Methods and research progress of noninvasive assessment of arterial stiffness / 中华老年医学杂志

Arterial stiffness plays a major role in the pathogenesis of numerous age-related diseases.Pulse wave velocity, distensibility, wave reflection, and pulse pressure are used to assess arterial stiffness, but the features and clinical significance of each parameter are different.Combined application of these parameters can comprehensively evaluate arterial stiffness.This review summarizes the methods and research progress of noninvasive assessment of arterial stiffness.

Association of estimated glomerular filtration rate with SYNTAX score in old patients with coronary heart disease / 中国医师进修杂志

Objective To explore the association between estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and the SYNTAX score in old patients with coronary heart disease. Methods Two hundred and fifty-six consecutive old patients with coronary heart disease were included in this study. The patients were angiographically diagnosed with coronary heart disease between January 2013 and April 2014 at the Department of Cardiology.eGFR was caculated by using BIS2 equation based on creatinine and cystatin C.SYNTAX score was caculated by SYNTAX score algorithm. Multiple linear regression and ordinal logsitic regreesion was used to analyze the association between eGFR and SYNTAX score. Results In patients with normal of renal function [eGFR≥90 ml/(min·1.73 m2), 110 patients], mild renal insufficiency [60 ml/(min · 1.73 m2) ≤ eGFR<90 ml/(min · 1.73 m2), 98 patients], midrange and severe renal insufficiency[eGFR<60 ml/(min · 1.73 m2), 48 patients], with the decrease in renal function of patients, SYNTAX score increased: (15.42 ± 9.65), (25.24 ± 8.34), (33.73 ± 10.15) scores, P<0.01. eGFR was an independent predictor of SYNTAX score (r=-0.059, P<0.01).eGFR was negatively correlated with SYNTAX score (r=-0.457, P<0.01). Conclusions eGFR is an independent predictor of SYNTAX score and negatively correlated with SYNTAX score in old patients with coronary heart disease. This might be helpful to explain the increased risk of coronary heart disease events and mortality in old patients with renal dysfunction.

Clinical values of ST-segment changes in ST-segment elevated myocardial infarction patients within 24 hours post primary percutaneous coronary interventions / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the clinical values of ST-segment changes in ST-segment elevated myocardial infarction (STEMI) patients within 24 hours after primary percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 225 patients with STEMI underwent primary PCI were enrolled, the ST segment resolution 1 hour after PCI was calculated and the patients were divided into group A (n = 135, Sgr;STE resolved ≥ 50%) and group B (n = 90, Sgr;STE resolved < 50%). The patients in group B were further divided into group C (n = 56, Sgr;STE resolved ≥ 50%) and group D (n = 34, Sgr;STE resolved < 50%) according to the ST segment resolution at 24 hours after PCI. TIMI flow after PCI, in-hospital major adverse cardiac events (MACE) and cardiac function about 7 days post PCI were analyzed.</p><p><b>RESULTS</b>Data between group A and group B were similar except the incidence of pre-PCI Killip ≥ II was significantly higher in group B than in group A (37.8% (34/90) vs. 17.0% (23/135), P < 0.05). Incidence of complicated diabetes (P < 0.05), pre-PCI Killip ≥ II (55.9% (19/34) vs. 26.8% (15/56), P < 0.05) and multivessel disease (70.6% (24/34) vs. 35.7% (20/56), P < 0.05) were significantly higher in group D than in group C. TIMI 3 and the opening time of IRA was similar between group A and group B and between group C and group D. The incidence of in-hospital MACE was significantly higher in group B than in group A (14.4% (13/90) vs. 3.0% (4/135), P < 0.05) which was similar between group C and group D.</p><p><b>CONCLUSION</b>Early (1 hour) but not late (24 hours) ST resolution post PCI is related to a favorable clinical outcome in STEMI patients.</p>

Minocycline postconditioning protects myocardium from ischemia-reper-fusion injury through attenuating poly(ADP-ribose) polymerase excessive activation / 中国病理生理杂志

AIM:To investigate whether minocycline postconditioning protects rat myocardium from ischemia-reperfusion ( I/R ) injury through attenuating poly ( ADP-ribose ) polymerase-1 ( PARP-1 ) excessive activation. METHODS:The left anterior descending coronary artery was ligated for 45 min and then reopened for 2 h to establish the rat model of myocardial ischemia-reperfusion injury.The male Wistar rats ( n =90 ) were randomly divided into sham group, I/R group, low-and high-dose minocycline groups, and 3-aminobenzamide (3-AB, PARP inhibitor) group.The myocardial infarct size was measured by Evans blue and 2,3,5-triphenyltetrazolium chloride ( TTC) staining.The morpho-logical changes of the myocardium were observed with HE staining.The cardiomyocyte apoptosis was detected using in situ TDT-mediated dUTP nick end labeling ( TUNEL) .The level of tumor necrosis factorα( TNF-α) and interleukin 1β( IL-1β) in the serum were measured by ELISA.The content of poly( ADP-ribose) ( PAR) in the reperfused myocardium and peripheral leukocytes were detected by Western blot.RESULTS: Compared with sham group, PAR expression, TNF-αcontent and IL-1βconcentration increased in all other groups.Compared with I/R group, treatment with low and high doses of minocycline and 3-AB significantly reduced the infarct size and myocardial apoptosis.PAR expression, TNF-αcontent and IL-1βconcentration in low-and high-dose minocycline groups and 3-AB group all decreased.No significant difference of the above parameters between high-dose minocycline group and 3-AB group was observed.CONCLUSION: Minocy-cline postconditioning may attenuate myocardial ischemia-reperfusion injury by depressing the activation of PARP-1 in car-diomyocytes and peripheral leukocytes in rats.

The influence of renal insufficiency on the prognosis of acute myocardial infarction patients with metabolic syndrome / 实用医学杂志

Objective To evaluate the influence of renal insufficiency (RI) on long-term major adverse cardiac events (MACE) of patients with acute myocardial infarction (AMI) plus metabolic syndrome (MetS) and received percutaneous coronary intervention (PCI). Methods This was a retrospective study. From February, 2011 to Octorber, 2013 , we consecutivly enrolled 223 AMI patients with MetS in the First Affiliated Hospital of China Medical University. There were 88 patients with RI in group A, and 135 patients as the control group (group B). Patients were followed up for major adverse cardiac events (MACE) for 1 year. Results Compared with group B, the incidence of 1-year MACE of patients in group A was increased (36.4% vs. 18.5%, P= 0.003). Result of Cox proportional hazard regression analysis showed that RI was a predictive factor for 1-year MACE (HR = 3.56,95%CI 1.004 ~ 4.170, P = 0.002). Conclusion The incidence of 1-year MACE for AMI patients with RI and MetS post-PCI was high. RI was a risk factor for poor prognosis of AMI patients with MetS.

Protective Effect of Intravenous Infusion of Low Dose Minocycline Postconditioning on Myocardial Ischemia-reperfusion Injury in Rat / 中国医科大学学报

Objective To evaluate the effects of low dose intravenous minocycline postconditioning on myocardial ischemia-reperfusion injury in rat,and to investigate the possible mechanisms. Methods Forty-eight male wistar rats were randomly divided into four groups:sham-operation (SO)group,ischemia-reperfusion(IR)group,low-dose minocycline(3 mg/kg,LM)group and high-dose minocycline(10 mg/kg,HM)group. The rat model of myocardial IR was established by occlusion of the left anterior descending coronary artery for 45 minutes and reperfusion for 120 minutes.After the reperfusion,the parameters of haemodynamics were recorded;creatine kinase MB(CK-MB),cardiac troponin-I(cTn-I),malond-ialdehyde(MDA),superoxide dismutase(SOD)in serum and myocardium,myocardial apoptosis index(AI)and the myocardial tissue morphology were determined. Results Compared with IR group,LM and HM treatment significantly reduced the levels of CK-MB form,cTn-I,AI and MDA, lowered LVEDP,enhanced LVSP and ±dp/dtmax,elevated the activity of SOD in serum and myocardium(P0.05). Conclusion LM postconditioning can protect against myocardial IR injury,and the protective effect may be related to the scavenging of oxide free radical,which further restrain the reac-tion of lipid peroxidation and apoptosis.

Influence of chronic cobalt chloride treatment on expression of Caspase-3 apoptosis gene within myocar-dial infarction area in GK diabetic rats / 心血管康复医学杂志

Objective:To explore the influence of chronic cobalt chloride (CoCl2 ) treatment on blood glucose and car-diomyocyte apoptosis in diabetic rats .Methods:In vivo MI model of rat was established using male GK diabetic rats and male Wistar rats (all weighing 200g~250g) .Blood glucose level was measured before model establishment .Af-ter successful operation ,rats were divided into six groups:Wistar sham operation group ,Wistar MI group ,Wistar MI + CoCl2 group ,GK sham operation group ,GK MI group and GK MI + CoCl2 group ,six rats survived in each group at least .After three weeks ,blood glucose level was measured and heart was excised ,expression of Caspase-3 apoptosis gene in ischemic necrosis area was measured .Results:(1) Compared with GK sham operation group and GK MI group on three weeks after operation ,there was significant reduction in blood glucose level [ (27.73 ± 2.58) mmol/L ,(27.87 ± 3.18) mmol/L vs .(16.3 ± 2.15) mmol/L] in GK MI + CoCl2 group ,P0.05 all .Conclusion:Chronic cobalt chloride treatment can decrease blood glucose level and reduce expression of Caspase-3 apoptosis gene in ischemic necrosis area in diabetic rats .

The clinical value of cardiac troponin Ⅰ in patients with unstable angina pectoris and minor myocardial damage / 中国医师进修杂志

Objective To study the clinical value of serum cardiac troponin Ⅰ (cTnⅠ) in patients with unstable angina pectoris (UAP) and minor myocardial damage.Methods The serum cTnⅠ level of 60 UAP patients (UAP group) were determined.The patients whose cTnⅠ were ≥ 0.1 μ g/L were ascribed to cTnⅠ positive group,and the patients whose cTnⅠ were ＜ 0.1 μ g/L were ascribed to cTnⅠ negative group.The correlation among clinical data,coronary arterial lesions and adverse cardiac events were analyzed.Forty healthy people were selected as control group.Results The positive rate of cTnⅠ in UAP group (35.0％,21/60) was significantly higher than that in control group (0),and there was statistical difference (P ＜ 0.01).The incidence rate of coronary arterial multi-branch lesions and/or severe stenosis in cTnⅠ positive group (19.0％,4/21) was higher than that in cTnⅠ negative group (5.1％,2/39),but there was no statistical difference (P ＞ 0.05).The incidence rate of 90 d adverse cardiac events in cTnⅠ positive group (33.3％,7/21) was significantly higher than that in cTnⅠ negative group (5.1％,2/39),and there was statistical difference (P ＜ 0.01).Conclusions Low-level cTnⅠ demonstrates minor myocardial damage sensitively and specifically.cTnⅠ level detected quantitatively can help to assess prognosis and provide risk stratification of UAP patients.

Nine-month angiographic and two-year clinical follow-up of polymer-free sirolimus-eluting stent versus durable-polymer sirolimus-eluting stent for coronary artery disease: the Nano randomized trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>First generation drug-eluting stents (DES) were associated with a high incidence of late stent thrombosis (ST), mainly due to delayed healing and re-endothelization by the durable polymer coating. This study sought to assess the safety and efficacy of the Nano polymer-free sirolimus-eluting stent (SES) in the treatment of patients with de novo coronary artery lesions.</p><p><b>METHODS</b>The Nano trial is the first randomized trial designed to compare the safety and efficacy of the Nano polymer-free SES and Partner durable-polymer SES (Lepu Medical Technology, Beijing, China) in the treatment of patients with de novo native coronary lesions. The primary endpoint was in-stent late lumen loss (LLL) at 9-month follow-up. The secondary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction or target lesion revascularization.</p><p><b>RESULTS</b>A total of 291 patients (Nano group: n = 143, Partner group: n = 148) were enrolled in this trial from 19 Chinese centers. The Nano polymer-free SES was non-inferior to the Partner durable-polymer DES at the primary endpoint of 9 months (P < 0.001). The 9-month in-segment LLL of the polymer-free Nano SES was comparable to the Partner SES (0.34 ± 0.42) mm vs. (0.30 ± 0.48) mm, P = 0.21). The incidence of MACE in the Nano group were 7.6% compared to the Partner group of 5.9% (P = 0.75) at 2 years follow-up. The frequency of cardiac death and stent thrombosis was low for both Nano and Partner SES (0.8% vs. 0.7%, 0.8% vs. 1.5%, both P = 1.00).</p><p><b>CONCLUSIONS</b>In this multicenter randomized Nano trial, the Nano polymer-free SES showed similar safety and efficacy compared with the Partner SES in the treatment of patients with de novo coronary artery lesions. Trials in patients with complex lesions and longer term follow-up are necessary to confirm the clinical performance of this novel Nano polymer-free SES.</p>

The prospective register study of domestic tirofiban for clinical application in acute coronary syndrome / 中华内科杂志

Objective To evaluate the current clinical application of domestic tirofiban in patients with acute coronary syndrome (ACS) and to explore its safety profile focused on the common causes and correlation factors for the hemorrhagic events.Methods The patients diagnosed as ST-elevation myocardial infarction (STEMI) and medium to high risk non-ST-elevation myocardial infarction (NSTEMI)/ unstable angina(UA) in 15 hospitals from September 2009 to December 2011 and given domestic tirofiban,were enrolled in this study.The following data were carefully collected:demographic data,comorbidities,concomitant medications,laboratory data,interventional treatment,application of tirofiban,hemorrhagic events and major adverse cardiac events(MACE) in hospital and at day 30 after discharge.Results (1) A total of 927 patients were enrolled in the study.The domestic tirofiban was given to 241 subjects (26.0％) before the intervention,567 subjects (61.2％) during the intervention and 89 subjects (9.6％) after the intervention.The standardized application was performed in 737 subjects (79.5％) with the loading dose of 10 μg/kg and the maintenance dose of 0.15 μg · kg-1 · min-1 In all the subjects,the average maintenance time was (30.4 ± 14.2) hours with the average dose of (339.3 ± 182.9)ml.(2)During hospitalization,major bleeding happened in 4 cases(0.4％) and major adverse cardiac events (MACE) in 37 cases (4.0％).(3)At day 30 after discharge,1 cases (0.1％)was reported with major bleeding and 9 cases (1.0％) with MACE.(3)The least MACE was showed in the preoperative tirofiban group (2.5％) and followed by the intraoperative group (4.1％) and the postopcrative group (9.0％).Compared with the non-standardized application group,MACE was significantly decreased in the standardized application group (2.44％ vs 10.00％,P ＜ 0.05).Conclusions The standardized application of the domestic tirofiban could decrease the incidence of MACE.Taken into account the combination therapy of clopidogrel and aspirin in the vast majority of patients,the domestic tirofiban exhibits a good safety profile with a relatively lower incidence of bleeding than the similar clinical studies.

The clinical values of the early ST resolution after successful primary percutaneous coronary intervention in acute myocardial infarction patients / 中国医师进修杂志

Objective To investigate the relationship between ST resolution and early prognosis of the patients with acute ST-elevation myocardial infarction (STEMI) receiving percutaneous coronary intervention (PCI).Methods A total of 80 consecutive patients with STEMI underwent primary PCI within 12 hours.ST segment elevation amplitude sum was measured and compared before PCI and 1 hour after PCI,and the percentage of declining was calculated.According to thrombolysis in myocardial infarction (TIMI) grading after PCI,the infarction related artery blood flow was recorded and compared.Ten of them who had experienced clear ST resolution (≥30％) before PCI were set aside.Among the other 70 patients,the ST resolution was calculated and the patients were divided into group A (41 cases,ΣSTE resolved ≥50％) and group B (29 cases,Σ STE resolved ＜ 50％).The left ventricular ejection fraction (LVEF),serious adverse cardiac events (MACE,including myocardial infarction,or revascularization,malignant arrhythmia,heart failure and death) in two groups during hospitalization was compared.Results The LVEF in postoperative 1 week in group A was higher than that in group B [(51.90 ± 5.06)％ vs.(46.87 ± 4.01)％,P ＜ 0.05].The incidence of in-hospital MACE during hospitalization in group A was lower than that in group B [7.3％ (3/41) vs.24.1％ (7/29)] (P ＜ 0.05).Conclusions Degree of ST resolution early after recanalization in acute STEMI patients receiving emergency PCI degree can better reflect the level of myocardial tissue perfusion and indirectly predict cardiac systolic function and in-hospital MACE.It can be used as evaluation index of early prognosis.

The use of in vivo cryotechnique in combination with electrocardiograph to study cardiac microcirculation in living mouse / 中国医师杂志

Objective The use of in vivo cryotechnique (IVCT) in combination with electrocardiograph (ECG) to study cardiac microcirculation under different hemodynamic conditions in living mouse.Methods Living mouse heart monitored by electrocardiograph was suffered from IVCT and freezing substitution under normal blood flow,myocardial ischemia or cardiac arrest conditions.Hematoxylin eosin (HE)staining,Schiff's staining and immunofluorescence staining for serum albumin,immunoglobulin were utilized on continuous paraffin sections,respectively.Confocal microscopy and statistical analyses were used.Results Comparing with normal hemodynamics,microvascular red cell volume reduction,morphology changed,myocardial cell glycogen loss,serum albumin ectopic distribution to myocardial cytoplasm,T tubular network failure and spacing width were happened in myocardial iscbemia condition; different shapes of red blood cells,myocardial cells glycogen deficiency,T tubular network failure and interval narrowing were found under cardiac arrest conditions.Conclusions Cardiac microcirculation,pathological changes of myocyte and its surrounding microenviroument in living mouse heart can be immediately captured in situ by the application of IVCT and ECG.

Analysis of relative risk factors for diabetic nephropathy / 心血管康复医学杂志

Objective: To study relative risk factors for diabetic nephropathy (DN). Methods: A total of 238 patients diagnosed as type 2 diabetes mellitus (DM) were enrolled in the study. According to urine microalbuminuria to urine creatinine ratio (UACR), patients were divided into pure DM group (group DM1, n=90), early diabetic nephropathy group (group DM2 , n=73) and clinical diabetic nephropathy group (group DM3 ,n=75). Clinic data of all patients were collected; Fasting blood glucose (FBG), 2h postprandial blood glucose (2hPB), blood lipids, uric acid (UA), fibrinogen (Fg) and glycosylated haemoglobin (HbA1c) were measured in all patients, and their correlations with DN were analyzed. Results: Compared with group DM1, the course of disease in DM [(7.25±6.29) years vs. (10.25±7.67) years vs. (13.53±7.82) years], levels of FBG [(8.46±2.52) mmol/L vs. (9.52±3.38) mmol/L vs. (10.82±3.30) mmol/L], 2hPB [(18.40±5.64) mmol/L vs. (20.27±5.94) mmol/L vs. (22.59±6.14) mmol/L], HbA1c [(7.96±1.65) % vs. (8.60±1.76) % vs. (9.55±2.09) %], triglyceride [TG, (1.72±0.86) mmol/L vs. (2.34±1.87) mmol/L vs. (3.16±1.85) mmol/L], Fg [(3.49±0.93) g/L vs. (3.88±1.21) g/L vs. (4.99±2.10) g/L] and UA [(295.42±52.34) μmol/L vs. (324.18±96.29) μmol/L vs. (351.23±56.88) μmol/L] significantly increased in group DM2 and group DM3 in order (P<0.01~0.001). Logistic gradual regression analysis indicated that course of DM, HbA1c, TG, Fg and UA were risk factors for DN (OR=1.008~1.910, P<0.01~0.001). Conclusion: The course of DM, blood glucose, blood lipid, uric acid and fibrinogen are risk factors of diabetic nephropathy; increased UACR reflects progress of patient’ condition in DM patients, its detection is used for diabetic prognosis and treatment.

Management and outcomes of patients with ST-elevation myocardial infarction in Liaoning province / 中华全科医师杂志

Objective To analyze the management and outcomes of patients with ST-segment elevation myocardial infarction (STEMI) in Liaoning province.Methods The data were collected from a prospective and multicenter registry study including 8 tertiary hospitals and 12 secondary hospitals in Liaoning province.Total 1429 patients with acute STEMI admitted to hospitals from June 2009 to June 2010 were included in the study.A unified follow-up questionnaire was applied on patient discharged.Results The average age of patients was (63 ± 13)years.37.4％ of patients recognized the disease as heart disease and 39.7％ were transported by emergency ambulance with a median symptom-to-door time of 150 min.52.9％ patients underwent emergency reperfusion therapy,including fibrinolytic therapy (24.4％) and primary percutaneous coronary intervention (PCI,28.1％).The in-hospital treatment included aspirin (99.6％),clopidogrel (81.9％),statins (90.1％),low molecular weight heparin (89.5％),β-blocker (66.0％),angiotensin converting enzyme inhibitor (ACEI)/ angiotensin receptor blocker (ARB)(66.6％).The in-hospital mortality was 10.7％ ; the mortality in females was higher than that in males (18.3％ vs.7.9％,P ＜ 0.01) and the mortality in older patients (≥ 65 years) was higher than that in younger patients (＜65 years)(17.0％ vs.5.2％,P ＜0.01).The follow-up treatment included:aspirin (81.1％),clopidogrel (45.0％),statins (61.0％),β-blocker (48.3％),ACEI/ARB (42.4％).The follow-up mortality was 5.0％ after hospital discharge.Conclusions Longer pre-hospital delay is commonly seen in STEMI patients.There is still certain gap of emergency reperfusion therapy and the evidence-based medication with related clinical guidelines of STEMI management in Liaoning.

Evaluation of left ventricular diastolic function in patients with chronic heart failure / 中国医师进修杂志

ObjectiveTo investigate the application of the ratio of early diastolic peak velocity of mitral valve(E) and early diastolic peak velocity of mitral annular(Ea) on evaluating left ventricuiar diastolic function in patients with chronic heart failure.MethodsLeft atrial diameter(LAD),left ventricular end-diastolic diameter (LVEDd),interventricular septal thickness (IVST),left ventricular ejection fraction (LVEF),E and late diastolic peak speed of mitral valve (A) of 30 patients with diastolic heart failure(DHF,DHF group),30 patients with systolic heart failure(SHF,SHF group) and 30 healthy persons (control group) were detected by conventional echocardiography.E/A ratio and E-wave deceleration time (DT) were calculated.Early diastolic peak velocity of longitudinal septal and left ventricular lateral part of mitral annulus (Esep,Elat) were measured by tissue Doppler imaging (TDI).Ea and E/Ea ratio were calculated as well as the relevant analysis was made.Results ( 1 ) LAD and IVST in DHF group were significantly higher than those in control group [(44.90±8.31) mm vs.(30.87±3.48) mm,(9.43±2.18) nn vs.(8.17 ± 1.12)mm,P＜0.05].LVEDd in SHF group was obviously higher than that in control group and DHF group [(66.30 ± 10.21) mm vs.(44.77 ± 4.17) mm,(48.60 ± 8.85) mm,P＜0.05],and LVEF and DT were significantly lower than those in control group and DHF group(P ＜ 0.05 ).(2) Esep,Elat and Ea in DHF and SHF group were significantly lower than those in control group( P ＜ 0.01 ),and E/Esep,E/Elat and E/Ea ratios were obviously higher than those in control group (P ＜ 0.01 ).( 3 ) The level of B type natriuretic peptide (BNP) in DHF and SHF group was significantly higher than that in control group [(477.73 ± 722.76),(978.60 ± 825.04) ng/L vs.(29.23 ± 17.84) ng/L,P ＜ 0.05 ].The level of BNP in SHF group was significantly higher than that in DHF group (P＜0.05 ).(4) Multivariate linear regression analysis showed that NYHA classification and BNP were correlated with E/Ea ratio (P ＜ 0.05).(5) The area under curve (AUC) of E/Ea in diagnosing chronic heart failure was 0.984 (95％ CI:0.000-1.000).AUC of E/Ea in identifying DHF and SHF was 0.857(95％ CI:0.773-0.940).The sensitivity and specificity of E/Ea were much higher than those of E/A.Conclusions Chronic left ventricular systolic insufficiency is commonly combined with different-degree diastolic dysfunction.The evaluation of left ventricular diastolic function can be more simple and accurate combined with pulse wave Doppler and TDI.

Effect and mechanism of high glucose on expression of hypoxia-inducible factor 1α in cultured neonatal rat cardiomyocytes under hypoxia and non-hypoxia conditions / 中国糖尿病杂志

Objective To investigate the effect and mechanism of different high concentrations glucose(Glu) on the expression of hypoxia-inducible factor 1α(HIF-1α) in cultured neonatal rat eardiomyocytes under hypoxia and non-hypoxia conditions. Methods Neonatal rat cardiomyocytes were cultured for 6 hours under different conditions and were divided into 6 groups:①Negative control group (5.5 mmol/L Glu) ; ②hypoxia mimicking cobalt chloride(Cocl_2) group(5.5 mmol/L Glu + 400 μmol/L cocl_2 ) ;③Different high concentrations Glu groups: (11.1 mmol/L, 22.2 mmol/L, 33.3 mmol/L Glu);④cocl_2 +different high concentrations Glu groups(11.1 mmol/L Glu +400 μmol/L cocl_2,22.2 mmol/L Glu +400 μmol/L cocl_2, 33.3 mmol/L Glu+400 μmol/L cocl_2);⑤High concentrations Glu + antioxidant α-tocopherol group(33.3 mmol/L Glu + 100 μmol/L α-tocopherol) ; ⑥ High concentrations Glu+antioxidant α-tocopherol+cocl_2 group(33.3 mmol/L Glu+400 μmol/L cocl_2+100 μmol/L α-tocopherol). The effect of high concentrations Glu, cocl_2 and high concentrations Glu plus cocl_2 on the expression of HIF- 1α mRNA and protein in cultured neonatal rat cardiomyocytes, as well as the effect of high concentrations Glu plus antioxidant α-tocopherol, high Glu concentrations plus cocl_2 and antioxidant α-tocopherol on the expression of HIF- 1α mRNA and protein were observed. Results 1. Compared with negative control group(5.5 mmol/L Glu), the 'expression of HIF- 1α was increased under cocl_2 mimicked hypoxia(5.5 mmol/L Glu+400 μmol/L cocl_2, 11.1 mmol/L Glu+400 μmol/L cocl_2 ,22.2 mmol/L Glu+400 μmol/L cocl_2,33.3 mmol/L Glu+400 μmol/L cocl_2). 2. The expression of HIF- 1α was increased gradually after the increasing of Glu concentrations(5.5 mmol/L, 11.1 mmol/L, 22.2 mmol/L and 33.3 mmol/L Glu).3.The expression of HIF-1α was decreased gradually after the increasing of Glu concentrations under certain cocl_2 plus different high concentrations Glu (5.5 mmol/L Glu+400 μmol/L cocl_2, 11.1 mmol/L Glu+400 μmol/L cocl_2, 22.2 mmol/L Glu+400 μmol/L cocl_2,33.3 mmol/L Glu+400 μmol/L cocl_2). 4. Under high concentration Glu plus antioxidant α-tocopherol (33.3 mmol/L Glu+100 μmol/L α-tocopherol) ,the expression of HIF- 1α was less increased than the same high Glu concentration(33.3 mmol/L Glu). 5. Under high Glu concentration plus cocl_2 (33.3 mmol/L Glu+400 μmol/L cocl_2), the expression of HIF- 1α increased less than that of the same high Glu concentration plus antioxidant α-tocopherol and cocl_2 (33.3 mmol/L Glu+400 μmol/L Cocl_2+ 100 μmol/L α-tocopherol). Conclusions High glucose increases the expression of HIF-1α under non-hypoxia, but blunts the expression of HIF-1α under hypoxia in cultured neonatal rat cardiomyocytes. Some mechanisms such as ROS (reactive oxygen species) signal transduction system and oxidative stress may be involved in it.

Analysis of coronary angiography characteristics in cases with acute myocardial infarction complicated combined with diabetes mellitus / 中国医师进修杂志

Objective To investigate the coronary angiography characteristics of acute myocardial infarction (AMI) combined with diabetes mellitus (DM). Methods Forty-five AMI patients combined with DM and 45 AMI patients without DM all received coronary angiography and the results were compared retrospectively, then the differences of coronary angiography and electrocardiogram characteristics were analyzed. Results The ratio of triple vessel lesions and diffuse lesions of coronary artery were more higher in AMI patients combined with DM than those in AMI patients without DM [64.4%(29/45) vs 35.6%( 16/45) and 82.2%(37/45)vs 40.0%(18/45),P< 0.05]. Non-ST segment elevation myocardial infarction (NSTEMI) was more common seen in AMI patients combined with DM than that in AMI patients without DM [37.8% (17/45)vs 17.8% (8/45),P<0.05]. Conclusion AMI patients combined with DM often have NSTEMI with triple vessel lesions and diffuse lesions of coronary artery.

The comparison of methodologies ot assessing myocardial reperfusion in patients with acute myocardial infarction after primary angioplasty / 中国医师进修杂志

Objective To assess the predictive value of coronary angiography TIMI myocardial perfusion grade (TMPG), electrocardiogram (ECG) single-lend ST segment resolution (STR), ECG Max-ST-segment deviation (MaxSTE) on judging myocardial reperfusion after primary angioplasty in the patients with acute myocardial infarction (AMI). Methods Primary percutaneous coronary intervention(PCI) was performed in 42 patients within 12 hours after AMI onset. Coronary angiography and ECG was done before and after angioplasty. TMPG, ECG single-leed STR and MaxSTE were used to assess myocardial reperfusion immediately after PCI. Myocardial perfusion scan was examined in all the patients using99mTc-MIBI SPECT on day 7±2. Results Compared with the level of myocardial perfusion demonstrated in myocardial scan of 99mTc-MIBI SPECT, the sensitivity, specificity and accuracy of TMPG, single-lead STR and MaxSTE was calculated. The sensitivity of TMPG, single-lead STR and MaxSTE was 93.75%, 87.50% and 81.25%, respectively, the specificity of them was 20.00%, 80.00% and 80.00%, respectively, and the accuracy was 76.19%, 85.71% and 80.95%, respectively. The findings in single-lead STR and MaxSTE matched well with the results of myocardial scan of 99mTc-MIBI SPECT. Conclusion In the patients suffering from AMI treated with PCI, ECG is an effective method to assess myocardial tissue reperfusion.

Effect of Metoprolol Tartrate on Central and Peripheral Arterial Pressure in Patients with Hypertension / 中华高血压杂志

Backgroud Various antihypertensive drugs decreased peripheral arterial pressure similarly,while their effects on central arterial pressure may be at variance.The studies of the effect on central arterial pressure of antihypertensive drugs,especially the effect ? adrenoreceptor blockers was paucity.Objective To investigate the effect of ? adrenoreceptor blocker metoprolol tartrate on central and peripheral arterial pressure in patients with hypertension.Methods Fifty patients with primary hypertension who underwent percutaneous coronary angiography were recruited.Radial arterial and ascending aortal pressure as peripheral and central blood pressure were determined.Patients were chewing 25-50 mg metoprolol tartrate or 10 mg nifedipine during the catheterization.Results After administering metoprolol tartrate,the magnitude of decreases in peripheral arterial pressure were significantly(P0.025).Both peripheral and central arterial pressure decreased significantly after administering nifedipine(P0.025).Conclusion Despite similar decrease of peripheral arterial pressure,the decrease magnitude of central arterial pressure by metoprolol tartrate was significantly smaller than that by nifedipine.

Acrolein-induced cell apoptosis in adult mice cardiomyocytes / 中国生化药物杂志

Purpose To investigate the responsiveness of intracellular oxygen free radical and calcium on acrolein exposure and acrolein-induced cardiomyocytes apoptosis. Methods The viable adult mice cardiac myocytes were isolated by modified langendorff methods. We have examined the intracellular oxygen free radical and calcium concentration using DCF and Fura-2 AM, and the cardiomyocytes viability with WST assay. Are evaluated the DNA ladder pattern and cell apoptotic morphology on the adult mice cardiomyocytes that are exposed to acrolein. Results Our results show that acrolein can increase markedly the intracellular oxygen free radical and calcium concentration, that reach 12 fold and twofold respectively compared to the resting value when the cells were exposed to 1 μmol/L of acrolein. Moreover, the injury induced by acrolein in cardiac myocytes is concentration-dependent. The cardiomyocytes viability treated with 25, 50, 100 μmol/L of acrolein respectively were significantly lower compared to controls (P ＜ 0.01 ). DNA ladder pattern and apoptotic morphological changes were found after being exposed to acrolein in the adult mice cardiomyocytes. Conclusion It is concluded that acrolein induces adult mice cardiomyocytes apoptosis, and it may be due to the increased intracellular oxygen free radicals and calcium concentration.