RutecarpineAttenuatesVascularSmoothMuscleCellCalcificationviaSirt1 / 中山大学学报(医学科学版)

@#【Objective】ThisstudyaimstoinvestigatewhetherrutecarpinehasaneffectoncalcificationofVSMCand itsunderlyingmechanism.【Methods】InvitromodelofratVSMCcalcificationwasusedinthisstudy.Rutecarpineat differentconcentrationswasusedtotreatculturedratVSMC.Theexpressionof Runx2，BMP2 and Osterix wasanalyzed byqRT-PCRandmineraldepositionwasdetectedbyalizarinredstaining.Inaddition，weexaminedtheeffectofrutecar⁃ pineonSirtuin-1（Sirt1）expressioninVSMCandtheeffectofSirt1inhibitoronVSMCcalcification.【Results】Alizarinred stainingandcalciumcontentassayshowedthatrutecarpineatdifferentconcentrationssignificantlyreducedcalcificationof ratVSMCinducedbyhighphosphorusandhighcalcium（136±10，75±6，52±6，31±5.29，P<0.05）.Usageofrutecar⁃ pinedecreasedtheactivityofALP，anosteogenicdifferentiationmolecularmarker，anddown-regulatedtheexpressionof Runx2（2.85±0.25，1.75±0.18，1.62±0.13，1.36±0.16，P <0.05），BMP2（3.2±0.32，1.85±0.17，1.65±0.15，1.43± 0.12，P<0.05）andOsterix（2.60±0.27，1.82±0.16，1.55±0.15，1.36±0.17，P<0.05），suggestingthatrutecarpineinhib⁃ ited osteogenic differentiation of VSMC. In addition，high phosphorus and high calcium down-regulated the expres⁃ sionofSirt1inVSMC.qRT-PCRandwesternblotanalysisconfirmedthatrutecarpineup-regulatedtheexpressionof Sirt1atbothmRNA（0.35±0.06，0.75±0.11；0.22±0.08，0.87±0.13，P <0.05）andproteinlevels（0.38±0.09，0.71±0.13，P<0.05）.QuantificationofcalciumcontentanalysisshowedinhibitionofSirt1byEX-527blockedtheinhibitory effectofrutecarpineonVSMCcalcification（138±13，36±7，87±8，P<0.05） .【Conclusion】Wedemonstratethatrutecar⁃ pineattenuatesVSMCcalcificationviaup-regulationofSirt1.

Changes in serum level of carboxy-terminal telopeptide of type I collagen in patients with coronary heart disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the serum level of carboxy-terminal telopeptide of type I collagen (ICTP) and explore its correlation with MMP-2 and MMP-9 in patients with coronary artery disease (CHD).</p><p><b>METHODS</b>A total of 103 CHD patients treated in our hospital between October, 2013 and May, 2014 were enrolled, including 39 with stable angina pectoris (SAP), 39 with unstable angina (UA), and 25 with acute myocardial infarction (AMI), with 38 non-CHD volunteers as the control group. The serum levels of ICTP, MMP-2, and MMP-9 were detected in all the subjects using enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>No significant difference in serum levels of MMP-2, MMP-9, or ICTP was found between the control and SAP groups or between UA and AMI groups (P>0.05), but the latter two groups had significantly higher serum levels of MMP-2, MMP-9, and ICTP than the former two groups (P<0.05). Serum ICTP level was found to negatively correlated with the fibrotic area and positively with the lipid component in the plaques (P<0.05). Regression analysis revealed significant positive correlations of serum ICTP with MMP-2 and MMP-9 (P<0.05).</p><p><b>CONCLUSION</b>An elevated serum ICTP level is indicative of the presence of unstable plaques in CHD patients. Serum ICTP is more strongly correlated with MMP-2 than with MMP-9, and can be used as a non-invasive marker for assessing vulnerable plaques in patients with acute coronary syndrome.</p>

Left atrial size and function after radiofrequency catheter ablation for paroxysmal atrial fibrillation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the impact of radiofrequency catheter ablation on left atrial (LA) size and function in patients with paroxysmal atrial fibrillation (PAF) and whether there is any difference between segmental pulmonary vein ostial isolation (SPVI) and circumferential pulmonary vein ablation (CPVA).</p><p><b>METHODS</b>Sixty-six patients with highly symptomatic atrial fibrillation were assigned to undergo either SPVI or CPVA. Transthorax echocardiography was performed before, 1 day, 1 months and 3 months after the procedure. LA dimension, LA area, late diastolic peak velocity of mitral valve inflow (A) and peak atrial systolic mitral annulus velocity (A') were recorded.</p><p><b>RESULTS</b>Of 66 consecutive patients with symptomatic PAF, 30 patients underwent SPVI and 36 underwent CPVA. After a mean follow-up of (315 +/- 153) days, 21 patients (70%) after SPVI and 28 patients (75%) after CPVA were free of atrial tachyarrhythmia. As compared with the baseline, LA area decreased at 1-month after ablation in SPVI group and at 3-month in CPVA group. LA dimension decreased also in SPVI group, but did not in CPVA group. A velocity and A' velocity declined remarkably 1 day after CPVA, and restored 3 months later. The former went back to the level of baseline, and the latter exceeded it apparently. In SPVI group, A velocity increased at 1-month, and maintained in 3-month after ablation. A' velocity increased at 3-month after ablation. No reduction of A velocity or A' velocity was found after SPVI.</p><p><b>CONCLUSIONS</b>This study demonstrated a decrease in LA area and an improvement in LA systolic function 3 months after ablation for PAF. The LA damage by CPVA was more than that by SPVI, which was characterized by the reduction of LA function 1 day after procedure and the delayed improvement of LA size and functional parameters.</p>

Ablation of postoperative "incisional" reentrant atrial tachycardia and flutter in children using the CARTO system / 中华儿科杂志

<p><b>OBJECTIVE</b>In children with congenital heart diseases who have undergone surgical interventions, postoperative arrhythmias frequently complicate the clinical course. "Incisional" atrial tachycardia or flutter is one of the most common forms of postoperative arrhythmias in these patients and can lead to significant morbidity and even mortality. The aim of this study was to investigate how to use antiarrhythmic drugs and the CARTO system to treat these cases.</p><p><b>METHODS</b>There were 12 patients with "incisional" atrial tachycardia or flutter complicating surgery for congenital heart diseases in this study (3 patients with correction of tetrology of Fallot, 3 with atrial septal defect repair, 2 with ventricular septal defect repair, 1 with switch, 1 with repair of Ebstein's anomaly, 1 with total anomalous pulmonary venous drainage, and 1 with atrial septal closure with the Amplatzer septal occlusion). Patients whose body weight was less than 10 kg or those who did not wish to accept ablation were treated with antiarrhythmic drugs, including digitoxin, propranolol, metoprolol and cordarone. CARTO system was used to map 6 patients whose body weight was more than 10 kg and who agreed with accepting ablation for atrial tachycardia and flutter. Radio-frequency ablation was performed in these 6 cases including two cases of "incisional" atrial tachycardia and 4 of atrial flutter.</p><p><b>RESULTS</b>(1) The antiarrhythmic drug was successful in 6 patients with "incisional" atrial tachycardia. (2) Six patients including 2 children with "incisional" atrial tachycardia and 4 children with atrial flutter were successfully ablated. But one case of "incisional" atrial tachycardia relapsed after 3 months of ablation. This case, however, was successfully ablated again later. No further relapse was observed during the 2 - 24 months of follow-up.</p><p><b>CONCLUSION</b>Ablation of "incisional" atrial tachycardia and flutter is the first choice to treat the patients whose body weight is more than 10 kg and those who agree with accepting ablation by CARTO system. Drug therapy of "incisional" atrial tachycardia and flutter is palliative and it is the only selection to treat the patients whose body weight is less than 10 kg or those who do not wish to accept ablation procedure.</p>