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AIM: To observe the effects of hypertriglyceridemia and fenofibrate on CD40L expression in platelets in vitro and in vivo. METHODS: In vivo experiments, according to its own strict standards, 20 patients were respectively selected for hypertriglyceridemia group and control group, before and after treatment of fenofibrate for hypertriglyceridemia patients. The CD40 ligand positive rates of platelets by flow cytometry and plasma soluble CD40 ligand by ELISA were examined under the same conditions as control group. The CD40L and sCD40L in each group were compared. In in vitro experiments, all 6 objects plasma was chosen in the same condition except for triglyceridemia, after the co-incubation of these plasma with the same healthy platelets was performed and the interference with wy14643, the CD40 ligand positive rate of platelets by flow cytometry and total platelets CD40 ligand protein content by Western blotting were examined under the same conditions in all objects. The CD40L positive rate and total CD40L content in each group were compared, respectively. RESULTS: The platelet CD40L positive rate and plasma sCD40L concentration in hypertriglyceridemia group were significant higher than those in control group (P<0.01). Followed the TG concentration decreased, the platelet CD40L positive rate and plasma sCD40L concentration decreased after the treatment of fenofibrate, the same as the total platelets CD40L content which was significant higher in hypertriglyceridemia group than that in control group in vitro (P<0.05). No effect of wy14643 on the total CD40L content expression was observed in vitro. CONCLUSION: Hypertriglyceridemia plasma stimulates immune-activation of platelets both in vitro and in vivo. sCD40L may mainly come from CD40L on platelet membrane. PPARα activator of fenofibrate may inhibit the immune-activation of platelets by reducing the concentration of plasma TG, but PPARα activator WY14643 cant inhibit the expression of CD40L and CD40L in vitro.
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BACKGROUND: Coronary angiography is called "the golden standard" for the diagnosis of coronary heart disease (CAD). Foreshortening of vessel segments in angiographic projection images usually caused by the inappropriate projection angles or positions may lead to misdiagnosis or missed diagnosis.OBJECTIVE: To investigate the optimal angiographic views of main coronary artery and its branches in different somatotype or heart type patients and to investigate the specific relationships between the optimal angiographic views and the different somatotypes and heart types with computer-assisted techniques.DESIGN: A controlled observation.SETTING: Department of Cardiology, the Second Affiliated Hospital of Nanchang University.PARTICIPANTS: Altogether 1 369 patients were admitted to the Second Affiliated Hospital of Nanchang University to undergo coronary angiography from January 2001 to December 2006 and recruited for this study. Written informed consents of coronary angiography were obtained from all the patients. The protocol was approved by the Medical Ethics Committee of Medical College of Nanchang University.METHODS: All 1 369 inpatients were assigned into 3 groups by body mass index (BMI): fat somatotype group (n =489, BMI: 26-31 kg/m2, transverse heart type), general somatotype group (n =502, BMI: 23-25 kg/m2, general heart type), and thin somatotype group (n =378, BMI: 17-22 kg/m2 vertical heart type). In each group, all arteries including left main coronary artery (LM), proximal segment of the anterior descending coronary artery (LAD), distal-mid segment of LAD, proximal segment of circumflex branch (LCX), distal-mid segment of LCX, proximal-mid and distal segments of right coronary artery (RCA) were properly and carefully analyzed using Compart software, and then we got its optimal angiographic viewing angle. Finally, we arranged these data and induced whether different somatotype group patients have different optimal angiographic viewing angles specifically for some coronary artery or not.MAIN OUTCOME MEASURES: Optimal angiographic viewing angles.RESULTS: All 1369 patients participated in the final analysis. Optimal angiographic viewing angle for LM: left anterior oblique (LAO)(40±5)°/ caudal (CAU)(25±5)° or right left anterior oblique (RAO) 25°/CAU35°. In the fat somatotype group, the angle should be added 10° to its optimal angle, and in the thin somatotype group, the angle should be decreased by 10°, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for proximal segment of LAD: RAO (50±8)°/ cranial (CRA)(23±8)°. In the fat somatotype group, the optimal angle should be added 10°, but in the thin somatotype group, it should be decreased by 10°. The differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for distal-mid segment of LAD: RAO (40±5)°/CRA (45±5)° or LAO (11±5)°/CRA (45±5)°. Optimal angiographic viewing angle for proximal segment of LCX: LAO (45±5)°/CAU (35±5)° or anteroposterior (AP)/CAU36°. Optimal angiographic viewing angle for distal-mid segmental of LCX: LAO (45±5)°/CAU (35±5)° or RAO (6±4)°/CAU (30±5)°. Optimal angiographic viewing angle for proximal-mid segment of RCA: LAO (35±5)°/CAU (14±5)° or LAO (48±5)°/CRA (15±5)°. For the thin or fat somatotype group, the optimal LAO angle should be increased by 15°, the optimal RAO angle should be decreased by10° for fat somatotype group and should be increased by 10° for thin somatotype group, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significantly (P < 0.05). Optimal angiographic viewing angle for distal segment of RCA: LAO (53±5)°/CAU (17±5)°.CONCLUSION: The message can be got clearly about the whole coronary artery and the accuracy percentage of stenosis by changing angiographic viewing angle regularly to its own optimal angle in different somatotype or heart type patients. It's very important for making the choice of diagnosis and therapy
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AIM:To observe the effect of immune-activated platelets and low-density lipoprotein cholesterol (LDL) on the expression and activity of cyclooxygenase-2 (COX-2) and peroxisome proliferator activated receptor ? (PPAR-?) in human umbilical vein endothelial cells (HUVECs) treated with activated platelets and LDL.METHODS:The platelets were activated by ADP.The co-culture system of HUVECs with immune activated platelets and/or LDL were established.The activity of COX-2 and expression of PPAR-? at mRNA and protein levels in HUVECs were detected by RT-PCR and Western blotting.The concentration of PGE2 was measured by ELISA for representing the COX-2 activity.The PPAR-? activity was determined by a nuclear factor assay kit.RESULTS:The COX-2 activity and mRNA expression of PPAR-?,the protein levels of COX-2 and PPAR-? and PGE2 concentration in activated platelets group were significant higher than those in un-activated platelets group (all P