The application of subdermal vascular network skin graft in severed finger reunion with small area skin defects / 中国医师进修杂志

Objective To explore the application of subdermal vascular network skin graft in severed finger reunion with small area skin defects.Methods Modified subdermal vascular network,which was inversion thin and middle thick,was used to repair defect of severed finger reunion without exposure of blood vessel.There were 10 patients and 14 fingers,including 7 patients and 10 fingers injured in the dorsal sid with 5 fingers' extensor tendon exposed,and 3 patients and 4 fingers injured in the palmar side with 2 patients' flexor tendon exposed.The defect area was ranged from 1.0 cm × 0.8 cm to 3.0 cm × 1.5 cm.Results In 6 larger subdermal vascular network,skin's edge became blue and blister appeared in the middle.The others was good with skin texture and aspect.Conclusions Modified subdermal vascular network skin graft is safe and effective choose to solve severed finger reunion with smnall area skin defects.

The aortic remodeling comparative study of contrast enhanced ultrasound and CT angiography in DeBakey type Ⅲ aortic dissection after thoracic endovascular aortic repair / 中华超声影像学杂志

Objective To compare the different features of contrast enhanced ultrasound(CEUS) and CT angiography (CTA) in abdominal aortic remodeling after thoracic endovascular aortic repair (TEVAR)of DeBakey type Ⅲ aortic dissection(AD),and to investigate the application value of CEUS in the follow-up of DeBakey type Ⅲ AD after TEVAR.Methods CEUS was performed in 28 patients with DeBakey type Ⅲ AD after TEVAR,in which 8 cases type Ⅲ a (simple type) were not involved of abdominal aorta,20 cases Ⅲ b(complex type) were involved in the abdominal aorta,all patients were performed CTA examination of aorta.The functional and morphological changes of abdominal aortic remodeling were observed by two methods in DeBakey type Ⅲ AD after TEVAR.Results There was no new rupture of the abdominal aorta in 8 cases type Ⅲ a AD,but 20 cases of type Ⅲ b AD showed the situation of ruptures,thrombosis,trues and falses lumen after 3 months of follow-up.CEUS was less than CTA in detecting the number of ruptures (P＜0.05),CEUS and CTA results were similar in the measurement of true and false lumen diameter (P＞0.05),but CEUS clearly showed the hemodynamic characteristics of abdominal aortic intimal tear,the size and position of rupture,moving blood flow of rupture,and true or false lumen,which provided more accurate data for the long term abdominal aortic remodeling of DeBakey type Ⅲ AD after TEVAR.Conclusions CEUS and aortic CTA can play a complementary role in DeBakey type Ⅲ AD after TEVAR of long-term follow-up,it is worth promoting.

Ultra-microstructural changes in iliac artery after bare and magnetic stent implantation in rabbits / 老年心脏病学杂志（英文版）

Objective To investigate the preventive effect of magnetic stent on coronary restenosis after percutaneous arterial stenting.Methods Twenty rabbits were divided randomly into 2 groups.Bare stent(BS group,n=10)or magnetic stent(MS group,n=10)wasimplanted in the left iliac artery of the rabbits of the 2 groups,respectively.Aspirin (25mg,qd )was administered orally to the rabbitsof both groups from 3 days before stenting until the rabbits were executed.Unfractionated heparin (2500u,qd) was delivered subcuta-neously after stenting for 7days.Five rabbits of each group were randomly selected to be executed at 7 or 30 days.Stmctural changesin the iniured arteries were studied by optical microscopey,transmissive electronic microscopey and immunohistochemistry.ResultsAt 7 days.more myofibroblasts were found migrating from adventitia to tunica media and intima in BS group than in MS group.insidethe media and intima,large amount of smooth muscle cells of synthetic type were observed.At 30 days after stenting,in magnetic group,most uascular smooth musele cells(SMCs)under the intima had transformed to contractile type and only little extracellular matrix(ECM)was observed around the SMCs;whereas,in BS group,the SMCs remained to be synthetic type and large amount of ECM wasobserved around the SMCs.which was composed mainly of proteoglycans and glycoproteins. Conclusions Magnetic stent caninhibit proliferation and migration of SMCs and reducing the production of ECM.and therefore,may prevent restenosis after coronarystenting.

Expressions of matrix metalloproteinases and tissue inhibitor of metalloproteinases after bare and magnetic stent implantation in rabbits / 老年心脏病学杂志（英文版）

Objective We aimed to investigate whether magnetic stent has preventive effect on in-stent restenosis by observing expressions of matrix metalioproteinase (MMP)2,MMP9,tissue inhibitor of matrix metalloproteinase (TIMP)1 and TIMP2 after balloon angioplasty,bare and magnetic stent implantation in rabbits.Methods Rabbits underwent balloon angioplasty,bare and magnetic stent implantation in the left iliac arteries.The changes of MMPs and TIMPs were examined at various time points in the injured arteries using the methods of zymography,Western blot analysis,reverse transcription-polymerase chain reaction (RT-PCR) and morphometric analysis.Results Balloon angioplasty group (BA) and magnetic stent group (MS) showed lower intrinsic gelatinolytic activity and higher expression of TIMPs with less intimae hyperplasia;Whereas bare stent (BS) group exhibited higher intrinsic gelatinolytic activity and lower expression of TIMPs with significant intimae hyperplasia.Conclusion Magnetic stent probably has preventive effect on in-stent restenosis by changing intrinsic matrix metalloproteinases activity and expression of TIMPs.

Standardization management of medical equipment operation / 医疗卫生装备

Accurate operation and installation circumstance of medical instruments and equipment directly affect their normal operation. Breakdown of medical instrument due to wrong operation accounts for 43% of all failures. This article makes a discussion on how to train staffs before operation,register utilization and maintenance,manage equipment by dedicated person and mak the best use of medical instrument.

The plasticity of adult stem cells and their application in myocardial regenerative medicine / 老年心脏病学杂志（英文版）

Current therapies for myocardial infarction and congestive heart failure are limited in efficacy or in applicability. The plasticity of adult stem cells and cellular transplantation offer a novel therapeutic approach to improve cardiac function. This review describes the latest progress in research, summarizes recent studies of adult stem cells and their application in myocardial regenerative medicine in China and abroad, and discusses the future directions of cell transplantation as a new therapy to repair injured hearts. (J Geriatr Cardiol 2004;1(2) :77-82. )

Cardiomyocyte-like differentiation of human bone marrow mesenchymal stem cells after exposure to 5-azacytidine in vitro / 老年心脏病学杂志（英文版）

Objective To investigate the potential of adult mesenchymal stem cells (MSCs) derived from human bone marrow to undergo cardiomyogenic differentiation after exposure to 5-azacytidine (5-aza) in vitro. Methods A small bone marrow aspirate was taken from the iliac crest of human volunteers, and hMSCs were isolated by 1.073g/mL Percoll and propagated in the right cell culturing medium as previously described. The phenotypes of hMSCs were characterized with the use of flow cytometry. The hMSCs were cultured in cell culture medium (as control) and medium mixed with 5-aza for cellular differentiation. We examined by immunohistochemistry at 21 days the inducement of desmin, cardiac-specific cardiac troponin I (cTnI), GATA 4 and connexin-43 respectively. Results The hMSCs are fibroblast-like morphology and express CD44+ CD29+ CD90+ / CD34- CD45- CD31- CD11a. After 5-aza treatment, 20-30% hMSCs connected with adjoining cells and coalesced into myotube structures after 14days. Twenty-one days after 5-aza treatment, immunofluorescence showed that some cells expressed desmin,GATA4, cTnI and connexin-43 in 5,10 μmol/L 5-aza groups, but no cardiac specific protein was found in neither 3μmol/L 5-aza group nor in the control group. The ratio of cTnI positively stained cells in 10 μmol/L group was higher than that in 5 μmol/L group (65.3 ± 4.7% vs 48.2 ± 5.4%, P ＜ 0.05). Electron microscopy revealed that myofilaments were formed. The induced cells expressed cardiac-myosin heavy chain (MyHC) gene by reverse transcription-polymerase chain reaction (RT-PCR). Conclusions Theses findings suggest that hMSCs from adult bone marrow can be differentiated into cardiac-like muscle cells with 5-aza inducement in vitro and the differentiation is in line with the 5-aza concentration. (J Geriatr Cardiol 2004;1(2) :101-107. )

Nitric oxide opens second window of protection in ischemic preconditioning via induction of heat-shock protein 72 / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To examine the inhibition of nitric oxide (NO) synthesis during ischemic preconditioning (IP) upon the induction of heat-shock protein 72 (HSP72) and the size-limiting effect of the second window of protection on infarction.</p><p><b>METHODS</b>Rabbits were subjected to either 4 cycles of 5-min long coronary artery occlusion separated by 10 min of reperfusion, or a sham operation. During this procedure, we administered 10 mg/kg of N(G)-nitro-L-arginine methyl ester (L-NAME, an inhibitor of NO synthase) intravenously 5 min before IP followed by its continuous infusion (1.5 mg/kg/min). Twenty-four hours after IP or the sham operation, the hearts were rapidly excised for assay of HSP72 expression or were subjected to 30 min of coronary artery occlusion followed by 120 min of reperfusion, at which point infarct size (IS) was measured.</p><p><b>RESULTS</b>Twenty-four hours after IP or the sham operation, there was no difference in heart rate or mean arterial pressure between the groups. Immunoblotting revealed an increase in HSP72 protein levels in the IP group, which was blocked by L-NAME. IS in the IP rabbits was reduced compared with controls (29.8 +/- 3.7% vs. 50.8 +/- 4.3%, P < 0.01). IS in the IP rabbits was elevated as a result of L-NAME treatment (46.0 +/- 5.1%). Administration of L-arginine reversed the effects of L-NAME on the induction of HSP72 and IS (33.5 +/- 4.0%). The intravenous administration of S-nitroso-N-acetylpenicillamine (an NO donor, 15 microg/kg/min) over 20 min increased the induction of HSP72 and reduced IS (31.3 +/- 5.7%, P < 0.01 vs. control) 24 h later.</p><p><b>CONCLUSION</b>These findings suggest that NO may be involved in the induction of HSP72 and the opening of the second window of protection of IP.</p>

Effect of static magnetic fields on the cellular proliferation and cycle of the Human bone marrow mesenchymal stem cells / 医学研究生学报

Objective: To observe the effect of static magnetic fields(SMF) on the proliferation of bone mesenchymal stem cells(MSC) in human. Methods: The MSC were obtained by using gradient centrifuge method, and then selected by the adhesive method. The third generation cells were irradiated by use of static magnetic fields at different intensities for 5 days(8 h/d). The method of MTT was employed to evaluate the level of proliferation. The parameters regarding the variation of the cell cycle were detected with the flow cytometry(FCM). Results: As compared to the control group, the proliferative rate of the MSC exposed to 0.05 mT SMF was significantly higher; there was no difference between the 0.10 mT group and control group; howere, cell proliferation was attenuated significantly when SMF intensity was 0.50 mT and 1.00 mT. No abnormal ploidy was found in any group. Conclusion: The effect of SMF on the proliferation of MSC is dependent on the magnetic intensity. 0.05 mT SMF can accerate the proliferation of MSC. 0.10 mT SMF have no effects on the growth of MSC. Wherease, 0.50 mT and 1.00 mT SMF can attenuate the growth of MSC.

Comparison of coronary stenting with or without predilation for infarct related lesions in patients with acute myocardial infarction / 中国介入心脏病学杂志

1?216 kPa(12 atm, 1 atm=101.325 kPa)] or low- (≤1?216 kPa) pressure inflation. Results In group A, all patients were successfully treated with PCI. In group B, 40 cases (95%) were successfully treated with DS, and DS in the remaining 2 patients failed due to an angle in IRL, which were successfully managed with pre-dilation. There were no procedure-related death, re-infarction, or emergency bypass surgery in both groups. The incidence of no-reflow after stenting was significantly higher in patients with high-pressure inflation than in those with low-pressure inflation (32% vs 7%, P

Stent supported coronary angioplasty in patients with severe ventricular dysfunction / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the immediate- and long-term outcomes of stent supported coronary angioplasty in patients with severe left ventricular dysfunction.</p><p><b>METHODS</b>Seventy-four consecutive patients with angiographic left ventricular ejection fractions < or = 40% underwent percutaneous coronary angioplasty, including 61 (81%) with stent back-up. Clinical follow-up (29.1 +/- 22.9 months) data were obtained in all clinically successful patients.</p><p><b>RESULTS</b>Angiographic success was achieved in 120 (89.5%) of 134 lesions. Clinical success was obtained in 66 (89.2%) patients with 1.4% procedure related mortality, 2.7% myocardial infarction and zero need of emergent bypass surgery. NYHA class reduction > or = 1 was seen in 29 (73%) of 40 successfully treated congestive heart failure patients at 6 months after the procedure. During long-term follow-up, 58 (87.9%) of 66 patients with clinical success were alive, including 44 (68.6%) free from cardiac events.</p><p><b>CONCLUSIONS</b>Patients with severe left ventricular dysfunction treated with stent supported PTCA experience a high rate of success, low procedure related mortality and satisfactory long-term survival.</p>

Effects of hydrogen peroxide on intracellular free calcium concentration in cultured neonatal rat cardiac myocytes and its antagonism by carvedilol / 解放军医学杂志

Objective To examine effects of hydrogen peroxide on intracellular free calcium concentration(i) in cardiac myocytes and its antagonism by carvedilol. Methods A cell culture of neonatal rat cardiac myocytes was used for experimentation. They were divided into four groups, i.e. control group, hydrogen peroxide (H 2O 2) group, carvedilol group,and H 2O 2 + carvedilol group. Confocal microscope was used with Fluo-3/AM as calcium indicator to detect changes in i immediately and 15 minutes after H 2O 2 intervention, respectively. Results The intracellular fluoresence intensity of a single cardiae myocyts in the control group and carvedilol group was low. The intracellular fluoresence intensity of a single cardiac myocyte in H 2O 2 group was significantly higher than in the control group 15 minutes after intervention (P

Clinical analysis of cutting balloon coronary angioplasty / 中国实用内科杂志

Objective To evaluate the safety,efficiency and short-term results of cutting balloon coronary angioplasty.Method This procedure was performed on 63 lesions in 52 patients (male 94%,age 57?9 years).Results The overall procedural success rate for the cutting balloon angioplasty without predilation were 92.1%.Seven out of 9 cases of total occluded lesions had satisfactory results.Two cases of in-stent restenosis were also treated with CB successfully.Forty-three lesions were treated with cutting balloon followed by stents insertion.In 20 lesions treated with the cutting balloon alone,there was a marked reduction in the luminal stenosis from 78.8?11.6% to 7.2?5.6%.One patient developed pericardial tamponade 3 hours after cutting balloon angioplasty,which was resolved with pericardiocentesis.No severe dissection,no abrupt coronary closure,no emergency bypass surgery and acute myocardial infarction occurred.During 6 to 2 months' follow-up,only one patient treated by cutting balloon alone experienced angina pectoris and coronary angiography showed a restenosis, there were no further cardiac event.Conclusion Cutting balloon coronary angioplasty is a safe and effective interventional therapy with a high success rate and satisactory short-term results.

The process of endothelialization after implantation of Cypher~(TM) stent in animal / 中国医师杂志

Objective To evaluate the effects of Cypher~(TM) Stent on endothelium regeneration and platelet activation after angioplasty. Methods Six mongrel dogs were implanted Cypher~(TM) stent and Bx sonic stent in the same artery.The target vessels were ablated after angiography and observed by scanning electron microscope at one month and three months after implantation of stents respectively.Result At one month,target vessels of Cypher~(TM) stent were covered with endothelium partly and platelet activation was observed.Target vessels of Bx sonic stent were entirely covered with endothelium and platelet activation wasn't observed.Three months later,target vessels of Cypher~(TM) stent and Bx sonic stent were entirely covered with endothelium and there was no platelet activation on the vessel surface for both groups.Conclusion Endothelium regeneration after implantation of Cypher~(TM) stent was much slower than that of implantation of bare metallic stent,and at three months,the endothelialization was finished.Intensive anti-platelet therapy should be considered after implantation of Cypher~(TM) stent.

The Changes of Postprandial Plasma Lipoproteins and Platelets Activity in the Elderly Patients with Coronary Heart Disease / 中国医师杂志

Objective To study the parameters of the postprandial plasma lipoproteins metabolism and the platelet activity change in the elderly patients with coronary heart disease(CHD). Methods 48 elderly patients with CHD (CHD group) and 30 healthy elderly subjects (control group) were enrolled in this study. The levels of plasma lipoproteins including TG, CH, LDL-C and HDL-C, plama PDGF bioactivity, and vWF plasma concentration were measured at 12 hours after fasting and 4 hours after a fat-rich meal. Results The plasma levels of pre-prandial and postprandial TG, CH, LDL-C, PDGF and vWF in the CHD group were significantly higher than those in the control group, while plasma HLD-C level in the CHD group was significantly lower than that in the control group. Compared with fasting state, the levels of plasma TG, CH and LDL-C in the postprandial state significantly increased, but plasma HDL-C level did not significantly decreased. The plasm PDGF and vWF values of CHD group in the postprandial state significantly elevated. Conclusion These data suggested that the plasma lipoproteins metabolism of the elderly patients with CHD was abnormal, and the platelets activation in the elderly patients with CDH was correlated with the changes of postprandial plasma lipoproteins metabolism.

Clinical Significance of the Platelet Activity Changes Before and After PTCA With Cutting Balloon Angioplasty / 中国医师杂志

Objective To study the platelet activity changes in patients before and after percutaneous coronary cutting balloon angioplasty (CBA) and plain old balloon angioplasty (POBA) as well as its clinical significance.Methods Blood was obtained from the coronary sinus. Bioassay method used for assessment of PDGF. The plasma 6-keto-PGF 1a level was determined using ELISA.Results The amount of PDGF and 6-keto-PGF 1a were significantly different after PTCA between CBA group and POBA group (P

High performance liquid chromatography analysis of porcine platelet-derived gro wth factor and its effect on DNA synthesis of human vascular endothelial cells / 第二军医大学学报

Objective: To determine the molecular weight and p urity of porcine platelet-derived growth factor (pPDGF) and to investigate its effect on DNA synthesis of human umbilical vein endothelial cells. Metho ds: In the present experiment, the high performance liquid chromatograph y was used and the molecular weight and purity of pPDGF were studied. Human umbi lical vein endothelial cells was cultured and effects of pPDGF on DNA synthesis of endothelial cells was observed by 3H-TdR incorporation in vitro. Results: The findings of high performance liquid chromatography showed that the molecular weight of pPDGF was 29 120 and the purity was 89.46%, a nd pPDGF significantly promoted DNA synthesis of quiescent endothelial cells wit h a maximal response at a concentration of 40 ng/ml at 48 h. Conclusion: The molecular weight of pPDGF is 29 120, and it can promote DNA synthes is of cultured human umbilical vein endothelial cells.

Correlative multifactor analysis on frequency of ventricular premature beats in coronary heart disease / 第三军医大学学报

Objective　To investigate the prognosis in risk of ventricular arrhythmia in coronary heart disease with heart rate variability (H RV), left ventricular ejection fraction (LVEF) and other clinical background dat a. Methods　A total of 81 patients were divided into ventricular premature beats (VPBs)≥30/h group and VPBs<30/h group. Their LVEF, HRV and cli nical data were studied and analyzed. Results　The age and blood pressure between 2 groups had no significant difference. LVEF, standard deviati on of all normal RR intervals (SDNN), SD of the average of NN interval (SDANN) a nd HRV triangular index (HRVI) were significant less in VPBs≥30/h group than in VPBs<30/h group (43.29±15.38 vs 67.33±11.47，P＜0.01；90.05±22.2 9 vs 117.90±30.32，P＜0.05；77.43±17.78 vs 105.69±28.79，P＜0.05 ；24.54±8.70 vs 32.70±10.87，P＜0.05, respectively). Incidence of myo cardial infarction (MI) was larger in VPBs≥30/h group than VPBs<30/h group. LVE F was the independent predictable factor in risk of ventricular arrhythmia with multinomial regression logistic analysis（B=0.119, P=0.032）. Co nclusion 　Our findings indicate that LVEF is an independent predictable factor i n risk of ventricular arrhythmia in coronary heart disease. Although HRV and MI history can not be used to predict VPB, significant difference is found between 2 groups. High-risk patients could be selected successfully when these data are considered in combination.

Nitric oxide opens the second window of protection in is chemic preconditioning via induction of heat shock protein 72 / 中国病理生理杂志

AIM: To examine the inhibition of nitric oxid e (NO) synthesis during ischemic preconditioning (IP) on the induction of heat s hock protein 72 (HSP72) and infarct size-limiting effect of the second window of protection. METHODS: Rabbits were subjected to 4 cycles of 5 min of coronary a r tery occlusion separated by 10 min reperfusion, or received a sham operation. Du ring this procedure, N G-nitro-L-arginine methyl ester (L-NAME, an inhibitor of NO synthase) was injected intravenously 5 min before IP followed by its continu ous infusion. Twenty-four hours later, the hearts were rapidly excised for assay ing HSP72 expression or were subjected to 30 min coronary artery occlusion follo wed by 120 min reperfusion and then measured infarct size (IS). RESULTS: Twenty-four hours later, immunoblotting revealed an inc rease in HSP72 protein levels in the IP group, and this was blocked by L-NAME. I S of the IP rabbits was reduced as compared with the control (29 8%?3 7% vs 50 8%?4 3%, P

Influence of constant magnetic fields on the proliferation of human umbilical arterial vascular smooth muscle cells pretreated with AngⅡ / 中国介入心脏病学杂志

Objective To observe the effects of constant magnetic fields (CMF) on angiotensinⅡ (AngⅡ)-stimulated proliferation of human umbilical arterial vascular smooth muscle cells (VSMC). Methods The experimental proliferation models of cultured human umbilical arterial VSMC stimulated with AngⅡ was establishea. The VSMC were cultured under 1 and 5 mT CMF for 48 hrs. Proliferation of the VSMC was detected by MTT and 3H-TdR incorporation method (A-value and cpm-value), and cell cycle was analyzed by flow cytometry. Results The CMF of 1 and 5 mT may antagonize proliferation of VSMC stimulated with AngⅡ, and hold-back VSMC from static phase (G 0/G 1)to DNA synthetic (S) and mitotic phase (G 2/M). Conclusion The study demonstrates that CMF of 1 and 5 mT can significantly inhibit the human VSMC proliferation.