Plasma cathepsin L and its related pro/antiangiogenic factors play useful roles in predicting rich coronary collaterals in patients with coronary heart disease.

Cathepsin L enhances angiogenesis by increasing extracellular matrix degradation and remodelling. This study investigated whether plasma cathepsin L could be used as a biomarker to predict collateral formation in patients with coronary heart disease (CHD). Patients with CHD (n = 218; aged 67 ± 11 years) underwent coronary angiography and were categorized as having either 'poor' or 'rich' collaterals. Plasma cathepsin L, the proangiogenic placenta growth factor (PLGF) and the antiangiogenic factors, cystatin C and endostatin, were measured. Elevated cathepsin L and PLGF levels were independently and significantly associated with enhanced collateral formation in patients with CHD; subgroup analyses also showed a significant correlation in patients with diabetes and acute coronary syndrome. Plasma endostatin and cystatin C levels were not significantly correlated with coronary collateral formation. Plasma cathepsin L and PLGF, acting as important modulators of angiogenesis, could be used as biomarkers to predict coronary collateral formation in patients with CHD.

Chemical constituents and pharmacological properties of Radix Inulae.

Radix Inulae is used as a gastric and antibacterial agent in traditional Chinese and Tibetan medicines. Most of its chemical constituents have been identified and include a series of sesquiterpenes with various carbon skeletons such as: eudesmanolide, elemanolide, germacranolide, sesquicaranolide, guaianolide and humulane. Certain organic solvent fractions and sesquiterpenes from Radix Inulae have been found to significantly inhibit the growth of tumor cell strains in vitro. They also show antibacterial, cardiovascular and hypoglycaemic as well as insulin-sensitization activities. The present review summarizes research on the chemistry and biological activity of Radix Inulae.

Association between Toll-like receptor 4 Asp299Gly polymorphism and coronary heart disease susceptibility.

Published data on the association between Toll-like receptor 4 (TLR4) Asp299Gly polymorphism and coronary heart disease (CHD) susceptibility are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. English-language studies were identified by searching PubMed and Embase databases (up to November 2016). All epidemiological studies were regarding Caucasians because no TLR4 Asp/Gly and Gly/Gly genotypes have been detected in Asians. A total of 20 case-control studies involving 14,416 cases and 10,764 controls were included in the meta-analysis. Overall, no significant associations were found between TLR4 Asp299Gly polymorphism and CHD susceptibility in the dominant model (OR=0.89; 95%CI=0.74 to 1.06; P=0.20) pooled in the meta-analysis. In the subgroup analysis by CHD, non-significant associations were found in cases compared to controls. When stratified by control source, no significantly decreased risk was found in the additive model or dominant model. The present meta-analysis suggests that the TLR4 Asp299Gly polymorphism was not associated with decreased CHD risk in Caucasians.

HLA-DR3 antigen in the resistance to idiopathic dilated cardiomyopathy.

Idiopathic dilated cardiomyopathy (IDC) has been hypothesized as a multifactorial disorder initiated by an environment trigger in individuals with predisposing human leukocyte antigen (HLA) alleles. Published data on the association between HLA-DR3 antigen and IDC risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. Studies were identified by searching the PUBMED and Embase database (starting from June 2015). A total of 19 case-control studies including 1378 cases and 10383 controls provided data on the association between HLA-DR3 antigen and genetic susceptibility to IDC. Overall, significantly decreased frequency of HLA-DR3 allele (OR=0.72; 95%CI=0.58-0.90; P=0.004) was found in patients with IDC compared with controls. When stratified by myocardial biopsy or non-biopsy cases, statistically decreased risk was found for IDC in myocardial biopsy cases (OR=0.69; 95%CI=0.57-0.84; P=0.0003). In the subgroup analysis by ethnicity, borderline statistically significantly decreased risk was found among Europeans from 12 case-control studies (OR=0.76; 95%CI=0.58-1.00; P=0.05). In conclusion, our results suggest that individuals with HLA-DR3 antigen may have a protective effect against IDC.

Preventive effect of reduced glutathione on contrast-induced nephropathy in elderly patients undergoing coronary angiography or intervention: a randomized, controlled trial.

Coronary angiography can be a high-risk condition for the incidence of contrast-induced nephropathy (CIN) in elderly patients. Reduced glutathione, under a variety of mechanisms, may prevent CIN in this procedure. We prospectively examined whether hydration with reduced glutathione is superior to hydration alone for prevention of CIN in an elderly Han Chinese population. A total of 505 patients (271 males and 234 females) aged 75 years or older who underwent non-emergency coronary angiography or an intervention were randomly divided into two groups. The treatment group received hydration with reduced glutathione (n=262) and the control group received hydration alone (n=243). Serum creatinine and blood urea nitrogen levels were measured prior to coronary angiography and 48 h after this procedure. The primary endpoint was occurrence of CIN, which was defined as 25% or 44.2 µmol/L above baseline serum creatinine levels 48 h after the procedure. The overall incidence of CIN was 6.49% in the treatment group and 7.41% in the control group, with no significant difference between the groups (P=0.68). In subgroup analysis by percutaneous coronary intervention, no significant differences were found between the two groups. In summary, reduced glutathione added to optimal hydration does not further decrease the risk of CIN in elderly patients undergoing coronary angiography or an intervention.

High levels of LDL-C combined with low levels of HDL-C further increase platelet activation in hypercholesterolemic patients.

High levels of low-density lipoprotein cholesterol (LDL-C) enhance platelet activation, whereas high levels of high-density lipoprotein cholesterol (HDL-C) exert a cardioprotective effect. However, the effects on platelet activation of high levels of LDL-C combined with low levels of HDL-C (HLC) have not yet been reported. We aimed to evaluate the platelet activation marker of HLC patients and investigate the antiplatelet effect of atorvastatin on this population. Forty-eight patients with high levels of LDL-C were enrolled. Among these, 23 had HLC and the other 25 had high levels of LDL-C combined with normal levels of HDL-C (HNC). A total of 35 normocholesterolemic (NOMC) volunteers were included as controls. Whole blood flow cytometry and platelet aggregation measurements were performed on all participants to detect the following platelet activation markers: CD62p (P-selectin), PAC-1 (GPIIb/IIIa), and maximal platelet aggregation (MPAG). A daily dose of 20 mg atorvastatin was administered to patients with high levels of LDL-C, and the above assessments were obtained at baseline and after 1 and 2 months of treatment. The expression of platelets CD62p and PAC-1 was increased in HNC patients compared to NOMC volunteers (P<0.01 and P<0.05). Furthermore, the surface expression of platelets CD62p and PAC-1 was greater among HLC patients than among HNC patients (P<0.01 and P<0.05). Although the expression of CD62p and PAC-1 decreased significantly after atorvastatin treatment, it remained higher in the HLC group than in the HNC group (P<0.05 and P=0.116). The reduction of HDL-C further increased platelet activation in patients with high levels of LDL-C. Platelet activation remained higher among HLC patients regardless of atorvastatin treatment.

Radiographic findings in Langerhans' cell disease affecting the mandible.

The radiographic features of histopathologically diagnosed mandibular Langerhans' cell disease are described for 29 cases of the condition. We divided the patients into two groups: adults (age 27 to 60 years) and juveniles (age 1.5 to 15 years). A characteristic sign in juveniles was an osteolytic lesion with an uneven margin and either a continuous or discontinuous periosteal reaction. Because of the wide variability in radiographic presentation in adults, it was very difficult to differentiate this from other lesions in adults on the basis of radiologic criteria.

[Intervention of lidocaine and Astragalus membranaceus on ventricular late potentials].

16 and 22 patients with positive ventricular late potentials (LP) recorded on signal-averaged electrocardiograms (SAECG) were treated with lidocaine 100 mg iv. or Astragalus membranaceus 24 g iv. drip for 2 weeks respectively. As a result, the SAECGs of 2 (12.5%) and 3 (13.6%) of them normalized respectively. Compared with baseline, there were no significant changes in average HFQRSD, LAS and RMS 40 after treatment of lidocaine. HFQRSD and LAS were shortened significantly 115.9 +/- 29.9 vs 125.1 +/- 29.4 ms (P < 0.001); and 44.8 +/- 15.4 vs 52.8 +/- 15.4 ms (P < 0.001), and RMS 40 was enlarged 20.0 +/- 18.6 vs 12.8 +/- 19.0 microV (P < 0.05) only after treatment of Astragalus membranaceus. It is suggested that the duration of LP was shortened.

A new route of transendocardial stem cell injection: from femoral vein to left ventricle through atrial septa.

OBJECTIVE: To evaluate the feasibility and safety of a new route of transendocardial stem cell injection. MATERIALS AND METHODS: Atrial septal puncture was performed in six young male pigs, and then a 6F syringe was passed through the puncture to reach the left atrium. Meanwhile, a guide wire was inserted into the left ventricle through the femoral artery, and echocardiography was used to confirm the relative position of the guide wire with the syringe. RESULTS: After atrial puncture through femoral vein, the syringe could reach the left atrium and finally the left ventricle. Echocardiography confirmed that both the guide wire and the syringe were located in the left ventricle. The diameter of atrial septa puncture and the diameter of the syringe implantation were 4.1 ± 0.5 mm and 8.4 ± 0.7 mm, respectively. But there is no difference in Left ventricle end-systolic dimension (LVES), left ventricle end-diastolic dimension (LVED) and left ventricle ejection fraction (LVEF) before surgery, after atrial septa puncture, after syringe implantation or one month after surgery. CONCLUSIONS: It is feasible to perform transendocardial stem cell injection by 6F syringe inserted through femoral vein. The surgery may cause atrial septa tearing but does not jeopardize myocardial function.

HLA-DR3 antigen in the resistance to idiopathic dilated cardiomyopathy

Idiopathic dilated cardiomyopathy (IDC) has been hypothesized as a multifactorial disorder initiated by an environment trigger in individuals with predisposing human leukocyte antigen (HLA) alleles. Published data on the association between HLA-DR3 antigen and IDC risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. Studies were identified by searching the PUBMED and Embase database (starting from June 2015). A total of 19 case-control studies including 1378 cases and 10383 controls provided data on the association between HLA-DR3 antigen and genetic susceptibility to IDC. Overall, significantly decreased frequency of HLA-DR3 allele (OR=0.72; 95%CI=0.58-0.90; P=0.004) was found in patients with IDC compared with controls. When stratified by myocardial biopsy or non-biopsy cases, statistically decreased risk was found for IDC in myocardial biopsy cases (OR=0.69; 95%CI=0.57-0.84; P=0.0003). In the subgroup analysis by ethnicity, borderline statistically significantly decreased risk was found among Europeans from 12 case-control studies (OR=0.76; 95%CI=0.58-1.00; P=0.05). In conclusion, our results suggest that individuals with HLA-DR3 antigen may have a protective effect against IDC.

High levels of LDL-C combined with low levels of HDL-C further increase platelet activation in hypercholesterolemic patients

High levels of low-density lipoprotein cholesterol (LDL-C) enhance platelet activation, whereas high levels of high-density lipoprotein cholesterol (HDL-C) exert a cardioprotective effect. However, the effects on platelet activation of high levels of LDL-C combined with low levels of HDL-C (HLC) have not yet been reported. We aimed to evaluate the platelet activation marker of HLC patients and investigate the antiplatelet effect of atorvastatin on this population. Forty-eight patients with high levels of LDL-C were enrolled. Among these, 23 had HLC and the other 25 had high levels of LDL-C combined with normal levels of HDL-C (HNC). A total of 35 normocholesterolemic (NOMC) volunteers were included as controls. Whole blood flow cytometry and platelet aggregation measurements were performed on all participants to detect the following platelet activation markers: CD62p (P-selectin), PAC-1 (GPIIb/IIIa), and maximal platelet aggregation (MPAG). A daily dose of 20 mg atorvastatin was administered to patients with high levels of LDL-C, and the above assessments were obtained at baseline and after 1 and 2 months of treatment. The expression of platelets CD62p and PAC-1 was increased in HNC patients compared to NOMC volunteers (P<0.01 and P<0.05). Furthermore, the surface expression of platelets CD62p and PAC-1 was greater among HLC patients than among HNC patients (P<0.01 and P<0.05). Although the expression of CD62p and PAC-1 decreased significantly after atorvastatin treatment, it remained higher in the HLC group than in the HNC group (P<0.05 and P=0.116). The reduction of HDL-C further increased platelet activation in patients with high levels of LDL-C. Platelet activation remained higher among HLC patients regardless of atorvastatin treatment.

Chemical constituents of Cistanche sinensis.

One new phenylethanoid glycoside, cistansinenside A and one new oligosaccharide, cistansinensose A1/A2, were isolated from the stems of Cistanche sinensis, together with six known compounds. The structures of the new compounds were elucidated on the basis of spectral data.

A new bisabolane sesquiterpenoid from Euphorbia chrysocoma.

The new sesquiterpenoid (6R)-2-chloro-6-[(1S)-1,5-dimethylhex-4-en-1-yl]-3-methylcyclohex-2-en-1-one (1), together with ten known compounds, (6R)-6-[(1S)-1,5-dimethylhex-4-en-1-yl]-3-methylcyclohex-2-en-1-one (2), bauerenol acetate (3), lupenone (4), alpha-amyrenone (5), beta-sitosterol (6), stigmasterol (7), beta-amyrin (8), ursolic acid (9), betulinic acid (10), scopolin (11), have been isolated from the roots of Euphorbia chrysocoma Lévl. et Vant. Their structures have been elucidated by spectroscopic data.

[Primary research on the clinical significance of ventricular late potentials (VLPs), and the impact of mexiletine, lidocaine and Astragalus membranaceus on VLPs].

The body surface signal-averaged electrocardiogram (SAECG) was recorded on 316 cardiac patients, 84% (266 patients) of whom were also taken 24-hour Holter ECG. VLPs were detected positively in 6.1%, 25%, 25.7%, 14.3% and 5.5% of patients with angina pectoris, myocardial infarction, myocarditis, cardiomyopathy and arrhythmia of unknown origin respectively, and the patients with complex ventricular arrhythmia had more VLPs positive determination definitely (P less than 0.05). The specificity of VLPs in the prediction of complex ventricular arrhythmia was greater than 80%, and the positive predictive accuracy was 70-80%. 5, 5 and 10 patients with VLPs were treated with Mexiletini Hydrochloridum, Lidocaini Hydrochloridum and Injection of Astragalus membranaceus respectively. As a result of treatment, the transfer of VLPs positive to negative was unsuccessful, but only the intervention of Astragalus membranaceus Injection made the duration of VLPs shortened significantly (39.8 +/- 3.3 ms versus 44.5 +/- 5.9 ms, P less than 0.01).

[The diagnostic value of computed coronal tomography in maxillofacial tumors].

CT images in both transverse axial and coronal planes of 52 cases of maxillofacial tumors were analyzed. The authors emphasized that coronal technique should not be neglected, especially when the tumor was near the base of the skull, the sphenoid sinus and the hard palate. Transverse axial scan alone could not demonstrate the exact extent of invasion and the adjacent relationship. Coronal scan affords exceptional visualization. In such conditions, the combination of scans in two planes is the most helpful in delineating such lesions. It provides important information for determining surgical or radiotherapeutic approaches.

[Evaluation of 28 cases of salivary malignancies with MR imaging]

Twenty-eight cases of MRI of the salivary malignancies confirmed histopathologically were shown in this paper.By observing separately and comparatively with SE (spin echo) T2 weighted imaging and PE(field echo) imaging,the authors consider that (1)the malignant tumors within the salivary glands displaying low and intermediate signal intensities on T2 weighted image may be thought as a characteristic sign in the diagnostic processes. (2) PE imaging as an effective method is able to differentiate the tumors from the calcification and fibrosis which were low and intermediate signal intensities on T2 weighted image. (3)the locations and sizes of the tumors have directly influenced on their marginal manifestations and adjacent normal tissue structures.

[Radiologic similarity and dissimilarity of Histiocytosis X in the mandible between non adult and adult]

28 cases of Histiocytosis X in the mandible were divided into two groups:the non adult group (19 cases,21 foci).and the adult group(9 cases,12 foci).their similarity and dissimilarity in radiological appearances were contrasted individually.The authors consider there were different roentgenographic manifestations between the two groups according to the diversity of physilological and morphological configuration in the mandible.The former group which had its characteristic roentgenologic feature displayed a radiolucent region with an irregular margin mostly accompanied with a periosteal reaction at the inferior and lateral surfaces of the mandible.Owing to lacking above mentioned demonstration,it was difficult to distinguish the lesions of later group from other disease in the mandible.