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Objective To study the feasibility of using fractional flow reserve (FFR) to guide whether to perform coronary revascularization of non-culprit moderate stenosis in patients with unstable angina and estimate their clinical prognosis. Methods This study enrolled unstable angina patients with multivessel disease. First successful stenting of the culprit artery, then the other non-culprit moderate coronary stenosis were randomized into PCI guided by angiography or guided by FFR measurements. Death from any cause, nonfatal myocardial infarction, unplanned hospitalization leading to urgent revascularization and clinical manifestations with angina were followed during the first year. Results 71 patients were included, among them 35 patiens were randomly assigned to angiography-guided PCI and 36 patients to FFR-guided PCI. In FFR-guided PCI group, FFR was successfully measured in all of non-culprit moderate coronary stenosis. In 23 stenosis, the FFR was greater than 0.80, and stents were not placed in these stenosis. In 13 stenosis with FFR<0.8, stent were inplant and FFR was raised≥0.95 after stenting. The percentage of patients who had a primary end-point event was higher in the angiography-guided PCI group than the FFR-guided PCI group (P<0.05). Neither the rate of mortelity from any cause nor the rate of non-fatal myocardial infarction had significant difference between the 2 groups. Related to the target vessels rates of nonfatal myocardial infarction (5.6%vs. 28.6%) and target lesion revascularization (5.6%vs. 31.4%) were statistically different (P<0.01 and P<0.05, respectively). Conclusions In patients with unstable angina, it is safe to use FFR values to guide decisions on the revascularization of angiographically moderate non-culprit stenosis. Routine measurement of FFR in addition to angiographic guidance, as compared with PCI guided by angiography alone, results in a significant reduction in major adverse events at 1 year, particularly in urgent revascularization, and clinical manifestations with angina get better.
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ObjectiveTo evaluate the safety, and the brief-and prolongedterm therapeutic efficacy for im- plantation of biodegradable stent Excel combined with Tirofiban made in China into patients with acute coronary syndrome(ACS). MethodA total of 301 patients were divided into Excel group (n = 100), Cypher group (n =102) and bare metal stem(BMS) (n = 99). The Tirofiban used in three groups was administered intravenously during and after operation.The loading dose of Tirofiban was 10 μg/kg given within 3 min followed by a Tirofiban intravenous maintenance infusion in 0.15 μg/(kg·min) with micro pump for 48 hours. Safety and efficacy were compared among three groups after stents implantation by the observation of TIMI flow, complication of bleeding, changes of platelet count, haematoglobin and hematocrit, incidence of angina, acute and subacute thrombosis inner stent and major adverse cardiac events (MACE) (cardiac death, nonfatal myocardial infarction and target ves-sel revascularization). Follow-up information got from out-patient clinic and telephone call including incidence of angina, MACE and rehospitalization were comapared sucessively 1 month, 6 monthes and 12 monthes after dis- charge. ResultsAmong there groups,there were no significant differences in demographics,and physical and lab-oratory findings before treatment. Successful rate of implantation was 100 percent and the TIMI flow of class Ⅲ was found in all patients. There was no complication of stroke and massive hemorrhage of gastrointestinal tract, and no significant differences in complication of bleeding, platelet count, hemoglobin and hematocrit after implantation. Incidence rates of acute thrombosis were 0, 0.98 and 1.01 percent in three groups, and there was no significant difference in acute thrombosis inner stent among three groups (P >0.05). The rates of angina, sub.acute stent thrombosis, MACE and rehospitalization among three groups had no differences at 1 month and 6 monthes follow-up (P > 0.05), but significant differences were not found until 12 monthes follow-up (P < 0.05). Conclusions Drug-eluting stent Excel with biodegradable polymer combined with Tirofiban made in China implanted in patients with ACS were capable of preventing acute and later thrombosis inner stent. This procedure had favourable safety, and brief-term and proionge-term therapeutic efficacy.
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Autophagy is a lysosome-dependent degradative pathway which is characterized by cytoplasmic vacuolization. However, it is not just a simple degradative pathway. Research shows that autophagy is related to many diseases, such as neurodegenerative disease, malignant tumor, ageing, pathogenic microorganism infection, myocardial ischemia/reperfusion injury and so on. Autophagy exactly exists in myocardial ischemia/reperfusion injury, and it becomes a new research hotspot. This review will focus on the occurrence and development of autophagy and its role, signal transduction and research status in myocardial ischemia/reperfusion injury.
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Objective To study the efficacy of the percutaneous thrombectomy for the no-reflow of acute myocardial infarction(AMI)in elderly patients with angiographically proven thrombus.Methods A total of 46 patients(≥60 years old)with AMI and coronary thrombus shown by angiography were randomly divided into group of PCI therapy(23 cases)and group of PCI plus percutaneous thrombectomy(23 cases).At 24 hours and 1 week after PCI,real-time imaging was performed by contrast pulse sequencing technology.Contrast score index(CSI),endocardial length of contrast defect(CDL),regional wall motion score index(WMSI)and wall motion abnormality(WML)were calculated. Results At each time point,in patients treated with a pereutaneous thrombectomy,CSI,CDL/LV length(%),WMSI and WML/LV length(%)were significantly lower than in PCI group[(2.0±0.3)vs.(2.5±0.7),(1.5±0.4)vs.(2.0±0.5),(15.5±5.4)%vs.(22.8±4.9)%,(9.6±2.5)%vs.(21.5±4.6)%,(2.1±0.5)vs.(2.4±0.7),(1.5±0.5)us.(2.1±0.5),(24.5±5.3)%vs.(35.6±8.3)%,(15.9±5.0)vs.(27.6±6.4)%,P<0.05 or P<0.01]. Conclusions The beneficial effect of the thrombectomy occurs at the microvascular level.Thrombectomy reduces the no-flow and the extent of microvascular obstruction,thus it was a feasible therapy in elderly patiens with AMI.
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AIM To observe whether acute stimulation of BRL 37344, a β3-adrenergic receptor (β3-AR) agonist, has the same effects of exacerbating hemodynamics and increasing in β3-AR expression on rats with failing heart as chronic administration. METHODSRats received two doses of isoprenaline (Iso, 340 mg·kg-1, sc, with a 24-h interval) to prepare heart failure model. After 8 weeks, rats were given iv BRL 37344 0.4 nmol·kg-1·min-1 for 10 min. Hemodynamics were measured at 0, 10, 30 min, 1, 2, 3 h, 1, 2 and 7 d after BRL 37344. Levels of β-AR mRNA in myocardium were measured at 0, 1, 2 and 7 d after BRL 37344 by reverse transcription-polymerase chain reaction. RESULTSCompared with Iso group, heart rate, left ventricular end systolic pressure and +dp/dtmax were significantly higher, and left ventricular end diastolic pressure was significantly lower during 1-3 h after BRL 37344 injection in Iso+BRL group. Then, they were restored to the same level as that prior to BRL 37344 injection. Compared with normal control, the levels of β1-, β2- and β3-AR mRNA displayed no significant change in BRL group;the level of β1-AR mRNA was lower and the level of β3-AR mRNA was higher in Iso group. In Iso+BRL group, much more lower β1-AR mRNA level and much higher β3-AR mRNA level were shown on d 2 and d 7 than Iso group. CONCLUSION Acute administration of β3-AR agonist has a shorter improved hemodynamics. But it caused the same result as chronic administration in reduction of β1-AR mRNA and increment of β3-AR mRNA in failure hearts, which may aggravate the cardiac functions.
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AimTo compare the protective immunity against challenge infection in mice immunized by crude antigen preparations derived from adult worms, newborn larvae and musele larvae of T richinella spiralis. MethodIntestinal adult worms, muscle larvae and blood absolute eosinophil level were counted; the level of serum IgG to antigens of T. spiralis muscle larvae was detected by ELISA. ResultsAdults reduimg rate was 82.19 %, 72.31% and 42.88 % in the adult, newborn larvae and muscle larvae antigen groups respectively. Muscle larvae were reduced 68.83%. 78.19% and 51.96% respectively. The serum IgG titer in all immunized groups increased significantly, the GMRT values of adult, newborn larvae and mudscle larval antigen groups were 7.46, 5.28and 4.92times higher than that in control group respectively. Periphery blood absolute eosinophil level enhanced significantly. ConclusionThe data demonstrate that all of the adult, newborn larvae and muscle larvae antigens of T. spiralis can activate specific humoral and cellular immunity which induce protection to challenge infection in mice. Among these antigens, adult and newborn larvae antigens show better immunogenicity and it may be possible that adult antigen will provide a potential vaccine for trichinosis.
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Aim In order to observe the pathological features and the dynamic distribution of RH strain T. gondii in main organs of infected mice, using indirect immunoenzymatic technique. To provide pathological diagonsising reference of toxoplasmosis and increase to understand the pathologensis of Toxoplasmosis. Methods Mice were infected intraperitoneally with 103 tachyzoites of T. gondii RH strain,and the parasites were detected using indirect immunoenzymatic technique in the liver, spleen, lungs and brain at 2,4,6 and 8 days postinfection. Results The liver was the first organ parasitized at D2, followed by spleen and lungs at D4, the brain at D8. At the early phase of infection, parasites were found on the edge of the liver and spleen. A few parasites were detected within the liver, spleen and lungs with time being. But parasites increased progressively and distributed well during the whole phase. The brain was the last organ to be parasitized. Parasites multiplicated rapidly so that the mice were seriously ill and died. Conclusions The indirect immunoenzymatic technique can demonstrate tachyzoites and Toaxoplasma antigen clearly in infected mice during acute stage. Many organs were infected such as liver, spleen,lungs and brain. The results suggest that the organs in the peritoneal cavity were infected directly by tachyzoites as IP infection, then the parasites disseminate through a blood way, and in the end, tachyzoites cross the blood-brain barries to reach the brain.
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The present study were to identify a dose-response relationship and study the histologic correlates. Group A : The rabbit's iliac segments of normal control,were performed in radiofrequency balloon angioplasty. Group B: The iliac segments of rabbits, which had been manually separated in to intime- media and media-adventitia layes, were performed in radiofrequency balloon angioplasty. Radiofrequency dose delivered from a metal electrode balloon produced dose-dependent thermal energy with compression. It produces fusion of separated wall layers. Range of radio -frequency from clean and shallow craters with histologic evidence of thermal compression at does(
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Growth dynamics of PP, CN and ZS2 strains of Toxoplasma gondii isolated in China was studied and compared with that of RH strain. HeLa cells were used in this work. It took only 2 min for the organisms of RH strain to infect the HeLa cells when con-tacting with the cells. By contrast, the CN strain requires 5 min, the ZS2 and PP strains, 10 min.Tcxoplasma began its multiplication after a lag time of about 6 h in the HeLa cells. The mean generation time of the 4 strains was assessed by calculating the number of the parasites in the parasitophorous vacuoles at different incubation times and by the linear regression equation. The results showed that the mean generation time was 5.2 h for RH strain, 5.98 h for CN strain, 6.78 h for ZS2 strain and 7.69 h for PP strain.Among the 3 strains of Toxoplasma gondii isolated in China, CN strain was similar to RH strain in their infectivity and proliferation.