Effect of Shuanglong formula on no-reflow in rats with myocardial ischemia/reperfusion / 中国药理学通报

Aim To explore the effect of Shuanglong formula(SLF) on no-reflow in rats with myocardial is-chemia/reperfusion (I/R). Methods The rats were divided into five groups, namely, sham group, I/R group,SLF(5,2.5,1.25 g·kg-1)group. Treatment group received SLF decoction by gavage once a day for five days,while other groups were offered drinking wa-ter by gavage once a day for five days. The rats in I/R group and SLF-pretreated group were induced by iga-tion of left anterior descending coronary artery,and the rats were subjected to ischemia for 4h followed by reperfusion. Sham operation group did not undergo oc-clusion of the coronary artery. After 4 hours' reperfu-sion, real-time myocardial contrast echocardiography was used to monitor regional blood perfusion and cardi-ac functions. Blood was collected from the abdominal aorta and the serum was separated, and the levels of cTnT, CRP, CK and LDH were measured. The myo-cardial no-reflow area and infarction area were assessed by thioflavin S and nitrotetrazolium blue chloride, re-spectively. Results The SLF-pretreated group exhibi-ted significant reductions in the infarct area and no-re-flow area compared with I/R group(P <0.01 or P <0.05). In SLF-pretreated groups, β, A and A·β significantly increased as compared to those in I/R group. The LV anterior wall systolic and diastolic thicknesses (LVAW d/s) were significantly improved in SLF-pretreated group compared with those in I/R group. The LV internal diameter in systole (LVID s) and the LV volume in systole(LV s) were significantly reduced in SLF-pretreated group compared with those in I/R group. The EF, FS and SV were significantly improved in SLF-pretreated group compared with those in I/R group. The comparison between SLF-pretreated group and I/R group showed no significant difference in LDH, CK, cTnT, and CRP levels. Conclusion Shuanglong formula minimizes the sizes of myocardial infarct area and no-reflow area,improving regional my-ocardial blood flow and cardiac function.

Developing traditional Chinese medicine injection is the need for curing sickness to save patients / 中国中药杂志

Safety issues of traditional Chinese medicine injections has been heated debate. There are two diametrically opposed views: it should be used reasonable and developed healthily or be forbidden to use. Some people have many misunderstandings and prejudices about the safety of traditional Chinese medicine injections. Compared with western medicine,traditional Chinese medicine has its own particularity. Traditional Chinese medicine has complex components. Its research and clinical application is different from western medicine. Adverse reactions of traditional Chinese medicine injections are related to many factors,such as a large number of irrational use,blind use of traditional Chinese medicine injections and western medicine injections,counterfeit and substandard drugs,incorrect methods of intravenous infusion,toxicity of supplementary materials,drug ingredients. Developing traditional Chinese medicine injection is the need for curing sickness to save patients. The purposeful, targeted, organized and planned systematic research of traditional Chinese medicine injections should be strengthened,especially the safety of traditional Chinese medicine. Strengthen supervision and control of rational drug use.Strengthen the examination and approval,supervision and management of all aspects to ensure the safety of patients.

Specificity of traditional Chinese medicine's clinical re-evaluation / 中国中药杂志

Clinical re-evaluation is to verify the drug's safety and effectiveness again,while the drug itself has not been improved. However, due to the complexity of traditional Chinese medicine, ingredients in bulk drugs, prescription, productive processes, quality standards and other aspects need to be enhanced. So improving the quality, safety and effectiveness of traditional Chinese medicine by clinical re-evaluation is also very necessary. Therefore, except for achieving those basic requirements of medicine, it should also be improved on itself and pay full attention to the particularity, then traditional Chinese medicine's clinical re-evaluation will play its due role.

Comparative on acute myocardial infarction models in beagle dogs and mongrel dogs / 中国中药杂志

<p><b>OBJECTIVE</b>To compare the acute myocardial infarction models in Beagle dogs and mongrel dogs, and study whether the Beagle dog model is sensitive to drug intervention.</p><p><b>METHOD</b>The acute myocardial infarction model of dog was set up through ligation of anterior descending branch of coronary artery in dogs, in order to observe morphological changes of the heart and determine artery length and heart coefficient of exposed anterior descending branch of coronary artery. The epicardium electrocardiogram (sigmaST, N-ST) was used to measure the degree of myocardial ischemia. The quantitative histological assay (nitroblue tetrazolium, N-BT stain) was adopted to determine the area of myocardial infarction.</p><p><b>RESULT</b>There was no significant difference between Beagle dogs and mongrel dogs in terms of sigmaST, N-ST and ischemia area. The diltiazem group of Beagle dogs showed obvious reduction in the ischemia area (P < 0.05 and P < 0.01), with notable decline in sigmaST and N-ST, however, it had no statistical difference compared with the Beagle dog model group. Beagle dogs had clear coronary branches, longer exposed arteries and less difference in organ coefficient, which were suitable for the preparation of the myocardial infarction model, whereas mongrel dogs had irregular coronary branches and exposed arteries, with greater individual difference.</p><p><b>CONCLUSION</b>Beagle dogs are superior to mongrel dogs in the preparation of the acute myocardial infarction model, which is sensitive to for drug intervention.</p>

[Correlation of large artery stiffness and coronary flow velocity reserve].

OBJECTIVE: Coronary flow velocity reserve (CFVR) is an important indicator of coronary endothelial functions and microcirculation. Pulse wave velocity (PWV) reflects the degree of aortic sclerosis and it is an independent predictor of cardiovascular events. The present study was designed to evaluate the correlation of large artery stiffness and CFVR. METHODS: A total of 101 consecutive subjects were enrolled to measure the brachial-ankle pulse wave velocity (baPWV). According to the presence or absence of higher baPWV (> 1400 cm/s), they were divided into 2 groups. Transthoracic echocardiography was employed to measure coronary flow velocity in coronary left anterior descending (LAD). Then after an intravenous infusion of adenosine triphosphate, the velocity of blood flow was measured when the vessel was in maximal dilation. The ratio of flow velocity of those in maximal dilation to those at rest was CFVR. RESULTS: The subjects with a higher baPWV (> 1400 cm/s) were markedly elder and had higher risks of hypertension and diabetes. Thus age, hypertension and diabetes contributed to arteriosclerosis. More importantly, the subjects with a higher baPWV (> 1400 cm/s) had a much lower level of CFVR (2.66 ± 0.74 vs 2.95 ± 0.76; P < 0.01) than those with a lower baPWV (< 1400 cm/s). Furthermore correlation analysis showed that CFVR and baPWV levels were significantly negatively correlated (r = -0.35, P < 0.01). CONCLUSIONS: A negative correlation exists between artery stiffness and coronary flow velocity reserve. The increased vascular stiffness may impair coronary endothelial function, cause the dysfunction of coronary microcirculation and raise the risks of cardiovascular events.

[Left ventricular flow vector characteristics and the relationship between flow vector and left ventricular systolic function in patients with anterior myocardial infarction].

OBJECTIVE: To assess left ventricular vortex and flow vector features and the relationship between vector flow and left ventricular systolic function in patients with anterior myocardial infarction by echocardiography-derived vector flow mapping (VFM). METHODS: Echocardiography was performed in 31 patients with anterior myocardial infarction and 20 healthy controls. Flow vector and velocity of left ventricle were analyzed on apical 3 chambers view with color Doppler. RESULTS: (1) Left ventricular intracavitary vortex during isovolumic contraction phase could be detected in both groups. Vortex was detectable also during contraction phase and relaxation phase in patients with myocardial infarction. There was no vortex during contraction phase, and there was only small and transit vortex during relaxation phase in control group. (2)Flow vector of apex and middle segments directed to apex and was opposite to that of basal segment of left ventricle in patients with myocardial infarction and in controls [(10.6 ± 8.3) cm/s vs. -(5.8 ± 7.2) cm/s, (19.5 ± 11.8) cm/s vs. -(16.6 ± 14.7) cm/s]. During rapid relaxation phase, the velocity in apex was lower in patients with myocardial infarction than that in control group [(6.8 ± 9.8) cm/s vs. (17.6 ± 15.8) cm/s, P < 0.01]. (3) There was a negative correlation between velocity in apex and left ventricular ejection fraction (LVEF) during rapid eject phase in patients with anterior myocardial infarction (r = -0.52, P < 0.05). Velocity in apex of patients with LVEF < 50% was higher than that of patients with LVEF ≥ 50% during rapid eject phase [(13.5 ± 9.0) cm/s vs. (5.8 ± 5.1) cm/s, P < 0.05]. CONCLUSIONS: Vortex period is prolonged in patients with anterior myocardial infarction compared to normal controls during whole cardiac cycle, flow vector of apex and middle segments is directed to apex during eject phase and there is a negative correlation between velocity in apex and LVEF during rapid eject phase in patients with anterior myocardial infarction.

Clinical application of intro-aortic balloon pump and centrifugal pump in low cardiac output syndrome after coronary artery bypass grafting / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application of Intra-aortic balloon pump (IABP) and centrifugal pump in low cardiac output syndrome (LCOS) after coronary artery bypass grafting (CABG).</p><p><b>METHODS</b>From April 2000 to January 2004, 5 patients suffered serious LCOS after CABG in our department. Because maximum vasoactive agent had no significant effect, we supported these 5 patients with IABP and centrifugal pumps. The centrifugal pumps were connected with cannulas of right superior pulmonary vein and ascending aorta. The flow rate of the centrifugal pumps were increased to 3-4 L/min gradually. The dosage of vasoactive agent and flow rate of the centrifugal pumps were decreased gradually after hemodynamics stabilized.</p><p><b>RESULTS</b>All 5 patients' hemodynamics were improved significantly after the left ventricular assist by IABP and centrifugal pumps. Five patients were weaned from the centrifugal pumps after 4 to 7 days successfully. But some degree damage to blood cells and renal function were detected. Renal function of 3 patients were recovered gradually after centrifugal pumps removed and discharged successfully, One patient died of acute renal failure, 1 patient died of multiple organ failure, 5 patients need transfusion of whole blood or concentrated erythrocytes and 4 patients need transfusion of platelets.</p><p><b>CONCLUSIONS</b>There were significant improvements in hemodynamics after support with IABP and centrifugal pumps in the patients who suffered serious LCOS with less effect of maximum vasoactive agent after CABG. Some complications on blood cells and renal function should be paid more attention.</p>