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Objective To discuss the relationships of the genotype of cytochrome P450 2C19 (CYP2C19) gene and and clopidogrel responsiveness.Methods The study enrolled 110 patients with acute myocardial infarction who were treated with clopidogrel in Tiantan Hospital of Beijing from November 2012 to May 2014.Patients were treated by aspirin and clopidogrel.CYP2C19 polymorphisms were detected by genotype testing kits.Platelet inhibition rates were measured by thrombelastography to represent the antiplatelet effect of clopidogrel.The platelet inhibition rates of clopidogrel were compared among different genotypes.Results Compared with carriers of CYP2C19 * 2 or * 3 reduced-function allele,CYP2C19 * 1 wild type had higher platelet inhibition rate of clopidogrel ((35.73 ± 19.29)％ vs.(48.30± 20.84)％),and the difference was significant(t =3.264,P＜0.05).There was no difference between intermediate metabolizer((35.72± 19.27)％) and poor metabolizer((35.75±19.89)％;P＞0.05).The frequency of wild-type homozygotes CYP2C19 * 1/* 1 was higher in responders than in low responders(frequency of low reaction group CYP2C19 * 1/* 1 14 cases (40.0％),* 1/.2 10 cases(28.6％),* 1/* 3 4 cases(11.4％),* 2/* 2 5 cases(14.3％),* 2/* 3 2 cases (5.7％),frequency of reaction group were 45 cases (60.0％),15 cases (20.0％),4 cases (5.3 ％),7 cases (9.3％),4 cases(5.3％);x2 =3.838,P =0.05).Conclusion Polymorphism of gene CYP2C19 is associated with different responses to clopidogrel.CYP2C19 * 2/ * 3 reduced-function allele is associated with low response to clopidogrel.
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Objective To investigate whether angiotensin Ⅱ type 1 receptor(AT1R)gene polymorphism is associated with essential hypertension(EH). Methods A total of 200 hypertension patients and 192 normotensive controls were enrolled. The AT1R gene 1166A/C and -810A/T polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-PFLP), and the association between the SNPs and the EH were analyzed statistically. Some biochemical index such as serum glucose (GLU) and total cholesterol (TC),triglyceride (TG), high density lipoprotein (HDL-C) and low density lipoprotein (LDL-C) were also measured. Results There was no significant difference between two groups of 1166A/C polymorphisms of AT1R gene(P ＞ 0.05 ). However, for the -810A/T polymorphism of AT1R gene, -810 AT and TT genotypes frequencies were significantly higher in EH patients than control (P = 0. 004). The -810T allele frequencies were higher in case than in control (22.5% vs. 11.5% ;P =0.000). We also found an association between EH and -810AT and TT genotypes by logistic regression analysis ( P = 0. 003 ), adjusted for other risk factors. The odds ratio was 2.57 (95% CI:1. 37 ～4. 84). Conclusions AT1R -810A/T polymorphism is associated with EH and -810T allele may be a risk factor of hypertension
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Objective To investigate the effects of Helicohacter pylori infection on plasma lipid levels. Methods HpIgG was measured by ELISA in both 242 patients with coronary heart disease (CHD) and 88 subjects without CHD, and compared between these two groups. Then 242 patients with CHD were divided into HpIgG positive group and HpIgG negative group ,and total cholesterol (TC) ,triglyceride (TG) ,high density lipaprotein (HDL), low density lipoprotein (LDL), apolipoprotein A (ApoA) , apolipoprotein B (ApoB) were analyzed and compared between these two subgroups. Results The rate of seropositivity for HpIgG in CHD patients was significantly higher than that of controls (53.3 % vs. 38.6 %, P < 0.05), and HDL, ApoA level in HplgG seropasitive group was signif-icantly lower than that of HpIgG seronegative one (P < 0.05). However, there was no difference of TC, TC, LDL and ApoB between these two subgroups (P > 0.05). Conclusion Hp infection may be associated with CHD. It may pro-mote the pathogenesis of CHD through lowering serum HDL-C level.
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Objecfive To analyze the relationship between aortic root dimension(ARD)and anterior circulation infarction(ACI)by measuring ARD of ACI patients.Methods The ARD of 110 ACI patients(56 men and 54 women)were measured with 2-dimensional uhrasonography during ventricular systole.66 control subjects(32 men and 34 women)without the clinical signs of cerebral infarction or organic heart disease and cardiac insufficiency were selected after carrying out detailed cage history inquiring.physical examination,CT or MRI and ultrasonic examination.ResultsARD in men and women Was respectively(29.80±2.35)mm and(28.88±3.06)mm in the ACI group.While it was(27.64±1.70)mm and(26.98±1.60)mm respectively in the control subjects.ARD in men and women was significantly higher in the ACI group as compared with the control subjects(P＜0.01).Logistic regression analysis indicated that the odds ratio(confidence interval)associated with ARD Was 1.630(1.205-2.204)in men and 1.494(1.098-2.033)in women for ACI.Conclusions There is a close relationship between ARD and ACI.ARD is an important risk factor of ACI.
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Objective To investigate changes of markers of prethrombotic state(PTS)with heart failure and to explore their clinical significances.Methods Plasma levels of t-PA、PAI-1、Fg、PT、APTT、ET-1、MPV were measured in 52 patients with heart failure and in 38 normal controls.Results Compared with the healthy control group,patients with heart failure had significant increase of plasma PAI-1、Fg and ET-1level.Conclusions PTS is present in heart failure,especially in those with more severe Nyha class.
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BACKGROUND: Craniocerebral injury can cause a series of visceral complications, among which cardiovascular complication is paid special attention.OBJECTIVE: To investigate the effects of craniocerebral injury on changes of circulatory and local angiotensin Ⅱ (Ang Ⅱ ) and local angiotensin Ⅱ receptor 1 (AT1) in the heart.DESIGN: Randomized controlled experiment taking animals as subjects.SETTING: Beijing Tiantan Hospital, and the College of Basic Medicine,Capital University of Medical Sciences.MATERIALS: The experiment was conducted at the Central Laboratory of Capital University of Medical Sciences and the Central Laboratory of Beijing Tiantan Hospital from 2003 to 2004. Totally 40 healthy male Wistar rats were divided randomly into craniocerebral injury group and control group with 20 in each group.METHODS: Rats in craniocerebral injury group were treated with weightdrop method to establish the model of craniocerebral injury, while rats in control group received no impact. Twenty-four hours after hitting, 10 rats in each group were selected to assay their Ang Ⅱ and AT1; the other 10 in each group were selected to observe their myocardial forms.myocardium of rats assayed with light microscope after hematoxylin-eosin staining and transmission electron microscope.It was significantly higher in craniocerebral injury group than in control ity: It was obviously higher in craniocerebral injury group than in control Ⅱ and AT1: The area of positive reactant and gray value in craniocerebral toxylin-eosin staining: Strong acidophil staining was found on myocardial cellular plasma in craniocerebral injury group. The results showed that cytoplasm shrank obviously; muscle fiber broke, decreased or disappeared.Focal hydropic degeneration, lysis or necrosis was observed in myocardium.Ultrastructural pathological observation revealed pathological damage of myocardium.CONCLUSION: Craniocerebral injury in rats can cause myocardial damage, and changes of angiotensin system may be one of the factors.
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Objective Cardiovascular mortality and morbidity is common in dialysis patients and fluid overload is the most important contributor. The aim of this study was to investigate the relationship between volume overload and hypertension in elderly continuous ambulatory peritoneal dialysis (CAPD) patients and effect of dietary salt restriction on blood pressure control. Methods Thirty-eight CAPD patients with age of 60 years old and over were enrolled in the present study. 38 patients with CAPD were restricted the intake of salt and fluid in stable CAPD patients for two months. Their body weight, extracellular water (ECW), intracellular water (ICW), total body water (TBW), blood pressure, serum albumin levels, urine volume and ultrafiltrate volume were measured before and after the dietary restriction. Bioimpedance analysis was used to assess their fluid status. ECW was normalized by patients' ideal weight (nECW). Results After dietary salt restriction, significant deceases in body weight 〔(60.5?10.3) kg vs (58.5?9.7) kg, P =0.000〕, ECW 〔(15.81?3.03) L vs (14.65?2.61) L, P =0.000〕 and systolic blood pressure 〔(134.0?18.3) mm Hg vs (128.3?21.0) mm Hg, P =0.05〕 were observed in 26 patients whereas the opposite changes were observed in the remaining 12 patients. A significant correlation was found between systolic blood pressure and nECW both before and after two months of dietary restriction ( r _ pre =0.379, P =0.019; r _ post =0.393, P =0.016) and between the changes in systolic blood pressure and changes in nECW ( r =0.514, P =0.001). Conclusions The present study suggests that there is a positive correlation between fluid status and blood pressure. Most of the elderly CAPD patients are fluid overloaded and that dietary salt restriction may be an effective way to control volume and blood pressure. However, the compliance of patients to dietary salt restriction can influence the effect.
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AIM: To test the effect of ERK1/2 on ischemic preconditioning (IPC) in diabetic rat hearts. METHODS: The diabetic rat model was made with alloxan. After eight weeks, 24 rats were divided into 4 groups: non-diabetic IPC rats (group A); non-diabetic non-IPC rats (group B); diabetic IPC rats (group C); diabetic non-IPC rats (group D). ECGⅡ lead, left ventricular development pressure (LVDP), and first derivative of LVDP ~(?dp/dt_~max ) were recorded. Myocardial phosphorylation of extracellular signal regulated kinases1/2 (ERK1/2) was detected by Western-blotting. RESULTS: (1) The ventricular arrythmia score was significantly lower in group A than that in group C (P