Objective To observed the changes of plasma levels of NT‐proBNP and hs‐CRP in patients with different types of coronary heart disease and investigate its clinical value .Methods 156 patients with CHD diagnosed by coronary computed tomo‐graphy angiography(CTA) were enrolled in this study ,including 35 cases of acute myocardial infarction(AMI) ,63 cases of unstable angina(UAP) and 58 cases of stable angina(SAP) .And 61 persons without CHD were selected as the control(CTR) .Plasma levels of NT‐proBNP and hs‐CRP were detected by the methods of immmunofluorescent antibody technic reader and turbidimetry ,respec‐tively .Results Plasma NT‐proBNP levels of AMI ,UAP ,SAP and CTR group were (1 903 .99 ± 2 055 .21) ,(897 .27 ± 947 .34) , (677 .98 ± 718 .12) ,(129 .39 ± 126 .49)ng/L ,respect ively .Plasma hs‐CRP levels were (28 .47 ± 20 .49) ,(12 .68 ± 8 .64) ,(10 .56 ± 7 .17) ,(2 .82 ± 1 .23)mg/L ,respectively .Plasma levels of NT‐proBNP and hs‐CRP in AMI group were obviously higher than those in UAP ,SAP and CTR group(P<0 .05) .Plasma levels of NT‐proBNP and hs‐CRP in UAP group were obviously higher than those in CTR group(P<0 .05) .There was no significant differences in these markers between SAP group and control group(P>0 .05) . Plasma BNP levels were positively correlated with plasma hs‐CRP .Conclusion Plasma levels of NT‐proBNP and hs‐CRP are asso‐ciated with different clinical phenotyes of CHD .Those markers may be helpful to the risk stratification and prognosis of CHD .

Objective To analyze the CT pulmonary angiography(CTPA) image quality and radiation dose of obesity patients with high and low tube voltage iterative reconstruction(IR) and the filtered back projection(FBP) reconstruct algorithm,and to explore the feasibility of low tube voltage IR algorithms in CTPA of obese patients.Methods Obese patients with suspected pulmonary embolism were randomly assigned into 80 kV or 120 kV group, and the images were treated with IR and FBP reconstructions.CT value of the basal segment of the right pulmonary artery, right upper lobe and main pulmonary artery were measured, and the average CT value of the pulmonary artery was further calculated, and the independent sample t test analysis was used.Results Comparing the CT value of the IR and FBP subgroup of two tube voltage groups, the differences were not significant (P>0.05), the differences of noise, signal noise ratio(SNR) and contrast noise ratio (CNR) were statistically significant (P<0.05), respectively.The CT value,noise,SNR and CNR of 80 kV group were significantly higher than those of the 120 kV group, and the differences were statistically significant (P<0.05), while the radiation dose were significantly lower than those of 120 kV group (P=0.000).Conclusion The CTPA image quality of 80 kV IR algorithm is significantly improved compared with the 120 kV FBP algorithm, and the radiation dose is significantly reduced, which could be used for CT pulmonary angiography in obese patients.

BACKGROUND: KATP channel regulates the response of cells to hypoxia and ischemia, mediates and is involved in the protection for cells or tissue organs. Our previous research confirms that Shenfu injection has good protective effect on myocardial ischemia/reperfusion injury in rats. There have been no reports on whether this protective effect is related to KATP channel in WeiPu deriodical database, WanFang database and Medline database until October 2005.OBJECTIVE: To observe the protective effect of Shenfu injection on myocardial ischemia/reperfusion injury in rats, and analyze its correlation with KATP channel.DESIGN: Completely randomized grouping design, randomized controlled trial.SETTING: Department of Anesthesiology, Second Hospital Affiliated to Dalian Medical University; Department of Anesthesiology, Second Hospital Affiliated to Chongqing Medical University.MATERIALS: Twenty-four adult SD rats of clean grade, of either gender, weighing 240 to 320 g, were employed in this trial. Shenfu injection (Sanjiu Medical & Pharmaceutical, Co., Ltd., Batch No. 031002) and glibenclamide (National Institute for the Control of Pharmaceutical and Biological Products) were employed.METHODS: This trial was carried out in the Laboratory of Anesthesiology, Second Hospital Affiliated to Chongqing Medical University from April to December 2004. Myocardial ischemia/reperfusion injury models were employed. Twenty-four rats were randomized into 4 groups, with 6 in each group: sham-operation group [putting through thread, but without ligation of left anterior descending coronary artery, 8 mL/kg normal saline, intravenous injection (i.v.)], ischemia/reperfusion group (8 mL/kg normal saline, i.v.), Shenfu injection group (8 mL/kg Shenfu injection, i.v.) and Shenfu injection + glibenclamide group (0.33 mg/kg glibenclamide and 8 mL/kg Shenfu injection, i.v.). Administration in each group was conducted 15 minutes before ligation except for that in sham-operation group (immediately after putting through thread). About 6 mL blood was taken from cardiac apex. Left ventricular anterior wall was divided into 3 parts, and then which were used for homogenate, electron microscope observation and immunohistochemical detection separatety. The superoxide dismutase (SOD) activity, malondialdehyde (MDA) level, expressions of tumor necrosis factor-α(TNF-α) and interleukin 6 (IL-6)and plasm cTnl level in myocardial tissue were detected. Ultra-structural changes of myocardial tissue were observed.MAIN OUTCOME MEASURES: SOD activity, MDA level, expressions of TNF-α and IL-6, plasm cTnI level and ultra-structural changes of myocardial tissue. RESULTS: All the 24 rats were involved in the result analysis, without deletion. ① Compared with sham-operation group,SOD activity in myocardial tissue in ischemia/reperfusion group was decreased, while the expressions of TNF-α and IL-6 were increased, with statistical difference (P ＜ 0.01). MDA level in the ischemia/reperfusion group was higher than that in the sham-operation group (P ＜ 0.01); Compared with ischemia/reperfusion group, SOD activity was increased, MDA level and expressions of TNF-α and IL-6 were all decreased in Shenfu injection group(P ＜ 0.01); There were no significant differences in above-mentioned indexes between Shenfu injection group and Shenfu injection + glibenclamide group (P ＞0.05). ②Compared with sham-operation group, the plasm cTnl level in the ischemia/reperfusion group and Shenfu injection+ glibenclamide group was significantly increased (P ＜ 0.01); Compared with ischemia/reperfusion group, plasm cTnl level in the Shenfu injection group was significantly decreased in Shenfu injection group (P ＜ 0.01); There were no signifi cant differences in plasm cTnl level between Shenfu injection group and Shenfu injection + glibenclamide group. ③ In the sham-operation group, the ultrastructure of myocardial cells was basically normal and mitochondrium swelled a little; In the ischemia/reperfusion group, karyolysis appeared, mitochondrium swelled obviously and considerable neutrophils infil trated; In the Shenfu injection group, myofilament of myocardial cells dissolved, mitochondrium swelled and nuclear mem brane was integrity; In the Shenfu injection + glibenclamide group, mitochondrium obviously swelled, myofilament present ed focus dissolving, sarcoplasmic reticulum expanded a little and allochromacy assembled in the edge of cells. CONCLUSION: Glibenclamide suppresses myocardial KATP channel, but does not eliminate the protective effect of Shenfu injection on myocardial ischemia/reperfusion injury. KTAP channel does not play an important role in the protection of Shenfu injection for myocardial ischemia/reperfusion injury.

BACKGROUND: It has been confirmed that Shenfu parenteral injection can ameliorate and treat various shocks, heart failure, myocardial ischemia and supraventricular/ventricular arrhythmia, and it also has a good protective effect on myocardial ischemia/reperfusion injury in rats.OBJECTIVE: To observe the effects of Shenfu parenteral injection on the protein expressions of myocardial apoptosis-related genes of Bcl-2, Bax and c-Fos in rats with acute ischemia/reperfusion injury.DESIGN: A complete randomized grouping design, controlled experiment.SETTING: Department of Anesthesiology, the Second Affiliated Hospital,Chongqing University of Medical Sciences.MATERIALS: The experiments were carried out in the Staff Room of Anesthesiology, the Second Affiliated Hospital, Chongqing University of Medical Sciences from April to December in 2004. Thirty-five healthy adult Wistar rats were provided by the experimental animaI center of Daping Hospital, Third Military Medical University of Chinese PLA. Shenfu parenteral injection was the TCM formula of Shenfu Tang, which is for recuperating depleted yang and rescuing the patient from collapse, and its main components are ginsenoside and aconitum alkaloid. It was the product of Yaan Sanjiu Pharmaceutical Co., Ltd., 10 mL/piece, the batch number was 030110.METHODS: In vivo models of myocardial ischemia/reperfusion injury were used. The 35 rats were divided into 5 groups according to the number of random number table, with 7 rats in each group: ① Sham-operated group: The rats were treated with only insertion of thread without ligation, followed by intravenous injection of saline (8 mL/kg), and then observed for 120 minutes. ② Shenfu parenteral injection 30-minute group: The rats were treated with intravenous injection of Shenfu parenteral injection (8 mL/kg) at 15 minutes before ligation, and then the left coronary artery anterior descending branch was ligated for 40 minutes and reperfused for 30 minutes. ③ Shenfu parenteral injection 120-minute group: The rats were reperfused for 120 minutes, and the others were the same as those in the Shenfu parenteral injection 30-minute group. ④ Saline 30-minute control group: The rats were treated with intravenous injection of saline (8 mL/kg) at 15 minutes before ligation, and then the left coronary artery anterior descending branch was ligated for 40 minutes and reperfused for 30 minutes. ⑤ Saline 120-minute control group: The rats were reperfused for 120 minutes, and the others were the same as those in the saline 30-minute control group. The expressions of Bcl-2, Bax and c-Fos proteins in myocardial tissues were detected with immunohistochemical method.MAIN OUTCOME MEASURES: The expressions of Bcl-2, Bax and cFos proteins in myocardial tissues of rats in each group were observed.RESULTS: All the 35 rats were involved in the analysis of results without deletion. ①As compared with the sham-operated group, the expressions of Bcl-2, Bax or c-Fos protein in myocardium were significantly increased(P ＜ 0.01), but the Bcl-2/Bax ratios were significantly decreased (P ＜0.01) in the saline 30 and 120-minute groups. ② As compared with corresponding saline groups, the expressions of Bcl-2 protein in the Shenfu parenteral injection 30 and 120-minute groups were significantly increased (P ＜ 0.01), the expressions of Bax and c-Fos proteins were remarkably decreased (P ＜ 0.01), and the Bcl-2/Bax ratios were significantly increased (P ＜ 0.01).CONCLUSION: Protective effect of Shenfu parenteral injection on ischemia/reperfusion myocardium may be correlated with its promotion of Bcl-2 protein expression, restrain to Bax and c-Fos protein expressions, and increase of Bcl-2/Bax ratio, and it restrains the apoptosis of myocardial cells.

Objective To assess the effects of different level iterative reconstructions (IR) on image quality of obese patients of 80 kV CT pulmonary angiography (CTPA).Methods Forty obese patients with clinically suspected pulmonary embolism were examined with CTPA,filtered back projection method (FBP) and three IR levels (iDose1,20％ IR/80％ FBP;iDose3,40％ IR/60％ FBP;iDose5,60％ IR/40％ FBP) to reconstruct images were used.The CT value of pulmonary artery trunk,upper lobe artery and lower lobe basal segment artery of right pulmonary were measured,and the image noise,SNR and CNR of four groups were calculated and compared.Results The image noise,SNR and CNR had significant difference in 4 groups (all P＜0.05),and the image noise had significant difference between each two groups (all P＜0.05),the SNR and CNR had statistical difference between FBP and iDose3,between FBP and iDose5 (P＜0.01).Conclusion Compared with FBP,80 kV combined with different level IR technologies can significantly decrease image noise and improve objective image quality in CTPA,the radiation dose that obese patients received can be reduced.

OBJECTIVETo evaluate the left ventricular (LV) radial and longitudinal systolic function in hypertrophic cardiomyopathy (HCM) patients by 3.0 T MR.

METHODSSixteen HCM (HCM group) and twenty normal adults (normal group) were examined with fast imaging employing steady-state (FIESTA) acquisition sequence of cardiac MRI. LV ejection fraction (LVEF), longitudinal shortening (LS) and fractional shortening (FS) in three standard levels were measured to analyze LV radial and longitudinal systolic function.

RESULTSAsymmetric hypertrophy was detected in all HCM patients. The LVEF and FS were significantly higher while LS was significantly lower in HCM group than those in normal group (P < 0.05 or 0.01). FS at basal and middle levels were significantly higher in HCM group than in normal group (both P < 0.01). FS in apex level was similar in the two groups (P = 0.057). Pearson correlation analysis showed that LS was negatively related with the number of hypertrophy segments in HCM patients (r = -0.537, P = 0.032). But there was no correlation between FS and the number of hypertrophy segments as well as FS and LS in HCM patients (r = -0.090, P = 0.739; r = 0.049, P = 0.856).

CONCLUSIONThe LV longitudinal systolic function was reduced but the LV radial systolic function remained unchanged in HCM patients, thus, LS changes could better reflect myocardial systolic function in HCM patients.

Adult ; Cardiomyopathy, Hypertrophic ; physiopathology ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Myocardium ; Systole ; Ventricular Dysfunction, Left ; Ventricular Function, Left

OBJECTIVETo establish cardiac magnetic resonance imaging(MRI) derived left ventricular (LV) global and region function parameters in normal adults.

METHODSTwenty normal adults were examined with fast imaging employing steady-state(Fiesta) acquisition sequence of cardiac MRI, LV global function and LV region function were measured at basal, middle, apical level and at 16 LV segments. The regional function parameters among different levels and different segments of the same level were analyzed.

RESULTS(1)LV global function: end-diastolic volume (109.17 ± 19.52) ml; end-systolic volume (37.76 ± 14.16) ml;ejection fraction (65.93 ± 7.79) %; wall thickening (83.24 ± 40.82) %; longitudinal shortening (15.51 ± 3.78) %; fractional shortening (31.78 ± 9.55) %;end-diastolic mass (95.20 ± 19.95) g. (2)LV regional function: In each LV level, there was no significant difference in end-systolic wall thickness (P > 0.05). End-diastolic wall thickness and wall thickening were similar between the middle and apical levels, but there were significant differences between middle and apical levels with the basal level(both P < 0.05). End-systolic wall thickness of the middle and the apical level was similar, but there were significant differences between middle and apical levels with the basal level (both P < 0.05). At the segments of the same level, end-diastolic wall thickness and the relevant regional function parameters between the segments of anteroseptal and inferoseptal at base and middle level were similar (P > 0.05); the end-diastolic wall thickness was the largest and the WT was the minimal at the septal segments of three levels, and the difference were significant between the septal and other segments in the same level (P < 0.05).

CONCLUSIONSFractional shortening and longitudinal shortening provide new indicators for assessing LV global function by cardiac MRI. There is obvious heterogeneity on LV regional function in normal adults, systolic function is the strongest in apical level and the weakest in spetal segments of LV.

Adult ; Female ; Healthy Volunteers ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Ventricular Function, Left ; Young Adult