Objective To investigate whether BNP(brain natriuretic peptide) could be relatively objective index for comprehensive risk stratification of exercise rehabilitation nursing in young and middle myocardial infarction patients. Methods BNP concentration and LVEF were measured respctively in young and middle myocardial infarction patients. Then the risk stratification was administrated based these index respectively and Barther Scores and significant statistical differences were calculated according to homogeneity test for variance. Results Blood BNP concentrations in acute phase among the divided group based on EF risk stratification were significant difference,hence the standard deviation is large,which led to variance nonhomogeneity,and stracification difference between groups is not clear and across-talking. Exercise rehabilitation nursing scores based on echocardiography EF value had significant difference even veariance is nonhomogeneity,hence the differ-ence is not clear beween groups.Exercise rehabilitation nursing scores based on BNP was administrated and significance is clear beween groups. Conclusions BNP concentration and LVEF value had certain relationship and cross-talking among them.Risk stratification based on BNP concentration had objective instructions for exercise rehabili tation nursing in actue infarction myocardial pa-tients.

Objective To study efficiency and safety of fondaparinux and Enoxaparin in treatment of Chinese patients with acute coronary syndrome (ACS) having undergone percutaneous coronary intervention (PCI). Methods One thousand and sixty ACS patients (945 with unstable angina, 115 with AMI) having undergone PCI in Henan provincial hospital from July 2011 to July 2013 were randomized into two groups treated with fondaparinux or enoxaparin respectively. Apart from treatment with oral aspirin and clopidogrel, those in the former group were treated with fondaparinux (2.5 mg IH QD) and the latter with enoxaparin (60 mg IH Q12H) subcutaneously for 2 days before operation, both suspended for 12 h before the operation. All of the patients were given heparin (60 IU/kg) during the operation. After the operation, the therapies with fondaparinux (2.5 mg IH QD) and enoxaparin (60 mg IH Q12H) were resumed subcutaneously for 3 days. Perioperative observation and follow-ups were made in terms of hemorrhage, thrombosis and major adverse cardiac events (MACE) in the patients during the hospitalization period, 2 and 4 weeks after operation. Results Fondaparinux and enoxaparin are both effective on anticoagulation for the patients after PCI. There was no significant difference about the incidence of MACE between the two groups (P > 0.05). But, fondaparinux group had lower incidence of hemorrhage than enoxaparin group (P < 0.05). Conclusion Fondaparinux and enoxaparin both have good anticoagulant activity in Chinese patients with ACS undergoing PCI, but fondaparinux may lower the risk of hemorrhage compared to enoxaparin.

Objective To explore the causes of short P R interval syndrome.Methods 15 patients of short P R interval syndrome were tested with transesophageal atrial pacing (TEAP),and then the results and the parameters of TEAP were analyzed.Results The detection rates of dual atrioventricular nodal pathways(DAVNP),L G L syndrome and latent preexcitation syndrome were 66.67%(10/15),26.67%(4/15)and 6.67%(1/15)respectively.Conclusion The most common causes of short P R interval syndrome are DAVNP and the L G L syndrome

Objective To observe the effect of simvastatin on intimal proliferation in abdominal aorta of rabbits after stenting.Methods Thirty male New Zealand white rabbits were allocated into two groups including the control group(n=15)and the treatment group(n=15).All the rabbits were fed on 1.5% high cholesterol diet and underwent ballon injury of abdominal aorta from femoral approach and stents were implanted in the segments with stenosis rate greater than 50%.Rabbits in the treatment group were given simvastatin 5 mg/d after stenting.Neointima proliferation of the stented segments was examined on the 30th day after stenting by histological staining and the expression of P27kip1 and PCNA in each group was also analyzed.Results Histological staining showed that on the 30th day after stenting,the thickness of vessel wall(0.107?0.072 mm vs 0.133?0.047 mm,P=0.006)and the area of neointima(0.975?0.084 mm2 vs 1.350?0.043 mm2,P=0.001)were less in the simvastatin treatment group compared with the control and the rate of lumen loss was less than that of the control(20.460%?2.325% vs 31.020%?1.904%,P=0.002).The expression of P27kip1 in the neointima VSMC cell nuclear was higher(7.149?0.305 vs 2.997?0.310,t=9.551,P

Equipment Failure ; Humans ; Stents ; Ultrasonography, Interventional

Objective To analyze the severity of coronary artery lesions and the prognosis in patients with low levels of free triiodothyronine (fT3)undergoing coronary angiography (CAG). Methods From August 2011 to August 2012, 600 consecutive suspected patients with coronary heart disease (CHD) who undergone CAG were selected. The patients were divided into two groups based on thyroid function prior to CAG:euthyroidism group (450 patients) and low T3 group (150 patients). All the patients underwent elective coronary angiography, then the severity of coronary artery lesions was assessed by the Gensini scores , and the patients were followed up for cardiovascular events. Results The incidence rate of CHD in low T3 group was significantly higher than that in euthyroidism group (P=0.01). Multiple variables logistic regression analysis showed that fT3 was a protective factor for CHD (OR = 0.351,P < 0.001); The severity of coronary artery lesions was greater in low T3 group than in euthyroidism group (P < 0.001). The mean duration of follow-up was (15.4 ± 3.6) months; the incidence of the composite end-point (death, non-fatal myocardial infarction and target vessel revascularization ) was significantly higher in low T3 group than in euthyroidism group (P=0.023). Conclusions Patients with a decreased T3 level has a higher incidence rate of CHD , an increase in the severity of coronary artery lesions , and a poorer prognosis.

Plaque rupture,platelet aggregation,and thrombogenesis are the main mechanisms of acute coronary syndrome (ACS),and inflammation factors play key roles in plaque unstability.Psychological stress promotes acute inflammatory response,leading to increased circulating levels of C-reactive protein (CRP),IL-6,and serum intercellular adhesion molecule (sICAM)-1.But it is not clear that whether psychological stress has a direct effect on atherosclerotic plaque stability.The purpose of this study was to investigate effects of chronic psychological stress on inflammatory marker (ICAM-1 ) in atherosclerotic plaque,and inflammatory markers in peripheral blood.Materials and methods Sixty male rabbits were randomized into 2 groups:the control group (n =10) and the atherosclerotic group (n =50).The latter were fed on high fatty diet and were given a large dose of vitamin D3 (3 600 000IU/kg) via intraperitoneal injection.After 8 weeks,the atherosclerotic model was estaslished.Then the 50 atherosclerotic model rabbits were divided into 3 subgroups:no-stress subgroup (n = 16),physiological stress subgroup (n = 16) and psychological stress subgroup (n =18).In physiological stress subgroup and psychological stress subgroup,drinking was cut from twice a day to once a day.At the same time,psychological stress subgroup was given empty bottle stress,and this process lasted for 2 weeks.One hour after the last stress,the blood samples were collected and the serum levels of CRP,IL-6 amd ICAM-1 were tested by radioimmunoassay or enzyme linked immunosorbent assay.The aorta and heart were extracted for pathology examination,and the express of ICAM-1 was tested by immunohistochemical examination.Results (1) After effective atherosclerotic animal model construction,the expression of ICAM-1 in aorta was higher in atherosclerotic group than that in control group (P＜0.01),and was notably higher in psychological stress subgroup than that in no-stress subgroup or in physiological stress subgroup (2.18±0.17 vs 1.58±0.22,1.22±0.15,P＜0.001,respectively).The expression in physiological stress subgroup was higher than that in no-stress subgroup (584±0.22 vs 1.22±0.15,P=0.001).(2) The serum level of IL-6 (51.80±4.60 pg/ml vs 27.60±4.19 pg/ml,8.01±1.39 pg/ml,7.83±1.37 pg/ml),sICAM-1 ( 1.24±0.25 vs 0.85±0.09,0.62±0.17,0.57±0.11),CRP ( 1.004±0.37 vs 0.90±0.29,1.01±0.22,0.71±0.13) in psychological stress group were significantly higher than that in other groups (All P＜0.05).There was a positive relationship between the serum level of CRP,IL-6 and ICAM-1 and the expression of ICAM-1 in aorta wall ( r =0.59,r =0.75,r =0.87,P＜0.01,respectively).Conclusions Psychological stress induces an increased expression of ICAM-1 in aortic atherosclerotic plaque,a higher serum level of CRP,IL-6,and sICAM-1 expression.Psychologial stress has a direct effect on the transition from stability to unstability through in-plaque and out-plaque inflammation.The serum level of CRP,IL-6 and ICAM-1 can reflex the inflammatory degree in atherosclerotic plaque.(J Geriatr Cardiol 2008;5:235-242)

Objective To evaluate the clinical effect of umbilical cord mesenchymal stem cells (MSCs) for treatment of chronic dilated cardiomyopathy complicated with systolic heart failure.Methods Fifty-nine patients with chronic dilated cardiomyopathy and systolic heart failure in Henan Provincial People's Hospital from December 2013 and December 2014 were selected and divided into treatment group (n =30)and control group (n =29).All patients were given routine drug treatment.Based on this,the patients in treatment group were given umbilical cord MSCs 20mL by intracoronary transplantation;the patients in control group were given the same volume of saline.The changes of cardiac function,left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter(LVEDD),6 minutes walking distance,the amino-terminal pro-brain natriuretic peptide (NT-proBNP) levels,the re-hospitalization rate,mortality rate of patients in the two groups were observed and compared at 1 month and 6 months after treatment.Results The cardiac function grading of the New York Heart Association (NYHA)of patients in the two groups were improved at 1 month and 6 months after treatment (P ＜ 0.05);the NYHA cardiac function grading of patients in the treatment group was significantly better than that in the control group at 1 month and 6 months after treatment (x2 =12.64,16.75;P ＜ 0.05).There was no statistic difference in LVEDD,LVEF,serum level of NT-proBNP and 6-min walking distance of patients between the two groups before treatment (P ＞ 0.05).There was statistic difference in LVEDD,LVEF,serum level of NT-proBNP and 6-min walking distance of patients in the two groups before treatment and 1 month,6 months after treatment(P ＞ 0.05).There was no statistic difference in LVEDD of patients between the two groups at 1 month after treatment (P ＞ 0.05);the LVEF,6-min walking distance of patients in the treatment group were significantly higher than those in the control group,but the serum level of NT-proBNP of patients in the treatment group was significantly lower than that in the control group at 1 month after treatment (P ＜ 0.05).At 6 months after treatment,the LVEDD,serum level of NT-proBNP of patients in the treatment group were significantly lower than those in the control group,but the LVEF and 6-min walking distance of patients in the treatment group were significantly higher than those in the control group (P ＜ 0.05).The mortality rate of patients in the treatment group (6.67％,2/30) was significantly lower than that in the control group (24.14％,7/29) (x2 =4.99,P ＜ 0.05).The re-hospitalization rate of patients in the treatment group and control group was 16.67％ (5/30) and 31.031.(9/29) respectively;there was no statistic difference in the re-hospitalization rate of patients between the two groups (x2 =1.68,P ＞ 0.05).Conclusion Umbilical cord MSCs can improve the cardiac function and cardiac remodeling,reduce the mortality rate of patients with chronic dilated cardiomyopathy complicated with systolic heart failure.

0.05).No significant difference was found in c-myc and p16 protein.CONCLUSION:Human BMSCs cultured in vitro in autologous serum meets the requirement of clinic,with enough number,well growth,without karyotype variation,and BMSCs can differentiate into cardiomyocytes.No tumorigenesis is found in body after implantation.Moreover,no significant difference is seen in telomerase activation and c-myc and p16 gene expression.

BACKGROUND: Both therapeutic effects of stem cell transplantation and differentiation mechanism remain controversial;however, plentiful clinical studies have indicated that stem call transplantation might improve heart function.OBJECTIVE: To evaluate the efficacy of intracoronary autologous bone marrow mononuclear call transplantation for the treatment of chronic heart failure.DESIGN: Case analysis. PARTICIPANTS: A total of 80 patients with chronic heart failure who were selected from Henan People's Hospital from 2003 to 2008 were divided into two groups: autologous bone marrow mononuclear call transplantation group (n=48) and conventional drug therapy group (n=32). There were no significant differences in sex, age, accepting conventional drug therapy,echocardiogram before transplantation, plasma brain natriuretic peptide level, and myocardial perfusion imaging between the two goups (P>0.05).METHODS: A one-year following up before and after cell transplantation, conventional drug therapy was performed in the two groups. Based on conventional drug therapy, autologous bone marrow mononuclear call suspension (10 mL) was slowly poured into coronary artery, and the cell number was adjusted to (3.1±1.6)×10 8. MAIN OUTCOME MEASURES: Changes of heart function were measured using ultrasound apparatus; plasma brain natriuretic peptide levels were detected using double antibodies immumofluorescence method; area of myocardial perfusion defect region was detected using single photon emission computed tomography.RESULTS: Patients in the two groups finished the one-year follow-up, and adverse effects and complications were not found before and after cell transplantation. ①Compared to before cell transplantation, end-systolic volume (ESV) of the left ventricle was significantly decreased in the autologous bone marrow mononuclear cell transplantation group after one year (P < 0.05), but ejection fraction (EF) of the left ventricle was significantly increased (P < 0.05). However, both ESV and EF were not changed in the conventional drug therapy group (P> 0.05). Compared to conventional drug therapy group, ESV and EF were changed significantly in the autologous bone marrow mononuclear call transplantation group after one year (P < 0.05). ②Compared to before cell transplantation, plasma brain natriuretic peptide levels were significantly decreased in the two groups (P < 0.05 or 0.01). Area of myocardial perfusion defect region was significantly decreased (P < 0.05 or 0.01), and the area change in the autologous bone marrow mononuclear call transplantation group was significantly greater than conventional drug therapy group (P < 0.05).CONCLUSION: Autologous bone marrow mononucleer call transplantation is safe and feasible for the treatment of chronic heart failure, and it also can remarkably improve heart function and myocardial perfusion within one year.