Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease / 中华医学杂志(英文版)

BACKGROUND@#Coronary artery disease (CAD) in octogenarians (age of ≥80 years) has a high risk of mortality and high medical expenses. Research shows that the prevalence of CAD is higher among octogenarians than that among younger people, but few such patients undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study aimed to evaluate different treatments with respect to their clinical effects and impacts on quality of life of octogenarians with CAD.@*METHODS@#Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital, Capital Medical University (Beijing, China) from January 2010 to January 2016 were collected in this study. The patients were categorized into three groups based on the treatments they received: the PCI group (n = 292), CABG group (n = 110), and medical treatment group (n = 117). The followings were recorded during follow-up: clinical data, death (all-cause and cardiovascular-related), re-hospitalization time, Seattle Angina Questionnaire (SAQ) score, and occurrence of hemorrhagic events (cerebral bleeding, gastrointestinal bleeding, and dermal ecchymosis).@*RESULTS@#The median follow-up duration was 25.0 (25th, 75th percentile: 17.0, 55.5) months among 417 patients. The all-cause death rates (28.2% vs. 12.0% and 14.6%, respectively) and cardiovascular-related death rates (15.4% vs. 3.8% and 6.4%, respectively) were significantly higher in the medical treatment group than those in the PCI group and CABG group (all P < 0.05). The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group (3.8% vs. 12.8% and 14.9%, respectively) (χ = 8.238, P = 0.018). The SAQ scores of physical limitation, angina frequency, treatment satisfaction, and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group (all P < 0.05). No significant difference in the angina stability score was observed among the three groups (F = 3.179, P = 0.204).@*CONCLUSION@#PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease / 中华医学杂志(英文版)

Background@#Coronary artery disease (CAD) in octogenarians (age of ≥80 years) has a high risk of mortality and high medical expenses. Research shows that the prevalence of CAD is higher among octogenarians than that among younger people, but few such patients undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study aimed to evaluate different treatments with respect to their clinical effects and impacts on quality of life of octogenarians with CAD.@*Methods@#Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital, Capital Medical University (Beijing, China) from January 2010 to January 2016 were collected in this study. The patients were categorized into three groups based on the treatments they received: the PCI group (n = 292), CABG group (n = 110), and medical treatment group (n = 117). The followings were recorded during follow-up: clinical data, death (all-cause and cardiovascular-related), re-hospitalization time, Seattle Angina Questionnaire (SAQ) score, and occurrence of hemorrhagic events (cerebral bleeding, gastrointestinal bleeding, and dermal ecchymosis).@*Results@#The median follow-up duration was 25.0 (25th, 75th percentile: 17.0, 55.5) months among 417 patients. The all-cause death rates (28.2% vs. 12.0% and 14.6%, respectively) and cardiovascular-related death rates (15.4% vs. 3.8% and 6.4%, respectively) were significantly higher in the medical treatment group than those in the PCI group and CABG group (all P < 0.05). The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group (3.8% vs. 12.8% and 14.9%, respectively) (χ2 = 8.238, P = 0.018). The SAQ scores of physical limitation, angina frequency, treatment satisfaction, and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group (all P < 0.05). No significant difference in the angina stability score was observed among the three groups (F = 3.179, P = 0.204).@*Conclusion@#PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

Unfractionated Heparin with Sequential Enoxaparin in Patients with Complex Coronary Artery Lesions during Percutaneous Coronary Intervention / 中华医学杂志(英文版)

<p><b>Background</b>Unfractionated heparin (UFH), despite its limitations, has been used as the primary anticoagulant alternative during the percutaneous coronary intervention (PCI). Some studies indicated that intravenous enoxaparin could be an effective and safe option. Our team used enoxaparin alone at one time according to the guidelines (Class IIA) and found a little catheter thrombosis during PCI. We recommend a new anticoagulation strategy using enoxaparin in combination with UFH. Enoxaparin has a more predictable anticoagulant response with no need of repeatedly monitoring anticoagulation during PCI. This retrospective study aimed to evaluate the efficacy and safety of using enoxaparin in combination with UFH in PCI patients with complex coronary artery disease.</p><p><b>Methods</b>Between January 2015 and April 2017, 600 PCI patients who received intravenous UFH at an initial dose of 3000 U plus intravenous enoxaparin at a dose of 0.75 mg/kg (observation group) and 600 PCI patients who received UFH at a dose of 100 U/kg (control group) were consecutively included in this retrospective study. The endpoints were postoperative 48-h thrombolysis in myocardial infarction (TIMI) bleeding and transfusion and 30-day and 1-year major adverse cardio-cerebrovascular events (MACCE).</p><p><b>Results</b>Baseline clinical, angiographic, and procedural characteristics were similar between groups, except there was less stent implantation per patient in the observation group (2.13 vs. 2.25 in the control group, P = 0.002). TIMI bleeding (3.3% vs. 4.7%) showed no significant difference between the observation group and control group. During the 30-day follow-up, the rate of MACCE was 0.9% in the observation group and 1.5% in the control group. There was no significant difference in the rates of MACCE, death, myocardial infarction, target vessel revascularization, cerebrovascular event, and angina within 30 days and 1 year after PCI between groups as well as in the subgroup analysis of transfemoral approach.</p><p><b>Conclusions</b>UFH with sequential enoxaparin has similar anticoagulant effect and safety as UFH in PCI of complex coronary artery disease.</p>

Tacrolimus-related hypertrophic cardiomyopathy in an adult cardiac transplant patient / 中华医学杂志(英文版)

Left ventricular hypertrophy associated with the use of tacrolimus is a rare complication of solid organ transplantation in adult recipients. We present a cardiac transplant recipient who developed severe concentric left ventricular hypertrophy with congestive heart failure related to myocardial hypertrophy on tacrolimus. Hypertrophy improved when the drug was discontinued and replaced with sirolimus.

Clinical and coronary angiographic features of young women with acute myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the clinical and coronary angiographic features of young women (≤ 44 years) with acute myocardial infarction (AMI).</p><p><b>METHODS</b>Clinic and coronary angiographic features were compared among 57 young women with AMI and 60 non-CHD young women, 78 young men with AMI and 80 elderly women with AMI were included, all patients were admitted to hospital from June 2003 to December 2010 and underwent coronary angiography. Body mass index (BMI), smoking history, familial history of early coronary artery disease, essential hypertension, type 2 diabetes mellitus, hyperlipidemia, serum uric acid (UA), menopause, lipids, total bilirubin (TBil), direct bilirubin (DBil), hemoglobin (Hb), red cell distribution width (RDW), fasting blood glucose (FBG) were measured.</p><p><b>RESULTS</b>(1) Prevalence of essential hypertension, hypertriglyceridemia and levels of fasting blood glucose, triglyceride, serum uric acid were significantly higher while high density lipoprotein cholesterol, and hemoglobin were significantly lower in young women with AMI group than in age-matched non-CHD control group (all P < 0.05). (2) Logistic regression analysis showed that essential hypertension (OR = 23.187), lower hemoglobin level (OR = 1.010) and uric acid (OR = 1.040) were independent risk factors for young women with AMI (all P < 0.05). (3) Coronary angiography revealed normal coronary finding in 6 cases, single-vessel disease in 35 cases (26 cases with left anterior descending artery disease) and two-vessel disease in 12 patients. The ratio of single vessel disease involved left anterior descending artery in young women was higher than that of young men and old women with AMI (all P < 0.05).</p><p><b>CONCLUSION</b>Essential hypertension, lower hemoglobin and uric acid are risk factors of young women with AMI. Single vessel coronary disease is the most common coronary angiographic feature of young women with AMI.</p>

Expression and identification of sigmaC gene of avian reovirus by baculovirus expression system / 病毒学报

Recombinant baculovirus containing sigmaC gene of Avian reovirus was constructed using Bac-To-Bac Baculovirus expression system, and recombinant sigmaC protein was expressed by infecting the sf9 cell with recombinant baculovirus. Firstly, sigmaC gene of Avian reovirus was cloned and inserted into donor plasmid pFastBacHTA to obtain recombinant donor plasmid pFsigmaC. Plasmid pFsigmaC was transformed into E. coli DH10Bac for integration into bacmid vector and the recombinant bacmid plasmid BacmidsigmaC was obtained. Recombinant baculovirus rBacsigmaC was obtained by transfection of the sf9 cells with BacmidsigmaC. Western blot and indirect immunofluorescence assay (IFA) were carried and the results showed that the recombinant sigmaC protein with 37 kDa molecular weight was expressed successfully.

Identification of VP3 antigenic epitopes of infectious bursal disease virus / 病毒学报

Infectious bursal disease virus(IBD) causes infectious bursal disease (IBD), which infects bursal of chicken and can evoke immune suppression. This study identified the antigenic epitopes of four McAbs to IBDV VP3(HRB-3F, HRB-7B, HRB-7C and HRB-10E)with pepscan. A set of 17 partially overlapping or consecutive peptides (P1-P17) spanning VP3 were expressed for epitope screening by pepscan. Finally, two antigenic epitopes, 109-119aa and 177-190aa of IBDV VP3, were identified by Western blot and ELISA. The peptides on epitopes could react with IBDV, and they had better immunnogenicity. The sequences of epitopes were compared with that of several other IBDV strains in the same region, and was found they were totally homologous. This study showed the two epitopes were novel conserved linear B cell epitopes on the VP3 of IBDV. This study provides basis for the development of immunity-based prophylactic, therapeutic and diagnostic measures for control of IBD and further for structural and functional analysis of IBDV.

Preparation and primary analysis of monoclonal antibodies against VP5 protein of chicken infectious bursal disease virus / 生物工程学报

Infectious bursal disease virus (IBDV), the causative agent of a highly contagious disease in chickens, carries a small nonstructural protein (NS). In this study, vvIBDV Gx-VP5 genes were cloned into plasmid pET30a( + ) and expressed in E. coli with IPTG inducing. BALB/c mice were immunized with the purified recombinant fusion protein. SP2/0 myeloma cells and spleen cells of BALB/c mice were fused by PEG(MW1500), three hybridoma cell lines were examined by indirect ELISA and clone for three times by limited dilution, and were named as 4B4, 6D12, 3E8. The subtype of the monoclonal antibodies were IgG1 with a subtype identified ELISA kit, and light chains were kappa. The ascites titers of monoclonal antibodies were 5 x 10(4), 3.5 x 10(4), 3 x 10(4) by indirect ELISA, respectively. Indirect ELISA and Western blot results showed that the monoclonal antibodies only acted with VP5 protein, IF analysis indicated that three monoclonal antibodies acted with IBDV Gt. There were specific fluorescence in detected Vero E6 cells which transient expressed VP5 protein by IFA. Therefore, monoclonal antibodies specific to IBDV VP5 proteins are specific method for detected VP5 proteins, and base on establish stabilize expressed VP5 protein Vero cell lines to research IBDV VP5 protein function.