静脉注射左西孟旦治疗重度失代偿性心力衰竭患者的疗效分析

Objective To compare the efficacy and safety of intravenous levosimendan and dobutamine in patients with decompensated heart failure refractory to conventional medications. Methods Patients were recruited into this multicentre, randomised, positive-controlled and parallel-group study to receive either levosimendan or dobutamine therapy. In the levosimendan group, an initial loading dose of levosimendan of 12 μg · kg was infused over 10 min, followed by a continuous infusion of 0. 1 μg · kg~(-1)·min~(-1) for 1 h and then 0. 2 μg · kg- ~(-1) · min~(-1) for 23 h. In the control group, dobutamine was infused for 1 h at an initial dose of 2 μg · kg~(-1)·min~(-1) without a loading dose, followed by a continuous infusion of 4 μg · kg~(-1) · min~(-1) for 23 h. Hemodynamic responses at 24 h were evaluated by echocardiography (in both groups) and Swan-Gans catheter (in the levosimendan group). Clinical assessment was performed to evaluate efficacy and safety of the medications. Results A total of 225 patients from 12 medical centers were　evaluated; 119 assigned to levosimendan and 106 assigned to dobutamine group. The effectiveness rate was　31.9% (38 patients) in the levosimendan group and 17. 9% ( 19 patients) in the dobutamine group (P <0. 01 ). At 24 h, left ventricular ejection fraction (LVEF) was improved by 6. 4% in the levosimendan group, compared with 4. 6% in the dobutamine group ( P > 0. 05 ). Stroke volume (SV) was increased by 11.1 ml in the levosimendan group and 2. 8 ml in the dobutamine group respectively (P < 0. 05). Dyspnea and clinical manifestations improvements were more significant in levosimendan therapy group compared to dobutamine group. There were less adverse effects including hypokalemia, hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group ( P < 0. 05 ). Conclusion Levosimendan was well tolerated and superior to dobutamine for patients with decompensated heart failure refractory to conventional medications.     

Effect of Losartan on the Cardiac and Renal Function in Patients With Chronic Heart Failure

Objectives To explore the effect of losartan on cardiac and renal function in patients with chronic heart failure (CHF). Methods Sixty-five patients with CHF were divided into two groups using a randomized, control and single blind method: losartan group (n=30) and convention group (n=35), with a treatment course of 8 weeks for both groups. The concentrations of cystatin C (cys C) in serum, microamount albumin (MA) in urine were measured by immunoturbidimetry. The concentration of aquaporin-2(AQP-2)was determined by enzyme-linked-immunosorbent assay (ELISA) and the heart contractile function was measured by echocardiography before and after treatment respectively. Results Comparing with routine treatment group, left ventricular end-diastolic dimension (LVEDd) decreased significantly, while left ventricular ejection fraction(LVEF)and left ventricular fractional shortening (LVFS) increased significantly in losartan group. The levels of cys C in serum and MA, AQP-2 in urine were significantly lower in losartan group than in routine treatment group. Conclusion Losartan can improve cardiac and renal function in patients with CHF.     

静脉注射左西孟旦治疗重度失代偿性心力衰竭患者的疗效分析

Objective To compare the efficacy and safety of intravenous levosimendan and dobutamine in patients with decompensated heart failure refractory to conventional medications. Methods Patients were recruited into this multicentre, randomised, positive-controlled and parallel-group study to receive either levosimendan or dobutamine therapy. In the levosimendan group, an initial loading dose of levosimendan of 12 μg · kg was infused over 10 min, followed by a continuous infusion of 0. 1 μg · kg~(-1)·min~(-1) for 1 h and then 0. 2 μg · kg- ~(-1) · min~(-1) for 23 h. In the control group, dobutamine was infused for 1 h at an initial dose of 2 μg · kg~(-1)·min~(-1) without a loading dose, followed by a continuous infusion of 4 μg · kg~(-1) · min~(-1) for 23 h. Hemodynamic responses at 24 h were evaluated by echocardiography (in both groups) and Swan-Gans catheter (in the levosimendan group). Clinical assessment was performed to evaluate efficacy and safety of the medications. Results A total of 225 patients from 12 medical centers were　evaluated; 119 assigned to levosimendan and 106 assigned to dobutamine group. The effectiveness rate was　31.9% (38 patients) in the levosimendan group and 17. 9% ( 19 patients) in the dobutamine group (P <0. 01 ). At 24 h, left ventricular ejection fraction (LVEF) was improved by 6. 4% in the levosimendan group, compared with 4. 6% in the dobutamine group ( P > 0. 05 ). Stroke volume (SV) was increased by 11.1 ml in the levosimendan group and 2. 8 ml in the dobutamine group respectively (P < 0. 05). Dyspnea and clinical manifestations improvements were more significant in levosimendan therapy group compared to dobutamine group. There were less adverse effects including hypokalemia, hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group ( P < 0. 05 ). Conclusion Levosimendan was well tolerated and superior to dobutamine for patients with decompensated heart failure refractory to conventional medications.     

2007年宁夏彭阳县饮茶型氟中毒调查结果分析

Objective To understand current prevalence of fluorosis, of drinking tea type in Pengyang County of Ningxia to offer scientific basis for preventing and curing, monitoring, health education. Methods Four towns were chosen as investigating spots in Pengyang County of Ningxia in 2007, from each 50 children aged 8-12 year old and 50 adults who either had tea or did not were investigated. Dean method was used to measure dental fluorosis of children and adult; meanwhile fluoride content in water, urine and drinking tea was tested using the fluoride ionic electrode method and that in brick tea using water immersion electrode method. χ2 testing, analysis of variance, u test, q test were performed. Results In adult drink tea group, control group, and children, the detaction rate of dental fluorosis were respectively 24.75%(99/400),9.5%(38/400)and 15.96%(71/445), obviously higher in drink tea group than the control group(χ2= 32.73, P<0.05). Urine average concentration of fluoride was (3.38±2.37), (2.09±1.33 ). (1.41±0.67)mg/L, obviously higher in drink tea group than the control group(u= 9.49, P<0.05). In 4 investigation spots tea fluoride averaged at (3.63±2.05)mg/L, fluoride content in drinking water was averagely (1.01±0.49) mg/L, with that of Wangwa Town [(1.31±0.33)mg/L] exceeding the national standard for drinking water (1.0 mg/L), where dental fluorosis rate was higher and fluoride content was higher than that in 3 other investigation spots (P<0.05). Conclusions Residents in Pengyang County in Ningxia who drink brick tea can cause accumulation of fluorine to poison in Ningxia, leading to fluorosis of drinking tea type; Wangwa Town have both drink tea and water fluorine poison.     

硒对高氟所致兔血管内皮损伤及动脉硬化影响的病理形态学研究

Objective To study morphological changes of rabbit artery endothelial cell injury and atherosclerosis caused by high fluoride and the role of selenium. Methods Twenty healthy male New Zealand white rabbits, body weight (2.0 ± 0.5)kg, were randomly divided into control group(drinking deionized water, fed basic diet), fluoride group(drinking fluoride 100 mg/L deionized water, fed basic diet), selenium group(drinking selenium 1 mg/L deionized water, fed basic diet), fluoride plus selenium group(drinking fluoride 100 mg/L deionized water, selenium 1 mg/L of deionized water, fed basic diet). The experimental period was 6 months. At 0, 3, 6 months of the experiment, serum fluorine and selenium levels were determined. At the end of the experiment,thoracic aorta was collected to observe its pathology and ultrastructural changes. Results Serum fluoride was significantly higher at the 3rd and the 6th month of experiment(all P ＜ 0.01 ) in fluoride group[ (0.589 ± 0.146),(0.772 ± 0.175)mg/L] and fluoride plus selenium group[ (0.502 ± 0.094), (0.693 ± 0.158)mg/L] than in control group[ (0.174 ± 0.002), (0.208 ± 0.031 )mg/L] and serum fluoride was significantly higher at 6 months than at 3 months(P ＜ 0.05 ) in fluoride group. Serum selenium was significantly higher at the 3rd and the 6th month of experiment (all P ＜ 0.01 ) in selenium group[ (0.252 ± 0.022), (0.319 ± 0.052)mg/L] and fluoride plus selenium group[ (0.239 ±0.016), (0.294 ± 0.018)mg/L] than in control group[(0.135 ± 0.014), (0.167 ± 0.019)mg/L], and serum selenium was significantly higher at the 6th month than at 3rd month of experiment in selenium group(P ＜ 0.05). Endothelial cell apoptosis indices were (4.92 ± 1.32)%, (30.30 ± 6.80)%, (6.57 ± 2.14)% and (14.29 ± 2.99)%, respectively in control group, fluoride group, selenium group and fluoride plus selenium group. Their main effect of fluorine and selenium was statistically significant (F = 106.833,20.082, all P ＜ 0.01 ). There were antagonistic effect between fluoride and selenium(F = 30.402, P ＜ 0.01 ). Pathological changes of rabbit aortic endothelial cells in fluoride group included endothelial with attached fibrin and red blood cells, and structural of the cells changed, with serious vascular injury; in fluoride plus selenium group apoptosis of endothelial cells decreased, with reduced number of attached red blood cells and fibrin, endothelial cell structure normal, the extent and scope of vascular damage significantly reduced. Conclusions Appropriate amount of selenium inhibits the apoptosis of endothelial cells induced by high fluoride, reduces aortic structural damage caused by high fluoride, and maintains the integrity of endothelial cells, thereby antagonizes the vascular damage and atherosclerosis induced by high fluoride.     

Expression of endonuclease G in the brain tissue of rats with chronic fluorosis

正Objective To investigate the possible mechanism of endonuclease G(Endo G)-mediated non-Gaspase-dependent apoptotic pathway in brain neuronal apoptosis in chronic fluorosis rats.Methods Sixty Sprague Dawley(SD)rats(half male and half female)were randomly divided into two groups:control group fed with tap water with fluoride content0.05 mg/L and fluorine group in which sodium fluoride was added into drinking water with     

The Relationships between Serum Concentration of IGF-I and Left Ventricular Function as well as Coronary Collateral Circulation in Patients with Coronary Artery Disease

Objective To investigate therelationships between serum concentration of insulin -like growth factor - I (IGF-I) and left ventricular function as well as coronary collateral circulation in patients with coronary artery disease (CAD) . Methods In 41 patients with CAD and 15 control subjects without CAD, the concentrations of serum IGF - I were measured using radioimmunoassay. The relationships between the concentration of serum IGF - I and Leaman coronary artery score, Rentrop grade of coronary collateral circulation, left ventricular ejection fraction (LVEF) as well as left ventricular wall motion Cortina score were assessed. Results 1. There was no significant difference in the mean level of serum IGF -I between the CAD group and the control group (107. 92±44.74 ng/ml vs 113.05 ±33. 65 ng/ml, P> 0. 05), but the IGF - I concentrations in the subgroup with collateral circulation were significantly greater than that in the control group (147. 33 ±29. 92 ng/ml vs 113. 05±33. 65 ng/ml, P < 0. 01) or in     

血管紧张素-(1-7)在减轻兔腹主动脉球囊损伤后血管壁胶原合成中的作用

Objective To explore the effects of Angiotensin (ANG)-( 1-7 ) on postangioplasty fibrotic remodeling and the involvement of TGF-β/Smad signaling pathway in this process. Methods Thirty two healthy New Zealand white rabbits were randomly divided into 4 groups: sham group, control group,ANG-(1-7) group and ANG-( 1-7 ) + A-779 group. Rabbits underwent angioplasty in the abdominal aorta or sham surgery. Subsequently, an osmotic minipump was implanted for saline, ANG-(1-7) (576 μg· kg~(-1) ·d~(-1)) or ANG-(1-7) + A-779 (576 μg · kg~(-1) · d~(-1)) delivery. Before and after 4 weeks treatment, the levels of ANG Ⅱ in plasma were measured by ELISA. At week 4, angiography and histomorphometric analysis were performed, mRNA levels of collagen Ⅰ and Ⅲ were assayed by RT-PCR and protein levels of TGF-β_1 and Stand2 in local vessel were assayed by Western blot. Results Following 4 weeks treatment,ANG-( 1-7 ) and ANG-( 1-7 ) + A-779 group displayed a significant elevation in lumen diameter [ (4. 11±0.10) mm and (3.34 ±0. 11) mm vs. (2.88 ±0.08) mm,P <0.05, respectively] and reduction in neointimal thickness [ (208 ± 17) μm and (407±25) μm vs. (448 ± 15) μm, P <0. 05, respectively],neointimal area [(0.27 ±0.09) mm~2 and (0.38 ±0.01) mm~2 vs. (0.41 ±0.02) mm~2, P<0.05,respectively] and restenosis rate [(28. 1 ±2.7)% and (36.8 ±2.2)% vs. (40. 1 ±2.7)% ,P<0.05,respectively] compared with control group. Collagen Ⅰ , Ⅲ mRNA and TGF-β_1 , Smad2 protein levels were significantly elevated in control group,ANG-(1-7) group and ANG-(1-7) + A-779 group compared to sham group ( P < 0. 01 or P < 0. 05 ) and reduced in ANG- (1-7) group compared to control group ( all P < 0. 05).Co-treatment with A-779 reversed the inhibitory action of ANG-( 1-7 ) . Plasma levels of ANG Ⅱ postangioplasty were similar in control and ANG-( 1-7 ) group and both were significantly higher than preoperation levels. Conclusion ANG-(1-7) attenuates postangioplasty collagen synthesis in rabbits possibly through down-regulating the expression of TGF-β_1 and inhibiting the activation of Smad2 pathway.     

血管紧张素-(1-7)在减轻兔腹主动脉球囊损伤后血管壁胶原合成中的作用

Objective To explore the effects of Angiotensin (ANG)-( 1-7 ) on postangioplasty fibrotic remodeling and the involvement of TGF-β/Smad signaling pathway in this process. Methods Thirty two healthy New Zealand white rabbits were randomly divided into 4 groups: sham group, control group,ANG-(1-7) group and ANG-( 1-7 ) + A-779 group. Rabbits underwent angioplasty in the abdominal aorta or sham surgery. Subsequently, an osmotic minipump was implanted for saline, ANG-(1-7) (576 μg· kg~(-1) ·d~(-1)) or ANG-(1-7) + A-779 (576 μg · kg~(-1) · d~(-1)) delivery. Before and after 4 weeks treatment, the levels of ANG Ⅱ in plasma were measured by ELISA. At week 4, angiography and histomorphometric analysis were performed, mRNA levels of collagen Ⅰ and Ⅲ were assayed by RT-PCR and protein levels of TGF-β_1 and Stand2 in local vessel were assayed by Western blot. Results Following 4 weeks treatment,ANG-( 1-7 ) and ANG-( 1-7 ) + A-779 group displayed a significant elevation in lumen diameter [ (4. 11±0.10) mm and (3.34 ±0. 11) mm vs. (2.88 ±0.08) mm,P <0.05, respectively] and reduction in neointimal thickness [ (208 ± 17) μm and (407±25) μm vs. (448 ± 15) μm, P <0. 05, respectively],neointimal area [(0.27 ±0.09) mm~2 and (0.38 ±0.01) mm~2 vs. (0.41 ±0.02) mm~2, P<0.05,respectively] and restenosis rate [(28. 1 ±2.7)% and (36.8 ±2.2)% vs. (40. 1 ±2.7)% ,P<0.05,respectively] compared with control group. Collagen Ⅰ , Ⅲ mRNA and TGF-β_1 , Smad2 protein levels were significantly elevated in control group,ANG-(1-7) group and ANG-(1-7) + A-779 group compared to sham group ( P < 0. 01 or P < 0. 05 ) and reduced in ANG- (1-7) group compared to control group ( all P < 0. 05).Co-treatment with A-779 reversed the inhibitory action of ANG-( 1-7 ) . Plasma levels of ANG Ⅱ postangioplasty were similar in control and ANG-( 1-7 ) group and both were significantly higher than preoperation levels. Conclusion ANG-(1-7) attenuates postangioplasty collagen synthesis in rabbits possibly through down-regulating the expression of TGF-β_1 and inhibiting the activation of Smad2 pathway.     

Expression of lipopolysaccharide binding protein and its receptor CD14 in experimental alcoholic liver disease

AIM:To evaluate the relationship between the expression oflipopolysaccharides(LPS)binding protein(LBP)and CD14mRNA and the severity of liver injury in alcohol-fed rats.METHODS:Twenty Wistar rats were divided into twogroups:ethanol-fed group(group E)and control group(group C).Group E was fed with ethanol(5-12g.kg~(-1).d~(-1))and group C received dextrose instead of ethanol.Rats ofthe two groups were sacrificed at 4 weeks and 8 weeks.Levels of endotoxin and alanine transaminase(ALT)inblood were measured,and liver pathology was observedunder light and electronic microscopy.Expressions of LBPand CD14 mRNA In liver tlssues were determined by RT-PCRanalysis.RESULTS:Plasma endotoxln levels were increased moresignificantly in group E(129±21 )ng.L~(-1) and(187±35)ng·L~(-1) at 4 and 8 wk than in control rats(48±9) ng·L~(-1) and(53±11)ng·L~(-1),respectively(P<0.05).Mean values ofplasma ALT levels were(1867±250)nkat·L~(-1) and(2450±367) nkat.L~(-1) in Group E.The values were increased moredramatically In ethanol-fed rats than in Group C after 4 and 8weeds.In liver section from ethanol-fed rats,there weremarked pathological changes(steatosis,cell infiltration andnecrosis).In ethanol-fed rats,ethanol administration led toa significant increase in LBP and CD14 mRNA levelscompared with the control group(P<0.05).CONCLUSION:Ethanol administration led to a significantIncrease in endotoxin levels in serum and LBP and CD14mRNA expressions in liver tissues.The increase of LBP andCD14 mRNA expression might wake the liver more sensitiveto endotoxin and liver injury.     

Effect of iodine excess on morphology of mouse thyroid follicle and pancreatic acinar cells

正Objective To explore the effect of different levels of iodine excess on morphological changes of mouse thyroid follicle and pancreatic acinar cells.Methods Sixty female mice (BALB/c) were selected and their body weight were 18-22 g. The mice were divided into 6groups according to body weight via the random number table method, 10 mice in each group. Potassium iodate was added to drinking water in exposure groups with iodine contents of 300, 600, 1 200, 2 400, and 4 800μg/L, while normal group (control) was given normal     

Long-term effect of stenting in unprotected left main coronary artery disease in the elderly

Objective To evaluate the feasibility, safety and efficacy of percutaneous stent implantation for treating left main coronary artery (LMCA) stenosis. Methods Consecutive patients with unprotected left main coronary artery disease treated by stent-based percutaneous intervention (PCI) at 6 medical centers in China were enrolled. Procedural data and clinical outcomes were obtained from all patients. Results From January 2001 to December 2004, 138 patients (79 males and 59 females; mean age: 69.7±5.8 years) underwent PCI for LMCA stenosis. Bare metal stents (BMS) were implanted in 51 patients with non-bifurcational lesions and in 5 patients with bifurcational lesions from January of 2001 to June of 2003 (BMS group);. drug eluting stents (DES) were used unselectively to cover both bifurcational and non-bifurcational lesions in 86 patients from July of 2003 to December of 2004 (DES group). Procedural success rate of the 138 cases was 98% (135/138). One patient (0.7%) with bifurcation lesion who was treated with DES died from severe heart failure 2 weeks after the procedure. During a mean follow up period of 21.3±5.6 months, one patient died from renal failure, one from sudden cardiac death, 4 underwent target lesion revascularization (TLR) in the BMS group, which all occurred in patients with bifurcational lesions; whereas in the DES group no deaths occurred and only one patient with bifurcational lesion had TLR. Conclusions (1) PCI is feasible and relatively safe to treat unprotected left main coronary artery disease in elderly patients at medical centers with experienced professionals. (2) BMS and DES have similar immediate and long-term efficacy in the treatment of ostium and shaft lesions of the LMCA. (3) DES are strongly suggested in the therapy of distal bifurcation lesion of unprotected LMCA.     

Effect of β blockers on β_3-adrenoceptor mRNA Expression in the Rats with Chronic Heart Failure

Objectives To investigate the changes of β3-adrenoceptor (β3-AR) mRNA expression in the rats with chronic heart failure (CHF), and to explore the effect of β blockers (βBs) on β3 mRNA expression. Methods Thirty-four rats were randomly divided into Sham group (n = 10) and heart failure group (n = 24). Rat model was established by aortic constriction. The survival rats in heart failure group were divided into heart failure control group (HF group, n = 6), metoprolol group (MET group, n = 8) and carvedilol group (CAR group, n = 8) three months after operation. Metoprolol tartarte was started orally with 12 mg·kg-1·d-1, carvedilol with 6 mg·kg-1·d-1, isometric saline was started in HF group. After three months of drug therapy, measurement of hemodynamics, index of ventricular mass, the level of β3-AR mRNA expression were performed. Results Compared with Sham group, left ventricular end systolic pressure (LVESP), and the absolute values of maximal rate of rise and fall ( ± dp/dtmax) of left ventricular pressure were all significantly decreased (P < 0.01), left ventricular end diastolic pressure (LVEDP) was significantly increased in HF group (P < 0.01). The hemodynamic parameters were improved by βBs, and carvedilol was more effective than metoprolol (P < 0.01). The index of ventricular mass was higher in HF group than MET group, CAR group and Sham group (P < 0.01). βBs significantly decreased the index of left ventricular mass (LVMI), and Carvedilol was more effective than metoprolol (P < 0.01). The index of right ventricular mass (RVMI) did not change in MET group (P > 0.05), but significant decrease could be seen in CAR group (P < 0.01). The level of β3-AR expression in left ventricle was greater than that in right ventricle whether in the failing heart or in the non-failing heart. Compared with Sham group, the level of β3-AR mRNA expression was significantly increased in HF group (P < 0.01). The levels of β3-AR mRNA expression showed a remarkable decrease in CAR group(P < 0.01), but was not seen in MET group. Conclusions The β3-AR expression level remarkably increases in the rat's left and right failing ventricles. Carvedilol is more effective on improving hemodynamics and attenuating ventricular remodeling than metoprolol in the rats with CHF. Carvedilol rather than metoprolol downregulates β3-AR expression in the rat's failing ventricles. The beneficial effect of carvedilol in CHF maybe partly due to the downregulation of β3-AR expression in the failing heart.     

Astragaloside IV attenuates carotid intimal hyperplasia by suppressing the basic fibroblast growth factor expression in rats

Bacground Percutaneous coronary intervention(PCI) has become one of the most effective treatments in coronary heart disease(CHD).However,the bottleneck problem of PCI is the in-stent restenosis(ISR).The aim of this study was to explore the effects of astragaloside IV(AST IV) on suppression of intimal hyperplasia modulation of the expression of basic fibroblast growth factor(b-FGF) in a rat carotid artery balloon injury model.Methods Fifty healthy male Sprague-Dawley(SD)rats were randomly divided into five groups:a sham-operation group(sham),a model group(model),and three astragaloside IV-treated groups.Three days before the surgery,1% carboxy methyl cellulose(CMC) or AST IV(20,40 or 60 mg·kg~(- 1)·d~(- 1)) was intragastrically administered into sham or 3 astragaloside-treated groups once a day for 17 days.Hematoxylin-elsin staining was carried out to determine the pathomorphological changes and the neointimal and media area ratio.Immunohistochemistry staining was performed to measure the expressions of proliferating cell nuclear antigen(PCNA)and basic fibrolast growth factor(b-FGF).PCNA and b-FGF were analyzed with Iamage-Pro Plus.Results(1) The carotid artery intimal hyperplasia in the rats of model was similar to lumen stenosis.Compared with the sham operation group,the area of the new intima and the ratio of the intima to media(I/M) were increased and the lumen area was decreased(P 0.01) in the model group.Astragaloside IV increased the lumen intimal dimension and decreased the area of new intima and the ratio of intima to media in a dose-dependent manner.(2) Compared with the sham-operation group,the expressions of PCNA and b-FGF in carotid artery of model group were significantly increased(P 0.01).AST IV decreased expressions of PCNA and b-FGF in the carotid artery of rats in a dosedependent manner.Conclusion Astragaloside IV significantly inhibits neointimal hyperplasia of rat carotid artery through down-regulating the expressions of PCNA and b-FGF.     

Infuences of Previous Angina Pectoris on Coronary Collateral Circulation and Left Ventricular Function in Patients with Acute Myocardial Infarction

Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed. Results ①In the 307 patients, there were 192 (62. 5 % ) with previous angina [PA (+) group] and 115 (37. 5 % ) without [PA (-) group].②The peak creatine kinase (CK) and CK MB were significantly higher in PA (-) group than in PA (+) group (P<0. 05 for both comparisons) . ③ Collateral circulation to infarct-related artery was more likely to be present in PA (+) group than in PA (-) group (P<0. 05) .④The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA (+) group than in     

Neuregulin-1 therapy improved cardiac function and reduced ANPmRNA expression in post myocardial infarction rats with cardiac dysfunction

Objective To observe the influence of neuregulin-1 on the cardiac function of post-myocardial infarction rats. Methods Left ventricular MI was created in Sprague-Dawley rats by ligation of the left anterior descending coronary. Six months after the operation, rats were evaluated with echocardiology methods. 36 rats that had an infarct area and a EF around 60% were randomized into 3 groups: MI group(n=12) were injected a blank vehicle fluid intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+NRG group(n=12), received NRG-1 10μg·kg-1 intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+Capt group (n=12) received captopril orally (dissolved in their drinking water 2g/L) for 30 days , after which tap water substituted the solution for 5 days. Final echocardiographic and hemodynamic measurements were made at the end of 1 month of therapy. Total RNA was extracted from frozen left ventricular tissues, and was reverse transcribed into first-strand PCR was performed with primers for BNP、ANP. Results Rats treated with neuregulin had a smaller LVDs (P=0.014), a better LVEF (P=0.004 ),and a tendency towards less lung perfusion than untreated rats. Neuregulin decreased the expression of ANP mRNA in the ventricle (P=0.025).Conclusion Neuregulin markedly improved the cardiac function of rats that survived myocardial infarction, and decreased the expression of ANP mRNA in the ventricle.     

慢性氟中毒大鼠脑组织中c-Jun氨基末端激酶表达水平观察

Objective To investigate the expression of c-Jun-N-terminal kinase(JNK) in rat brains with chronic fluorosis and try to reveal the molecular mechanism for the neural impairment induced by the disease.Methods The rats were randomly divided into 3 groups, normal control group(drinking water containing less than 0.5 mg/L of sodium fluoride, NaF), lower fluoride exposed group(drinking water containing 5 mg/L NaF) and higher fluoride exposed group(drinking water containing 50 mg/L NaF), 24 in every group. The rats were examined at the sixth month after feeding. The concentration of fluorine in urine and blood was detected by F-ion selective electrode. The expression of JNK in brains was investigated by using Western blotting and immunohitochemistry staining, and analyze the correlation between activating of JNK and the concentration of fluorine in blood. Results The increased concentration of fluorine in urine(control: 0.92 ± 0.30, lower fluoride exposed group: 2.56 ± 0.91,higher fluoride exposed group: 5.73 ± 3.14, P ＜ 0.05) were observed when 6 months after the beginning of the experiment, and the amount of fluorine in blood was also higher in rats with fluorosis(control: 0.12 ± 0.07, lower fluoride exposed group: 0.36 ± 0.14, higher fluoride exposed group: 0.50 ± 0.18, P ＜ 0.05). The expression of phospho-JNK at protein levels were higher in the brains of rats with fluorosis than that of controls (control: 1.00 ± 0.37, lower fluoride exposed group: 1.20 ± 0.28, higher fluoride exposed group: 1.74 ± 0.69, P ＜ 0.05), whereas no change of total-JNK was found(F = 0.046, P ＞ 0.05). Furthermore, the expression of phospho-JNK in the parietal cortex(119.3 ± 14.1), occipital cortex(112.7 ± 5.4), hippocampus CA3(100.6 ± 8.9), dorsal thalamus (117.8 ± 10.4) and olivary nucleus( 112.6 ± 5.9) of rats in higher fluoride exposed group were higher than that in control( 104.1 ± 8.9,106.6 ± 9.6,106.6 ± 9.7,108.9 ± 6.4,100.3 ± 8.4, all P ＜ 0.05) and lower fluoride exposed group(96.7 ± 17.1,102.5 ± 8.3,106.4 ± 6.5,110.2 ± 9.3,102.4 ± 4.7,102.5 ± 9.8, all P＜ 0.05). The positive stained neurons of total-JNK also distributed in the same brain regions of rats, but no difference was detected between the rats with fluorosis and controls(all P ＞ 0.05). The increased level of phospho-JNK was positively correlated with the fluoride contents in blood of the rats with fluorosis (r = 0.677). Conclusions The expression of phospho-JNK in brains of rats with fluorosis was significantly increased with a correlation to fluoride content in blood, which might be connected to the mechanism of neural impairment induced by chronic fluorosis.     

Subclavian artery angioplasty in elderly patients with coronary-subclavian steal syndrome: preliminary comparison between a modified brachial technique and the standard femoral approach

Background and Objective Elderly patients who have been submitted to coronary bypass grafting with the left internal mammary artery (LIMA) may develop a coronary-subclavian steal syndrome because of a left subclavian artery (LSA) stenosis. Usually stenting of LSA is performed by the standard femoral route with guiding catheter technique, but this technique can be particularly difficult in elderly patients who often have iliac-femoral kinking and aortic tortuosity. We compared a new “ad hoc” brachial artery approach technique with the standard guiding catheter technique through the femoral access. Methods Between January 2005 and September 2006, four patients underwent LSA stenting using the left brachial artery access obtained with a 6F or 7F 45-cm-long valved anti-kinking sheath as the Super Arrow Flex sheath (Arrow International, PA, USA). The sheath was positioned just before the LIMA graft ostium and a 0.035 inch 260-cm-long Storq guidewire (Cordis Inc., Johnson & Johnson, Warren, NJ) was advanced across the lesion to the descending aorta. A balloon-expandable Genesis (Cordis Inc., Johnson & Johnson, Warren, NJ) endovascular stent was easily deployed, and the correct position was checked by direct contrast injection through the long sheath. This small group of patients has been compared to a group of 5 age-matched patients with coronary steal syndrome in whom the procedure has been performed with standard technique including femoral approach and guide catheter. Results The procedure was successful in all patients; vertebral and LIMA ostia remained patent in all cases. In the control group, cannulation of the subclavian artery was difficult in two cases, while one patient developed a groin hematoma. Mean pretreatment gradient was 32 mm Hg with a range of 25 to 40 mm Hg (34 mmHg, range 26- 43, in the control group, P=0.87) and fell to 2 mm Hg with a range of 0 to 4 mm Hg (3.1 mmHg, range 0 to 5, P=0.89) posttreatment. Mean contrast dose was 60±16 ml (138±26 ml in the control group, P>0.01), whereas mean fluoroscopy and procedural time were 5.7±1.6 minutes (10.8±1.0 minutes in the control group, P>0.01) and 15.7±6.3 minutes (28±7.1 minutes in the control group, P>0.01). At a mean follow-up of 10±3.2 months all patients are alive and free from angina and residual induced ischemia. Conclusions Our brief study suggested that brachial artery access be considered the optimal route to treat coronary-subclavian steal syndrome in elderly patients because of clear advantages; these included no manipulation of catheter to cannulate the artery, perfect coaxial position of the catheter at the site of LSA stenosis, clear visualization of the LIMA and vertebral ostia, and easy access to these vessels in case of plaque shifting or embolic protection device deployment.     

Effects of N-acetylcysteine on expression of transforming growth factor-β1 in diabetic nephropathy rats

Objective To investigate the effects of N-acetylcysteine (NAC) on the expression of transforming growth factor-β1 (TGF-β1) in renal cortex of diabetic nephropathy rats.Methods A rat model of DN was established.The rats were randomly divided into control group,DN group and NAC group.After 8 weeks treatment,urinary albumin excretion rate (UAER) was determined.The expression of TGF-β1 in renal cortex was detected by immunohistochemistry and RT-PCR analysis.Pathomorphological changes of renal cortex were observed.Results (1)The levels of UA ER were significantly higher in DN group and NAC group [(1268.3±297.5) μg/24 h and (315.9-±86.8) μg/24 h] than in control group [(31.2±8.9) μg/24 h,q-29.85,16.76,both P＜0.01].The groups of DN and NAC versus group of control showed the increased levels of activity of TGF-β1 in renal cortex [immune-histochemistry index of glomerular mesangial area:7.35±1.17 and 3.87 ± 0.71 vs.1.95±0.34,q= 10.75,5.82,both P＜0.01];immune-histochemistry index of renal tubulointerstitium [21.21± 3.78 and 10.67±1.86 vs.3.62±0.79,q=15.20,11.36,both P＜0.01];the expression of mRNA in renal cortex[0.72±0.06 and 0.45±0.05 vs.0.23±0.04,q=9.13,7.45,both P＜0.01].The pathomorphological changes were significant in DN group and NAC group.(2)The NAC group versus DN group showed a decreased levels of UAER (q=8.17,P＜0.01),activity of TGF-β1 in renal cortex [immune-histochemistry index of glomerular mesangial area:q= 4.97,P＜0.01]immune-histochemistry index of renal tubulointerstitium (q = 6.86,P ＜ 0.01 );the expression of mRNA in renal cortex (q= 3.69,P＜0.05) and showed improvement of pathomorphology in renal cortex.(3) There was a significantly positive correlation between expression quantity of TGF-β1 mRNA in renal cortex and UAER level in NAC group(r= 0.749,P＜0.05).Conclusions The protective effects of NAC on the kidney of DN rats may be partly related with inhibition on the expression of TGF-β1.