Oxidized high-density lipoprotein accelerates atherosclerosis progression by inducing the imbalance between treg and teff in LDLR knockout mice.

High density lipoprotein (HDL) dysfunction has been widely reported in clinic, and oxidation of HDL (ox-HDL) was shown to be one of the most common modifications in vivo and participate in the progression of atherosclerosis. But the behind mechanisms are still elusive. In this study, we firstly analyzed and found strong relationship between serum ox-HDL levels and risk factors of coronary artery diseases in clinic, then the effects of ox-HDL in initiation and progression of atherosclerosis in LDLR knockout mice were investigated by infusion of ox-HDL dissolved in chitosan hydrogel before the formation of lesions in vivo. Several new evidence were shown: (i) the serum levels of ox-HDL peaked early before the formation of lesions in LDLR mice fed with high fat diet similar to oxidative low density lipoprotein, (ii) the formation of atherosclerotic lesions could be accelerated by infusion of ox-HDL, (iii) the pro-atherosclerotic effects of ox-HDL were accompanied by imbalanced levels of effector and regulatory T cells and relative gene expressions, which implied that imbalance of teff and treg might contribute to the pro-atherosclerosis effects of ox-HDL.

Effects of New Compound Traditional Chinese Medicine Prepatations Banxiao Capsule on the Mobilization of Endothelial Progenitor Cells / 医学研究杂志

Objective To investigate the effects of new compound traditional Chinese medicine prepatations Banxiao capsule on the mobilization of endothelial progenitor cells ( EPCs) .Methods After EPCs from mouse bone marrow treated with variable dose of Banxiao capsule, we detected the proliferation by CCK-8 assay, quantified the number of CD34/Flk-1 double positive cells by flow cytometric analysis, evaluated the migratory function of EPCs by transwell chamber assay, and studied the protein level of Bcl-2/Bax by Western blot analysis.Results Compared with untreated group, the proliferation potential of EPCs in Banxiao low dose (20μg/ml) and high dose (200μg/ml) group was increased(P<0.05), the number of CD34/Flk-1 double positive cells were increased (P<0.05), migrative activity of EPCs was increased (P<0.05),the level of Bcl-2 protein were increased, and the level of Bax protein were decreased.Con-clusion Banxiao capsule can enhance proliferation of EPCs through up-regulating of expression of Bcl-2/Bax.

Clinical relevance of angiographic coronary collaterals during primary coronary intervention for acute ST-elevation myocardial infarction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Collaterals to occluded infarct-related coronary arteries (IRA) have been observed after the onset of acute ST-elevation myocardial infarction (STEMI). We sought to investigate the impact of early coronary collateralization, as evidenced by angiography, on myocardial reperfusion and outcomes after primary percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Acute procedural results, ST-segment resolution (STR), enzymatic infarct size, echocardiographic left ventricular function, and major adverse cardiac events (MACE) at 6-month follow-up were assessed in 389 patients with STEMI undergoing primary PCI for occluded IRA (TIMI flow grade 0 or 1) within 12 hours of symptom-onset. Angiographic coronary collateralization to the occluded IRA at first contrast injection was graded according to the Rentrop scoring system.</p><p><b>RESULTS</b>Low (Rentrop score of 0 or 1) and high (Rentrop score of 2 or 3) coronary collateralization was detected in 329 and 60 patients, respectively. Patients with high collateralization more commonly had prior stable angina and right coronary artery occlusion, but less often had left anterior descending artery occlusion. At baseline, these patients presented with less extent of ST-segment elevation and lower serum levels of creatine kinase myocardial band (CK-MB) and cardiac troponin I (cTnI). Procedural success rate, STR, corrected TIMI flame count, and area under the curve of CK-MB and cTnI measurements after the procedure were similar between patients with high collateralization and those with low collateralization (for all comparisons P > 0.05). There were no differences in left ventricular ejection fraction and rates of MACE at 6 months according to baseline angiographic collaterals to occluded IRA.</p><p><b>CONCLUSIONS</b>In patients with acute STEMI undergoing primary PCI within 12 hours of symptom-onset, coronary collateralization to the occluded IRA was influenced by clinical and angiographic features. Early recruitment of collaterals limits infarct size at baseline, but has no significant impact on myocardial reperfusion after the procedure and subsequent left ventricular function and clinical outcomes.</p>

The Regulative Role of ERK5/Bim Pathway in Hypothermal Stimulation Induced Neonatal Rat’s Cardiomyocytes Injury and Apoptosis / 中国循环杂志

Objective: To explore the regulative role of extracellular regulated protein kinase-5 (ERK5)/Bcl-2 interacting mediator of cell death (Bim) pathway in hypothermal stimulation induced neonatal rat’s cardiomyocytes (CMs) damage and apoptosis. Methods: CMs were cultured for hypothermal stimulation and the speciifc siRNA was used to down-regulate the ERK5 or Bim in CMs. The cell apoptosis was detected by lfow cytometry, protein expression was examined by Western blot analysis, the intracellular Ca2+, reactive oxygen species (ROS) and mitochondrial membrane potential (ΔΨm) were evaluated by lfuorescent labeling and lfow cytometry. Results: In hypothermal stimulated CMs, ERK5 siRNA could promote Bim protein expression, but Bim siRNA could not inlfuence ERK5, while attenuated p-ERK5 expression. ERK5 siRNA induced higher apoptosis rate, while Bim siRNA could decrease such effect. ERK5 siRNA increased the intracellular Ca2+overloading, ROS activation andΔΨm damage, while Bim siRNA played the role to against those effects in hypothermal stimulated CMs. Conclusion: Our study revealed that ERK5/Bim pathway played the important regulative roll in hypothermal stimulation induced neonatal rat’s CMs damage and apoptosis.

Selective atrial vagal denervation guided by evoked vagal reflex to treat refractory vasovagal syncope.

A 57-year-old woman with refractory vasovagal syncope and a sinus pause of 6.8 seconds during tilt-table test accepted the suggestion of atrial vagal denervation. Radiofrequency pulses were delivered on positive vagal reflex sites according to the standard of heart rate (HR) drop ≥20% after high frequency stimulation (HFS). The endpoint of inexistence of HR decrease at repeating HFS was achieved in 18 sites. No syncope attacked during 12 months and three tilt-table tests performed at 1, 6, and 12 months were negative. Extensive ablation on atrial endocardium for vagal denervation is suggested to be efficient in cardioinhibition type of VVS.

A continuous glycemic observation during early phase of acute myocardial infarction in patients without known diabetes mellitus / 中华内分泌代谢杂志

One hundred and eleven patients with acute myocardial infarction and without known diabetes mellitus who underwent continuous glucose monitoring were divided into normoglycemia(n = 30),transient hyperglycemia(n = 36),and persistent hyperglycemia(n = 45)groups.Compared with other two groups,higher mean blood glucose,standard deviation of blood glucose,largest amplitude of glycemic excursions,mean amplitude of glycemic excursions,and absolute mean of daily differences were observed in the patients with persistent hyperglycemia group(all P<0.01),who were more likely to be female with the history of hypertension and old myocardial infarction(all P<0.05).It was shown that the levels of aspartate aminotransferase,creatine phosphokinase(CK),CK-MB,total cholesterol,triglyceride,low-density lipoprotein cholesterol,HbA1C,and C reactive protein levels were higher in these patients(P<0.01).

Efficacy and safety of fixed combination of nitrendipine and atenolol in treatment for patients with mild to moderate essential hypertension and their optimal dosage matching / 中华全科医师杂志

Objective To evaluate efficacy and safety of fixed combination of nitrendipine and atenolol in treatment for patients with mild to moderate essential hypertension and their optimal dosage matching.Methods Totally,275 patients with essential hypertension were selcted from seven hospitals in Shanghai,Nanjing and Suzhou,China and randomized into five groups with same proportional probability in a double-blind,double-dummy,parallel active-controlled,multi-center clinical trial,receiving fixed combination of nitrendipine and atenolol at three different dosage matching (nitrendipine/atenolol 5/12.5 mg,5/10 mg,5/7.5 mg for groups 1,2 and 3),and nitrendipine (10 mg for group 4) or atenolol (25 mg for group 5),respectively for eight weeks.Results Mean reduction of diastolic blood pressure (DBP)was (17±7) mm Hg,(18±9) mm Hg and (17±7) mm Hg for groupl,2 and 3,respectively from the baseline,significantly greater than that in groups 4 and 5[(13±7) mm Hg and (12±6) mm Hg,respectively].Mean reduction of systolic blood pressure (SBP) was (21 ±11)mm Hg,(24±12) mm Hg,(23±11) mm Hg,(19±13) mm Hg and (18±9) mm Hg,respectively for the five groups from the baseline,and the reduction in group 2 was significantly greater than that in group 5,with an overall efficacy of 94.4%,98.1% and 88.2% for groups 1,2 and 3,respectively,all statistically higher than that in group 5 (71.4%) with P＜0.01,eight weeks after treatment.The ratio of patients with increased dose of antihypertensive agents in week 5 was lower in group 2 than that in the other four groups,with mild adverse reaction only,no obvious change in laboratory biochemical examinations,and no needs in special management.Conclusions Fixed combination of atenolol and nitrendipine with an optimal doses of 5 mg and 10 mg respepctively was effective and safe for mild and moderate hypertension with good tolerance.

Efficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension / 上海交通大学学报（医学版）

Objective To evaluate the efficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension in comparison with losartan. Methods Two hundred and thirty-seven patients with mild to moderate essential hypertension were enrolled in a randomized, double-blind, multi-center, paralleded and active-controlled trial, and were divided into olmesartan group (olmesartan 20 mg + losartan 50 mg placebo) and losartan group (losartan 50 mg + olmesartan 20 mg placebo) for a 8-week therapy. Four weeks after treatment, dosages of drugs were doubled in patients with seated diastolic blood pressure ≥90 mmHg (1 mmHg =0.133 kPa). All patients were followed up every two weeks, and the efficacy and adverse effects were observed. Another 32 patients with mild to moderate essential hypertension were enrolled and given olmesartan only, and ambulatory blood pressure monitoring was performed before and 8 weeks after treatment. Results Compared with those before treatment, both systolic blood pressure and diastolic blood pressure significantly decreased in olmesartan group and losartan group 8 weeks after treatment [(15.2 ±13.3) mmHg and (19.5 ±11.8) mmHg, respectively for systolic blood pressure (P <0.001); (15.9 ±7.48) mmHg and (16.2 ± 5.95) mmHg, respectively for diastolic blood pressure (P < 0.01) ], while there was no significant difference between these two groups (P > 0.05). There was no significant difference in total effective rate and incidence of adverse effect between these two groups (86.9% vs 93.7% and 7.63% vs 5.88% , P > 0.05) . Ambulatory blood pressure monitoring demonstrated that trough to peak ratios of systolic blood pressure and diastolic blood pressure were 86% and 71%, respectively. Conclusion Domestic olmesaratan provides an effective, safe and long action in the treatment of mild to moderate essential hypertension.

Isolation, cultivation and identification of endothelial progenitor cells from rabbit bone marrow by in vitro amplification method / 中国组织工程研究

AIM: To isolate and culture endothelial progenitor cells (EPCs) in blood vessel by in vitro amplification from bone marrow of rabbits to provide cytology basis for the implantation of autologous EPCs in the repair of blood vessel endothelium. METHODS: The experiment was performed at the Department of Cardiology, Changzheng Hospital, Second Military Medical University of Chinese PLA from March 2005 to February 2006. ①Dil labeled acetylated low density lipoprotein, FITC labeled BS-1 lectin, mouse anti-human CD34 antibody, rabbit anti-human FIK-1 antibody, mouse anti-human CD133 monoclonal antibody were purchased from molecular probes company, vector company, Biolegend company, Biolegeng company and R&D company. ②Totally 8 New Zealand rabbits were selected to extract the bone barrow. Mononuclear cell was isolated from bone marrow by density centrifugation. With the inoculated density of 1?106/cm2, it was put in the M199 medium containing vascular endothelial growth factor and Basic fibroblast growth factor (bFGF) for in vitro cultivation for 7 days. Cell growth and reproductive activity were observed. ③EPCs were identified by Dil labeled acetylated low density lipoprotein and FITC labeled BS-1 lectin. The cells showed red fluorescence were cells phagocytized acetylated low density lipoprotein, while those with green gluorescence were cells bind with BS-1, and the cells double stained showed orange fluorescence. ④Expressions of CD133, CD34 and Flk-1 were detected with immunofluorescent staining and flow cytometry. RESULTS: ①Observation of cell morphous: New isolated mononuclear cells were round. After cultivation for 72 hours, adherent cells showed colony-like growth, and the cells were round or irregular, and the caryocinesis was relatively obvious. Till the 7th day after cultivation, cell colony was connected each other, showing fusiform endothelioid cells. ②Reproductive activity of EPCs in blood vessel: At days 2-4, the reproduction of EPCs was rapid, and then became slow gradually. Growth curve showed typical "S" shape. At days 6 and 7, the EPCs grew rapidly. The absorbance (A) reached 0.58?0.15 and 0.62?0.23, respectively. ③Result of EPCs identification by Dil labeled acetylated low density lipoprotein and FITC labeled BS-1 lectin: In kytoplasm of EPCs, red fluorescent concentration bind with acetylated low density lipoprotein appeared, with the positive rate of over 95%. Combined rate with BS-1 lectin reached 100% nearly. Double staining rate reached over 90%. ④Result of EPCs immunohistochemical method and flow cytometry: The cell-surface marker CD133, FlK-1 and CD34 were positive. CONCLUSION: Cell colony with the feature of EPCs can be isolated and cultured from rabbit bone marrow by in vitro amplification method successfully.

Upregulation of CD40--CD40 ligand system in patients with diabetes mellitus.

BACKGROUND: Diabetes is associated with an increased risk of cardiovascular disease and atherosclerosis. Increasing evidence shows that CD40-CD40L interaction plays a crucial role in the pathogenesis of atherosclerosis and coronary artery disease. The purpose of this study was to assess whether CD40 system expressions were disrupted in patients with diabetes. METHODS: Sixteen normal controls and 72 patients including 20 with type 2 diabetes mellitus (DM), 15 with type 1 DM, 20 with coronary heart disease (CHD) and 17 CHD with coexisting DM were investigated. The expression of CD40 and CD40L on platelet was analyzed by indirect-immunofluorescence flow cytometry and serum-soluble CD40L level was determined by a commercially available ELISA. Serum of AGE was detected by fluorescence spectroscopy. RESULTS: Type 1 DM, type 2 DM, CHD and CHD Patients with coexisting diabetes showed a significant increase of CD40 (81.8 +/- 11.7, 70.7 +/- 11.6, 68.5 +/- 10.2, 79.9 +/- 11.9 MIF, respectively) and CD40L (18.4 +/- 5.1, 13.9 +/- 4.1, 13.5 +/- 3.7, 16.7 +/- 4.7 MIF, respectively) coexpression on platelets as well as sCD40L (15.6 +/- 3.5, 14.1 +/- 3.3, 12.2 +/- 3.5, 13.5 +/- 3.6 ng/ml, respectively) compared with controls (p < 0.01). A positive correlation was found between serum AGE levels in patients with DM and CD40-CD40L system. We also observed a significant correlation between hemoglobinA1c (HbA1c) concentration and CD40L on platelets (r = 0.71, p < 0.001) as well as sCD40L (r = 0.69, p < 0.001), but not for CD40 on platelets. CONCLUSIONS: Patients with diabetes show increased coexpression of CD40 system, especially CD40L, which may create a proinflammatory and prothrombotic milieu for aggravating the development of atherosclerosis.

Clinical implications of increased expression of CD40L in patients with acute coronary syndromes / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate clinical implications of expression of CD40L in monocytes and changes in serum soluble CD40L in patients with acute coronary syndromes (ACS).</p><p><b>METHODS</b>Sixteen control and 56 patients, including 24 with stable angina (SA), 20 with unstable angina (UA) and 12 with acute myocardial infarction (AMI) enrolled in this study. Expression of CD40L in monocytes was analyzed by flow cytometry and sCD40L levels were measured by ELISA.</p><p><b>RESULTS</b>Expression of CD40L in monocytes and serum levels of sCD40L in UA and AMI patients were higher than in SA patients and controls. In patients with AMI, sCD40L levels showed no significant increase when compared to patients with UA, while AMI patients had a peak level of sCD40L at 24 hours after AMI. PTCA induced a marked rise in sCD40L levels in all patients, while CD40L expression in monocytes showed no difference between patients with PTCA, before and after.</p><p><b>CONCLUSION</b>Enhanced level of serum sCD40L may be a reliable prognostic indicator for ACS and may represent a marker of coronary disease activity.</p>

Insulin enhances glucose transporter 1 gene expression of low-flow ischemic myocardium / 中国病理生理杂志

AIM: To investigate the mechanism underlying insulin-stimulated increase in glucose uptake during low-flow myocardial ischemia. METHODS: The expression of myocardial GLUT1 polypeptide was determined by semiquantitative immunoblotting. The expression of GLUT1 mRNA was determined by semiquantitative Northern blotting. RESULTS: After infusing insulin during low- flow myocardial ischemia for 8 h，the expression of both GLUT1 mRNA and GLUT1 polypeptide was significantly higher in experimental myocardium than that in normal myocardium. The glucose uptake was upregulated at the same time in the exprimental myocardium. CONCLUSION: Insulin enhances the expression of GLUT1 mRNA and GLUT1 polypeptide in ischemic myocardial regions. GLUT1 expression may be an important mechanism by which myocardial cells enhance glucose uptake and metabolism during low-flow myocardial ischemia.

Examination of coronary sinus and blood flow by transthoracic and transesophageal echocardiography / 第二军医大学学报

Objective: To study the examination of coronary sinus (CS) and blood flow by transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods: Thirty patients with supraventricular tachycardia were studied by TTE and TEE. The CS was visualized using modified 4 chamber view. The position of the probe was optimized until the coronary sinus with its ostium into the right atrium could be visualized. CS flow recordings were performed by TEE with Doppler sample volume placed in the CS within a distance of no more than 10 mm from its ostium. Results: In all patients the angle between the doppler beam and the long axis of the CS was <30°. The CS was fully displayed in 18 patients by TTE and 28 patients by TEE. The length and width of the CS were (16.53±2.57) mm and (4.51±1.30) mm by TTE, (24.11±2.46) mm and (5.06±0.97) mm by TEE.The CS flow was characterized by biphasic flow.Its flow velocity was (39±7.8), (31±6.1) and (21±4.7) cm/s respectively. The CS flow velocity-imeintegral was(43±11.6),(43±13.0),(27±8.2) cm/s. Conclusion: Echocardiography is reliable for detecting CS and its flow. TTE is more feasible for detecting CS and its flow than TEE.

Additive e ffects of hyperinsulinemia and ischemia on canine myocardial GLUT4 gene expression in vivo / 第二军医大学学报

Objective: To investigate whether there is additi ve effects of hyperinsulinemia and ischemia on expression of canine myocardial G LUT4 gene in vivo. Methods: The expression of myocardial GLU T4 was determined by semiquantitative immunoblotting.The expression of GLUT4 mRN A was determined by semiquantitative Northern blotting. Results: Dramatic changes were seen in GLUT4 mRNA and GLUT4 expression in the ischemic hearts.After infusing insulin for 8 h,regional GLUT4 mRNA and GLUT4 levels in is chemic hearts were 2.5, 2.3-fold that of expression in normal hearts(P<0.01 ). Myocardial glucose uptake in ischemic hearts was increased by 4-fold when co mpared with normal hearts(P<0.01). Conclusion: There are not only additive effects of hyperinsulinemia and low-flow ischemia on canine myoc ardial GLUT4 mRNA and GLUT4 expression in vivo, but also increase of myocar dial glucose uptake. Enhanced GLUT4 expression may be an important protective m echanism by which myocardial cells enhance glucose uptake and metabolism during low-flow ischemia.

Tetrandrine improves myocardial stunning in vitamin D3-induced calcium over load rats / 第二军医大学学报

Objective: To investigate the changes of myo cardial contractile function during myocardial stunning in calcium overload rats and the protective effects of tetrandrine. Methods: Forty-six rats were randomized into control, myocardial ischemia, myocardial stunning, low and high dose of tetrandrine groups. Another 10 rats were used to identify the calcium overload. vitamin D3 (0.3 million Unit/kg) and nicotinic acid were adm inistered. After 16 d when calcium overload occured, left anterior descending ar tery was ligated. Twenty minutes of myocardial ischemia followed by 60 min of re perfusion was induced. The contractile function parameters were determined dynam ically. At the end of experiment, myocardial cytosolic ［Ca2+］i was deter mined in various groups. In tetrandrine groups, tetrandrine (62.2 or 93.6 μmol/ kg ) was administered by gastrogavage daily.After 16 d, the rats undergone the e xperiments mentioned above. Results: Sixteen days after vitamin D3 , nicotinic acid were given, ［Ca2+］i increased by 2.6 folds (146.8±10.8 ) vs (368.5±22.6) nmol/L, (P<0.01). Whereas, ［Ca2+］i in tetrand rine groups were (210.8±16.4) and (198.6±15.3) nmol/L, which were significantl y lower than that of calcium overload group. Twenty minutes of myocardial ische mia resulted in the decrease of dp/dtmax and Vmax in all groups with the most si gnificant in stunning and calcium overload groups. The contractile function rest ored gradually after reperfusion. At all time points, dp/dtmax and Vmax in both tetrandrine groups were higher than those in both stunning and calcium overload groups. And effect with higher dose of tetrandrine were more significant than in low dose of tetrandrine. After 60 min of reperfusion, dp/dtmax in stunning, cal cium overload, low and high dose of tetrandrine groups were 49.7%, 51.5%, 71.0% and 83.4% of that in control, respectively， and Vmax were 55.0%, 49.8%, 73.9% and 77.5% of that in control, respectively. Conclusion: T he myocardial contractile function in vitamin D3-induced calcium overload gro up is impaired. On basis of myocardiocyte calcium overload, transient ischemia l eads to myocardial stunning. At the stage of ischemia, the impaired degree of my ocardial contractile function is similar to that in stunning group, suggesting a t this stage the effect of ischemia on myocardial function is greater than that of calcium overload. Tetrandrine chronically improves the myocardial function in Vitamin D3-induced calcium overload rats.

Clinical study of L-carnitine improving heart function in pat ients with congestive heart failure / 第二军医大学学报

Objective: To observe the effect of L-carniti ne (L-CN) in the treatment of congestive heart failure (CHF). Meth ods: Fifty-six cases of chronic CHF randomly received routine treatment (Digitalis, diuretics, vasodilator, ACEI or βblocker) or L-CN (3.0 g/d ,V D×10 d) with routine therapy. Results: The treatment efficiency of L-CN group and control group were 89.3% and 60.7% (P<0.01), respect ively. No adverse reactions related to the drug were observed. Conclusio n: L-CN with routine therapy might be a safe way to the treat CHF.

Study on the interrelationship between time domain analysis of heart rate variab ility and chronic renal failure / 第二军医大学学报

Objective: To assess the autonomic nervous impairm ent in chronic renal failure and its related factors. Methods: F orty adults were randomly selected including in-patients in the nephrology ward and healthy subjects for routine medical examination. The subjects were classifi ed into 4 groups: normal subjects(NS)，normal renal function，nitremia， uremic patients. The time domain measurements of heart rate variability(HRV) and ambula tory blood pressure were analyzed simultaneously . Results: (1) There were significant differences as compared with normal subjects in the time domain measurements of HRV in uremic group. It decreased significantly when the patient was defined as end stage chronic renal failure. There were no significan t differences between NS，normal renal function group and nitremic group. (2) Ti me domain measurements of HRV was significantly lower(P<0.05) in uremia with renal hypertension than in uremia with normal blood pressure. Conclusio n: (1) Patients with chronic renal failure(HRV) have their cardiac auton omic nervous system impaired conspicuously in the course of uremia. (2) There is a positive correlation between cardiac autonomic nervous system impairment in p atients with CRF and renal function levels. Uremia itself is an independent fact or for the impairment of cardiac autonomic nervous system. (3) Renal hypertensio n with uremia may intensify the impairment of cardiac autonomic nervous system of the patients.

The change of coronary circulating TNF-α level in patients with coronary heart disease after PTCA and its significance / 第二军医大学学报

Objective:To observe the effect of percutaneous tr ansluminal coronary angioplasty (PTCA) on coronary circulating tumor necrosis fa ctor-α (TNF-α) activity. Methods: Plasma TNF-α levls were measured with radioimmunoassay and bioactive assay respectively. Result s: Plasma TNF-α activity in femoral artery (AO) was significantly incr eased immediately after PTCA ［(15.86±3.75) U/ml vs （41.32±4.36） U/ml， P<0.01］, and plasma TNF-α activity in coronary sinus was remarkably incre ased immediately after PTCA　［(16.72±4.14） U/ml vs （65.61±6.25） U/ml, P<0.01］. There was no change in plasma TNF-α activity in AO 24 h after PT CA ［(18.32±5.12） U/ml vs （15.86±3.75） U/ml, P>0.05］. Conclu sion: The increase in plasma TNF-α activity after PTCA may be associat ed with the injury of coronary artery caused by PTCA, suggesting that TNF-α ma y be involved in the coronary occlusion and the development of coronary restenos is after PTCA.

Beta-blockers in the treatment of heart failure / 第二军医大学学报

It is now clear that continued stimulation o f the neurohormonal system in heart failure (HF) has serious deleterious effects on the heart. The increase of circulating catecholamines exerts direct toxic ef fect on cardiac myocytes, increases membrane permeability and myocardial fibrosi s; lead to aggravation of HF. β-blockers are commonly used in the treatment of HF including propranolol, metoprolol, bisoprolol, bucindolol and carvedilol. These drugs are used in combination with ACEIs, digitalis and diuretics. Genera lly, the benefits of β-blockade therapy in HF include improving symptoms, decr easing morbidity, mortality, elevating need for hospitalization and quality of l ife. β- blockade therapy arrests and reverts LV remodeling and improves the ri sk of life threatening arrhythmias and sudden cardiac death. A few serious adver se effects include hypotension, heart blocks, bradycardia and fluid retention.

Insulin stimulates translocation of GLUT4 and glucose uptake in ischemic myocar dium in dog / 第二军医大学学报

Objective: To investigate whether insulin stimulates the translocation of glucose transporter-4 (GLUT4) and glucose uptak e in ischemic myocardium. Methods: Plasma concentration of gluc ose, lactate, free fatty acid and insulin were determined by autoanalyser, and G LUT4 was studied by Western blotting analysis. Results: Insulin increased GLUT4 significantly in sarcolemma of ischemic myocardium ［(25±4)% vs (40±6)%］, and GLUT4 content in intracellular membrane decreased proporti onally. The glucose uptake increased significantly in insulin-ischemic myocardi um. The uptake of insulin-ischemic myocardium was almost 2 times that of ischem ic myocardium. Conclusion: Insulin stimulation results in GLUT4 translocation and increases glucose uptake in ischemic myocardium. When myocardi al ischemia occurs, insulin is helpful in increasing myocardial glucose uptake a nd utilization.