Objective To investigate the clinical significance of ECG QRS wave extension of the time limit for heart failure patients.Methods A retrospective analysis of heart failure patients electrocardiogram QRS complex duration and ultrasound heartbeat graph parameters were conducted,and according to the ECG QRS complex duration the patients were divided into QRS ≥ 120ms group and Q RS ＜ 120ms group,The cardiac functional grading,ultrasound heartbeat graph parameters,incidence rate of malignant arrhythmia,mortality within 1 year were compared between the two groups,in order to explore the possibility of QRS complex duration and the United States of America New York Heart Association(NYHA) classification of cardiac function,left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),malignant arrhythmia incidence,mortality.Results No significant difference was found in the cardiac function between QRS ≥ 120ms group and QRS ＜120ms group(t =0.00,0.10,0.11,all P ＞ 0.05).LVEDd of ECG QRS complex duration ≥ 120ms group was significantly higher than that of ECG QRS complex duration ＜ 120ms group (t =3.31,P ＜ 0.05).In addition,LVFS value and LVEF value of ECG QRS complex duration≥ 120ms group were significantly lower than those of ECG QRS complex duration ＜ 120ms group (t =17.05,3.54,all P ＜0.05).However,LAD between the two groups had no significant difference(t =0.09,P ＞ 0.05).40 cases in ECG QRS complex duration ≥ 120ms group,8 cases had malignant arrhythmia in the hospital,6 cases of cardiac death,2 patients died of pulmonary infection.In ECG QRS complex duration ＜ 120ms group,4 cases had malignant arrhythmia during hospitalization,3 cases of cardiac death,1 cases died of septic shock.The incidence rate of malignant arrhythmia and mortality within 1 year of ECG QRS complex duration ≥120ms group were significantly higher than those of ECG QRS complex duration ＜ 120ms group (x2 =4.01,P ＜0.05).In the ECG QRS complex duration ≥ 120ms group,LVEDd of 6 cardiac death patients was higher than 70mm,LVEF was less than 30％.Conclusion Wave duration ≥ 120ms has nothing to do with the cardiac function grade,gender,age,heart failure,but relate with the incidence rate of malignant arrhythmia and mortality within 1 year,which can be used to evaluate disease severity and prognosis.

0.05). Conclusion Combined inplantation of different types of DES is safe and does not increase the incidence of MACE.

Objective To compare the long term outcomes of delayed or primary percutaneous transluminal coronary intervention(PCI) with concervative drug therapy for acute myocardial infarction(AMI).Methods The data of 276 patients with AMI hospitalized during January 1996 to October 2003 were analyzed retrospectively.The patients were divided into three groups including: primary PCI group(75 cases underwent primary PCI within 12 hours of symptom onset),delayed PCI group(73 cases underwent delayed PCI after 24 hours symptom onset) and conservative drug therapy group(128 cases without PCI treatment).Major adverse cardiac events(MACE) were recorded during the follow-up period(mean 4.3?2.7 years).Echocardiography was carried out and long-term mortality rate was recorded during follow-up.Results The Baseline characteristics of the three groups were similar except elevation in ST segment and in-hospital duration which were significantly different in the primary PCI group.The percentage of follow-up completion was 89.5%(247/276).The in-hospital mortality of the conservative therapy group was higher than both PCI groups.The LVEF of the delayed PCI group,primary PCI group and the conservation therapy group were 57.4%?3.4%,59.3%?7.5% and 54.7%?4.1% respectively.There was 1 deceased case in both the delayed and primary PCI group but 14 cases in the conservative group.There was no significant difference between the two PCI groups in terms of combined end point of death and clinical events different.Conclusion Compared with conservative drug therapy,delayed PCI can further improve the long-term prognosis of STEMI patients.

0.05) after SVT episode. Compared to the SVT group and basic status, the extraction ration of glucose and oxygen of CAD patients obviously increased( P

Objection To compare the efficacy and tolerance of perioperative intravenous Metoprolol or calcium iron antagonist injection on patients with cardiac complications which undergoing noncardiac surgery. Method The clinical data of 135 patients who underwent noncardiac surgery from March 2003 to May 2004 was analyzed. According to the different drugs used to treat the perioperative cardiac complications (tachycardia arrhythmia, hypertension and myocardium ischemia), patients were allocated to metoprolol group (87 cases) and calcium antagonist group (48 cases, including Verapamil 21 patients and Diltiazem 27 patients). The effects of the therapy on heart rate and blood ressure control and ischemia relieving were compared between two groups. Results There is no significant difference at baseline data between two groups. Compared with calcium antagonist, intravenous metoprolol could more reduce heart and relieve myocardium ischemia quickly. The effect of blood pressure controlling was more significant in calcium antagonist group than in metoprolol group. The incidence of side-effects events was lower in metoprolol ( 8.0%) than in calcium antagonist group (22.9%).Conclusions Intravenous metoprolol injection is effective and safe in treating perioperative cardiac complications in patients with noncardias surgery.

Objective To study the effect of Depside Salt from Salvia Miltiorrhiza on angina pectoris and platelet function.Methods The study group was comprised of 56 patients with stable angina,who were randomly divided into the high-dosage Depside Salt from Salvia Miltiorrhiza group,the low-dosage Depside Salt from Salvia Miltiorrhiza group and the Danshen control group. Before and after the 14-day treatment,the clinical symptom and serum level of PAG, P-selectin were measured,and exercise electrocardiography was performed. Results After treatment with Depside Salt from Salvia Miltiorrhiza,the symptom of angina pectoris was alleviated and exercise ECG was improved,while no significant difference was found compared with control group.Serum PAG and P-selectin were decreased after treatment with Depside Salt from Salvia Miltiorrhiza ,and significantly more than Danshen.Conclusion Depside Salt from Salvia Miltiorrhiza injection can remarkably inhibite the aggregation and activation of platelet,and is effective for angina pectoris.

Objective To compare the effects of clopidogrel and ticlopidine in combination with aspirin in preventing direct coronary stenting complication in patients with acute myocardial infarction.Methods The clinical data of 74 cases with ST-segment elevation myocardial infarction were retrospectively analysed. The patients were divided into two groups. Before direct coronary stenting, clopidogrel,300mg loading dose then 75mg once daily or ticlopidine 250mg twice daily in addition to aspirin 100mg once daily were given to two groups respectively. Hemorrhage, neutropenia, thrombocytopenia were observed during 4 weeks. The frequency of clinical cardiovascular events (including cardiac mortality, myocardial re-infarction, need for revascularization) were followed up at 6 months. Results The incidence of major cardiac events in clopidogrel group was less than ticlopidine group ( 21.1% with Clopidogrel and 44.4% with Ticlopidine,P= 0.031). The incidence of light hemorrhage patents individually were 6(15.8%) vs 14(38.9%). The mean number of neutrophile white celll individually were 5.8 ?1.7 vs 4.2 ?3.6 (?10 9/L). The platelet count were 130.3 ?42.1 vs 89.2 ?53.3(?10 9/L), P

BACKGROUND: Results from clinical trials suggested that clopidogrel and ticlopidine had side effects of granulopenia, and aspirin could inhibit endothelial progenitor cell proliferation. There is no report of effects of these drugs on human bone marrow mesenchymal stem cells (hBMSCs) in stem cell transplantation. OBJECTIVE: To investigate the effects of antiplatelet drugs including clopidogrel, ticlopidine and aspirin on hBMSC proliferation and secretion. DESIGN, TIME AND SETTING: The cytology in vitro observation was performed at the Laboratory of Toxicology, Shanghai Municipal Center for Disease Control and Prevention from March to December 2006.MATERIALS: The second passage of hBMSCs was kindly donated from Shanghai Tissue Engineering Research & Development Center, Shanghai Ninth People's Hospital. Clopidogrel (Lot number J20040006) and ticlopidine (Lot number H19980186) were obtained from Hangzhou Sanofi-Synthelabo Minsheng Pharmaceutical CO., Ltd. Aspirin (Lot number 20050059) was obtained from Bayer Vital GmbH. METHODS: The standard culture medium consisted of DMEM-LG, 10% heat-inactivated FBS, 100 U/mL penicillin and 100 μg/mL streptomycin. After being cultured in vitro expanded out to passage 6, hBMSCs were treated with antiplatelet drugs of different concentrations and compared with control group. MAIN OUTCOME MEASURES: Cell proliferation was assessed by 3- (4, 5-dimethylthiazol -2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assay, level of vascular endothelial growth factor (VEGF) of culture medium was detected by enzyme-linked immunoadsordent assay (ELISA), and surface antigens of hBMSCs were analyzed by the flow cytometry. RESULTS: A570 values of hBMSCs treated by clopidogrel or ticlopidine of 0.02,0.1,0.4,2,10,40 μmol/L were higher than control group (P < 0.01), while A570 values of aspirin group of 60, 600, 2 000 μmol/L were lower than control group(P < 0.05). Antiplatelet drugs had no obvious effect on cell surface antigens(CD34, CD105, CD106)expressed by hBMSCs. Treated by high dose clopidogrel or ticlopidine (40 μmol/L), VEGF level from hMSCs was lower than that of control group(P < 0.01), but VEGF level of low dose (0.02 μmol/L) ticlopidine group was higher than control group(P < 0.01), and there was no significantly difference of VEGF level among low dose clopidogrel group (0.02 μmol/L), aspirin group (5, 2 000 μmol/L), and control group(P > 0.05). CONCLUSION: Clopidogrel and ticlopidine improve proliferation of hBMSCs, but aspirin inhibits proliferation of hBMSCs. High dose of clopidogrel and ticlopidine suppress VEGF secretion of hBMSCs, while low dose of ticlopidine promote it. Antiplatelet drugs have no obvious effect on hBMSCs differentiation.

Objective To analyze the incidence of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage(t-SAH), time windows of CVS as well as the risk factors. Method A total of 98 patients,with t -SAH admitted from June 2007 to December 2008, were enrolled for this prospective study. The hemodynamics of middle cerebral artery (MCA) in these patients was monitored with trancranial Doppler (TCD) daily for 7 days after admission and on the 14th day of hospital stay. The incidence of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage (t-SAH) ,time windows of CVS as well as the risk factors were analyzed. Results Of them, 41 patients (41.8%) had CVS. The flow velocity of MCA in patients with GCS≤ 8 was significantly higher than that in patients with GCS≥9. Classified by t-SAH cumulative blood Hijdra method, 2(4.44%) of 45 patients(45.9%)with scores 6 or less,9 (29.0%)of 31 patients (37.8%) with scores 6～ 13,and 8 (36.4%) of 22 patients (20.0%)with scores 13 or more had CVS. Severe CVS occurred in 13 (35. 1% )of 37 surgical patients (37.8%), and local cerebral infarction occurred in four surgical patients after symptomatic treatment. The flow velocity of the MCA was significantly higher in surgical patients than that in non-surgical patients 3 days after admission. Conclusions The severity of original trauma, bleeding, location of t-SAH and operation are the major risk factors to lead to CVS in patients with t-SAH. Attention should he paid to those risk factors during the treatment of patients with t-SAH.

OBJECTIVE: To study the effect of Zhenju Jiangya Tablet (ZJ) on the injured endothelial cells and endothelium-dependent relaxation function of hyperlipidemia rabbits. METHODS: Male New Zealand rabbits were randomized into four groups: control group, hyperlipidemia group, ZJ group and sivastatin group. The endothelium-dependent relaxation function was evaluated by APV using intravascular Doppler, and the morphology of endothelial cells was detected by light microscopy and electron microscopy, and nitric oxide synthase was evaluated. RESULTS: ZJ reduced the lesions of hyperlipidemia vessels, and the APV after Ach injection of each group was (1.14+/-0.26), (1.74+/-0.59), (1.22+/-0.37) and (1.17+/-0.41) respectively. The eNOS of each group was (4.21+/-0.37), (1.43+/-0.88), (3.95+/-0.67) and (4.08+/-0.46) nmol x min(-1) x g(-1) respectively. CONCLUSION: ZJ can improve the abnormality of endothelial cells and endothelium-dependent relaxation function of hyperlipidemia.