Growth differentiation factor 15 predicts cardiovascular events in stable coronary artery disease / 老年心脏病学杂志（英文版）

BACKGROUND@#Growth differentiation factor 15 (GDF-15) has been explored as a potential biomarker for various inflammatory diseases and cardiovascular events. This study aimed to assess the predictive role of GDF-15 levels in cardiovascular events and all-cause mortality, considering traditional risk factors and other biomarkers.@*METHODS@#A prospective study was conducted and 3699 patients with stable coronary artery disease (CAD) were enrolled into the research. Baseline GDF-15 levels were measured. Median follow-up was 3.1 years during the study. We analyzed clinical variables and several biomarkers. Multivariable Cox regression analysis was performed to evaluate prognostic performance of GDF-15 levels in predicting myocardial infarction (MI), heart failure, stroke, cardiovascular death, and non-cardiovascular death.@*RESULTS@#Baseline GDF-15 levels for 3699 patients were grouped by quartile (≤ 1153, 1153-1888, 1888-3043, > 3043 ng/L). Higher GDF-15 levels were associated with older age, male gender, history of hypertension, and elevated levels of N-terminal pro B-type natriuretic peptide (NT-pro BNP), soluble suppression of tumorigenesis-2 (sST2), and creatine (each with P < 0.001). Adjusting for established risk factors and biomarkers in Cox proportional hazards models, a 1 standard deviation (SD) increase in GDF-15 was associated with elevated risk of clinical events [hazard ratio (HR) = 2.18, 95% confidence interval (CI): (1.52-3.11)], including: MI [HR = 2.83 95% CI: (1.03-7.74)], heart failure [HR = 2.71 95% CI: (1.18-6.23)], cardiovascular and non-cardiovascular death [HR = 2.48, 95% CI (1.49-4.11)] during the median follow up of 3.1 years.@*CONCLUSIONS@#Higher levels of GDF-15 consistently provides prognostic information for cardiovascular events and all cause death, independent of clinical risk factors and other biomarkers. GDF-15 could be considered as a valuable addition to future risk prediction model in secondary prevention for predicting clinical events in patient with stable CAD.

Xuebijing Injection Regulates Mitochondrial N-formyl Peptides/NLRP3 Inflammatory Pathway to Treat Severe Acute Pancreatitis in Rats / 中国实验方剂学杂志

ObjectiveTo investigate the therapeutic effect of Xuebijing injection （XBJ） on sodium taurocholate （Na-Tc）-induced severe acute pancreatitis （SAP） in rats. MethodForty rats were randomly assigned into 5 groups： sham operation group， SAP model group， and low-， medium-， and high-dose （4， 8， 12 mL·kg·d-1， respectively） XBJ groups. SAP model was established by retrograde injection of Na-Tc （1 mL·kg-1） into the biliary and pancreatic ducts. XBJ was injected intraperitoneally 3 days before and 0.5 h after modeling. The ascitic fluid volume and the pancreas weight-to-body weight ratio were measured. The pathological changes of pancreatic tissue were observed via hematoxylin-eosin （HE） staining. The protein levels of formyl peptide receptor 1 （FPR1） and nucleotide-binding oligomerization domain-like receptor 3 （NLRP3） in pancreatic tissue were detected by immunohistochemistry. Western blot was employed to determine the expression levels of NADH-ubiquinone oxidoreductase chains 1-6 （MT-ND1， MT-ND2， MT-ND3， MT-ND4， MT-ND5， and MT-ND6） in rat plasma. ResultCompared with sham operation group， the SAP model group showcased increased ascitic fluid volume and pancreas weight-to-body weight ratio （P<0.05）， serious lesions in pancreatic tissue， increased total pathological score （P<0.05）， and up-regulated protein levels of FPR1 and NLRP3 in pancreatic tissue （P<0.05）. The model group had lower MT-ND2 level （P<0.05） and higher MT-ND1， MT-ND3， and MT-ND6 levels in plasma （P<0.05） than the sham operation group， while MT-ND4 and MT-ND5 had no significant differences between the two groups. Compared with SAP model group， the XBJ treatment decreased ascitic fluid volume and pancreas weight-to-body weight ratio （P<0.01）， ameliorated pancreatic lesions， and down-regulated the protein levels of FPR1 and NLRP3 in pancreatic tissue （P<0.01）. The treatments， especially high-dose XBJ （P<0.01）， down-regulated the expression of MT-ND1 （P<0.01）， MT-ND3 （P<0.01）， MT-ND6 （P<0.01）， and MT-ND4 and did not change that of MT-ND5. ConclusionXBJ may antagonize partial mitochondrial N-formyl peptides and excessive inflammatory response mediated by FPR1/NLRP3 to treat SAP in rats.

A new / 亚洲男科学杂志(英文版)

There are many unknown genetic factors that lead to infertility in nonobstructive azoospermia men. Here, we performed whole-exome sequencing in blood samples obtained from 40 azoospermia patients with meiotic arrest and found a novel c.151_154del (p.D51fs) frame-shift mutation in exon 3 of the testis expressed 11 (TEX11) gene in one patient. Sanger sequencing analysis of the patient and 288 fertile men was performed to validate the mutation. Immunohistochemical analysis showed TEX11 expression in late-pachytene spermatocytes and in round spermatids in fertile human testes. In contrast, testes of the patient with TEX11 mutation underwent meiotic arrest and lacked TEX11 expression. Western blotting of human embryonic kidney (HEK293) cells transfected with a vector for the p.D51fs TEX11 variant detected no TEX11 expression. In conclusion, we identified a novel frame-shift mutation in the TEX11 gene in an azoospermia patient, emphasizing that this gene should be included in genetic screening panels for the clinical evaluation of azoospermia patients.

Mutational analysis of the / 亚洲男科学杂志(英文版)

As a crucial transcription factor for spermatogenesis, GATA-binding protein 4 (GATA4) plays important roles in the functioning of Sertoli and Leydig cells. Conditional knockout of GATA4 in mice results in age-dependent testicular atrophy and loss of fertility. However, whether GATA4 is associated with human azoospermia has not been reported. Herein, we analyzed the GATA4 gene by direct sequencing of samples obtained from 184 Chinese men with idiopathic nonobstructive azoospermia (NOA). We identified a missense mutation (c.191G>A, p.G64E), nine single-nucleotide polymorphisms (SNPs), and one rare variant (c.

Therapeutic Effect of Modified Yinchenhao Tang on Cholestatic Liver Disease in Rats / 中国实验方剂学杂志

Objective::To investigate the protective effect of modified Yinchenhao Tang on α-isothiocyanate(ANIT)-induced cholestatic liver disease (CSLD). Method::Wistar rats were randomly divided into 7 groups: blank control group, model control group, compound Glycyrrhizin capsules group(22.5, 45 mg·kg-1), modified Yinchenhao Tang low, middle and high dose groups(4.1, 8.1, 16.2 g·kg-1). A model of cholestatic liver injury was prepared by intragastric administration of ANIT (100 mg·kg-1). Glycyrrhizin capsules and modified Yinchenhao Tang were administered intragastrically on the second day of modeling for 4 consecutive days. And bile duct intubation was performed on the fifth day to measure the bile flow rate of the rats, and serum was taken to test the total bilirubin(TBIL), direct bilirubin(DBIL), indirect bilirubin(IBIL), alanine aminotransferase(ALT) and total bile acid(TBA) serological indicators of each group. Pathological changes of liver tissues were observed by hematoxylin-eosin (HE) staining. The expression levels of G protein-coupled bile acid receptor(TGR5), nucleotide binding oligomerization domain-like receptor 3(NLRP3) and cysteinyl aspartate specific proteinase-1(Caspase-1) proteins in the iver tissues were detected by Western blot. Result::Compared with the blank control group, bile flow rate in the model group decreased significantly(P<0.01). TBIL, DBIL, IBIL, ALT and TBA level in serum were significantly increased(P<0.01), liver tissue lesions were severe, and significantly increased the expression of liver tissue TGR5 and Caspase-1.Compare with model group, the compound Glycyrrhizin capsules group had no significant effect on bile flow rate and TBIL, DBIL, IBIL, ALT and TBA level in serum. Bile flow rate increased and TBIL, DBIL, IBIL, ALT and TBA level in serum decreased significantly in modified Yinchenhao Tang high dose group. The compound Glycyrrhizin capsules group and modified Yinchenhao Tang group have different extents of improvement the pathological changes of the lung tissues, and the protein expression of TGR5 and Caspase-1 were significantly decreased in the liver tissue(P<0.01). Conclusion::Modified Yinchenhao Tang can effectively treat CSLD in rats, and its mechanism may be related to bile acid and bile acid receptor TGR5-mediated inflammatory factors.

Study on medical technical support system in tent-form field medical system / 医疗卫生装备

Objective To develop a medical technical support module and box-type medical technical equipment so as to supply medical oxygen and water for the tent-form field medical system at field conditions.Methods The medical technical support module had its service orientation analyzed to determine its functional requirements and technical indexes, which involved in PSA oxygen generation technology with variable frequency,constant pressure and self-adaptability to altitudes as well as medical water preparation technology by integrated membrane separation. Box-type modules for medical oxygen generation and medial water preparation were trial-produced with the mode of integrated box and instruments as well as high-density polyethylene as the box material.Results The oxygen production was 1.3 Nm3/h,and the oxygen concentration was 92.7%.The flow volume of cleaning water and purified water was 433.7 and 37.2 L/h respectively at 25℃,and the water quality accorded with the relevant water quality indexes of GB 5749—2006 and the national pharmacopoeia(2010 edition). Conclusion This set of medical equipment can meet the design requirements and can effectively guarantee the medical oxygen and medical water needed for medical treatmentin field tent hospital under field conditions. [Chinese Medical Equipment Journal,2018,39(5):7-11]

Therapeutic effect evaluation of single and double stent strategy on coronary bifurcation lesions / 心血管康复医学杂志

Objective :To explore therapeutic effect of single and double stent implantation on coronary bifurcation le-sions.Methods : Clinical data of 455 patients with coronary bifurcation lesions , who received drug-eluting stent (DES) implantation in General Hospital of PLA from Jan 2014 to Oct 2016 ,were retrospectively analyzed .Accord-ing to interventional strategy ,patients were divided into single stent group (n＝235) and double stent group (n＝220).The lesion distribution ,lesion features of proximal ,distal and bifurcation ,stent implantation ,surgical selec- tion ,postoperative instant blood flow ,clinical adverse events were observed and compared between two groups .Re-sults :There were no significant difference in general data ,lesion distribution suggested by coronary angiography ,le-sion feature of proximal ,distal and bifurcation between two groups , P＞0. 05 all.All patients used Cross-over tech-nique in single stent group ,while double stent group used Crush (46.81%) ,Culotte (37.73%) ,T-stent and V-stent surgery .There were no significant difference in postoperative instant TIMI blood flow grade 3 rate of main vessel and side branch between two groups , P＞0. 05 both .During hospitalization ,incidence rate of nonfatal myocardial infarction in double stent group was significantly higher than that of single stent group (7.27% vs.2.98%) , P＝0.037. During 12-month follow-up ,compared with single stent group ,there was significant reduction in restenosis rate (5.53% vs.1.36%) , and significant rise in incidence rate of nonfatal myocardial infarction (2.55% vs. 6.82%) in double stent group ,P＝0.016 ,0.030 respectively .Conclusion :The therapeutic effect between single and double stent implantation treating coronary bifurcation lesions is no significant ,but restenosis rate of double stent group significantly reduces and incidence rate of nonfatal myocardial infarction significantly rises .

Mesenchymal Stem Cells Stimulated by Growth Factors Release Exosomes with Potent Proangiogenic Activity / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the proangiogenic activity of exsomes released by human umbilical cord mesenchymal stem cells (MSCs) stimulated by erythropoietin and platelet-derived growth factor BB (PDGF-BB).</p><p><b>METHODS</b>Human umbilical cord-derived MSCs were seeded and maintained in culture overnight. The media were then replaced by alpha-MEM containing EPO (1 U/ml) and/or PDGF-BB (50 ng/ml), and the culture was maintained for 72 hours. The exosomes from the culture supernatants were isolated with a routine ultra-catrifagation method. Flow cytometric analysis was performed to identify the origin of the exosomes, and their morphological features were observed by using a transmission electron microscopy. The exosomes were added at a concentration of 10 µg/ml into the culture system of human umbilical cord vein endothelial cells. MTT assay was used to evaluate the proliferative status. The Matrigel assay was used to observe the formation of net-work structures which were calculated after culture for 12 hours.</p><p><b>RESULTS</b>Flow cytometric analysis showed that microparticles released by human umbilical cord MSCs expressed CD9, CD63 and CD81, which was in accordance with the surface molecular features of exosomes. Under an electron microscope, the exosomes took the featured cystic shape. The protein contents of exosomes released by untreated, EPO-stimulated, PDGF-BB-stimulated and EPO plus PDGF-BB stimulated MSCs (10 cells) were 256±124 µg, 1021±392 µg, 830±265 µg and 2207±733 µg, respectively. The results revealed that MSCs treated by EPO and PDGF-BB released significantly higher amounts of exosomes (P<0.01). MTT assay proved that the exosomes from EPO and PDGF-BB treated MSCs had more potent proliferation-promoting activity on human umbilical cord vein endothelial cells than those from untreated MSCs. The Matrigel assay showed that the numbers of capillary-like structures in untreated, EPO-, PDGF-BB and EPO plus PDGF-BB-treated groups were 2.6±0.84, 4.6±1.57, 4.2±0.78 and 6.3±1.34 per high power objective. Treatment with EPO or PDGF-BB dramatically enhanced the numbers of capillary liue structure, compared with that of untreated group (P<0.01) and those in EPO and PDGF-BB combination group was significantly greater than those of EPO or PDGF-BB group (P<0.01).</p><p><b>CONCLUSION</b>EPO and PDGF-BB can stimulate MSCs to release exosomes with more potent proangiogenic activity.</p>

High levels of testosterone inhibit ovarian follicle development by repressing the FSH signaling pathway / 华中科技大学学报（医学）（英德文版）

The effect of high concentrations of testosterone on ovarian follicle development was investigated. Primary follicles and granulosa cells were cultured in vitro in media supplemented with a testosterone concentration gradient. The combined effects of testosterone and follicle-stimulating hormone (FSH) on follicular growth and granulosa cell gonadotropin receptor mRNA expression were also investigated. Follicle growth in the presence of high testosterone concentrations was promoted at early stages (days 1-7), but inhibited at later stage (days 7-14) of in vitro culture. Interestingly, testosterone-induced follicle development arrest was rescued by treatment with high concentrations of FSH (400 mIU/mL). In addition, in cultured granulosa cells, high testosterone concentrations induced cell proliferation, and increased the mRNA expression level of FSH receptor (FSHR), and luteinized hormone/choriogonadotropin receptor. It was concluded that high concentrations of testosterone inhibited follicle development, most likely through regulation of the FSH signaling pathway, although independently from FSHR downregulation. These findings are an important step in further understanding the pathogenesis of polycystic ovary syndrome.

Myocyte Enhancer Factor-2A Gene Mutation and Coronary Artery Disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Premature ventricular contractions (PVCs) are common in the general population, and frequent PVCs may result in the poor quality of life or even the damage of cardiac function. We examined the efficacy and safety of a traditional Chinese medicine Wenxin Keli for the treatment of frequent PVCs among a relatively large Chinese cohort.</p><p><b>METHODS</b>We performed a randomized, double-blind, placebo-controlled, parallel-group, multicenter trial. A total of 1200 eligible participants were randomly assigned in a ratio of 1:1 to receive Wenxin Keli or the placebo for 4 weeks. The primary and secondary endpoint was the change of PVC numbers and PVC-related symptoms after a 4-week treatment compared with baseline, respectively. In addition, vital signs, laboratory values, and electrocardiographic parameters were assessed in a safety analysis.</p><p><b>RESULTS</b>At the initial evaluation, no significant differences in the baseline characteristics were observed between the Wenxin Keli group and the placebo group. A smaller number of PVCs was observed after the 4-week treatment than at baseline, in both the Wenxin Keli group (5686 ± 5940 vs. 15,138 ± 7597 beats/d, P < 0.001) and the placebo group (10,592 ± 8009 vs. 14,529 ± 5929 beats/d, P < 0.001); moreover, the Wenxin Keli group demonstrated a significantly greater reduction in the frequency of PVCs than the placebo group (P < 0.001). In a full analysis set, patients in the Wenxin Keli group exhibited significantly higher total effective responses in the reduction of PVCs compared to those in the placebo group (83.8% vs. 43.5%,P < 0.001). The per-protocol analysis yielded similar results (83.0% vs. 39.3%,P < 0.001). Treatment with Wenxin Keli also demonstrated superior performance compared to the placebo with respect to PVC-related symptoms. No severe adverse effects attributable to Wenxin Keli were reported.</p><p><b>CONCLUSIONS</b>Wenxin Keli treatment effectively reduced the overall number of PVCs and alleviated PVC-related symptoms in patients without structural heart diseases and had no severe side effects.</p>

Thrombosis and morphology of plaque rupture using optical coherence tomography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Thrombosis following plaque rupture is the main cause of acute coronary syndrome, but not all plaque ruptures lead to thrombosis. There are limited in vivo data on the relationship between the morphology of ruptured plaque and thrombosis.</p><p><b>METHODS</b>We used optical coherence tomography (OCT) to investigate the morphology of plaque rupture and its relation to coronary artery thrombosis in patients with coronary heart disease. Forty-two patients with coronary artery plaque rupture detected by OCT were divided into two groups (with or without thrombus) and the morphological characteristics of ruptured plaque, including fibrous cap thickness and broken cap site, were recorded.</p><p><b>RESULTS</b>The fibrous cap of ruptured plaque with thrombus was significantly thinner compared to caps without thrombus ((57.00 ± 17.00) µm vs. (96.00 ± 48.00) µm; P = 0.0076).</p><p><b>CONCLUSIONS</b>Plaque rupture associated with thrombosis occurs primarily in plaque covered by a thin fibrous cap. Thick fibrous caps are associated with greater stability of ruptured plaque.</p>

Evaluation of neointimal coverage in patients with coronary artery aneurysm formation after drug-eluting stent implantation by optical coherence tomography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The vessel healing in patients with coronary artery aneurysms (CAA) that form after drug-eluting stent (DES) implantation is not clear. This study aims to assess the vessel healing in patients with CAA formation after DES implanation.</p><p><b>METHODS</b>From June 2008 to August 2011, follow-up coronary angiography was conducted on 1160 patients who underwent percutaneous coronary intervention (PCI). The average period of follow-up was about (18.95 ± 13.05) months. A total of 175 patients who underwent DES implantation into de novo lesions and who underwent coronary angiography and optical coherence tomography (OCT) examination during follow-up were identified. Patients were divided into the CAA group (n = 31) and non-CAA group (n = 144) based on the results of the coronary angiography. The cardiac events including angina and acute myocardial infarction were noted; in addition, the neointimal thickness and the frequency of strut malapposition and strut uncoverage were also noted.</p><p><b>RESULTS</b>A greater proportion of incomplete neointimal coverage (17.17% vs. 1.90%, P < 0.001) and strut malapposition (18.20% vs. 1.38%, P < 0.001) were observed in the CAA group. The neointimal thickness in the CAA group was significantly thinner than that in the non-CAA group ((146.6 ± 94.8) µm vs. (192.5 ± 97.1) µm, P < 0.001), as detected via OCT. Patients with CAA formation had a higher frequency of cardiac events including angina pectoris (25.81% vs. 6.25%, P = 0.001) and acute myocardial infarction (9.68% vs. 0.13%, P = 0.002) and thrombosis (16.13% vs. 0.69%, P < 0.001). The longitudinal length of the CAA in the cardiac event group was significantly longer than in the no cardiac event group ((20.0 ± 9.07) mm vs. (12.05 ± 5.38) mm, P = 0.005).</p><p><b>CONCLUSION</b>CAA formation after DES implantation is frequently associated with cardiac events as a result of stent malapposition and incomplete neointimal coverage.</p>

Clinicopathological and prognostic significance of the expression of ADAM17 mRNA and protein in esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of A disintegrin and metalloproteinase 17 (ADAM17) mRNA and ADAM17 protein in esophageal squamous cell carcinoma (ESCC), and to evaluate their correlation with clinicopathological features and prognosis.</p><p><b>METHODS</b>The expression of ADAM17 mRNA in 50 ESCC and 50 normal esophageal tissues was detected by RT-PCR. The expression of ADAM17 protein in 80 ESCC and 80 normal esophageal tissues was detected with immunohistochemioal staining (SP). Log rank test and Cox proportional hazards analysis were used to analyze the prognosis of ESCC.</p><p><b>RESULTS</b>The expression of ADAM17 mRNA in 50 ESCC and 50 normal esophageal tissues was 0.937 ± 0.241 and 0.225 ± 0.077, respectively. The positive expression rates of ADAM17 protein in 80 ESCC and 80 normal esophageal tissues was 66.2% and 6.2%, respectively. The expressions of ADAM17 mRNA and ADAM17 protein in the ESCC were significantly higher than those in normal esophageal tissues (P < 0.01). The expressions of ADAM17 mRNA and protein were positively correlated with lymph node metastasis and TNM staging (P < 0.05). There were no correlations between the expressions of ADAM17 mRNA and protein and sex, age and histological grade (P > 0.05) . The expression of ADAM17 protein was positively correlated with EGFR protein (P < 0.01). The lymph node metastasis, TNM staging and the expression of ADAM17 and EGFR protein were independent prognostic factors.</p><p><b>CONCLUSIONS</b>ADAM17 mRNA and protein are highly expressed in ESCC than in normal esophageal tissues and may play an important role in the development, invasion and metastasis of ESCC. They may be used as prognostic factors of ESCC.</p>

Anticoagulant efficacy and safety of argatroban for patients undergoing elective percutaneous coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the anticoagulant efficacy and safety of argatroban for patients undergoing elective percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>A total of 300 consecutive patients with coronary heart disease undergoing elective PCI were enrolled and randomized into heparin group (100 U/kg via artery sheaths, n = 150) and argatroban group (200 µg/kg bolus, followed by 350 µg·kg(-1)·h(-1) i.v. infusion, n = 150). The primary efficacy endpoint was the activated clotting time (ACT) results (10 min and 60 min after anticoagulant administration and at the point at the end of PCI). The additional dosage of heparin or argatroban was given if the ACT value during PCI procedure < 250 s. Activated partial thromboplastin time (APTT) was also measured at pre-procedure, 10 min after anticoagulant injection and 60 min after PCI. The primary safety endpoint was thrombosis and hemorrhagic events during PCI procedure and hospital stay.</p><p><b>RESULTS</b>All patients in the two groups attained the target ACT ( ≥ 250 s), and ACT in heparin group was significantly prolonged [(343.32 ± 44.70) s vs. (289.60 ± 20.88) s, P < 0.01], at 10 min after anticoagulation injection. ACT was similar between the two groups at 60 min after anticoagulation injection [(291.26 ± 46.79) s vs. (288.40 ± 21.61) s, P > 0.05]. The ACT value in argatroban group was similar at 10 min and 60 min after injection (P > 0.05). Supplemental anticoagulant was needed for 13 (8.7%) patients in heparin group and 2 (1.3%) patients in argatroban group because of ACT under 250 s (P < 0.05) . At the end of PCI procedure, ACT in heparin group was significantly shorter than in argatroban group [(247.16 ± 41.38)s vs. (278.65 ± 20.51) s, P < 0.01]. APTT in heparin group was significantly prolonged than in argatroban group not only at 10 min point [(182.16 ± 4.37) s vs. (81.69 ± 21.49) s, P < 0.01] after anticoagulant injection but also at the point of 60 min after PCI procedure[(169.13 ± 6.35)s vs. (56.21 ± 15.68) s, P < 0.01]. There was no thrombus event in two groups and no bleeding event in argatroban group, and there was three bleeding events in heparin group [2.0% (3/150) vs.0, P > 0.05].</p><p><b>CONCLUSION</b>Argatroban is an effective and safe anticoagulation agent during elective PCI procedure, anticoagulant efficacy and risk of bleeding side effects of argatroban are similar to heparin.</p>

Neovascularization in the carotid atherosclerotic plaque is not associated with inflammatory cell aggregation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Monocytes and macrophages in atherosclerotic plaque lead to plaque instability. The aim of the study was to determine if plaque neovascularization led to inflammation.</p><p><b>METHODS</b>Patients were consecutively enrolled if their carotid intimal media thickness was > 2 mm, as revealed by duplex ultrasound. The patients then underwent dynamic contrast enhanced magnetic resonance imaging (DCE MRI) and fluorine-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography combined with computed tomography (PET CT). A target to background ratio (TBR) of ≥ 1.25 or < 1.25 served as the cutoff point for the presence and absence of inflammation, respectively.</p><p><b>RESULTS</b>Twenty-six patients underwent bilateral carotid DCE MRI and 24 patients also underwent PET CT. One hundred and fifty-five plaques were evaluated by both DCE MRI and PET CT. There was no significant difference in plaque morphology between the TBR ≥ 1.25 (n = 61) and TBR < 1.25 (n = 94) groups. No significant differences were found in plasma volume and transfer constant between the TBR ≥ 1.25 and TBR < 1.25 groups.</p><p><b>CONCLUSION</b>Our study did not find a significant correlation between plaque neovascularization and the aggregation of inflammatory cells.</p>

Optical coherence tomography assessment of edge dissections after drug-eluting stent implantation in coronary artery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Edge dissections after coronary stent implantation are associated with increased short-term risk of major adverse cardiovascular events. The incidence and outcome of edge dissections after coronary stent implantation were reportedly different using different imaging techniques. We used optical coherence tomography (OCT) to assess the incidence, morphological findings and related factors of edge dissections after drug-eluting stent (DES) implantation.</p><p><b>METHODS</b>Totally 42 patients with 43 de novo lesions in 43 native arteries undergoing DES implantation with OCT imaging were enrolled in this study.</p><p><b>RESULTS</b>Nine edge dissections were detected in 43 arteries after DES implantation. There were four morphological patterns of stent edge dissections indentified in this study: (1) superficial intimal tears (n = 3), (2) subintimal dissections (n = 4), (3) split of media (n = 1), (4) disruption of the fibrotic cap of plaque (n = 1). Stent edge expansion and stent expansion were both higher in the group with dissections than those in the group without dissections (1.682 ± 0.425 vs. 1.229 ± 0.285, P = 0.0290; 1.507 ± 0.445 vs. 1.174 ± 0.265, P = 0.0072).</p><p><b>CONCLUSIONS</b>The incidence of stent edge dissections detected by OCT was 21%. Stent edge dissection is related with stent edge expansion and stent expansion.</p>

Ex vivo assessment of coronary lesions by optical coherence tomography and intravascular ultrasound in comparison with histology results / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the diagnostic accuracy of optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in the detection of ex vivo coronary plaques with different compositions compared with histology results.</p><p><b>METHODS</b>OCT and IVUS were performed in 15 autopsied heart specimens and the isolated coronary artery was assessed by routine histological processing thereafter. Coronary plaques were classified into 3 types (lipid-rich plaque, calcified plaque and fibrous plaque) according to standard criteria respectively. Sensitivity and specificity for detection of different types of plaque by OCT and IVUS were calculated according histology results.</p><p><b>RESULTS</b>Seventy seven coronary plaques were analyzed. OCT demonstrated a sensitivity and specificity of 69% and 88% for lipid-rich plaque, 93% and 92% for calcified plaque, 88% and 98% for fibrous plaque. IVUS demonstrated a sensitivity and specificity of 61% and 92%, 98% and 97%, 68% and 90% respectively. The agreement between OCT and IVUS in assessment of coronary plaque was 0.831 (Kappa = 0.72, P < 0.01).</p><p><b>CONCLUSIONS</b>Both OCT and IVUS correctly detected ex vivo coronary plaques and there was a good agreement in assessment of coronary plaques between OCT and IVUS. OCT is superior to IVUS in assessment of fibrous plaque and is similar as IVUS in assessment of calcified plaque.</p>

Clinical manifestations of patients with systemic lupus erythematosus and coronary artery disease / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics of patients with systemic lupus erythematosus (SLE) and coronary artery disease (CAD).</p><p><b>METHODS</b>Clinical data of 3911 SLE patients were retrospectively analyzed and CAD was diagnosed by coronary angiography in 26 (0.7%) SLE patients (10 stable angina pectoris, 5 unstable angina pectoris, 8 STEMI and 3 non-STEMI). The tradition risk factors, first onset of cardiac events, blood biochemistry index, treatment and activity of SLE, coronary angiographic features were compared with 552 CAD patients without SLE.</p><p><b>RESULTS</b>Compared with CAD patients without SLE, CAD patients with SLE were younger [(50.4 ± 15.2) years vs. (60.6 ± 11.6) years, P < 0.01], the mean number per patient of Framingham tradition risk factors was less (1.11 ± 1.18 vs. 2.50 ± 1.28, P < 0.05). CAD patients with SLE were prone to premature coronary artery disease [76.9% (20/26)], and ACS was the most common manifestation in SLE patients with premature coronary artery disease [65.0% (13/20)], the duration of steroid use was significantly longer [24.00 (3.75, 57.00) months vs. 1.00 (0.00, 2.00) months, P < 0.05] and 24 hours total urine protein [(1.93 ± 1.97) g vs. (0.76 ± 0.75) g, P < 0.05] was significantly higher in the ACS patients with SLE than non-ACS patients with SLE. Coronary stenosis was evidenced in most of the SLE patients with CAD [76.9% (20/26)] and incidence of coronary thrombotic occlusion was significantly higher in SLE patients with CAD than CAD patients without SLE [30.8% (8/26) vs. 11.8% (65/552), P < 0.05].</p><p><b>CONCLUSION</b>The incidence of CAD in SLE patients is low and the major form of CAD in SLE patients is premature coronary artery disease and mostly induced by coronary thrombotic occlusion.</p>

Evaluation on the neointimal coverage post drug-eluting stent implantation by optical coherence tomography / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the neointimal coverage after the implantation of various drug eluting stents (DES) by optical coherence tomography (OCT).</p><p><b>METHODS</b>The study comprised of 62 patients implanted DES for (15.3 ± 5.7) months. Patients were divided into three groups according to the type of implanted stent: Cypher group (patient = 26, stent = 57), Endeavor group (patient = 17, stent = 23) and Firebird group (patient = 19, stent = 32). OCT images of the stent were analyzed by software equipped by Light Lab system. Intimal thickness of 64 µm, 168 µm and 366 µm represents 10%, 25% and 50% lumen area loss, respectively. Neointimal coverage was thin with intimal thickness ≤ 64 µm, satisfactory with intimal thickness between 65 µm and 366 µm and hyperplasia and restenosis with intimal thickness > 366 µm.</p><p><b>RESULTS</b>The percent of complete neointimal coverage was similar among groups (P > 0.05). The thickness of neointimal coverage in Cypher and Endeavor and Firebird group was (178.7 ± 11.9) µm, (228.7 ± 17.1) µm and (170.3 ± 13.3) µm, respectively (all P < 0.05). The symmetry of Cypher stent was better than Firebird stent, and the symmetry of Firebird stent was better than Endeavor stent.</p><p><b>CONCLUSION</b>There was significant difference on neointimal coverage after various types of DES implantation, and OCT can be used to evaluate the symmetry of neointimal coverage post implantation of various DES.</p>

Omeprazole affects clopidogrel efficacy but not ischemic events in patients with acute coronary syndrome undergoing elective percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Omeprazole, usually used in the antiplatelet therapy during percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS), has been reported to increase ischemic events in retrospective studies. However, other clinical trials gave paradoxical results. The aim of this study was to assess the effects of omeprazole on clopidogrel efficacy and clinical events.</p><p><b>METHODS</b>All patients (n = 172) received aspirin (loading dose 300 mg and maintenance dose 100 mg/d) and clopidogrel (loading dose 600 mg and maintenance dose 75 mg/d) during the therapy. They were randomized to receive omeprazole (20 mg/d) or placebo for 30 days. Residual platelet activities in the adenosine 5'-diphosphate (ADP) pathway were detected on the fifth day after PCI with thrombelastography (TEG)-mapping. The clinical events were recorded after one month.</p><p><b>RESULTS</b>According to the five levels of platelet activities, the frequency distributions of the inhibition rates were significantly different (P = 0.0062). However, no significant change was seen in the distribution among the highest or the lowest inhibiting levels (> 95% and < 30% inhibition rate). And there were no significant differences (P > 0.05) in events incidence, while gastro-intestinal bleeding decreased in co-administration of omeprazole.</p><p><b>CONCLUSIONS</b>Omeprazole significantly blunts clopidogrel efficacy while not exacerbates ischemic events in ACS undergoing PCI. Omeprazole even can decrease gastro-intestinal bleeding in those patients.</p>