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Objective@#To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE).@*Methods@#PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed.@*Results@#The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE.@*Conclusion@#The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.
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Low frequency high power ultrasound is a recent addition to the list of methods for arterial angioplasty. This paper introduced the effects of the low frequency high power ultrasound and summarized the results of many experiments with its use for different kinds of arterial obstruction.
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Humans , Angioplasty , Methods , Arterial Occlusive Diseases , General Surgery , Arteriosclerosis , General Surgery , Constriction, Pathologic , Endarterectomy , Methods , Femoral Artery , General Surgery , Ultrasonic Therapy , MethodsABSTRACT
Objective To evaluate the clinical feasibility and safety of percutaneous transluminal coronary thrombolysis in acute myocardial infarction. Methods Consecutive patients( n =25) with evidence of AMI and thrombolysis in myocardial infarction(TIMI) grade 0 or 1 in the infarction related arteries(IRA) underwent coronary ultrasound thrombolysis. Degree of residual stenosis was measured and analyzed with SHIMADZU Digitex, a 2400 computerized analyzing system. Changes in imaging and blood flow in IRA, CK MB before and after the treatment, ST segment in ECG and clinical manifestations were observed to evaluate the feasibility of using angioplasty with ultrasound to treat AMI. Results It was found that IRA achieved grade Ⅲ of TIMI blood flow in 23 out of the 25 patients with AMI (potency recovering rate=92%) and the residual stenosis was 41.39?14.08%. Within 10 minutes after the treatment, disappearance of chest pain, depression of ST segment more than or equal to 50% and obvious migrating forward of CK MB peak value were found in the 23 patients. There were no adverse clinical events during the procedure and hospitalization. Conclusion Angioplasty with high intensity, low frequency ultrasound can be used as a new approach for treating acute myocardial infarction, opening IRA as early as possible and restoring TIMI blood flow grade Ⅲ.
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Objective To investigate the serum level of vascular endothelial growth factor (VEGF) in patients with coronary artery disease (CAD) and its clinical significance. Methods The study included 36 patients with CAD and 10 non-coronary heart disease patients as the control. The concentrations of serum VEGF in the coronary veins and the aorta were measured by an enzyme-linked immunsorbent assay (ELISA). Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and were cultured in M199 medium supplemented with 20% fetal bovine serum. After 7 days culture, attached cells were collected. The effect of VEGF on the migration of endothelial progenitor cells (EPCs) were assayed with modified Boyden chamber assay. Results The serum VEGF levels of stable angina pectoris (SAP) patients (208.46?44.74 ?g/L) and acute coronary syndrome (ACS) patients (267.29?93.99 ?g/L) were much higher than that of the controls group (120.77?26.25 ?g/L,P
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Objective To investigate the cardiomyocyte apoptosis and protein expressions of bcl-2 and bax in adriamycin (ADM)-induced myocardial damage in rats treated with neuregulin-1? (NRG-1?).Methods Sixty male SD rats weighing 200 to 250 g were randomly divided into 3 groups:control,ADR-DCM and ADR+NRG groups.ADR-DCM group (n=20) was weekly injected 2.0 mg/kg of ADR via tail vein once a week for 8 weeks to produce cardiomyopathy.The rats of ADR+NRG group (n=20) was given an injection of NRG-1? at 10 ?g/(kg?d) via tail vein for 5 d after the establishment of cardiomyopathy by ADR injection.The animals from control group (n=20) received 2 ml/kg normal saline by injection,once a week for 8 weeks.Nine weeks later,rats were executed under anesthesia and their heart was resected.Apoptotic cardiomyocytes were detected by using the terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method.The expressions of bcl-2 and bax protein were determined by Western blotting.Results The index of apoptotic cardiomyocytes was increased significantly in ADR-DCM group and ADR+NRG group compared with control group (P
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Objective To explore the expression of lectin-like oxidized low-density lipoprotein receptor-1 ( LOX-1) in a rat model after balloon arterial injury and investigate the effect of cilostazol on the mRNA and protein expressions of LOX-1. Methods Twenty-four male SPF SD rats were randomly divided into 3 groups ( n =8 for each group) ,sham operation group,balloon arterial injury group and cilostazol treatment group. For the rats from balloon arterial injury group and cilostazol treatment group,the left common carotid artery were in- juried by a balloon catheter. The expression of LOX-1 mRNA and protein in neointimal hyperplasia after balloon arterial injury were examined by RT-PCR and immunohistochemistry respectively. The contents of MDA in blood serum was examined by TBA. Results LOX-1 mRNA and protein were expressed in the neointimal hyperplasia after balloon arterial injury but not in the sham-operation group. The expression level of LOX-1 was significantly lower in the cilostazol treatment group than that in the model group ( P
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Objective To investigate the relationship between the oxidized low-density lipoprotein(ox-LDL) in the blood from the coronary sinus and impaired endothelium-dependent vasodilation in patients with coronary artery disease(CHD).Methods Four groups of patients were subjected,including acute myocardial infarction group(AMI,n=22),unstable angina group(UA,n=29),and stable angina group(SA, n=25) and control group(n=20) who was first suspected as CHD and then verified with normal coronary angiograms.Blood form the coronary sinus was collected through cardiac cathetering and the ox-LDL level was measured by Sandwich ELISA method.Brachial arterial hyperemia-induced flow mediated dilation(FMD) and sublingual nitroglycerin(NTG) mediated vasodilation were measured by high resolution ultrasound.Results The blood level of ox-LDL in patients with CHD was markedly higher than those in control group(P
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Objective To investigate the effect of different types and dosages of contrast media on the function and cell injury of rat renal artery endothelium. Methods Renal artery rings were isolated from SD rats and incubated in IMDM medium with 30,60,90 ?l/ml Diatrizoate or Ioversol. The contents of NO and ET-1 were detected by Griess method and radioimmunoassay. The release of LDH was assessed by colotimetric method. Results After being incubated with Diatrizoate or Ioversol for 1 h,the renal artery endothelium did not show significant changes in the release of NO,but the release of ET-1 increased in a dose-dependent manner. When the renal artery endothelium was stimulated with Diatrizoate at dosage of 90 ?l/ml for 4 h,the release of LDH was increased markedly. A slight,but insignificant,increased release of LDH induced by Ioversol was observed. Conclusion Both Diatrizoate and Ioversol can affect the function of renal artery endothelium by interfering the secretion of ET-1,and the effects of Diatrizoate are more obvious than Ioversol. High-dose Diatrizoate can also induce renal artery endothelial cells injury.
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Objective To evaluate the clinical feasibility of disruption of intracoronary plaques using catheter-delivered ultrasound. Methods Ultrasound was introduced via catheterization to treat patients (n=18) with serious stenosis of the coronary artery. Comparison of stenosis degree and ST segment in routine ECG before and after the treatment was conducted. Pre- and post-treatment exercise tests were performed to measure the time needed for induction of angina, the time needed for induction of decrease in ST segment for 0.1 mV and maximal range of decrease in ST segment. Results Ultrasound was found to have dissolved atherosclerotic plaques in 18 cases of coronary heart disease with stenosis in one blood vessel ≥75%. The residual stenosis was (40.11?15.33)% after the treatment, representing a decrease of 44.58% as compared with that before the treatment [(84.69?4.69)%], P
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Spine fusion stabilize adjacent vertebral segments by achieving bone union. The preferred method of spine fusion involves decortication of the host bed and transplantation of autologous bone graft from the iliac crest. Although autologous bone grafting is the gold standard, this procedure has significant complication. Gene therapy represents the new frontier of medical science that holds much promise for the improvement of spinal arthrodesis. Studies have shown the efficacy in using liposome-mediated and adenovirus-mediated gene transfer of bone morphogenetic protein (BMP) and related gene in animal models. Several studies in which gene transfer has been used specifically to enchance spine fusion in animal models are reviewed. Current main areas of research, including the elucidation of gene expression profiles during bone formation and the development of new gene transfer vehicles, promises the development of clinically applicable techniques in the near future.
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Animals , Bone Morphogenetic Proteins , Genetics , Physiology , Genetic Therapy , Methods , Genetic Vectors , Osteogenesis , Genetics , Spinal Fusion , Methods , TransfectionABSTRACT
Objective To explore the relationship of the plasma ox-LDL level and endothelium flow mediated vasodilation(FMD)in acute coronary syndrome patients(ACS).Methods From March to October 2004,in the Department of Cardiology,the Fourth PLA Hospital,51 patients with ACS were divided into 2 groups:AMI group(22patients)and UAP group(29 patients).20 subjects with normal coronary angiograms served as the control group.Nitrir oxide(NO)and plasma ox-LDL was measured by spectrophotometer and Sandwich ELISE method,respectively.The brachial arterial hyperemia-induced flow mediated vasodilation(FMD)and sublingual nitroglycerin(NTG)mediated vasodilation were measured by high resolution ultrasound.Results (1)The FMD in ACS group was significantly decreased compared with the control group[(7.2?1.42)、(7.6?1.12)vs(15.46?1.2),P0.05).(2)The No in ACS group was sigificantly lower than that in control group;the NO in AMI group was even lower[(48.46?12.44)、(60.42?10.30)vs(94.72?12.34)?mol/L,P1,which meant ox-LDL was a risk factor;the OR of FMD was
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AIM: To evaluate the mobilization of endothelial progenitor cells (EPCs) in mice peripheral blood during hindlimb ischemia alone or in combination with granulocyte colony stimulating factor (G-CSF). METHODS: Hindlimb ischemia was established in mice by surgical excision of both femoral arteries. Fluorescence-activated cell sorting (FACS) was used to detect the expression of cell-surface CD34 and vascular endothelial growth factor recepter-2 (VEGFR2) antigens. The ratio of double-positive cells for CD34 and VEGFR2 was regarded as the level of EPCs in peripheral blood. In G-CSF administration in combination with hindlimb ischemia group, the percentage of double-positive cells was also detected. RESULTS: As compared with control group, hindlimb ischemia increased the percentage of EPCs in mice peripheral blood. The hindlimb ischemia combined with G-CSF administration significantly enhanced the percentage of EPCs. CONCLUSION: Ischemia increases the number of EPC in peripheral blood. It may induce the migration of EPC from barrow to peripheral blood. By mobilizing barrow, G-CSF enhances this effect.
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Objective To evaluate the effects of recombinant human neuregulin-1? on a rat model of adriamycin-induced dilated cardiomyopathy(ADR-DCM).MethodsMatched adult male Sprague-Dawley rats were administered with 2.5 mg/kg adriamycin intravenously once a week for 10 weeks to establish models of ADR-DCM.The ADR-DCM rats were randomly divided into 3 groups as follows: the rhNRG-1? group(rhNRG-1?,20 ?g/kg,i.v.,once a day for 10 d,n=8),the negative control group(excipient,n=8),and the positive control group(digoxin,0.062 5 mg/kg,i.v.,once a day for 10 d,n=7).Another 8 normal SD rats in the same situation served as normal control group(control,n=8).Their heart function and hemodynamics were evaluate after the treatment.The ratio of heart weight/body weight was calculated and the thickness of LV parietes was measured.The pathological lesions of cardiac muscle tissues were evaluated after HE staining.Brain contents of natriuretic peptide(BNP) and troponin T(TnT) were determined.The animal treatment was all accorded to the ethical standards.ResultsCompare with the normal control group,the LVESD and LVEDD of ADR-DCM rats were increased(P
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Objective To summarize our experience with combined cardiac pacing and beta-blocker therapy in patients with long-QT syndrome. Methods Nine patients with long-QT syndrome were treated with Propranolol. Its effectiveness was analyzed during matched periods before and after starting beta-blocker therapy. If sinus bradycardia, sinus arrest and atrioventricular occurred during the Propranolol treatment, DDD pacemaker were implanted. Results After initiation of beta-blockers, there was a significant reduction in the rate of cardiac events [(0.86?0.92) to (0.34?0.69) events per patient per year, P
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Objective To study the adriamycin(ADR)-induced expression of ErbB4 in and apoptosis of cardiac muscle cells of rats with dilated cardiomyopathy and their intervention with neuregulin-1?.Methods Sixty male SD rats,weighing 200-250 g,were randomly divided into ADR 1 group(n=10),ADR 2 group(n=20),ADR+neuregulin-1? group(n=20),and normal control(NC) group(n=10).Rats in ADR1 and ADR2 groups were injected with 2.0 mg/kg of ADR through the tail vein,once a week for 8 and 12 weeks,respectively.Rats in ADR+neuregulin-1? group were injected with 2.0mg/kg of ADR through the tail vein,once a week for 8 weeks,followed by neuregulin-1? [10 ?g/(kg?d)],once a day for 5 d.Rats in NC group received normal saline [2 ml/(kg?d)],once a week for 8 weeks.Expression of ErbB4 was detected by Wes-tern blotting.Lesions of cardiac muscle were scored with HE staining.Apoptosis of cardiac muscle cells was detected with the TUNEL method.Results The apoptotic index of cardiac muscle cells was significantly lower in ADR+neuregulin-1? group than in ADR 1 group(P