Objective To investigate the effects of rapamycin on the number and function of peripheral blood endothelial progenitor cells (EPCs). Methods Total mononuclear cells (MNCs) were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After 7-day culture, adherent cells were treated with rapamycin in a series of final concentrations of 1.0, 2.0, 5.0?g/ml for 6, 12, 24, and 48h. EPCs were identified as adherent cells double positive for DiLDL-uptake and lectin binding by direct fluorescent staining as demonstrated under a laser scanning confocal microscope. EPCs were further documented by demonstrating the expression of VEGFR-2, AC133 and CD34 with flow cytometry. EPCs proliferation and migration were assayed with MTT assay and modified Boyden chamber assay, respectively. EPCs adhesion assay was performed by replating them on fibronectin-coated dishes, and then adherent cells were counted. In vitro vasculogenesis activity was assayed by in vitro vasculogenesis kit. Results Incubation of isolated human MNCs with rapamycin resulted in a decrease in the number of EPCs, and rapamycin also decreased EPCs proliferative, migratory, adhesive and in vitro vasculogenesis capacity in both concentration and time dependent manners. Conclusion Rapamycin decreases the number, proliferative, migratory, adhesive and in vitro vasculogenesis capacity of EPCs.

Objective To evaluate safety and effect of percutaneous balloon mitral valvuloplasty(PBMV) for patients with rheumatic mitral stenosis and left atrial thrombi.Methods PBMV was performed in 27 patients with rheumatic mitral stenosis and left atrial thrombi. 19 cases of left atrial fresh thrombi revealed by transesophageal echocardiography (TEE) received warfarin orally for 3-6 months before PBMV. Results PBMV was successful in all cases of mitral stenosis and left atrial thrombi. Left atrial fresh thrombi was completely resolved in 9 cases and became smaller chronic organized thrombi in 10 cases after warfarin anticoagulation treatment among 19 cases of left atrial fresh thrombi revealed by TEE. In 5 cases of left atrial chronic organized thrombi shown only transthoracic echocardiography and without anticoagulation treatment, one case had cerebral embolism. No complication occurred in other cases.Conclusions The study showed that patients with rheumatic mitral stenosis and atrial fibrillation should have routine TEE. PBMV for rheumatic mitral stenosis with left atrial thrombi after anticoagulation treatment is safe and effective.

Objective To investigate the effect of high glucose on the number and proliferation, migration and adhesion of peripheral endothelial progenitor cells (EPCs). Methods Total mononuclear cells (MNCs) were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin coated culture dishes. After 7 days of culture, several groups of attached cells were incubated with glucose in a series of concentrations (15, 25, 35, 45mmol/L) for different durations (6, 12, 24 and 48h). EPCs were characterized as adherent cells which were double positive for DiLDL uptake and lectin binding by direct fluorescent staining demonstrated under a laser scanning confocal microscope. EPCs were further documented by demonstrating the expression of KDR, VEGFR 2 and AC133 with flow cytometry. EPCs proliferation, migration and in vitro vasculogenesis activity were assayed with MTT assay, modified Boyden chamber assay and in vitro vasculogenesis kit, respectively. EPCs adhesion assay was performed by replating MNCs on fibronectin coated dishes, and then the adherent cells were counted. Results Incubation of isolated human MNCs with high glucose concentration decreased the number of EPCs, and this effect was most prominant when glucose concentration was 45mmol/L, and incubated for 24 hours (approximately 1 fold decrease, P

0.05).Compared with SHR group,left ventricular weight mass index decreased significantly in SHR-A group(P

Objective To investigate the efficacy and safety of warfarin in the prevention of cerebral infarction in nonvalvular atrial fibrillation (NVAF). Methods One hundred and thirty-six NVAF patients were randomized into warfarin group [receiving adjusted-dose warfarin,international normalized ratio(INR)was 2.0 - 3.0], aspirin group( receiving aspirin 100 mg/d) and control group (treated without anticoagulants )by random digits table. Followed up 18 months, and the main end point events and adverse effect of the three groups were compared. Results In 136 cases,4 cases lost,and 77 cases(58.3%) were male. The mean dose of warfarin was(2.5 ± 1.0) mg. During the follow-up period, main end point events occurred in 12 cases,with 1 case (2.50%, 1/40) in warfarin group, 4 cases(9.52%, 4/42 ) in aspirin group and 7 cases ( 14.00%, 7/50)in control group. There was no significant difference in main end point events among the three groups ( x2 =2.084,P =0.353). But in the patients with 3 or above risk factors,there was significant difference in the survival curve among the three groups ( x2 = 6.404, P = 0.041 ). The incidence rate of bleeding was higher in warfarin group than that in aspirin group,but there was no significant difference [5.00%(2/40) vs. 2.38%(1/42),P ＞ 0.05]. Conclusions Warfarin can improve survival rate especially in the patients with 3 or above risk factors,and the complication of bleeding occurs mostly when INR ＞ 3.0.Under closed monitoring (INR 2.0-3.0),adjusted-dose warfarin is safety and efficacy.

BACKGROUND:There are many reports about clinical effect of femoral fractures with intramedul ary nail and distal femoral fractures with locking plate. However, there is less report about clinical effect of femoral and distal femoral fractures.
OBJECTIVE:To investigate the clinical effect of femoral and distal femoral fractures using intramedul ary nail combined with locking plate.
METHODEighteen patients with femoral and distal femoral fractures were treated by internal fixation with intramedul ary nail combined with locking plate. Among them, six cases had femoral and supracondylar fractures, seven cases had femoral and condylar fractures, and five cases had femoral and intercondylar fractures.
According to the AO classification, three cases were type 33A2, three cases were type 33A3, two cases were type 33B1, five cases were type 33B2, one case was type 33C1, three cases were type 33C2, and one case was type 33C3. The fractures union and complications were fol owed up and observed, and knee joint function was judged by HSS score.
RESULTS AND CONCLUSION:Al the 18 patients were fol owed up for 12-24 months. The time for fracture union ranged from 3 to 5 months, average 3.4 months. No infection and disunion, no fracture malunion, no internal fixation loosening and breaking, no refracture happened. The HSS score ranged from 68 to 96 points, average 86.8 points. There were 12 excellent cases, 5 good cases, and 1 common case. The excellent and good rate was 94.4%. The internal fixation using intramedul ary nail combined with locking plate is a good method for treatment of femoral and distal femoral fractures, due to less surgical trauma, simple and reliable fixation, high rate of fracture healing, low rate of complications, and excellent function.

AIM: The purpose of this study was to determine whether the signal transduction systems were activated at the molecular atrial tissue level in patients with atrial fibrillation (AF) and whether atrial expression of extracellular-signal regulated kinase (ERK) and protein phosphatases is altered. METHODS: Atrial tissue sample of 30 patients undergoing cardiac surgery were examined. 20 patients had AF, 10 patients had no history of AF. The mRNA expression of calcineurin B and MKP-1 were detected by semi-quantitative RT-PCR. ERK1 and phospho-ERK1 were analyzed at the protein level by Western blot. RESULTS: Western blot analysis showed that atrial fibrillation did not induce significant change in ERK1 expression level in the left atrium. In contrast , phospho-ERK1 content was increased in the patients with AF in comparison with those who had sinus rhythm (SR). The mRNA expression of calcineurin B and MKP-1 in the patients with AF were significantly higher than that in patients with SR. CONCLUSION: The activation of extracellular-signal regulated kinase and protein phosphatases may have correlation with the initiation or maintenance of atrial fibrillation.

AIM: To clarify the effect of the specific sodium-hydrogen antiporter HOE642 on ischemia/reperfusion(I/R) injury including apoptosis, and the relationship between its effect and the time of HOE642 administration. METHODS: The isolated rat heart model were randomly divided into group A and B. Furthermore, the rat hearts in group A were divided into four subgroups including I/R, HOE-Pr+I/R, HOE-Is+I/R and HOE-Re, also the rat hearts in group B were divided into the following subgroups including control, I/R and HOE642+I/R. The LVDP, LVEDP, arrythmia coronary flow and the enzymatic activity in myocardium were measured in group A, and TUNEL method was applied to probe apoptosis in group B. RESLUTS: It was found that the LVEDP, arrythmias and the enzymatic activity including CK-MB and LDH were significantly lower in group HOE-Pr+I/R than that in group I/R, while the LVDP was obviously higher in HOE-Pr+I/R than that in I/R. The administration of HOE642 during ischemia could decrease LVEDP, arrythmias and enzymatic activity in myocardium, but not the LVDP. Furthermore, the results showed that HOE642 could inhibit apoptosis induced by ischemic/reperfusion injury. CONCLUSIONS: HOE642 is an effective cardio-protector in case of ischemic/reperfusion injury especially when it is applied before ischemia. The inhibition of apoptosis might be involved in the mechanisms underlying the protective effect of HOE642.

AIM: The aim of this study was to study the changes of rabbit heart electrophysiological properties caused by increasing left ventricular afterload, and to assess the effects of streptomycin or verapamil on these changes. METHODS: The rabbit heart preparation in situ was used,and the afterload of left ventricle was increased by clipping in part the root of ascending aorta. The changes of heart electrophysiological parameters including relative refractory period (RRP),effective refractory period (ERP),monophasic action potential duration (MAPD_ 90 ) and ventricular fibrillation threshold(VFT) were observed before and after altering the afterload of left ventricle and were compared in the absence and presence of streptomycin or verapamil. RESULTS: The rising of left ventricular afterload [(72?11)mmHg] led to shortening of RRP,ERP and MAPD_ 90 ,and to descent of VFT ( P 0.05) except increasing of VFT ( P

AIM: To evaluate effects of diltiazem on platelet hyperreactivity in situations associated with endothelial injury and their possible relationship to cytosolic calcium concentration. METHODS: Blood samples were collected at 7 time points from 35 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) who received combined diltiazem and aspirin/ticlopidine therapy or aspirin/ticlopidine therapy alone. Platelet expression of glycoprotein Ⅱb/Ⅲa and cytosolic calcium concentration were measured, respectively, by whole blood flow cytometry and fluorospectrophotometry. The effects of diltiazem of different concentrations on expression of glycoprotein Ⅱb/Ⅲa were also studied in vitro in blood samples from patients with chronic stable angina. RESULTS: Of the two treatments, aspirin/ticlopidine therapy did not prevent an acute increase of expression of glycoprotein Ⅱb/Ⅲa 5 minutes and 10 minutes after first inflation and 10 minutes after PTCA, whereas combined diltiazem and aspirin/ticlopidine therapy had a significant inhibitory effect. In the group receiving aspirin/ticlopidine therapy, there was a short-term elevation of platelet [Ca~(2+)]i immediately following PTCA which was significantly reduced by diltiazem treatment. Expression of glycoprotein Ⅱb/Ⅲa was significantly inhibited in vitro by diltiazem in the concentration of 200 ?g/L or higher, but not 50 ?g/L. CONCLUSIONS: Combined diltiazem and aspirin/ticlopidine therapy significantly inhibited platelet activation that continued in the presence of conventional aspirin/ticlopidine treatment. Antiplatelet effects of diltiazem were probably a consequence of reduction of platelet [Ca~(2+)]i and may only be achieved in higher than therapeutic concentrations. [