Hepatocyte growth factor improves right ventricular remodeling in pulmonary arterial hypertensive rats via decreasing neurohormonal activation and inhibiting apoptosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hepatocyte growth factor (HGF) inhibits the development of pulmonary artery hypertension (PAH) by reducing pulmonary artery pressure and right ventricle (RV) hypertrophy. However, whether HGF can prevent RV remodeling via inhibiting apoptosis in RV cardiomyocytes and decreasing neurohormonal activation remains unknown.</p><p><b>METHODS</b>The PAH and subsequent RV remodeling in rats were induced by subcutaneous injection of monocrotaline (MCT). The PAH rats were transfected with adenovirus carrying HGF (Ad-HGF) via intratracheal instillation. Three weeks after transfection, the hemodynamics indexes were measured, serum levels for angiotonin II (ANG II) and brain natriuretic peptide (BNP) were determined by ELISA. Histological analysis was used to assess the RV hypertrophy and fibrosis. The cardiomyocyte apoptosis in RV was assayed by TUNEL staining. The mRNA expression of BNP, angiotensin-converting enzyme (ACE), Bax and Bcl-2 in RV was determined by reverse transcriptase polymerase chain reaction (RT-PCR), the protein expression of transforming growth factor (TGF)-β1 and tumor necrosis factor (TNF)-α in RV was determined by Western blotting.</p><p><b>RESULTS</b>HGF treatment significantly decreased the mean PAH, RV systolic pressure, serum ANG II and BNP levels. HGF treatment also significantly decreased the RV hypertrophy, collagen deposition, and the number of apoptotic cardiomyocytes. Moreover, HGF treatmemt significantly decreased the expression of BNP, ACE, Bax, TGF-β1, and TNF-α, while it significantly increased the expression of Bcl-2.</p><p><b>CONCLUSIONS</b>Gene transfer of HGF decreases MCT-induced PAH and improves RV remodeling. This effect is mediated not only by improving the hemodynamics but also by decreasing neurohormonal activation and inhibiting cardiomyocytes apoptosis. HGF gene treatment may be an effective strategy for improving RV remodeling in MCT-induced PAH.</p>

Association between change of health care providers and pregnancy exposure to FDA category C, D and X drugs / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Changing health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs.</p><p><b>METHODS</b>A 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures.</p><p><b>RESULTS</b>A total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease.</p><p><b>CONCLUSION</b>Change of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.</p>

The effect and mechanism of swimming exercise on left ventricular remodeling in spontaneously hypertensive rats / 中华物理医学与康复杂志

Objective To investigate the effects of swimming exercise training on left ventricular (LV)remodeling and its possible mechanism in spontaneous hypertensive rats (SHR).Methods Twenty eightweek-old male SHRs were divided into SHR control (SC) group and SHR exercise training (ST) group,with 10 rats in each group.Ten eight-week-old male Wistar rats were used as normal control (WC) group.The ST group was subject to 60-min moderate swimming exercise without loading once daily,6 times a week,for a total of 12 weeks; while the SC and WC group had no special intervention.The blood pressure was examined once weekly.After 12 weeks,the norepinephrine (NE)and serum angiotonin Ⅱ (ANG Ⅱ) levels were determined by ELISA.The LV hypertrophy was assessed by analysing the ratio of LV weights to body weights (LVW/BW) and cardiomyocyte diameter.The collagen deposited in LV was detected by sirius red staining.The expressions of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) in LV were determined by semi-quantitative real time-polymerase chain reaction (RT-PCR) and Western blotting.Results After 12 weeks,the blood pressure,serum NE and ANG Ⅱ levels,LVW/BW ratio,cardiomyocyte diameter and collagen volume fraction (CVF) increased significantly in SC group compared with WC group; while those in ST group decreased significantly.In addition,in ST group the mRNA and protein expressions of TNF-α,IL-6,IL-1 βand TGF-β1 also decreased significantly.Conclusions The swimming exercise could reduce the blood pressure of SHR and improve LV remodeling.This effect was mediated not only by improving the hemodynamics,but also by decreasing sympathetic nerve and renin-angiotensin system (RAS) activities,decreasing the gene expressions of cytokines.The swimming exercise may be an effective strategy for improving LV remodeling in hypertension.

Therapeutic efficacy of recombinat human brain natriuretic peptide on elderly acute myocardial infarction with heart failure / 中华老年医学杂志

Objective To evaluate the clinical efficacy of recombinat human brain natriuretic peptide (rhBNP) in the treatment of acute myocardial infarction (AMI) with heart failure in aged patients. Methods Totally 63 elderly patients with AMI and heart failure were randomly divided into therapy (29 cases) and control (34 cases) groups.Besides routine treatment,the therapy group received rhBNP in continuous intravenous infusion, while control group was treated with nitroglycerin.Both drugs were administered for 3-5 days.The dyspnea remission rates after treatment were recorded.At the same time,heart rates and blood oxygen saturation,left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVDD),serum interleukin 6 (IL-6) and high sensitivity C reactive protein (hsCRP) were recorded before and after treatment. Results The total effective rate after the treatment was 79.3 ％ (23/29) in therapy group and 64.7％ (22/34) in control group(P =0.017).The dyspnea remission rate was better in therapy group than in control group (P＜0.05).The heart rate,blood oxygen saturation,LVEF,hsCPR and IL-6 in therapy group were [(120± 11) times/min,(78 ± 6) ％,(28 ± 32) ％,(25.78 ± 2.44) mg/L,(40.74 ± 5.43) μg/L]before treatment,and after treatment [ ( 89 ± 9) times/min,( 97 ± 6 ) ％,(43 ±± 20) ％,( 12.78 ± 2.54 )mg/L,(28.45±2.34) μg/L] (all P＜0.05).The above indexes in control group were [(117±8)times/min,(80±8) ％,(29±31)％,(21.44±1.33) mg/L,(41.87±5.46) μg/L] before treatment,and after treatment[(109± 10) times/min,(34±18) ％,(43±20) ％,(17.63± 1.62) mg/L,(36.56±3.02) μg/L].The heart rate and the levels of IL-6 and hsCPR were reduced,blood oxygen saturation and LVEF were increased in therapy group than those in control group. Conclusions rhBNP is efficient in the treatment of elderly AMI with heart failure.

Effects of recombinant human growth hormone on myocardial inflammatory eytokine expression and heart function in rats with acute myocardial infarction / 中华老年医学杂志

ObjectiveTo explore the effects of recombinant human growth hormone(rhGH)on myocardial inflammatory cytokine expression and heart function in rats with acute myocardial infarction (AMI). MethodsRats with AMI induced by left anterior descending coronary branch ligation were randomized to rhGH and control groups compared with sham-operated group. The effects of 4 weeks of therapy with GH starting 24 hours after myocardial infarction on myocardial cytokines expression and heart function were studied. Myocardial inflammation was examined by analyzing the myocardial cytokine production including the pro-inflammatory cytokines: interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α and the anti-inflammatory cytokine: IL-10. Echocardiography was used to evaluate heart function. ResultsThe levels of TNF-α, IL-1β, IL-6 and IL-10 in the infarcted and non-infarcted region of control group were markedly elevated compared to sham-operated group (all P＜0.05). After 4 weeks therapy, rhGH reduced the expression of TNF -α, IL-1β, IL-6 and increased IL-10 expression in the infarcted and non-infarcted region of rhGH group compared to control group (all P＜0. 05 ). Echocardiography showed that rhGH markedly improved left heart function (P＜0. 05 ). ConclusionsEarly rhGH treatment can improve heart function and myocardial inflammatory cytokine expression after AMI. One of immunopharmacologic mechanisms underlying the beneficial effects of rhGH on heart function improvement may involve the attenuation of pro-inflammatory cytokines and the increase of anti-inflammatory cytokine levels in cardiac myocytes.

Decreased plasma urotensin Ⅱ levels inversely correlate with extent and severity of coronary artery disease / 老年心脏病学杂志（英文版）

Objective To determine the plasma urolensin Ⅱ(UⅡ) levels in various types of coronary heart disease and to clarify how the plasma UⅡ levels correlate with the clinical presentation, extent and severity of coronary artery atherosclerosis (CAD). Methods: One hundred and three aged patients undergoing elective diagnostic coronary angiography for proven or clinical suspected coronary heart disease were enrolled in this study. The extent and severity of coronary artery disease were evaluated by vessel score and Gensini score, respectively. Plasma UⅡ levels were measured by radioimmunoassay. Results: The plasma UⅡ levels in the patients with modest to severe coronary stenosis (3.03±0.34 pg/ml, 1.83±0.67 pg/ml) were significantly lower than that in subjects with normal coronary artery (4.80±1.11 pg/ml, P＜0.001). The plasma UⅡ levels in patients with coronary heart disease were also significantly lower than that in patients with insignificant coronary stenosis (P ＜ 0.001). Compared to patients with stable angina pectoris, plasma UⅡ levels in patients with acute coronary syndrome were significantly decreased (1.89±0.51 pg/ml vs 2.42±0.77 pg/ml, P＜ 0.001). Plasma UⅡ levels were found to be negatively correlated with the severity of coronary artery stenosis (r = -0.488, P＜0.001), as well as the vessel score (r = -0.408, P＜0.05) in the patients with CAD. Conclusion: Significant inverse correlations exist between the plasma UⅡ levels, and the extent and severity of coronary artery stenosis. These findings suggest that plasma UⅡ contribute to the development and progression of coronary artery stenosis, and may be a novel marker to predict clinical types, as well as the extent and severity of coronary artery disease in the patients.

Effects of valsartan and indapamide on plasma cytokines in essential hypertension / 中南大学学报(医学版)

Objective To investigate and compare the effect of valsartan and indapamide on inflammatory cytokines in hypertension. Methods Forty-one untreated patients with mild to moderate hypertension and 20 age- and sex-matched normotensives were enrolled in this study. Hypertensives were treated with indapamide 1.5 mg/d (n=20) or valsartan 80 mg/d (n=21) for 4 weeks, and blood samples for determining monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 (MIP-1α), sP-selectin, asymmetric dimethylarginin (ADMA), angiotensin Ⅱ (AngⅡ), and 6-keto-PGF1α were collected before the treatment and 4 weeks after the treatment. Results Hypertensives exhibited significantly higher blood pressure, as well as elevated plasma levels of MCP-1, MIP-1α, sP-selectin and serum level of ADMA compared with the normotensives. Nevertheless, there was no significant difference in serum 6-keto-PGF1α and AngⅡ between the hypertensives and the normotensives. After the treatment with indapamide or valsartan for 4 weeks, both the systolic and diastolic blood pressures, though still higher than those of the normotensives, decreased markedly. After the treatment with indapamide for 4 weeks, MCP-1, MIP-1α and sP-selectin slightly decreased, but not statistically significant (P＞0.05). Those cytokines decreased significantly after being treated with valsartan for 4 weeks [(19.16±3.11) pg/mL vs (16.08±2.67) pg/mL, P＜0.05; (27.74±8.36) pg/mL vs (17.64±7.59) pg/mL, P＜0.05; (2.67±3.18) pg/mL vs (6.15±2.94) pg/mL, P＜0.01]. In the 2 treatment groups, 6-keto-PGF1α markedly increased [(61.96±20.81) pg/mL vs (96.72±25.89) pg/mL, P＜0.05; (63.25±16.92) pg/mL vs (143.22±43.45) pg/mL, P＜0.01]; ADMA decreased significantly [(1.35±0.74) pg/mL vs (0.98±0.56) μmol/L, P＜0.05; (1.31±0.68) pg/mL vs (0.71±0.52) μmol/L, P＜0.01]. Though AngⅡ slightly increased, no statistical significance was found (P＞0.05). Conclusion The levels of MCP-1, MIP-1α, sP-selectin and ADMA were elevated in mild to moderate hypertensives. Valsartan and indapamide have similar blood pressure lowering effect. Valasartan exerts more significant effect on cytokines than indapamide does.

Information Management System for Rescuing Batches of the Sick and Wounded / 医疗卫生装备

Objective To investigate the information management method for improving the efficiency of rescuing batches of the sick and wounded.Methods A portable palm computer were used to collect the information of the sick and wounded and the collected data were transmitted in real time to the server of the higher rescuing institution in the hospital via wired and wireless networks after being counted up,analyzed and summarized.Results The higher rescuing institution took the real-time information as the decision-making base at any time to give orders and provide assistance that fed back to the rescuing site at any moment.Conclusions The system combines medical rescuing with modern computerized information system,realizing the informatization,digitalization and automation of direction and management models in rescuing batches of the sick and wounded and greatly improving the efficiency for rescuing the sick and wounded.

Mechanisms underlying the protective effect of renal ischemic preconditioning on ischemia-reperfusion myocardium of rabbits / 中国病理生理杂志

AIM: To investigate the mechanisms underlying the protective effect of kidney ischemic preconditioning on rabbit myocardium in case of ischemia-reperfusion and the possible role of oxygen free radicals in the process. METHODS: Animals were divided into four groups: ischemia/reperfusion(I/R), classical ischemic preconditioning(CIPC), kidney ischemic preconditioning (KIPC) and superoxide dismutase in combination with kidney ischemic preconditioning(SOD+KIPC). The endo genous myocardial pretective material, nitric oxide(NO) and 5'-nucleotidase(5'-NT) were checked in four groups. RESULTS: As compared with I/R group, both CIPC and KIPC could ameliorate left ventricular function, reduce plasma PLA 2 activity and arrhythogenic rate also, the myocardial 5'-NT and NO production were significantly higher than that of the rabbit of I/R group. However, the protective effect on rabbit myocardium was significantly weakened by the SOD administration before the ischemic preconditioning. CONCLUSION: Protective effect of KIPC on myocardium may be due to increase in endo genous myocardial protective materials, oxygen free radicals may play an important role in the endo genous myocardial protective material release.

Effect of protein kinase C on the expression of myocardial HSP70 mRNA during myocardic ischemic preconditioning in rabbits / 中国病理生理杂志

AIM: To study the relationship between myocardial HSP70 and PKC during myocardial ischemic preconditioning(IPC). METHODS: PKC inhibitor, polymyxin B(PMB) and PKC activator, phorbol 12-myristate 13-acetate(PMA) were applied to the models of myocardial ischemia/reperfusion in vivo and in vitro in rabbits, respectively, and the ventricular functions, PLA 2 in the serum, and the expression of mycardial HSP70 mRNA were examined.RESULTS: IPC decreased PLA 2 activity, improved the left ventricular function and increased the expression of myocardial HSP70 mRNA. Howerer, all these effects of IPC could be blocked by PMB. Interestingly, PMA mimicked IPC with attenuating the injuries of cardial myocytes and increasing myocardial HSP70 mRNA expression. CONCLUSION: PKC is involved in the myocardial HSP70 expression in case of ischemic preconditioning.