Research progress on tumor radiotherapy-induced coronary artery diseases / 中华放射肿瘤学杂志

In recent years, radiotherapy has been widely applied in tumor patients. The short-term and long-term impact on the cardiovascular system has captivated increasing attention from radiologist and cardiologist. Along with higher radiation dose and longer follow-up, the incidence rate of coronary artery disease tends to significantly elevate, especially in patients with breast cancer and lung cancer. With the advancement of radiotherapy technologies, different tumors, different radiation doses and different modes of radiation delivery exert different effects on coronary artery. There are still some disputes about how to prevent, diagnose, evaluate, and treat the high-risk population of coronary artery diseases after radiotherapy. How to optimize the treatment strategy before and after radiotherapy to reduce the incidence of short-term and long-term coronary artery diseases in cancer patients needs further clinical research.

Pseudoaneurysm caused by Pseudomonas aeruginosa infection after renal transplantation: a case report / 中华器官移植杂志

Objective:To explorethe the clinical manifestations, treatment and prognosis of anastomotic pseudoaneurysm after renal transplantation caused by infection.Methods:Clinical data of 1 recipient with pseudoaneurysm after renal transplantation due to Pseudomonas aeruginosa infection were retrospectively analysed and combined with a literature review. Results:At Month 2 post-transplantation, the recipient developed right lower abdominal pain, and contrast-enhanced ultrasound examination showed a pseudoaneurysm at the artery anastomosis. Anti-infection and anti-rejection therapy had no obvious effect, and therefore next surgical exploration was performed. A size4.0 cm×3.5cm pseudoaneurysm was found intraoperatively at the graft renal artery anastomosis.After graft was evaluated as having no preservation value, the transplanted kidney and pseudoaneurysm were resected. Bacterial culture indicated Pseudomonas aeruginosa infection.The recipient recovered well and waited for next transplantation. Conclusions:Pseudoaneurysm of transplanted kidney is a very rare complication after renal transplantation, and caused by infection of Pseudomonas aeruginosa is more rarer, It has not been reported in mainland China.This type of recipient has the characteristics of high graft inactivation rate and high mortality rate. Timely surgical resection can effectively prevent the deterioration of disease.

Clinical effects of free superficial femoral artery femoral triangle perforator flap in the repair of skin and soft tissue defects in extremities / 中华烧伤杂志

Objective@#To investigate the clinical effects of free superficial femoral artery femoral triangle perforator flap in the repair of skin and soft tissue defects in extremities.@*Methods@#From January 2016 to November 2017, 14 patients (9 males and 5 females, aged 19 to 54 years) with skin and soft tissue defects in extremities accompanied with tendon and bone exposure were admitted to our unit. The size of skin and soft tissue defects after debridement ranged from 7 cm×3 cm to 10 cm×7 cm. The defects were repaired with free superficial femoral artery femoral triangle perforator flaps, with size ranging from 13.0 cm×2.0 cm to 20.0 cm×4.5 cm. The medial femoral cutaneous nerve was applied to the flap. The perforator flap was grafted onto the medial femoral cutaneous nerve in 6 patients. The donor sites were sutured directly. The survival of flaps and the follow-up of patients were observed.@*Results@#All flaps of 14 patients survived successfully. The recipient sites and donor sites were healed completely in 13 patients, and 1 patient with partial skin necrosis at the edge of flap was healed after treatment. All patients were followed up for 6 months to 1 year after the operation. The flaps were in good shape, with nearly normal color and soft texture and no cicatrix contracture deformity. The flaps recovered protective sense in 6 patients who had medial femoral cutaneous nerve grafting, and the sensory recovery of the flap was slightly worse in the remaining 8 patients. There was no significant complications on the appearance and walking of the donor thigh in 14 patients, only a linear scar was left on the inner thigh, and no numbness was felt in the donor sites of patients.@*Conclusions@#The free superficial femoral artery femoral triangle perforator flap is an ideal therapy for repairing skin and soft tissue defects in extremities.

Repair of the defect on midface using perforator flap of facial artery / 中华整形外科杂志

Objective@#To explore the clinical application of facial artery perforator flap in repairing medium-size midfacial defects.@*Methods@#Sixteen patients with facial tumors or trauma were admitted in the Affiliated Hospital of Zunyi Medical University, from October 2017 to March 2018. The patients were 41—74 years of age, including 8 males and 8 females. The tissue defects were caused by basal cell carcinoma(BCC, n=10), trauma (n=4), and squamous cell carcinoma (SqCa, n=2). The size of tumor and trauma ranged from 0.3 cm×2 cm to 2 cm×4 cm. Patients with skin tumors undergone extended radical resection, according to the nature of the tumor. Debridement was performed routinely in patients with trauma. Facial artery perforator flap was designed based on the size and shape of defect area. The scar of donor site was as parallel or hidden in the nasolabial groove. The perforator branch of the lateral nasal artery was used as the pivot point, to cover the wound surface without tension. The ipsilateral secondary relay flap pedicled with the perforator of the nasal artery was designed, which was in triangular shape and slightly larger in size than the primary flap. The pedicle was located in the middle of the flap, then the flap was pushed to cover the donor site of primary flap. The postoperative results were evaluated by patients.@*Results@#All primary and secondary relay skin flaps survived. The follow-up period of the first stage was 3—12 months, with an average of 7.5 months. There was no obvious scar, no eyelid eversion or angular deviation, and no recurrence of tumor was observed. The primary and secondary flaps have similar appearance and matched color with normal skin. Ten patients were very satisfied with the surgical outcome, and 6 were satisfied, at the latest follow-up.@*Conclusions@#The facial artery perforator relay skin flap is an alternative method to repair medium facial defect.

Selection strategy of superficial iliac circumflex artery and lateral circumflex femoral artery perforator flap in wound repair / 中华整形外科杂志

Objective@#To provide clinical guidance for clinical selection, through retrospective analysis for the advantages and disadvantages of superficial iliac circumflex artery and lateral circumflex femoral artery perforator flap in wound repair.@*Methods@#From July 2016 to January 2018, 89 cases were repaired with superficial iliac circumflex artery or lateral femoral circumflex artery perforator flap, including 32 cases of superficial circumflex iliac artery perforator flap, 18 cases of upper limb, 6 cases of face and neck, and 8 cases of lower extremity. There were 52 cases of lateral circumflex femoral artery perforator flap, 21 cases of upper limb, 2 cases of neck, 3 cases of trunk, 26 cases of lower extremity, 5 cases of superficial circumflex iliac artery perforator flap combined with lateral femoral circumflex artery perforator flap, 3 cases of upper limb and 2 cases of lower extremity. The perforators of superficial circumflex iliac artery or (and) lateral circumflex femoral artery were detected by portable Doppler flow detector before operation. According to the wound size, the superficial circumflex artery perforator flap or (and) lateral circumflex femoral artery perforator flap was or (were) designed and resected. End-to-end or end-to-side anastomosis was performed in vascular pedicle. In the combined resection group, the end-to-end or end-to-side anastomosis of the perforator of the lateral circumflex thigh artery was performed, and the pedicled part of the superficial circumflex iliac artery was used for supercharging.@*Results@#All the flaps survived successfully except one combined flap had tip necrosis on the superficial iliac circumflex artery perforator flap part. and healed after 2 weeks of dressing change. Venous crisis occurred on the first day after operation of superficial iliac circumflex artery perforator flap in 1 case.10 cases of lateral femoral circumflex artery perforator flap were slightly bloated and 3 cases returned to hospital for secondary thinning. All the flaps were soft in texture, satisfactory in shape and function, and numbed in the small area of the donor region of the perforator flap of lateral femoral circumflex artery in the early stage. All the patients had no severe complications after follow-up.@*Conclusions@#The perforator flap of superficial iliac circumflex artery and lateral femoral circumflex artery are ideal donor areas for wound repair. The perforator flap of superficial iliac circumflex artery is preferred for small area wound, hand wound and small bone defect. Lateral circumflex femoral perforator flap is suitable for all trunk and limbs with large or complex wounds.

Therapeutic efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters larger than 2.8 mm / 中华心血管病杂志

Objective@#To evaluate the efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters ≥ 2.8 mm.@*Methods@#This prospective study included 215 consecutive patients with 238 de novo lesions, who received paclitaxel-coated balloon angioplasty in Beijing Hospital from May 2014 to June 2016. According to the reference vessel diameter, the patients were divided into large vessel disease (LVD) group (reference vessel diameter≥2.8 mm, 85 patients and 90 lesions) and small vessel disease (SVD) group (reference vessel diameter<2.8 mm, 130 patients and 148 lesions). Clinical characteristics, interventional procedures and major adverse cardiovascular events (includingall-cause mortality, non-fatal myocardial infarction and target lesion revascularization) after procedure were compared between the 2 groups.@*Results@#(1)Patients in LVD group were younger than SVD group ((60.1±11.1) years old vs. (65.0±10.6) years old, P<0.01), and less patients had diabetes (24.7% (21/85) vs. 43.1%(56/130), P<0.01).(2)Prevalence of three-vessel disease (35.5%(30/85) vs. 53.6%(67/130), P<0.05) and complex lesions (type B2/C,34.4% (31/90) vs. 50.0%(74/148), P<0.05) were significantly lower in LVD group than in SVD group.(3) During pre-dilation, the rate with plain balloons use was significantly higher in SVD group than in LVD group(76.4%(113/148) vs. 58.9%(53/90), P<0.01), while the proportion of additional use of non-compliant balloons was significantly higher in LVD groupthan in SVD group(20.0% (18/90) vs. 3.4% (5/148) , P<0.01). The ratio of paclitaxel-coated balloon diameter/RVD was significantly lower (0.87±0.12 vs. 0.96±0.15, P<0.01) and the duration of dilationwas significantly shorter ((41.5±9.5) seconds vs. (45.1±9.1) seconds, P<0.01) in LVD group than those in SVD group. Each group had 1 failure case that was bailout stented with drug-eluting stents. The success rate of paclitaxel-coated balloon treatment was similar in LVD group and SVD group (98.9% (89/90) vs. 99.3%(147/148), P>0.05).(4) At the fourth day of procedure, there was 1 acute myocardial infarction requiring emergent target lesion revascularization in SVD group. No major adverse cardiovascular event was observed in LVD group during hospitalization. Forty-two patients with 53 lesions, including 27 LVD lesions and 26 SVD lesions,underwent coronary angiography at (9.4±4.6) months after paclitaxel-coated balloon intervention. The quantitative coronary angiography analysis showed that minimal lumen diameter significantlyincreased during follow-up than that of post-procedurein SVD group ((1.71±0.36)mm vs. (1.52±0.30)mm, P<0.05) , while in LVD group the minimal lumen diameter was similar between during follow-up and post-procedure ((2.35±0.48)mm vs. (2.19±0.34)mm, P>0.05). Major adverse cardiovascular event rate was 0 in LVD group and 2.3%(3/130) in SVD group (P>0.05) during follow up. No death was observed in this patient cohort.@*Conclusion@#Treatment with paclitaxel-coated balloon for de novo coronary lesions with diameters≥2.8 mm is safe and effective.

Use of VIABAHN stent in endovascular treatment of iliac, femoral or popliteal artery injury / 中华普通外科杂志

Objective To evaluate therapeutic effect of endovascular treatment of iliac,femoral or popliteal artery injury with VIABAHN stent.Methods Endovascular treatment of iliac,femoral or popliteal artery injury was performed with VIABAHN stents in 12 patients admitted to our hospital from August 2015 to December 2013.Results Technical success rate was 100％.Strong instant postoperative pulsation of all dorsal and posterior tibial arteries could be palpated.No procedural and postoperative short term complications (endoleak,stent migration,hematoma at puncture site,thrombosis in arteries and stents and contrast nephropathy) were found.ABI value of injured lower limbs was promoted from preoperative 0.45 ± 0.12 to postoperative 0.95 ± 0.06.Mild stenosis (＜ 30％) of proximal end of stent was noted in one case by CTA.Patients were followed up for 3-18 months [averaging (10 ± 4) months].There was no postoperative limb ischeamia related symptoms.ABI was above 0.9 in all patients.Conclusion The short and middle term therapeutic effect of endovascular treatment of iliac,femoral and popliteal artery injury with VIABAHN stent was satisfactory.

Application of anterolateral thigh free flap with multiple perforators descending from lateral circumflex femoral artery in reconstruction of complex defects of children extremities / 中华显微外科杂志

Objective To investigate the application of anterolateral thigh (ALT) free flap preserving multiple perforators descending from lateral circumflex femoral artery (LCFA) in reconstruction of complex defects of children extremities.Methods From January,2016 to January,2017,7 children admitted with soft tissue defects were reconstructed with ALT free flap preserving multiple perforitors descending from LCFA.According to body surface projection and distribution patterns of perforators descending from LCFA,preoperative portable Doppler was used to localize these perforators.Fascia lata harvest was spared for those without ligament and articular joint reconstruction.Defects and fascia lata was closed primarily.All patients were followed up at regular intervals.Results Follow-up period was 3-9 months(mean,6.5 months.Follow-up methods include on-site follow-up,wechat follow-up,telephone follow-up,etc.).The color of ALT flaps was normal.The texture of ALT flap was good.The linear scar in donor sites was found.The paresthesia around incision in donor sites was complained of.Postoperative appearance and function of injured limbs was satisfactory.Conclusion Design of Unipaddled or multipaddled ALT free flap with multiple perforators descending from LCFA is flexible.Perforators are thick and consistent.ALT flap with multiple perforators descending from LCFA is an ideal one to be used in reconstruction of complex soft tissue defects.

Effects from transplantation of human amniotic mesenchymal stem cells on survival of random skin flap in rats / 中华创伤杂志

Objective To investigate the feasibility of human amniotic mesenchymal stem cells (hAMSCs) transplantation to improve the survival of ischemic ultra-long random skin flap vascularization,so as to promote the survival of skin flap.Methods The hAMSCs were isolated from human amnion,cultured in vitro,and identified by immunocytochemistry.The phenotype of hAMSCs was analyzed by flow cytometry.CellTrackerTM-CM-Dil was used to label before hAMSCs transplantation into skin flap.Twenty SD adult rats were selected and the 2 cm × 8 cm ischemic ultra-long random skin flap models were constructed in the left and right sides of the rat back.The pedicles of flaps were on the lliac crest level.The flaps were divided into left group (injection with 0.5 ml LG-DMEM) and right group (0.5 ml 1 × 106/ml hAMSCs) after the flap was lifted.The survival rate of flap was observed 7 d after surgery.The blood perfusion values,namely blood perfusion unit at pedicle and in the middle,were monitored by laser Doppler flow monitor at the immediate time,24 h,48 h,4 d and 7 d of the skin flap after surgery.The capillary density of the skin flap was observed through histological observation of the tissue (0.5 cm from adult and necrotic junction).The distribution and survival rate of CM-Dil labeled hAMSCs were observed by fluorescent microscope.Results In term of survival rate of the flap,left group was (50.6 ± 2.2) ％,and right group was (70.9 ± 2.1) ％.The survival rate of the flap in right group was greater than that of left group (P ＜ 0.05).Blood perfusion unit detected in the pedicle of left group at days 4 and 7 after surgery was higher than that of the right group (P ＜ 0.05).Blood perfusion unit in middle of flap of left group at 24 h,48 h,4 d and 7 d were lower than that of right group (P ＜ 0.05).The flap capillary density at 7 d after surgery were (8.8 ± 1.2)/mm2 in left group and (23.5 ± 1.6)/mm2 in right group (P ＜ 0.05).The tissue of flap was made frozen section,and the fluorescence microscope showed there were CM-Dil labeled hAMSCs in skip flap in right group,which could manifest the survival and distribution of hAMSCs in skip flap.Conclusion The application of hAMSCs in the middle and distal parts of ultralong random skin flap can significantly improve the survival rate of skin flap,and increase the density of microvascular reconstruction in the flap.

Effects from transplantation of human amniotic mesenchymal stem cells on survival of random skin flap in rats / 中华创伤杂志

Objective To investigate the feasibility of human amniotic mesenchymal stem cells (hAMSCs) transplantation to improve the survival of ischemic ultra-long random skin flap vascularization,so as to promote the survival of skin flap.Methods The hAMSCs were isolated from human amnion,cultured in vitro,and identified by immunocytochemistry.The phenotype of hAMSCs was analyzed by flow cytometry.CellTrackerTM-CM-Dil was used to label before hAMSCs transplantation into skin flap.Twenty SD adult rats were selected and the 2 cm × 8 cm ischemic ultra-long random skin flap models were constructed in the left and right sides of the rat back.The pedicles of flaps were on the lliac crest level.The flaps were divided into left group (injection with 0.5 ml LG-DMEM) and right group (0.5 ml 1 × 106/ml hAMSCs) after the flap was lifted.The survival rate of flap was observed 7 d after surgery.The blood perfusion values,namely blood perfusion unit at pedicle and in the middle,were monitored by laser Doppler flow monitor at the immediate time,24 h,48 h,4 d and 7 d of the skin flap after surgery.The capillary density of the skin flap was observed through histological observation of the tissue (0.5 cm from adult and necrotic junction).The distribution and survival rate of CM-Dil labeled hAMSCs were observed by fluorescent microscope.Results In term of survival rate of the flap,left group was (50.6 ± 2.2) ％,and right group was (70.9 ± 2.1) ％.The survival rate of the flap in right group was greater than that of left group (P ＜ 0.05).Blood perfusion unit detected in the pedicle of left group at days 4 and 7 after surgery was higher than that of the right group (P ＜ 0.05).Blood perfusion unit in middle of flap of left group at 24 h,48 h,4 d and 7 d were lower than that of right group (P ＜ 0.05).The flap capillary density at 7 d after surgery were (8.8 ± 1.2)/mm2 in left group and (23.5 ± 1.6)/mm2 in right group (P ＜ 0.05).The tissue of flap was made frozen section,and the fluorescence microscope showed there were CM-Dil labeled hAMSCs in skip flap in right group,which could manifest the survival and distribution of hAMSCs in skip flap.Conclusion The application of hAMSCs in the middle and distal parts of ultralong random skin flap can significantly improve the survival rate of skin flap,and increase the density of microvascular reconstruction in the flap.

Study of efficacy and safety of Paclitaxel drug coated balloon in elderly patients with de novo coronary disease / 中华老年医学杂志

Objective To evaluate the efficacy and safety of Paclitaxel drug coated balloon (DCB) (SeQuent Please) in an elderly patients with de novo coronary disease.Methods We performed a retrospective study of 158 consecutive patients (63 patients aged ≥65 yrs and 95 patients aged ＜65 yrs) received DCB therapy in Cath Lab of Beijing Hospital.Clinical characteristic was recorded and coronary angiography was analyzed with quantitative coronary angiography (QCA) software.Results In elderly group,more patients have hypertension (65.1％ vs.56.8％),atrial fibrillation (7.9％ vs.2.1％),previous percutaneous coronary intervention (PCI) history (44.4％ vs.23.2％,P＜0.01) and non ST-elevated myocardial infarction (NSTEMI) (14.3％ vs.4.2％,P ＜0.05).In non-elderly group,more patients were male (71.6％ vs.50.8％,P＜0.05) and current smoker (52.3％ vs.30.2％,P＜ 0.01).Old patients had more complicated lesions,especially calcified lesions (36.8％ vs.14.0％,P＜0.01).Despite of that,our study showed a higher success rate of PCI in elderly group.Both groups of patients showed significant acute gain in minimal lumen diameter (MLD) after DCB released.At 4 days post-operation,there was one case that underwent acute myocardial infarction requiring emergent target lesion revascularization (TLR) in non-elderly group.No major adverse cardiac event (MACE) was observed in the elderly group during hospitalization.Twenty-one patients underwent coronary angiographic followed up at average 9 months post PCI.The QCA analysis showed that MLD of lesions treated with DCB had mildly increased [(2.00±0.67) mm vs.(1.91 ± 0.47) mm,P＞0.05],the late lumen loss (LLL) was (-0.09±0.50) mm.At 9 months follow-up,the MACE rate in the elderly group was 1.6％ and 1.1％ in non-elderly group,with TLR rates at 0.0％ and 1.1％ respectively (both P＞0.05).No death was observed in either group.Conclusions The efficacy and safety of DCB on the elderly patients with de novo lesions is as good as non-elderly patients despite more complex anatomy and comorbidities.

Advanced sensate proper digital artery escalating flaps for repair of fingertip skin defect / 中华创伤杂志

Objective To investigate the feasibility of advanced sensate proper digital artery escalating flaps in reconstruction of fingertip skin defect.Methods Between January 2012 and February 2015,15 cases (17 fingers) of fingertip skin defect accompanied with exposed tendon or phalange were treated,including 9 males and 6 females,with mean 41 years of age (range,7-55 years).Injury resulted from hit by heavy objects in 5 cases,knife cutting in 4,machine twist injury in 4 and mass resection in 2.Fingertip defects were covered with the flaps carrying proper digital artery and nerves in order to one-stage reconstruct finger pulp epicritic sensibility and avoid onychogryphosis.Joint function was assessed with the standard set up by Chinese Medical Association Hand Surgery Branch.Results All flaps survived.One case had ankylosis of the middle interphalangeal joint caused by poor weight-bearing exercise and was improved after exercise.Two cases with large defect in the distal finger pulp had slight onychogryphosis after operation.Period of follow-up was 6-14 months (mean,8 months).The injured fingers showed good appearance and sense,with two-point discrimination of the flap ranging from 6-8 mm.There was no linear scar or tenderness in the finger tip.Hypertrophic scar was not obvious in the flap donor area.Function assessment was excellent in 16 fingers and good in 1 finger.Conclusion The flaps result in good blood supply,good sense,no onychogryphosis and no linear scar and are easy to be operated,indicating an ideal method to reconstruct fingertip defect.

Percutaneous transluminal angioplasty for the treatment of diabetic foot / 中华普通外科杂志

Objective To evaluate percutaneous transluminal angioplasty ( PTA) for stenosed arteries of the lower extremities in patients with ischaemic diabetic foot. Methods We retrospectively analyzed the clinical and follow-up data of using PTA to treat diseased infrapopliteal arteries in diabetic patients who were hospitalized from Oct,2006 to May,2008. Results Technical success rate was 87% , procedure related complications developed in 8. 9% of patients, postoperative complications were 11. 1% , perioperative mortality was 2. 5% , limb salvage rate was 90% , pain symptom was significantly mitigated or relieved, ulcer healed well. The median hospitalstay was 10 days. Restenosis rates were 38. 1 % , 50% respectively at 1 year and 2 years. Rest pain and ulcer recurrence rates were 10% and 12% at 1 year and 2 years respectively; Amputation rates were 10% and 15. 3% at 1 year and 2 years. Restenosis ( or occlusion) , rest pain or ulcer recurrence and amputation rate in Fontain Ⅳ group is significantly poorer than that in Fontain Ⅰ - Ⅲ group (P ＜0. 05). Conclusions Percutaneous transluminal angioplasty (PTA) for critical limb ischeamia in patients with ischaemic diabetic foot are feasible, with minimal invasiveness, low complications. Fontain classification predicts PTA thrapeutic results.

The Role of Apoptosis-Inducing Factor on TNF-α Induced Apoptosis in Cultured Neonatal Rat Cardiontyocytes / 中国基层医药

Objective This study was designed to investigate the role of apoptosis-inducing factor on neonatal rat cardiomyocytes apoptosis induced by TNF-a,and to detect the effect of IL-10 on the apoptosis rate of cardio-myocytes apoptosis induced by TNF-α.Methods Neonatal rat cardiacmyocytes in primary culture were exposed to TNF-α( 100ng/ml)for 12 hours,18 hours,24 hours,TNF-α( 100ng/ml) for lohours pretreated by IL-10(50ng/ml) 1 hour,or IL-10(50ng/ml) for 19hours.Apoptotic cells were detected by flow cytometry and Hoechest 33258 dye; Western blot were used to determine the apoptosis-inducing factor protein expression.Results The apoptosis rate of cardiomyocytes increased in TNF-α 12 hours group than that of control[ Flow cytometry (5.08 ±0.79% ) vs ( 2.2± 0.77)% ,P <0.05],and reach the peak in TNF-α 18 hours group compared with control[ Flow cytometry(14.39± 2.31)%vs(2.2±0.77)%,P<0.01;Hoechst 33258 dyeing(18.936±2.791)% Vs(2.890± 1.326)% ,P< 0.01];also elevated in TNF-α 24 hours group vs control[Flow cytometry(4.61±0.84)% vs(2.2 ±0.77)% ,P< 0.05].AIF expression:Increased expression of AIF in the cells treated by TNF-α( 100 ng/ml) 12 hours,reached highest in TNF-α( 100 ng/ml) for 18 hours group and decreased in TNF-α( 100 ng/ml) 24 hours group compared with control;AIF expression is not decrease in TNF-α( 100 ng/ml) 18 hours pretreated by IL-10(50 ng/ml) for 1-hour group comparing with TNF-α( 100 ng/ml) 18hours group.Conclusion The study demonstrated that AIF contributed to TNF-α induced apoptosis of rat cardiomyocytes; IL-10 alleviated the apoptosis of rat cardiacmyocytes induced by TNF-α,and AIF may not its mechanism.

Soluble CD40 Ligand and fibrinogen in acute myocardial infarction / 中国综合临床

Objective To observe the changes of serum soluble CD40 ligand (sCD40L) and fibrinogen in acute myocardial infarction (AMI) patients and to investigate the clinical predictive value of increased serum sCD40L and fibrinogen. Methods Serum sCD40L level of 60 AMI patients was determined by enzyme-linked im-munosorbent assay (ELISA). Plasma level of fibrinogen was measured. The patients were followed up for 2 years af-ter discharge from the hospital and were observed for cardiovascular event. Results AMI patients had higher sCD40L and fibrinogen levels than those of controls [(15.36±7.32) μg/L vs. (5.79±2.78) μg/L, (4.60±1.37)g/L vs. (3.03±0.82) g/L,P<0.001] ,which were significantly higher in the patients experiencing cardio-vascular event than those without cardiovascular event [(18.14±6.34) μg/L vs. (14.38±6.67) μg/L and (4.97±1.33)g/L vs. (4.20±1.24} g/L] (P<0.05). The patients with sCD40L≥14.5 μg/L or fibrinogen≥ 4.4 g/L experienced increased risk of adverse cardiovascular events (P<0.05). In AMI patients, sCD40L level was significantly higher in patients with diabetes than in nondiabetics [(18.38±6.71) μg/L vs. (14.46±6.48) μg/L, P<0.05)]. Fibrinogen level was related to sCD40L (r=0.27, P<0.05) and LVEF(r=-0.319, P<0.05). Conclusion Increased sCD40L and fibrinogen levels,which maybe related to the pathogenesis of AMI,can be found in AMI patients and can indicate an independent increased risk of major adverse cardiovascular events. Diabetes is independently associated with elevated sCD40L level in AMI patients.