Objective To evaluate the safety and efficacy of distal protection device(GuardWire PlusTM) during high risk PCI in patients with acute myocardial infarction(AMI).Methods Seventy-two patients with AMI admitted from September 2004 to May 2006 who received PCI were categotized into the GuardWire PlusTM group(GW group,n=38) and the conventional guidewire group(NGW group,n=34) according to the device used.The basic clinical characteristics,angiographic results,degree ST of resolution and changes in serum CK-MB and cTnI levels were compared.LVEF was measured by echocardiography at discharge and again at 3 months after PCI.Results All the distal protection deveices were applied successfully in the GW group.A greater percentage of patients in the GW group had post procedural ST-segment resolution ≥50% compared with the NGW group(68.4% vs 41.2%,P

Objective To discuss the relationship between leptin level and polycystic ovary syndrome (PCOS) in adolescent patients with polycystic ovary syndrome, and to explore the classification diagnosis method of adolescent PCOS and indicator for clinical monitoring of obese patients. Methods All enrolled adolescent individuals were assigned into four groups: 30 normal adolescent individuals in the control group, 30 simple adolescent obese individuals in the simple obesity group,27 obese adolescent PCOS patients in the obese PCOS group and 14 nonobese adolescent PCOS patients in the nonobese PCOS group. The fasting serum samples were prepared for leptin level measurement and analysis, Results The serum leptin level of in the control group, the simple obesity group, the obese PCOS group and the nonobese PCOS group were ( 19.44 ± 6. 63 ) μg/L vs.(23.09 ±7. 39) μg/L, (42. 99 ±9. 83) μg/L and (31, 92 ±7, 02) μg/L,respectively. Leptin in the obese PCOS group was significantly higher than that in the control group and the simple obese group (t = 2. 903 and 2. 714 respectively,Ps ＜ 0. 05 ). Conclusion Monitoring the serum level of leptin can not only aid the classification of adolescent PCOS patients and guide the treatment, but also can serve as a indicator for therapeutic monitoring of obese adolescent PCOS.

Objective To investigate the effects of penehyclidine hydrochloride on blood-brain barrier in a rat model of cardiopulmonary bypass ( CPB) . Methods Sixty adult male SD rats, aged 4-6 months, weighing 320- 370 g, were randomly divided into 5 groups ( n = 12 each) : sham operation group (group S), CPB group, and low-, median- and high-dose penehyclidine hydrochloride groups (groups LP, MP and HP). The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg, intubated and mechanically ventilated. The femoral and jugular arteries and jugular vein were cannulated. CPB was performed for 60 min. Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in groups LP, MP and HP respectively, while the equal volume of normal saline was added in group CPB. Evans blue was injected via femoral vein at 1 h before the animals were sacrificed. Six rats in each group were sacrificed, their brains immediately removed and the hippocampi isolated for determination of Evans blue content. The other rats were sacrificed and the hippocampi isolated to determine the water content and observe the ultrastructure of blood-brain barrier. Results Compared with group S, the Evans blue content and water content were significantly increased in the other groups ( P ＜ 0.05) . Compared with groups CPB and LP, the Evans blue content and water content were significantly decreased in groups MP and HP ( P ＜ 0.05) . The Evans blue content was significantly lower in group HP than in group MP ( P ＜ 0.05). The CPB-induced changes were significantly attenuated in groups MP and HP compared with groups CPB and LP. Conclusion Penehyclidine hydrochloride can protect blood-brain barrier against the CPB-induced injury and the effect is related to the dose.

Objective To investigate the effect of penehyclidine hydrochloride on brain injury induced by cardiopulmonary bypass (CPB) in rats. Methods Thirty adult male SD rats were randomly divided into 5 groups ( n = 6 each): sham operation group (group S), CPB group, and low, median and high dose penehyclidine hydrochloride groups (group PL, PM , PH). Penehyclidine hydrochloride 0.2, 0.6 and 2.0 mg/kg were added to the priming solution in group PL, PM and PH respectively, while the equal volume of normal saline was added instead in group S. Blood samples were obtained at 2 h after termination of CPB to determine the plasma concentrations of neuron specific enolase (NSE) and S-100β protein. The brain tissues were taken to observe the ultrastructure of hippocampal neurons with electron microscope. Results The concentrations of NSE and S-100β protein were significantly higher in the other groups than in group S, while lower in group PM and PH than in group CPB and PL( P＜ 0.05). The S-100β protein concentration was significantly lower in group PH than in group PM( P ＜ 0.05). The damage to hippocampal neurons was significantly attenuated in group PM and Ps. Conclusion Penehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced brain injury in a dose-dependent manner in rats.

Object To find out which of the 27 ginsenosides isolated from Panax ginseng C A Mey that may inhibit the proliferation of human osteosarcoma cell line U 2OS Methods Effects of each individual ginsenoside on the proliferation of U 2OS cell were studied by determining the viability of cancer cells during culture with or without the presence of the test compound DNA assay was determined by flow cytometry Results Ginsonosides Ro, Rh 1, Rh 2, F 1 and L 8 at concentrations of 5 ?mol/L could obviously suppress the proliferation of U 2OS cells while ginsenosides Rg 1, F 3, Rf, PPT and PT significantly inhibited the cancer cells Flow cytometry revealed that ginsenosides Ro, Rg 1, Rf, F 1, Rh 2 ,PPT and PT induced cell cycle arrest at G 0/G 1 phase with obvious decrease of cell count at S and G 2+M phase Moreover, ginsenosides Rf 1, Rg 1, F 1 and PPT induced significantly high rates of cell death as compared with the control Conclusion These data suggested that ginsenosides inhibited U 2OS proliferation via cell cycle arrest or induction of cell death

Objective To investigate the effects of cardiopulmonary bypass (CPB) on the expression of tight junction protein occludin in rat lung tissues.Methods Twenty adult male Sprague-Dawley rats were randomly divided into 2 groups (n=10 each): sham operation group (group S) and CPBgroup.The rats underwent 1 h of CPB and were observed 2 h later in group CPB.The lung water content,neutrophil percentage and protein concentration in bronchoalveolar lavage fluid (BALF) were measured.The expression of occludin in lung tissues was detected by immunohistochemistry and Western-blot analysis.The ultrastructure of alveolar epithelial barrier was observed with transmission electron microscope.Results Compared with group S,the lung water content,protein concentration in BALF and neutrophil percentage were significantly increased (P ＜ 0.05),the expression of occludin in lung tissues was significantly down-regulated (P ＜ 0.05) and the damage to alveolar epithelial barrier was aggravated in group CPB.Conclusion The expression of occludin in lung tissues is down-regulated and the damage to alveolar epithelial barrier is induced after CPB,which may be one of the important factors in acute lung injury induced by CPB.

Objective To investigate the effect of monosialoganglioside GM-1 on cardiopulmonary bypass (CPB)-induced brain injury in rats.Methods Twenty-seven adult male Sprague-Dawley rats,weighing 350-450 g,aged 15 months,were randomly divided into 3 groups (n=9 each): control group (C group),CPB group and GM-1 group.The animals were anesthetized with chloral hydrate,tracheostomized and mechanically ventilated.Right common carotid and right jugular vein were cannulated for closed-chest CPB.In groups CPB and GM-1,the rats underwent 1 h CPB.GM-1 20 mg/kg was added to the priming solution in group GM-1,while the equal volume of normal saline was given in group CPB.The animals were sacrificed at 3 h after termination of CPB or 3 h after the end of ventilation in group C,the brains were removed and the hippocampi isolated for microscopic examination and for determination of apoptosis (using TUNEL) and Bax and Bcl-2 protein expression (by immunohistochemistry and Western blot).Results Compared with group C,the number of apoptotic neurons and ratio of Bax/Bcl-2 were significantly increased,and the expression of Bcl-2 and Bax protein was up-regulated in groups CPB and GM-1 (P ＜ 0.05).Compared with group CPB,the number of apoptotic neurons and ratio of Bax/Bcl-2 were significantly decreased,the expression of Bax protein was down-regulated and the expression of Bcl-2 protein was up-regulated in group GM-1.The pathological changes were severe in group CPB and attenuated in group GM-1.Conclusion GM-1 can attenuate CPB-induced brain injury in rats and inhibition of the apoptosis in neurons may be involved in the mechanism.

Objective To study changes of neuroendocrine in patients with ST segment elevation acute myocardial infarction (STEMI) after using distal protection device (GuardWire PlusTM). Method Seventy patients with STEMI received percutaneous coronary intervention (PCI) in Municipal Hospital Qingdao, during September 2004 to December 2006. They were randomdy (random numbs) enrolled in this prospective and control study. All the patients were divided into 2 groups: the distal protection device group (GW) and the non-distal protection device group (NGW).The inclusion criteria were:onset within 6 hours, chest pain more than 30 minutes without response to nitroglycerin, two or more adjacent ST segnents elevated over 0.2 mv,the proximal or middle diameter of infarction artery over 3 mm, and the increased plasma creatine kinase. The exclusion criteria were fluctuation in hemodynamics, severe heart failure, arteriopathy of left main coronary artery, mechanical complications of acute myocardial infarction and multi-vessel disease scheduled for coronary artery bypass. The plasma levels of endothelin(ET) , plasma renin activity (PRA),aldosterone (ALD),angiotensin Ⅱ (Ang Ⅱ), norepinephrine (NE) and epinephrine (E) were measured on the day of operation and on the 1st,2nd,3rd and 5th day after operation, respectively. The t-test was used to compare those neuroendocrine elements between two groups. Results There were no differences in plasma levels of all the neuroendocrine elements between two groups before operation. Compared with the NGW group, the levels of neuroendocrine elements in the plasma rapidly decreased in the GW group at 1 d after the operation ( P ＜ 0.05). Conclusions In patients with ST segment elevation acute myocardial infarction, the distal protection device can decrease the changes in neuroendocrine.

ObjectiveTo investigate the effect of penehyclidine hydrochloride on acute lung injury induced by cardiopulmonary bypass (CPB) in rats.MethodsForty adult male SD rats aged 4-6 months weighing 330-420 g were randomly divided into4 groups ( n =10 each): sham operation group (group S),acute lung injury group (group ALI) and low and high dose of penehyclidine hydrochloride groups (groups PL and PH ).Penehyclidine hydrochloride 0.6 and 2.0 mg/kg were added to the priming solution in groups PL and PH,while the equal volume of normal saline was added in group ALI instead.The rats of groups ALI,PL and PH were underwent 1 h of CPB.Arterial blood samples were collected before CPB and at 2 h after CPB for blood gas analysis.The superior vera cava blood samples and lung tissues were collected at 2 h after CPB for determination of concentrations of TNF-α and IL-6,lung tissue contents of water and malondialdehyde (MDA) and activity of glutathione peroxidase (GSH-px).The pathological change of lung tissue was also examined.ResultsCompared with group S,PaO2 was significantly decreased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were increased,while activity of GSH-px in lung tissues was decreased in groups ALI,PL and PH ( R ＜ 0.05).Compared with group ALI,PaO2 was significantly increased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were decreased,activity of GSH-px in lung tissues was increased (P ＜ 0.05),and the pathological change was reduced in groups PL and PH.Compared with group PL,PaO2 was significantly increased at 2 h after CPB,plasma concentrations of TNF-α and IL-6 and contents of water and MDA in lung tissues were decreased,activity of GSH-px in lung tissues was increased ( P ＜0.05),and the pathological change was reduced more obviously in group PH.ConclusionPenehyclidine hydrochloride 0.6 or 2.0 mg/kg can reduce the CPB-induced lung injury in a dose-dependent manner by antioxidant and anti-inflammatory mechanism in rats.

BACKGROUND: Currently, most of the clinical trials of cell transplantation for ischemic heart disease is the transplantation of bone marrow mononuclear cells through the bypass graft artery in patients with acute myocardial infarction, but reports in combination with cell transplantation for old myocardial infarction are few. OBJECTIVE: To investigate the safety and feasibility of intracoronary artery injection of bone marrow mononuclear cells through the bypass graft artery during coronary artery bypass grafting (CABG). DESIGN: Self-control and case analysis. PARTICIPANTS: A total of 10 patients who had old myocardial infarction, left ventricular ejection fraction (LVEF)≤40%, were selected from Cardiovascular Institute and Fuwai Hospital from November 2004 to June 2005. METHODS: The bone marrow mononuclear cells were harvested from the bone marrow by Ficoll density gradient centrifugation method before the CABG was carried. And the patients received CABG and 10 mL mononuclear cell suspension through the grafts into anterior descending branch. In addition, 10 mL mononuclear cell suspension was injected into the circumflex branch and right coronary artery through the proximal heart. MAIN OUTCOME MEASURES: The heart function was evaluated with transthoracic echocardiography (TEE) and cardiac MRI after the operation. RESULTS: All patients recovered. A total of 45-60 mL bone marrow was harvested from iliac crest, and 4.1 ×10~7 mononuclear cells were isolated and identified by trypan blue test (cell activity >95%). TEE showed that the LVEF at 1 week and 1, 3 months postoperatively was significantly improved compared with before operation; creatase arid troponin T were not increased, and no myocardial infarction changes were found. MRI showed that the LVEF was significantly increased following operation (P < 0.01); left ventricular end-diastolic and systolic diameters were significantly decreased (P < 0.05). There was no complication associating with bone marrow harvest, or cell transplantation. CONCLUSION: Bone marrow mononuclear cells transplantation through bypass graft, as an adjunctive therapy, is safe and feasible.