Food Intake Habit and Cardiovascular Risk

To determine the relationshipof dietary factors to cardiovascular disease, surveys were carried out in 1985 (pilot study) and 1989 (core study) as a part of the International Cooperative Cardiovascular Diseases and Alimentary Comparison (CARDIAC) study. Food pattern was observed and blood pressure was measured with an automatic electronic sphygromanometer. The diet in Guangzhou seems more refined, fresher and offers more variety than that in the other areas in China. Both systolic and diastolic blood pressure have risen in the period of socioeco-nomic development. Food intake habits are changing in Guangdong, China, with a trend toward an unhealthy diet which increases the risk of cardiovascular disease.

Clinical Exploration of Transcatheter Closure of Patent Ductus Arteriosus With Duct Occluder in Infants

Objectives To explore the feasibility, necessity, and security of transcatheter closure of patent ductus arteriosus （PDA） in infants. Methods There were 230 infants with PDA. The ages were （7.3 ±3.2 ） months and the weight （6.6 ± 2.8） Kg in average. They were separated into two groups. Group A was formed by the infants weighing less than 6 Kg, Group B over 6 Kg. Right heart catheterization was performed first to calculate the ratio of Qp/Qs. Then descending aortography demonstrated the diameter and shape of PDA. Proper occluder was selected to finish the inter- vention. Echocardiography was performed after intervention 24 hours and 1, 3, 6, 12 and 24 months. Results In Group A the technical achievement ratio was 94.6% with the average diameter of PDA （6.2±3.2） mm. In Group B the technical achievement ratio was 100% with the average diameter of PDA （4.8 ± 2.5 ） mm. We used the Amplatzer Duct Occluder with the type from 6 -8 mm to 12 - 14 ram, the delivery sheath from 6 French to 8 French. 24 hours after intervention, echocardiography demonstrated that there were 6 residual shunts in Group A while 22 in Group B. After 1 year, residual shunt existed in neither group. There were 4 patients whose femoral arteries pulsed weakly after intervention in Group A, while in Group B there were 3. They all recovered 24 hours after the application of urokinase. In Group A blood flow velocity in descending aorta increased in 5 infants, while in Group B there were 3. They all resumed in 6 - 12 months. Conclusions Transcatheter closure of PDA in infants is safe and technically feasible. However, indication should be strictly selected and the intervention should be performed by experienced physician.

Heart Rate Distribution and Cause-specific Death in General Population of South China

Objectives To analyses heart rate （HR） distribution of healthy adults in the south China community and evaluate relative risk of HR to total cause of death and cardiac cerebral vascular death. Methods Analytical data come from the baseline survey and follow-up visits in the PRC-USA Collaborative Study of Cardiovascular Epidemiology in urban and rural samples of Guangzhou. The baseline survey was initiated in 1983 and 1984, and rescanned in 1987 and 1988. Since 1991 Follow-up visits for endpoint events were carried once every two years. Average follow-up year was 16.2 from baseline to 2000. People excluded from cardiac cerebral vascular disease, diabetes and other various chronic diseases were regarded as ＂healthy adults＂. Heart rates of these subjects were measured on resting electrocardiogram. Endpoint evens include： total cause of death, first attack of coronary disease and cerebral vascular events. SAS software was used for analysis. Cox Proportional Hazards model was used to evaluate the impact of HR on total death and cardiac cerebral vascular disease. Results A total of 4570 men and women aged 35-55 years from urban and rural Guangzhou were investigated. 3493 healthy subjects were enrolled in the analysis, including 1694 men and 1799 women. Mean oftheHRis （67.9 ±10.6） beats/min （bpm） in the whole population, （66.3±10.7）bpm in men and （69.3± 10.4） in women. The 52 percentile of the HR was 51 in men and 54 in women. The 952 percentile of the HR was 85 in men and 88 in women. Single correlation analysis showed there was negative relationship between age and HR, but it was only statistical significant in female. Analysis with Cox Proportional Hazards model show that HR 〈 50 bpm tops the risk of total causes of death （1.725）and HR 50-59 bpm decreased the risk of total causes of death （0.843）. Relative risk of cardiac cerebral vascular events exceeds 1 when HR 〈 50 and 〉90 bpm （1.486 and 7.008 respectively）. It was less than 1 in other groups but there was no significant difference between each group. Conclusions Traditional normal range of HR in adult should be adjusted. In certain extent lower HR is advantageous to decrease cardiac cerebral vascular events, total causes of death and has better prognosis.

VEGF-expressing Bone Marrow Mesenchymal Stem Cells Transplantation Improved Heart Function of Myocardial Infarct Rabbits

Objectives To treat myocardial infarction with MSCs transplantation combined with VEGF gene therapy in rabbits and to study its mechanisms. Methods Forty-eight rabbits were randomly divided into MI group （n=12）, MSCs group （n=12）, VEGF group （n=12）, MSCs＋VEGF group （M＋V group, n=12）. Rabbit myocardial infarction models were founded by the ligation of left anterior descending artery. 107 MSCs were injected into the infarct-zone in four sites 2 weeks later in MSCs and M＋ V group, phVEGF gene were injected in infarct-zone in VEGF group and MSCs transfected with phVEGF gene were injected in M＋V group. Heart function including LVEDP, LVSP, LVDP, -dp/dtmax, ＋dp/dtmax, were measured in vivo. The hearts were harvested at 4 weeks after transplantation and sectioned for HE stain, immunohistochemical stain of BrdU and VIII factor antigen. Results The left ventricular hemodynamics parameters showed that heart function were improved more in M＋V group than MSCs group, MI group and VEGF group. The numbers of BrdU positive cells in M＋ V group（61±8）were more than in MSCs group （44±8, P 〈 0.01）. The numbers of vessels in infarcted zone were more in M＋V group （49±8） than in MSCs group （33±6, P 〈 0.01）,VEGF group（30±8, P 〈 0.01）and Mlgroup （18±4, P〈0.01）. Conclusions VEGF-expressing MSCs transplantation could improve heart function after myocardial infarction, and they were more effective than sole MSCs transplantation. Keeping more MSCs survival and ameliorating the blood supply of infarct-zone might be involved in the mechanisms.

Morphology and Function of the Aortic Valve after Transcatheter Closure of Ventricular Septal Defect with Aortic Valve Prolapse

Objective:This study aims to evaluate the morphology and function of the aortic valve after transcatheter closure of ventricular septal defect(VSD)with aortic valve prolapse(AVP)abased on clinical and radiological outcomes.Methods:From January 2013 to November 2014,164 consecutive patients(97 males,59.1%)with VSD and AVP were treated by transcatheter closure.The patients were divided into the mild AVP group(n=63),moderate AVP group(n=89)and severe AVP group(n=12).The clinical and radiological outcomes of these patients were analyzed retrospectively.Results:In total,146(89.0%)patients were successfully treated with VSD occluders,including 59/63(93.7%)with mild AVP,80/89(89.9%)with moderate AVP and 7/12(58.3%)with severe AVP.The degree of AVP was ameliorated or disappeared in 39(26.7%)patients,and remained unchanged in 103(70.5%)patients after the intervention.In the 35 patients who initially had trivial-to-moderate aortic regurgitation(AR),the degree of AR was ameliorated or disappeared in 25(71.4%)patients,aggravated from trivial to mild AR in 1(2.9%)patient,and remained unchanged in 9(25.7%)patients.In 111 patients without AR,1(0.9%)patient had mild AR and 24(21.6%)patients had trivial AR after intervention.The depth and width of the prolapsed aortic valve decreased after transcatheter closure of VSD in all three groups.During the 70-month(range,54–77)follow-up period,no patients with AVP and AR needed an aortic valve intervention.Conclusions:Transcatheter closure of VSD with AVP is feasible.The morphology and function of the prolapsed aortic valve improved and remained stable for a long period after intervention.

Contemporary treatments and outcomes of preterm infants with critical congenital heart disease in a tertiary cardiovascular institute in China

Background The survival rate of preterm infants with critical congenital heart disease （P-CCHD） has been improved by medicine advances. The aims of this study were to investigate the contemporary treatments for short-term outcomes of P-CCHD and to evaluate risk factors associated with the outcomes. Methods Sixty-four P-CCHD patients admitted to Guangdong General Hospital between 2011 and 2015 were included in this study. De-mographic characteristics and patient records were reviewed. Logistic regression was used to analyze the risk fac-tors of P-CCHD outcome. Results Thirty-six patients underwent surgical treatments for cardiac anomalies. Moreover, 31.25% of the P-CCHD infants did not receive surgery because these parents refused further treat-ment. The in-hospital mortality rate was 8.3% for the patients who underwent surgeries. During a median follow-up of 1.2 years, the survivors were basically healthy. However, mental and physical growth retardation remained. Conclusions Compared to infants in developed Western countries, the treatments and short-term outcomes of P-CCHD infants were satisfactory. However, the long-term outcomes remain to be determined.

Complications Related to Transcatheter Occlusion of Atrial Septal Defect with Amplatzer Septal Occluder in Children

Objectives To investigate the causes, theraputic and preventive methods of com- plications associated with transcatheter occlusion of at- rial septal defect ( ASD) using the Amplatzer septal oc- cluder (ASO) in children. Methods 289 cases un- derwent transcatheter closure of ASD with ASO. Com- plications occurred in 9 cases. The complications in procedure included systemic circulatory systemic air embolism in 2, pulmonary air embolism in 1, pericar- dial tamponade in 1, ASO malposition requiring emer- gency surgical removal in 1, transient atrial extrasysto- les in 1 and sizing balloon rupture in 1 case. 2 cases with postoperative complications were found in the fol- low-up studies. These included perforation of mitral valve and ASO partially dislodged. In this study, 5 children with intraoperative complication received e- mergency therapy including surgical intervention, and others needed only follow-up, as the complications were transient or asymptomatic. Results There were no children death in this study. The 5 cases who re- ceived treatment were completely healing, and the oth- ers with intra - procedure complications were also had no sequela existed. Cases with mitral valve and ASO partially dislodged were still in follow-up studies, as the 2 patients having no symptoms. Conclutions Air embolism were occurred easily in atrial septal defect cases who received ASO therapy. Complications mainly caused by inappropriate operative procedure and some complications needed emergency treatments. Follow-up studies were important to cases with transcatheter oc- clusion therapy.

Clinical Study on Perioperative Myocardial Ischemia in Patients Undergoing Aorta-Coronary Artery Bypass Grafting

We monitored 26 patients withcoronary artery disease (CAD) undergoing aorta -coronary artery bypass grafting (CABG) by using Holter and studied the characteristics of myocardial ischemia during CABG perioperative period. Our results showed as follows.Of 26 cases , 19(70. 07 % ) had 151 ischemic episodes (including 90 preoperative episodes in 16 cases , 36 intraoperative episodes in 16 cases and 34 postoperative episodes in 12 cases). This result showed a high incidence of perioperative myocardial ischemia.When we expressed the characteristics of ischemic episodes as duration (Dur) , area under ST segment curve (AUC) and maximum ST segment deviation (Max- ST) , the results just showed less pre - and more intra - operative Max -ST (1. 6mm vs 2. 3mm).When we expressed severity of ischemia as sum of episode number (Num - Burden), duration(Dur-Burden) and AUC(AUC-Burden) per hour, the results showed some deviations of severity among different perioperative periods in the three sides Num - Burden, Dur - Burden and AUC - Burden, and a trend of severer intra - operative ischemia and lighter post - operative ischemia. Our results also showed clear correlations among pre - , intra - and post - operative ischemia in three sides of Num - Burden, Dur - Burden and AUC- Burden. All Spearman coefficients reached statistical significance.Also , the paper discussed some factors affecting these myocardial ischemia during perioperative period.

Improvement of the Technique for Transcatheter Closure of Atrial Septal Defect in Children

Objectives To improve experience of procedure and success rate of interventional treatment of atrial septal defect （ASD） in children, applying the technique of controlling release of devices in the pulmonary vein （controlling two disc of device opening for subsequence） in children cases with ASD who can not be occluded by regularly interventional treatment. Methods Since 2000 year 182 child cases （male 70 and 112 female） underwent the procedure of controlling release of devices in the pulmonary vein. The patients＇ age was from 2 to 14 years old （average 3.77±1.55）. The body weight was from 9 to 48 Kg （average 21.53±10.63）. When the devices were placed on the right position with difficulty and failure in some cases with short and soft rims of the defect and large defect and the angle between the device and the interval atrial septal （IAS）, It could be helpful to put the device into the left upper pulmonary vein, and to make right atrium （proximal） disc opened before the left atrium （distal） disc naturally fall down. At the end the double disc of the device clamped and stood up at the right position of the IAS. After closure of ASD, patients were followed up regularly by echocardiography, X-ray and ECG in the 1,3,6,12 month and 3,5 years. Results The successful rate of device implantation in the improving group （98.4%） was obviously higher than that in the regularly group （68%）. The techniques improved in this group with the smaller age, the lighter weight, the larger defect and the larger device comparing with the regularly group. The velocity of the pulmonary vein before occlusion procedure was （0.54±0.15）m/s; after procedure was （0.56±0.16）m/s, P 〉 0.05,there were no significant difference. All cases couldn＇t found pulmonary congestion by follow up. Conclusions The method of controlling release of device in the pulmonary vein has been used more than 5 years in the occlusion of ASD with double disc device. It is feasible and safety. The aim of the improvement is for overcoming the problem with larger ASD and the rim deficiency in the interventional procedure in children with ASD. In summary： 1. The performance of the procedure must be careful; 2. To avoid complication when put the sheath into the pulmonary vein; 3. To avoid to put the left disc into pulmonary vein too long and pull the device too much; 4. When the procedure have to operate repeatedly, the device can not be released before the position satisfactory. The improvement of the technique is needed to carry on long-term follow-up in the clinical trials.

Changes of Serum Vascular Endothelial Growth Factor Concentrations in Acute Myoardial Infarction Rats and Patients

Objective To investigate thechanges of serum vascular endothelial growth factor (VEGF) concentration in a rat model of acute myocar-dial infarction (AMI) and in patients with AMI before and after thrombolytic therapy. Methods Eighty-eight male Sprague-Dawley rats were used and sixteen patients with AMI were studied in this study. AMI was produced by left coronary arterial ligation in 80 animals, and eight rats undergoing thoracotomy but not coronary ligation served as sham controls. The blood samples of rats were drawn from the right atrium before (0 hour, sham animals) and 1, 3, 6, 12 or 24 hours and 2, 3, 5, 7or 14 days after AMI (n = 8, respectively) . The blood samples of patients with AMI were collected from an antecubital vein before and 3 hours after thrombolytic therapy. Serum VEGF concentrations were measured by a sensitive and specific enzyme-linked immunosorbent assay (ELISA) . Results The mean serum VEGF concentration in 8 sham animals was 66. 99±17. 83pg/ml. Six hours after A-MI, the level of serum VEGF significantly increased to 125. 68±28. 07 pg/ml (P < 0. 01 vs Sham controls), and reached a peak (240. 61 ±70. 63 pg/ml, P < 0. 01 vs Sham controls) at 24 hours after ligation, and then decreased gradually over the remaining 2 weeks. However, the level remained significantly elevated for 14 days (107. 64±30. 13 pg/ml, P < 0. 01 vs Sham controls) . The basal serum level of VEGF in patients with AMI was significantly higher than that in 16healthy control subjects (285.92±125. 12 vs 80. 44 ±24. 57 pg/mL, P< 0.01), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents (r = 0.866, P< 0.001 and r = 0.948, P< 0.001; respectively) . Three hours after thrombolysis, the level of VEGF had fallen to 111. 57 ±31. 29 pg/mL (P <0. 01 vs Before thrombolytic therapy; P < 0. 05 vs control subjects) . Conclusion The present study shows that the concentrations of serum VEGF are markedly and permanently increased in the rat model of AMI and in patients with AMI. Serum VEGF concentrations may serve as a sensitive target in diagnosing AMI and judging reper-fusion.

Combined Application of Circulatory Assist Devices Following Cardiac Arrest in Patients after Cardiac Surgery

Objectives To evaluate retrospectively the potential benefits of combined utilization of various assisted circulation devices in cardiac arrest patients who did not respond to conventional cardiopulmonary cerebral resuscitation （CPCR）. Methods Assisted circulation devices, including emergency cardiopulmonary bypass （ECPB）, intra-aortic balloon pump （IABP）, and left ventricular assist device （LVAD）, were applied to 16 adult patients who had cardiac arrest 82 rain-56 h after open heart surgery and did not respond to 20 rain or longer conventional CPCR. ECPB was applied to 2 patients, ECPB plus IABP to 8 patients, ECPB plus IABP and LVAD to 6 patients. Results One patient recovered fully and one patient died. Of the other 14 patients, 13 resumed spontaneous cardiac rhythm and one did not; none of them could be weaned from ECPB. Further treatment of the 14 patients with combinations of assisted circulation devices enabled 6 patients to recover. One of the 7 recovered patients died of reoccurring cardiac arrest after 11 days; the other 6 were discharged in good condition and were followed up for 3-49 months （mean =22 months）. Of the 6 discharged patients one suffered cerebral embolism during LVAD treatment, resulting in mild limitation of mobility of the right limbs ; the other 5 never manifested any central nervous system complications. There was no late deaths giving a 37.5% （6/16） long-term survival rate. Conclusions ECPB could effectively reestablish blood circulation and oxygen supply, rectify acidosis, and improve internal milieu. The combined utilization of ECPB, IABP, and LVAD reduces the duration of ECPB, improves the incidence of recovery, and offers beneficial alternatives to refractory cardiac arrest patients.

Screen for Coronary Artery Disease Specific Genetic Expression by Representational Differential Analysis

Objective To screen coronaryartery disease (CAD) specific expressions and clone their genes. Method Blood samples were collected from CAD and non - CAD patients at the end of coronary angiography. mRNA from samples was isolated and converted into cDNA. After ligated with specific linkers, the cDNA was amplified with complementary primers. PCR products from CAD samples were named as tester; the ones from non - CAD samples were named as driver. With different ratio of tester to driver (1 : 100,1: 1, 000, and 1: 10, 000), they were mixed, denatured, and renatured. Single strand cD-NA was eliminated by Mung bean nuclease. Double strand cDNA presented only in tester was amplified, ligated in vector pUC19 and pUC53, and transformed into E. coll DH5a. Strains with inserted cDNA fragments were picked up based on blue and white selection. Insertions were screened by endonuclease digestion and DNA sequencing. Results were compared with DNA sequences of GeneBank. Results: After the selection with representational differential analysis, CAD specific cDNA fragments with different sizes (about 1kb, 0. 75kb, and 0. 6kb) were cloned. Among them, two fragments from unknown genes were identified. One presented a 43. 3 % similarity with part of the rattus norvegicus lipocortin gene. Another presented a 45. 4 % similarity with part of the human polynucleotide kinase 3' - phosphatase gene. Conclusion There are at least two CAD specific - ex- pressions from unknown genes that were partially similar to lipocortin and polynucleotide kinase 3'- phos-phatase genes, respectively. Expression of these genes might affect the formation and progression of plaque within coronary artery.

Experiment Study Of The Preventive Effects Of Valsartan ElutingStent On In - stent Restenosis

Objectives Background -Neointima hyperplasia and arterial remodeling are the main mechanisms of restenosis after percutaneous transluminal coronary angioplasty. The successful use of coronary stents neutralizes the acute elastic recoil and improves the remodeling mode with reducing restenosis rate by 10 % . But the in - stent neointima hyperplasia becomes more severe. This study aims to set up model of in - stent restenosis in vivo, and to e-valuate the preventive role of implantation of valsartan eluting stent for restenosis. Methods and Results Twenty - two male New Zealand white rabbits were divided into control group and valsartan group. In-travascular ultrasonic (IVUS) results showed the in-trastent neointimal areas of the control group were larger than those of the valsartan group (P < 0. 01) . The minimal lumen area of control group was smaller than that of the valsartan group ( P < 0. 01). Angiog-raphy results showed the normal lumen diameters were similar between two groups ( P> 0.05) . The lumen stenosis rates compared with the normal diameters of the valsartan group were significantly improved over that of the control group ( P < 0. 05) . It was comparable to the IVUS analysis. There were no cases of a-neurysm or thrombosis. Conclusions Valsartan e-luting stents produced a significant inhibition of neointimal hyperplasia and luminal encroachment in rabbits without obviously producing any serious side -effects. These results demonstrate the potential therapeutic benefit of valsartan eluting stents in the pre- vention and treatment of human coronary restenosis.

Surgical Treatment of 144 Children with Ventricular Septal Defect and Severe Pulmonary Hypertension

Objective To report the result of surgical treatment for 144 children with ventricular septal defect and severe pulmonary hypertension. Method The diagnosis had been confirmed by cardiac catheter before the operation, Pp/Ps (0. 81±0.09) and Rp (9.41 ±5.37 ) wood. Ventricular septal prothesis was performed under cardiopulmonary bypass. Transthoracic intracardiac monitoring line inserted into pulmonary artery in 117 cases. Results Fourteen cases died of the 144 postoperatively, with mortality of 9.12% . Preoperative Pp/Ps≥0. 8 and Rp≥10 wood made the mortality higher than that of others ( P < 0. 05 ) . 32 persons had post - operative SpPA > 50 mmHg among the survivors and among the children with preoperative Pp/Ps ≥0. 8 and Rp≥10 wood the mortality was 28. 6 % being higher than that among those with Pp/Ps≥0. 8 and Rp < 10 wood. Conclusion The higher the preoperative Pp/Ps and Rp are, the higher the surgical mortality is. The prevention and treatment of postoperative pulmonary hypertension crisis should be given more attention. The placement of transthoracic intracardiac monitoring lines plays an important role in the prevention and treatment of the complications occurring postoperationally in children with pulmonary hypertension.

Complete Coronary Revascularization with on Pump Beating Heart

Background Off-pump coronary artery bypass grafting (CABG) is becoming increasingly popular world - wide. But it is not always feasible. Current cardioplegic techniques do not consistently avoid myocardial ischemic damage. So we use on pump beating heart technique to supplement off-pump CABG. Methods Based on 860 off-pump CABG cases between Aug 1998 to Aug 2000. From Aug 1999 to Aug 2000, 46 CABG cases were performed with on pump beating heart technique at Mani-pal Hospital Heart Foundation, Bangalore, India. All surgeries were performed through a median sternotomy. Exposure techniques were tailored to individual vessels and cardiac regions and local immobilization was performed with octopus. Vascular control was achieved with occluders and shunts. Total cardiopulmonary bypass (CPB) was established before or during CABG and normolthemia was used. Results Among 46 on -pump beating heart CABG patients, 26 patients used CPB before or during OP - CABG because of unstable hemodynamics and electric instability , 7 had very deep intramyocardial left anterior descending arteries, 5 patients had poor LV function (LVEF < 30 % ), 8 patients had cardiomegaly. The average number of grafts was 3.5. No operative mortality. Three patients had postoperative myocardial infarction. Anesthetic time 4. 5±1. 2 hours, extubation time 10±2. 5 hours, blood lost 680±230 mL, blood requirement 540±150 mL, preoperative LVEF 50. 3±13 % , postoperative LVEF 64. 1±14 %, ICU stay 1. 5±0. 5 days, hospi- tal stay 9.2±1.8 days. Conclusion Complete coronary revascularization with on pump beating heart is a supplement for off - pump CABG when it is not feasible. It eliminates intraoperative globe myocardial ischemia and avoids transient myocardial injury during cardioplegic arrest and myocardial reperfusion.

Radiofrequency Ablation Mapping with Circumferential Catheter for Paroxys- mal Atrial Fibrillation Originating From the Pulmonary Veins

Objectives To assessed the feasibility and effectiveness of electrophysiological mapping of pulmonary veins with a circumferential 10 - electrode catheter and radiofrequency catheter ablation therapy for patients with paroxysmal atrial fibrillation. Background Standard mapping and ablation of focal sources of atrial fibrillation are associated with very long procedure times and low efficacy. Mapping and ablation pulmonary veins guide with a circular catheter could overcome these limitations. Methods 16 patients [male 11, female 5, mean age (51 ±14. 5) years] with paroxysmal atrial fibrillation refractory to antiarrhythmic drugs were included in this group. A circumferential 10 - electrode catheter was used to pulmonary vein mapping during sinus rhythm or CSd pacing to determine the origin of atrial premature contractions. When the ablative target pulmonary vein was found, the pulmonary vein potentials' distribution and activation were assessment pulmonary veins' ostial ablation was performed at the segments showing earliest activation of pulmonary vein potentials. The end point was designed: 1) elimination of pulmonary vein potential; 2) pulmonary vein potential dissociation from atrial waves; 3) atrial ectopic beats disappear. Results A total of 36 pulmonary veins were ablated, including 16 left superior, 12 right superior, 7 left inferior and 1 right inferior. 1 pulmonary vein in 2 patients was ablated, 2 pulmonary veins in 8 patients were ablated, 3 pulmonary veins were ablated in 5 patients and 4 pulmonary veins were ablated in 1 pa- tient. Procedure duration and fluoroscopy time respectively were 186. 7±63. 8 min and 51. 5±15. 0 min. During the follow-up 1-12 months, 11 patients (68. 7 % ) were free of AF without any antiarrhythmic drugs, 2 of them were reablation, effective in 3/16 (18. 7 % ) and unsuccessful in 2/16 (12. 6 % ) . 2 cases recurred with atrial premature, 1 was treated with amiodarone and the other was repeat electrophysiologi-cal mapping and ablation, 5 cases with paroxysmal a-trial fibrillation recurred, 3 of them were treated with amiodarone (2 cases) or sotalol (1 case) , one was implantled with DDDR pacemaker (having programmer of anti - atrial fibrillation), one was repeat ablation. PV's diameter in 2 of them reduced more than 50 % , but they were asymptomatic during the follow - up period. 1 case had pneumothorax complication and disappeared after 7 days. Conclusions This study suggests that careful mapping and elimination of these ectopic foci under the guide of circular catheter may have higher success rate and splendid future.

Development of Heart Rate Variaty in the Early and Rehabilitation Phase of AMI

Heart rate variaty (HRV) of 85cases with AMI was observed in the early phase after onset and rehabilitation phase at first month and sixth month, and was contrasted with six time threshold indices of 111 cases with coronary heart disease and that of 35 normal control. We found the HRV of AMI was apperantly lower in the acute phase than that of coronary heart disease and normal controls. HRV recovered gradually with inclining to be stable after half a year, but it was still lower than that of controls. Low HRV in early phase of AMI suggested the poor prognosis.

The Role of Bedside Troponin T Test for Identification of High Risk Patients With Acute Chest Pain

Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain.Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group. The odds ratio of acute heart failure of positive group vs. negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31 patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain.

Role of Dendritic Cells in Myocarditis Induced by Coxsackie B_3 Virus in Mouse

Background and Objectives Autoimmune reaction may play an important role in the pathogenesis and progress in virus myocarditis. Dendritic cells are the initiators of immune reaction to foreign antigens and are considered to be key players in the induction and maintenance of autoimmune reactions. This study was undertaken to investigate the role of DC in mice with virus myocarditis. Methods and Results Fifty Balb/c mice were injected Coxsackie B3 virus to induce myocarditis and ten mice were injected culture liquid as control group. The hearts of virus - infected mice were harvested on day 3, 7, 14, 28 after the injection. All the hearts were sliced to do HE staining, MHC Ⅱ antigen and S - 100 protein immunohistochemical staining. The inflammation response and expression of MHC Ⅱ antigen and S - 100 protein positive stained cells were observed. The MHC Ⅱ antigen positive score were 1.42±0.95, 2.24 ±1. 00, 3. 23± 1. 16, 2. 58 ± 1. 05 respectively in group 3d, 7 d, 14 d, 28 d, which were significant different from control group(0. 50 ±0.75, P <0. 05). The S-100 positive staining cells in control group was 3. 2±1. 0. And the numbers were 6. 7 ± 1. 4 , 16. 4 ± 2. 5 , 21. 2±3. 3 , 13. 4 ± 2. 3 respectively in group 3 d, 7 d, 14 d, 28 d, and there were significant differences compared with the control group ( P < 0. 01) . Conclusions Immune reaction was involved in the pathogenesis in Coxsackie B3 virus - induced myocarditis in mouse, and dendritic cell might play an important role in the immune reaction.

Differentiation of Rabbit Bone Marrow Mesenchymal Stem Cells to Myogenic Cells and Expression of VEGF After Gene Transfection

Objectives To induce the differentiation of rabbit bone marrow mesenchymal stem cells （MSCs） to myogenic cells in vitro, and to investigate the expression of vascular endothelial growth factor （VEGF） gene in MSCs transfected by AdTrackCMV-VEGF165. Methods MSCs were isolated and purified from rabbit bone marrow by percoll （11）73 g/ml） and then cultured in low glucose DMEM with 10% FBS. AdTrackCMV-VEGF165 eukaryotic expression vector was constructed and transfected into the MSCs. After being incubated with 5-azacytidine （5- Aza）, the expression of troponin I in MSCs was assayed by immunohistochemistry and the expression of VEGF gene was identified by northern blot and western blot. The concentration of VEGF in the supernatant was measured by ELASA. Results MSCs were isolated and cultured successfully from rabbit bone marrow. The positive cTnI stain of some MSCs after the induction of 5-aza indicated that the cells were differentiated to myogenic cells. Northern blot and western blot showed that the expression of VEGF 165 mRNA was much higher in the hVEGF165 gene transfected cells than that of the control. The concentration of VEGF in the supernatant got to the peak 3-5 days after hVEGF165 gene transfection （1011- 1027 pg/ml） and decreased gradually thereafter, but still higher than that of control group or pAdTrackCMV group （349 pg/mLvs 116 pg/mL or 125pg/ml respectively, MSCs could be induced P〈 0.01）. Conclusions to differentiate to myogenic cells by 5-aza in vitro and could express VEGF by VEGF gene transfection.