Effects of Tongxinluo Capsule on Platelet Activating Factor, Vascular Endothelial Function, Blood Flow of Thrombolysis in Myocardial Infarction in Acute Myocardial Infarction Patients after Delayed Percutaneous Coronary Intervention / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore effects of Tongxinluo Capsule (TC) on platelet activating factor (PAF), vascular endothelial function, thrombolysis in myocardial infarction (TIMI) blood flow, and heart function in acute myocardial infarction (AMI) patients after delayed percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Totally 80 AMI inpatients were recruited at Department of Cardiology, People's Hospital of Jiangxi Province, from Jan. 2008 to Sep.2013. Those in line with inclusion criteria were randomly assigned to TC treatment group and the conventional treatment group by random digit table, 40 in each group. Besides, another 40 healthy subjects from examinees at Outpatient Department were recruited as a healthy control group. PCI was performed after 1-week treatment. Then blood samples were collected, and then blood contents of CD62P, CD63, GP II b/III a, ET-1, NO, and plasma von Willebrand factor (vWF) levels were detected. Coronary TIMI blood flow and corrected TIMI frame count (CTFC) were determined during PCI. Meanwhile, noninvasive blood pressure (BP) and heart rate (HR) were recorded before and after PCI, and cardiac function measured. They were compared with the healty control group.</p><p><b>RESULTS</b>Compared with the healthy control group, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, and ET-1 significantly increased, but NO significantly decreased in AMI patients (all P < 0.05). After 1-week intervention of TC, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, NO, and ET-1 significantly decreased (P < 0.05, P < 0.01). Compared with the conventional treatment group at the same time point, blood contents of CD62p, CD63, GP II b/IIIa receptor compound, vWF, and ET-1 decreased more significantly in the TC group (P < 0.05, P < 0.01), increased NO levels were also more obviously seen (P < 0.01). The aforesaid parameters changed more obviously at day 30, as compared with those changes at week 1 (P < 0.05, P < 0.01). The TIMI blood flow grade and CTFC were more obviously improved after PCI in the two treatment groups. Better TIMI blood flow was seen in the TC group. TIMI level 3 blood flow rate was higher in the TC group than in the conventional treatment group with statistical difference (P < 0.05). The left ventricular ejective factor (LVEF) after PCI was obviously elevated in the TC group and the conventional treatment group (P < 0.01), and the improvement was more obviously seen in the TC group (P < 0.05). There were 6 cases of recurrent angina, 3 cases of ventricular tachycardial (VT)/ventricular fibrillation (VF), 6 cases of heart failure (HF), 1 case of cardiac sudden death in the conventional treatment group, with the total incidence of cardiovascular events being 40% (16/40). There were 2 cases of recurrent angina, 2 cases of VT/VF, 2 cases of HF, no cardiac sudden death in the TC treatment group, with the total incidence of cardiovascular events being 15% (6/40). There was statistical difference in the recurrent rate of cardiovascular events between the two groups (χ² = 2.27, P < 0.05).</p><p><b>CONCLUSION</b>TC not only could prevent coronary embolism of AMI patients after delayed PCI, attenuate vascular endothelial injury, but also could improve TIMI blood flow, and strengthen cardiac systolic function.</p>

Application of percutaneous balloon mitral valvuloplasty in patients of rheumatic heart disease mitral stenosis combined with tricuspid regurgitation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Tricuspid regurgitation (TR) is frequently associated with severe mitral stenosis (MS), the importance of significant TR was often neglected. However, TR influences the outcome of patients. The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) procedure in rheumatic heart disease patients with mitral valve (MV) stenosis and tricuspid valve regurgitation.</p><p><b>METHODS</b>Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR. Mitral balloon catheter made in China was used to expand MV. The following parameters were measured before and after PBMV: MV area (MVA), TR area (TRA), atrial pressure and diameter, and pulmonary artery pressure (PAP). The patients were followed for 6 months to 9 years.</p><p><b>RESULTS</b>After PBMV, the MVAs increased significantly (1.7 ± 0.3 cm 2 vs. 0.9 ± 0.3 cm 2 , P < 0.01); TRA significantly decreased (6.3 ± 1.7 cm 2 vs. 14.2 ± 6.5 cm 2 , P < 0.01), right atrial area (RAA) decreased significantly (21.5 ± 4.5 cm 2 vs. 25.4 ± 4.3 cm 2 , P < 0.05), TRA/RAA (%) decreased significantly (29.3 ± 3.2% vs. 44.2 ± 3.6%, P < 0.01). TR velocity (TRV) and TR continue time (TRT) as well as TRV × TRT decreased significantly (183.4 ± 9.4 cm/s vs. 254.5 ± 10.7 cm/s, P < 0.01; 185.7 ± 13.6 ms vs. 238.6 ± 11.3 ms, P < 0.01; 34.2 ± 5.6 cm vs. 60.7 ± 8.5 cm, P < 0.01, respectively). The postoperative left atrial diameter (LAD) significantly reduced (41.3 ± 6.2 mm vs. 49.8 ± 6.8 mm, P < 0.01) and the postoperative right atrial diameter (RAD) significantly reduced (28.7 ± 5.6 mm vs. 46.5 ± 6.3 mm, P < 0.01); the postoperative left atrium pressure significantly reduced (15.6 ± 6.1 mmHg vs. 26.5 ± 6.6 mmHg, P < 0.01), the postoperative right atrial pressure decreased significantly (13.2 ± 2.4 mmHg vs. 18.5 ± 4.3 mmHg, P < 0.01). The pulmonary arterial pressure decreased significantly after PBMV (48.2 ± 10.3 mmHg vs. 60.6 ± 15.5 mmHg, P < 0.01). The symptom of chest tightness and short of breath obviously alleviated. All cases followed-up for 6 months to 9 years (average 75 ± 32 months), 2 patients with severe regurgitation died (1 case of massive cerebral infarction, and 1 case of heart failure after 6 years and 8 years, respectively), 2 cases lost access. At the end of follow-up, MVA has been reduced compared with the postoperative (1.4 ± 0.4 cm 2 vs. 1.7 ± 0.3 cm 2 , P < 0.05); LAD slightly increased compared with the postoperative (45.2 ± 5.7 mm vs. 41.4 ± 6.3 mm, P < 0.05), RAD slightly also increased compared with the postoperative (36.1 ± 6.3 mm vs. 28.6 ± 5.5 mm, P < 0.05), but did not recover to the preoperative level. TRA slightly increased compared with the postoperative, but the difference was not statistically significant (P > 0.05). The PAP and left ventricular ejection fraction appeared no statistical difference compared with the postoperative (P > 0.05), the remaining patients without serious complications.</p><p><b>CONCLUSIONS</b>PBMV is a safe and effective procedure for MS combined with TR in patients of rheumatic heart disease. It can alleviate the symptoms and reduce the size of TR. It can also improve the quality-of-life and prognosis. Its recent and mid-term efficacy is certain. While its long-term efficacy remains to be observed.</p>

Anthraquinones and triterpenoids from roots of Knoxia roxburghii / 中国中药杂志

Nine compounds were isolated from an ethanol extract of the roots of K. roxburghii by using a combination of various chromatographic techniques including column chromatography over silica gel, MCI gel, Sephadex LH-20, and reversed-phase HPLC. On the basis of physical-chemical properties and spectroscopic data analysis, their structures were identified as munjistin (1), 1-methoxy-3,6-dihydroxy-2-hydroxymethyl-9,10-anthraquinone (2), 1,2,3-trihydroxy-9,10-anthraquinone (3), arjunolic acid (4), hyptatic acid-A (5), hyptatic acid-B (6), 2α,3β,24-trihydroxyurs-12-en-28-oic acid (7), 2α,3β,23-trihydroxyurs-12-en-28-oic acid (8), and daucosterol (9). Compounds 1-9 were obtained from this genus for the first time.

Effect of tongxinluo capsule on platelet activities and vascular endothelial functions as well as prognosis in patients with acute coronary syndrome undergoing percutaneous coronary intervention / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Tongxinluo Capsule on platelet activities and vascular endothelial functions as well as prognosis in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) at different stages.</p><p><b>METHODS</b>160 patients with acute coronary syndrome were randomly assigned to Tongxinluo (TXL) group (80 patients) and the conventional treatment group (80 patients). And 50 healthy subjects were set up as the health control group. Patients' plasma platelet activating factors (CD62p, CD63), and glucose protein (GP) IIb/IIIa, and endothelium-1 (ET-1), von Willebrand factor (vWF), nitric oxide (NO) levels, and endothelium dependent flow-mediated dilatation (FMD) were detected respectively. Patients in the TXL group orally took TXLC for six months. The aforesaid indices were re-detected in all patients after two months and six months. Comparison between before and after treatment in the same group and inter-group comparison were performed in the two groups.</p><p><b>RESULTS</b>Compared with the health control group, CD62p, CD63, GPIIb/IIIa, vWF, and ET-1 levels increased significantly in ACS patients after PCI (all P<0.01), NO and FMD significantly decreased (P<0.01). CD62p, CD63, GPIIb/IIIa and, vWF also increased, and FMD decreased after PCI (all P<0.05), but insignificant difference was found in ET-1 and NO (P>0.05). In the TXL group and the conventional treatment group, the levels of CD62p, CD63, GPIIb/IIIa, vWF and ET-1 decreased significantly (P<0.05, P<0.01), NO and FMD increased (P<0.05, P<0. 01) when compared with before treatment. Compared with the conventional treatment group, the decrement of CD62p, CD63, GPIIb/IIIa and vWF (P<0.05, P<0.01), and the increment of FMD and NO (both P<0.05) were more obvious in the TXL group. The aforesaid indices were more obviously different between 6-month treatment and 2-month treatment in the TXL group and the conventional treatment group (P<0.05, P<0.01). Seven patients suffered from angina, six from heart failure, three from ventricular tachycardiac (VT)/ventricular fibrillation (VF), and two died suddenly in the conventional treatment group after six months of treatment, while only one suffered from angina, one from heart failure, and none from VT/VF or died suddenly in the TXL treatment group after 6 months of treatment.</p><p><b>CONCLUSION</b>TXL could be used in the prevention and treatment of coronary thrombosis, protect the vascular endothelial functions, as well as improve the prognosis of ACS patients after PCI.</p>

Transcatheter radiofrequency ablation under the guidance of three-dimensional mapping for the treatment of complex cardiac arrhythmias / 介入放射学杂志

Objective To investigate the effectiveness and safety of transcatheter radiofrequency ablation guided by a three-dimensional mapping system (Ensite or Carto) for the treatment of complex cardiac arrhythmias. Methods A cohort of 123 consecutive hospitalized inpatients during the period from February 2006 to December 2008 were selected for this study. These patients suffered from various arrhythmias, including paroxysmal atrial fibrillation (n=58). Persistent or permanent atrial fibrillation (n=10), atrial flutter (n=13), atrial tachycardia (n=12) and ventricular tachycardia or frequent ventricular premature beats (n=30). Transcatheter radiofrequency ablation for arrhythmias was performed under the guidance of an EnSite3 000/NavX or Array mapping system in 80 cases, and under the guidance of a CARTO mapping system in the remaining 43 cases. Results Successful ablation of arrhythmias was obtained by single operation in 106 cases(86.18%). Including 59 cases with atrial fibriUation,11 cases with atrial flutter, 10 cases with atrial tachycardia, and 26 cases with ventricular tachycardia or premature ventricular beat. Ablation procedure was carried out and was successful in 10 cases with a successful rate of 94.31%, including 5 cases with atrial fibrillation. 1 case with recurred atrial flutter, 1 case with recurrent atrial tachycardia, and 3 cases with ventricular tachycardia or premature ventricular beat. After operation, complications occurred in 6 cases, including cardiac tamponade in 4 cases, distal embolism of the left anterior descending coronary artery in 1 case, and pulmonary embolism in 1 case. Conclusion Three-dimensional mapping system can clearly and stereoscopically display the cardiac structures. Therefore, this technique is of great value in guiding the transcatheter radiofrequency ablation for complex arrhythmias, in improving the success rate of ablation and in increasing the safety of the procedure.

Effects of tongxinluo capsule on platelet activating and inflammation factors as well as vascular endothelial function in patients with essential hypertension complicated with diabetes mellitus / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effects of Tongxinluo Capsule (TXLC) on platelet activating factor, vascular inflammation factor and vascular endothelial function in patients with essential hypertension (EH) complicated with diabetes mellitus (DM).</p><p><b>METHODS</b>One hundred patients of EH with DM were equally assigned to the TXLC group (treated by TXLC) and the control group (treated with the conventional therapy). Their fasting blood drawn from the cubital vein on the next morning of hospitalization was taken for determining serum level of high sensitivity C-reactive protein (hs-CRP) by emulsion immunoenhancement turbidimetry; plasmal fibrinogen C (FIB-C) by diffusive turbidimetry; platelet activating indices, CD62p and glucose protein (GP) II b/III a receptor complex by flow cytometry; endothelin-1 (ET-1) by radioimmunoassay and nitrogen oxide (NO) content by enzyme method. The outcomes were compared with those of 50 healthy persons. After patients were treated for 8 weeks, all the above-mentioned indices were reexamined and compared between groups. Results Blood levels of hs-CRP, FIB-C, CD62p, GP II b/IIIa and ET-1 in patients were significantly higher than those in healthy persons (all P < 0.01). All the indices as well as the blood pressure (both systolic and diastolic) reduced in patients of both groups significantly (P < 0.05 or P < 0.01), but the reducing was more significant in the TXLC group than in the control group. Besides, level of NO significantly increased in the TXLC group (P < 0.05).</p><p><b>CONCLUSION</b>TXLC can inhibit the platelet activation and vascular inflammation response, also improve the vascular endothelial function in patients with EH complicated with DM. It may play a certain role in preventing and treatment of the occurrence of thrombotic complications in them.</p>

Effect of danhong injection on platelet activation and inflammatory factors in patients of acute coronary syndrome after intervention therapy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Danhong Injection (DHI) on platelet activation and inflammatory factors in patients of acute coronary syndrome (ACS) after intervention therapy.</p><p><b>METHODS</b>One hundred ACS patients were randomly assigned to the DHI group and the control group equally. Both were treated with the conventional treatment, including aspirin, clopidogrel, beta-receptor blocker, angiotensin converting enzyme inhibitor, etc. for 2 weeks after percutaneous coronary intervention (PCI), and to the patients in the DHI group, intravenous dripping of DHI was given simultaneously. Fasting venous blood of patients were collected before PCI and on the next morning of PCI to determine the platelet activation indices, expression of CD62p and receptor complex of glucose protein (GP) II b/III a by flow cytometry; plasma fibrinogen C (FIB-C) by scattering turbidimetry, and serum high-sensitivity C-reactive protein (hs-CRP) with emulsoid immuno-enhancing turbidimetric test kit. The outcomes were compared with those determined in 40 healthy persons for control.</p><p><b>RESULTS</b>Serum levels of CD62p, GP II b/III a, FIB-C and hs-CRP in ACS patients were significantly higher than those in the healthy control (all P<0.01), and those were significantly higher after PCI than before PCI (P <0.05 or P<0.01). After being treated for 2 weeks, the 4 platelet activation indices were lowered to different extent in both groups, but the lowering in the DHI group was more significant than that in the control group (P<0.05).</p><p><b>CONCLUSION</b>DHI can inhibit the platelet activation and inflammatory reaction in ACS patients after PCI.</p>

Effect of tetramethylpyrazine on platelet activation and vascular endothelial function in patients with acute coronary syndrome undergoing percutaneous coronary intervention / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of tetramethylpyrazine (TMP) on platelet activation and vascular endothelial function after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>Eighty patients with ACS were assigned to the TMP group (40 patients) and the control group (40 patients). Before and at the next day of PCI, patient's expressions of the indices of platelet activation CD62p, CD63 and glucose protein (GP) II b/III a were tested by flow cytometry, von Willebrand (vWF) by ELISA, endothelin-1 (ET-1) by RIA, and plasma content of nitrogen oxide (NO) were determined by enzyme reaction, at the same time, the flow-mediated dilatation (FMD) in brachial artery was measured as well using color Doppler. All the afore mentioned indexes were reexamined for comparing when patients in the TMP group received TMP treatment for 14 days.</p><p><b>RESULTS</b>Before PCI blood levels of CD62p, CD63, GP II b/III a, vWF and ET-1 expression increased significantly (all P < 0.01), FMD and NO decreased significantly (P < 0.01) in ACS patients, as compared with those in the healthy control. After PCI, level of vWF increased significantly (P < 0.05), FMD decreased significantly (P < 0.05), while CD62p, CD63, GP II b/III a, ET-1 and NO changed insignificantly (P > 0.05). As compared with the control group, levels of CD62p, CD63, GP II b/III a, vWF and ET-1 decreased significantly (P < 0.05 or P < 0.01), FMD increased significantly (P < 0.05) in the TMP group.</p><p><b>CONCLUSION</b>TMP can be useful for preventing and treating the intra-coronary thrombosis and protect the vascular endothelial function in patients undergoing PCI.</p>

Catheter closure of ventricular septal defects using Amplatzer occluder / 介入放射学杂志

Objective To evaluate the clinic effectiveness and safety of transcatheter closure of ventricular septal defect using homemade Amplatzer VSD occluder. Methods From Jan 2003 to April 2005,16 patients (11 males,5 femles) with VSD underwent an attempt of catheter closure using homemade Amplatzer occluder.The mean age of patients was (13.98 ?11.05) years (ranged from 3.5 to 41 years);the mean weight of patients was (32. 1 ?17.59) kg (ranged from 12.5 to 59 kg);the mean diameter ofVSD measured by transthoracic echocardiography (TTE) was(5.34?1.75)mm(ranged from 3.7 to 9mm). All patients underwent closure under TTE or transthoracic echocardiography(TEE)guidance. Results The devices were deployed successfully in 12patients.There was complete closure in 11patients immediatelly,and residual sbunt in 1 patients.After proccdure, bundle branch block(right and left bundle) were occurred in 7patients.Hemolysis was in 1patients.There were no other servere complications.Conclusions Transcatheter closure of VSD using this new occluder is safe and effective. Early results are good.Further clinical trials are underway to assess the long-term results.

The serious complications of percutaneous balloon mitral valvuloplasty and their management / 中国介入心脏病学杂志

Objective To analyze the serious complications of percutaneous balloon mitral valvuloplasty (PBMV). Methods Between October , 1986,and November, 2000, 1200 patients with rheumatic mitral stenosis age 9-66 older underwent PBMV by Inoue Way. 98% of the balloon catheters were self-made and single balloon catheters.Results Operative successful rate was 98.82% . Serious complications occurred in 51 patients or (4.4%), including 4 cases of death (0.33%), 5 acute serious mitral regurgitation (0.42%), 8 acute cardiac tamponade (0.66%), 28 severe arrhythmia (2.3%), 4 acute left ventricular failure and acute pulmonary edema (0.33%), and 8 systemic thromboembolis. The four cases of death included 1 with acute pulmonary edema, 1 with cardiac arrest, and 2 with acute left ventricular failure with low cardiac output. Conclusion The results demonstrate that PBMV is an efifective and reliable procedure in the treatment of rheumatic mitral stenosis, but a marked decreasement in complication rates is attributable to refinement of patient selection criterion, technical advance in procedure, and strictly management of patients.

Percutaneous balloon mitral valvuloplasty for mitral stenosis with moderate mitral regurgitation / 中国介入心脏病学杂志

Objective To evaluate the effects of percutaneous balloon mitral valvotomy (PBMV) for mitral stenosis (MS) with moderate mitral regurgitation (MR), particularly with bad mitral condition. Methods PBMV was performed in 62 patients with both MS and MR, of whom 7 had bad mitral condition, and the changes of mitral valve area, mean left atrial pressure , mitral valve gradient, cardiac function and left ventricular maximal diameter were observed. Results Mitral valve area increased from (0.83?0.18) cm 2 to (1.86?0.24) cm 2 (P