Preparation,characterization and in vitro cytotoxicity evaluation of hydroxycamptothecin-phospholipid complex / 国际药学研究杂志

Objective To prepare hydroxycamptothecin-phospholipid complex(HCPT-PC),characterize its physicochemi-cal properties,and evaluate the cytotoxicity. Methods The particle size and morphology of HCPT-PC were characterized by malvern particle size potentiometer,scanning electron microscopy(TEM)and transmission electron microscopy(TEM). Its composite mecha-nism was investigated by X-ray powder diffraction and infrared spectroscopy. The solubility and antitumor activity were also investigat-ed. Results The particle size of HCPT-PC was(145.08±18.37)nm. Scanning electron microscopy and transmission electron micros-copy revealed that HCPT-PC was uniformly distributed with a spherical shape. X-ray powder diffraction indicated that HCPT changed from crystalline to amorphous state in HCPT-PC. Fourier transform infrared spectroscopy showed that there was a weak interaction be-tween HCPT and PC. The solubility of HCPT-PC in water,PBS,ethanol and n-octanol was about 21.91,20.36,1.42 and 6.32 times than that of HCPT,respectively. After treated with HepG2,SMMC-7721 and H22 cells for 48 and 72 hours,IC50 of HCPT-PC was higher than that of HCPT by 3.57,11.14,2.79,37.26,21.23 and 24.49 times,respectively. Conclusion HCPT is compounded into an amorphous-state HCPT-PC by a weak interaction with the polar end of PC. Its solubility and anti-hepatocarcinoma activity are signif-icantly higher than HCPT.

Intensified Antiplatelet Treatment Reduces Major Cardiac Events in Patients with Clopidogrel Low Response: A Meta-analysis of Randomized Controlled Trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Clopidogrel low response (CLR) is an independent risk factor of adverse outcomes in patients undergoing percutaneous coronary intervention (PCI), and intensified antiplatelet treatments (IAT) guided by platelet function assays might overcome laboratory CLR. However, whether IAT improves clinical outcomes is controversial.</p><p><b>METHODS</b>Relevant trials were identified in PubMed, the Cochrane Library, and the Chinese Medical Journal Network databases from their establishment to September 9, 2014. Trials were screened using predefined inclusion criteria. Conventional meta-analysis and cumulative meta-analysis were performed using the Review Manager 5.0 and STATA 12.0 software programs.</p><p><b>RESULTS</b>Thirteen randomized controlled trials involving 5111 patients with CLR were recruited. During a follow-up period of 1-12 months, the incidences of cardiovascular (CV) death, nonfatal myocardial infarction (MI), and stent thrombosis were significantly lower in the IAT arm than in the conventional antiplatelet treatment arm (relative risk [RR] = 0.45, 95% confidence interval [CI]: 0.36-0.57, P < 0.000,01), whereas bleeding was similar between the two arms (RR = 1.05, 95% CI: 0.86-1.27, P = 0.65).</p><p><b>CONCLUSIONS</b>IAT guided by platelet function assays reduces the risk of CV death, nonfatal MI, and stent thrombosis (ST) without an increased risk of bleeding in patients undergoing PCI and with CLR.</p>

Effect of aspirin plus clopidogrel therapy on aspirin resistance after off-pump coronary artery bypass surgery / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effect of the anti-platelet effect of aspirin plus clopidogrel on off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy.</p><p><b>METHODS</b>Sixty patients who underwent standard OPCAB were randomized immediately after surgery in two groups: the aspirin alone group of 30 patients who received aspirin (100 mg) daily; and the combination group of 30 patients who received clopidogrel (75 mg) plus aspirin (100 mg) daily. Platelet aggregation in response to arachidonic acid (PLAA) and adenosine diphosphate (PLADP) were measured at baseline (before surgery) and 1-6, 8, and 10 days after the medication. Postoperative bleeding and other perioperative parameters were compared between these two groups.</p><p><b>RESULTS</b>There were no significant differences between the two groups in perioperative findings including average number of distal anastomosis, operative time, postoperative bleeding, ventilation time, and intensive care unit stay (all P>0.05). The proportion of patients with the PLAA above 20% value was significantly lower in the combination group than those in the aspirin alone group (32.1% vs 62.1%, P<0.05). PLAA of two groups one and two days after taking aspirin or plus clopidogrel were (24.2±31.9)% vs. (49.6±32.6)% and (13.8±27.2)% vs. (37.6±37.4)%, respectively (P<0.05). No obvious postoperative complication was noted in both groups. Multivariate analysis showed that clopidogrel administration was independently correlated with aspirin resistance (P=0.044, OR = 0.09;95% CI=0.07-0.48).</p><p><b>CONCLUSION</b>Early combined use of aspirin plus clopidogrel after OPCAB can remarkably reduce OPCAB-related aspirin resistance and enjoy similar safety.</p>

Initial experience of percutaneous coronary intervention guided by computed tomography coronary angiography derived roadmap and magnetic navigation system / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility, efficacy and safety of the percutaneous coronary intervention (PCI)guided by computed tomography (CT) coronary angiography derived roadmap and magnetic navigation system (MNS).</p><p><b>METHODS</b>During June 2011 and May 2012, thirty consecutive patients receiving elective PCI were enrolled, coronary artery disease was primarily diagnosed by dual-source CT coronary angiography (DSCT-CA) at outpatient clinic and successively proved by coronary artery angiography in the hospital. Target vessels from pre-procedure DSCT-CA were transferred to the magnetic navigation system, and consequently edited, reconstructed, and projected onto the live fluoroscopic screen as roadmap. Parameters including characters of the target lesions, time, contrast volume, radiation dosage for guidewire crossing, and complications of the procedure were recorded.</p><p><b>RESULTS</b>Thirty patients with 36 lesions were recruited and intervened by PCI. Among the target lesions, sixteen were classified as type A, 11 as type B1, 8 as type B2, 1 as type C. The average length of the target lesions was (22.0 ± 9.8) mm, and the average stenosis of the target lesions was (81.3 ± 10.3)%. Under the guidance of CT roadmap and MNS, 36 target lesions were crossed by the magnetic guidewires, with a lesion crossing ratio of 100%. The time of placement of the magnetic guidewires was 92.5 (56.6 - 131.3) seconds. The contrast volume and the radiation dosage for guidewire placement were 0.0 (0.0 - 3.0) ml and 235.0 (123.5 - 395.1) µGym(2)/36.5 (21.3 - 67.8) mGy, respectively. Guidewires were successfully placed in 21 (58.3%) lesions without contrast agent. All enrolled vessels were successfully treated, and there were no MNS associated complications.</p><p><b>CONCLUSIONS</b>It is feasible, effective and safe to initiate PCI under the guidance of CT derived roadmap and MNS. This method might be helpful for the guidewire placement in the treatment of total occlusions.</p>

Magnetic navigation system assisted percutaneous coronary intervention: a comparison to the conventional approach in daily practice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The benefits of the magnetic navigation system (MNS) for percutaneous coronary intervention (PCI) remain unclear, and a comparison of the MNS assisted approach to the conventional approach for PCI, when used in daily practice, is little studied. This study aimed to investigate the benefits of an MNS assisted technique as compared to the conventional technique for PCI.</p><p><b>METHODS</b>Forty-eight consecutive patients scheduled for PCI were recruited between December 2009 and April 2010. MNS assisted PCIs were performed on 54 target vessels. Another 45 patients with 54 target vessels undergoing conventional PCIs were selected from a historical population of patients to match the MNS group according to the coronary lesion type (ACC/AHA classification). Emergency PCIs and chronic total occlusions were excluded from both groups. Analyses were performed using Stata 9.2 statistical software.</p><p><b>RESULTS</b>There were no significant differences between the baseline characteristics of the MNS group and the control group. The success rates were 100.0% for the MNS assisted PCI and 98.1% for the conventional PCI, which did not reach a significant difference (P = 1.000); there were also no significant differences in terms of guide wire crossing time ((51.7 ± 30.5) seconds vs. (57.5 ± 49.4) seconds, P = 0.448), operation time ((28.4 ± 15.9) minutes vs. (28.0 ± 24.7) minutes, P = 0.935), X-ray exposure ((458.1 ± 350.1) µGym(2) vs. (558.7 ± 451.7) µGym(2), P = 0.197; and (94.2 ± 80.9) mGy vs. (96.2 ± 77.3) mGy, P = 0.895) or contrast usage ((7.3 ± 4.0) ml vs. (6.1 ± 3.7) ml, P = 0.121) between the two groups. However, a trend toward shorter guide wire crossing time and less X-ray exposure were observed for the magnetic group.</p><p><b>CONCLUSION</b>In daily practice, MNS assisted PCI resulted in a similar procedural success rate, operation time, and contrast usage, with a trend toward shorter guide wire crossing time and less X-ray exposure when compared to the conventional PCI.</p>

Clinical study on the coronary artery interventions guided by the magnetic navigation system / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of the magnetic navigation system used in the real world percutaneous coronary artery intervention.</p><p><b>METHODS</b>All lesions detected by the coronary artery angiography in the magnetic-navigation catheter lab indicated for percutaneous coronary artery intervention (PCI) were included and treated under the guidance of the magnetic navigation system. The characteristics of the target lesion, process of the procedure, time and dosage of the X-ray exposure, and procedure-related complication were recorded and analyzed.</p><p><b>RESULTS</b>One hundred and twenty one patients with 138 lesions were recruited and intervened by PCI during the period from April 2006 to June 2008. Thirty lesions were classified as type A, 50 as type B1, 36 as type B2, 22 as type C (including seven total occlusions). The average stenosis of the target lesions was (85.3 +/- 10.0)%, mean length was (21.1 +/- 10.0) mm. Under the guidance of the magnetic navigation system, 134 target lesions were passed by the magnetic guide-wires, the lesion passing ratio was 97.1%. The X-ray exposure time, X-ray dosage and the contrast volume used during the period of the wire placement were (55.9 +/- 35.4) seconds, (98.0 +/- 86.1) mGy/(490.0 +/- 422.2) microGym(2) and (8.0 +/- 5.4) ml, respectively. A total of 164 stents were implanted in the vessels where the target lesions were passed by the magnetic wires. There was no magnetic navigation system associated complication. Magnetic guide-wires failed to pass four target lesions, two of which were chronic total occlusions (CTOs), and the other two were calcified subtotal occlusions.</p><p><b>CONCLUSIONS</b>It is feasible and safe to adopt the magnetic navigation system for the real-world coronary artery intervention. The magnetic guide-wire possesses a high lesion-passing ratio. The CTOs and calcified subtotal occlusions are not ideal lesions for use of the magnetic navigation system.</p>

Psychological status in 1083 hospitalized patients with coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the prevalence and associated factors of anxiety and depression symptoms in hospitalized Chinese patients with coronary artery disease (CAD).</p><p><b>METHODS</b>From June 2007 to May 2009, 1083 hospitalized patients with confirmed coronary artery disease were recruited in this study. The ZUNG Self-rating Anxiety Scale (SAS) and the ZUNG Self-rating Depression Scale (SDS) were used for the psychological assessment. Economic status, living condition and the environment of both living and working places were evaluated by epidemiological questionnaires.</p><p><b>RESULTS</b>The prevalence of pure anxiety, pure depression symptoms and the combination of anxiety and depression symptoms were 7.9%, 28.3% and 14.3% respectively. Incidence of anxiety and depression symptoms was significantly higher in female patients compared with in male patients (P = 0.003, 0.012 respectively) and in aged patients than in middle-aged patients (P = 0.001). The elderly, less than 9 years of education and poor sleep quality increased the risk of anxiety symptom with ORs of 1.63 (95%CI: 1.21 - 2.21), 1.54 (95%CI: 1.15 - 2.07) and 1.62 (95%CI: 1.34 - 1.96), respectively, while workplace noise, history of chronic disease and poor sleep quality increased the risk of depression symptom with ORs of 1.52 (95%CI: 1.18 - 1.98), 1.36 (95%CI: 1.06 - 1.75) and 1.27 (95%CI: 1.08 - 1.50), respectively. Female (OR = 1.91, 95%CI: 1.22-2.98), aged patient (OR = 1.84, 95%CI: 1.23 - 2.76), workplace noise (OR = 1.61, 95%CI: 1.07 - 2.42), history of chronic disease (OR = 1.84, 95%CI: 1.24 - 2.71) and poor sleep quality (OR = 1.73, 95%CI: 1.35 - 2.21) were significantly correlated with the combined incidence of anxiety and depression symptoms.</p><p><b>CONCLUSION</b>Around half of the Chinese hospitalized CAD patients were complicated with various degrees of anxiety and/or depression symptoms. Female and aged patients were at higher risk for anxiety and depression symptoms. Sleep quality, workplace noise, years of education and history of chronic disease were independent risk factors for anxiety or depression symptoms.</p>

Effect of herbal tongxinluo on thrombus formation and neointimalhyperplasia of the balloon injured rabbit peripheral arteries / 中国临床药理学与治疗学

Aim The effect of herbal tongxinluo on the thrombus formation and neointimal hyperplasia of the balloon injured rabbit abdominal aorta and iliac artery was observed.Methods 36 New zealand rabbits were divided randomly into 3 groups:tongxinluo group (16 rabbits);aspirin group(11 rabbits) and control group(9 rabbits). The rabbits were treated with herb tongxinluo 0.38 g?kg-1?d-1, aspirin 50 mg?kg-1?d-1 and 0.09% natrium chloride 10 ml?d-1 alternatively. The arterial injury model was made 1 week after taking the medicine and the injured segments were taken at 24 hours,1 week or 1 month after the procedure, then the samples were stained by hematoxylin and eosin. The thrombus formation and the neointimal hyperplasia of the injured arteries were observed under microscope. Results The arterial neointimal hyperplasia was seen in both abdominal aorta and iliac artery 24 hours and 7 days after the balloon injury in each group, which led to stenosis in 5%～40% of the arterial lumen, the neointimal hyperplasia was much more significant in 2 rabbits 1 month after the balloon injury. The ratio of the arteries with thrombosis in aspirin group was less than that in the other 2 groups, but the difference was not significant. The ratio of neointimal hyperplasia in tongxinluo group was significantly less than that in aspirin and control groups. Conclusion The balloon injured rabbit abdominal aorta and iliac artery appeare to be an ideal model in researching restenosis after percutaneous transluminar coronary angioplasty (PTCA) . Herbal Tongxinluo significantly inhibit the neointimal hyperplasia of the balloon injured rabbit peripheral arteries, which indicate that herbal Tongxinluo might be a promising medicine in preventing restenosis.