Effect of xiongshao capsule on vascular remodeling in porcine coronary balloon injury model

Objective: To study the effect of Xiongshao capsule (XSC) on vascular remodeling in porcine coronary balloon injury model.Methods: Coronary artery restenosis model was established by oversized balloon injury at mid-region of the left anterior descending coronary artery. They were divided into 5 groups, untreated or treated with probucol, Xueguantong, low and high dose of XSC respectively, and compared. The effect of XSC on late lumen loss resulted from vascular remodeling was evaluated by quantitative histological method with combining histopathological analysis and coronary angiographie examination.Results: The (59 ± 20)% of late lumen loss was caused by vascular remodeling and (41 ± 20)% caused by intimai hyperplasia. Compared with the control group, all the treatment could significantly reduce the late lumen loss after balloon injury (P<0.05 orP < 0.01 ), both low and high dose of XSC could significantly reduce the late lumen loss caused by remodeling (P<0.05 and P<0.01 respectively).Conclusion: Vascular remodeling plays an important role in late lumen stenosis formation in coronary artery after balloon injury. XSC could significantly inhibit the pathological vascular remodeling, and thus reduce the late lumen loss and prevent the restenosis of the injured coronary artery. Part of a National Ninth-Five Planning Project (No. 96-9060601)     

球囊血管成形术后再狭窄中ET和IGF—I的改变

目的 探讨内皮素（endothelin,ET)及胰岛素样生长因子－I（insulin like growth factor-I,IGF-I)在球囊损伤血管内皮后的改变及意义。方法 用自制导管制造大鼠血管内皮损伤模型,观察不同损血管病理改变,同时用放射免疫法测定血将ET及IGF－I含量。结果 血管内皮损伤后,随着时间延长,平滑肌细胞大量增殖造成管腔狭窄,将ET及IGF－I升高明显,各时间点与对照组相比均有显著性差异,且两者具有较好相关性。结论 ET与IGF－I相互作用促进血管平滑肌增殖,两者可能共同能与了球囊血管成形术后再狭窄的病理过程。     

中老年上睑皮肤松垂整复疗效的探讨（附82例临床报告）

目的：探讨中老年上睑皮肤松垂患者的整复疗效。方法：术前以捏摄法描出须切除上睑皮肤松弛的皮肤量。术中以对合法检查切口两侧皮肤,在自然闭眼下是否刚好对合,以此为标准调整须切除的多余皮肤量。结果：８２例１６４眼上睑皮肤松垂整复效果满意率达１００％,并同时获得满意的美容效果。结论：捏摄法和对合法是治疗中老年上睑皮肤松垂患者较理想的方法。     

冠心病患者冠状动脉内成形及支架术前后QT离散度的变化

目的 体表心电图ＱＴ离散度（ＱＴｄ）增大在冠心病患者是预测室性心律失常事件的有用指标。旨在估价冠心病患者经皮冠状动脉腔内成形主支架术（ＰＴＣＡ＋ｓｔｅｎｔ）前后对ＱＴ离散度的影响。方法 对６０例冠心病患者行ＰＴＣＡ＋ｓｔｅｎｔ术前后ＱＴ离散度进行分析。男性４６例,女性１４例,平均年龄５７岁,患者为单支血管病变３６例,多支血管病２４例。本组对ＰＴＣＡ＋ｓｔｅｎｔ术前后同步３导联的标准１２导联心电图Ｑ     

PBMV治疗二尖瓣狭窄伴中-重度肺动脉高压

目的评价经皮二尖瓣球囊扩张术（ＰＢＭＶ）治疗二尖瓣狭窄伴中或重度肺动脉高压的疗效。方法用Ｉｎｏｕｅ球囊导管行ＰＢＭＶ治疗二尖瓣狭窄伴肺动脉收缩压≥６０ｍｍＨｇ（８．００ｋＰａ）患者１０１例。用超声心动图和心导管法观察血流动力学效应。结果术后血流动力学明显改善,二尖瓣瓣口面积增加（Ｐ〈０．０１）;肺动脉收缩压及肺循环阻力明显降低（Ｐ〈０．００１）,这些变化在心房颤中层得中尤为明显。结论ＰＢＭＶ治疗严     

经皮球囊二尖瓣成形术治疗风湿性二尖瓣狭窄的体会

目的：初步探讨经皮球囊二尖瓣成形术（PBMV）技术操作中的几个问题及处理对策。方法：采用国产单球囊导管对4例风湿性心脏病二尖瓣狭窄患进行PBMV。结果：4例患均获成功,血流动力学均明显好转。结论：PBMV技术操作中有关几个问题的处理对策是提高手术效果有效可行的方法。     

直接经皮冠脉内支架植入术治疗急性心肌梗死

目的：评价直接冠脉内支架植入术治疗急性心肌梗死的临床疗效。方法：１７例急性心肌梗死患者于症状发作后２～１４小时施行冠脉内支架术。结果：所有患者冠脉再通均获成功。ＴＩＭＩ血流均达到３级。无残余狭窄,血管再通距症状发作时间平均５．７小时,所有患者胸痛均在术后２小时内明显缓解;除２例ＳＴ段持续抬高外,其余病例均在术后２小时ＳＴ段下降〉５０％;心肌酶峰明显提前。１例左主干病变于术后１周发生严重泵衰竭死亡;     

西京医院冠心病介入治疗537例

目的　总结西京医院冠心病介入治疗的成功率及并发症发生率 .方法　回顾性分析 1998- 12前所有冠心病介入治疗病历完整患者的临床资料 .结果　在 5 37例患者中 ,6 9.3%为不稳定性心绞痛 ,2 0 .3%射血分数≤ 40 .0 % ,6 4.6 %为多支病变 .治疗血管 6 71支、病变 76 9处 ,B,C型病变77.9% .介入治疗病例成功率为 89.2 % .病变成功率 89.1% ,严重并发症发生率为 3.4% (死亡 1.9% ,Q波心梗 2 .0 % ,急症冠脉搭桥术 0 .2 % ) .普遍应用支架前后对比 ,病例成功率提高 (91.0 % vs80 .0 % ,P<0 .0 1) ,严重并发症发生率下降 (2 .6 % vs 6 .4% ,P<0 .0 5 ) .结论　我院病例病情严重 ,介入治疗成功率和并发症发生率与国外文献报道相似 .支架提高了介入治疗的安全性     

选择性PTCA逆转左室重构疗效观察

观察经皮冠脉腔内成形术能否逆转冠心病患的左室重,方法以二维超心动图测量１５例成功实施ＰＴＣＡ的左室收缩功能围术期演变,结果ＬＶＲＭ的ＣＨＤ患术后左室收缩末溶积首先缩小,随后ＬＶＥＳＶ及左室舒张末容积均缩小显;而无ＬＶＲＭ,术后ＬＶＥＳＶ及ＬＶＥＤＶ均无变化。     

Suppression of neointimal thickening by a newly developed HMG-CoA reductase inhibitor,BAYw6228, and its inhibitory effect on vascular smooth muscle cell growth

1. The aim of this study was to determine whether BAYw6228 (BAYw), a newly developed 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitor, could suppress an atherogenic process such as intimal thickening by a mechanism other than lowering the level of serum cholesterol.
2. First, we evaluated the in vitro effect of BAYw on the proliferation of vascular smooth muscle cells (SMC) from various species: Sprague-Dawley (SD) rats, New Zealand (NZ) white rabbits, intimal cells from Watanabe hereditary hyperlipidemic (WHHL) rabbit and SMC from the new-born human aorta. The increasing rate of total protein content of these cells was inhibited by the addition of BAYw in a dose-dependent fashion. In the presence of 2% foetal calf serum (FCS), the value of IC₅₀ was 1.0 μM in SD rats. 2.1 μM in NZ white rabbits, and 0.3 μM in WHHL rabbits. With human SMC, the value was 0.02 μM in the presence of 10% FCS and 0.2 μM with a mixture of growth factors.
3. Based on these above in vitro findings, we next examined the in vivo effect of the agent to determine whether it could suppress rabbit intimal thickening induced by balloon catheterization. A balloon catheter was inserted from a peripheral branch of the left external carotid artery to the aorta to denude the endothelium of the left common carotid artery in Japanese white rabbits. After 12 days they were divided into control and BAYw groups. The former were subcutaneously injected with saline and the latter with BAYw 1 mg kg⁻¹ day⁻¹. Two days after the beginning of treatment, a second balloon injury was performed to the previously injured left common carotid artery in both groups. After another two weeks, the left common carotid artery was removed and variously stained. Although the total serum cholesterol in the BAYw group was significantly lower than in the control (P<0.05), the difference was not enough to affect intimal thickening. In addition, the BAYw group had a smaller intima/media ratio than the control group, decreasing to 45% of control (P<0.05). By anti-α smooth muscle actin antibody staining, these intimal thickening areas were entirely occupied by SMCs, and their amount was attenuated by BAYw. By anti-rabbit macrophage antibody (RAM 11) staining, the number of positive cells in the intimal thickening was markedly decreased in the BAYw group compared to control (P<0.01).
4. These results indicate that BAYw has an inhibitory effect on intimal thickening by attenuating intimal SMC proliferation and infiltration of macrophages, suggesting that BAYw could be effective in the prevention of the progression of atherosclerotic plaque-like restenosis after angioplasty.