Incremental value of epicardial fat volume on predicting obstructive coronary artery disease with myocardial ischemia / 中华心血管病杂志

Objective: This study aimed to investigate the association between epicardial fat volume (EFV) and obstructive coronary artery disease (CAD) with myocardial ischemia, and evaluate the incremental value of EFV on top of traditional risk factors and coronary artery calcium (CAC) in predicting obstructive CAD with myocardial ischemia. Methods: This study was a retrospective cross-sectional study. Patients with suspected CAD who underwent coronary angiography (CAG) and single photon emission computerized tomography-myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from March 2018 to November 2019 were consecutively enrolled. EFV and CAC were measured by non-contrast chest computed tomography (CT) scan. Obstructive CAD was defined as coronary artery stenosis≥50% in at least one of the major epicardial coronary arteries, and myocardial ischemia was defined as reversible perfusion defects in stress and rest MPI. Obstructive CAD with myocardial ischemia was defined in patients with coronary stenosis severity≥50% and reversible perfusion defects in the corresponding areas of SPECT-MPI. Patients with myocardial ischemia bot without obstructive CAD were defined as none-obstructive CAD with myocardial ischemia group. We collected and compared the general clinical data, CAC and EFV between the two groups. Multivariable logistic regression analysis was performed to identify the relationship between EFV and obstructive CAD with myocardial ischemia. ROC curves were performed to determine whether addition of EFV improved predictive value beyond traditional risk factors and CAC for obstructive CAD with myocardial ischemia. Results: Among the 164 patients with suspected CAD, 111 patients were males, and average age was (61.4±9.9) years old. 62 (37.8%) patients were included into the obstructive CAD with myocardial ischemia group. 102 (62.2%) patients were included into the none-obstructive CAD with myocardial ischemia group. EFV was significantly higher in obstructive CAD with myocardial ischemia group than in none-obstructive CAD with myocardial ischemia group ((135.63±33.29)cm3 and (105.18±31.16)cm3, P<0.01). Univariate regression analysis showed the risk of obstructive CAD with myocardial ischemia increased by 1.96 times for each SD increase in EFV(OR 2.96; 95%CI, 1.89-4.62; P<0.01). After adjustment for traditional risk factors and CAC, EFV remained as an independent predictor for obstructive CAD with myocardial ischemia (OR, 4.48, 95%CI, 2.17-9.23; P<0.01). Addition of EFV to CAC and traditional risk factors was related to larger AUC for predicting obstructive CAD with myocardial ischemia (0.90 vs. 0.85, P=0.04, 95%CI: 0.85-0.95) and the global chi-square increased by 21.81 (P<0.05). Conclusions: EFV is an independent predictor for obstructive CAD with myocardial ischemia. Addition of EFV to traditional risk factors and CAC has incremental value for predicting obstructive CAD with myocardial ischemia in this patient cohort.

Association between inflammation activity of left atrial epicardial adipose tissue measured by 18F-FDG PET/CT and atrial fibrillation / 中华心血管病杂志

Objective: To explore the association between inflammation activity of left atrial epicardial adipose tissue (LA-EAT) measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and atrial fibrillation (AF). Methods: A total of 78 patients with AF, who underwent 18F-FDG PET/CT in the Nuclear Medicine Department of the Third Affiliated Hospital of Soochow University due to abnormally elevated levels of tumor indicators or malignant tumors from March 2018 to December 2019, were enrolled in this retrospective study. According to the examination date of PET/CT and basic characteristics of AF patients (gender, age), a 1∶1 propensity score matching was used to enroll a non-AF control group (78 patients). The maximum standard uptake value of left atrial epicardial tissue (LA-EAT FDG SUVmax) and total EAT volume (V-EAT) were measured by 18F-FDG PET/CT. Left ventricular ejection fraction (LVEF) and left atrial diameter (LAD) were obtained by echocardiography. Blood lipids and biomarkers of inflammation were measured. The differences of clinical data and EAT-related indicators were compared between the AF group and control group. Logistic multivariate regression analysis was used to determine the related factors of AF. Then the receiver operating characteristic (ROC) curve was used to determine the cutoff value of LA-EAT FDG SUVmax on the diagnosis of AF. Univariate and multivariate logistic regression analysis were used to analyze the relationship between the increase of LA-EAT FDG SUVmax and AF. Results: The age was (66.9±10.2) years and there were 55 males (70.5%) in the AF group. The age was (66.9±8.0) years, and there were 52 males (66.7%) in the control group (both P>0.05). The LAD ((44.2±5.8) mm vs. (35.4±4.4) mm), V-EAT ((122.1±42.0) cm3 vs. (91.6±34.5) cm3), and LA-EAT FDG SUVmax ((1.6±0.3) vs. (1.4±0.2)) values were significantly higher, while LVEF ((60.1±4.7)% vs. (63.9±2.9)%) was lower in the AF group than in the control group (P all<0.001). Multivariate logistic regression analysis showed that LAD (OR=1.340, 95%CI 1.195-1.502), V-EAT (OR=1.016, 95%CI 1.001-1.031), and LA-EAT FDG SUVmax (OR=1.375, 95%CI 1.095-1.723) were positively correlated with AF, LVEF (OR=0.781, 95%CI 0.659-0.926) was negatively correlated with AF(P all<0.05). The area under the ROC curve of LA-EAT FDG SUVmax for diagnosis of AF was 0.680 (95%CI 0.597-0.764, P<0.001), and the best cut-off value was 1.415 with a sensitivity of 65.4% and specificity of 61.5%. After adjusting for high-density lipoprotein cholesterol, LVEF, LAD and V-EAT, LA-EAT FDG SUVmax≥1.415 was independently associated with AF (OR=2.982, 95%CI 1.122-7.926, P=0.010). Conclusions: The inflammatory activity of LA-EAT measured by 18F-FDG PET/CT is an independent risk factor of AF, and the increased inflammatory activity of LA-EAT is positively correlated with AF.

Pharmacokinetics of ganoderic acids / 中国中药杂志

Ganoderic acid(GA) is one of main bioactive components produced by Ganoderma lucidum,which a traditional Chinese herbal medicine and a kind of tracyclic triterpene lanosterol derivatives with highly oxidized structure. It has a variety of important pharmacological activities,such as anticancer,immunoregulation,anti-oxidation,anti-diabetes and anti-HIV. At present,the studies of GA mainly focus on biosynthesis,fermentation control,isolation and purification,structure identification and pharmacological effects.However,there are a fewer pharmacokinetic studies of GA,although it is closely related to the clinical application. Recent studies have shown that GA can be absorbed rapidly by gastrointestinal tract and distributed in various tissues and organs after oral intake. GA is metabolized by liver at phase Ⅰ and phase Ⅱ,and then mainly excreted by bile. In this paper,the pharmacokinetic characteristics of GA and its absorption,distribution,metabolism and excretion(ADME) will be systematically summarized,in order to provide scientific basis for the application and development studies of Ganoderma triterpenoid drugs and their rational clinical use.

Drug therapy of multiple sclerosis: Research advances / 国际药学研究杂志

Multiple sclerosis (MS) is an autoimmune disease characterized by the immune-mediated demyelination of the central nervous system (CNS). There are still no disease-modifying therapeutics to cure MS per se, all patients need drugs to control their diseases. Most drugs in clinic target the immune system. New therapeutic strategies have evolved that specifically target the neurode-generative aspect of MS. Remyelinating agents are actively under investigation, and may yield novel strategies to increase neuronal functionality and survival in the coming years. In this review, we mainly describe the administration, mechanism of action, safety and efficacy of dugs currently approved for MS therapy. We also briefly introduce the new drugs for the treatment of MS currently under investigation.

Efficacy of medication directed by home-monitoring cardiac resynchronization therapy in chronic heart failure patients / 中国医学科学杂志(英文版)

PATIENTS with chronic heart failure (CHF) have a high incidence of atrial/ventricular arrhythmias which seriously affect life span and quality of life. Cardiac re-synchronization therapy (CRT) can improve cardiac function and reverse myocardial remodeling, therefore improving the quality of life and reducing mortality. CRT with Home-Monitoring (HM) can be used to monitor cardiac arrhythmias and other heart physiological indexes such as intrathoracic impedance and hemodynamics. Through wireless satellites, the data from the patients are sent to a monitor center for analysis. Doctors can identify emergent information and make a rapid diagnosis based on the information stored in the monitor center. CRT with HM has been verified as a valid method to optimize drug treatment according to individual parameters.

Effects of noninvasive positive pressure ventilation on patients with arrhythmia complicated by sleep apnea syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of noninvasive positive pressure ventilation (NPPV) in treatment of patients with arrhythmia complicated by sleep apnea syndrome (SAS).</p><p><b>METHODS</b>One hundred and thirty-five arrhythmia patients with polysomnography diagnosed SAS were randomly divided into NPPV group (69 cases) and control group (66 cases), the NPPV group was treated with standard medications and NPPV, and the control group was treated with standard medications. SAS related parameters were compared between the groups after 3 months therapy.</p><p><b>RESULTS</b>(1) Epworth sleepiness scale (ESS) score, apnea-hypopnea index (AHI) and arousal index were significantly lower (8.25 ± 5.41 vs.4.08 ± 3.43, 39.95 ± 7.32 vs. 4.71 ± 1.80 and 39.69 ± 4.40 vs. 15.20 ± 2.05, P < 0.01) while not rapid eye movement (NREM) III and rapid eye movement stage of sleep time and lowest pulse oxygen saturation (LSaO2) were significantly higher in NPPV group than in control group [(4.53 ± 2.10)% vs. (16.78 ± 2.59)%,(8.37 ± 1.380)% vs. (15.25 ± 1.41)%, (77.15 ± 6.72)% vs. (93.35 ± 2.03)%, P < 0.01] after 3 months therapy. (2) Incidence of Sinus bradycardia, sinus tachycardia, sinus arrest, atrial premature beats, ventricular premature beats, paroxysmal atrial tachycardia, paroxysmal ventricular tachycardia, atrial fibrillation, II-III degree atrioventricular block, ST-T segment changes were reduced from 57.4%, 44.4%, 7.4%, 20.4%, 13.0%, 36.5%, 12.0%, 8.3%, 37.0%, 53.7% to 4.6%, 1.9%,0.0%, 3.7%, 2.8%, 7.0%, 0.9%, 0.0%, 1.9%, 4.6% (all P < 0.05) and the total number of arrhythmias happened at night were significantly lower (all P < 0.05) while the heart rate variability (HRV) were significantly higher (P < 0.01) in NPPV group than in control group; AHI was positively while LSaO2 was negatively correlated with the total night arrhythmia number (P < 0.01).</p><p><b>CONCLUSION</b>Noninvasive positive pressure ventilation is an effective therapy strategy for treating patients with arrhythmia complicated by sleep apnea syndrome.</p>

Effects from cyclic mechanical stretch on proliferation of rheumatoid arthritis fibroblast-like synoviocytes / 医用生物力学

Objective To investigate the effects from cyclic mechanical stretch on proliferation of rheumatoid arthritis fibroblast-like synoviocytes (RA-FLSs). Methods In the experimental groups, cyclic mechanical stretch, with frequency of 1.0 Hz and magnitude of 3%, 6% and 9%, respectively, was applied to RA-FLSs for 2 h, 6 h, and 12 h. The control group remained in the same culture condition as the experimental groups, but without any mechanical stretch. After mechanical loading, the cell viability was analyzed by MTS, and its proliferation was assayed by flow cytometry. RT-PCR was used to measure the gene expression of the cell cycle regulatory factors, including CDK2, cyclinD1, cyclinE1, and P27. Results Cyclic mechanical stretch with magnitude of 6% and 9% for 6 h or 12 h significantly decreased the cell proliferation and viability in RA-FLSs (P0.05). Conclusions The effects from cyclic mechanical stretch on proliferation of RA-FLSs depend on the stretch magnitude and duration. Mechanical stretch with magnitude of 6% and 9% can inhibit RA-FLSs proliferation, which may be achieved by regulating the expression of Cyclin E1, CDK2 and P27. This study provides references for investigating the role of mechanical stimulation in pathogenesis of rheumatoid arthritis, as well as its prevention and treatment.

Effects of cyclic mechanical stretch on BMP-2 expression in RA and OA fibroblast-like synoviocytes / 医用生物力学

Objective To explore the role of mechanical stimulation in synovium under different pathological conditions through studying the effects of cyclic mechanical stretch on the expression of bone morphogenetic protein 2 (BMP-2) in rheumatoid arthritis (RA) and osteoarthritis (OA) fibroblast-like synoviocytes (FLS). Method 6% and 0.5 Hz stretch generated by Flex cell 4000 tension systems was applied on normal, RA and OA FLS of human knee joint source under normal and inflammatory conditions for 2 h or 6 h, respectively. Results Cyclic mechanical stretch of 6%, 0.5 Hz had no significant effects on the expression of BMP-2 in normal, RA and OA FLS at 2 h, while in RA FLS it increased significantly at 6 h. Inflammatory cytokines (IL-1β) didn’t influence normal FLS at 2 h, but made BMP-2 mRNA significantly increased at 6 h. IL-1β increased BMP-2 mRNA of RA FLS significantly both at 2 h and 6 h. IL-1β increased BMP-2 mRNA of OA FLS significantly only at 2 h, but had no significant effect at 6 h. The co-effect of IL-1β and cyclic mechanical stretch induced the ascension of BMP-2 expression significantly in normal and RA FLS at 2 h, and in normal, RA and OA FLS at 6 h. Conclusions Response of BMP-2 mRNA to mechanic stimulation and IL-1β in normal, RA and OA FLS were different. Inflammation may play a more important role than mechanical stimulation in the pathogenesis of RA and OA. Synergetic effect in inflammation and mechanical stimulation were found in OA FLS at 6 h, which reveals that they may co-act in the occurrence and development of OA.

Assessment of left ventricular systolic synchronicity by quantitative tissue velocity imaging in patients with left ventricular noncompaction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess left ventricular systolic synchronicity by quantitative tissue velocity imaging (QTVI) in patients with left ventricular noncompaction (LVNC).</p><p><b>METHODS</b>Eighteen LVNC patients and 30 healthy controls were included. Two-dimensional echocardiography, QTVI was applied on parasternal long axis view, apical two-chamber and four-chamber view. Tissue velocity curve was obtained from the middle and basal segments of left ventricular posterior, lateral, septal, anterior, inferior and anteroseptal walls. Time interval from the beginning of QRS complex to the peak systolic velocity (Q-Ts) and the maximal difference in Ts among all 12 LV segments (Max-DeltaTs) was calculated.</p><p><b>RESULTS</b>Q-Ts from basal and middle segments of left ventricular inferior, lateral and posterior walls was significantly prolonged in LVNC patients compared to controls (P < 0.001). Max-DeltaTs was also significantly increased in LVNC patients [(161.9 +/- 93.2) ms] than that in controls [(61.2 +/- 27.4) ms, P < 0.001].</p><p><b>CONCLUSIONS</b>There was significant left ventricular asynchronies in patients with LVNC and delayed systolic contraction occurred mostly in the basal and middle segments of left ventricular inferior, posterior and lateral walls.</p>

Coronary characteristics of young smokers with coronary heart disease and the effects of tobacco control on smoking cessation / 中华心血管病杂志

<p><b>OBJECTIVE</b>Coronary features of young smokers and non-smokers with coronary heart disease were compared and the effect of tobacco control education was analyzed.</p><p><b>METHODS</b>A total of 160 young patients (14 - 35 years old) diagnosed with coronary heart disease by coronary angiography were included in this study, patients were followed up for 3 months. There were 118 smokers and 42 non-smokers, smokers were further divided to psychological counseling intervention group (68 cases) and control group (50 cases), non-smokers were also divided into psychological counseling intervention group (22 cases) and control group (20 cases).</p><p><b>RESULTS</b>Incidence of single-vessel lesion (50.84% vs. 66.67%) was significantly lower, acute coronary syndrome (75.42% vs. 50.00%), double-vessel lesions (24.58% vs. 19.05%), three-vessel lesions (11.86% vs. 4.74%) as well as coronary artery ectasias (12.71% vs. 9.52%) was significantly higher in smokers than in non-smokers. Gensini scores (61.94 ± 40.35 vs. 45.08 ± 28.97) was significantly higher in smokers than in non-smokers (all P < 0.05). At the end 3-months follow up, smoking cessation rate was significantly higher in psychological counseling intervention group than in control group (61.76% vs. 30.00%, P < 0.05). New smokers was zero in psychological counseling intervention group and 1 in control group among previous non-smokers.</p><p><b>CONCLUSION</b>Smoking is linked with severe coronary artery lesion in young patients with coronary heart disease and psychological counseling intervention could significantly increase the short-term successful smoking cessation rate in these patients.</p>

Effects of taurine on hemorheology of rats with type 2 diabetes / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To observe the effects of taurine on hemorheology and oxidative stress of diabetic rats.</p><p><b>METHODS</b>40 rats were divided into control group, diabetes group and treatment group at random. Diabetic model was reproduced by intraperitoneal injection of streptozotocin. After having been treated with taurine for 8 weeks, glycosylated hemoglobin (HbA1c) and the serum contents of glucose, superoxide dismutase(SOD), malondialdehyde (MDA) were measured. The changes of hemorheology in different groups were detected respectively.</p><p><b>RESULTS</b>Compared with control group, the content of glucose, MDA and HbA1c in diabetic rats was increased, the activity of SOD was decreased, the levels of whole blood viscosity and the aggregation index of red blood cells and hematocrit were increased and RBC deformability index was decreased in diabetic rats. Moreover, taurine was able to apparently reduce high blood glucose and HbA1c (P < 0.05), markedly elevated the activity of SOD, lowered the content of MDA (P < 0.01); and taurine also could significantly reduce the levels of whole blood viscosity and the aggregation index of red blood cells and hematocrit in the meanwhile, and increase RBC deformability index (P < 0.05 or P < 0.01).</p><p><b>CONCLUSION</b>Taurine could enhance the ability of oxidation resistance, improve blood rheology property in diabetic rats, at the same time it could be beneficial to prevent and cure the development of diabetic blood vessel complication.</p>

Effect of decoction of Radix glycyrrhizae on the growth and acid-production of Streptococcus mutans in vitro / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the antibacterial activity of decoction of Radix glycyrrhizae against Streptococcus mutans (S. mutans) in vitro.</p><p><b>METHODS</b>The decoction of Radix glycyrrhizae was prepared by boiling particles of Radix glycyrrhizae, the diameter was 0.2-3.2 mm. In distilled water and filtered, the filtrate was collected for study. The minimal inhibitory concentration (MIC) and the minimal bactericidal concentration (MBC) of the decoction against S. mutans were detected using double dilution. The effect of decoction on growth and acidogenic profile of S. mutans were investigated by detecting the Abs of bacteria suspension and the pH value of medium at definite time intervals(0, 3, 7, 12, 23, 40 h) during cultured.</p><p><b>RESULTS</b>The MIC determined for decoction was 50 mg x mL(-1) and there was no bactericidal effect when concentration of decoction lower than 100 mg x mL(-1). The decoction inhibitted multiplication of bacteria significantly and the effects became stronger with concentration increasing. The decoction also inhibitted S. mutans producing acid and the effect became stronger with concentration increasing. The most efficient inhibition were observed when incubated 12 hours.</p><p><b>CONCLUSION</b>The decoction of Radix glycyrrhizae can inhibite the growth and acid-production of S. mutans in vitro.</p>

Study on protein extraction methods for Streptococcus mutans / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To establish an efficient and stable method for protein extraction of Streptococcus mutans.</p><p><b>METHODS</b>The collected bacteria were treated by freeze-thaw and ultrasonic (method 1), ultrasonic (method 2), boiling (method 3), boiling and ultrasonic (method 4), respectively. The index such as state of bacteria broken, concentration of extracted protein and SDS-PAGE of protein were employed to evaluate the effects of above four methods.</p><p><b>RESULTS</b>Beside the method 3, the other three methods could break the bacteria effectively, of which ultrasonic was the key factor. The pattern of SDS-PAGE which treated by method 1, method 2 and method 4 was almost same, but method 1 resulted in the best abundance. There was significantly difference among the four protein concentration extracted by four methods (P < 0.05). All methods exhibited good stability and reproducibility.</p><p><b>CONCLUSION</b>Method of freeze-thaw and ultrasonic resulted in an efficient proteins extraction of Streptococcus mutans which demonstrated good stability and reproducibility and easy to handle.</p>

Effect of Triple Drugs Combination Therapy Amlodipine,Imidapril,Candesartan on Microalbuminuria in Patients with Type 2 Diabetes Mellitus and Hypertension / 中华高血压杂志

Objective To delineate the speculation that triple combination of small doses of calcium antagonist (levoamlodipine),the ACEI(imidapril)and the ARB(candesartan)may exert more significantly effect on mi- croalbuminuria(MAU)in patients with type 2 diabetes mellitus and hypertension.Methods One hundred sixty ca- ses of consecutive patients with type 2 diabetes mellitus and hypertension were randomized to receive following vari- ous combinations:amlodipine 2.5 mg/candesartan 4 mg(n=40),candesartan 4 mg/imidapril 5 mg(n=40);imidapril 5 mg/amlodipine 2.5 mg(n=40),and amlodipine 2.5 mg/candesartan 4,mg plus imidapril 5 mg(n=40).The changes in blood pressure and MAU were determined before and after treatment.Results Four combinations of treatment all significantly lowered BP(P