The effect of calcium dobesilate on venous function following saphenectomy in coronary artery bypass grafting

BACKGROUND: The aim of this study was to determine whether prophylactic use of calcium dobesilate (CD) can improve venous function after saphenous vein harvest in coronary artery bypass graft (CABG). MATERIALS AND METHODS: A total of 100 patients who underwent elective CABG were divided into four equal groups. In Group A, the greater saphenous vein (GSV) was harvested below the knee and, in Group B, through the knee till the groin. These patients remained untreated. Group C received CD in a dosage of 1500 mg po daily after the GSV was harvested below the knee. Group D received same dosage of CD after the GSV was harvested through the knee till the groin. Venous function of ipsilateral leg was evaluated clinically and by Doppler ultrasonography in the postoperative first week and second month. RESULTS: Clinical findings of venous insufficiency were observed with a similar rate between groups at both early and late periods. In Groups A and B, after 2 months, flow velocities decreased and reflux periods increased significantly. In groups C and D, treatment with CD for 2 months after saphenectomy resulted in a significant increase in flow velocities and a significant decrease in reflux periods. Patients in Groups B and D have significantly more impaired venous functions. CONCLUSION: Saphenectomy results in ipsilateral leg venous dysfunction, which seems to be unrelated to leg swelling and to be more prominent in patients with high-level saphenectomy. In addition, to be careful about the restriction of the saphenectomy procedure into the most appropriate level, prophylactic use of CD can prevent this deterioration when it was added to varice socks.     

Prevention of atrial fibrillation after coronary artery bypass graft surgery using a potassium-magnesium-aspartate solution (Inzolen)

BACKGROUND: Atrial fibrillation (AFIB) following cardiac surgery is a frequent complication. The purpose of this study was to evaluate the efficacy of a potassium-magnesium-aspartate solution (Inzolen) for the prevention of AFIB. METHODS: In a randomised, prospective, double-blinded study, we studied 88 patients undergoing elective coronary artery bypass graft surgery (CABG). After surgery, patients were allocated randomly to one of two groups. Group A (n = 43) received a potassium-magnesium-aspartate solution (Inzolen), group B (n = 45) received potassium chloride; both solutions were administered continuously for 48 hours to keep the potassium serum levels between 4.5 and 5.5 mmol/l. Patients were observed for 5 days postoperatively and the incidence of atrial fibrillation was noted. At the end of surgery (T0), 4 h (T1), 24 h (T2), 48 h (T3), and 120 h (T4) postoperatively, magnesium and potassium serum levels were measured. RESULTS: The two groups did not differ significantly with regard to demographics and perioperative data. No significant difference in the incidence of postoperative atrial fibrillation was seen (group A: 41.9 % vs. group B 31.1 %; P = 0.53). In group A, the magnesium serum levels were significantly higher at T1 (1.15 +/- 0.18 vs. 0.87 +/- 0.11 mmol/l), T2 (1.24 +/- 0.22 vs. 0.82 +/- 0.10 mmol/l) and T3 (1.15 +/- 0.18 vs. 0.81 +/- 0.20 mmol/l) compared to group B, whereas potassium levels were similar in the two groups throughout the study period. CONCLUSIONS: The use of a potassium-magnesium-aspartate solution (Inzolen) showed no significant difference in potassium chloride for the prophylaxis of postoperative atrial fibrillation secondary to CABG.     

Combined effect of glucose and verapamil in experimental cardioplegia

In this study, we determined whether pre-ischemic enhancement of the ATP level and the addition of verapamil (a calcium blocker) to the cardioplegic solution could improve myocardial protection during cardiac arrest. Using the Langendorff preparation of the isolated rat heart plus different cardioplegic solutions, five groups of normal rat hearts and five groups of hypertrophied rat hearts were subjected to 90-minute ischemic periods at 28 degrees +/- 1 and reperfusion of 30 minutes at 37 degrees C. Group A received no cardioplegic solution; Group B received KCl, 30 mEq/L; Group C received type B perfusion with verapamil; and Group D received 15 minutes of pre-ischemic oxygenated enhancement perfusion containing KCl, 30 mEq/L, and glucose as substrate at 37 degrees C. Group E received the same perfusion as Group D, with the addition of verapamil to the enhancement perfusion. Light and E/M microscopy was performed on representative samples of left ventricular muscle. We found that pre-ischemic enhancement with KCl, glucose, and verapamil was only protective in the normal hearts after 90 minutes of ischemia. In hypertrophied hearts, the addition of verapamil to the enhancement solution was harmful. The use of pre-ischemic enhancement solution without verapamil provided the best myocardial protection after 90 minutes of ischemia in the hypertrophied hearts.     

过继转移日本血吸虫感染鼠DC亚群对过敏性哮喘肺组织病理改变及CCL2表达的抑制作用

目的通过过继转移日本血吸虫感染鼠树突状细胞(DC)亚群,探讨DC亚群在抑制过敏性哮喘中的作用。方法用CD8α和CD11c磁珠分离纯化日本血吸虫感染鼠DC亚群,分别获得CD8α-CD11c+DC和CD8α+CD11c+DC。将24只BALB/c小鼠随机分为4组:A组为健康对照组,CD8α-DC/OVA组(B组)为过继转移日本血吸虫感染鼠DCCD8α-CD11c+亚群并诱发过敏性哮喘组,CD8α+DC/OVA组(C组)为过继转移日本血吸虫感染鼠DC CD8α+CD11c+亚群并诱发过敏性哮喘组,OVA组(D组)为单纯诱发过敏性哮喘组。B、C两组小鼠分别经尾静脉过继转移5×105 DC亚群,1h后B、C和D组均开始诱发哮喘。4周后处死小鼠,取左肺做病理切片和免疫组织化学染色,观察炎症变化,检测肺组织CCL2表达情况。结果与C组和D组比较,B组肺部炎症显著减轻,按照Underwood标准,A、B、C和D等4组总评分分别为0、7.67±2.34、11.17±1.47和11.75±2.22,差异有统计学意义(P<0.05)。4组小鼠肺组织CCL2平均吸光度值分别为0.0327±0.0154、0.3967±0.0250、0.5274±0.0281和0.5631±0.0282,差异有统计学意义(P<0.05)。结论日本血吸虫感染鼠CD8α-CD11c+DC亚群对过敏性哮喘小鼠肺组织病理改变及CCL2的表达有抑制作用。     

Antiarrhythmic effect of magnesium sulfate after open heart surgery: effect of blood levels

BACKGROUND: Arrhythmias following cardiac surgery is still a difficult complication to treat. Magnesium sulfate is an effective antiarrhythmic agent with negligible side effects. In this study, effects of magnesium sulfate as a first line antiarrhythmic agent was compared with results of two different well-accepted antiarrhythmic agents. METHODS: One hundred patients with arrhythmia were prospectively randomized to a study and a control group. Lidocaine and amiodarone were accepted as standard antiarrhythmic agents. Patients in study group were received magnesium sulfate routinely as a first line antiarrhythmic agent. Unresponsive arrhythmias were treated with standard antiarrhythmic agents. Control group patients received only standard antiarrhythmics. RESULTS: Magnesium sulfate alone was effective in 56% of the study group whereas 74% of the control group were responsive to standard antiarrhythmics (P=n.s.). In study group, a subgroup analysis according to blood levels of Mg2+ revealed that magnesium sulfate was more effective in patients with low Mg2+ levels (63% for low Mg2+ levels, 55% for normal Mg2+ levels, 36% for high Mg2+ levels) and ventricular arrhythmias (60% for ventricular and 40% for supraventricular arrhythmias), without statistical significance. CONCLUSIONS: Magnesium sulfate is an effective and safe antiarrhythmic agent for arrhythmias developed after open-heart surgery. Its antiarrhythmic effect may relate to its pharmacological properties and unrelated to normalization of the circulating magnesium concentrations. We recommend its use as a first line antiarrhythmic agent without routine measurement of blood levels.     

Bispectral index-guided anaesthesia for off-pump coronary artery bypass grafting

Bispectral index (BIS) monitoring may assist reduction in utilisation of anaesthetic agents during general surgical procedures. This study was designed to test whether the use of BIS monitoring reduces the anaesthetic requirements during off-pump coronary artery bypass grafting (CABG). This prospective - clinical trial was conducted on 40 adult patients undergoing elective off-pump CABG. Patients received either isoflurane or propofol anaesthesia. BIS monitoring, which guided the dose of anaesthetic, was carried out in 50 percent of the patients. The amount of anaesthetic agent (isoflurane or propofol) administered from the start of anaesthesia to the end of surgical procedure was calculated and were compared in four groups of patients - namely Group A (I-no BIS) received isoflurane; end tidal concentration was maintained at 1-1.2% in a low flow technique throughout the procedure, Group B (I-BIS) received isoflurane in a low flow technique; inspired concentration was dictated by BIS value maintained at 50; Group C (P-no BIS) received propofol at a dose range of 4-8 mg/kg/hr and in Group D(P-BIS) the propofol infusion rate was dictated by BIS value maintained at 50. The quantity of isoflurane was significantly less for Group B (I-BIS) as compared with Group A (I-no BIS) (37 +/- 4 vs. 24 +/- 4 ml; p< 0.05) and similarly the amount of propofol infused was significantly less in Group D (P-BIS) as compared with Group C (P-no BIS) (176 +/- 9 vs. 120 +/- 6 ml; p< 0.05). BIS guided anaesthesia reduces the anaesthetic agent required for the performance of off-pump CABG. This can be extrapolated in terms of saving agent and reduced cardiac depression during off-pump CABG.     

亚硝基铁氰化钠来源的外源性NO体外杀伤旋毛虫肌幼虫作用研究

目的探讨亚硝基铁氰化钠(SNP)来源的NO体外杀伤旋毛虫肌幼虫的作用及其相关机制。方法制作浓度为1 000条/ml的旋毛虫肌幼虫悬液。培养板每孔加入0.1 ml肌幼虫悬液,再加入SNP,使其终浓度分别为0.02、0.05、0.10、0.20、0.50 mmol/L和1.00 mmol/L,并设空白对照组,37℃5%CO2培养箱中孵育4 d后收集各孔肌幼虫,镜检计数,计算并比较各组肌幼虫死亡率。另于培养板中每孔加入0.1 ml肌幼虫悬液,分别设A组(对照组,1.00 mmol/L SNP)、B组(0.15 mmol/L Fe SO4+1.00 mmol/L SNP)、C组(1.00 mmol/L L-半胱氨酸+1.00 mmol/L SNP)、D组(0.15 mmol/L Fe SO4+1.00mmol/L L-半胱氨酸+1.00 mmol/L SNP)、E组(0.15 mmol/L Hb+1.00 mmol/L SNP),培养、检测方法同前,计算并比较各组肌幼虫死亡率。结果 0.02 mmol/L SNP组与空白对照组的旋毛虫肌幼虫死亡率分别为(5.50±1.80)%和(4.93±0.25)%(P0.05)。0.05、0.10、0.20、0.50、1.00 mmol/L SNP组虫体死亡率分别为(20.19±2.71)%、(29.21±2.12)%、(41.81±2.03)%、(47.85±3.79)%和(60.98±5.19)%,与空白对照组比较差异均有统计学意义(P均0.05)。旋毛虫肌幼虫死亡率与SNP浓度呈正相关(rs=0.875,P0.05)。B、C、D、E组肌幼虫死亡率分别为(49.48±1.34)%、(47.29±2.79)%、(26.28±1.37)%和(17.93±3.49)%,均较A组(60.98±5.19)%有所下降(P均0.05)。结论 SNP来源NO对体外培养的旋毛虫肌幼虫具有杀伤作用,而血红蛋白、硫酸亚铁、L-半胱氨酸对该杀伤具有抑制作用,以血红蛋白抑制效果最显著。     

Low magnesium concentration in erythrocytes of children with acute asthma

Magnesium (Mg) is the second most abundant intracellular cation and is involved in numerous physiological functions, including protein folding, intracellular signaling and enzyme catalysis. It has been shown that magnesium deficiency exacerbates pulmonary airways hyper reactivity. Several studies suggest that magnesium level has no effect on asthma but others had shown a contributory effect. Because of its intracellular abundance the aim of this study was to determine if there was any difference in plasma and intracellular Mg concentrations of children with acute asthma compared to non asthmatic children. Twenty nine patients with acute asthma aged 2 to11 years admitted to the emergency department of hospital and 37 non asthmatic children with the same age were included in our study. 0.5 mL of heparinized whole blood samples of patients who were meeting inclusion criteria at the onset of admission with bronchoconstriction and before using any medication was drawn and it was immediately sent to the laboratory. Plasma and erythrocytes were separated and stored at -20C and later their Mg levels were quantified with atomic absorption spectrophotometry method. The average plasma and intracellular magnesium levels in patients were (0.79 +/- 0.098 mmol/L) and (1.17 +/- 0.27 mmol/L) respectively. Results of 37 non asthmatic persons [plasma (0.85 +/- 0.1 mmol/L ) and erythrocytes (1.33 +/- 0.21 mmol/L)] showed that there was no significant difference between plasma Mg levels in two groups (p 0.06) but intracellular magnesium level was significantly lower (p 0.03) in patients group. These results indicate that intracellular Mg level may be a more accurate method to assess Mg level in patients with asthma. Hence, determination of Mg concentration in erythrocytes may be used in evaluation of asthma pathophysiology. There are recommendations for using intravenous Mg sulfate in acute asthma, and this study supports the rational for using it in emergency departments for acute severe asthma.     

停搏液中Ca2+浓度对未成熟心肌的影响

目的 :探讨未成熟心肌停搏液中合适的 Ca2 +浓度。方法 :建立未成熟心肌细胞缺氧 /复氧损伤模型和未成熟离体心脏缺血 /再灌注损伤模型。采用荧光指示剂法测定心肌细胞内游离钙离子浓度和荧光微量法测定细胞内丙二醛 （MDA）含量 ;测定离体心脏心功能变化。结果 :当心脏停搏液中 Ca2 +浓度为 1.2 mm ol/ L 时 ,在常温未成熟心肌细胞缺氧 /复氧损伤中 ,细胞内钙超载、脂质过氧化反应较轻 ;而在离体心脏模型中 ,心功能恢复比与停搏液中 Ca2 +浓度的关系呈顶部较平坦的曲线 ,以 Ca2 +浓度为 1.0 mmol/ L 时恢复较佳。结论 :停搏液中适合未成熟心肌的 Ca2 +浓度为 1.0～ 1.2 m mol/ L。     

低剂量聚乙二醇联合硫酸镁用于肠道准备的效果评价

背景：聚乙二醇（PEG）为临床常用肠道准备清洁剂,但仍存在一些缺点。笔者等设计了一种低剂量PEG联合低剂量硫酸镁的肠道准备方案,以期能减少PEG溶液摄入量,提高肠腔清洁程度,减少气泡,缩短结肠镜检查时间。目的：以标准剂量PEG方案为对照,评价新方案在结肠镜检查前肠道准备中的有效性、耐受性、安全性以及合适的给药时机。方法：连续收集拟行结肠镜检查者180例,随机分为三组。A组服用标准剂量PEG（68.56 g/包×2包）、B组连续服用低剂量PEG（1包）和硫酸镁（25%,60 ml）、C组间断服用低剂量PEG和硫酸镁行肠道准备。内镜医师单盲行Boston肠道准备量表（BBPS）和肠腔内气泡评分,记录结肠镜检查时间。问卷调查患者对药物的耐受性,记录服药后不良反应。监测用药前后心率、血压和实验室指标。结果：所有患者均完成肠道准备和全结肠镜检查。B、C两组BBPS总分显著高于A组（P〈0.05）,结肠镜检查时间显著短于A组（P〈0.05）,B组肠腔内气泡评分显著低于A、C两组（P〈0.05）。B、C两组药物口感评分、完全服用率和愿意再服率均高于A组。三组间总体不良反应评分无明显差异。结论：与标准剂量PEG方案相比,连续服用低剂量PEG和低剂量硫酸镁用于结肠镜检查前肠道准备更为有效,耐受性更高;两种方案安全性相似。     

硫化氢及一氧化氮在非酒精性脂肪性肝病患者血浆中的变化

目的探讨硫化氢（H2S）、一氧化氮（NO）在非酒精性脂肪性肝病（NAFLD）发病中的作用。方法 45例确诊的NAFLD患者,根据脂肪肝程度分为轻度组（A组）、中度组（B组）、重度组（C组）。选择20例同期健康体检正常者为对照组（D组）。全部标本同步检测血甘油三酯（TG）、胆固醇（TC）、NO及H2S水平。结果 A、B、C组H2S水平分别为（22.78±3.23）μmol/L、（17.98±2.67）μmol/L、（12.57±2.12）μmol/L,与D组（29.13±4.47）μmol/L相比均显著下降,差异有统计学意义（A组与D组比较,P〈0.05;B、C组与D组比较,P〈0.01）。C组H2S水平低于B组,B组H2S水平低于A组,差异有统计学意义（P〈0.05）。A、B、C组血NO水平分别为（42.45±6.12）μmol/L、（54.77±5.99）μmol/L、（69.23±6.33）μmol/L,与D组（29.23±3.97）μmol/L相比均显著上升,差异有统计学意义（P〈0.01）。C组NO水平高于B组,B组NO水平高于A组,差异有统计学意义（P〈0.05）。A、B、C组TG水平分别为（2.45±0.94）mmol/L、（2.99±0.89）mmol/L、（3.87±1.13）mmol/L,与D组（1.63±0.24）mmol/L相比均显著上升,差异有统计学意义（P〈0.01）。C组TG水平高于B组,B组TG水平高于A组,差异有统计学意义（P〈0.05）。A、B、C组TC水平分别为（9.99±1.46）mmol/L、（10.13±1.99）mmol/L、（10.24±2.21）mmol/L,与D组（5.44±0.78）mmol/L相比均显著上升,差异有统计学意义（P〈0.01）。A、B、C组间TC水平比较,差异无统计学意义（P〉0.05）。结论 H2S、NO与NAFLD的发生、发展相关,非酒精性脂肪性肝病程度与TG密切相关。     

Protective effect of pioglitazone on kidney injury in diabetic rats

Objective:To investigate the protective effect of pioglitazone on kidney injury in diabetic rat model and its mechanisms.Methods:Forty healthy Sprague Dawley rats were selected and randomly divided into five groups,with 8 rats in each group.Group A served as control group and were administered with sterile citrate buffer(i.p.)as placebo.Groups B.C,D and E rats were injected(i.p.)with streptozotocin to induce type I diabetes,Diabetic rats in Group B were intragastrically administered with sterile saline solution alone.Groups C,D and E rats were iutragastrically given pioglitazone hydrochloride suspension at doses of 10,20,30 mg/kg per day.respectively.After eight weeks of treatment,all rats were anesthetized and blood was withdrawn from the abdominal aortic ofr detection of hemoglobin A_(1c),serum creatinine(SCr)and blood ures nitrogen(BUN)levels.Rats were then sacrificed and the left kidney was excised for calculation of kidney hypertrophy index(KHI),observation of renal pathological changes using light microscope and electron microscope.Mean glomerular cross-sectional areas(MGA).mean glomerular volume(MGV).glomerular basement membrane thickness and foot process fusion ratio were ealculated.RT-PCR was employed for detection of podocalyxin(PCX)protein expression.Results:Results showed that levels of hemoglobin A_(1c),BUN.SCr in Groups B,C.D and E rats were significantly higher than those in Group A(P0.05),while BUN aud SCr levels in rats of Groups C,D and E were significantly lower than those in Group B(P0.05).KHI,MGA and MGV levels were significantly higher in Groups B.C,D and E rats than those in Group A(P0.05);KHI and MGA levels in Group B rats were significantly higher than those in Groups C.D and E(P0.05)and MGV in Groups D and E was significantly lower than that in Gtoups B and C(P0.05).Histology study showed normal glomerulus structure,morphology,volume,endothelial cells and mesangial cells as well as clear glomerular eapillary in Group A rats.Renal mesangial matrx proliferation and expansion of glomerulus cavities in Groups B.C.D and E were observed.However.damage degree in Groups C.D and E were more moderate than that iu Group B.Conclusions:Pioglitazone can reduce kidney damage in diabetic rats.which may be attributed to its role in increasing glomerular PCX protein expression and inhibiting urinary excretion of PCX,and its effect is dose dependent.     

Passive infusion: a simple delivery method for retrograde cardioplegia

Some damage to the capillaries and increase in myocardial edema have been shown when retrograde cardioplegia perfusion pressure exceeds 40-50 mmHg, or possibly when it falls within this pressure interval. To avoid these complications, we designed a very simple delivery method for retrograde cardioplegia: passive continuous infusion by gravitational force alone. From August 2002 through April 2003, 147 patients undergoing elective coronary artery bypass surgery were randomly allocated into 2 groups. In both groups, isothermic blood cardioplegic solution was infused continuously in a retrograde fashion, after antegrade cardioplegic arrest. Group 1 (n=76) received retrograde infusion passively by gravitational force, while Group 2 (n=71) received retrograde infusion from a manually controlled pressure bag, with the pressure maintained at about 40 mmHg. Myocardial biopsy specimens were taken just before the aorta was declamped, and myocardial edema was scored upon histopathologic examination. Postoperative myocardial damage was evaluated with periodic measurements of CK-MB isoenzyme and cardiac troponin T levels. We recorded cardioplegic infusion pressures and rates, and the total amount of potassium administered. The mean cardioplegic infusion pressures and rates, total potassium levels, and cardioplegic solution amounts were significantly lower in Group 1 than Group 2. Histologic observations revealed significantly less myocardial edema in Group 1. There were no differences between groups in CK-MB isoenzyme or cardiac troponin T levels, mortality, or morbidity. Retrograde continuous infusion of isothermic blood cardioplegic solution by gravitational force alone appears to provide satisfactory myocardial protection and to eliminate the harmful effects of higher pressures upon the myocardium.     

日本血吸虫可溶性虫卵抗原免疫小鼠CD11c~+CD8_α~-DC对过敏性哮喘的抑制作用

目的研究日本血吸虫可溶性虫卵抗原(SEA)免疫小鼠CD11c+CD8α-树突状细胞(DC)亚群对卵清白蛋白(OVA)诱发的过敏性哮喘的抑制作用。方法 BALB/c小鼠经腹腔及足垫注射SEA 50μg/只,每周1次,共4次。用抗体包被的免疫磁珠分离小鼠脾CD11c+CD8α+DC与CD11c+CD8α-DC亚群。另取18只BALB/c小鼠,随机分为4组,A组为健康对照组,B组为OVA致敏单纯哮喘组,C组为过继转移SEA免疫CD11c+CD8α+DC组,D组为过继转移SEA免疫CD11c+CD8α-DC组。C、D组小鼠分别经尾静脉过继转移5×105个CD11c+CD8α+DC和5×105个CD11c+CD8α-DC,1h后B、C、D组小鼠同时用OVA诱发哮喘,4周后剖杀,取肺组织,做病理切片,经苏木素-伊红(HE)染色后,光镜下观察肺部炎症变化。结果 A组小鼠肺组织无炎症反应;B组小鼠肺组织炎症反应广泛且严重,在支气管及肺泡周围有大量炎性细胞浸润;C组小鼠肺组织炎症反应仍较明显;D组小鼠肺组织炎症反应较B、C组显著减轻,仅有少量炎细胞浸润。4组小鼠按照Underwood标准进行病理评分,总分分别为0、14.00±1.00、12.33±0.58和7.20±1.30,差异有统计学意义(P<0.05)。结论日本血吸虫SEA免疫小鼠CD11c+CD8α-DC亚群对过敏性哮喘有抑制作用。     

The reciprocal protective effects of magnesium and calcium in hyperkalemic cardioplegic solutions on ischemic myocardium

Summary The cardioprotective effects of magnesium and calcium in hyperkalemic cardioplegic solutions were investigated in isolated rat hearts. Isolated rat hearts were arrested for 30 min at 37°C in cardioplegic solutions containing magnesium and calcium in varying concentrations. In St. Thomas' Hospital cardioplegic solution, the magnesium and calcium concentrations were varied as follows: Mg 0; Ca 0.1, 0.3, 0.6, 1.2 mmol/l (mM)./ Mg 4; Ca 0.1, 0.3, 0.6, 1.2 mM./ Mg 8; Ca 0.1, 0.3, 0.6, 0.9, 1.2 mM./ Mg 12; Ca 0.1, 0.6, 0.9, 1.2 mM./ Mg 16; Ca 0.1, 0.6, 1.2, 1.5 mM. For each magnesium concentration, the percentage recovery of aortic flow generated dose-response curves depending on calcium concentration. The maximum percentage recovery of aortic flow was 76.0%±2.7% (mean ±SEM) in the Mg0–Ca0.1 mM group, 77.1%±2.0% in the Mg4–Ca0.3 mM group, 78.5%±2.3% in the Mg8–Ca0.6 mM group, 79.8%±2.4% in the Mg12–Ca0.9 mM group and 80.0%±3.4% in the Mg16–Ca1.2 mM (ST solution) group. Significant difference in the recovery of aortic flow has not been observed among these groups, and furthermore, significant differences in the recovery of other parameters of cardiac function and Ck leakage have not been observed among these groups. These results suggest that the cardioprotective effects depend on the relative combination of magnesium and calcium concentrations, and that it is important to maintain an appropriate balance of magnesium and calcium in hyperkalemic cardioplegic solutions.     

An experimental study of atherosclerosis as a sequela of coronary arteritis

In order to examine the effect of corticosteroids on coronary atherogenesis in collagen diseases, an experimental study of serum sickness was performed. Forty-two rabbits were divided into four groups (Groups A-D). Group B, C and D rabbits received four intravenous injections of bovine serum albumin (250 mg/Kg) at 16-day intervals. Groups A, C and D rabbits were fed ad libitum cholesterol supplemented diet (1%) 16 days after the last injection. Group D rabbits received subdermal injections of prednisolone (1 mg/Kg) three times per week in the same period. After 124 days, all rabbits were sacrificed. Serum cholesterol and phospholipid increased in Group A, C and D rabbits. Group A rabbits showed intimal foam cell proliferation. Group B rabbits showed slight fibrous intimal thickening. The coronary arteries of Group C rabbits showed fatty-proliferative intimal thickening and an increase in the incidence of vascular lesions (13.9% of the coronary arteries as compared with 11.7% for Group A and 8.4% for Group B). The coronary lesions of Group D showed the same pattern as those of Group C, but the incidence of lesions was 6.0%. It was concluded that prednisolone did not augment immunologically induced atherosclerosis.     

Determining the optimal fasting glucose target for patients with type 2 diabetes: Results of the multicentre,open-label,randomized-controlled FPG GOAL trial

The optimal fasting blood glucose (FBG) target of achieving HbA1c less than 7.0% in type 2 diabetes (T2D) patients remains controversial. This open-label trial randomized (1:3:3) 947 adults with uncontrolled T2D (HbA1c >7% to ≤10.5%) who were using one to three oral antidiabetic drugs to achieve an FBG target of 3.9 < FBG ≤5.6 mmol/L (Group 1), 3.9 < FBG ≤6.1 mmol/L (Group 2) or of 3.9 < FBG ≤7.0 mmol/L (Group 3). Targets were achieved using a pre-defined insulin glargine 100 U/mL titration scheme. The primary endpoint was proportion of patients achieving HbA1c <7.0% at 24 weeks. At 24 weeks, 44.4%, 46.1% and 37.7% of patients achieved HbA1c <7.0% in Groups 1, 2 and 3, respectively (P = 0.017; Group 2 vs Group 3). Alert hypoglycaemia (glucose ≤3.9 mmol/L) was significantly more frequent in Group 1 than in Group 3 (38.9 vs 23.3%; P < 0.001) but was not in Group 2 vs Group 3 (27.5% vs 23.3%; P = 0.177). Clinically important hypoglycaemia (glucose ≤3.0 mmol/L) was reported in 4.8%, 2.0% and 3.8% of patients in Groups 1, 2 and 3, respectively. In conclusion, the optimal FBG target for most Chinese patients with T2D appears to be 3.9-6.1 mmol/L.     

高糖及高胰岛素对小鼠骨髓内皮前体细胞增殖及功能的影响

目的研究高糖及高胰岛素对骨髓内皮前体细胞(EPCs)增殖、凋亡及分泌功能的影响。方法通过密度梯度离心法从小鼠(BALB/c)的骨髓中分离出EPCs,将细胞分为4组,A组为对照组(葡萄糖浓度5.5mmol/L),B、C组葡萄糖浓度分别为11.0 mmol/L、22.0 mmol/L,D组(葡萄糖浓度22.0 mmol/L+胰岛素25U/L)。利用四甲基偶氮唑盐(MTT)法检测细胞的增殖能力,流式细胞仪检测细胞凋亡,硝酸还原酶法测定细胞培养液中一氧化氮(NO)、一氧化氮合酶(NOS)的含量。结果骨髓源性EPCs的增殖能力与A组(1.31±0.21)比较,B、C、D组(B组0.93±0.27,C组0.78±0.31,D组0.57±0.24)均明显降低,差异有统计学意义(均为P<0.05);B、C、D组间比较差异无统计学意义(均为P>0.05)。实验5 d后,B组的凋亡率为(17.95%±0.38%)、C组的凋亡率为(32.5%±0.63%)、D组的凋亡率为(31.48%±1.26%),3组的凋亡率均较A组的凋亡率(15.75%±0.60%)增高;C组及D组凋亡率均较B组增加,差异均有统计学意义(均为P<0.01)。细胞分泌NO、总NOS(TNOS)显著减少、而诱导型NOS(iNOS)分泌显著增加(均为P<0.01)。结论高糖及高胰岛素引起的EPCs增殖能力降低,促使细胞凋亡,并损害细胞的分泌功能;高胰岛素对高糖引起的EPCs损害并未改善。     

Effects of Chinese herbal drug, dai-saiko-to on plasma lipids, lipoproteins and liver lipid contents in guinea pig

Effects of Chinese herbal drug, Dai-saiko-to, on plasma lipids, lipoproteins and liver lipid contents were investigated in guinea pig with/without cholesterol feeding. Guinea pigs were divided into 4 groups (Group 1: normal chow (N) diet, Group 2: N + 1% Dai-saiko-to (D) diet, Group 3: 1% cholesterol (C) diet, Group 4: 1% C+ 1% D diet), and were treated for 5 weeks. Significant body weight reductions were observed in Groups 3 and 4 compared to Groups 1 and 2. Significant reductions of plasma triglyceride (TG) and very low and low density lipoproteins [(V) LDL]-TG were found in Group 3 compared to Groups 1, 2, and 4. (HDL)-TG significantly decreased in Groups 3 and 4 compared to Groups 1 and 2, but no significant difference was noted between Groups 1 and 2, and Groups 3 and 4. Liver lipid contents analysis showed no significant changes between Groups 1 and 2, and Groups 3 and 4, respectively, but the distribution of lipid droplets as pathologically determined using a computer program showed Group 4 had less lipid deposition compared to Group 3. These data suggest that Dai-saiko-to acts on triglyceride metabolism in hypercholesterolemic guinea pigs.     

Ability of Amiodarone and Propranolol Alone or in Combination to Prevent Post‐coronary Bypass Atrial Fibrillation

Atrial fibrillation (AF) is the most common arrhythmia in coronary artery bypass grafting (CABG) patients. The purpose of this study was to determine the best prophylaxis for AF prior to CABG. In this double‐blind randomized study, 240 consecutive patients underwent elective CABG. They were then divided randomly into three groups to receive propranolol (n = 80), amiodarone (n = 80), or both drugs (n = 80). All groups received their medications from preoperative day 7 to post‐CABG day 5. The patients were well matched for age, sex, risk factors, comorbidities, ejection fraction, and cardioplegic technique. Post‐CABG AF developed in 22 patients (9.2%) of whom 13 (16.3%) had received propranolol, 5 (6.3%) had received amiodarone, and 4 (5%) had received both drugs. The difference between the propranolol group and the other two groups was statistically significant (P= 0.02), but that between the amiodarone and amiodarone + propranolol group was not significant. Age was a significant predictor of post‐CABG AF (P= 0.034). Other factors such as diabetes, sex, hyperlipidemia, smoking, hypertension, family history, cerebrovascular accidents, left atrial size, and ejection fraction were not significant predictors of post‐CABG AF. Preoperative amiodarone or amiodarone with propranolol were more effective than propranolol in reducing the frequency of AF. There was a strong relationship between age and the development of AF. (Clinicaltrial.gov registration NCT00654290.)