Objective To assess the clinical value of transcatheter arterial chemoembolization(TACE) for the treatment of metastatic liver leiomyosarcoma(MLL).Methods CT triphasic scanning and TACE were performed in 8 patients with MLL,which was proved by fine-needle aspiration biopsy and immunohistochemical study.A follow-up of 1-3 years was conducted.Based on the enhancement degree of the hepatic lesion and the DSA manifestations of the lesion,which were observed both before and after TACE,and also on the survival time,the therapeutic effectiveness was evaluated.Results Of the eight cases,single metastasis was seen in 3 and multiple metastasis in 5.Excellent result was obtained in 6 cases and good result in 2 cases.Based on the imaging findings,marked effect was seen in 3 cases,good effect in 4 cases and no improvement in one case.The surviva1 rate at 1,2 and 3 years was 87.8%,50.0% and 37.8% respectively.Conclusion TACE is a safe and effective treatment for MLL.

BACKGROUND:Previous study reveals that,glycated albumin plays an important role on the apoptosis of endothelial cells and the expression of monocyte chemoattractant protein-1 through increasing the activity of mitogen activated protein kinase and protein tyrosine kinase,besides generating active oxygen products. OBJECTIVE:To investigate the effects of glycated albumin on the expression of monocyte chemoattractant protein-1 in the cultured human umbilical vein endothelial cells(HUVECs) . DESIGN,TIME AND SETTING:A single sample observation was carried out in the Cardiovascular Laboratory of Southeast University(Nanjing,Jiangsu,China) from May to November in 2006. MATERIALS:ECV304 HUVEC strain was provided from Shanghai Institute of Cell Biology,Chinese Academy of Sciences(China) . METHODS:Experimental procedures were assigned to two parts. On one hand,HUVECs were cultured with glycated albumin of the concentration of 400 mg/L for 0,8,16,24,48,or 72 hours. On the other hand,HUVECs were cultured with glycated albumin of the concentrations of 100,200,400,and 800 mg/L for 24 hours. In the control group,HUVECs were incubated with bovine serum albumin of the concentration of 400 mg/L and RPMI 1640 culture medium without addition of the serum. MAIN OUTCOME MEASURES:The proliferation of HUVECs was estimated by MTT colorimetric assay. The content of monocyte chemoattractant protein-1 in the supernatant was measured by enzyme-linked immunosorbent assay. RESULTS:Glycated albumin inhibited the proliferation rate of HUVECs in a time-dependent manner(P

BACKGROUND:It is shown in past researches that total saponin of ginseng has the effect of promoting multiplication of bone marrow hematopoietic stem cells and progenitor cells in vitro, and promoting secretion of bone marrow hemotopoietic factors, however there has been little researches on the effect of multiplication of bone marrow stromal cells.OBJECTIVE: To investigate the effect of ginsenoside Rg1 on pig's bone marrow stromal cells multiplication in vitro.DESIGN: A controlled observation.SETTING:Department of Cardiology and Department of Dermotology,First Affiliated Hospital, Nanjing Medical University; Department of Pharmacology, Nanjing Medical University.MATERIALS: The experiment was conducted at the Cardiovascular Pharmaceutical Laboratory of Nanjing Medical University from January 2002 to February 2003. The experimental pigs ahd the powder of ginsenoside Rg1were chosen METHODS :The bone marrow stromal cells cultured in vitro were divided as control and experimental groups. For experimental group insenoside Rg1 in different concentrations (10-7,5×10-7,10-6,5×104 mol/L)were added for induction culture, and for control group the media of the same volume was added. The multiplication conditions of bone marrow stromal cells were respectively detected by fibroblast colony forming in vitro, tritiated thymidine {[3H]TdR} incorporation and MTT.MAIN OUTCOME MEASURES: ① The effect of ginsenoside Rgl on the fibroblast colony forming units of bone marrow stromal cells in vitro. ②The effect of ginsenoside Rg1 on [3H]TdR incorporation of bone marrow stromal cells. ③ The effect of ginsenoside Rg1 on bone marrow stromal cells multiplication detected by MTT.RESULTS:① The effect of ginsenoside Rg1 on the fibroblast colony forming units of bone marrow stromal cells in vitro: The numbers of units in experimental group were all higher than that in control group (P ＜ 0.05-P ＜ 0.01),especially obvious in (5-50)×10-7 mol/L experimental group, reaching peak in the concentration being 10-6 mol/L. ② The effect of ginseno side Rg1 on [3H]TdR incorporation of bone marrow stromalcells: As the concentration of ginsenoside Rg1 was 10-6 mol/L, the [3H]TdR incorporation efficiency of bone marrow stromal cells was obviously higher that that in control group (P ＜ 0.05-P ＜ 0.01), and the effect was enhanced as the dosage increased. ③ The effect of ginsenoside Rgl on bone marrow stromal cells multiplication detected by MTT: The value of absorbance in experimental group was obviously higher than that in control group (P ＜ 0.05-P ＜ 0.01), and it was dose-dependent. CONCLUSION: Ginsenoside Rg1 had an effect of multiplication on pig's bone marrow stromal cells in vitro, and it was dose-dependent.

Objective To investigate the prevalence of CKD in patients underging coronary angiography with suspected coronary heart disease(CHD). Methods A total of 1031patients with suspected CHD undergoing coronary angiography in Zhongda Hospital from December 2008 to October 2009 were enrolled in the study.The prevalence of CKD and associated risk factors were analyzed.GFR Wag estimated with MDRD equation.CKD was deftned as eGFR<60branches of coronary artery was considered as CHD. Results The mean age of patients were (64.37±11.02)years.There were 543 males and 488 females,including 551 patients with CHD and 134 patients with CKD(13%).Patients with CHD had a significantly higher prevalence of CKD compared with patients without CHD(18.33%vs 6.88%,P<0.01).With the increasing number of stenosis coronary vessels(n=0,1,2,3),eGFR was declined[(84.25±19.00),(81.61±23.92),increased(0.42%,0.82%,1.96%,3.25%,P=0.006),and the prevalence of CKD increased (6.88%,13.11%,21.57%,23.38%,P<0.01).Logistic regression analysis indicated that increasing age(OR 1.094,95%C/1.068 to 1.120),increasing number of stenosis coronary vessels(OR 1.288,95%CI 1.074 to 1.543).hypertension(OR 1.974,95%CI 1.082 to 3.603),cardiac systolic insufficiency(OR 3.183,95%CI 1.696 to 5.972),and hyperuricemia(OR 5.366,95%CI 3.224 to 8.9311 were risk factors for CKD. Conclusions The prevalence of CKD in patients with CHD diagnosed by coronary angiography is quite high.Aging,elevated number of stenosis coronary vessels,hypertension,cardiac systolic insufficiency and hyperuricemia are important risk factors for angiographic patients with CKD.

Objective Assessment of right ventricular function in patients with atrial septal defect (ASD) is difficult. The Doppler myocardial performance index (MPI) may provide a method of assessing function in these patients. The purposes of this study were to evaluate the right ventricular function and its changes in patients with ASD after transcatheter closure of ASD. Methods MPI, defined as the sum of isovolumic relaxation time and isovolumic contraction time derived by ejection time, was measured from tricuspid inflow and right ventricular outflow; Doppler velocity profiles recorded during routine echocardiography. Twenty nine patients ( 13 men, 16 women;mean age 25.28 ± 12.69, range 6 to 57 years) were diagnosed to secundum ASD [the stretched diameters of ASD were from 9 To 36 (24.91 ±7.98) mm], and had a successfully placed Amplatzer septal occluder (ASO) (the sizes of ASO were from 11 to 40 mm ); there were 81 sex-matched, age-matched healthy people (control group 41men, 40 women; mean age 29.02 ± 14.22, range 4 to 45 years).MPI was measured again on 3 days and 1 month after closure of ASD. Change in the study group was assessed and compared to the control subjects with structurally normal hearts. A complete 2- dimensional and Doppler echocardiographic examination was performed in all study groups. Results 1) The isovolumic relaxation and isovolumic contraction times [respectively(77.59 ± 14.39)ms vs (60.93 ± 12.94)ms, P＜0.0001; (28.28 ± 10.88)ms vs (23.64 ± 9.01)ms, P=0.027] were prolonged, and ejection time [(260.65 ± 21.86 )ms vs (271.85 ± 21.92)ms, P=0.033] was shortened in patients with ASD compared with that in control subjects, resulting in a marked increase in the MPI(0.40 ± 0.07 vs 0.31 ± 0.05, P＜0.0001) from normal values; 2) by Pearson's correlations, the MPI had no correlation with heart rate and blood pressure in control subjects and patients with ASD, but it correlated positively with age in patients with ASD; 3) by Pearson's correlations, the MPI correlated positively with the diameter of ASD and pulmonary artery pressure; 4) after transcatheter closure of ASD, the MPI decreased markedly. Conclusions 1) MPI is a conceptually new, simple, and reproducible Doppler index in patients with ASD; 2) MPI is free from the effect of age, heart rate and blood pressure; (3) MPI appears to be relatively dependent on changes in the diameter of ASD and pulmonary artery pressure; 4) the right ventricular function was improved after transcatheter closure of ASD.

Objective To study the characteristics of clustering of cardiovascular risk factors in patients less than 50 years-old of premature stable coronary heart disease(PSCHD)complicated with nonalcoholic fatty liver(NAFL).Methods One hundred and six patients with documented PSCHD were recruited into this study and their clinical data,including biochemical parameters,high-sensitivity C-reactive protein(hsCRP),white blood cell(WBC)count,ete.,were analyzed based on whether they had NAFL by B-type ultrasound scanning and their homeostasis model assessment ratio(Homa-IR)by the criteria for metabolic syndrome formulated by the International Diabetes Federation.Results Thirty-two (30.1percent)of 106 patients of PSCHD complicated with NAFL,and 74(69.9 percent)without NAFL. As compared to patients without NAFL,patients with NAFL had higher fasting blood glucose(FBS),serum level of insulin(INS),total cholesterol(TC),triglyceride(TG),serum activity of alanine aminotransferase(ALT),hsCRP,WBC count,body mass index(BMI),Homa-IR,and higher proportion of those with abnormal blood glucose,hypertension.metabolic syndrome(MS)and carotid atherosclerosis (CA)(P＜0.05),respectively.Bi-variate correlation analysis revealed that hsCRP positively correlated to BMI,TG,ALT and Homa IR(r=0.420,P=0.000;r=0.200,P=0.040;r=0.218,P=0.048:and r=0.546,P=0.000,respectively)and inversely correlated with serum level of high-density lipoprotein cholesterol(HDL-C)(r=-0.220,P=0.023).WBC count positively correlated with FBS(r=0.211,P=0.030).BMI,hsCRP,ALT,and proportions of hypertension,diabetes,MS,NAFL and CA in patients with Homa-IR above median were significantly higher than those in patients with that below median ( P＜0.05,respectively).Conclusions More risk faetors for chronic inflammatory reaction,cardiovascular disease and insulin resistance were clustered more obviously in patients of PSCHD complicated with NAFL.

BACKGROUND:Among many transplanted cells,adult autologous bone barrow-derived mononuclear cells have beenused in clinical practice because they are easy to be obtained,without immunological rejection and ethical disputationand other advantages.How to distinguish donor cells from receptors and observe the survival of donor cells following stem cell transplantation still trouble people.OBJECTIVE: superparamagnetic iron oxide (SPIO)particles-labeled bone marrow-derived mononuclear cells from minipigs were used to observe the feasibility of in vivo tracking with magnetic resonance imaging(MRI).DESIGN:A controlled observation experiment.SETTING:Institute of Cardiovascular Disease,Zhongda Hospital Affiliated to Southeast University.MATERIALS:This experiment was carried out in the Institute of Cardiovascular Disease,Zhongda Hospital Affiliated to Southeast University between April 2006 and August 2006.Healthy Chinese minipigs,aged 3 to 4 months,weighing from 20 to 30 kg,were provided by the Experimental Animal Center of Southeast University[SYXK(Su)2002-0012].METHODS: Autologous bone marrow-derived mononuclear cells of minipigs were isolated and cultured. Bone marrow-derived mononuclear cells in the suspension were traced with SPIO particles.Ferrum in the cells were shown by Prussian blue staining, and cell viability was evaluated by trypan blue exclusion method. Eleven minipigs used for preparation of model of myocardial infarction were divided into experimental group(n=9)and control group(n=2).By means of percutaneous left or right cervical artery or femoral artery puncturation, 1.5 to 2.0 mm balloon was used to occlude 1/3 left anterior descending branch,304 to 405 kPa,60 minutes later,ischemic preconditioning was conducted 3 tO 4 times before operation. When pig models of myocardial infarction were successful that was proved by surface electrocardiogram,bone marrow-derived mononuclear cells were percutaneously injected into coronary artery.Coronary arteriography was performed through femoral artery acupuncture at 24 hours after establishing infarction models.Suspension of bone marrow-derived mononuclear cells was perfused into coronary artery with OTW catheter.Then,the injector and OTW catheter for containing cells were rinsed with normal saline containing heparin and infused with the residual cells within 10 minutes.Non-labeled cells were perfused in 2 minipigs of control group by the same method.Postoperatively, bone marrow-derived mononuclear cells were traced by magnetic resonance and compared with Prussian blue-stained myocardial tissue sections.RESULTS: Seven minipigs of experimental group and one minipig of control group were Involved in the final analysis.One of each group was used for preparation of model of myocardial Infarction.One minipig of experimental group died from anesthetic accident before magnetic resonance.①Bone marrow-derived mononuclear cells all were nearly labeled by SPIO particles. Bone marrow-derived mononuclear cells could further proliferate in culture medium containing Fe2O3-PLL without obvious changes of cellular shape. ②T2+WI showed that 5 of 8 models of myocardial infarction presented fuzzy low-echo signal region in peripheral myocardial infarction after transplantation of labeled cells and the low-echo signal disappeared 4 weeks Iater. Ex vivo T2+WI sequence showed there was a dot-distributed low-echo signal region in the peripheral infarction region.③It was found in histological examination that 5 models(cell number over 106) had Prussian blue-positive cells,which distributed the same as those in magnetic resonance signal reducing region.CONCLUSION:SPIO particles-labeled bone marrow-derived mononuclear cells are safe and effective;T2+ WI is sensitive to tracing SPIO particles-labeled bone marrow-derived mononuclear cells;Magnetic resonance can in vivo trace SPIO particles-labeled stem cells transplanted through coronary artery,magnetic resonance signal change is related with the number of stem cells and division growth.

ObjectiveTo evaluate the safety and efficacy of firofiban in gerontal patients with acute coronary syndrome(ACS). MethodA total of 106 elderly patients with ACS admitted form December 2006 to June 2008 were enrolled in a prospective case-control study. Patients were divided into percutaneous coronary intervention (PCI) group and medicine group. Both groups were randomly divided into two sub-groups, tirofiban sub-group and placebo sub-group. Patients in the PCI group received tirofiban infused in dose of 10 μg·kg- within 3 minutes as loading dose before operation and then an infusion of 0.15μg'kg-1·min-1 as maintenance dose for 24～36 hours. In medicine group,the loading dose was 0.4 μg·kg-1·min-1×30 min and the maintaining dose was 0.1 μg·kg-1·min-1×48 hours, The rates of major adverse cardiac events (MACE) consisting of death, myocardial infarction or refractory ischemia during hospital stay stay and 30 days' follow-up, bleeding rates TIMI grade, corrected TIMI frame count (CTFC) and myocardial blush grade(MBG) after PCI were compared between sub-groups of PCI group. ResultsThe basic clinical data were similar among the sub-groups. In medicine group,the MACE rate during 30 days' follow-up was much lower in the tirofiban sub-group than in the placebo sub-group (12.0% vs. 36.4 %, P < 0.05). In comparison with medicine group, in PCI group, there were fewer TIMI frames [(23.5 ±5.1) frames vs. (31.4±5.2) frames, P < 0.01] and higher percentage of myocardial blush grade 3(64.3% vs. 29.0%, P < 0.01) in firotiban sub-group of PCI group. No significant differences in bleeding rates were found between all sub-groups. ConclusionsTirofiban is safe and effective in gerontal ACS patients with blood flow and reperfusion improved.