Performance of Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) in Chinese Population with Primary Prevention Indications: A Prospective Observational Cohort Study.

BACKGROUND International studies have shown that use of a subcutaneous implantable cardioverter defibrillator (S-ICD) could reduce lead-related complications while maintaining adequate defibrillation performance; however, data from the Chinese population or other Asian groups are limited. MATERIAL AND METHODS SCOPE is a prospective, multicenter, observational cohort study. Two hundred patients with primary prevention indication for sudden cardiac death (SCD), who are candidates for S-ICD, will be enrolled. From the same population, another 200 patients who are candidates for transvenous implantable cardioverter defibrillator (TV-ICD) will be enrolled after being matched for age, sex, SCD high-risk etiology (ischemic cardiomyopathy, and non-ischemic cardiomyopathy, ion channel disease, and other) and atrial fibrillation in a 1: 1 ratio with enrolled S-ICD patients. All the patients will be followed for 18 months under standard of care. RESULTS The primary endpoint is proportion of patients free from inappropriate shock (IAS) at 18 months in the S-ICD group. The lower 95% confidence bound of the proportion will be compared with a performance goal of 90.3%, which was derived from the previous meta-analysis. The comparisons between S-ICD and TV-ICD on IAS, appropriate shock, and complications will be used as secondary endpoints without formal assumptions. CONCLUSIONS This is the first prospective multicenter study focusing on the long-term performance of S-ICD in a Chinese population. By comparing with the data derived from international historical studies and a matched TV-ICD group, data from SCOPE will allow for the assessment of S-ICD in the Chinese population in a contemporary real-world implantation level and programming techniques, which will help us to further modify the device implantation and programming protocol in this specific population in the future.

Left Bundle Branch Area Pacing versus Right Ventricular Pacing in Patients with Atrioventricular Block: An Observational Cohort Study.

Objective: We aim to conduct a comparison of the safety and effectiveness performance between left bundle branch area pacing (LBBAP) and right ventricular pacing (RVP) regimens for patients with atrioventricular block (AVB). Methods: This observational cohort study included patients who underwent pacemaker implantations with LBBAP or RVP for AVB indications from the 1st of January 2018 to the 18th of November 2021 at West China Hospital. The primary composite outcome included all-cause mortality, lead failure, or heart failure hospitalization (HFH). The secondary outcome included periprocedure complication, cardiac death, or recurrent unexplained syncope. A 1 : 1 propensity score-matched cohort was conducted for left ventricular (LV) function analysis. Results: A total of 903 patients met the inclusion criteria and completed clinical follow-up. After adjusting for the possible confounders, LBBAP was independently associated with a lower risk of the primary outcome (OR 0.48, 95% CI 0.28 to 0.83, p = 0.009), including a lower risk of all-cause mortality and HFH. No significant difference in the secondary outcome was detected between the groups except that LBBAP was independently associated with a lower risk of recurrent unexplained syncope. In the propensity-score matching cohort of echocardiographic analysis, the LV systolic dyssynchrony index was lower in LBBAP compared with that in RVP (5.68 ± 1.92 vs. 6.50 ± 2.28%, p = 0.012). Conclusions: Compared to conventional RVP, LBBAP is a feasible novel pacing model associated with a significant reduction in the primary composite outcome. Moreover, LBBAP significantly reduces the risk of recurrent unexplained syncope and improves LV systolic synchrony. This study is registered with ClinicalTrials.gov NCT05722379.

Clinical use conditions of lead deployment and simulated lead fracture rate in left bundle branch area pacing.

INTRODUCTION: Left bundle branch area pacing (LBBAP) is achieved by advancing the lead tip deep in the septum. Most LBBAP implants are performed using the Medtronic SelectSecure™ MRI SecureScan™ Model 3830 featuring a unique 4 Fr fixed helix lumenless design. Details of lead use conditions and long-term reliability have not been reported. This study was designed to quantify the mechanical use conditions for the 3830 lead during and after LBBAP implant, and to evaluate reliability using bench testing and simulation. METHODS: Fifty bradycardia patients with implantation of the 3830 lead for LBBAP were enrolled. Use conditions of lead deployment at implantation were collected and computed tomography (CT) scans were performed at 3-month follow-up. Curvature amplitude along the pacing lead was determined with CT images. Fatigue bending was performed using accelerated testing in a more severe environment than routine clinical use conditions. Conductor fracture rate in a simulated patient population was estimated based on clinical use conditions and fatigue test results. RESULTS: The number of attempts to place the 3830 lead for LBBAP was 2.1 ± 1.3 (range: 1-7) with 13 ± 6 lead rotations at the final attempt. Extreme implant conditions were simulated in bench testing with 5 applications of 20 turns followed by up to 400 million bending cycles. Reliability modeling predicted a 10-year fracture rate of 0.02%. CONCLUSIONS: LBBAP implants require more lead rotations than standard pacing implants and result in unique lead bending. Application of simulated LBBAP use conditions to the 3830 lead in an accelerated in-vitro model does not produce excess conductor fractures. IMAGE-LBBP Study ID of ClinicalTrial.GOV: NCT04119323.

Computed tomography imaging-identified location and electrocardiographic characteristics of left bundle branch area pacing in bradycardia patients.

INTRODUCTION: Left bundle branch area pacing (LBBAP) is a novel physiological pacing modality. The relationship between the pacing lead tip location and paced electrocardiographic (ECG) characteristics remains unclear. The objectives are to determine the lead tip location within the interventricular septum (IVS) and assess the location-based ECG QRS duration (QRSd) and left ventricular activation time (LVAT). METHODS: This multicenter study enrolled 50 consecutive bradycardia patients who met pacemaker therapy guidelines and received LBBAP implantation via the trans-ventricular septal approach. After at least 3 months postimplant, 12-lead ECGs and pacing parameters were obtained. Cardiac computed tomography (CT) imaging was performed to assess the LBBAP lead tip distance from the LV blood pool. RESULTS: Among the 50 patients, analyzable CT images were obtained in 42. In 23 of the 42 patients, the lead tips were within 2 mm to the LV blood pool (the LV subendocardial (LVSE) group), 13 between 2 and 4 mm (the Near-LVSE group), and the remaining 6 beyond 4 mm (the Mid-LV septal (Mid-LVS) group). No significant differences in paced QRSd were found among the three groups (LVSE, 107 ± 15 ms; Near-LVSE, 106 ± 13 ms; Mid-LVS, 104 ± 15 ms; p = .87). LVAT in the LVSE (64 ± 7 ms) was significantly shorter than in the Mid-LVS (72 ± 8 ms; p < .05), but not significantly different from that in the Near-LVSE (69 ± 8 ms; p > .05). CONCLUSION: In routine LBBAP practice, paced narrow QRSd and fast LVAT, indicative of physiological pacing, were consistently achieved for lead tip location in the LV subendocardial or near LV subendocardial region.

Tectorigenin alleviates intrahepatic cholestasis by inhibiting hepatic inflammation and bile accumulation via activation of PPARγ.

BACKGROUND AND PURPOSE: Increasing evidence suggests that human cholestasis is closely associated with the accumulation and activation of hepatic macrophages. Research indicates that activation of PPARγ exerts liver protective effects in cholestatic liver disease (CLD), particularly by ameliorating inflammation and fibrosis, thus limiting disease progression. However, existing PPARγ agonists, such as troglitazone and rosiglitazone, have significant side effects that prevent their clinical application in the treatment of CLD. In this study, we found that tectorigenin alleviates intrahepatic cholestasis in mice by activating PPARγ. EXPERIMENTAL APPROACH: Wild-type mice were intragastrically administered α-naphthylisothiocyanate (ANIT) or fed a diet containing 0.1% 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC) to simultaneously establish an experimental model of intrahepatic cholestasis and tectorigenin intervention, followed by determination of intrahepatic cholestasis and the mechanisms involved. In addition, PPARγ-deficient mice were administered ANIT and/or tectorigenin to determine whether tectorigenin exerts its liver protective effect by activating PPARγ. KEY RESULTS: Treatment with tectorigenin alleviated intrahepatic cholestasis by inhibiting the recruitment and activation of hepatic macrophages and by promoting the expression of bile transporters via activation of PPARγ. Furthermore, tectorigenin increased expression of the bile salt export pump (BSEP) through enhanced PPARγ binding to the BSEP promoter. In PPARγ-deficient mice, the hepatoprotective effect of tectorigenin during cholestasis was blocked. CONCLUSION AND IMPLICATIONS: In conclusion, tectorigenin reduced the recruitment and activation of hepatic macrophages and enhanced the export of bile acids by activating PPARγ. Taken together, our results suggest that tectorigenin is a candidate compound for cholestasis treatment.

Multicenter Computer-Aided Diagnosis for Lymph Nodes Using Unsupervised Domain-Adaptation Networks Based on Cross-Domain Confounding Representations.

To achieve the robust high-performance computer-aided diagnosis systems for lymph nodes, CT images may be typically collected from multicenter data, which cause the isolated performance of the model based on different data source centers. The variability adaptation problem of lymph node data which is related to the problem of domain adaptation in deep learning differs from the general domain adaptation problem because of the typically larger CT image size and more complex data distributions. Therefore, domain adaptation for this problem needs to consider the shared feature representation and even the conditioning information of each domain so that the adaptation network can capture significant discriminative representations in a domain-invariant space. This paper extracts domain-invariant features based on a cross-domain confounding representation and proposes a cycle-consistency learning framework to encourage the network to preserve class-conditioning information through cross-domain image translations. Compared with the performance of different domain adaptation methods, the accurate rate of our method achieves at least 4.4% points higher under multicenter lymph node data. The pixel-level cross-domain image mapping and the semantic-level cycle consistency provided a stable confounding representation with class-conditioning information to achieve effective domain adaptation under complex feature distribution.

Natural product-based semisynthesis and biological evaluation of thiol/amino-Michael adducts of xanthatin derived from Xanthium strumarium as potential pesticidal agents.

Xanthatin, a natural sesquiterpene lactone, occurs as one of the major constituents of Xanthium plants (Compositae) and exhibits many important biological properties. To discover natural products-based pesticides, forty-nine Michael-type thiol/amino adducts of xanthatin were synthesized and characterized, while their pesticidal activities were investigated. Among them, compounds 2c, 2h, 2i, and 2t exhibited more potent antifungal activity against Botrytis cinerea (IC50 = 0.96, 0.38, 6.33, and 7.21 µg/mL, respectively) than xanthatin and the two commercial fungicides. Compounds 2t and 2u displayed broad-spectrum and excellent antifungal effects against all tested phytopathogenic fungi, while their IC50 values ranged from 7.21 to 75.88 µg/mL. Compounds 2a, 2f, 2l, 2m, 2v, 7c, 7e, 7h, 7i, and 7j showed moderate larvicidal activity against Plutella xylostella Linnaeus. Furthermore, compounds 2b, 7g, and 7h demonstrated significant ovicidal activity against P. xylostella with the LC50 values of 14.04, 10.00, and 11.95 mg/L, respectively. These findings suggest that thiol/amino appended in the C-13 position of xanthatin may improve antifungal and ovicidal activities for the derivatives. It was also noticed that the exocyclic double bond of xanthatin is crucial for its larvicidal activity. This work also provides some important hints for further design, synthesis, and structural modification of the xanthanolides sesquiterpene lactones toward development of the new environmentally friendly pesticides for sustainable agricultural production.

Semisynthesis and insecticidal bioactivities of benzoxazole and benzoxazolone derivatives of honokiol, a naturally occurring neolignan derived from Magnolia officinalis.

Honokiol, a natural bioactive neolignan isolated from the bark and leaf of Magnolia officinalis and Magnolia obovata, exhibits many important biological properties. In continuation of our interest in discovery of the agrochemicals derived from the natural sources, thirty-seven new 8/8'-alkylthiol-benzoxazole and N-alkyl/sulfonyl-benzoxazolone derivatives of honokiol were prepared and their insecticidal activities were evaluated against the larvae of Mythimna separata Walker and Plutella xylostella Linnaeus. The results showed that eleven derivatives exhibited potent insecticidal activity against M. separata when compared with the positive control. Particularly, compound 5h displayed the most promising insecticidal activity against M. separata with the final mortality rate (FMR) of 58.6%. Meanwhile, compounds 7n (FMR = 65.3%), 7p (FMR = 61.5%), and 8c (FMR = 65.3%) demonstrated a greater insecticidal activity against P. xylostella than toosendanin, a well-known botanical insecticide. Additionally, the preliminary structure-activity relationships (SARs) were also discussed. This study indicates that these honokiol derivatives could be used as leads for the further derivation and development of the potential pesticide candidates for crop protection.

Semisynthesis and biological evaluation of some novel Mannich base derivatives derived from a natural lignan obovatol as potential antifungal agents.

Obovatol, a novel lignan isolated from the leaf and stem bark of Magnolia obovata Thunb exhibits many important biological activities. To discover natural-product-based potential fungicides with novel structural skeletons, a series of Mannich base derivatives were prepared by the C-4-aminomethylated modification of obovatol and all synthesized compounds were evaluated for antifungal activities in vitro against several phytopathogenic fungi using the spore germination method and the mycelium growth rate method. Furthermore, their structures were also characterized by 1H NMR, 13C NMR, and HR-MS, and compound 2k was further analyzed by single-crystal X-ray diffraction. Among all of the derivatives, compounds 2b (IC50 = 28.68 µg/mL) and 2g (IC50 = 16.90 µg/mL) demonstrated greater inhibition of Botrytis cinerea spore germination than two positive controls, hymexazol and difenoconazole. Compounds 2c, 2f, and 2g displayed potent mycelial growth inhibition of B. cinerea with an average inhibition rate (AIR) of >90% at a concentration of 100 µg/mL. Additionally, the structure-activity relationships (SARs) suggested that the introduction of a diethylamino, pyrrolyl, 1-methyl-piperazinyl or 1-ethyl-piperazinyl groups on the C-4 position of obovatol may be more likely to yield potential antifungal compounds than the introduction of 4-phenyl-piperazinyl or 4-phenyl-piperidinyl groups.

Unpaired Low-Dose CT Denoising Network Based on Cycle-Consistent Generative Adversarial Network with Prior Image Information.

The widespread application of X-ray computed tomography (CT) in clinical diagnosis has led to increasing public concern regarding excessive radiation dose administered to patients. However, reducing the radiation dose will inevitably cause server noise and affect radiologists' judgment and confidence. Hence, progressive low-dose CT (LDCT) image reconstruction methods must be developed to improve image quality. Over the past two years, deep learning-based approaches have shown impressive performance in noise reduction for LDCT images. Most existing deep learning-based approaches usually require the paired training dataset which the LDCT images correspond to the normal-dose CT (NDCT) images one-to-one, but the acquisition of well-paired datasets requires multiple scans, resulting the increase of radiation dose. Therefore, well-paired datasets are not readily available. To resolve this problem, this paper proposes an unpaired LDCT image denoising network based on cycle generative adversarial networks (CycleGAN) with prior image information which does not require a one-to-one training dataset. In this method, cyclic loss, an important trick in unpaired image-to-image translation, promises to map the distribution from LDCT to NDCT by using unpaired training data. Furthermore, to guarantee the accurate correspondence of the image content between the output and NDCT, the prior information obtained from the result preprocessed using the LDCT image is integrated into the network to supervise the generation of content. Given the map of distribution through the cyclic loss and the supervision of content through the prior image loss, our proposed method can not only reduce the image noise but also retain critical information. Real-data experiments were carried out to test the performance of the proposed method. The peak signal-to-noise ratio (PSNR) improves by more than 3 dB, and the structural similarity (SSIM) increases when compared with the original CycleGAN without prior information. The real LDCT data experiment demonstrates the superiority of the proposed method according to both visual inspection and quantitative evaluation.

DHEA improves the antioxidant capacity of endometrial stromal cells and improves endometrium receptivity via androgen receptor.

OBJECTIVE: To investigate the effect of dehydroepiandrosterone (DHEA) on mouse decidual endometrial stromal cells (ESCs) and to explore mechanisms regulating endometrial receptivity. STUDY DESIGN: Mouse ESCs were incubated with increasing concentrations of DHEA during decidualization. Treatment with flutamide (FLU), a specific androgen receptor (AR) antagonist, was also performed. Flow cytometry was used to measure intracellular reactive oxygen species (ROS). Real time-PCR was used to determine mRNA expression of decidual PRL-related protein (dPRP), AR, and HomeoboxA10 (HOXA10). Protein levels of AR and HOXA10 were measured by western blot. RESULTS: DHEA significantly inhibited ESC proliferation at concentrations ≥1×10(-6)M. DHEA treatment reduced intracellular ROS in a dose-dependent manner. Expression of dPRP was minimally affected by DHEA at concentrations of 1 to 100nM. However, DHEA (100nM) significantly increased the expression of HOXA10 at both the mRNA and protein levels (P<0.01). Importantly, this DHEA-mediated increase in HOXA10 was attenuated by treatment with FLU. Finally, neither DHEA nor FLU influenced expression of AR mRNA or protein. CONCLUSION: Low concentration of DHEA improves the antioxidant capacity of decidual ESCs. DHEA treatment may also improve endometrium receptivity via AR.

Compression of the ostium of left main coronary artery caused by aortic root intramural hematoma after blunt thoracic trauma.

We reported a case of compression of the ostium of left main coronary artery caused by aortic root intramural hematoma after blunt thoracic trauma treated with percutaneous coronary intervention (PCI). A 46-year-old man visited our hospital because of exertional chest discomfort and dyspnea for 4 months. He was diagnosed as compression of the ostium of left main coronary artery caused by aortic root intramural hematoma, severe stenosis in the ostium of the left main coronary artery. The percutaneous coronary intervention was conducted, and a drug-eluting stent was implanted successfully. The symptoms were improved and the patient had a good recovery after PCI surgery.

Higher ratio of triglyceride to high-density lipoprotein cholesterol may predispose to diabetes mellitus: 15-year prospective study in a general population.

The aims of the study were to examine whether the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) could predict future diabetes mellitus (DM) in a general population during a 15-year follow-up. The data were collected in 1992 and then again in 2007 from the same group of 711 individuals. Because 24 of them were found to be diabetic in 1992, our analysis was eventually based on the usable data collected from the remaining 687 individuals (male, 58.1%). During the period 1992-2007, 74 individuals were found to have developed DM (10.8%). After adjusting the associated variables, it was found that TG and TG/HDL-C were independent DM risk factors, with the odds ratios being 1.292 (P = .047) and 1.341 (P = .010), respectively, although they were poor in their DM discriminatory power (area under the receiver operating characteristic curve, 0.662 and 0.672, respectively). Combined with other risk factors (fasting plasma glucose, waist circumference, and family history of DM), the DM discriminatory power of TG and TG/HDL-C was improved (area under the receiver operating characteristic curve, 0.764 and 0.767, respectively). The DM incidence increased with ascending risk score. Single HDL-C seems unable to predict future DM. Triglycerides and TG/HDL-C were independent DM risk factors; and of the two, TG/HDL-C was a stronger risk factor. The DM discriminatory power of TG and TG/HDL-C was poor; therefore, it is recommended that they be used in combination with other risk factors. Diabetes mellitus incidence increased with ascending risk score.

The relationship between visfatin and HOMA-IR in hypertensive patients, and the effect of antihypertensive drugs on visfatin and HOMA-IR in hypertensive patients with insulin resistance.

OBJECTIVE: To investigate the correlation between serum visfatin and insulin resistance (IR) in non-diabetic essential hypertensive (EH) patients with and without IR, and to evaluate the effect of antihypertensive treatment on serum visfatin and IR in these patients. METHODS: A total of 81 non-diabetic EH patients, including 54 with IR and 27 without IR, were enrolled. After two weeks wash-out, patients with IR were randomly assigned to telmisartan (group T) or amlodipine (group A) for 6 months. Blood samples were taken before and after treatment for measurement of routine biochemical parameters, visfatin and insulin resistance (measured by HOMA-IR). RESULTS: Visfatin was independently correlated with HOMA-IR (r=0.845, P=0.000). After 6 months of treatment, both drugs lowered HOMA-IR, more significantly so in group T than group A (P=0.010). Serum visfatin levels increased in group T but decreased in group A. CONCLUSION: Serum visfatin levels were higher in non-diabetic EH patients with IR compared with those without IR. Visfatin is independently correlated with HOMA-IR. Telmisartan lowers HOMA-IR to a greater extent than amlodipine. Interestingly, serum visfatin increased with telmisartan yet decreased with amlodipine treatment.

[Association between serum uric acid and early kidney damage in middle-aged and elderly].

OBJECTIVE: To investigate the association between serum uric acid (UA) and early kidney damage and the prevalence of early kidney damage [89 >or= GFR >or= 60 ml * min(-1) * (1.73m(2))(-1)] in the middle-aged and elders with normal serum creatinine. METHODS: A survey of cardiovascular risk factors, including serum UA and estimated glomerular filtration rate (eGFR) [according to MDRD (modification of diet in renal disease) equation], was carried out in a local general population of Chengdu. A total of 1023 subjects with normal serum creatinine [mean age: (63 +/- 6) years; male: female = 52.7%: 47.3%] were recruited by random sampling method. The subjects were divided into 4 groups (A, B, C, D) according to the quartiles of serum UA levels (A: UA < 282 micromol/L, B: 282 micromol/L or= 379 micromol/L). RESULTS: In the group, the prevalence of early kidney damage was 28.1% (men: 35.8% > women: 19.5%, P < 0.01). In men and women, serum UA and mild kidney dysfunction were negatively correlated, and the prevalence of early kidney damage significantly increased with the elevated level of serum UA. The prevalence of early kidney damage was higher in men than women (P < 0.01). According to the logistic regression analysis adjusting for age, gender, waist, body mass index, triglyceride, HDL-C, total cholesterol, history of hypertension and diabetes type 2, the odds ratio of the prevalence of early kidney damage were 1.0 [B: 1.740 (P = 0.151), C: 3.599 (P = 0.01) and D: 5.488 (P < 0.01) respectively]. CONCLUSION: In the middle-aged and elders with normal serum creatinine, serum UA and eGFR are negatively correlated. And serum UA level is independently associated with early kidney damage.

Relationship between high density lipoprotein antioxidant activity and carotid arterial intima-media thickness in patients with essential hypertension.

The objective of this study was to evaluate high-density lipoprotein (HDL) antioxidative activity and its possible influencing factors in patients with essential hypertension and to investigate the correlations between HDL antioxidative activity and the carotid arterial intima-media thickness (CIMT). Thirty-three patients with essential hypertension and 32 healthy people as control were included. High- and low-density lipoprotein in plasma were isolated by one-step density gradient ultracentrifugation, and induced oxidation with external Cu(2+). Antioxidant activity of HDL, lag time, and lipid peroxidation degree were determined by spectrophotometric and thiobarbituric acid reactive substances (TBARS) methods. Paraoxonase 1 (PON1) activity in serum was measured with continuous monitoring using phenylacetate as a substrate. The CIMT was measured with a high-resolution ultrasound Doppler system. In patients with essential hypertension, the inhibitory effect of HDL on low-density lipoprotein (LDL) oxidation and the PON1 activity were reduced (72.29 +/- 2.03)% vs. (80.91 +/- 2.06)%, and (112.21 +/- 8.64)u/ml vs. (146.43 +/- 8.79)u/ml (all P < 0.05). The lag time of oxidation and the lipid peroxidation between the hypertensive group and the control group did not show a statistically significant difference. Multiple stepwise regression analysis revealed that HDL antioxidative activity might be affected by PON1 activity (P = 0.004), diastolic pressure (P = 0.004), sex (P = 0.006), and that CIMT might be affected by HDL antioxidative activity (P = 0.030), systolic pressure (P = 0.026), and total cholesterol level (P = 0.033). The HDL antioxidative activity is reduced in patients with essential hypertension and significantly affected by sex. The CIMT was negatively correlated with HDL antioxidative activity, which suggests that decreased HDL antioxidative activity may be one of the important determinants for the development of atherosclerosis in patients with essential hypertension.

[Intermedin (IMD) gene expression in hypertrophic cardiac myocyte of renal vascular hypertension rats and the intervention of Valsartan, Amlodipine and Enalapril in the expression].

This experiment on rats was aimed to investigate the expression of intermedin (IMD) in hypertrophic cardiac myoctye of renal vascular hypertension induced by incomplete ligation of the left renal artery, and so to detect and compare the changes of the expression after administration of Valsartan, Amlodipine and Enalapril respectively. The criterion for standard modeling was systolic pressure > or = 140 mmHg. At 4 weeks after successful modeling, 60 SD male rats were randomly divided into 5 groups, namely the hypertrophy group, the 3 drug-treatment groups, and the sham-operation group as control. Blood pressure, left ventricular mass index (LVMI), and the left ventricular mean transverse diameter of myocardial cell (LVTDM) were investigated at the 10th week after model establishment. Gene expression of IMD mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR), and the optical density of the band was measured by use of the Gel Documentation System. The ratio of IMD mRNA to beta-actin mRNA was considered the relative amount of IMD. When compared with control, the blood pressure increased significantly in the hypertrophy group. There was no statistically significant difference between the treatment groups. No significant difference in heart rate was noted at 4 weeks after operation in all groups. LVMI and LVTDM levels were significantly higher in the hypertrophy group than in the other groups; LVMI and LVTDM levels showed no significant difference among the treatment groups but they were obviously higher than those of the Sham-operation group. The gene expression of IMD mRNA in the hypertrophy group was upregulated in the myocardium, when compared with that in the other groups. Meanwhile, although IMD mRNA in the treament groups was higher than that in the Sham-operation group, no statistically significant difference of myocardial IMD mRNA was found between the treament groups. These results suggested that, in this experiment, intracardiac IMD mRNA was upregulated and could participate in the regulation of cardiac remodeling in renal vascular hypertension-induced cardiac hypertrophy. This upregulation could improve the pathologic and physiologic process of cardiac hypertrophy, and could associate with the pressure loading or myocardia hypertrophy. However, the change did not display any difference that could be attributed to the variety of hypotensive drugs.

[Relationship between apolipoprotein E polymorphism and cognitive function in patients with primary hypertension].

To explore the relationship between apolipoprotein E polymorphism and cognitive function in primary hypertension patients, we collected 200 Chinese primary hypertensive patients. Blood pressure (BP), heart rate (HR), height, body weight, waistline, hip circumference were measured. The Mini Mental State Examination (MMSE) was applied to test the cognitive function and compute score. Full-automatic bio-chemistry analyzer was used to determine total cholesterol (TC) and triglyeride (TG) and fasting glucose. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) was used for the analysis of the apolipoprotein E polymorphism. We found that in primary hypertension patients, the genotype frequency of epsilon3/4 and epsilon4/4 were significantly higher in the cognitive impairment group than that in the cognitive normal group. The allele frequency of e4 is obviously higher in the cognitive impairment group than that in the cognitive normal group. Age and epsilon4/4 genetype were positively correlated with hypertensive-cognitive impairment, while cultural level was negtively correlated with it. ApoEepsilon4 allele and age might be risk factors for the cognitive impairment in hypertensive patients. The epsilon4 homozygote (epsilon4/4) might be an important influencing factor for the progression of cognitive impairment.