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Objective@#To explore the imaging characteristics and related influencing factors of in-stent neoatherosclerosis (ISNA) in patients with restenosis after drug-eluting stent(DES) implantation with optical coherence tomography(OCT).@*Methods@#A total of 25 cases of coronary heart disease patients(DES placement time ≥8 months) with coronary artery angiography showing DES in-stent restenosis (ISR) in Zunyi medical college affiliated hospital from July 2013 to December 2015 were included in this study and patient's data were retrospectively analyzed.In these patients with ISR, OCT images were acquired before percutaneous coronary intervention. Patients were divided into the ISNA group (12 patients and 12 lesions) and non-ISNA group(13 patients and 13 lesions) according to the result of OCT. ISNA on OCT was defined as neointima formation with the presence of lipids or calcification.@*Results@#(1) The incidence of chronic kidney disease and increased low-density lipoprotein cholesterol level in ISNA group were significant higher than that in non-ISNA group(all P<0.05). The stent implantation time in ISNA group was longer than that in the non-ISNA group(53.0(14.0, 81.0) months vs. 15.0(8.5, 32.5) months, P<0.01). In addition, clinical manifestation of acute coronary syndrome was present in 8 out of 12 patientsin ISNA group, and stable angina pectoris was found in 10 out of 13 casesin non-ISNA group(P<0.01). (2) Quantitative analysis of OCT showed that the lumen area was less in ISNA group than in non-ISNA group((3.45±1.82)mm2 vs. (4.17±1.68)mm2, P<0.01), and neointimal area(3.89(2.26, 5.52)mm2 vs. 2.96(1.99, 4.22)mm2, P<0.01), neointimal load (53.15(40.18, 67.30)% vs. 41.54(32.08, 56.91)%, P<0.01), neointimal thickness(0.98(0.63, 1.36)μm vs. 0.72(0.51, 1.03)μm, P<0.01) were higher in ISNA group than in non-ISNA group.(3)Qualitative analysis of OCT showed that the prevalence of homogeneous intima was less in the ISNA group than in the non-ISNA group ((41.42±22.56)% vs.(72.06±18.68)%, P<0.05), on the contrary, the heterogeneous intima was more common in the ISNA group ((58.57±22.56)% vs. (27.94±18.68)%, P<0.05). There was no significant difference between two groups in the peri-stentmicrovessels (9/12 vs. 5/13,P>0.05), and prevalence of intraintimalmicrovessels was higher in the ISNA group than in non-ISNA group (7/12 vs. 2/13, P<0.05). In addition, thin cap fibrous plaque(7/12 vs. 0, P<0.01), disrupted intima with visible cavity (7/12 vs. 1/13, P<0.05),andintraluminal red thrombus(7/12 vs. 1/13, P<0.05) were significantly higher in ISNA group than in non-ISNA group.@*Conclusions@#Results of OCT show that ISNA occurs frequently in patients with ISR after DES implantation. The stent implantation time, incidence of chronic kidney disease and higher low-density lipoprotein cholesterol level are associated with the formation of ISNA in these patients.
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Objective To investigate the effects and mechanisms of HMGB-1 combined with MSCs transplantation on the heart function in rat with acute myocardial infarction.Methods A total of 144 male SD rats were divided into the healthy control group,model control group,MSCs transplantation group,HMGB-1 injection group,HMGB-1 injection+ MSCs transplantation group,HMGB-1 BoxA injection+MSCs transplantation group.On the 28th day after surgery,the heart function,myocardial pathological section,myocardial infarction area and new vessel density in infarction area were detected.Andthe level of related serum cytokines were measured on the 3rd,7th and 28th days after surgery.Results On the 28th day after surgery,left ventricular end diastolic dimension (LVDd) and left ventricular iiaternal diameter at end-systole (LVDs) in the HMGB-1 injection+ MSCs transplantation group were significantly decreased and the fractional shortening (FS) and ejection fraction (EF) value were significantly increased compared with the other five groups (P＜0.05);the infarction area in the HMGB-1 injection+MSCs transplantation group was significantly decreased and the new vessels number in the infarction area was significantly increased compared with the other model groups (P＜0.05).On the 3rd and 7th days after surgery,serum TLR4 and VEGF levels in the HMGB-1 injection+MSCs transplantation group were the highest (P＜0.05).On the 7th and 28th days after surgery,the levels of serum IL-6,NF-κB and TNF-α in the HMGB-1 injection+MSCs transplantation group were the lowest among all groups (P＜0,05).Conclusion HMGB-1 injection combined with MSCs transplantation treatment can effectively improve the prognosis of myocardial infarction.
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Objective To evaluate the right ventricular (RV) function in patients with acute inferior wall myocardial infarction ( AIMI ) with tissue Doppler imaging and M-mode echocardiography. Methods There were 50 cases of AIMI, 34 males and 16 females. And 50 healthy persons were as control group, 30 males and 20 males. From the echocardiographic apical 4- chamber views, the systolic, early and late diastolic motion (SD, DED, DAD) of the tricuspid annulus were recorded at the RV free wall with the use of two-dimentional guided M-mode recordings. Peak systolic, early and late diastolic velocities (Sm, Em, Am) of the tricuspid annulus were also recorded at the same site by tissue Doppler imaging. The ratios of DAD/DAD and Em/Am were calculated. Results SD, DED, Sm and Em of the tricuspid annulus at the RV free wall, as well as the ratios of DED/DAD and Em/Am, were reduced significantly in patients with AIMI as compared with health control [SD: (18.7±5.5) mmvs. (24.9±2.8) mm; DED: (10.9±3.4) mmvs. (16.6±3.4) mm;Sm: (12.9±2.8) cm/s vs. (15.9±2.7) cm/s; Em: (12.3±3.4) cm/s vs. (16.7±4.7) cm/s;DED/DAD: (1.5±0.6) vs. (2.3±0.9); Em/Am: (0.9±0.4) vs. (1.1±0.3); t=18.711,19. 055, 11. 851, 14. 781, 6.068, 2. 127; P＜0. 01 or 0. 05, respectively]. There were no statistically significant differences in DAD and Am between two groups [DAD: (8. 8±1.9) mm vs. (7.7±2.1)mm; Am: (17.5±4.8) cm/s vs. (16.6±5.2) cm/s; t=0.414, 0.649; both P＞0.05].Conclusions The systolic and diastolic functions of RV are impaired in patients with AIMI.
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AIM: To investigate the function and the mechanism of transplanting bone marrow derived peripheral blood mesenchymal stem cells(PBMSCs) on restenosis after carotid balloon angioplasty in the model of carotid atherosclerosis rabbits,and to determine if the functions of PBMSCs are enhanced after hypoxia preconditioning.METHODS: Bone marrow cells were mobilized by granulocyte colony-stimulating factor(G-CSF),and PBMSCs were collected through density gradient centrifugation and adherent culture,labeled with enhancement type green fluorescent protein(EGFP) genes.All animals with carotid atherosclerosis stenosis were randomly divided into three groups: hypoxia preconditioning group(n=24,received intravenous transplantation of PBMSCs with hypoxia preconditioning),non-hypoxia preconditioning group(n=24,received normal culture of PBMSCs) and control group(n=24,only received equal-volume of culture medium).Vascular endothelial growth factor(VEGF) was determined by enzyme linked immunosorbent assay(ELISA) at 7 d,14 d and 28 d post-angioplasty,respectively.The vessel morphology,the homing of MSCs and the reendothelialization were analyzed with Weigert staining and immunohistochemistry.RESULTS: Compared to control group,the level of VEGF significantly increased in both hypoxia preconditioning group and non-hypoxia preconditioning group at all time points(P