Prenatal ultrasonographic characteristics and prognosis of fetal umbilical-portal-systemic venous shunt: analysis of 14 cases / 中华围产医学杂志

Objective:To summarize the prenatal ultrasonographic features and prognosis of fetal umbilical-portal-systemic venous shunt (UPSVS).Methods:This retrospective study retrieved the records of 14 fetuses with UPSVS from Chongqing Health Center for Women and Children from January 2018 to September 2020, to describe their ultrasonographic features, concomitant malformations, chromosomal examination results, and follow-up.Results:All the 14 cases were classified into three types: Type Ⅰ ( n=2), the umbilical vein directly connected to the systemic venous detouring around the liver; Type Ⅱ ( n=2), the umbilical vein connected to the distal inferior vena cava instead of the left atrium after entering the liver through the ductus venosus; and Type Ⅲa ( n=10), those with an intrahepatic shunt, between the intrahepatic portal venous system and the hepatic vein. Of the 14 fetuses, 11 had normal chromosome test results, including four had serum screening of Down syndrome in the first trimester, four had non-invasive prenatal testing, and three had prenatal genetic diagnosis. Six cases were complicated by other system malformations. Fetal growth restriction and heart failure were found in four cases each. Four pregnancies were terminated due to other anomalies and the other 10 ended in live births with good prognosis for the fetuses. Conclusions:Special attention should be paid to the fetal umbilical- portal-venous system when there are unexplained fetal growth restriction, fetal heart failure, or abnormal blood vessels in the abdominal section of the fetus. UPSVS has typically ultrasonographic features, which can prenatally determine the shunt type and the integrity of the intrahepatic portal venous system. A full assessment of the intrauterine fetal condition and other malformations are of great value in prognostic counseling.

Neonatal Ebstein's anomaly with type B Wolff-Parkinson-White syndrome: a case report / 中华围产医学杂志

This paper reported a male newborn with Ebstein's anomaly complicated by type B Wolff-Parkinson-White syndrome. The baby was delivered at 39 weeks of gestation and diagnosed as Ebstein's anomaly complicated by type B Wolff-Parkinson-White syndrome 2 d after birth. He was improved and discharged after conservative management in the Department of Internal Medicine. No abnormality was found by fetal echocardiography at 20 weeks of gestation, while supraventricular tachycardia was diagnosed by M-mode ultrasonography at 38 weeks of gestation due to rapid fetal heart rate. In addition to hemodynamic changes,the abnormal cardiac structure in patients with Ebstein's anomaly may also lead to tachyarrhythmia. Therefore, in fetuses diagnosed with supraventricular tachycardia by prenatal ultrasound or children with type B Wolff-Parkinson-White syndrome detected by electrocardiogram after birth, tricuspid valve should be carefully scanned under echocardiography to avoid the missed diagnosis of Ebstein's anomaly.

Prenatal ultrasonic characteristic analysis of umbilical artery thrombosis / 中华超声影像学杂志

Objective:To investigate the prenatal ultrasonic characteristics and hemodynamic changes of umbilical artery (UA) thrombosis in fetus, and to improve the accuracy of prenatal ultrasound diagnosis.Methods:The prenatal sonographic features and hemodynamic index of 5 cases with umbilical artery thrombosis(UAT) in Chongqing Health Center for Women and Children from January 2018 to April 2020 were analyzed and summarized retrospectively.Results:The absence of blood flow in one of the two UA was found in the third trimester of pregnancy while two UA were displayed in previous ultrasound scans and the blood flow of the UA on the right side of the bladder disappeared in 5 cases. The umbilical cord cross section showed three cavities in 5 cases. The long axis section of the umbilical cord showed hyperecho in one UA with no blood flow in 4 cases, and no exact hyperecho in the UA only showed no blood flow in 1 case. The UA systolic/diastolic velocity ratio(S/D)<2.0 and UA pulsatility index (PI)<5 th were observed in 5 cases. The middle cerebral artery (MCA) PI<5 th in 4 cases and 10 th<MCA-PI<25 th in 1 case were observed. There was no abnormal cerebroplacental ratio (CPR) in 5 cases. One fetus died in utero as the pregnant woman refused to be hospitalized. The remaining 4 neonates had good outcomes. UAT was defined in 5 cases after delivery, 1 case with hypercoiled (over coiled) umbilical cord and another case with hypocoiled (under coiled) was found. There were no abnormalities in gross imagings of placenta in 5 cases. Pathological examination was performed in 4 cases, focal infarcts and calcifications were found in placental tissue, among which, subchorionic fibrin deposition and inflammatory cell infiltration were observed in 2 cases. Conclusions:UAT has characteristic prenatal sonographic features.In this study, S/D and PI measured in unobstructed UA has little effect on the assessment of fetal intrauterine condition during the formation of UAT, while MCA-PI has important clinical significance for the assessment of fetal intrauterine condition.

Application of missed and misdiagnosed case analysis in fetal heart teaching of ultrasound standardized resident training / 中华医学教育探索杂志

Human fetal heart is the difficulty in ultrasound standardized resident training, which involves embryogenesis, anatomy, fetal circulation characteristics, the mechanism of cardiac malformation and the points of ultrasonic diagnosis. This study investigated the application of missed and misdiagnosed case analysis in fetal heart teaching in ultrasound standardized resident training. The teacher selected the missed and misdiagnosed cases according to the teaching purpose, the students subsequently discussed, analyzed and reported the causes of missed and misdiagnosed cases, then the teacher combed and explained the key knowledge and extended knowledge points. According to the questionnaire survey, the students agreed that the analysis of missed and misdiagnosed cases can mobilize the enthusiasm of learning, help to understand the knowledge, and guide the future clinical work.

Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy / 中华围产医学杂志

Objective@#To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome.@*Methods@#The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018. Scatter plots of left/right bronchus angle (α/β) ratios were drawn. Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test.@*Results@#In the normal group, scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14, P<0.05), indicating that the right bronchus always went more steeply than the left one. In the case group, the α/β ratios were around 1.0. In the right group, the α value increased and was close to the β value [(153.90±5.43)° vs (156.02±5.59)°, t=-2.56, P>0.05] and presented as bilateral right bronchial angle; in the left group, the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56)°, t=-1.18, P>0.05] and presented as bilateral left bronchial angle. There were significant differences in the α and β values among the normal group, the right and left groups (all P<0.05), and the bronchial angles of the right group were both greater than those of the left group (all P<0.05).@*Conclusions@#Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy / 中华围产医学杂志

Objective To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome.Methods The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018.Scatter plots of left/right bronchus angle (α / β) ratios were drawn.Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test.Results In the normal group,scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14,P＜0.05),indicating that the right bronchus always went more steeply than the left one.In the case group,the α/β ratios were around 1.0.In the right group,the α value increased and was close to the β value [(153.90±5.43) ° vs (156.02±5.59) °,t=-2.56,P＞0.05] and presented as bilateral right bronchial angle;in the left group,the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56) °,t=-1.18,P＞0.05] and presented as bilateral left bronchial angle.There were significant differences in the α and β values among the normal group,the right and left groups (all P＜0.05),and the bronchial angles of the right group were both greater than those of the left group (all P＜0.05).Conclusions Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome.

Neglect and associated factors among preschool children in two-child families in southwest Shandong Province / 中国学校卫生

Objective@#To investigate neglect among preschool children in two-child families in southwest Shandong Province, and to provide reference is for improving nursing parenting quality of two-child families.@*Methods@#A questionnaire survey was conducted among 2 646 parents of two-child families and 2 074 parents of one-child families from 16 kindergartens in southwest Shandong Province.@*Results@#The total neglect rate of two-child family preschool children in southwest Shandong Province was 27.37%, and the degree score of neglect was(40.15±5.51). The physical neglect rate(10.39%), emotional neglect rate(40.15±5.51), total neglect (38.15±4.88) and emotional neglect (46.12±6.91) of boys were higher than those of girls, and the difference was statistically significant(χ2/t=4.57, 6.65, 4.58, 4.72, P<0.05); No significant frequencies were found in total neglect rate, total neglect, neglect rate and neglect at all levels among all age groups(P>0.05); Among preschool children with siblings aged 7-<13, ≥13, total neglect rate(30.44%, 32.77%), emotional neglect rate(10.20%,12.00%), total neglect degree (44.71±5.98, 45.33±5.20) and emotional neglect degree (45.95±7.12, 48.86±4.97) of preschool children in two-child families have higher than those in onechild families, and the differences were of statistical significance(χ2/t=31.10, 4.55, 27.92, 24.13, 19.83, P<0.05); the total neglect rate(27.37%), emotional neglect rate(23.47%), emotional neglect (43.68±6.83) of twochild families and the total neglect (40.15±5.51) were higher than those of one-child families, and the differences were of statistical significance(χ2/t=4.98, 4.96, 3.76, 8.53, P<0.05). The age of siblings(OR=0.58), the education level of mothers(OR=0.64), and the main executor of family education (OR=1.54) were main factors to influence the child neglect of preschool children in two-child families(P<0.05).@*Conclusion@#Neglect of preschool children in two-child families is higher than that in one-child families in southwest Shandong, especially among those preschool boys and preschool children whose siblings were of school age.

Quantitative ultrasound analysis in evaluation of fetal lung maturity / 中国介入影像与治疗学

Objective To investigate the application value of DFY-Ⅱ ultrasound imaging analysis software in evaluation of fetal lung maturity in different pregnancy.Methods Totally 315 cases of healthy single pregnancies (24-41 weeks) were collected.The sonographic views of fetal right side sagittal plane were obtained.The echo intensity of fetal lung and liver were analyzed and the ratio was canculated with DFY-Ⅱ ultrasound imaging analysis software.Results The ratio of echo intensity from fetal lung and liver had positive correlation with gestational weeks (r=0.94,P＜0.05),the linear regression equation was Y=0.60+0.07X (r2 =0.883).Conclusion The ratio of echo intensity by fetal lung and liver analyzed with DFY-Ⅱ ultrasound imaging analysis software can be an effective method to evaluate fetal lung maturity.

Relationship between molecular phenotype of ductal carcinoma in situ and that of invasive ductal carcinoma of the breast / 临床与实验病理学杂志

Purpose To investigate the relationship between molecular phenotype of ductal carcinoma in situ ( DCIS) and that of inva-sive ductal carcinoma ( IDC) of the breast. Methods Immunohistochemical method was used to detect ER, PR, HER-2 and CK5 ex-pression in 165 cases of breast cancer, with DCIS and IDC existed in every one of the samples. Results In the 165 cases of breast cancer, the ER, PR, HER-2 and CK5 expression of IDC was positively correlated with that of DCIS, respectively. To evaluate IDC phenotype, the number of basal phenotype was 18 (10. 9%), HER-2-overexpression 20 (12. 1%), luminal A 102 (61. 8%), lumin-al B 20 (12. 1%), null phenotype 6 (3. 6%);to evaluate DCIS phenotype, the number of basal phenotype was 19 (11. 5%), HER-2-overexpression 20 (12. 1%), luminal A 104 (63%), luminal B 17 (10. 3%), null phenotype 5 (3%). 157 cases (95. 2%) of IDC had the same phenotype with DICS, but the rest 8 cases (4. 8%) not, three cases of luminal A DCIS transformed into one HER-2-overexpression and two null phenotype IDC, three of HER-2-overexpression DCIS transformed into luminal B IDC, one null pheno-type DCIS transformed into one luminal A IDC, and one basal phenotype DCIS transformed to HER-2-overexpression IDC. Conclusion Most of IDC have the same phenotype with DCIS, but there exist small part of DCIS which could transform into other phenotype IDC.

Value and prospects of constructing digital slides data of forensic medicine / 中华医学教育探索杂志

As a rising histological specimen carrier,digital slide has advantages of easy search and fast browse.By digital scanning and stitching of traditional slides and uploading traditional slides as well as pathological information to network servers,the construction of digital slides data can take its own superiority to assist forensic medicine teaching.Combined with our research and teaching experience,this article discussed the application prospects of digital slide technology and digital slides data so as to provide references for the improvement and reformation of forensic medicine education.

Role of neuropeptide Y and peroxisome proliferator-activated receptor γ coactivator-1α in stress cardiomyopathy / 华中科技大学学报（医学）（英德文版）

Death following situations of intense emotional stress has been linked to the cardiac pathology described as stress cardiomyopathy, whose pathomechanism is still not clear. In this study, we sought to determine, via an animal model, whether the transcriptional coactivator peroxisome proliferator-activated receptor γ coactivator-1alpha (PGC-1α) and the amino peptide neuropeptide Y (NPY) play a role in the pathogenesis of this cardiac entity. Male Sprague-Dawley rats in the experimental group were subjected to immobilization in a plexy glass box for 1 h, which was followed by low voltage electric foot shock for about 1 h at 10 s intervals in a cage fitted with metallic rods. After 25 days the rats were sacrificed and sections of their hearts were processed. Hematoxylin-eosin staining of cardiac tissues revealed the characteristic cardiac lesions of stress cardiomyopathy such as contraction band necrosis, inflammatory cell infiltration and fibrosis. The semi-quantitative RT-PCR analysis for PGC-1α mRNA expression showed significant overexpression of PGC1-α in the stress-subjected rats (P<0.05). Fluorescence immunohistochemistry revealed a higher production of NPY in the stress-subjected rats as compared to the control rats (P=0.0027). Thus, we are led to conclude that following periods of intense stress, an increased expression of PGC1-α in the heart and an overflow of NPY may lead to stress cardiomyopathy and even death in susceptible victims. Moreover, these markers can be used to identify stress cardiomyopathy as the cause of sudden death in specific cases.

Role of neuropeptide Y and peroxisome proliferator-activated receptor γ coactivator-1α in stress cardiomyopathy / 华中科技大学学报（医学）（英德文版）

Death following situations of intense emotional stress has been linked to the cardiac pathology described as stress cardiomyopathy, whose pathomechanism is still not clear. In this study, we sought to determine, via an animal model, whether the transcriptional coactivator peroxisome proliferator-activated receptor γ coactivator-1alpha (PGC-1α) and the amino peptide neuropeptide Y (NPY) play a role in the pathogenesis of this cardiac entity. Male Sprague-Dawley rats in the experimental group were subjected to immobilization in a plexy glass box for 1 h, which was followed by low voltage electric foot shock for about 1 h at 10 s intervals in a cage fitted with metallic rods. After 25 days the rats were sacrificed and sections of their hearts were processed. Hematoxylin-eosin staining of cardiac tissues revealed the characteristic cardiac lesions of stress cardiomyopathy such as contraction band necrosis, inflammatory cell infiltration and fibrosis. The semi-quantitative RT-PCR analysis for PGC-1α mRNA expression showed significant overexpression of PGC1-α in the stress-subjected rats (P<0.05). Fluorescence immunohistochemistry revealed a higher production of NPY in the stress-subjected rats as compared to the control rats (P=0.0027). Thus, we are led to conclude that following periods of intense stress, an increased expression of PGC1-α in the heart and an overflow of NPY may lead to stress cardiomyopathy and even death in susceptible victims. Moreover, these markers can be used to identify stress cardiomyopathy as the cause of sudden death in specific cases.

Enhancing cytotoxicity of Mitoxantrone on human breast cancer cell with microbubble contrast during low-frequency ultrasound exposure / 中国医学影像技术

Objective To investigate the antitumor effect and its mechanism of microbubble contrast combined with Mitoxantrone exposed to low-frequency ultrasound on human breast cancer cell MCF-7. Methods MTT method was applied to examine the growth inhibition of MCF-7 treated with Mitoxantrone. MCF-7 cells were randomly divided into 4 groups:Mitoxantrone group (group D), ultrasound+Mitoxantrone group (group U+D), ultrasound+microbuble +Mitoxantrone group (group U+M+D) and control group (group C). The cytoactive of each group was examined with MTT. The intracellular drug content in each group was measured with high performance liquid chromatography. The morphology of MCF-7 cells apoptosis was observed with transmission electron microscopy (TEM). Results The IC_(50) of Mitoxantrone was 2.87 μg/ml. The differences of cytoactive among all groups were significant (P<0.05). The intracellular drug content of group U+M+D was higher than that of group U+D, and the latter was higher than that of group D. The morphological changes of apoptosis were observed with TEM. Conclusion Low-frequency ultrasound can promote intracellular drug content as to enhance the sensitivity of chemotherapy drugs on tumor cells, and this effect can be enhanced by microbubble contrast exposure to low-frequency ultrasound.

Expression and significance of androgen receptor in breast carcinoma with different ER and PR status / 临床与实验病理学杂志

Purpose To investigate the expression and significance of androgen receptor (AR) in breast carcinoma with different ER and PR status.Methods Immunohistochemical method was used to detect AR, ER and PR expression in 173 cases of breast carcinoma, and all the cases were grouped according to: (1) AR status: AR~- positive subgroup and AR~- negative subgroup, (2) ER status: En subgroup (negative for both ER and PR), Ep subgroup (positive for ER and/or PR), (3)AR, ER and PR status: En-AR~+ subgroup (AR~- positive cases of En subgroup), En-AR~- subgroup (AR~-negative cases of En subgroup), Ep-AR~+ subgroup (AR~- positive cases of Ep subgroup), and Ep-AR~- subgroup (AR~-negative cases of Ep subgroup).En-AR~- subgroup also was called negativE-for-all subgroup, and the rest three subgroups were called partly-or-completely positive subgroup (positive for at least one of the three markers), and then, the groups were compared with clinicopathological features.Results The positive rate of AR was 62.8% (54/86) in Ep subgroup and 37.9%(33/87) in En subgroup, and there was significant difference between them (P=0.001).Compared to AR~-negative subgroup, AR~-positive subgroup had smaller tumor size, less mitosis count and lower grade(P<0.05).Compared to the other three subgroups, En-AR~- subgroup had more mitosis count and higher grade (P<0.01).In En subgroup,AR~- positive cases had less mitosis count and lower grade (P<0.05), and in Ep subgroup,AR~- positive cases had higher stage(P=0.000), but no significant difference were found among partly or completely positive subgroups.Conclusions The expression of AR may play a different role in breast carcinoma with different ER and PR status, because it indicates good prognosis in negative for both ER and PR subgroup, but bad in ER and/or PR positive subgroup. When choosing a personalized therapy, all the combinations of hormone receptor status should be considered for the patients.

Changes of the Cytokines and Endothelium Function in Patients with Chronic Pulmonary Heart Failure Disease at High Altitude Area / 医学研究杂志

Objective To investigate the changes and clinical significance of the plasma cytokines and endothelium function in patients with chronic pulmonary heart failure disease at high altitude area.Methods Plasma levels of tumor necrosisfactor-alpha(TNF-?),interleukin-6(IL-6),endothelin-1(ET-1) were measured in 278 chronic pulmonary heart patients with various degrees of heart failure and in 48 healthy controls.Left ventricular ejection fraction(LVEF),Right ventricular ejection fraction(RVEF) and Pulmonary(PASP) were examined with echocardiography.Results Plasma levels of TNF-?,IL-6,ET-1 were elevated in patients of functional classes Ⅱto Ⅳ as compared with age-matched control subjects and were progressively elvated with the decreasing functional status of the patients.The levels of TNF-?,IL-6,ET-1 respectively were positively correlated with PASP but negtively correlated with LVEF and RVEF(P

Perforin and granzyme--the perfect material of biologic missile / 生物医学工程学杂志

Perforin and granzyme are important effector molecules in cytolytic cells. They can induce apoptosis of tumor cells and infection cells. The research of biologic missile is noticed with the progress in therapy targeting to the disease. It is supposed that perforin and granzyme play an important role in biological missiles because of their biologic function and structure. A review on several aspects of these effector molecules is presented.

Relationship between blood ox-LDL levels in coronary sinus and impaired endothelium-dependent vasodilation in patients with coronary artery disease / 第三军医大学学报

Objective To investigate the relationship between the oxidized low-density lipoprotein(ox-LDL) in the blood from the coronary sinus and impaired endothelium-dependent vasodilation in patients with coronary artery disease(CHD).Methods Four groups of patients were subjected,including acute myocardial infarction group(AMI,n=22),unstable angina group(UA,n=29),and stable angina group(SA, n=25) and control group(n=20) who was first suspected as CHD and then verified with normal coronary angiograms.Blood form the coronary sinus was collected through cardiac cathetering and the ox-LDL level was measured by Sandwich ELISA method.Brachial arterial hyperemia-induced flow mediated dilation(FMD) and sublingual nitroglycerin(NTG) mediated vasodilation were measured by high resolution ultrasound.Results The blood level of ox-LDL in patients with CHD was markedly higher than those in control group(P

Changes of plasma ox-LDL and endothelium-dependent vasodilation in patients with acute coronary syndrome / 中国实用内科杂志

Objective To explore the relationship of the plasma ox-LDL level and endothelium flow mediated vasodilation(FMD)in acute coronary syndrome patients(ACS).Methods From March to October 2004,in the Department of Cardiology,the Fourth PLA Hospital,51 patients with ACS were divided into 2 groups:AMI group(22patients)and UAP group(29 patients).20 subjects with normal coronary angiograms served as the control group.Nitrir oxide(NO)and plasma ox-LDL was measured by spectrophotometer and Sandwich ELISE method,respectively.The brachial arterial hyperemia-induced flow mediated vasodilation(FMD)and sublingual nitroglycerin(NTG)mediated vasodilation were measured by high resolution ultrasound.Results (1)The FMD in ACS group was significantly decreased compared with the control group[(7.2?1.42)、(7.6?1.12)vs(15.46?1.2),P0.05).(2)The No in ACS group was sigificantly lower than that in control group;the NO in AMI group was even lower[(48.46?12.44)、(60.42?10.30)vs(94.72?12.34)?mol/L,P1,which meant ox-LDL was a risk factor;the OR of FMD was

The relationship between oxidized LDL and coronary endothelial dysfunction in patients with coronary heart disease / 中国介入心脏病学杂志

Objective To investigate the role of oxidized LDL and coronary endothelial dysfunction in the development and progress of coronary heart disease(CHD).Methods 29 patients with unstable angina(UA),25 patients with stable angina(SA) and 20 patients without coronary heart disease(control) were studied.Oxidized low-density lipoprotein(ox-LDL)、 Nitric oxide(NO),and circulating endothelial cells(CEC) were measured in both coronary sinus and peripheral blood during percutaneous coronary intervention(PCI).Results The level of NO in coronary sinus in patients with CHD was lower,while the level of ox-LDL and CEC was markedly higher than those in the control group.In CHD patients,the level of NO in coronary sinus blood was lower,while the level of ox-LDL and CEC was higher than that in peripheral blood.It was no siginificant difference between coronary sinus and peripheral blood was observed in the control group.Conclusion Oxidized LDL not only plays an important role in coronary endothelial dysfunction,but also contributes to the progress in the cornornary heart disease.It may be one of the pathophysiological basis of acute coronary incidents.