40岁以下冠心病患者的介入治疗

目的　评价 40岁以下冠心病患者接受经皮冠状动脉腔内介入治疗的近期和远期疗效。　方法　选择 82例冠心病患者 (≤ 40岁 )行经皮冠状动脉腔内成形术 (PTCA)及支架植入治疗。结果　 82例患者 95处病变行血管重建治疗 ,手术成功率达 97 5 6 % ;狭窄改善程度由 84 5 %± 11 8%降至 4 0 %± 1 2 % ;1例 (1 2 2 % )因手术失败行冠状动脉旁路移植术 ;无一例发生严重并发症。临床随访 75例 (35～ 5 2个月 ,平均 42 1± 6 8个月 ) ,3例死亡 (2例为非心源性 ) ,3例发生心肌梗死 ;靶血管再手术率为 12 10 % ,总再狭窄率为 31 43% ,支架再狭窄率为 13 16 % ;87 8%的患者无任何症状。结论　冠状动脉介入治疗对青年冠心病患者有良好的近期和远期疗效 ,安全性高 ,并发症少

动作电位参数作为区分狗心室肌三种细胞的可行性研究

应用细胞膜片钳技术测定狗心室肌细胞的电生理特征、动作电位(AP)以及收缩的参数,并用统计学方法评价所测量的参数是否可将心内、外膜及中层(M)细胞有效地区分开。结果:获取52个混合的有3种心肌细胞的AP,以AP穹隆的高度以及AP切迹的膜电位水平和穹隆上升的速度将其分三组细胞。以穹隆的膜电位水平能有效区分心外膜与其他两种细胞(P0.05)。以AP时程(APD)可以有效区分M细胞与其他两种细胞(P0.05)。尖峰切迹时间以及收缩参数均不能有效区分三种心室肌细胞(P>0.05)。结论:狗心室单个细胞AP的一些参数,可以作为辨别心内、外膜,M细胞的依据

Controlled Release of Recombinant Ephrin-b2/Fc from Self Assembling-peptide in Myocardial Infarction Therapy

目的通过体外观测和体内实验探讨自聚肽rAd16-Ⅱ对EPHrIn-b2/fC重组蛋白的控制释放效应及其免疫原性,解决心肌梗死蛋白质治疗中裸露的蛋白质在机体有效作用时间短且易被降解的问题。方法体外观测rAd16-Ⅱ的塑型及对EPHrIn-b2/fC重组蛋白的控制释放;构建Sd大鼠心肌梗死模型,将存活大鼠分为2组分别予心肌内注射EPHrIn-b2/fC蛋白(E组,n=25)和自聚肽EPHrIn-b2/fC蛋白凝胶(ES组,n=25),在设定的时间点(1 H,3H,24 H,7 d,14 d)各收集心肌组织和血清样本5个,分别用免疫荧光和免疫印迹技术检测EPrHIn-b2蛋白驻留和丢失情况;皮下注射rAd16-Ⅱ,5 W后ElISA法检测血清抗体滴度,评估rAd16-Ⅱ的免疫原性。结果 rAd16-Ⅱ在PbS中可自我聚合组装成纳米纤维网状结构;这种结构在体外可使EPHrIn-b2/fC重组蛋白的释放持续144 H,其中超过50%量在120 H内释放;免疫荧光显示除注射后1 H外,EPHrIn-b2/fC蛋白在ES组的驻留量明显高于同期的E组(P<0.05);免疫印迹显示注射早期,ES组EPHrIn-b2/fC蛋白的血液释入量明显少于同期的E组(P<0.05);ElISA法检测血清抗rAd16-Ⅱ抗体效价与阴性对照组无显著差异。结论 rAd16-Ⅱ可明显地延缓EPHrIn-b2/fC重组蛋白的释放,是承载EPHrIn-b2/fC蛋白用于心肌梗死治疗和缺血性研究的较为可靠和安全的生物载体材料。Aim To explore the controlled release effect of the recombinant Ephrin-b2 /Fc chimera from self assembling peptide of RAD16-Ⅱ and the immunogenicity of RAD16-Ⅱ.Take RAD16-Ⅱas a delivery vehicle to prevent the ungroomed Ephrin-b2 / Fc protein from being degraded in vivo and increase therapeutic effect.Methods The moulding of the oligopeptide was observed by macroscopy and microscopy.The releasing effect was assayed by releasing curve obtained from test in vitro.In vivo,Sprague-Dawley rats were prepared to acute myocardial infarction models by ligation of the left anterior descending branch.The survival rats were divided into 2 groups and separately intra myocardially injected recombinant Ephrin-b2 / Fc proteins( E group,n = 25) and sapeptide- Ephrin-b2 / Fc protein complex( ES group,n = 25).At set time( 1 h,3 h,24 h,7 d,14 d),the samples of the myocardial tissue and sera were collected and respectively used for immunofluorescence and westernblot to determine the remaining or losing of the protein.RAD16-Ⅱsolution was administrated through subcutaneous injection.5 weeks later,the titer of anti-sapeptide in serum was assayed by ELISA.Results It is observed that RAD16-Ⅱsolution can self-assemble into nanofibers which fabricate net structure in condition of PBS.Within net structure,the releasing duration of chimeric Ephrin-b2 / Fc lasted up to 144 h and more than 50% mass was released in 120 h.As shown in immunofluorescence,the retention duration of the chimeric protein in ES group was significantly longer than that in E group at the same time( P < 0.05).And westernbolt also demonstrated the amount of protein releasly into blood in ES group was less significant than that in E group( P < 0.05).The titer of the antibody was not significantly different from RAD16-Ⅱ administration to negative control group,which showed that RAD16-Ⅱ would not trigger immune response.Conclusion RAD16-Ⅱ oligopeptide can postpone the release of chimeric Ephrin-b2 / Fc both in vivo and in vitro.It is a relatively reliable and safe biomaterial delivery vehicle of Ephrinb2 / Fc protein in myocardial infarction and ischemia research.福建省科技计划重点项目(2013D024

动脉粥样硬化性肾动脉狭窄的早期发现

探讨冠状动脉造影同时行肾动脉造影的必要性及动脉粥样硬化性肾动脉狭窄的相关危险因素分析。共 4 91例临床疑似冠心病患者行冠状动脉造影同时行非选择性或选择性肾动脉造影 ,并对相关的临床因素进行评价 ,筛选出动脉粥样硬化性肾动脉狭窄的独立危险因素。冠心病组患者中动脉粥样硬化性肾动脉狭窄的发病率为2 0 % ,显著高于非冠心病组 (2 .6 % )。冠心病、外周血管疾病是动脉粥样硬化性肾动脉狭窄的独立危险因素 (多元Logistic回归分析示 ,P <0 .0 0 1、P =0 .0 0 3) ,是其早期发现的指标。对怀疑有冠心病的患者 ,在冠状动脉造影同时行肾动脉造影有助于动脉粥样硬化性肾动脉狭窄的早期发现

Inhibition of TNF alpha-induced adhesion molecule expression by (Z)-(S)-9-octadecenamide, N-(2-hydroxyethyl,1-methyl)

National Natural Science Foundation [30670512]Inflammation is a primary event in atherogenesis. Oleoylethanolamide (OEA), a naturally occurring fatty-acid ethanolamide, lowers lipid levels in liver and blood through activation of the nuclear receptor, peroxisome proliferator-activated receptor-alpha (PPAR alpha). We designed and synthesized (Z)-(S)-9-octadecenamide, N-(2-hydroxyethyl, 1-methyl) (OPA), an IDEA analog. The present study investigated the effect of OPA on the expression of adhesion molecules in human umbilical vein endothelial cells (HUVEC). OPA inhibited expression of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) stimulated by Tumor Necrosis Factor-alpha (TNF-alpha) via activation of PPAR alpha. This inhibition of VCAM-1 and ICAM-1 expression decreased adhesion of monocyte-like cells to stimulated endothelial cells. These results demonstrate that OPA may have anti-inflammatory properties. Our results thus provide new insights into possible future therapeutic approaches to the treatment of atherosclerosis. (C) 2011 Elsevier B.V. All rights reserved

Echocardiography and 64-Multislice Computed Tomography Angiography in Diagnosing Coronary Artery Fistula

Xiamen Board of Health, Xiamen, ChinaBackground/Purposes: There are various types of coronary artery fistula (CAF) with complex shapes; therefore, it is important to obtain a correct diagnosis and to understand its relations to the adjacent structures before surgery. This study evaluated echocardiography and 64-multislice computed tomography (64-MSCT) angiography in diagnosing CAF. Methods: Sixteen patients with CAF, confirmed by surgical operation or digital subtraction angiography, were examined by echocardiography. Five of them were further examined by 64-MSCT angiography for detailed anatomical information before surgery. The imaging data for echocardiography and 64-MSCT angiography were analyzed retrospectively. Results: Among the 16 patients, 12 were correctly diagnosed by echocardiography, of whom five were confirmed by 64-MSCT angiography. Four cases missed diagnosis by echocardiography, and one of these was correctly diagnosed by 64-MSCT Seventeen fistulae were found, of which, two appeared in one patient. Ten fistulae originated from the left coronary artery and seven from the right. The draining site was the right heart in eight, pulmonary artery in five, left heart in three and aorta in one. Conclusion: Echocardiography can act as the routine examination of CAF, and 64-MSCT angiography can provide more detailed anatomical and pathological information for surgery than echocardiography