulating expression of TR1 as well as down-stream CaMK IV. It is also suggested that the increased As may be responsible for down-regulation of TR1 and CaMK IV in cerebellum and that the down-regulated TR1 may be involved in As-induced impairment of learning and memory via inhibiting CaMK IV and its down-stream pathway.


Gao G.-Q.,General Hospital of Beijing Military Command | Ma Q.-Y.,General Hospital of Beijing Military Command | Guan H.,No 210 Hospital Of Pla | Shang L.-X.,General Hospital of Beijing Military Command
Journal of Dalian Medical University | Year: 2015

Objective: To survey the incidence of premature rupture of membrane (PROM) in a large sample of pregnant women to provide a basis for further understanding the disease and its clinical treatment. Methods: We enrolled 2544 pregnant women in the study and conducted a retrospective analysis. Demographic characteristics were investigated. Potential risk factors were analyzed. Results: (1) In 2544 pregnant women, 392 patients had PROM with an incidence rate of 15.4%. (2) Mothers with lower education and urinary and reproductive system infection, exposed to passive smoking, complicated with diabetes mellitus and taking vitamin compound preparations for relatively long time during pregnancy had significantly higher incidence of PROM (P <0. 05). (3) Incidence of PROM increased with maternal age and times of abortion (P<0. 05). Conclusions: Some demographic characteristics, repeated abortion history and some adverse events during pregnancy are associated with risk of PROM. The relationship between intake of vitamin compound preparations and PROM is worth to be studied further.


Guan H.,No 210 Hospital Of Pla | Guan H.,Dalian Medical University | Wang M.,Dalian Medical University | Li X.,No 210 Hospital Of Pla | And 5 more authors.
European Journal of Public Health | Year: 2013

Background: Manganese (Mn) is an essential element and a potential toxicant for developing organism. Deficiency and excess of it were both deleterious to fetal growth in experimental animals. However, literature on relationship between Mn status and birth outcome in humans is sparse. Methods: Mn concentrations were measured in mother whole blood (MWB) and umbilical cord blood (UCB) in 125 pairs of mother-infant; birth size was examined and relationship between them was analysed. Potentially environmental factors influencing Mn loads in maternal and fetal organisms were investigated through epidemiological method. Results: Mn level in UCB was significantly higher than that in MWB (mean value: 54.98 vs. 78.75 μg/L), and a significant positive correlation was shown between them. There was a quadratic curvilinear (inverted U-shaped curve) relationship between MWB Mn and birth size, and between UCB Mn and birth size. Both univariate analysis and multiple linear regression analysis showed that exposure to harmful occupational factors during gestation remarkably increased maternal and fetal Mn levels. Living close to major transportation routes (<500 m) also increased the MWB Mn levels. Conclusion: Our results suggested that lower or higher Mn level in maternal and umbilical blood may induce adverse effect on birth size in humans. In addition, increased levels of Mn in MWB or UCB may be associated with exposure to some environmental hazard factors. © 2013 The Author.


Guan H.,No 210 Hospital Of Pla | Guan H.,Dalian Medical University | Piao F.,Dalian Medical University | Zhang X.,Tieling Health College | And 5 more authors.
Biological Trace Element Research | Year: 2012

To evaluate prenatal exposure to arsenic in the general population and its effects on birth size, we conducted a cross-sectional study in Dalian, China. Arsenic concentration in maternal and cord blood was detected by inductively coupled plasma-mass spectrometry and its effects on birth size were analyzed by multivariate analysis and multiple linear regression analysis. Arsenic concentrations in cord blood were significantly lower than those in maternal blood. A significant positive correlation was shown between maternal and cord blood arsenic concentrations. Maternal arsenic concentration was negatively associated with birth weight, height and chest circumference, and fetal arsenic concentration was negatively associated with head circumference. Our results indicate that arsenic exposure at environmental levels in uterus may pose adverse effects on fetal development. © 2012 Springer Science+Business Media, LLC.


Guan H.,Dalian Medical University | Guan H.,No 210 Hospital Of Pla | Piao F.-Y.,Dalian Medical University | Li X.-W.,No 210 Hospital Of Pla | And 3 more authors.
Biomedical and Environmental Sciences | Year: 2010

Objective: : To examine maternal and fetal exposure levels to four carcinogenic metals, arsenic (As), cadmium (Cd), nickel (Ni), and beryllium (Be), and to investigate their environmental influences. Methods: Metal concentrations in maternal and umbilical cord blood were measured by inductively coupled plasma-mass spectrometry (ICP-MS). Environmental factors that might play a role in exposure were analyzed using Mann-Whitney nonparametric U-tests and multiple linear regression. Results: The concentrations of As, Cd, and Ni in umbilical cord blood (5.41, 0.87, and 139.54 μg/L) were significantly lower than those in maternal blood (6.91, 1.93, and 165.93 μg/L). There were significant positive correlations between the maternal and cord concentrations of each carcinogen. Our results showed that: (i) exposures to potentially harmful occupational factors during pregnancy were associated with high levels of maternal As, Cd, and Ni; (ii) living close to major transportation routes (<500 m) or exposure to second-hand smoke during pregnancy increased the maternal Cd levels and (iii) living close to industrial chimneys induced high maternal Ni levels. Multiple linear regression analysis showed that these environmental factors remained significant in models of the influences of these four carcinogens. Conclusion: Both mothers and fetuses had been exposed to As, Cd, Ni, and Be. The increased levels of these carcinogens in pregnant women were associated with some detrimental environmental factors, such as occupational exposure, contact with second-hand smoke and living close to major transportation routes or industrial chimneys. Copyright © 2010 by China CDC.


Yan M.-J.,No 210 Hospital Of Pla | Chen R.-L.,Dalian Medical University | Piao F.-Y.,Dalian Medical University
Journal of Dalian Medical University | Year: 2014

Objective: To investigate apoptotic effect of 2,5 - Hexanedione (2,5 - HD) on bone marrow mesenchymal stem cells (BMSCs) of rats and its mechanism.Methods: Thecellswere isolated from Bone marrows of rats and cultured. The morphology ofcells were observed, their surface markers were determined by flow cytomerty. Moreover, the cells could be induced tofat cells andosteoblasts. These cells were confirmed to be BMSCs. In this study, the fifth generation of rat BMSCs was exposed to 0, 10, 20 and 40 mmol/L 2,5 - HD for 24 h and the cells viability was measured by MTT assay. Themorphological changes of BMSCs were observed using HE staining and The apoptotic morphologic changes of BMSCs were observed by Hoechst 33342 staining. The protein expression of Bcl - 2 and Baxwasdetermined by Western blot.Results: Our results showed thatexposure to 2,5 - HD decreased survival of BMSCs and induced apoptosis. Moreover, 2,5 - HD significantly increasedBaxexpression (P < 0.05) and significantly decreased Bel - 2 expression (P < 0.05).Conclusion: These results suggest that 2,5-HD - induced apoptosis of BMSCs may be associated withdisturbanceinBax/Bcl - 2 protein expression.


PubMed | No 210 Hospital Of Pla
Type: Journal Article | Journal: Biological trace element research | Year: 2012

To evaluate prenatal exposure to arsenic in the general population and its effects on birth size, we conducted a cross-sectional study in Dalian, China. Arsenic concentration in maternal and cord blood was detected by inductively coupled plasma-mass spectrometry and its effects on birth size were analyzed by multivariate analysis and multiple linear regression analysis. Arsenic concentrations in cord blood were significantly lower than those in maternal blood. A significant positive correlation was shown between maternal and cord blood arsenic concentrations. Maternal arsenic concentration was negatively associated with birth weight, height and chest circumference, and fetal arsenic concentration was negatively associated with head circumference. Our results indicate that arsenic exposure at environmental levels in uterus may pose adverse effects on fetal development.


PubMed | Dalian Medical University and No 210 Hospital Of Pla
Type: | Journal: Scientific reports | Year: 2016

Chronic exposures to arsenic had been associated with metabolism diseases. Peroxisome proliferator-activated receptor gamma (PPAR) was found in the liver, regulated metabolism. Here, we found that the expression of PPAR was decreased, the generation of reactive oxygen species (ROS) and autophagy were increased after treatment with As2O3 in offsprings livers. Taurine (Tau), a sulfur-containing -amino acid could reverse As2O3-inhibited PPAR. Tau also inhibit the generation of ROS and autophagy. We also found that As2O3 caused autophagic cell death and ROS accelerated in HepG2 cells. Before incubation with As2O3, the cells were pretreated with PPAR activator Rosiglitazone (RGS), we found that autophagy and ROS was inhibited in HepG2 cells, suggesting that inhibition of PPAR contributed to As2O3-induced autophagy and the generation of ROS. After pretreatment with Tau, the level of PPAR was improved and the autophagy and ROS was inhibited in As2O3-treated cells, suggesting that Tau could protect hepatocytes against As2O3 through modulating PPAR pathway.


PubMed | General Hospital of Peoples Liberation Army, Fu Wai Hospital, Nanjing First Hospital, Wuhan Asia Heart Hospital and 8 more.
Type: Comparative Study | Journal: JAMA | Year: 2015

The safety and efficacy of bivalirudin compared with heparin with or without glycoprotein IIb/IIIa inhibitors in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are uncertain.To determine if bivalirudin is superior to heparin alone and to heparin plus tirofiban during primary PCI.Multicenter, open-label trial involving 2194 patients with AMI undergoing primary PCI at 82 centers in China between August 2012 and June 2013.Patients were randomly assigned to receive bivalirudin with a post-PCI infusion (n=735), heparin alone (n=729), or heparin plus tirofiban with a post-PCI infusion (n=730). Among patients treated with bivalirudin, a postprocedure 1.75 mg/kg/h infusion was administered for a median of 180 minutes (IQR, 148-240 minutes).The primary end point was 30-day net adverse clinical events, a composite of major adverse cardiac or cerebral events (all-cause death, reinfarction, ischemia-driven target vessel revascularization, or stroke) or bleeding. Additional prespecified safety end points included the rates of acquired thrombocytopenia at 30 days, and stent thrombosis at 30 days and 1 year.Net adverse clinical events at 30 days occurred in 65 patients (8.8%) of 735 who were treated with bivalirudin compared with 96 patients (13.2%) of 729 treated with heparin (relative risk [RR], 0.67; 95% CI, 0.50-0.90; difference, -4.3%, 95% CI, -7.5% to -1.1%; P=.008); and 124 patients (17.0%) of 730 treated with heparin plus tirofiban (RR for bivalirudin vs heparin plus tirofiban, 0.52; 95% CI, 0.39-0.69; difference, -8.1%, 95% CI, -11.6% to -4.7%; P<.001). The 30-day bleeding rate was 4.1% for bivalirudin, 7.5% for heparin, and 12.3% for heparin plus tirofiban (P<.001). There were no statistically significant differences between treatments in the 30-day rates of major adverse cardiac or cerebral events (5.0% for bivalirudin, 5.8% for heparin, and 4.9% for heparin plus tirofiban, P=.74), stent thrombosis (0.6% vs 0.9% vs 0.7%, respectively, P=.77), acquired thrombocytopenia (0.1% vs 0.7% vs 1.1%; P=.07), or in acute (<24-hour) stent thrombosis (0.3% in each group). At the 1-year follow-up, the results remained similar.Among patients with AMI undergoing primary PCI, the use of bivalirudin with a median 3-hour postprocedure PCI-dose infusion resulted in a decrease in net adverse clinical events compared with both heparin alone and heparin plus tirofiban. This finding was primarily due to a reduction in bleeding events with bivalirudin, without significant differences in major adverse cardiac or cerebral events or stent thrombosis.clinicaltrials.gov Identifier: NCT01696110.

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