冠状动脉内多普勒血流测定在冠状动脉造影正常者中的应用价值

目的 本研究旨在通过对有胸痛但冠状动脉造影正常者行冠状动脉内多普勒血流速度测定 ,评价这组病人的冠状动脉血流储备功能及其影响因素。方法 对 12 6例冠状动脉造影正常而获得满意血流频谱病人 [男 6 7例 ,女 5 9例 ,平均年龄 (5 3 1± 13 0 )岁 ],采用冠状动脉内多普勒血流速度描记技术对左前降支进行血流速度测定 ,并经冠状动脉内注射腺苷 18μg后测定冠状动脉血流速度储备 (CFVR)。结果 12 6例病人的左前降支的CFVR平均值为 2 71± 0 74,基础冠状动脉平均峰值血流速度 (bAPV)为 (18 7± 7 2 )cm s,充血相平均峰值血流速度 (hAPV)为 (47 7± 15 2 )cm s。其中6 5 1%的病人CFVR低于 3 0 ,与CFVR正常者 (≥ 3 0 )相比 ,这组病人的bAPV较高而hAPV较低。CFVR与基础心率成负性直线相关 (r=- 0 34 8,P <0 0 0 1) ,而bAPV与基础心率呈正性直线相关 (r =0 376 ,P <0 0 0 1)。CFVR和bAPV与血压均无明显相关关系。有无高血压及高脂血症对CFVR无明显影响。糖尿病患者的CFVR低于无糖尿病的患者 (2 30± 0 47vs 2 80± 0 6 8,P =0 0 44 )。结论 有胸痛但冠状动脉造影正常的病人中约 2 3存在微血管功能障碍 ,冠状动脉血流储备功能受心率的影响 。

冷盐水灌注导管对常规射频消融失败心房扑动患者的消融治疗

常规射频消融在部分普通型心房扑动患者不能产生三尖瓣环至下腔静脉之间峡部的双向传导阻滞 ,本研究观察冷盐水灌注导管对该部分患者的消融效果。 12 5例行射频消融治疗的普通型心房扑动患者中 ,7例患者从三尖瓣环至下腔静脉口或至欧氏嵴射频消融超过 15次未能产生峡部双向传导阻滞 ,定义为射频消融失败。对该 7例患者换用冷盐水灌注导管 ,以相同于常规射频消融的方法在峡部找到传导间隙后 ,行射频消融。全部患者消融成功 ,平均消融 4.5± 2次 ,导管温度 40± 1℃ ,阻抗 79± 5 .4Ω ,未观察到明显的并发症。表明常规射频消融的失败与常规射频消融不能产生峡部足够的损伤有关 ,冷盐水灌注导管对常规射频消融失败的患者可以成功地产生峡部的双向传导阻滞。

射频消融房室结改良消融前后心脏电生理变化的探讨

目的比较房室结双径路伴房室结内折返性心动过速(AVNRT)患者,射频消融(RFCA)慢径路改良术,消融前、后心脏各部分腔内电生理改变。方法在相同条件下,于消融前、后分别进行腔内电生理检查。记录消融前、后:希氏束电图(HIS),心房有效不应期(A—ERP),功能不应期(A—FRP),心室有效不应期(V—ERP),功能不应期(V—FRP),房室结前传有效不应期(AVN—ERP),前传文氏点(AVN—WKB),房室结逆传有效不应期(VAN—ERP),逆传文氏点(VAN—WKB),将消融前、后心脏各部分电生理参数进行配对,经SPSS统计分析软件进行T检验分析。结果消融前、后:HIS电图,A—ERP,A—FRP,V—ERP,V—FRP,AVN—ERP,及VAN—WKB均无显著差异(P>0.05)。AVN—WKB,VAN—ERP有显著差异(P<0.05)。讨论射频消融房结改良对房室结双径路AVNRT疗效肯定。在消融前、后(急性期)房室结前、逆传电生理均有一定改变。这与消融改变了房室结的部分结构,如大部分病列慢径路消失有关。不同消融部位对房室结传导电理改变产生不同的结果。没有证据表明消融后,45岁以上年龄组房室结传导改变大于45岁以下年龄组。男女不同性别组之间亦无差异。

APOLIPOPROTEIN E GENE POLYMORPHISMS AND RISK FOR CORONARY ARTERY DISEASE IN CHINESE XINJIANGUYGUR AND HAN POPULATION

Objective To examine the relationship between apolipoprotein E (Apo E) gene polymorphism and risk of coronary artery disease (CAD), analyzing association of polymorphism with classical risk factors. Methods A total of 124 patients (including 84 Han population and 40 Uygur population) with angiographically verified CAD or myocardial infarction were prospectively evaluated. Data referring to hypertension, diabetes, and tobacco consump-tion were recorded. The levels of total cholesterol (TC), high density lipoprotein (HDL) cholesterol, Apo A1 and B, and triglycerides (TG) were determined. DNA was obtained from 124 patients and 70 controls. In order to determine Apo E genotypes, DNA was PCR amplified and digested with HhaI. The genetic polymorphism of Apo E is due to three common alleles, epsilon(ε) 2, ε3, ε4, at a single autosomal gene locus. These alleles determine the six phenotypes E2/2, E3/3, E4/4, E4/2, E4/3, and E3/2. Results In Uygur population, the frequency of the ε2, ε3, and ε4 was 0.155, 0.648, and 0.197 respectively. In Han po-pulation, the frequency of the ε2, ε3, and ε4 was 0.081, 0.772, and 0.146 respectively. In the patient group, the frequency of the ε2, ε3, and ε4was 0.060, 0.758, and 0.182 respectively. In the control group, the frequency of the ε2, ε3, and ε4 was 0.193, 0.671, and 0.136 respectively. ε2 frequency of Uygur’ patients and controls was 0.050 and 0.290 respectively. Serum low density lipoprotein (LDL) cholesterol, TC, and TG values tended to decrease from the Apo E-4 phenotypes to Apo E-2 phenotypes. When deletion polymorphism of ε2 was compared with the common risk factors for CAD, its risk ratio (RR) is 4.38. Conclusions These studies confirm and find that Apo E phenotype distribution in Uygur population differs significantly from that in Han population in Xinjiang. CAD patients have significantly lower ε2 allele and slightly higher ε3 or ε4 allele frequency than controls, especially in Uygur population. It shows protective effects of ε2 on CAD.

Effects of autoantibodies against β_1-adrenoceptor in hepatitis virus myocarditis on action potential and L-type Ca^(2+) currents

AIM:To investigate the effects of autoantibodies against β_1-adrenoceptor in hepatitis virus myocarditis on action potential and L-type Ca^(2+) currents. METHODS:Fifteen samples of autoantibodies against β_1- adrenoceptor positive sera of patients with hepatitis virus myocarditis were obtained and IgGs were purified by octanoic acid extraction.Binding of autoantibodies against β_1- adrenoceptor to guinea pig cardiac myocytes was examined by immunofluorescence.Using the patch clamp technique, the effects on the action potential and I_(ca-L) of guinea pig cardiac myocytes caused by autoantibodies against β_1-adrenoceptor in the absence and presence of metoprolol were investigated. Cell toxicity was examined by observing cell morphology and permeability of cardiac myocytes to trypan blue. RESULTS:The specific binding of autoantibodies against β_1-adrenoceptor to guinea pig cardiomyocytes was observed. Autoantibodies against β_1-adrenoceptor diluted at 1:80 prolonged APO_(20),APD_(50)and APD_(90) by 39.2%,29.1% and 15.2% respectively,and only by 7.2%,5.3% and 4.1% correspondingly in the presence of 1 μmol/L metoprolol. Autoantibodies against β_1-adrenoceptor diluted at 1:80, 1:100 and 1:120 significantly increased the I_(ca-l) peak current amplitude at 0 mV by 55.87±4.39%,46.33±5.01% and 29.29±4.97% in a concentration-dependent manner.In contrast,after blocking of β_1-adrenoceptors (1 μmol/L metoprolol),autoantibodies against β_1-adrenoceptor diluted at 1:80 induced a slight increase of I_(ca-L) peak amplitude only by 6.81±1.61%.A large number of cardiac myocytes exposed to high concentrations of autoantibodies against β_1- adrenoceptor (1:80 and 1:100) were turned into rounded cells highly permeable to trypan blue. CONCLUSION:Autoantibodies against β_1-adrenoceptor may result in arrhythmias and/or impairment of myocardiums in HVM,which would be mediated by the enhancement of I_(ca-L.

INSULIN RESISTANCE AND CAROTID ATHEROSCLEROSIS IN 221 PATIENTS WITH POTENTIAL HYPERGLYCEMIA

Objective To investigate the relationship between insulin resistance and carotid atherosclerosis in patients with potential hyperglycemia. Methods A total of 221 patients were recruited among those with potential hyperglycemia. All participants underwent physical examination, medical history interview, and 75 g oral glucose tolerance test. Venous blood was sampled for measurement of insulin and cholesterol levels. The intima-media thickness (IMT) in bilateral common carotid arteries was observed by B-mode ultrasound. Insulin resistance index was calculated by homeostasis model assessment (HOMA-IR). Subjects were stratified in quintiles according to HOMA-IR values. Risk factors and atherosclerotic parameters were analyzed. Results With HOMA-IR value increase, incidence of impaired glucose tolerance, diabetes mellitus, hypertension, and coronary artery disease increased, the levels of triglyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose, 2 hour plasma glucose, and fasting insulin increased as well, while the level of high density lipoprotein cholesterol (HDL-C) decreased. Meanwhile, all atherosclerotic parameters increased. Multivariate regression analysis showed that TG, total cholesterol, HDL-C, LDL-C levels, and ln(HOMA-IR) were related to IMT, hence were risk factors for IMT increase. Conclusion Insulin resistance is implicated in atherogenesis.

Allograftic bone marrow-derived mesenchymal stem cells transplanted into heart infarcted model of rabbit to renovate infarcted heart

Objective: To investigate the directed transplantation of allograftic bone marrow-derived mesenchymal stem cells (MSCs) in myocardial infarcted (MI) model rabbits. Materials and Methods: Rabbits were divided into 3 groups, heart infarcted model with MSCs transplanted treatment (MSCs group, n=12), heart infarcted model with PBS injection (control group, n=20), sham operation with PBS injection (sham group, n=17). MSCs labelled by BrdUrd were injected into the MI area of the MSCs group. The same volume of PBS was injected into the MI area of the control group and sham group. The mortality, LVIDd, LVIDs and LVEF of the two groups were compared 4 weeks later. Tropomyosin inhibitory component (Tn I) and BrdUrd immunohistochemistry identified the engrafted cells 4 weeks after transplantation. Result: The mortality of the MSCs group was 16.7% (2/12), and remarkably lower than the control group's mortality [35% (7/20) (P<0.05)]. Among the animals that survived for 4 weeks, the LVIDd and LVIDs of the MSCs group after operation were 1.17±0.21 cm and 0.74±0.13 cm, and remarkably lower than those of the model group, which were 1.64±0.14 cm and 1.19±0.12 cm (P<0.05); the LVEF of the MSCs group after operation was 63±6%, and remarkably higher than that of the model group, which was 53±6% (P<0.05). Among the 10 cases of animals that survived for 4 weeks in the MSCs group, in 8 cases (80%), the transplanted cells survived in the non MI, MI region and its periphery, and even farther away; part of them differentiated into cardiomyocytes; in 7 cases (70%), the transplanted cells participated in the formation of blood vessel tissue in the MI region. Conclusion: Transplanted allograftic MSCs can survive and differentiate into cardiomyocytes, form the blood vessels in the MI region. MSCs transplantation could improve the heart function after MI.

Anticoagulation therapy in intra-aortic balloon counterpulsation： Does IABP really need anti-coagulation ？

Objective: To investigate if intra-aortic balloon pump(IABP) is contraindicated without anticoag-ulation therapy. Methods: Some 153 IABP patients in the King Abdulaziz Cardiac Center(KSA) were random-ly assigned into two groups. Anticoagulation group( Group A) consisted of 71 patients who were given heparin intravenously with target aPTT 50 - 70 seconds. Non-anticoagulation group( Group B) consisted of 82 patients without intravenous heparin during balloon pumping. Hematological parameters including platelet count, D-dimer, Plasminogen activator inhibitor-1 (PAI-1) and fibrinogen degradation products(FDP) were checked respectively at the point of baseline, 24 hours, 48 hours and 24 hours post IABP counterpulsation. Clot deposits on balloon surface, vascular complications from IABP including bleeding and limb ischemia were recorded.Results: Platelet count and PAI-1 level decreased at 24 hours and 48 hours in both groups ( P < 0.05) . D-dimer and FDP level increased at 24 hours and 48 hours in both groups( P < 0.05), but returned to the baseline level 24 hours post IABP removal( P > 0.05) . Three patients in Group A and 2 patients in Group B developed minor limb ischemia( P > 0.05). No major limb ischemia in either group. Two patients in Group A suffered major bleeding and required blood transfusion or surgical intervention, whereas no patient had major bleeding in Group B. Eight patients had minor bleeding in Group A, but only 2 patients in Group B ( P <0.05). No clot deposit developed on IABP surface in either group. Conclusion: IABP is safe without routine anticoagulation therapy. Selecting appropriate artery approach and early detection intervention are key methods for preventing complications.

Effectof Ginsenoside Re on Cardiomyocyte Apoptosis and Expression of Bcl-2/Bax Gene after Ischemia and Reperfusion in Rats

To observe the effectof ginsenoside Re on cardiomyocyte apoptosis and Bcl- 2 / Bax gene expression after ischemia (30 m in) and reperfusion (6 h) in rats and to elucidate the possible m echanism s of ginsenoside Re on inhibition of cardiom yocyte apoptosis,the ischem ia/ reperfusion heart m odel was established by ligating the left anterior descending branch of coronary artery in Wistar rats.The apoptotic cardiom yocytes were confirmed by transm ission electron m icroscopy and counted by in situ nick end labeling(TU NEL) method and lightm icroscopy.The m RNA and protein expression of Bcl- 2 and Bax genes were studied by in situ hybridization and im munohis- tochemical staining.Mean optical density (OD) value of the positive fields of m RNA and protein expression was quantitatively exam ined by im age analysis system.The results were as follows: (1) The apoptotic cardiomyocytes were found in ischemic fields in the ischem ia/ reperfusion group and weren't observed in the sham- operation group by transmission electron microscopy;(2 ) The num bers of the apoptotic cells were134.4 5± 4 5 .6 1/ field in the ischemia/ reperfusion group,and 90 .6 6± 19.2 2 / field in the ginsenoside Re- treated group.The differences was significant between two groups(P<0 .0 1) ;(3) Gene expression of Bcl- 2 and Bax were increased significantly in the is- chemia/ reperfusion group and ginsenoside Re- treated group when compared with the sham - opera- tion group.There was no significant difference in the gene expression of Bcl- 2 between the gin- senoside Re- treated group and ischemia/ reperfusion group(P>0 .0 5 ) ,but gene expression of Bax was decreased significantly in the ginsenoside Re- treated group as compared with the ischem ia/ reperfusion group(P<0 .0 1) .The ratio of Bcl- 2 / Bax was increased significantly in the ginseno- side Re- treated group when com pared with the ischem ia/ reperfusion group and sham- operation group.These findings suggest that m yocardial ischem ia- reperfusion can induce cardiom yocyte apoptosis,and ginsenoside Re can significantly inhibit cardiom yocyte apoptosis induced by ischemi- a- reperfusion in rats.It is concluded that ginsenoside Re inhibits cardiomyocyte apoptosis by in- hibiting expression of pro- apoptotic Bax gene and raising the ratio of Bcl- 2 / Bax.

Early association of electrocardiogram alteration with infarct size and cardiac function after myocardial infarction

Objective: Myocardial infarction (MI) is the main cause of heart failure, but the relationship between the extent of MI and cardiac function has not been clearly determined. The present study was undertaken to investigate early changes in the electrocardiogram associated with infarct size and cardiac function after MI. Methods: MI was induced by ligating the left anterior descending coronary artery in rats. Electrocardiograms, echocardiographs and hemodynamic parameters were assessed and myocardial infarct size was measured from mid-transverse sections stained with Masson抯 trichrome. Results: The sum of pathological Q wave amplitudes was strongly correlated with myocardial infarct size (r = 0.920, P < 0.0001), left ventricular ejection fraction (r = -0.868, P < 0.0001) and left ventricular end diastolic pressure (r = 0.835, P < 0.0004). Furthermore, there was close relationship between MI size and cardiac function as assessed by left ventricular ejection fraction (r = -0.913, P < 0.0001) and left ventricular end diastolic pressure (r = 0.893, P < 0.0001). Conclusion: The sum of pathological Q wave amplitudes after MI can be used to estimate the extent of MI as well as cardiac function.

Percentage of peak-to-peak pulsatility of portal blood flow can predict right-sided congestive heart failure

AIM: To study the change of portal blood flow for the prediction of the status of right-sided heart failure by using non-invasive way.METHODS: We studied 20 patients with rheumatic and atherosclerotic heart diseases. All the patients had constant systemic blood pressure and body weight 1 week prior to the study. Cardiac index (CI), left ventricular end-diastolic pressure (LVEDP), mean aortic pressure (AOP), pulmonary wedge pressure (PWP), mean pulmonary arterial pressure (PAP), mean right atrial pressure (RAP), right ventricular end-diastolic pressure (RVEDP) were recorded during cardiac catheterization. Ten patients with RAP＜10 mmHg were classified as Group 1. The remaining 10 patients with RAP ≥ 10 mmHg were classified as Group 2. Portal blood velocity profiles were studied using an ultrasonic Doppler within 12h after cardiac catheterization.RESULTS: CI, AOP, and LVEDP had no difference between two groups. Patients in Group 1 had normal PWP (14.6±7.3mmHg), PAP (25.0±8.2 mmHg), RAP (4.7±2.4 mmHg), and RVEDP (6.4±2.7 mmHg). Patients in Group 2 had increased PWP (29.9±9.3 mmHg), PAP (46.3±13.2 mmHg), RAP (17.5±5.7 mmHg), and RVEDP (18.3±5.6 mmHg) (P＜0.001).Mean values of maximum portal blood velocity (Vmax), mean portal blood velocity (Vmean), cross-sectional area (Area)and portal blood flow volume (PBF) had no difference between 2 groups. All the patients in Group 1 had a continuous antegrade portal flow with a mean percentage of peak-topeak pulsatility (PP) 27.0±8.9 % (range: 17-40 %). All the patients in Group 2 had pulsatile portal flow with a mean PP 86.6±45.6 (range: 43-194 %). One patient had a transient stagnant and three patients had a transient hepatofugal portal flow, which occurred mainly during the ventricular systole. Vmax, Vmean and PBF had a positive correlation with CO (P＜0.001) but not with AOP, LVEDP, PWP, PAP,RAP, and RVEDP.PP showed a good correlation (P＜0.001)with PWP, PAP, RAP, and RVEDP but not with CI, AOP, and LVEDP. All the patients with PP ＞40 % had a right-sided heart failure with a RAP=10 mmHg.CONCLUSION: The measurement of PP change is a simple and non-invasive way to identify patients with right heart failure.

NON-INVASIVE IMAGING OF CORONARY ARTERY WITH 16-SLICE SPIRAL COMPUTED TOMOGRAPHY

To evaluate the value of 16-slice spiral CT in the demonstration of coronary artery and in the diagnose of coronary artery stenosis. Methods Plain and enhanced CT scans were performed with a 16-slice CT scanner (Sensation 16, Siemens, Germany) in 230 patients with suspected coronary heart disease (CHD). Parameters of the plain scan were: 120 kV, 133 mA, slice col-limation 16 mm×1.5 mm, rotation time 0.42 seconds, increment 1.5 mm, and slice width 3 mm. Parameters of the enhanced scan were: 120 kV, 500 mA, slice collimation 16 mm×0.75 mm, rotation time 0.42 seconds, increment 0.5 mm, and slice width 1 mm. Enhanced CT scan was performed with a rapid intravenous injection of 100 mL iothalamate meglumine (Ultravist) (370 mgI/mL) or Omnipaque (350 mgI/mL) and 30 mL 0.9% NaCl chaser bolus at a flow rate of 3.5 mL/s. Calcium scoring with plain scan images and two and three dimensional reconstruction with enhanced scan images were made in all cases, among which 30 cases underwent conventional coronary angiography. Demonstration of coronary arteries and their stenosis were evaluated and the factors that might influence the image quality were analyzed. Results Coronary calcium scores were calculated and coronary artery was demonstrated in our study. In the evaluationof image quality with volume rendering technique (VRT) images, 78.3% of the images were of the first class, 12.2% the sec-ond class, and 9.6% the third class. Multi-planar reconstruction (MPR) and maximal intensity projection (MIP) were better than VRT in the demonstration of small branches. The image quality was related to the heart rate, with or without arrhythmia, and breath-hold ability of patients. Comparative study of the stenosis of coronary arteries in 30 cases showed that the sensi-tivity and specificity of 16-slice coronary CT angiography (CTA) to diagnose significant stenosis were 95.8% and 94.8% resp-ectively. Conclusion As a non-invasive and quick method, 16-slice coronary CTA is sensitive and specific to diagnose the stenosis of coronary arteries and can be used as a screening method in the diagnosis of CHD.

ERK1/2 contributes negative regulation to STAT3 activity in HSS-transfected HepG2 cells

Signal transducer and activator of transcription 3 (STAT3) is a recently characterized transcription factor which is essential to liver regeneration. We have previously reported that hepatic stimulator substance (HSS), a novel growthpromoting substance, phosphorylated the epidermal growth factor (EGF) receptors and activated downstream RasMAP kinase (extracellular signal-regulated kinases, ERK1/2) cascade. However, whether HSS signal is related to STAT3pathway remains unclear. The present study is aiming to explore the regulatory effect of activation of ERK1/2 evoked by HSS on STAT3 phosphorylation and STAT3 signaling. Human hepatoma cell line HepG2 was stably transfected with HSS cDNA and HSS expression was measured by Northern blot. The results showed that the transfection of HSS into HepG2 resulted in remarkable increase in cellular proliferation as compared with the non-transfected cells, and it was further proved that the cellular proliferation in the HSS-transfected cells was related to ERK1/2 activation. Treatment of the cells with 50 μM of PD98059, an ERK1/2 specific upstream inhibitor, resulted in ERK1/2 inactivation completely.Inhibition of ERK1/2 allowed the tyrosine of STAT3 to be phosphorylated in a dose-dependent manner to PD98059.Furthermore, transient transfection of STAT3 mutant (STAT3S727A) into HSS-bearing cells could remarkably reverse the inhibitory effect of ERK1/2 on STAT3 phosphorylation. Based upon these results, it is concluded that ERK1/2negatively modulates STAT3 phosphorylation and this function is dependent on residual serine-727 (S727) of STAT3.

PREVENTION OF PERICARDIAL CONSTRICTION BY TRANSCATHETER INTRAPERICARDIAL FIBRINOLYSIS WITH UROKINASE

Objective To investigate whether intrapericardial urokinase irrigation along with pericardiocentesis could prevent peri-cardial constriction in patients with infectious exudative pericarditis. Methods A total of 94 patients diagnosed as infectious exudative pericarditis (34 patients with purulent pericarditis and 60 with tuberculous pericarditis, the disease courses of all patients were less than 1 month), 44 males and 50 females, aged from 9 to 66 years (mean 45.4 ± 14.7 years), were consecutively recruited from 1993 to 2002. All individuals were randomly given either intrapericardial urokinase along with conventional treatment in study group, or conventional treatment alone (including pericardiocentesis and drainage) in control group. The dosage of urokinase ranged from 200 000 to 600 000 U (mean 320 000 ± 70 000 U). The immediate effects were detected by pericardiography with sterilized air and diatrizoate meglumine as contrast media. The long-term investigation depended on the telephonic survey and echocardiographic examination. The duration of following-up ranged from 8 to 120 months (mean 56.8 ± 29.0 months). Results Percutaneous intrapericardial urokinase irrigation promoted complete drainage of pericardial effusion, signifi-cantly reduced the thickness of pericardium (from 3.1 ± 1.6 mm to 1.6 ± 1.0 mm in study group, P < 0.001; from 3.4 ± 1.6 mm to 3.2 ± 1.8 mm in control group, P > 0.05, respectively), and alleviated the adhesion. Intrapericardial bleeding related to fibrinolysis was found in 6 of 47 patients with non-blood pericardial effusion and no systemic bleeding and severe puncture-related complication was observed. In follow-up, there was no cardiac death, and pericardial constriction events were observed in 9 (19.1%) of study group and 27 (57.4%) of control group. Cox analysis illustrated that urokinase could significantly reduce the occurrence of pericardial constriction (relative hazard coefficient = 0.185, P < 0.0001). Conclusion The early employment of intrapericardial fibrinolysis with urokinase and pericardiocentesis appears to be safe and effective in preventing the development of pericardial constriction in patients with infectious exudative pericarditis.

CLINICAL SIGNIFICANCE OF COMPLETE LEFT BUNDLE BRANCH BLOCK IN DILATED CARDIOMYOPATHY

Clinical, electrocardiographic and echocardiographic findings in 64 patients with dilated cardiomyopathy were retrospectively studied. Compared with 51 patients without complete left bundle branch block (CLBBB), 13 patients with CLBBB had higher New York Heart Association (NYHA) functional class (P<0. 05), increased left ventricular end-diastolic and end-systolic diameters (P<0. 002) and myocardial mass (P<0. 02). severe mitral regurgitation (P<0. 01) and higher mortality rate (P<0. 04). Multivariate stepwise regression analysis revealed that the presence of CLBBB was an independent prognostic factor for patients with dilated cardiomyopathy.

GST polymorphisms are associated with hepatocellular carcinoma risk in Chinese population

AIM: To investigate the association between GSTM1 and GSTT1 polymorphisms and the risk of hepatocellular carcinoma (HCC) in Chinese population. METHODS: Literature databases including PubMed, ISI web of science and other databases were searched.Pooled odds ratio (OR) and 95% CI were calculated using random- or fixed-effects model. Subgroup analysis and sensitivity analysis were also performed. RESULTS: Nineteen studies of GSTM1 (2660 cases and 4017 controls) and 16 studies of GSTT1 (2410 cases and 3669 controls) were included. The GSTM1/GSTT1 null genotypes were associated with increased risk of HCC in Chinese population (for GSTM1, OR = 1.487, 95% CI: 1.159 to 1.908, P = 0.002; for GSTT1, OR = 1.510, 95% CI: 1.236 to 1.845, P = 0.000). No publication bias was detected. In subgroup analysis, glutathione S-transferases polymorphisms were significantly associated with HCC risk among the subjects living in high-incidence areas, but not among the subjects living in low-incidence areas. CONCLUSION: The present meta-analysis suggests that GSTM1/GSTT1 null genotypes are associated with increased risk of HCC in Chinese population.

In vitro effect of biologically active coating on endothelialisation of Nitinol coils designed for the closure of intracardiac shunt

Objective:To evaluate in vitro the effect of biologically active coating on endothelialisation of Nitinol coils designed for the closure of intracardiac shunt. Methods:Covalently binding procedure was performed with chemical vapor deposition (CVD). Heparin(200 IU/ml),r-hirudin(21 nmol/ml),or fibronectin(15 μg/ml),respectively, were bound to the basic coating(poly(amino-p-xylylene-co-p-xylylen)). In vitro tests were performed on five different coating groups(n=2 each):uncoated Nitinol, basic coating,heparin-,r-hirudin-,and fibronectin-coating. Human umbilical vein endothelial cells(HUVECs) were cultured in the presence of tested coils for 48 and 72 h. Adhesion of HUVECs were evaluated with light microscopy,and with confocal laser scanning microscopy after double-staining of vinculin,phalloidin, Ki67 and fibronectin. Results: After 48 and 72 h of incubation,except HUVECs around the basic coating showing abnormal morphology, HUVECs were able to grow next to all kinds of coils. By CLSM adhering cells were typically confined to maximal three secondary coil windings. HUVECs adhered best to the fibronectin coated coils,followed by the uncoated Nitinol. HUVECs barely adhered to the basic coating. The adhesion to heparin coating or r-hirudin coating was observed with various cell densities. Heparin coating seemed to support cell adhesion better than r-hirudin coating did. The HUVECs assembled fibronectin matrix on the fibronectin coating and uncoated Nitinol coil. Vinculin was expressed on both fibronectin coating and uncoated Nitinol as well, mostly diffused,but occasionally also in focal contacts. Ki67 expression was mainly noticed on the uncoated Nitinol coil and fibronectin coated coil,only occasionally on other materials. The densities and morphology of HUVECs, adhered to the correspohding well surfaces,were similar for all wells. The only exception was the well with the basic coating coil after three days of incubation. In this case, the cell density was diminished,and the cells became more elongated. The cells grown on the well surfaces exhibited a more profound matrix assembly and more pronounced focal adhesions than the cells adhered to the coil surfaces did. Conclusion:Except for basic coating,biologically active substance coated or uncoated coils show no acute cytotoxicity on HUVECs. Due to better cell proliferation,cell matrix assembling,and focal adhesion,only fibronectin coating improves the endothelialisation of Nitinol coils.

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing. Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years. Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teena-gers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8 ±5.2 mmHg, P< 0.01; 12.2% ±12.0% vs. 2.5% ±4.4%, P< 0.001, respectively). There was a similar trend for diastolic blood pressure (8.4 ±6.4 mmHg vs. 3.7 ±6.4 mmHg, P= 0.052; 13.2% ±10.6 % vs. 6.8% ±10.1%, P= 0.053, respectively). Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.