Outcome and Influencing Factor Analysis for Graft Vessels in Patients After Coronary Artery Bypass Grafting / 中国循环杂志

Objective: To investigate the outcome and inlfuencing factors of graft vessels including saphenous vein graft (SVG) and left internal mammary artery graft (LIMAG) in patients after coronary artery bypass grafting (CABG). Methods: A total of 92 patients with post-CABG symptom recurrence from 2010 to 2015 were analyzed by angiography and clinical features for their native coronary vessel and graft vessel. There were 83 male and 9 female patients with the mean age of (62.6±10.8) years. The outcomes of graft vessel were assessed; correlation study was conducted between SVG, LIMAG lesions and traditional atherosclerosis risk factors like age, gender, hypertension, hyperlipidemia, diabetic mellitus, smoking, family history of coronary artery disease (CAD) with other clinical factors such as the time of angina recurrence, thetime from coronary angiography (CAG) to CABG, type of SVG (sequential graft or individual graft), the features of native target vessel lesions prior grafting. Results: The average time from CABG to symptom recurrence was (35.10±24.7) months. There were 146 grafts including 52 LIMAG and 94 SVG (60 individual and 34 sequential grafts), the patency rate of LIMAG was higher than SVG (63.5% vs 44.7%),P=0.030. SVG lesion was positively related to symptom recurrence (OR=1.119, 95% CI 1.002-1.249,P=0.046) and trended to female gender (P=0.065), while not related to other clinical factors; LIMGA lesion was not related to any clinical factors. The patency rate of sequential SVG was higher than individual SVG (58.9% vs. 36.7%,P=0.038). The native target vessel lesion (deifned by pre-operative occlusion/stenosis) was similar between individual SVG group (24/14) and no-lesion SVG group (17/5),P=0.388; while the native target vessel lesion in LIMAG group (7/12) was lower than no-lesion LIMAG group (23/10),P=0.04. Conclusion: Post-CABG lesion was not obviously related to traditional risk factors of CAD, post-SVG lesion was positively related to the time of post-CABG angina recurrence. SVG mid-and long-term patency in sequential graft vessel was higher than that in individual graft vessel. Pre-CABG native coronary blood lfow would affect the outcome of individual LIMAG but not SVG.

Allogeneic bone marrow mesenchymal stem cell transplantation for acute myocardial infarction in rats / 中国组织工程研究

BACKGROUND:A number of studies have shown that bone marrow mesenchymal stem cells can survive in the infarcted myocardium and improve cardiac function. OBJECTIVE:To investigate the effects of al ogeneic rat bone marrow mesenchymal stem cells on heart failure in acute myocardial infarction models of rats and possible mechanisms. METHODS:Rat bone marrow mesenchymal stem cells were isolated from the bone marrow of 39 male Wistar rats by density gradient centrifugation with Percol . After ligating anterior descending coronary artery, 39 female Wistar rats were randomly divided into three groups:control group (Dulbecco’s modified Eagle’s medium, n=12), mesenchyma stem cells group (n=15) and mononuclear cells group (n=12). Eight weeks later, hemodynamics and left ventricular function were measured. Histopathological and immunohistochemical examinations were performed. RESULTS AND CONCLUSION:Compared with the control group, left ventricular end diastolic pressure, left ventricular relative weight, the col agen volume fraction of type I and type III in the infarction zone of the left ventricle were al significantly decreased, in contrast to ±dp/dtmax,-dp/dtmax/left ventricular systolic pressure, body weight and vascular density in infarction zone were al significantly increased both in mesenchymal stem cells group and mononuclear cells group. There were no significant differences between two treatment groups except for interventricular septal thickness and vascular density in non-infarction zone. 5-Bromo-2'-deoxyuridine positive cells were observed in the infarction area of mesenchyma stem cells group but no positive cells in mononuclear cells group. Some bal-like cellmasses were found positively stained with desmin and cardiac troponin T. Results have suggested that embedded bone marrow mesenchymal stem cells survived in exogenous host hearts. The therapy of mononuclear cells and mesenchymal stem cells could limit the left ventricular remodeling after acute myocardial infarction and improve left ventricular function through angiogenesis inducing and col agen deposition decreasing.

The cardiac function changes before and after pituitary tumor resection in patients with pituitary adenoma complicated with dilated cardiomyopathy / 中华内科杂志

Objective To evaluate the cardiac function changing before and after resection of pituitary tumor in patients with pituitary adenoma complicated with dilated cardiomyopathy with retrospective analysis method.Methods The clinical data of 14 cases of patients with pituitary adenoma complicated with dilated cardiomyopathy,treated with resection of pituitary tumor,in PLA General Hospital,from 2005 to 2011,were collected and analyzed.Comparative analysis of cardiac function were made in these patients before and after the surgery,also with the postoperative recovery status,using echocardiography and other noninvasive detection means to detect the growth hormone ( GH),left ventricular end-diastolic diameter (LVEDD),septal thickness (ST),left ventricular posterior wall thickness (LVPWT),left ventricular ejection fraction (LVEF) values.Results After the resection of pituitary tumor,the LVEDD,ST,LVPWT,LVEF levels were all significantly better than that before the surgery.Before the surgery the GH,ST,LVPWT,LVEF levels were 93.89 μg/L,11.13 mm,43.92％ and 10.53 mm,while those after the surgery were 5.16 μg/L,10.64 mm,49.28％ and 8.87 mm.The difference of the GH level before and after the surgery was correlated with the difference of ST,LVEDD and LVEF in a linear manner.Conclusions Recection of pituitary tumor can significantly improve the cardiac function in patients with pituitary adenoma complicated with dilated cardiomyopathy,and the cardiac function improving level is correlated with the difference of GH levels before and after the surgery.

Effect of phosphocreatine on transient outward potassium current in ischemic ventricular mid-myocardial cells of rats / 中国病理生理杂志

AIM: To determine the effect of exogenous phosphocreatine (PCr) at different concentrations on transient outward potassium (Ito) current in rat ischemic ventricular mid-myocardial (M) cells and to explore the antiarrhythmia mechanism in the treatment of ischemic heart disease. METHODS: M cells were isolated enzymatically from left ventricular mid-myocardium of rats. Peak Ito current was recorded by patch-clamp technique in the whole-cell configuration when M cells were superfused with normal Tyrode solution,simple ischemic solution,and simulated ischemic solution containing PCr at concentrations of 5,10,20 and 30 mmol/L for 10 min. RESULTS: Peak Ito current density of M cells superfused with simple simulated ischemic solution was significantly reduced by (76.1±6.3)% (P0.05). CONCLUSION: PCr reverses the inhibition of Ito current under ischemic condition in M cells,which may be the mechanism responsible for arrhythmia prevention in ischemic heart disease. PCr at concentrations of 0～10 mmol/L exerts significant dose-effect relationship.

Cardiac Function in Patients with Myocardial Infarction Treated with Spironolactone: A Doppler Tissue Imaging Study / 中国康复理论与实践

@#ObjectiveTo study the effects of anti-aldosterone on left ventricular function in patients with myocardial infarction. Methods130 patients with myocardial infarction were divided into anti-aldosterone group (spironolactone 20～40 mg/d + enalapril 10～20 mg/day, n=61) and control group (enalapril 10～20 mg/d, n=69). The echocardiogram and Doppler tissue imaging (DTI) were performed at enrolling time, and 6, 12 months after treatment. ResultsIn the anti-aldosterone group, the average mitral systolic wave (s) was significantly increased 6 months after treatment （P<0.05） to the enrolling time. LVEF and LVEDD improved 12 months after treatment （P<0.05）. In the control group, the average mitral systolic wave, LVEDD and LVEF did not significantly improve (P>0.05). Ratio of peak early to late diastolic filling velocity (e/a) was no significantly different between the anti-aldosterone group and the control group. ConclusionThe combination of anti-aldosterone and ACEI in patients with myocardial infarction can improve the left ventricular systolic function after 6 and 12 months, but cannot to the diastolic function.

Relationship between Plasma Thyrotropin and Brain Natriuretic Peptide in Elderly Patients with Diastolic Heart Failure / 中国康复理论与实践

@#ObjectiveTo investigate the relationship between thyrotropin (TSH) levels and B-type natriuretic peptide (BNP) in elderly patients with diastolic heart failure (DHF). MethodsPlasma levels of TSH and BNP were measured in 93 elderly patients diagnosed DHF clinically. ResultsThe BNP was (1011.07±238.27) pg/ml and (769.36±169.55) pg/ml in patients with high TSH level（>5.5 μIU/ml, n=46) and normal TSH level (0.35～5.5 μIU/ml, n=47) (P<0.05), respectively. ConclusionHigh TSH levels might promote the plasma BNP secretion in elderly patients with diastolic heart failure.

N-terminal pro-brain natriuretic peptide but not high-sensitivity C-reactive protein is related to severity of coronary artery stenosis in patients with acute coronary syndrome / 老年心脏病学杂志（英文版）

Objective Biochemical indicators such as N-terminal pro-brain type natriuretic peptide(NT pro-BNP)and high-sensitivity Creactive protein(hsCRP)predict mortality in acute coronary syndrome(ACS).However,little is known about the relationship of these factors with severity of coronary artery stenosis in patients with.Methods Three hundred and thirty-one subjects including 246 unstable angina pectoris patients and 85 myocardial infarction patients were recruited and classified into two groups:single-vessel disease group(1-vessel disease,n=93)and multiple-vessel disease group(≥2-vessels disease,n=238)according to selective coronary angiography.Plasma levels of NT pro-BNP and hsCRP were measured and severity of coronary stenosis was determined by Gensini score.Results NT pro-BNP but not hsCRP level was higher in patients with myocardial infarction than in patients with unstable angina pectoris.The patients with multiple-vessel disease had significantly higher NT pro-BNP level but not hsCRP compared with those with single-vessel disease.NT pro-BNP levels increased significantly as left ventricle(LV)function decreased,and only NT proBNP but not hsCRP level was related to Gensini score of severity of coronary stenosis in ACS.Conclusion NT proBNP but not hsCRP level is related to severity of coronary artery stenosis in patients in ACS.

Clinical analysis of recent prognosis of elderly inpatients at different ages with acute myocardial infarction / 中华老年医学杂志

Objective To investigate the influence of age on recent prognosis of elderly inpatients with acute myocardial infarction (AMI).Methods A total of 2535 inpatients with AMI were divided into different age groups.The influences of age and coexistent diseases on prognosis in AMI patients were analyzed retrospectively.Results The hospital mortality and 30-day mortality were higher in patients aged ≥80 years compared with patients aged 65-79 years and patients aged 60-64 years(χ2 =46.378,P<0.01 ;χ2 = 44.534, P<0.01).In 60-64 years old patients with AMI, the prevalences of old myocardial infarction (OMI), renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group (all P<0.05).In 65-79 years old patients with AMI, the prevalences of OMI, hypertension, diabetes,cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).In 80-94 years old patients with AMI, the prevalences of OMI, diabetes, cerebrovascular disease, renal insufficiency, respiratory insufficiency were higher and the prevalence of angina pectoris was lower in death group than in survival group(P<0.05).The prevalences of OMI, hypertension, diabetes, cerebrovascular disease,respiratory insufficiency were significantly increased in 80-94 years old death group versus 60-64 and 65-79 years old death group(all P<0.05).Conclusions The mortality rate of elderly patients with AMI is increased with age and atypical angina pectoris should be paid more attention in these patients.

Effect of Hepatocyte Growth Factor on Mitral Regurgitation Caused by Acute Myocardial Infarction in Canines / 中国康复理论与实践

@#Objective To investigate the effect of hepatocyte growth factor (HGF) on mitral regurgitation caused by acute myocardial infarction in canines.Methods The acute myocardial infarction model was established by ligating proximal left anterior descending coronary artery (LAD) with 13 hybrid canines. The myocardial infarction model was successfuly established in 12 animals and those were randomly divided into the HGF-group and control group with 6 animals in each group. Canines of the HGF-group were injected with pc-DNA3-HGF 1 ml (about 300 μg) at the margin of infarcted myocardial and animals of the control group were injected with equal volume saline. The data were measured through echocardiography in the 1st, 4th and 8th week after ligation as following parameters: left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left atrial area, mitral regurgitation area and the ratio of left atrial area to mitral regurgitation area. Left ventricular myocardium specimens were obtained in the 8th week after ligation and stained with hematoxylin and eosin for histological examination or with picrosirius red staining to assess the collagen content.Results Compared with the control group, LVEF in the HGF-group increased in the 4th week after ligation; LVEF significantly improved and LVESV decreased in the 8th week after ligation ( P<0.05). In the 8th week after ligation, left atrial area, mitral regurgitation area and the ratio of left atrial area to mitral regurgitation area in the HGF-group were lower than that in the control group. In the HGF-group, neovascularization and fewer scars were observed histologically. Compared with the control group, the HGF-group showed higher capillary density in margin of infarcted area by factor Ⅷ-related immunohistochemistry staining ( P<0.01).Conclusion HGF gene can improve cardiac function and relieve mitral regurgitation after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, diminishing myocardiolysis and scarring.

Effects of Combination Therapy of Probucol and Atorvastatin on Adjusting Lipids in Spontaneously Hypertensive Rat with High Lipids Diet / 中国康复理论与实践

@#Objective To evaluate the effects of combination therapy of probucol and atorvastatin on adjusting lipids.Methods 92 spontaneously hypertensive rats(SHR) were randomly divided into the group C(control group) fed with normal diet and normal saline(NS),and group M,group A,group P and group P+A all fed with high lipids diet.At the same time,group M was added with NS,group P with probucol(150 mg/kg/day),group A with atorvastatin(10 mg/kg/day),and group P+A with probucol(150 mg/kg/day) plus atorvastatin(10 mg/kg/day).After 8 weeks,all rats were killed.The total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),glutamic-pyruvic transaminase(GPT) and glutamic-oxal(o)acetic transaminase(GOT) were measured respectively before and after experiment.Results The serum levels of TC,LDL-C,HDL-C in every group with high lipids diet were obviously higher than baseline data(P<0.01),but TG level decreased.The serum levels of TC and LDL-C in the group P,group A and group P+A were significantly lower than that in the group M(P<0.01),especially in the group P+A.The serum level of HDL-C in the group P+A was obviously lower than that in the group M and group A(P<0.01).The serum levels of TG in the group P+A and group A were significantly lower than that in the group M(P<0.01),and that in the group P+A was lower than that in the group P(P<0.05).The serum levels of GPT and GOT in every group with high lipids diet(especially in the group M) were higher than ever(P<0.01),and that in the group P+A was obviously lower than that in the group A(P<0.01).Conclusion High lipids diet may due to the disorder of serum lipids and liver dysfunction.Combination therapy of probucol and atorvastatin can strengthen the effects on adjusting lipids,furthermore the effects are stronger than that of monotherapy.Combination therapy may reduce the hepatic damage that high lipids diet duo to,and decrease the hepatic negative effects of atorvastatin.

Effect of Blood Glucose Levels on Lipid-lowering Therapy in Patients with Myocardial Infraction / 中国康复理论与实践

@#Objective To investigate the effect of blood glucose levels on lipid-lowering therapy in patients with myocardial infraction (MI).Methods The data of 174 patients with acute or old MI and finished a two-year follow-up were analyzed retrospectively. The patients were divided into four groups: diabetes mellitus (DM) with well blood glucose control (DM+W group), diabetes mellitus with bad blood glucose control (DM+B group), non-diabetes mellitus with well blood glucose control (NDM+W group) and non-diabetes mellitus with bad blood glucose control (NDM+B group). Blood lipids levels, dose and side effects of statins were statistically analyzed.Results All the 174 patients had a mean follow-up period of 28±7 months, and 51 patients (25.9%) had diabetes mellitus. In DM+B group (n=13, 25.5%) and NDM+B group (n=24, 19.5%), there were no statistically difference between enrollment and 2-year follow-up in the mean levels of blood total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c), but the mean level of LDL-c had a trend of elevation. In DM+W group, the mean level of LDL-c was 2.57 mmol/L at 2-year follow-up, which did not achieve the recommended LDL-c goal (2.06 mmol/L). There were no differences in statin therapy between each group. After 2-year follow-up, there were only 93 patients (53.4%) received normal dose of statin, 60 patients (34.5%) took low dose of statin and 16 patients (9.2%) had no statin therapy. There were no differences in hepatic enzyme abnormality between each group.Conclusion The bad control of blood glucose in patients with MI effect the efficacy of statins in lipid-lowering therapy. The doses of statin are insufficient especial in patients with MI and DM.

Feasibility of Hydration Treatment During Perioperative Period of Interventional Therapy for Gerontic Patients with Coronary Heart Disease Complicated by Chronic Renal Insufficiency / 中国康复理论与实践

@#Objective To investigate the safety and efficacy of protective measures(hydration treatment)during perioperative period of interventional therapy for renal function of gerontic patients with coronary artery disease(CAD)complicated by chronic renal insufficiency(CRI).Methods The relation between hydration therapies and the renal function of 168 CAD patients(≥60 years old)complicated by CRI were analyzed.These patients were divided into three groups:in the group A,patients underwent selective coronary angiography(SCA)with conventional treatment during interventional perioperative period(IPP);in the group B,patients underwent SCA and treated with the NaCl plus low dose NaHCO3 during IPP;in the group C,patients underwent percutaneous coronary intervention(PCI),and meanwhile treated with the same dose NaCl and NaHCO3 as the group B during IPP.Results Coronary interventions were successful in all 168 patients.Contrast medium associated nephropathy(CAN)was found in 30 patients,and incidences of the CAN were 17(27.4%)in the group A,3(7.5%)in the group B and 10(15.2%)in the group C,respectively.The accompanying diseases and characteristics of the patients also effected the incidence of CAN:the CAN incidence of patients with hyperlipidemia was significantly higher than that with normal cholesterol(P<0.001);patients with diabetes was significantly higher than that with normal serum glucose(P<0.001);patients with stenosis of renal artery was significantly higher than that with normal renal artery(P<0.001);patients with heart failure(grade Ⅲ～Ⅳ)was significantly higher than that with the grade Ⅰ～Ⅱ(P<0.001).Conclusion The hydration treatment with the NaCl plus low dose NaHCO3 during IPP can protect renal function and increase tolerance for gernotic CAD patients complicated by CRI during IPP,and improve prognosis.

Complications following paclitaxel-eluting stent implantation:6-month follow-up / 中国组织工程研究

BACKGROUND:The safety and efficacy of paclitaxel-eluting stents (Taxus DES) has been proved by international researchers in clinic investigations.Based on further inclusion criteria,the incidence of in-stent restenosis is still lower than that of bare-metal stent.OBJECTIVE:TO observe restenosis of Taxus DES and the effect on local vessels through applying the follow up of coronary angiography and to investigate the biocompatibility of stent and host.DESIGN:Following-up observation.SETTING:Department of Cardiology,General Hospital of Chinese PLA.PARTICIPANTS:A total of 297 patients who had undergone coronary Taxus DES implantation for coronary artery disease were selected from Cardiovascular Department of General Hospital of Chinese PLA from May 2003 to May 2005.There were 265 males and 32 females and their ages ranged from 36 to 76 years.All patients provided informed consent,and the experiment had got confirmed consent from local ethic committee.METHODS:All patients were implanted Taxus DES and received the follow up within 6 and 12 months.In addition,at 6 months after operation,coronary angiography was used to measure the reference vessel diameter (RVD) and the minimal lumen diameter(MLD),calculate diameter restenosis rate and observe late loss.MAIN OUTCOME MEASURES:Coronary angiography at 6 months after Taxus DES implantation and biocompatibility of stent and host.RESULTS:①Quantitative angiographic analysis(QCA):Angiographic follow-up showed that the late loss of in-stent was significantly higher than that of pro-in-lesion and dis-in-lesion(P＜0.05).②Coronary angiography in-stent restenosis:In 134 angiographic follow-up patients,a total of 14 patients experienced restenosis,and the incidence was 10.4%(14/134).The patterns of restenosis were diffuse in-stent in 7 patients and the rate of revascularization was 6.7%.③Stent aneurysm:Angiographic evidence of aneurysm was observed in one patient among follow-up cases,and the rate of which was 0.75% (1/134).④Clinic follow-up major adverse cardiac events(MACE):Among 297 patients,one patient was attracted sudden death 5 months after intervention (0.34%; 1/297),and one patient was suffered subacute thrombosis 5 days after stent implant (0.34%;1/297),and late thrombosis occurred in 2 patients.The general rate of MACE was 1.35%.CONCLUSION:①The late loss of Taxus DES mainly takes place in in-stent.The patterns of restenosis of Taxus DES are in majority of diffuse in-stent,and the incidence of MACE is low.②Taxus DES possibly results aneurysm in local vessels.The follow up indicates that Taxus DES has a good biocompatibility to patients.

Establishment of atherosclerosis models induced by feeding high-fat diet plus arterial intimal injury of the ventral aorta with balloon in rabbits / 中国组织工程研究

BACKGROUND:Studies regarding atherosclerosis models preparation commonly established by feeding high-fat diet or arterial intimal injury to healthy or hyperlipoidemia animals.OBJECTIVE:To establish atherosclerosis models induced by feeding high-fat diet combined with arterial intimal injury of ventral aorta with balloon.DESIGN,TIME AND SETTING:A comparative observation experiment was performed at the Animal Experimental Center of Chinese PLA General Hospital from January to March 2007.MATERIALS:Twenty New Zealand rabbits were randomly divided into high-fat diet,and high-fat diet combined with arterial intimal injury groups,with 10 animals in each group.High-fat diet was composed of common forage,4% cholesterol,10% pork fat and 10% egg yolk powder.METHODS:Rabbits in the high-fat diet group were fed with high-fat diet.Animals in the high-fat diet combined with arterial intimal injury group were underwent operation of sacculus injury after fed with high-fat diet for 4 weeks.MAIN OUTCOME MEASURES:Arteriae aorta was harvested after 12 weeks of operation and received pathological examination,thickness ratio of fatty streak and plaque,intima,and tunica media was calculated.Serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL) and low density lipoprotein cholesterol(LDL) was measured.RESULTS:After 12 weeks,the levels of TC,TG,HDL and LDL were increased,which was more obviously in the high-fat diet combined with arterial intimal injury group(P

Effective treatment and optimal prognosis of peripheral artery disease / 中国组织工程研究

OBJECTIVE: Newer medicine therapies have been proved efficacy in patients with intermittent claudication. With rapid advances of intervention devices and techniques for peripheral vessels in recent years, which has improved the therapy of peripheral artery disease (PAD). To review the clinical developments in treatment of PAD so as to provide references for optimal integrated therapy of medicine with proper interventional treatment, which enable PAD patients to achieve the greatest long-term prognosis. DATA SOURCES: A computer-based search for literatures related to PAD from 1991 to April 2006 was conducted in Medline databasewith the of "peripheral arterial disease, catheterization, peripheral, genetics", and the language was limited to English. Meanwhile, Chinese relevant literatures between 1994 and April 2006 were searched in Journal Full-text Database and Wanfang Database by computer with the keywords of "peripheral arterial disease, intermittent claudication, management". STUDY SELECTION: Primary selection was performed by following inclusive criteria: PDA and drug treatment, stent, angioplasty, genetic therapy, surgery, and articles related to PDA were selected. Scientific criteria of treatment for PDA were looked for in basic researches, clinical studies and those published in formal organizations. Exclusive criteria: Repetitive studies, reviews and Meta analytical literatures were excluded. DATA EXTRACTION: A total of 60 literatures about the treatment for PDA were collected, 30 enrolled articles in which were reviewed. Thirty repetitive studies, reviews and Meta analytical literatures were excluded. DATA SYNTHESIS: ①The prevalence of PAD depends on the diagnosis. Given the inaccuracy of physical examination, use of pulse examination as the sole criterion would grossly overestimate the prevalence. In contrast, a historical query for intermittent claudication would underestimate the prevalence of PAD. The ankle-brachial index (ABI) has been validated by angiography with the sensitivity of 95% and the specificity of 100%.②The risk factors of PAD were similar to those in patients with cardiovascular disease and cerebrovascular disease. The goals of therapy for patients with PAD are to prevent systemic atherosclerotic disease progression and clinical cardiovascular events as well as prevent limb loss and improve the functional status of patients with intermittent caludication.③Medical therapy of PAD should include manipulations of risk factors for atherosclerotic heart disease, including smoke-stopping, body mass reducing, blood glucose controlling, blood pressure controlling and hypercholestermia reducing etc. Instructive exercise therapy is the most effective way in non-interventional therapy, while medicine therapy mainly included antiplatelet therapy, angiotenic therapy and anticoagulation therapy. If the patients has obvious clinical ischemia symptoms and cannot be relieved by medical treatment, then interventional therapy or surgery is necessary. CONCLUSION: Patients with PAD can achieve the best long-term prognosis by an instructive exercise treatment integrated with optimal medicine therapy and proper interventional therapy.

Progression of the Study of Adipose-derived Mesenchymal Stem Cell (review) / 中国康复理论与实践

@# As a multipotential stem cell, adipose-derived mesenchymal cell presents similar characters with bone marrow-derived menchymal stem cell in morphology and biology, and has the ability of directional differentiation to the all three germ layers. The adipose-derived mesenchymal stem cell could be harvested conveniently with slighter wound, and has a broad prospect in cell therapy and tissue engineering.

Effects of Simple or Complex Stenting Techniques on Left Main Bifurcation Lesions / 中国康复理论与实践

@#Objective To evaluate the immediate and long-term outcomes of left main bifurcation lesions using different stenting techniques.Methods 27 patients undergone unprotected left main coronary artery stenting had been analyzed.14 cases with simple stenting techniques and 13 cases with complex stenting techniques were involved.Results 40 coronary stents were deployed in 27 patients.The procedural success rate was 100%.No major adverse cardiac events(MACE)had developed in hospital.More true bifurcation lesions were involved in complex stenting group than in simple stenting group(84.6% vs 14.3%,P=0.0004),as well as multivessel lesions involved(100% vs 57.1%,P=0.0074).The residual ostial restenosis of left anterior descending artery(LAD)in complex stenting techniques group was more than that in simple stenting techniques group((4.29±4.25)vs(10.85±5.51),P=0.002).The residual ostial restenosis of left circumflex artery(LCX)in complex stenting group was less than that in simple stenting group((4.61±3.01)vs(13.63±11.21),P=0.009).The patients were followed up for 2～53 months.Angina pectoris recurred in 3 cases(11.1%)and target lesion revascularization(TLR)developed in 2 cases(7.41%).The total MACE happened in 2 cases(7.41%).There was no significant difference between complex stenting group and simple stenting group about symptom recurrence(7.1% vs 15.4%,P=0.59)and TLR(0 vs 15.4%,P=0.13).Conclusion Both simple and complex stenting techniques are feasible with better in-hospital and long-term outcomes.

Diagnosis of Aged and non-Aged Inpatients Suspected Dilated Cardiomyopathy / 中国康复理论与实践

@# Objective To analyse the diagnosis characteristics of the aged and non-aged patients with dilated cardiomyopathy (DCM).Methods 192 inpatients suspected DCM from 2004 to 2006 were analysed retrospectively, as the groups of the aged (≥60 y) and non-aged (<60 y). Results The percentage of the aged group with idiopathic dilated cardiomyopathy (IDCM) or ischemic cardiomyopathy (ICM) was obviously higher than that of the non-aged group (P<0.01 and P<0.05, respectively). The percentage of the non-aged group with alcoholic cardiomyopathy (ACM) or viral cardiomyopathy (VCM) was higher than that of the aged group(P<0.01). Conclusion There are various diseases similar to DCM should be identified. The causes leading to DCM are different in the aged and non-aged patients.

Application of Doppler Tissue Imaging in Assessment of Cardiac Function of Patients after Percutaneous Coronary Intervention for Myocardial Infarction: One Year Follow-up / 中国康复理论与实践

@#Objective To evaluate the application of Doppler tissue imaging (DTI) in assessment of cardiac function after percutaneous coronary intervention (PCI) for myocardial infarction (MI) for long term follow-up. Methods 86 patients with MI were divided in PCI group (45 cases) and conventional therapy group (41 cases). All the patients received two-dimensional echocardiography (2DE) and DTI measurements. The left ventricular ejection fraction (LVEF), peak E, peak A wave velocities and peak E versus peak A (E/A) of 2DE were recorded, as well as the velocity of systolic wave(s), early diastolic filling wave(e), late filling wave(a) and wave e versus wave a (e/a ) of DTI. Results The LVEF and the average velocity of systolic wave (s) of mitral annulus was increased after PCI (P<0.05). S wave was related to LVEF, but the sensitivity of s wave is better than that of LVEF. There was no difference in the pulse Doppler trans mitral flow velocity E/A before and after PCI (P>0.05) , but the average velocity of mitral annulus (e/a ) was remarkably increased after PCI (P<0.01).Conclusion The left ventricular systolic and diastolic function in MI patients be improved after PCI. DTI is a sensitive method to detect the cardiac function after MI and PCI.

Effects of Long Term Statins Treatment on Blood Lipid and Left Ventricular Function in Patients with Myocardial Infarction / 中国康复理论与实践

@#Objective To observe the curative effects of long term statins treatment on blood lipid and left ventriclar function of myocardial infarction patients. Methods 70 patients with myocardial infarction were randomly divided into two groups: Statins treatment group (n=37) and control group (n=33). The level of blood lipid, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF) were mearsured before and 2 years after the treatment. Results The long term applies of statins can bring statistically different (P<0.05) of TC and LDL-C to myocardial infarction patients. LVESD and LVEF were statistically different (P<0.05) before and after statins were used. Conclusion The long term applies of statins can improve the lipidic metabolism and left ventricular function after myocardial infarction.