摘要：Background:Inverted T waves in precordial leads are often seen in patients with acute pulmonary embolism (APE) and acute coronary syndrome (ACS).The purpose of this study was to analyze the electrocardiogram (ECG)difference between APE and ACS related inverted T waves in precordial leads.MethodsThe ECG difference among 62 patients with APE and 125 patients with ACS related inverted T waves in precordial leads were compared.Results Compared with ACS,Patients with APE were more frequently associated with incomplete or complete RBBB or slurred S wave in lead V1,the sum of the depth of inverted T waves in leads V1 and V2 not less than in lead V3 and V4 (inverted TV1+V2≥ inverted TV3+V4),and inverted T waves in leads V,and ]R .ConclusionsComplete or incomplete RBBB or slurred S wave in lead V1,inverted T waves in leads V1 and Ⅲ,and inverted TV1+ V2≥ inverted TV3+V4 are useful criteria for predicting APE.

摘要：Background Coronary in-stent restenosis (ISR) is an important complication of percutaneous coronary intervention (PCI).However,the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2) level and coronary ISR after PCI is rarely reported.Methods 30 patients with coronary ISR after PCI were recruited as the experimental group,63 patients without coronary ISR after PCI were served as the control group.LpPLA2,hypersensitive C-reactive protein (Hs-CRP) and Low density lipoprotein cholesterol (LDL-C) were measured respectively.Smoking,hypertension,diabetes mellitus and other related factors were recorded.The relationships between these factors and restenosis of coronary stent after PCI were analyzed.Results The correlation analysis showed statistically significant (P＜0.05) between the level of Lp-PLA2,Hs-CRP and the restenosis of coronary stent after PCI,and that Lp-PLA2 level was an independent risk factor for coronary ISR after PCI.The correlation of Lp-PLA2 to ISR was superior to that of Hs-CRP to ISR.Conclusion The increased level of LpPLA2 is correlated to coronary ISR after PCI.Therefore,plasma level of Lp-PLA2 may be used as a clinically useful marker for coronary ISR prediction in patients undergoing PCI.

摘要：Objectives This experiment used whole-cell patch-clamp technique to investigate the course of recovery from use-dependent block of Na+channels (Nav 1.5) in human embryonic kidney (HEK) cells, on which to verify the effects of volatile oil of Nardostachy chinesis Batal (Gansong). Methods Two pulses generated by computer followed by a recovery pulse and a test pulse, the interval duration between the two pulses varied from 16 ms to 1 s, and holding po-tential is -80 mV to - 140 mV. The peak Na~ current for a given recovery time was normalized to the fully recovered peak current, and the normalized value was the plot as a function of the recovery time to study the effects of 3 ppm con-centration Gansong volatile oil on recovery from use-dependent block of Navl. 5 in HEK. Results It showed that Gan-song group, comparing with control group, delayed the time courses of recovery from use-dependent block [(33.2 ±:5.77) ms for control group and (52. 5±6. 08) ms for 3 ppm Gansong group, P < 0. 05]. In the presence of Gansong,inhibition of the Na+ current was enhanced by increasing frequency of depolarizing pulse from 56. 5 ms to 16 ms. In the control group, the time course of recovery showed that recovery started at 19. 5 ms and finished by 36. 5 ms. In the presence of Gansong, the time course of recovery showed that recovery started at 36. 5 ms and finished by 56. 5 ms.Na+ currents recovered from the use-dependent block varying with holding potential (holding potential-dependent).Conclusions The results suggested that Na+ currents recovered from the use-dependent block correlated with persistent time, holding potential. The Gansong volatile oil has inhibitive effect on the Na+ current recovery.

摘要：Objective To compare the acute hemodynamic effects of five different pacing modes in patients with cardiac function NYHA class to Ⅱ without bundle branch block (BBB). Methods This study included 12 patients (SSS 7, Ⅲ°AVB 5) undergoing pacemaker implantation. Right ventricular apex (RVA), right ventricular outflow tract (RVOT),right ventricular bifocal (RV-Bi), left ventricular base (LVB) and bi - ventricular (Bi - V) pacing at 60～ 80 ppm were done in VVI mode prior to implantation of DDD pacemaker. The cardiac index (CI), mean pulmonary artery pressure (mPAP) and pulmonary capillary wedge pressure (PCWP) were measured with Swan - Ganz thermodilution catheter after 5 minutes of each pacing mode. Results ( 1 ) Comparing to pacing at RVA (CI: 2. 41 ±0. 38 L/min per m2, PCWP: 16. 7± 3.3 mmHg), the CI increased and the PCWP decreased significantly in pacing at RVOT(CI: 2.63 ±0.46, PCWP: 13.8±2.3), LVB(CI: 2.78±0.52,PCWP: 14.4±3.1), RV-Bi(CI: 2.83±0.57,PCWP: 12.8±2.5) and Bi-Vpacing(CI: 2.94±0. 60, PCWP: 12. 7 ±2.5), P ＜ 0. 01, respectively.(2) The CI of RV- Bi and Bi- V pacing was higher than that of RVOT and LVB pacing, the PCWP was lower, P ＜ 0.05, respectively. (3) There was no significant difference between RV- Bi pacing and Bi- V pacing in CI and PCWP. Conclusion There is no significant difference between RV - Bi pacing and Bi V pacing in the acute hemodynamic effects; however,dual - site pacing is much better than single site pacing in that aspect for patients with cardiac function NYHA class Ⅰ to Ⅱ without BBB. Among single site pacing, the RVOT and LVB pacing is better than RVA pacing in cardiac function.

摘要： Cardiac paraganglioma is an extremely rare clinical en-tities of the heart. The usual investigations for pheochro-mocytoma are necessary, however the most useful, spe-cific to primary cardiac tumors, are coronary angiogra-phy and echocardiography. While complete surgical ex-cision is the standard treatment of mainstay. We report a case of a 55-year-old woman with cardiac paraganglioma located in fight atriaoventricular groove of the heart. As we know, this is the first case that cardiac paraganglioma located in fight atriaoventricular groove of the heart in English literature.

摘要：Bacground Percutaneous coronary intervention (PCI) has become one of the most effective treatments in coronary heart disease (CHD).However,the bottleneck problem of PCI is the in-stent restenosis (ISR).The aim of this study was to explore the effects of astragaloside Ⅳ (AST Ⅳ) on suppression of intimal hyperplasia modulation of the expression of basic fibroblast growth factor (b-FGF) in a rat carotid artery balloon injury model.Methods Fifty healthy male Sprague-Dawley(SD) rats were randomly divided into five groups:a sham-operation group(sham),a model group (model),and three astragaloside Ⅳ-treated groups.Three days before the surgery,1％ carboxy methyl cellulose (CMC) or AST Ⅳ (20,40 or 60 mg· kg-1· d-1) was intragastrically administered into sham or 3 astragaloside-treated groups once a day for 17 days.Hematoxylin-elsin staining was carried out to determine the pathomorphological changes and the neointimal and media area ratio.Immunohistochemistry staining was performed to measure the expressions of proliferating cell nuclear antigen (PCNA)and basic fibrolast growth factor(b-FGF).PCNA and b-FGF were analyzed with Iamage-Pro Plus.Results (1) The carotid artery intimal hyperplasia in the rats of model was similar to lumen stenosis.Compared with the sham operation group,the area of the new intima and the ratio of the intima to media(I/M) were increased and the lumen area was decreased (P ＜ 0.01) in the model group.Astragaloside Ⅳ increased the lumen intimal dimension and decreased the area of new intima and the ratio of intima to media in a dose-dependent manner.(2) Compared with the sham-operation group,the expressions of PCNA and b-FGF in carotid artery of model group were significantly increased (P ＜ 0.01).AST Ⅳ decreased expressions of PCNA and b-FGF in the carotid artery of rats in a dosedependent manner.Conclusion Astragaloside Ⅳ significantly inhibits neointimal hyperplasia of rat carotid artery through down-regulating the expressions of PCNA and b-FGF.

摘要：Objectives To detect whether persisting or transient glucose metabolism disorder is responsible for admission hyperglycemia in patients with acute myocardic infarction (AMI). Methods Two groups of patients were enrolled: AMI group and control group. Fasting plasma glucose, 2 hours plasma glucose, glycated albumin(GA) and glycated haemoglobin (HbA1c) were measured at baseline in both groups and 30 days after AMI attack in AMI group. Results (1) There were no significant differences in baseline characteristics between both groups; (2) Compared with the control group, the levels of GA and HbA1c in AMI group at baseline were significantly higher. (3) At 30 day follow-up in AMI group, both FBG and 2hPG decreased to normal values, HbA1c did not change, but only GA kept on increasing. Conclusions Hyperglycemia on admission in patients with AMI resulted from both preexisting metabolic disorder and stress reaction as well. GA is the only indicator that could recall the exaggeration of glucose metabolic disorder during AMI attack at 30 day follow-up.

摘要：Background Flavonoids from fruits, vegetables and plants have been widely studied on their effects of improving lipidemia,anti-inflammation,anti-platelet aggregation and anti-oxidative activities.However,we don't know if flavonoids from rape bee pollen have the same effects in patients with dyslipidemia (DL),type 2diabetes mellitus(T2DM),and cerebral infarction(CI).Methods The study involved with patients selected and divided into 4 groups,30 cases of DL,of T2DM,of CI and health control (HC) for each.Forty mg flavonoids from rape bee pollen administrated orally twice a day for two months.Blood sugar (BG),total cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C),white blood-cell counts (WBC),platelet counts (PLT),high-sensitivity C-reactive protein (hsCRP) and malondialdehyde (MDA) were analyzed in four groups before and after taking flavonoids for two months.Results ( 1 ) Basic levels of TC,BG,WBC,PLT and hsCRP in groups of T2DM,CI,and TG and MDA in groups of DL,T2DM and CI were significantly higher than those in HC (P ＜ 0.05-0.001 ).(2) The levels of TG,WBC,PLT, hsCRP and MDA were significantly decreased, while HDL-C was remarkably increased after taking flavonoids for two months (P ＜ 0.05-0.001 ) in group of DL,T2MD,and CI.These indexes were not different in the group of HC after taking flavonoids (P ＞ 0.05).Conclusions The results could indicate metabolic disturbance,inflammation,and high oxidative stress in patients with dyslipidemisa,type 2 diabetes mellitus,and cerebral infarction.The flavonoids from rape bee pollen may have effects of antioxidant activity,improving lipids,and anti-inflammation on these patients.

摘要：Background In recent years, astragalus made great progress in the treatment of heart failure, and become an important supplementary conventional treatment of heart failure drugs.The article will investigate the effect of astragalus injection on plasma adiponectin concentration and its possible mechanisms in patients with chronic heart failure.Methods sixty-two chronic heart failure (CHF) patients with NYHA functional class Ⅱ-Ⅳ grade were randomly divided into treatment group (treatment group of 31 cases) and conventional treatment group (control group of 31 cases),blood samples were collected at 2 weeks before and after treatment in 62 CHF patients and in 30 healthy subjects. Plasma adiponeetin and brain natriuretic peptide were measured in two groups before and after treatment.NYHA functional class and left ventricular function indexes were also assessed by echocardiography.Results The NYHA functional class were improved after treatment (P ＜ 0.05),and significantly in treatment group than in control group (P ＜ 0.05); There were significantly decreased in left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) and improved in left ventricular ejection fraction (LVEF) after treatment in treatment group (P ＜ 0.05).At the same time,plasma adiponectin and brain natriuretic peptide levels were significantly decreased after astragalus injection in treatment group (P ＜0.05).Conclusion These findings indicate that astragalus injection can improve cardiac remodeling,decrease the secretion of brain natriuretic peptide, which may exercise through the lipid effect to decrease plasma adiponectin concentration.[ S Chin J Cardiol 2011 ; 12(3):172 -177]

摘要：Objectives We report a case in which a patient who suffered from angina secondary to mediastinal irradiation and have been treated by off-pump coronary artery bypass (OPCAB) in our hospital since 3 years ago.A 34-year-old man presented with angina for 8 years after receiving radiation therapy for Hodgkin's lymphoma.We retrospectively reviewed all the cases of OPCAB in our hospital and followed-up data for up to 3 years post-operatively.Mediastinal irradiation is probably the cause of significant ostial stenosis of left main coronary and fight coronary artery.OPCAB grafting was performed on this patient 3 years ago.His angina disappeared after operation,and he recovered well during follow-up.Conclusions Patients with malignancies who have received mediastinal irradiation should be carefully followed up and routinely screened for the premature development of coronary artery disease.OPCAB may be an appropriate treatment for coronary artery disease caused by mediastinal irradiation.

摘要：Objectives To investigate the changes of β3-adrenoceptor (β3-AR) mRNA expression in the rats with chronic heart failure (CHF), and to explore the effect of β blockers (βBs) on β3 mRNA expression. Methods Thirty-four rats were randomly divided into Sham group (n = 10) and heart failure group (n = 24). Rat model was established by aortic constriction. The survival rats in heart failure group were divided into heart failure control group (HF group, n = 6), metoprolol group (MET group, n = 8)and carvedilol group (CAR group, n = 8) three months after operation. Metoprolol tartarte was started d-1, isometric saline was started in HF group. After three months of drug therapy, measurement of hemodynamics, index of ventricular mass, the level of β3-AR mRNA expression were performed. Results Compared with Sham group, left ventricular end systolic pressure (LVESP), and the absolute values of maximal rate of rise and fall ( ± dp/dtmax) of left ventricular pressure were all significantly decreased (P ＜ 0.01), left ventricular end diastolic pressure (LVEDP) was significantly increased in HF group (P ＜ 0.01). The hemodynamic parameters were improved by βBs, and carvedilol was more effective than metoprolol (P ＜ 0.01). The index of ventricular mass was higher in HF group than MET group, CAR group and Sham group (P ＜ 0.01). βBs significantly decreased the index of left ventricular mass (LVMI),and Carvedilol was more effective than metoprolol (P＜ 0.01). The index of right ventricular mass (RVMI)did not change in MET group (P ＞ 0.05), but significant decrease could be seen in CAR group (P ＜0.01). The level of β3-AR expression in left ventricle was greater than that in right ventricle whether in the failing heart or in the non-failing heart. Compared with Sham group, the level of β3-AR mRNA expression was significantly increased in HF group (P ＜ 0.01). The levels of β3-AR mRNA expression showed a remarkable decrease in CAR group (P ＜0.01), but was not seen in MET group. Conclusions The β3-AR expression level remarkably increases in the rat's left and right failing ventricles. Carvedilol is more effective on improving hemodynamics and attenuating ventricular remodeling than metoprolol in the rats with CHF. Carvedilol rather than metoprolol downregulates β3-AR expression in the rat's failing ventricles. The beneficial effect of carvedilol in CHF maybe partly due to the downregulation of β3-AR expression in the failing heart.

摘要：Background Atrial fibrillation(AF)was used to be considered as nongenetics disorder, but recent studies have revealed that genetics variants conferred susceptibility to AF development,but most with limited evidence.In order to systematically evaluate the overall contributions of gene-disease association studies to current understandings of the genetic susceptibility to atrial fibrillation,we perform a systematic review and meta-analysis based on comprehensive searches. Method All studies on the associations of genetics variants with AF risk were identified by searching the following databases:Medline, Embase, BIOSIS,Global Health, LILACS and CBMDisc.Odds ratios(CI) and 95％ confidence intervals(CI) were calculated under homozygote comparison(HC),dominant model(DM)and recessive model(RM),respectively.Results A total of 41studies on 32 genes and 72 polymorphisms locations were identified.The summary OR Was statistically significant associations in 23(31.94％) single nucleotide polymorphisms (SNPs).The genes in renin-angiotensinaldosterone system (RAAS) and ion channels were the mostly studied.Four SNPs(50.00％)in RAAS genes were significantly associated with AF susceptibility：ACE I／D(HC：OR=1.53,95％CI：1.14.2.0 DM：OR=1.47,95％CI：0.86-1.53;RM：OR=0.49,95％CI：0.41—0.59);AGT A-20C(HC：OR=1.56,95％CI：1.41-2.12);AGT M235T(HC：OR=2.37,95％CI：1.21—4.65).Statistically significant associations were also found in the following genes and SNPs：ABCA1 G1051A,BCHE G1615A,CETP A1061G,1405V,TaqIB,CRP C1444T,EDN2 A985G,eNOS T-786C,IL-10 T-819C,A.592C,MinK G38S,KCNH2 rs1805120,Kir 3.4 C171T,G810T,MMP2 C-1306T,Factor Ⅱ G20210A,SCN5A H58R,SLC26A8 I639V,G-protein β-subunit C825T,chromatosome 4q25 rs2200733 and rs 10033464.Conclusions Nearly one—third of SNPs were statistically significant associated with AF risk,with variants in RAAS genes most highly significant association.More studies on a wide range of genes are merited.

摘要：Objectives To investigate the inhibitory effect of clopidogrel on release of soluble CD40 ligand (sCD40L) by ADP-activated platelet in patients with non-ST-segment elevation acute coronary syndromes(NSTEACS).Methods Forty-two patients with NSTEACS were treated with clopidogrel for 6～8 days.In order to obtain platelet rich plasma (PRP) samples,the venous blood was drawn before and after treatment,respectively.The platelets were activated by adenosine diphosphate (ADP),thus releasing sCD4OL,sCD40L levels were determined by enzyme-linked immunosorbent assay (ELISA) at different time of the reaction.Results Plasma sCD40L concentration before treatment was (0.199±0.155 ) ng/mL,and (0.190±0.176) ng/mL after treatment (P＞0.05).Before treatment the PRP sCD40L level at 20-minute of platelet activation was (4.34±2.51 )ng/mL,and decreased to (2.79±1.93 ) ng/mL after treatment (P＜0.001).The corresponding level at 40-minute of platelet activation was (5.29±3.13 ) ng/mL before treatment and (2.87±1.59 ) ng/mL after treatment(P＜0.001 ).Conclusions Short-term clopidogrel administration might inhibit the release of sCD40L by ADP-activated platelet in patients with NSTEACS,suggesting that,in addition to its antiplatelet potency,clopidogrel may still have an anti-inflammatory effect.