目的:观察通心脉方对大鼠离体心脏缺血再灌AKt及p38αMAPK(p38 a mitogen-activated protein kinase,MAPK)蛋白表达的影响,初步探讨通心脉方对心肌缺血再灌注损伤及细胞凋亡的作用机制。方法:采用Langendorff离体心脏灌流方法模拟缺血...目的:观察通心脉方对大鼠离体心脏缺血再灌AKt及p38αMAPK(p38 a mitogen-activated protein kinase,MAPK)蛋白表达的影响,初步探讨通心脉方对心肌缺血再灌注损伤及细胞凋亡的作用机制。方法:采用Langendorff离体心脏灌流方法模拟缺血再灌注模型;分光光度法观察心肌组织中超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、丙二醛(MDA)、caspase-8及caspase-3含量的变化,酶联免疫(ELISA)法观察心肌组织中肿瘤坏死因子-α(TNF-α)含量的变化,免疫印迹(Western blot)法检测心肌组织p-p38αMAPK(phosphoryl-ated p38αmitogen activated protein kinase)、p38αMAPK、p-AKt(phosphorylated AKt)及AKt蛋白表达的变化。结果:与缺血再灌注组对比,正常灌流组、通心脉方大、中剂量组及卡维地洛组MDA、TNF-α、caspase-8及caspase-3含量显著降低,差别有统计学意义(P<0.01或P<0.05),SOD及CAT含量显著升高,差别有统计学意义(P<0.05或P<0.01);p38αMAPK及AKt在各组表达相对恒定,与缺血再灌注组相比,差别无统计学意义(P>0.05),p-p38αMAPK在与缺血再灌注组明显激活,在通心脉方大、中剂量组及卡维地洛组表达明显降低,差别有统计学意义(P<0.01);p-AKt在与缺血再灌注组激活,而在通心脉方大、中剂量组及卡维地洛组表达进一步增加(P<0.05)。结论:通心脉方能保护心肌缺血再灌注损伤和细胞凋亡,其作用机制可能与通过抑制脂质过氧化,下调p-p38αMAPK表达,减少TNF-α的形成,进而抑制caspase-8及caspase-3活性以及激活细胞增殖信号AKt有关。展开更多
Objective: Using receiver operating characteristics (ROC) curve to evaluate the value of pulse wave velocity (PWV) in the diagnosis of coronary heart disease (CHD). Methods: By using coronary angiography as golden dia...Objective: Using receiver operating characteristics (ROC) curve to evaluate the value of pulse wave velocity (PWV) in the diagnosis of coronary heart disease (CHD). Methods: By using coronary angiography as golden diagnostic standard of CHD, 218 patients were divided into both CHD group (n=121) and non-CHD group (n = 97). All these patients received PWV test. The efficacy of PWV of each artery segments in the diagnosis of CHD was evaluated by ROC curve. The sensitivity and specificity were calculated with the golden diagnostic standard of CHD. Results:The PWV of right carotid to femoral artery (Rc-f), left carotid to femoral artery (Lc-f), right radial to carotid artery (Rc-r), left radial to carotid artery (Lc-r) in CHD group were significantly higher than that of non-CHD group (9. 31±1. 75 vs 7.60±1.59, P<0. 01; 9. 02±1.71 vs 7. 52±1.50, P<0. 01; 8. 69±1. 37 vs 8. 00±1. 27, P<0. 01; 8.52±1. 03 vs 8. 03±1. 2, P<0. 01 respectively). However, the PWV of both right and left femoral to ankle artery (Rf-a and Lf-a) had no significant differences between the two groups. We then compared the area under curve (AUC) of each ROC(AUCROC) of PWV of Rc-f, Lc-f Rc-r and Lc-r to evaluate their diagnostic efficacy for CHD. We found that AUCROC of Rc-f PWV was the biggest (AUCROC = 0. 818), at the peak point of its ROC curve, the PWV was 8. 32 m/s. PWV>8. 32 m/s of Rc-f could predict the presence of CHD with a sensitivity of 79% and specificity of 77%. Conclusion: The PWV of Rc-f, Lc-f, Rc-r, Lc-r are significantly higher in CHD group than that in non-CHD group, and PWV of Rc-f is the most accurate in the detection of CHD. The PWV>8. 32 m/s of RC-F is a valuable predictor of CHD.展开更多
The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases （CVD）. The burden of CVD is expected to i...The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases （CVD）. The burden of CVD is expected to increase particularly for the most common types of chronic heart disease of the elderly including coronary artery disease, heart failure and atrial fibrillation. In this context of dramatic demographic changes, geriatric cardiologists are facing important challenges. In this review, we outline the basic concepts of geriatric cardiology and describe these challenges as well as the unmet needs around this discipline with also a focus on the translation from basic research.展开更多
Atherosclerosis and its related cardiovascular disease is the most common cause of morbidity and mortality in the Western world. The roots of this disease may lie, in part, in dietary and lifestyle behaviors, indicati...Atherosclerosis and its related cardiovascular disease is the most common cause of morbidity and mortality in the Western world. The roots of this disease may lie, in part, in dietary and lifestyle behaviors, indicating that modifica- tion of these behaviors may lead to profound improvements.展开更多
A growing number of studies have reported that serum uric acid（SUA） is associated with coronary heart disease（CHD）, which has been increasingly recognized and valued by the medical community. This paper surveys th...A growing number of studies have reported that serum uric acid（SUA） is associated with coronary heart disease（CHD）, which has been increasingly recognized and valued by the medical community. This paper surveys the epidemiological studies of hyperuricemia and CHD and summarizes the clinical study discussing the association between hyperuricemia and coronary heart disease with a prospect of exploring the possible mechanisms of compound Danshen dripping pills in reducing SUA in patients with coronary heart disease.展开更多
Objective To report our operative experience with aortic root replacement in 231 patients with aortic root aneurysm and discuss the current indications, methods, and surgical techniques、Methods Between January 1994...Objective To report our operative experience with aortic root replacement in 231 patients with aortic root aneurysm and discuss the current indications, methods, and surgical techniques、Methods Between January 1994 and August 1999, a group of 231 consecutive patients underwent aortic root replacement at our hospital, with 13 being treated on an emergency basis、 There were 189 men and 42 women, ranging in age from 14 to 69 years、 The diameter of the aneurysm varied from 4、5 to 11?cm、 Among this group, 145 had isolated aortic root aneurysms, 65 suffered from DeBakey type Ⅰ aortic dissection, and the remaining 21 were diagnosed as having DeBakey type Ⅱ aortic dissection、 Aortic valve regurgitation occurred in all cases、 Aortic root replacement was performed with composite valved graft in 229 patients, and in 2 patients the aortic valve was preserved、Results The hospital mortality rate was 3、03% (7 patients)、 Early complications included re-exploration for bleeding in 6 patients, pericardial effusion in 9, as well as cerebral infarction, pleural effusion, and pneumothorax in 2 patients each、 One hundred and seventy-five patients (78、12%) were followed up, with a mean follow-up time of 15、7±13、1 months (range, 2 weeks to 65 months)、 One patient died from lower-limb embolism and renal dysfunction 3 months postoperatively、 Three patients died from postoperative anticoagulation accidents、 The preoperative and postoperative mean left ventricular end-diastolic diameters were significantly different (68、1±9、4?mm, range 54 to 112?mm; vs 54、8±8、2?mm, range 38 to 88?mm; P<0、001)、Conclusions Once a diagnosis of acute aortic root dissecting aneurysm is made, the patient should undergo surgery as soon as possible if the general conditions permit、 Aortic aneurysm without dissection or with chronic dissection should be operated if the diameter of the aneurysm is greater than 5?cm展开更多
OBJECTIVE: To investigate a quantitative method for using radial artery pulse waveforms to assess the effect of pulsatile flow during cardiopulmonary bypass(CPB).METHODS: A total of 34 adults with heart disease who un...OBJECTIVE: To investigate a quantitative method for using radial artery pulse waveforms to assess the effect of pulsatile flow during cardiopulmonary bypass(CPB).METHODS: A total of 34 adults with heart disease who underwent open-heart surgery between April2010 and January 2011 were randomized into a pulsatile perfusion group(n=17) and a non-pulsatile perfusion group(n=17). Radial arterial pulse waveforms of pulsatile and non-pulsatile perfusion patients were observed and compared before and during CPB.RESULTS: No pulse waveform could be detected at patients' radial artery in both groups when the aorta was cross-clamped. Pulse waveforms could be detected at pulsatile perfusion patients' radial artery, but could not be detected at non-pulsatile perfusion patients' radial artery during CPB. Additionally, patients' pulse waveforms during pulsatile perfusion were lower than those before the operation.CONCLUSION: Our findings indicate that radial artery sphygmogram can be used as a valid indicator to evaluate the effectiveness of pulsatile perfusion during CPB.展开更多
文摘目的:观察通心脉方对大鼠离体心脏缺血再灌AKt及p38αMAPK(p38 a mitogen-activated protein kinase,MAPK)蛋白表达的影响,初步探讨通心脉方对心肌缺血再灌注损伤及细胞凋亡的作用机制。方法:采用Langendorff离体心脏灌流方法模拟缺血再灌注模型;分光光度法观察心肌组织中超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、丙二醛(MDA)、caspase-8及caspase-3含量的变化,酶联免疫(ELISA)法观察心肌组织中肿瘤坏死因子-α(TNF-α)含量的变化,免疫印迹(Western blot)法检测心肌组织p-p38αMAPK(phosphoryl-ated p38αmitogen activated protein kinase)、p38αMAPK、p-AKt(phosphorylated AKt)及AKt蛋白表达的变化。结果:与缺血再灌注组对比,正常灌流组、通心脉方大、中剂量组及卡维地洛组MDA、TNF-α、caspase-8及caspase-3含量显著降低,差别有统计学意义(P<0.01或P<0.05),SOD及CAT含量显著升高,差别有统计学意义(P<0.05或P<0.01);p38αMAPK及AKt在各组表达相对恒定,与缺血再灌注组相比,差别无统计学意义(P>0.05),p-p38αMAPK在与缺血再灌注组明显激活,在通心脉方大、中剂量组及卡维地洛组表达明显降低,差别有统计学意义(P<0.01);p-AKt在与缺血再灌注组激活,而在通心脉方大、中剂量组及卡维地洛组表达进一步增加(P<0.05)。结论:通心脉方能保护心肌缺血再灌注损伤和细胞凋亡,其作用机制可能与通过抑制脂质过氧化,下调p-p38αMAPK表达,减少TNF-α的形成,进而抑制caspase-8及caspase-3活性以及激活细胞增殖信号AKt有关。
基金National Natural Science Foundation of China(81874375),Natural Science Foundation of Hunan Province(2022JJ30430)Natural Science Foundation of Hunan Province(2021JJ30491).
文摘Objective: Using receiver operating characteristics (ROC) curve to evaluate the value of pulse wave velocity (PWV) in the diagnosis of coronary heart disease (CHD). Methods: By using coronary angiography as golden diagnostic standard of CHD, 218 patients were divided into both CHD group (n=121) and non-CHD group (n = 97). All these patients received PWV test. The efficacy of PWV of each artery segments in the diagnosis of CHD was evaluated by ROC curve. The sensitivity and specificity were calculated with the golden diagnostic standard of CHD. Results:The PWV of right carotid to femoral artery (Rc-f), left carotid to femoral artery (Lc-f), right radial to carotid artery (Rc-r), left radial to carotid artery (Lc-r) in CHD group were significantly higher than that of non-CHD group (9. 31±1. 75 vs 7.60±1.59, P<0. 01; 9. 02±1.71 vs 7. 52±1.50, P<0. 01; 8. 69±1. 37 vs 8. 00±1. 27, P<0. 01; 8.52±1. 03 vs 8. 03±1. 2, P<0. 01 respectively). However, the PWV of both right and left femoral to ankle artery (Rf-a and Lf-a) had no significant differences between the two groups. We then compared the area under curve (AUC) of each ROC(AUCROC) of PWV of Rc-f, Lc-f Rc-r and Lc-r to evaluate their diagnostic efficacy for CHD. We found that AUCROC of Rc-f PWV was the biggest (AUCROC = 0. 818), at the peak point of its ROC curve, the PWV was 8. 32 m/s. PWV>8. 32 m/s of Rc-f could predict the presence of CHD with a sensitivity of 79% and specificity of 77%. Conclusion: The PWV of Rc-f, Lc-f, Rc-r, Lc-r are significantly higher in CHD group than that in non-CHD group, and PWV of Rc-f is the most accurate in the detection of CHD. The PWV>8. 32 m/s of RC-F is a valuable predictor of CHD.
文摘The field of geriatric cardiology reflects the evolving medical approaches tailored to address the needs of the growing population of oldest old with cardiovascular diseases （CVD）. The burden of CVD is expected to increase particularly for the most common types of chronic heart disease of the elderly including coronary artery disease, heart failure and atrial fibrillation. In this context of dramatic demographic changes, geriatric cardiologists are facing important challenges. In this review, we outline the basic concepts of geriatric cardiology and describe these challenges as well as the unmet needs around this discipline with also a focus on the translation from basic research.
文摘Atherosclerosis and its related cardiovascular disease is the most common cause of morbidity and mortality in the Western world. The roots of this disease may lie, in part, in dietary and lifestyle behaviors, indicating that modifica- tion of these behaviors may lead to profound improvements.
文摘A growing number of studies have reported that serum uric acid（SUA） is associated with coronary heart disease（CHD）, which has been increasingly recognized and valued by the medical community. This paper surveys the epidemiological studies of hyperuricemia and CHD and summarizes the clinical study discussing the association between hyperuricemia and coronary heart disease with a prospect of exploring the possible mechanisms of compound Danshen dripping pills in reducing SUA in patients with coronary heart disease.
文摘Objective To report our operative experience with aortic root replacement in 231 patients with aortic root aneurysm and discuss the current indications, methods, and surgical techniques、Methods Between January 1994 and August 1999, a group of 231 consecutive patients underwent aortic root replacement at our hospital, with 13 being treated on an emergency basis、 There were 189 men and 42 women, ranging in age from 14 to 69 years、 The diameter of the aneurysm varied from 4、5 to 11?cm、 Among this group, 145 had isolated aortic root aneurysms, 65 suffered from DeBakey type Ⅰ aortic dissection, and the remaining 21 were diagnosed as having DeBakey type Ⅱ aortic dissection、 Aortic valve regurgitation occurred in all cases、 Aortic root replacement was performed with composite valved graft in 229 patients, and in 2 patients the aortic valve was preserved、Results The hospital mortality rate was 3、03% (7 patients)、 Early complications included re-exploration for bleeding in 6 patients, pericardial effusion in 9, as well as cerebral infarction, pleural effusion, and pneumothorax in 2 patients each、 One hundred and seventy-five patients (78、12%) were followed up, with a mean follow-up time of 15、7±13、1 months (range, 2 weeks to 65 months)、 One patient died from lower-limb embolism and renal dysfunction 3 months postoperatively、 Three patients died from postoperative anticoagulation accidents、 The preoperative and postoperative mean left ventricular end-diastolic diameters were significantly different (68、1±9、4?mm, range 54 to 112?mm; vs 54、8±8、2?mm, range 38 to 88?mm; P<0、001)、Conclusions Once a diagnosis of acute aortic root dissecting aneurysm is made, the patient should undergo surgery as soon as possible if the general conditions permit、 Aortic aneurysm without dissection or with chronic dissection should be operated if the diameter of the aneurysm is greater than 5?cm
基金Grants from the National Natural Science Foundation of China(No.81173200,No.81373556)the Research and Assessment of the Effects of Pulsatile Perfusion During Cardiopulmonary Bypass Based on the Monitoring"Cunkou"Pulse Waveforms of Traditional Chinese Medicine Research Fund of Shanghai Municipal Public Health Bureau(No.2010J015A)
文摘OBJECTIVE: To investigate a quantitative method for using radial artery pulse waveforms to assess the effect of pulsatile flow during cardiopulmonary bypass(CPB).METHODS: A total of 34 adults with heart disease who underwent open-heart surgery between April2010 and January 2011 were randomized into a pulsatile perfusion group(n=17) and a non-pulsatile perfusion group(n=17). Radial arterial pulse waveforms of pulsatile and non-pulsatile perfusion patients were observed and compared before and during CPB.RESULTS: No pulse waveform could be detected at patients' radial artery in both groups when the aorta was cross-clamped. Pulse waveforms could be detected at pulsatile perfusion patients' radial artery, but could not be detected at non-pulsatile perfusion patients' radial artery during CPB. Additionally, patients' pulse waveforms during pulsatile perfusion were lower than those before the operation.CONCLUSION: Our findings indicate that radial artery sphygmogram can be used as a valid indicator to evaluate the effectiveness of pulsatile perfusion during CPB.
