BACKGROUND: Peroxisome proliferator-activated receptor-gamma(PPAR-γ) can restrain the inflammatory reaction of hypertrophic myocardium through restraining the expression of interleukin-6, cyclooxygenase, endothelin-1, nitricoxide synthase, matrix metalIoproteinase-9, gelatinase and adhesion molecule, etc.OBJECTIVE: To observe the influence of rosiglitazone sodium(the ligand for PPAR-γ) on inflammatory factors in rats with myocardial hypertrophy in the course of myocardial hypertrophy resulting from pressure load.DESIGN: Randomized controlled trial based on animals.SETTING: Department of Cardiovascular Surgery, Xinqiao Affiliated Hospital, the Third Military Medical University of Chinese PLA.MATERIALS: Fifty purebred male SD rats of S.P.F. Grade, whose body mass was (220±22) g.METHODS: The experiment was completed in the Institute of Battle Surgical Research, the Third Military Medical University of Chinese PLA from August 2004 to October 2005. Fifty rats were randomly divided into 5groups: control group, sham operation-normal saline group, sham operationrosiglitazone group, myocardial hypertrophy-normal saline group and myocardial hypertrophy-rosiglitazone group, 10 rats per group. The rat model of myocardial hypertrophy induced by pressure overload was established with the method of coarctation of abdominal aorta. Rosiglitazone group: At the postoperative 4th week, the rats were injected intraperitoneally with the Normal saline group: At the postoperative 4th week, the rats were injected intraperitoneally with normal saline[1 mL/(kg.d)] for 1 week. At the postoperative 5th week, the indexes of myocardial hypertrophy and hemodynamics were determined. The contents of tumor necrosis factor-α, platelet activating factor and myeloperoxidase in the left ventricle muscle were determined with radioimmunosorbent technique. The expression of PPAR-γ mRNA was detected with RT-polymerase chain reaction. The activity of nuclear factor-κB was detected with EMSA.MAIN OUTCOME MEASURES: The indexes of hemodynamics, cardiac ventricle reconstitution and cardiac muscle in the rat models.RESULTS: Except 1 rat in the control group died of the external injury induced by biting after 3 weeks, 49 of 50 rats entered the result analysis.①After the coarctation of aorta, the contents of tumor necrosis factor-α, platelet activating factor and myeloperoxidase of hypertrophic myocardium in the myocardial hypertrophy-rosiglitazone group were lower significantly than those in the myocardial hypertrophy-normal saline group(P ＜ 0.01-0.05), but they were still higher than those in the control group(P＜0.01).②The expressions of PPAR-γ mRNA of myocardial tissue in both the myocardial hypertrophy-rosiglitazone and myocardial hypertrophy-normal saline groups were higher obviously than those in the control group(P＜0.01), and those in the myocardial hypertrophy-rosiglitazone group were higher than those in the myocardial hypertrophy-normal saline group(P＜0.01).③The activity of nuclear factor-κB combined with DNA in cardiac muscle cell in both the myocardial hypertrophy-normal saline and myocardial hypertrophy-rosiglitazone groups were higher obviously than those in the control group (P＜0.01), and those in the myocardial hypertrophy-rosiglitazone group were lower obviously than those in the myocardial hypertrophy-normal saline group(P＜0.01).CONCLUSION: The increasing of pressure load induces myocardial hy pertrophy. The activation of nuclear factor-κB in the tissue of hypertrophic myocardium is strengthened obviously. The expressions of tumor necrosis factor-α, platelet activating factor and myeloperoxidase in hypertrophic myocardium increase. This inflammatory reaction, which is strengthened obviously, can be restrained by rosiglitazone sodium that is the synthetical lig and for PPAR-γ.

Objective To investigate the effects of rosiglitazone, an synthetic ligand of peroxisome proliferator activated receptor-?(PPAR-?) on the expression of proinflammatory factors in rats of myocardial hypertrophy. Methods The rat model of hypertrophy were established by coarctation of abdominal aorta in male SD rats, and the rats with myocardial hypertrophy were treated with rosiglitazone or physiological saline (n=10 for each therapy). Some rats underwent sham operation and were given rosiglitazone or physiological saline (n=10 for each therapy). Rosiglitazone at the dose of 4 mg?kg -1?d -1 or saline of 1 ml?kg -1?d -1 was given intraperitoneally for 1 week after postoperative 4 weeks. Another 9 rats served as control. Hemodynamics, ventricular hypertrophic index, TNF-?, PAF, MPD, PPAR-? and NF-?B were detected in all rats at postoperative 5 week. Results Significant hypertrophy was found in the left ventricle in rats undergoing the coarctation of abdominal aorta. The myocardium level of TNF-?, PAF, MPD was higher in rats with myocardial hypertrophy than in rats undergoing sham operation at postoperative 5 weeks (P

0.05).Platelet aggregation was decreased on the 2nd postoperative day and significantly increased on the 4th postoperative day (P

Objective To study the effects and mechanisms of growth hormone(GH) pretreatment on the inflammatory response of liver in rats after cardiopulmonary bypass(CPB).Methods The CPB model in rat was established.The rats were randomly divided into GH pretreatment group(GH group),CPB group,and sham group.The serum levels of endotoxin,TNF-?,and liver function were determined at different intervals respectively.Simultaneously,the liver tissues were collected for the detection of the CD14 mRNA and TNF-? mRNA by RT-PCR.Results Compared with pre-CPB,the serum levels of endotoxin,TNF-? were significantly increased,and the lesion of liver function was apparent in GH group and CPB group.Meanwhile,the expression of CD14 mRNA and TNF-? mRNA in liver tissues were also increased obviously in both groups.However,the serum levels of endotoxin and TNF-? and the expression of CD14 mRNA and TNF-? mRNA in liver tissues at the same time point in GH group were significantly lower than those in CPB group(P

Objective To review retrospectively the clinical experience in surgical treatment of congenital subaortic stenosis in 21 cases. Methods A total of 21 cases of congenital subaortic stenosis, including 12 cases of diaphragmatic type of stenosis and 9 cases of cast constriction, underwent intracardiac surgery from January 1999 to June 2003. Simple resection of stenosis membrane was performed in 12 cases, simple resection of stenosis membrane plus resection of myocardium of left ventricle outflow tract in 9 cases, simple resection of stenosis membrane plus resection of myocardium of left ventricle outflow tract plus treatment of united cardiac monstrosity in 16 case. Results No operative death and complications were found in all patients. Disappearance of cardiac murmur was found in 15 cases and diminishment of cardiac murmur in the rest of the patients after operation. A follow up time for 6 months to 2 years revealed that there were no obvious clinical symptoms, and the surgical outcomes were satisfactory. The cardiac ultrasound suggested that the left ventricular outflow tract was fluent without recurrent constriction. Conclusion Early treatment of congenital subaortic stenosis should be conducted when the disease was diagnosed. Better knowledge of pathological anatomy, proper operation, and prevention of complications are essential.

Obiective To investigate the influence of rapid atrial pacing(RAP)on the expression of ?1c subunit of L-type calcium channel,and the protective effect of verapamil.Methods 30 rabbits were randomly assigned into RAP group and verapamil pre-conditioned group.Each group was further divided into 5 subgroups(n=3 for each subgroup).Electrode was embedded in the right atrium through right external jugular vein.Pacing was performed for 6h,12h,24h and 48h in different subgroups.No pacing in the sham operation group.For verapamil pre-conditioned group,the drug was intravenously administered(0.2mg/kg)30 minutes before the initiation of rapid atrial pacing.Right atrium tissue was harvested for determination of mRNA and protein expression of L-type calcium channel subunits by reverse transcription polymerase chain reaction(RT-PCR)and Western blot.Results The mRNA level of ?1c subunit started to be reduced 6h after rapid atrial pacing(RAP)and continued to decline as pacing continued,and the expression of protein was parallel with mRNA.Otherwise,the mRNA level of ?1c subunit started to decrease 24h after RAP and continued to decline while pacing continued,and the expression of protein paralleled with that of mRNA in verapamil pre-conditioned group.Verapamil can attenuate the down-regulation of L-type calcium channel of the atrium induced by RAP only at 24h after RAP,but the effect was less intent.Conclusion mRNA and protein expression level of L-type calcium channel subunits decreased after RAP,The calcium channel blocker verapamil can attenuate the down-regulation of L-type calcium channel of atrium induced by RAP resulting in a decrease or postponement of calcium overload in atrial myocytes,thus exerting protective effects on atrial electrical remodeling,but such effects vanished after prolonged pacing.

Objective To observe the localization and expression of hepatocyte growth factor(HGF),c-Met and Caspase-3 in pulmonary arterioles during the formation process of pulmonary arterial hypertension(PAH) induced by left to right shunt in rats,and explore the effect of HGF and c-Met in the formative process of PAH.Methods Eighty male SD rats(aged 4-5 weeks) were randomly divided into control group and shunt group(40 each).Rats in shunt group underwent right common carotid artery-external jugular vein shunt with cannulation to reproduce PAH model of left to right shunt,and animals in control group only received sham operation.Pulmonary hemodynamic and pathologic examination were performed 4,8,12 and 16 weeks after operation in both groups,while the expression of HGF,c-Met and Caspase-3 proteins in pulmonary arterioles were determined by immunohistochemisty at the above time points.Results Pulmonary artery systolic pressure(PASP),mean pulmonary arterial pressure(mPAP) and the ratio of pulmonary to systemic circulation flow(Qp/Qs) were obviously increased in rats with A-V shunt compared with controls at all time points after operation(P

Objective To investigate the role of cell apoptosis in the gut mucosal barrier dysfunction in rats undergoing cardiopulmonary bypass(CPB) . Methods The rat model of CPB was set up. The rats were divided into CPB group, sham operation(SO) group and normal control group. The morphological changes of ileum mucosal tissues were observed by microscope and electron microscope at 3h, 6h, 12h and 24h after operation, respectively. The apoptotic index of gut mucosal epithelial cells was measured with TUNEL method. Results Gut mucosal morphology was normal in CPB group at 3h, 6h and 12h after operation, but gut mucosal epithelial desquamation occurred at 24h after operation. Typical apoptotic cells could be seen with electron microscope in CPB group at every time point. Apoptotic index of gut mucosal epithelial cells significantly increased in CPB group at every time point compared with SO group, and peaked at 6h after operation. Apoptotic cells were mostly located in the gut crypt. Conclusion The data suggested that the apoptosis of intestinal epithelial cells significantly increased at early stage of post-CPB in rats, which might contribute to gut mucosal barrier dysfunction.

AIM: To investigate the effect of chronic atrial fibrillation (AF) on free calcium concentration and expression of Ca 2+ /calmodulin dependent protein kinase Ⅱ (CaMKⅡ) in human atrial myocytes. METHODS: The intracellular free calcium concentration in acute isolated atrial myocytes and the expression of CaMKⅡ in atrial tissue of rheumatic heart disease patients with atrial fibrillation (AF) and with normal sinus rhythm were measured by laser scanning cofocal microscopy technique and Western blotting, respectively. RESULTS: The intracellular Ca 2+ concentration in patients with atrial fibrillation was significantly higher than that in patients with normal sinus rhythm [(276.38?38.12) nmol/L vs (122.28?45.63) nmol/L, P

Objective To evaluate the effects of selected decontamination of the digestive tract(SDD) on intestinal derived endotoxmia,inflammation mediator and clinical outcome in patients of rheumatic heart disease undergoing valve replacement operation with cardiopulmonary bypass(CPB).Methods Thirty patients with CPB were randomly divided into control group(n=15) and treatment group(SDD group,n=15).The patients in control group routinely took preoperative preparation while those in treatment group orally administrated Tobramycin 100 mg,garlicin 40 mg and Lactulose 10ml three times per day in addition to routinely preoperative bowel preparation.The levels of endotoxin,D-lactate,TNF-? and complement 3 were measured at four time points of anesthetic induction,CPB end,2 h and 24 h after CPB.Results The level of D-lactate in the patients of SDD group was significantly lower than that of the control group at time points of anesthetic induction and 2 h after CPB(P0.05).Conclusion The endotoxemia can be induced by CPB.The regime of SDD is an effective way of preventing endotoxemia,but it may not have effect on inflammation medium and clinical outcome.