Objective To evaluate value of multi-indexes of real-time myocardial contrast echocardiography (RT-MCE) for the detection of coronary artery disease(CAD). Methods A total of 35 patients scheduled for coronary angiography underwent RT-MCE, and were undergone gated single photon emission computed tomography(gated-SPECT) after RT-MCE shortly. Coronary angiography was performed within one week of RT-MCE in all patients. All patients were divided CAD and no-CAD group. The observing indexes included: (1)The images of RT-MCE were analyzed quantitatively from microbubble replenishment curves for myocardial perfusion by using the Qlab software; A,β and A×β were compared between two groups. The sensitivity and specificity of RT-MCE for detection of CAD were performance by ROC curves Gensini score were calculated in 22 patients. Then the correlation analysis was used for comparing the value of A,β and A×β with Gensini score. (2) The sensitivity and specificity of gated-SPECT and RT-MCE for assessment of CAD were calculated by 4 score method. (3) RT-MCE for the detection of coronary artery stenosis with multi-indexes. Results (1) A,β and A×β were significant difference between two groups. The cutoff of A,β and A×β was 4. 58,0. 64 and 2. 73,then the sensitivity and specificity of RT-MCE for detection of CAD were 86. 0% , 80. 2% , 88. 9% and 84.1 % , 64. 6% , 79. 9 % , respectively. The correlation index was - 0. 79, - 0. 51 and - 0. 76 comparing the results of A, β and A ×β with Gensini. (2) The sensitivity and specificity of gated-SPECT for assessment of CAD were 84. 8 % and 82. 7% ,respectively. (3) The sensitivity of multi-indexes RT-MCE increased, the sensitivity was 89. l%,90. 4% and 96.3% when combinated A and β,A and A×β,and β and A×β, respectively. Conclusions RT-MCE with multi-indexes has a valuable application for assessment of CAD. The severity of CAD could be evaluated by RT-MCE.

Objective To investigate the effects of puerarin(Pur)on myocardial perfusion and ventricular wall motion in patients withacute coronary syndrome(ACS).Methods Thirty-seven patients with ACS were randomly divided into two groups:conventionaltreatment group(n=17,11 males,range of age:32-80 years,average age:60.9±4.9 years)and Purtreatment group(n=20,12 males,rangeof age:40-76 years.average age:62.7±3.5 years).Patients in the conventional treatment group received standard treatment according tothe current guidelines,while patients in the Pur treatment group received intravenous administration of Pur(500 mg/day)for 10 daysplus conventional treatment.Real-time myocardial contrast echocardiography (RT-MCE) was performed to evaluate the change inmyocardial perfusion index (MPI)and veiltricular wall motion index(VWMI)at admission and 10 days after treatment.Results At10 days after treatment,MPI was significantly higher(P＜0.01)and VWMI significantly lower(P＜0.01)in the Pur group comparingwith those in the conventional group.Conclusions Puerarin might improve myocardial microcirculation perfusion and ventricularwall motion in patients with ACS.

AIM:To investigate the effects of Akt1 gene transfection into myocardium after ischemia-reperfusion (I/R) on mitochondrial permeability transition. METHODS:Forty adult male SD rats were divided randomly into five groups with 8 rats each:control group,I/R group,Ad-gene group,Ad-blank group and Ad-inhibitor group. The rats in Ad-gene group were injected with 30 μL Lipofectamine 2000 solution including Akt1 gene to the myocardium 48 h before ischemia while those in control group and I/R group were injected with PBS of the same volume. Rats in Ad-blank group were injected with Lipofectamine 2000 of the same volume into myocardium. In Ad-inhibitor group 30 μL Lipofectamine 2000 and gene complexes with LY294002 were injected. Hemodynamics,apoptotic index,the concentrations of lactate dehydrogenase,creatine kinase,the expression of Akt1,cytosolic,mitochondrial cytochrome C and MPT were also measured. RESULTS:The lowest level of Akt1 protein expression was observed in control group. The protein expression of Akt1 in Ad-gene group was higher than that in I/R group,Ad-blank group and Ad-inhibitor group. The AI,LDH and CK in Ad-gene group were significantly lower than those in other groups except control group. Transfection of Akt1 markedly reduced the loss of mitochondrial cytochome C after I/R injury. Ad-gene transfection led to a significant increase in absorbance at 540 nm compared to I/R group,Ad - black group and Ad-inhibitor group (P<0.05). CONCLUSION:Akt1 gene prevents myocardial apoptosis after I/R injury. Akt1 gene also inhibits the opening of mitochondria permeability transition and protects mitochondrial functions of myocardium in I/R injury.

Objective: To investigate the causal relationship between junior high school students aggressive behavior, physical exercise and academic performance, so as to provide a reference basis for the development of scientific exercise programs. Methods: A longitudinal followup study was conducted on 502 junior high school students over a 12month period from June 2021 to June 2022 using the Buss-Perry Aggressive Questionnaire (BPAQ), Physical Activity Questionnaire for Adolescents (PAQ-A), and test scores as the measurement tools (T1:June 2021, T2:December 2021, T3:June 2022), and a crosslagged model was constructed to measure the relationship between aggression, physical activity and academic performance. Results: At T1, physical exercise had a positive effect on academic performance at T2 (β=0.22) and a negative effect on aggressive behavior at T2 (β=-0.13), aggressive behavior negatively affected academic performance at T2 (β=-0.23), and academic performance had a negative effect on aggressive behavior at T2 (β=-0.09). Physical exercise at T2 had a negative effect on aggressive behavior at T3 (β=-0.05) and a positive effect on academic performance at T3 (β=0.19). Aggressive behavior at T2 negatively influenced academic performance at T3 (β=-0.08). Academic performance at T2 negatively influenced aggressive behavior at T3 (β=-0.06) (P<0.05). The results of crosslagged modeling of junior high school students aggressive behavior, physical exercise and academic performance showed that the model was well fitted (χ2/df=8.80, CFI=0.96, NFI=0.95, RFI=0.87, IFI=0.96, TLI=0.88, RMSEA=0.12). The results of multigroup structural equation modeling showed that the differences between the models and the baseline model (CFI=0.95, TLI=0.86, RMSEA=0.10, 90%CI=0.08-0.11, P<0.01) were not statistically significant in terms of gender (△CFI<0.05, P>0.05). Conclusions Physical exercise negatively predictes aggressive behavior and positively predictes academic performance, and academic performance and aggressive behavior negatively affect each other. A scientific exercise program should be developed to reduce aggression and effectively improve adolescents academic performance.

Objective To investigate the predictive value of systemic immune-inflammation index(SII)and N-terminal pro-brain natriuretic peptide(NT-proBNP)level in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)developing contrast-induced acute kidney injury(CIAKI)after PCI.Methods A total of 1085 elderly STEMI patients undergoing emergency PCI in the Affiliated Hospital of Xuzhou Medical University from January 2018 to March 2023 were consecutively recruited as a training set,and another 287 elderly STEMI pa-tients receiving emergency PCI in the East Branch of the Affiliated Hospital from January 2021 to June 2023 were included as a verification set.According to the diagnostic criteria of CIAKI,they were divided into CIAKI group(n=95)and non-CIAKI group(n=990).Based on the results of restricted cubic spline(RCS)analysis,the patients from the training set were assigned into low-risk subgroup(n=292),moderate-risk group(n=515)and high-risk group(n=278).Multivari-ate logistic regression analysis was used to analyze the independent risk factors of CIAKI in elder-ly STEMI patients after PCI,and ROC curve was plotted to analyze the predictive value of combi-nation of SII and NT-proBNP.The risk of CIAKI was compared among the patients at different risk grades.Results Age,SII,baseline serum creatinine,NT-proBNP,fasting blood glucose and use of diuretics were independent risk factors for CIAKI after primary PCI in elderly STEMI patients(P＜0.05,P＜0.01).The AUC value of SII combined with NT-proBNP in predicting CIAKI was 0.801(95％CI:0.761-0.842,P＜0.01),with a sensitivity of 83.2％and a specificity of 67.5％,both superior to that of SII or NT-proBNP alone.RCS analysis revealed an increased risk of CIAKI at SII ≥1084.97 × 109/L and NT-proBNP ≥296.12 ng/L.The incidence of CIAKI was increased with the increase of risk grades(1.71％vs 6.41％vs 20.50％).Conclusion SII and NT-proBNP are independent risk factors for CIAKI after emergency PCI in elderly STEMI pa-tients.And their combination has better predictive value for CIAKI.

Rats ; Animals ; Myocardial Reperfusion Injury/metabolism* ; Luteolin/metabolism* ; Down-Regulation ; Rats, Sprague-Dawley ; MicroRNAs/metabolism* ; Reperfusion Injury ; Apoptosis