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<p><b>Background</b>Our previous studies have shown that Tongxinluo (TXL), a compound Chinese medicine, can decrease myocardial ischemia-reperfusion injury, protect capillary endothelium function, and lessen cardiac ventricle reconstitution in animal models. The aim of this study was to illuminate whether TXL can improve hypercholesterolemia-impaired heart function by protecting artery endothelial function and increasing microvascular density (MVD) in heart. Furthermore, we will explore the underlying molecular mechanism of TXL cardiovascular protection.</p><p><b>Methods</b>After intragastric administration of TXL (0.1 ml/10 g body weight) to C57BL/6J wild-type mice (n = 8) and ApoE-/- mice (n = 8), total cholesterol, high-density lipoprotein-cholesterol, very-low-density lipoprotein (VLDL)-cholesterol, triglyceride, and blood glucose levels in serum were measured. The parameters of heart rate (HR), left ventricular diastolic end diameter, and left ventricular systolic end diameter were harvested by ultrasonic cardiogram. The left ventricular ejection fraction, stroke volume, cardiac output, and left ventricular fractional shortening were calculated. Meanwhile, aorta peak systolic flow velocity (PSV), end diastolic flow velocity, and mean flow velocity (MFV) were measured. The pulsatility index (PI) and resistant index were calculated in order to evaluate the vascular elasticity and resistance. The endothelium-dependent vasodilatation was evaluated by relaxation of aortic rings in response to acetylcholine. Western blotting and real-time quantitative reverse transcription polymerase chain reaction were performed for protein and gene analyses of vascular endothelial growth factor (VEGF). Immunohistochemical detection was performed for myocardial CD34 expression. Data in this study were compared by one-way analysis of variance between groups. A value of P < 0.05 was considered statistically significant.</p><p><b>Results</b>Although there was no significant decrease of cholesterol level (F = 2.300, P = 0.240), TXL inhibited the level of triglyceride and VLDL (F = 9.209, P = 0.024 and F = 9.786, P = 0.020, respectively) in ApoE-/- mice. TXL improved heart function of ApoE-/- mice owing to the elevations of LVEF, SV, CO, and LVFS (all P < 0.05). TXL enhanced aortic PSV and MFV (F = 10.774, P = 0.024 and F = 11.354, P = 0.020, respectively) and reduced PI of ApoE-/- mice (1.41 ± 0.17 vs. 1.60 ± 0.17; P = 0.037). After incubation with 10 μmol/L acetylcholine, the ApoE-/- mice treated with TXL aortic segment relaxed by 44% ± 3%, significantly higher than control group mice (F = 9.280, P = 0.040). TXL also restrain the angiogenesis of ApoE-/- mice aorta (F = 21.223, P = 0.010). Compared with C57BL/6J mice, the MVD was decreased in heart tissue of untreated ApoE-/- mice (54.0 ± 3.0/mmvs. 75.0 ± 2.0/mm; F = 16.054, P = 0.010). However, TXL could significantly enhance MVD (65.0 ± 5.0/mmvs. 54.0 ± 3.0/mm; F = 11.929, P = 0.020) in treated ApoE-/- mice. In addition, TXL obviously increased the expression of VEGF protein determined by Western blot (F = 20.247, P = 0.004).</p><p><b>Conclusions</b>TXL obviously improves the ApoE-/- mouse heart function from different pathways, including reduces blood fat to lessen atherosclerosis; enhances aortic impulsivity, blood supply capacity, and vessel elasticity; improves endothelium-dependent vasodilatation; restraines angiogenesis of aorta-contained plaque; and enhances MVD of heart. The molecular mechanism of MVD enhancement maybe relate with increased VEGF expression.</p>
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Objective To compare the complete ablation rate of radiofrequency (RF) ablation and high-intensity focused ultrasound (HIFU) in the treatment of uterine ifbroids with different blood supply. Methods One hundred and ten patients with 146 uterine ifbroids in Xijing Hospital of the Fourth Military Medical University from January 2009 to December were randomly divided into two groups and treated with HIFU or RF respectively. Each group had 55 patients. All patients were examined by color Doppler lfow imaging before the treatment. The blood supply of ifbroids were semi-quantitatively classiifed into three grades including G1, G2 and G3. The HIFU group had 15 patients with 20 ifbroids in which blood supply was G1, had 32 patients with 38 ifbroids in which blood supply was G2, and had 8 patients with 10 ifbroids in which blood supply was G3. The RF group had 14 patients with 18 ifbroids in which blood supply was G1, had 31 patients with 42 ifbroids in which blood supply was G2, and had 10 patients with 18 ifbroids in which blood supply was G3. The complete ablation rates of the two treatments were evaluated by contrast-enhanced ultrasound one week before and after treatments. Fibroids which had no contrast agent perfusion and smooth boundary were completely ablated. Statistical analyses were used to compare the complete ablation rates and postoperative complications rates of these two methods. Results When ifbroid′s blood supply was G1, the complete ablation rate was 80.0%(16/20) and 88.9%(16/18) in HIFU and RF group, respectively. The difference was not statistically signiifcant (χ2=0.563, P>0.05). When ifbroid′s blood supply was G2 and G3, the complete ablation rate in HIFU and RF group was 90.5%(38/42) vs 55.3%(21/38) and 72.2% (13/18) vs 20.0% (2/10), respectively. There was statistically difference between these two groups (χ2 =12.778, P < 0.05;χ2=7.049, P < 0.05, respectively). Postoperative complications included fever, abdominal pain, pelvic effusion and vaginal discharge and unilateral lower limb numbness. The incidence of complications was lower in HIFU group than that in RF group, which was 9.1%(5/55) and 27.3%(15/55) respectively, This difference was statistically signiifcant (χ2=6.111, P<0.05). Conclusions HIFU and RF are both effective in treating uterine ifbroids with few blood supply. However, RF can be more effective than HIFU in treating hypervascular ifbroids. Therefore, RF might be able to apply to majority of the ifbroids. As a non-invasive therapy, HIFU is more suitable for hypovascular ifbroids and could be the ifrst therapy in clinic.