Influence of dual antiplatelet therapy combined different dose of atorvastatin calcium on serum levels of MCP‐1 and VE‐cadherin in patients with acute cerebral infarction／ / 心血管康复医学杂志

To explore influence of dual antiplatelet therapy combined different dose of atorvastatin calci‐um on serum levels of monocyte chemoattractant protein (MCP)‐1 and vascular endothelial cadherin (VE‐cadherin) in patients with acute cerebral infarction atorvastatin routine dose group (ACI).Methods :A total of 119 ACI patients admitted in our hospital from 2016 to 2017 were randomly divided into atorvastatin routine dose group (n＝61) and large dose group (n＝58 ,40mg ,once／d) ,both groups received routine treatment and aspirin + clopidogrel for 30d. NIHSS ,serum levels of hsCRP ,TNF‐α ,IL‐8 ,MCP‐1 and VE‐cadherin ,carotid atherosclerotic plaque size and IMT before and after treatment ,and incidence of adverse reactions were measured and compared between two groups . Results :Compared with before treatment ,there was significant reduction in NIHSS score after 15d and 30d in two groups ,and those of 30d were significantly lower than those of 15d ,P＝0. 001 all ;compared with routine dose group after 15d and 30d ,there was significant reduction in NIHSS score [15d :(5.32 ± 1. 63 ) scores vs .(4. 13 ± 1.25 ) scores] in large dose group ,P＝ 0.001 ;Compared with routine dose group after 30d ,there were significant reduc‐tions in serum levels of hsCRP [(9.37 ± 1.85)mg／L vs.(6. 35 ± 1.94)mg／L] ,TNF‐α[(10. 15 ± 2.47)μg／L vs.(7. 44 ± 1.94)μg／L ] ,IL‐8 [(20. 35 ± 4.48 )μmol／L vs.(15. 14 ± 3. 61 ) μmol／L ] ,MCP‐1 [(234.54 ± 32. 53 ) ng／L vs. (185.46 ± 29. 47) ng／L] ,VE‐cadherin [(5. 32 ± 0. 49)mg／L vs.(4. 18 ± 0.54) mg／L] ,plaque size [(17.25 ± 3.14) mm2 vs.(14.13 ± 2.07)mm2 ] and IMT[(1.08 ± 0.25)mm vs.(0.85 ± 0. 17)mm] in large dose group ,P＝0.001 all. There was no significant difference in incidence rate of adverse reaction between two groups .Conclusion :Large dose atorvastatin combined dual antiplatelet therapy can significantly reduce serum levels of MCP‐1 and VE‐cadherin ,im‐prove brain function without increasing incidence rate of adverse reactions .

Changes and relations between heart function and organ blood flow in rats at early stage of severe burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the instant changes in heart function and organ blood flow, and their relations in rats at early stage of severe burn.</p><p><b>METHODS</b>Thirty-six SD rats were divided into sham injury group (S, n = 6) and burn group (B, n = 30) according to the random number table. Rats in B group were subjected to 30% TBSA full-thickness burn. Five time points for observation: 10 and 30 minutes, and 1, 3, and 6 hour (s) post injury (PIM/H) were set up, with 6 rats at each time point. Rats in S group were sham scalded with 37 degrees C warm water. Hemodynamics indexes including heart rate (HR), mean artery pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), LV + or - dp/dt max were determined. Blood flow of heart, brain, kidney, spleen, stomach, and ileum was determined respectively with fluorescent microspheres method. The correlation between LV + or - dp/dt max and myocardial blood flow was analyzed.</p><p><b>RESULTS</b>(1) Compared with those of S group, HR in B group decreased gradually after injury; MAP, LVSP, LV +dp/dt max, LV -dp/dt max and myocardial blood flow in B group decreased obviously at PIM 10 (with F value respectively 12.062, 12.629, 11.066, 18.374, 9.468, and P values all below 0.01). Among them, myocardial blood flow decreased from (6.8 + or - 0.8) mL x min(-1) g(-1) to (2.6 + or - 0.5) mL x min(-1) x g(-1). Above-mentioned indexes increased gradually as the time after injury went on, with the highest values (except for LV +dp/dt max) observed at PIH 1, which decreased again later, with values at PIH 3 and 6 significantly lower than those in S group (the same F values as above, P values all below 0.01). There was no obvious difference in LVEDP between S group and B group at each time point (F = 1.205, with P values all above 0.05). (2) Compared with those of S group, blood flow of kidney, spleen, stomach, and ileum of rats in B group at PIM 10 declined obviously (with F value respectively 22.694, 20.856, 12.653, 7.293, P < 0.05 or P < 0.01), but the decline range was smaller than that in heart. The lowest values of above-mentioned indexes were observed at PIH 1 or PIH 3. Brain blood flow of rats in B group at each time point was close to that in S group (F = 1.812, with P values all above 0.05). (3) The correlation coefficient r between LV +dp/dt max, LV -dp/dt max and myocardial blood flow was respectively 0.651 and 0.617, showing significant positive correlation (with t value respectively 4.456 and 4.222, and P values all below 0.01).</p><p><b>CONCLUSIONS</b>The myocardial ischemia and decrease in cardiac function may occur in a very short time after severe burn (PIM 10). The rapid decrease of heart blood flow plays an important role in the change in cardiac function. Myocardial damage and decrease of cardiac function may be one of the important factors result in the decline of blood flow in other organs.</p>

Influence of endothelin-1 and NO on the instant change in cardiac function of rats at early stage of severe burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore whether endothelin-1 and NO are involved in the instant changes in cardiac function at early stage of severe burn.</p><p><b>METHODS</b>(1) Thirty-one Wistar rats were divided into sham burn A group (SA, n = 7), burn A group (BA, n = 10), non-selective endothelin A/B receptor antagonist PD142893 group (n = 7), and the selective endothelin A receptor antagonist BQ-123 group (n = 7) according to the random number table. Rats in the latter three groups were inflicted with 30% TBSA full-thickness burn. Immediately after injury, rats in PD142893 group and BQ-123 group were intravenously injected with PD142893 (0.1 mg/kg) and BQ-123 (30 nmol x kg(-1) x min(-1)) respectively. Rats in SA group were treated the same as rats in BA group except for sham injury. The cardiac function indexes of rats in BA and SA groups including left ventricular systolic pressure (LVSP) heart rate (HR) and LV + or - dp/dt max were monitored before injury and 10, 30, 60, 180 minutes post injury (PIM) using physiological signal acquisition and processing system. The respective changes in cardiac function indexes of rate in each group between PIM 10 and pre-injury in the value of percentage were calculated. (2) Another 20 Wistar rats were enrolled and divided into sham burn B group (SB, n = 4) and burn B group (BB, n = 16) according to the random number table, and they were subjected to above-mentioned injury. Heart tissues of rats in BB group were obtained at PIM 10, 30, 60, and 180 respectively (4 rats at each time point), and that in SB group were obtained immediately after injury. Endothelin-1 and NO contents in heart tissues were determined with ELISA.</p><p><b>RESULTS</b>(1) Compared with the pre-injury value, LVSP, HR, LV +dp/dt max, LV -dp/dt max of rats in BA group decreased significantly since PIM 10 (with F value respectively 7.14, 16.40, 14.09 14.98, P < 0.05 or P < 0.01). No significant change was observed in above 4 indexes in rats of SB group between above mentioned two time points (with F value respectively 0.59, 0.51, 1.03, 1.04, P values all above 0.05). (2) In BA group, compared with the pre-injury value, LVSP decreased 27%, HR decreased 14%, LV +dp/dt max decreased 51%, LV -dp/dt max decreased 50% at PIM 10. Compared with those in BA group at PIM 10, cardiac function indexes were improved significantly in PD142893 group, with LVSP decreased 14% (F = 8.10, P < 0.01), HR increased 4% (F = 6.50, P < 0.01), LV +dp/dt max decreased 31% (F = 23.67, P < 0.05), LV -dp/dt max decreased 14% (F = 10.39, P < 0.01). In BQ-123 group, compared with the pre-injury value, HR increased 3%, LV -dp/dt max decreased 26% at PIM 10, which were obviously improved as compared with those in BA group (with F value respectively 6.50 and 10.39, P < 0.05 or P < 0.01); the percentage changes of LVSP and LV +dp/dt max in BQ-123 group were close to that in BA group (with F value respectively 8.10 and 23.67, P values both above 0.05). (3) Compared with those in SB group, myocardial tissue endothelin-1 content of rats in BB group increased significantly at PIM 10, 60, 180 (F = 2.85, P < 00.05 or P < 0.01), and NO content increased significantly at PIM 60, 180 (F = 1.87, with P values all below 0.05).</p><p><b>CONCLUSIONS</b>Endothelin-1 may participate in the instant decline of cardiac function of rats at early stage of severe burn, and plays an important role in the instant myocardial damage after injury.</p>