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Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan on acute myocardial infarction complicated by heart failure.Methods Patients who suffered from anterior wall acute myocardial infarction (AMI) with heart failure (KillipⅡ ~ Ⅲ) within 12 to 24 hours after the onset of chest pain were randomized into two groups: the control group (n=30, receiving dobutamine and/or cedilanid) and the experimental group (n=30, receiving rh-BNP combined with levosimendan).The hemodynamics, parameters of laboratory tests and adverse events were observed before and after treatment.Results The experimental group showed that the respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), arterial blood gas oxygen saturation (SaO2), cardiac index (CI), extravascular lung water index (EVLWI) were significantly different between 2 h and sequential time points after treatment and pre-treatment (allP<0.05).The control group showed that RR, HR, SaO2, CI, EVLWI were significantly different between 6 h and sequential time points after treatment and pre-treatment (P<0.05 for all).There were significant differences in RR, HR, SBP, SaO2, CI, EVLWI at 2 h and 6 h after treatment between the two groups (P<0.05 for all).Parameters of RR, HR, CI, EVLWI at 72 h after treatment had differences between the experimental group and controls.Patients in the experimental group presented larger urine volume, lower level of plasma NT-pro BNP, higher left ventricular ejection fraction (LVEF) and shorter length of stay in CCU as compared with patients in the control group (P<0.05 for all).In adverse events monitoring in hepatic parameters, electrolyte level and coagulation function before and after treatment, there was no significant difference between the two groups.Conclusions Compared with the conventional treatment, the combination therapy with rh-BNP and levosimendon can improve the hemodynamics, increase the urine volume, decrease the level of plasma NT-proBNP and elevate LVEF significantly, so as to improve the clinical symptoms and shorten the hospital stay in patients with acute myocardial infarction complicated by heart failure.
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AIM:To explore the changes of plasma levels of soluble vascular endothelial growth factor receptor 2 ( sVEGFR2) and superoxide dismutase ( SOD) in hypertensive patients and hypertensive diabetic patients.METHODS:In this cross-sectional study, 88 cases were enrolled, which were divided into hypertensive group (n=31), hypertensive diabetic group ( n=31 ) and control group ( n=26 ) .Blood pressure was obtained from each participant with mercury sphygmomanometer.The levels of sVEGFR2 and SOD were measured by ELISA.Meanwhile, the levels of plasma glucose, glycosylated hemoglobin A1c ( GHbA1c) and lipid profile were detected.RESULTS:The levels of total cholesterol ( TC) and body mass index (BMI) were significantly higher in hypertensive group than those in control group (P<0.05).The levels of TC, low-density lipoprotein cholesterol ( LDL-C) , triglyceride ( TG) , BMI, waist circumference were significantly higher in hypertensive diabetic group than those in control group (P<0.05).The plasma levels of sVEGFR2 and SOD in both hypertensive diabetic group and hypertensive group were significantly decreased compared with control group ( P<0.05), while the mean plasma levels of sVEGFR2 and SOD in hypertensive diabetic group were significantly decreased compared to the hypertensive group ( P<0.05 ) .A significantly positive correlation between sVEGFR2 and SOD in the whole study population (P<0.05) was observed.CONCLUSION: The plasma level of sVEGFR2 is decreased in both hypertensive and hypertensive diabetic patients, and more significantly decreased in hypertensive diabetic patients.De-creased SOD level may be associated with to the reduction of sVEGFR2.
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AIM: To explore the effect of hydrogen sulfide on the senescence of human umbilical vein endothe -lial cells (HUVECs) induced by high glucose.METHODS: Senescence model was established by treating HUVECs with33 mmol/L glucose for 48 h.The parameters were detected to demonstrate the effect of hydrogen sulfide on senescence andthe mechanism involved was also investigated .RESULTS: In the cells treated with high glucose, the proliferation was attenuatedwith a higher number of senescence -associated β-galactosidase (SA-β-Gal) positive cells, and plasminogen activatorinhibitor 1 (PAI-1) protein expression, malondialdehyde (MDA) production and NF-κB p65 activity were increasedsignificantly, but the expression of superoxide dismutase 1 (SOD1) was decreased.However, the cell number and SOD1expression were increased, and the number of SA-β-Gal positive cells, PAI-1 protein expression, MDA production and theactivity of NF-κB p65 were decreased after sodium hydrosulfide (100 and 200 μmol/L) treatment.CONCLUSION: Exogenoushydrogen sulfide prevents HUVECs against high glucose -induced senescence by suppressing oxidative stress and NF -κB p65 activity.
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Objective To compare the diagnostic performance of prospective electrocardiogram (ECG)-gating 320-detectorcomputed tomography coronary angiography (CTCA) versus retrospective ECG-gating CTCA. Methods 500consecutive patients suspected coronary artery disease with heart rate of less than 65 bpm were performed coronary computed tomography angiography (CCTA) with prospective (group P)and retrospective (group R) ECG gating in turn. The image quality was divided into four levels. Success rates, effective radiation dose,image quality and diagnosis were evaluated. Results Success rates of examination in group P and R are100%.Mean patient radiation dose was significantly different in group P (3.28±1mSv) and R(14.36 ±2.3 mSv).131 and 142 of 3750 segments (250 patients x 15 segments per patient) were too small(1.5mm)tobe characterized in group P and R. 96. 51% (3619/3750) and 96.12% (3608/3750) characterized segments were not significantly different in group P and R. 95.09% segments received a score of 4 and 1.09% segments received a score of 3 in group P, while 95.23% and 0.74% in group R.The cause of 2 and 3 points in the two groups was motion artifact. Stair-step artifacts and images scored as 1were not found.Compared with CAG,the sensitivity,specificity,false positive andfalse negative value in group P(86. 49% ,98. 70% ,88. 89% ,98.38%) and R(83. 87% ,98.74% ,89. 65%,97.93%) were not significantly different. Conclusion Although the patient radiation exposure was significantly lower, the diagnostic performance of prospective ECG-gating 320-detector CTCA was comparable with that of retrospective ECG-gating 320-detector CTCA on patients with stable heart rates less than 65 bpm.
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Objective To study imaging features of Joubert syndrome on CT and MRI. Methods Ten cases with clinically diagnosed Joubert syndrome were retrospectively studied. Routine CT examinations were performed in all ten cases and MRI in four cases. Results He typical imaging features of Joubert syndrome included “midline cleft” between cerebellar hemispheres, “bat-wing” and “triangular-shaped” fourth ventricle, and “molar tooth sign”. On CT images, all cases had “midline cleft”, “bat-wing” and “triangular-shaped” fourth ventricle was present in nine cases, and “molar tooth sign” in eight cases. On MRI, “midline cleft”,“bat-wing” and “triangular-shaped” fourth ventricle , and “molar tooth sign” were present in all four cases. Conclusion There are typical imaging features of Joubert syndrome. CT and MRI play an important role for the diagnosis.
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The sella MRIand CT of 11 patients with primary pituitary dwarfism (PPD) were evaluated in this study. The results revealed that MRI could find the aplasia of the pituitary and the abnormality of the pituitary stalk and pituitary posterior lobe, while CT only could show the disapperance of the pituitary and not the morphology of the pituitary and its posterior lobe. The CT scanning of the pituitary stalk was less clear than that of MRI. It is suggested that MRI has better tissue contrast and sensitivity, especially to the display of slight structure. Besides, the sella abnormality in MRI provides an important morphological basis for diagnosis and treatment of PPD.