Coronary Computer Tomography Angiography Features and Associated Risk Factors of Coronary Artery Disease in Young Patients With Suspected Coronary Artery Disease / 中国循环杂志

Objectives:To observe the detection rate of coronary artery disease (CAD) by coronary computer tomography angiography (CCTA) in young patients with suspected CAD, and to explore the imaging features and related risk factors of CAD. Methods:Data from 2 099 patients aged≤45 years who underwent CCTA in our hospital due to suspected CAD were retrospectively obtained. The risk factors of CAD in this patient cohort were analyzed, detection rate and imaging features of CAD among≤20, 21~30, 31~40 and 41~45 years subgroups were compared. Presence or absence of coronary plaque, plaque nature and stenosis degree were recorded. Results:CAD was detected in 229(10.9%) out of 2 099 patients. Incidence of male gender, smoking, dyslipidemia, hypertension, diabetes mellitus, and family history of CAD was significantly higher in CAD group than in non-CAD group (P＜0.05~0.001). Detection rate of CAD significantly increased in proportion with increase of age (F=11.4,P＜0.001) and was 3.1%, 6.2%, 9.7% and 12.9%, respectively in the ≤ 20,21-30,31-40 and 41-45 years groups. The proportion of single-vessel disease (72.5%) was significant higher than the multiple lesion (27.5%) in CAD patients (P＜0.001). There were 183 (56.7%) non-calcified plaques including 39(12.1%) low-attenuation plaques and 54(16.7%) mixed plaques, 86(26.6%) calcified plaques including 72(22.3%) spotty calcified plaques in the 323 diseased vessels. Severe stenosis was found in 158(49.0%) vessels. Conclusions:The prevalence of CAD was 10.9% in this young patient cohort with suspected CAD and imaging features were characterized as single-vessel disease and non-calcified plaques. CCTA should be recommended to young patients with suspected CAD, especially in 30-45-year-old male patients with following risk factors:smoking, hypertension, hyperlipidemia, diabetes mellitus and family history of CAD.

The effect on proliferation and invasion after silence c-cbl gene in ovarian cancer SKOV3 cell / 重庆医学

Objective To study the expression of c-cbl protein in ovarian cancer and its effect on proliferation and invasion in ovarian cancer cell .Methods The expression of c-cbl protein in ovarian tissue were detected by immunohistochemical(S-P meth-od) ,the mRNA expression of c-cbl protein in ovarian cancer SKOV3 cells were detected .the proliferation ability and migration in o-varian cancer SKOV3 cells were detected by EdU assay and Transwell assay .Western blot was used to detect the expression of P21 and P53 protein .Results c-cbl was located in the cytoplasm in ovarian cancer tissues .c-cbl showed moderate or strong positive ex-pression in ovarian cancer .In contrast ,it showed weakly positive or negative expression in normal ovarian tissue .c-cbl expressed in-creased significantly in ovarian cancer compared with those of in normal ovarian tissue(P < 0 .05) ;c-cbl expressed was associated with FIGO stage in ovarian cancer(P< 0 .05) ;silence c-cbl expression in ovarian cancer SKOV3 cells decreased the proliferation and invasion(P< 0 .05) .Silence c-cbl expression increased the expression of P21 and P53 protein(P< 0 .05) .Conclusion c-cbl was in-creased expression in ovarian cancer tissues .Silence c-cbl expression may be related to increased expression of P21 and P53 .

Clinical features of unexpected sudden death clustered in 7 families in Yunnan Province / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of unexpected sudden death (SUD) clustered in families in Yunnan province.</p><p><b>METHODS</b>This retrospective study analyzed the clinical features of SUD occurred between July to September 2005 in 7 families in Yunnan province.</p><p><b>RESULTS</b>All 16 SUD patients shared common clinical features such as fatigue and repeated syncope and one group of SUD patients (n = 8 from 4 families) presented with the gastric intestinal tract manifestations including nausea, vomiting, abdominal pain and diarrhea with suspected dietary history and abnormal laboratory enzyme findings (GOT/GPT, CK/CKMB, LDH/LDH1 etc.). In SUD patients without gastric intestinal tract manifestations (n = 8 from 3 families), there were no clear symptoms before death and repeated ventricular tachycardia and ventricular fibrillation were recorded in one survivor. There was no clear evidence for the involvements of hereditary and infectious factors for observed SUD.</p><p><b>CONCLUSION</b>The reason for the unexpected sudden death clustered in 7 families in Yunnan remains unclear. Repeated syncope and fatigue served as the common clinical features in the presence or absence of gastric intestinal tract manifestations in all SUD cases. Further studies are needed to clarify the pathology and detailed clinical manifestations of SUD occurred in this area.</p>

Value and limitations of multislice spiral CT in diagnosing coronary artery stenoses / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the value and limitations of multislice spiral CT in diagnosing coronary artery stenoses.</p><p><b>METHODS</b>A total of 65 patients with known or suspected coronary artery disease were examined by multislice spiral CT (retrospectively ECG-gating; 0.5 s rotation; one-sector reconstruction algorithm; intravenous contrast agent) and the results were compared with quantitative coronary angiography.</p><p><b>RESULTS</b>In the 889 coronary artery segments of 65 patients, 795 could be evaluated by CT (89.4%), 148 out of 167 coronary artery segments with significant stenoses (> or = 50% reduction of vessel diameter) were correctly detected by CT, 597 out of 628 coronary artery segments with normal or mild stenosis (< 50% reduction of vessel diameter) were correctly detected by CT. These values correspond to a sensitivity of 88.6%, specificity of 95.1%, positive predictive value of 82.7%, and negative predictive value of 96.9% for the detection of significant coronary artery stenosis by CT. Adding the 23 coronary artery segments with significant stenosis which could not be judged by CT, the sensitivity of CT for diagnosing coronary stenosis was 77.9%. In the 795 evaluable coronary artery segments, 78 out of 86 coronary artery segments with high-grade stenosis (> or = 75% reduction of vessel diameter) were correctly detected by CT, 692 of 709 coronary artery segments with normal or mild stenosed (< 75% reduction of vessel diameter) were correctly detected by CT. These values correspond to a sensitivity of 90.7%, specificity of 97.6%, positive predictive value of 82.1%, and negative predictive value of 98.9% for the detection of high-grade coronary artery segments stenosis by CT. Adding 13 coronary artery segments with high-grade stenosis which could not be judged by CT, the sensitivity was 78.8%.</p><p><b>CONCLUSION</b>Multislice spiral CT permits the visualization of significant coronary artery stenosis with high accuracy in case of sufficient image quality.</p>

Electrocardiogram analysis in high risk population of unexplained sudden death in Yunnan province / 中华心血管病杂志

<p><b>OBJECTIVE</b>The purpose of this study was to analyze the electrocardiographic features of the people living in the area with high incidence of unexplained sudden deaths in Yunnan province.</p><p><b>METHOD</b>The electrocardiograms of 338 residents from three villages (Dayao, Ninglang, Heqing) with high incidence of unexplained sudden deaths and one control village (Dali) were analyzed [averaged age was (33.4 +/- 11.7) years, 175 men and 163 women].</p><p><b>RESULTS</b>The incidence of cardiac arrhythmias was similar low in all groups. The left ventricular hypertrophy was observed in 34.6% of residents from Dayao. QTc significantly prolonged in the residents from all 3 high incidence areas compare the control area of Dali [control (386.8 +/- 27.22) ms, Ninglang (428.92 +/- 25.71) ms, Heqing (440.67 +/- 28.03) ms, Dayao (417.7 +/- 24.00) ms, P < 0.05 vs. control]. Incidence of U wave was significantly higher in Heqing village than that in control village (P < 0.05). The QUc of these 3 villages was: (613.67 +/- 37.34) ms, (597.19 +/- 46.47) ms, (608.59 +/- 39.59) ms respectively, and also significantly longer than the control village of Dali (589.33 +/- 41.27) ms (P < 0.05). The typical pattern of U wave presents as enlarged U wave and apparent T-U complex. In the 7 residents who have the family history of unexplained sudden death, 6 residents have U wave, and 4 of them present typical U wave pattern.</p><p><b>CONCLUSION</b>The significant ECG changes in villages with high incidence of unexplained sudden death in Yunnan province were prolonged QTc, enlarged U wave and apparent T-U complex and these ECG features suggested the repolarization abnormalities of the heart in these subjects.</p>

Morphologic features of sudden cardiac death in Yunnan province, with emphasis on myocarditis / 中华病理学杂志

<p><b>OBJECTIVES</b>To study the pathologic feature of sudden cardiac death in Yunnan province and to investigate the role of myocarditis.</p><p><b>METHODS</b>During the period from 1991 to 2006, there were 29 cases of sudden cardiac death with autopsy performed. Fourteen of these cases were diagnosed to have myocarditis based on Dallas criteria and World Heart Federation's consensus. The clinical and pathologic findings were reviewed. The cardiac conduction system was examined in details by serial sectioning in 3 cases.</p><p><b>RESULTS</b>Fourteen cases suffered with myocarditis, which accounted for 48% of all cases of sudden cardiac death studied. The age of the deceased ranged from 8 to 68 years (mean = 30 years), with male-to-female ratio equaled to 9:5. Lymphocytic myocarditis and neutrophil myocarditis were the two major types, affecting 11 and 3 cases, respectively. The inflammatory infiltrates were often patchy rather than diffuse. The inflammatory foci were detected only in 8% to 42% (average = 20%) of the paraffin sections of the heart tissue. These lesions were usually located in the lateral wall of left ventricle and occasionally in interventricular septum and right ventricular wall. Myocardial injury was mild in most cases while patchy myocytolysis or coagulation necrosis was observed only in a few cases. Most of the lesions were relatively new and histologic evidence of myocardial repairing sometimes coexisted. Pericarditis and subacute endocarditis were also identified in 4 and 1 cases, respectively. Atrioventricular node was involved by myocarditis in 1 of the 3 cases examined for cardiac conduction system. Two cases showed gross evidence of cardiac dilatation (either left ventricle or biventricular). Respiratory tract and pulmonary infection was present in 5 cases.</p><p><b>CONCLUSIONS</b>Myocarditis represents one of the major pathologic changes of sudden cardiac death occurring in Yunnan province. The inflammation is usually focal. Further studies are required for delineation of possible etiologies which may include virus, bacteria or exogenous toxin.</p>