A rare case of tricuspid valve thrombus with acute pulmonary embolism / 中华医学杂志(英文版)

The development of thrombus on the tricuspid valve is very rare. This report describes a case of acute pulmonary embolism (PE) with a mass on the tricuspid valve in a normal heart, detected by bedside transthoracic echocardiography (TTE). After successful surgical management, the histopathological examination revealed the mass from the tricuspid valve to be mixed thrombus. The early use of bedside TTE can facilitate the prompt diagnosis and aggressive therapy when PE is suspected.

Optimal time for human umbilical cord blood cell transplantation in rats with myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Cell therapy for cardiac regeneration is still under investigation. To date there have been a limited number of studies describing the optimal time for cell injection. The present study aimed to examine the optimal time for human umbilical cord blood cells (HUCBCs) transplantation after myocardial infarction (MI).</p><p><b>METHODS</b>The animals underwent MI by ligation of the left anterior descending coronary artery and received an intravenous injection of equal volumes of HUCBCs or phosphate buffered saline at days 1, 5, 10 and 30 after MI. HUCBCs were detected by immunostaining against human human leucocyte antigen (HLA). Cardiac function, histological analysis and measurement of vascular endothelial growth factor (VEGF) were performed 4 weeks after cell transplantation.</p><p><b>RESULTS</b>HUCBCs transplantation could improve cardiac function in rats that received transplantation at 5 and 10 days after MI. The best benefit was achieved in rats that received cells at 10-day after MI. Survival of engrafted HUCBCs, angiogenesis and VEGF expression were more obvious in the 10-day transplantation group than in the other transplantation groups. No evidence of cardiomyocyte regeneration was detected in any transplanted rats.</p><p><b>CONCLUSIONS</b>HUCBCs transplantation could improve cardiac function in rats that received HUCBCs at days 5 and 10 after MI with the optimal time for transplantation being 10 days post MI. Angiogenesis, but not cardiomyocyte regeneration, played a key role in the cardiac function improvement.</p>

The effect of radial artery on coronary bypass surgery in patients aged 65 years and older / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of autologous radial artery (RA) on coronary artery bypass grafting (CABG) in the elderly aged 65 years and older.</p><p><b>METHODS</b>Three hundreds and twenty-two patients aged 65 years and older underwent CABG with autologous RA from January 2000 to March 2007. Peri-operative complication and mortality were observed and follow-up was performed.</p><p><b>RESULTS</b>Three hundreds and forty-four RA grafts including 300 cases of single and 22 cases of bilateral RA were collected. The total number of distal anastomosis was 974, with the mean of (3.0 +/- 0.4). The mean of RA distal anastomosis was (1.1 +/- 0.4). There were 321 single, 16 Y or T composite and 7 sequential grafts of RA constructed. The distal end of RA was anastomosed to right coronary artery system for 234 times, to obtuse marginal for 95 times, to diagonal or intermediate ramous artery for 22 times. The proximal end of RA was anastomosed to aorta for 328 times, to left internal mammary artery for 9 times and to saphenous vein for 7 times. Only 13 patients manifested transient paresthesia in the area of radial aspect of thumb and no other complication occurred in the forearm. During hospitalization, 7 patients died. No patient died after the follow-up of (46.5 +/- 6.7) months. Seventy-three patients were performed with coronary angiography postoperatively. It was showed by coronary angiography that all RA conduits were patent after the duration of (47.5 +/- 11.2) months after CABG.</p><p><b>CONCLUSION</b>Utilization of RA to CABG in the elderly is safe and effective.</p>

Effects of carvedilol and metoprolol on cardiac fibrosis in rats with experimental myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of carvedilol and metoprolol on cardiac fibrosis in rats with experimental myocardial infarction (MI).</p><p><b>METHODS</b>MI was induced in male Sprague-Dawley rats by ligating the left coronary artery. Rats randomly received saline, carvedilol (10 mg.kg(-1).d(-1)) or metoprolol (20 mg.kg(-1).d(-1)) beginning at 4 weeks post MI for 8 weeks per gavage. Sham-operated rats serve as control. Collagen perivascular circumferential collagen area (PCVA), peri-coronary circumferential collagen area (VLCA) and interstitial collagen volume fraction (ICVF) as well as myocardial hydroxyproline content were determined after hemodynamic measurements at the study end.</p><p><b>RESULTS</b>LVEDP were significantly lower and +/- dp/dt significantly higher in carvedilol and metoprolol treated MI rats than that in saline treated MI rats. Myocardial hydroxyproline, PCVA/VLCA ratio and ICVF were significantly reduced in metoprolol, more significantly reduced in carvedilol treated MI rats compared to saline treated MI rats (all P < 0.05).</p><p><b>CONCLUSION</b>Metoprolol and carvedilol could decrease the concentration of hydroxyproline and ICVF in MI rats.</p>

Effects of aldosterone on inducible nitric oxide synthase/nitric oxide pathway in aortic adventitia / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the effect and related mechanisms of aldosterone (ALD) on inducible nitric oxide synthase (iNOS) activity and nitric oxide (NO) production in aortic adventitia.</p><p><b>METHODS</b>Aortic adventitias from SD rats were incubated for 6 hours with various protocols: buffer alone (control), ALD (10(-8) mol/L - 10(-6) mol/L), ALD + spironolactone (10(-5) mol/L, ALD + SP), ALD + RU486 (10(-5) mol/L), LPS 10 ng/ml (LPS), ALD + LPS (10 ng/ml), ALD + LPS + SP (10(-5) mol/L), and ALD + LPS + RU486. Nitrate/nitrite (NOx), an index of NO production, was measured by Greiss Reaction. iNOS activity was determined by isotope-labeled L-arginine convertion rate.</p><p><b>RESULTS</b>(1) NOx production and iNOS activity were similar between ALD and control groups (P > 0.05). NOx production was significantly reduced while iNOS activity remained unchanged in the ALD (10(-6) mol/L) + SP group compared to ALD (10(-6) mol/L) group. NOx production by 10(-7) mol/L and 10(-6) mol/L ALD increased by 50.0% and 58.7% respectively (P < 0.01) and iNOS activity was also significantly increased (P < 0.01) in ALD + RU486 group than that in ALD group. (2) LPS significantly increased the NOx production and iNOS activity (P < 0.01) and these effects were not augmented by adding ALD to LPS (P > 0.05) and SP significantly blocked and RU486 significantly enhanced the effects by LSP and ALD on NOx production and iNOS activity (P < 0.05).</p><p><b>CONCLUSION</b>Aldosterone has a dual effect on iNOS/NO through mineralocorticoid receptor and glucocorticoid receptor pathway.</p>

Efficacy of intravenous aspirin use in patients with acute coronary syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the efficacy of intravenous versus oral aspirin use in patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>ACS patients were randomly treated with intravenous aspirin (300 mg/d, IA, n = 30), low oral aspirin (100 mg/d, OA1, n = 32) or high oral aspirin (300 mg/d, OA2, n = 33). Aspirin sensitivity was tested by optical platelet aggregation using adenosine diphosphate (ADP) and arachidonic acid (AA). The serum CD62p contents were examined by Flow cytometry.</p><p><b>RESULTS</b>Platelet aggregation expressed as ratio of reduction of ADP and AA post various aspirin were similar among 3 groups [IA: ADP (12.0 +/- 10.4)%, AA (6.7 +/- 11.2)%; OA1: ADP (6.0 +/- 14.6)%, AA (6.9 +/- 12.3)%; OA2: ADP (9.4 +/- 16.6)%, AA (7.3 +/- 13.0)%, all P > 0.05]. CD62p decreasing level post various aspirin were also similar among groups [IA: (10.9 +/- 18.6)%, OA1: (9.0 +/- 11.8)%, OA2: (7.1 +/- 15.7)%, all P > 0.05]. Side-effects and MACE post various aspirin use were comparable among groups.</p><p><b>CONCLUSION</b>Inhibiting efficacy on platelets function by intravenous aspirin (300 mg/d) was comparable to that of by oral aspirin (100 mg/d, 300 mg/d) in patients with acute coronary syndrome and could be used as an alternative route for patients who can't take oral aspirin.</p>