Objective To study the effects of aged and exercise training on hydroxylysylpyridinoline (HP) crosslinking concentrations of extracellular matrix in right ventricular (RV),left ventricular septum (LVS) and left ventricular free-wall (LVFW) in Fischer 344 rats.Methods We evaluated HP crosslinking concentrations of RV,LVS and LVFW extracellular matrix in young adult versus old Fischer 344 rats using high-pressure liquid chromatography (HPLC).Rats were assigned to either a sedentary control group or an exercise training group.Results HP crosslinking concentrations in LVS [(0.23±0.01) vs.(0.43±0.03)mol HP/mol Col,P＜0.05] and LVFW [(0.22±0.05) vs.(0.51±0.03) mol HP/mol Col,P＜0.05] in old sedentary control rats were elevated compared with adult sedentary rats.In adult exercise training rats,training had no effect on HP crosslinking concentration in any of the three regions of the heart.As compared with old sedentary rats,HP crosslinking concentrations in LVS [(0.22±0.06) mol HP/mol Col vs.(0.43±0.03)mol HP/mol Col,P＜0.05] and LVFW[(0.21±0.07)mol HP/mol Col vs.(0.51±0.03) mol HP/mol Col,P＜0.05] were decreased in old exercise training rats.Conclusions HP crosslinking concentration are increased with aging in LVS and LVFW of rats,and exercise can prevente this age associated change.

Objective To study the relationship of left-ventricular function change with circulation levels of CD34+ cells,toll like receptor 2 (TLR2),TLR4 and high sensitivity C-reactive protein (hs-CRP)in elderly isolated systolic hypertension.Methods According to New York Heart Association (NYHA)class,left ventricular ejection fraction (LVEF) and systolic blood pressure (SBP),the healthy subjects and the patients were divided into 5 groups:control 30 cases,class Ⅰ 25 cases,class Ⅱ 29 cases,class Ⅲ 24 cases and class Ⅳ 20 cases.The expressions of circulating CD34 + cells,TLR2 and TLR4 in the patients and healthy subjects were measured by flow cytometry.The level of hs CRP was measured by nephelometry immunoassay.Results In class Ⅳ versus class Ⅰ,the levels of LVEF[(26.4±2.1)％vs.(40.5±3.6)％]and CD346 [(0.5±0.2) × 109 vs.(2.5±0.4) ×109 /L]were decreased,while SBP[(211.1±8.4)mm Hg vs.(151.1±5.9)mm Hg],TLR2 [(8.0±1.0) vs.(3.2±1.1)MFI],TLR4 [(6.4±1.3)MFT vs.(2.4±1.1)MFI]and hs-CRP [(14.7±0.3)mg/L vs.(4.9±0.6)mg/L]were increased (all P＜0.05).Conclusions The lower levels of CD34+ cells,higher TLR2,TLR4 and hs CRP levels are correlated with increasing SBP,decreasing LVEF and higher NYHA class.

Objective To study the effect of overexpression of tumor necrosis factor-α (TNFα) in failing heart on contractile function of mouse diaphragm. Methods Diaphragms excised from transgenic mice with cardiac specific overexpression of TNF-α and from wild-type littermate controls were studied in vitro with direct electrical stimulation. Cytosolic oxidant levels were measured with 2',7'-dichlorofluorescin diacetate (DCFH-DA). Emissions of the oxidized product were detected by fluorescence microscopy. Results The diaphragm contractile force in transgenic animals with heart failure was 47% less than in controls [(13. 2±0. 8) N/cm2 vs. (25.1±0. 6) N/cm2 , P＜O. 01]. The weakness was associated with greater intracellular oxidant levels (P＜0. 05) and was partially reversed by 30-minute incubation with the antioxidant N-acetylcysteine (NAC) 10 mmol/L ( P ＜ 0. 01 ).Exogenous TNF-a 500 mmol/L increased oxidant production in diaphragm of wild-type mice and caused weakness that was inhibited by NAC. Conclusions Overexpression of TNF in failing heart causes oxidative stress which leads contractile dysfunction in mouse diaphragm.

Objective To explore the correlation of mimecan/osteoglycin withnuclear factor koppa B(NF-κB) and P53 in peripheral arterial disease (PAD) and PAD combined with type 2 diabetes in the elderly.Methods 120 patients with PAD and 60 healthy controls were enrolled in this study.PAD patients were divided into PAD group (n=60) and PAD combined with type 2 diabetes group (n =60) according to clinical diagnostic criteria.Patients in PAD group were divided into class Ⅰ (n=15),class Ⅱ (n=15),class Ⅲ (n=15) and class Ⅳ (n=15),and patients in PAD combined with type 2 diabetes group were divided to class Ⅰ (n=14),class Ⅱ (n=15),class Ⅲ (n=16) and class Ⅳ (n=15) according to Fontaine's classification.The levels of NF-κB,P53 and mimecan in peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA).Results The levels of NF-κB,P53 and mimecan were significantly increased in PAD combined with type 2 diabetes group as compared with PAD and control groups [NF-κB..(32.8±5.3) mg/L vs.(19.8±4.2) mg/L,(26.3 ±4.8) mg/L; P53:(3.4±1.3) mg/Lvs.(2.5±1.1) mg/L,(1.4±0.8) mg/L; mimecan:(16.4 ±0.8) mg/L vs.(10.3±0.8) mg/L,(4.8±0.6) mg/L; all P＜0.05].There were significant differences in the levels of NF-κB,P53 and mimecan in class Ⅰ,class Ⅱ,class Ⅲ and class Ⅳ in PAD group [NF-κB:(20.3±3.1) mg/L,(24.5±3.4) mg/L,(28.2±4.6) mg/L and (34.2±5.3) mg/L; P53:(2.2 ±1.8) mg/L,(2.6±1.8) mg/L,(3.3±1.9) mg/L and (3.7±2.7) mg/L;mimecan (8.9±2.6) mg/L,(12.4±1.8) mg/L,(15.6±1.5) mg/L and (17.7±1.6) mg/L; all P ＜0.05].There were significant differences in the levels of NF-κB,P53 and mimecan in class Ⅰ,class Ⅱ,class Ⅲ and class Ⅳ in PAD group combined with type 2 diabetes group [NF-κB:(25.5±4.2) mg/L,(28.8±3.7) mg/L,(33.4±5.6) mg/L and (38.5±4.7) mg/L; P53:(2.5±1.1)mg/L,(2.9±1.0)mg/L,(3.7±1.2)mg/L and(4.6±1.3)mg/L; mimecan:(11.7±2.4)mg/L,(14.9± 1.8)mg/L,(17.4±2.5)mg/L and(20.7±2.8)mg/L; all P＜0.05].The levels of NF-κB,P53 and mimecan was increased with the aggravation of PAD (all P＜0.05).Conclusions The increased levels of NF-κB and P53 are correlated with the increase in mimecan level and Fontaine's classification.

Objective To study the relationship of levels of circulating endothelial microparticles (EMP62E, EMP31) and high-sensitivity C-reactive protein (hs-CRP) with severity of chronic left heart failure in elderly patients. Methods According to New York Heart Association (NYHA) class and left ventricular ejection fraction (LVEF), the healthy subjects and the patients were divided into five groups: control group [LVEF: (63.97±4.65)%], classⅠ group [LVEF: (42.67±2.06)%], classⅡ group [LVEF: (34.26±3.17)%], class Ⅲ group [LVEF: (29.05±1.07)%] and class Ⅳ group[ LVEF:(25.17±1.42)%] . The levels of circulating EMP62E, EMP31 and hs-CRP of the patients and healthy subjects were measured by flow cytometry and nephelometry immunoassay, respectively. Results There were significantly differences in EMP62E, EMP31 and hs-CRP between class Ⅳ group and classⅠ group P＜0.01) EMP62E [(1092.7 ± 102.8) counts/μl vs. (291.0±21.9) counts/μl], EMP31 [(1596.1±46.3) counts/μl vs. (477.8±40.3) counts/μl] and hs-CRP [(14.74±0.07) mg/L vs. (4.86 ± 0.09) mg/L]. The levels of circulating EMP62E, EMP31 and hs-CRP were gradually elevated significantly along with the increased severity of chronic left heart failure in elderly. Conclusions The upregulation of circulating EMP31, EMP62E and hs-CRP may contribute to the development of chronic heart failure in elderly.

Objective To observe the effect of changes in CD34+ cell level on various degrees of chronic heart failure (CHF) in the elderly. Methods The enrolled patients were divided into four CHF groups according to the New York Heare Association(NYHA) functional class: NYHA class I (n=23), Ⅱ (n=27), Ⅲ (n = 20) and IV group (n= 16) , and there were 41 healthy controls over the same period. The levels of peripheral blood CD34+ cells were measured, and the tumor necrosis factor-α (TNF-α). its soluble receptors (sTNFR-1 and sTNFR-2) and vascular endothelial growth factor (VEGF) were also measured. Results The levels of CD34+ cells were elevated in the early CHF and depressed in the advanced CHF in elderly patients. The levels of CD34+ cells were (0. 6± 0.2) 109/L in control group, (2.4±0. 4) 109/L in NYHA class I group, (1.9±0.2)×109/L in NYHA class Ⅱ group, (1.3±0.1)×109/L in NYHA class Ⅲ group and (0.5±0.2)×109/L in NYHA class Ⅳ group, respectively (all P<0.01).And TNF-α, sTNFR-1, sTNFR-2 and VEGF were increased in severe chronic left ventricular failure CNYHA class IV vs. I group:TNF-α: (61.4± 15.7) ng/L vs. (28.4±10.8)ng/L; sTNFR-1: (2820.9±1282.8)ng/L vs. (690.8±62.7) ng/L; sTNFR-2: (4113.1±1102.2) ng/L vs. (740.8± 112.3)ng/L; VEGF: (996.3±487.1)ng/L vs. (423. 3±147. 9)ng/L, all P<0. 013. Conclusions The changes of CD34+ cell level may predict various degrees of chronic heart failure in elderly patients.

Objective To study the changes in expression of high-sensitivity C-reactive protein (hsCRP),glutathione S-transferase Pi(GSTPi)and annexin A5 (AnxA5)in elderly patients with old myocardial infarction and the clinical significance.Methods Serum levels of GSTPi and AnxA5 were measured by ELISA and the level of hs-CRP was measured by immunoturbidimetry in elderly patients with old myocardial infarction (n =185)from December 2012 to November 2015.Results Along with the increasing coronary artery stenosis,GSTPi level was decreased and AnxA5/hs-CRP levels were increased in elderly patients with old myocardial infarction.In comparison between coronary artery stenosis ＞ 95％ group versus stenosis of 55％-65％ group,GSTPi was(190.0±37.0)μg/L vs.(289.0 ±86.0)μg/L,AnxA5 was(33.9±4.0)μg/L vs.(8.1 ± 2.9) μg/L,and hs-CRP was (15.3 ± 1.3) mg/L vs.(5.9 ± 0.8) mg/L with statistically significant differences(all P＜0.01).There were significant differences between LVEF 30％ group[GSTPi(198.0±39.0) μg/L,AnxA5(38.9±5.1)μg/L and hs-CRP(17.9± 1.9)mg/L]and LVEF 40％-54％ group[GSTPi(219.0± 61.0)μg/L,AnxA5 (12.9±3.9)μg/L and hs-CRP(10.1 ± 1.0) mg/L] (all P＜0.01).There were significant differences between NYHA Ⅳ group [GSTPi (171.0 ± 43.0) μg/L,AnxA5 (18.1 ± 5.0) μg/L and hs-CRP (16.9±2.1)mg/L]and NYHAⅠgroup[GSTPi(295.0±91.0)μg/L,AnxA5(7.3±3.1)μg/L and hs-CRP (7.8± 1.3)mg/L](all P＜0.01).Conclusions The expression of GSTPi,AnxA5 and hs-CRP in elderly patients with old myocardial infarction may become the new indicators to forecast the degrees of coronary artery stenosis and heart failure.

Objective To explore the unique relationship between Willis circle and cerebral watershed infarction in a Chinese population. Methods A retrospective analysis of cerebral CT angiography was conducted in 471 non-cere?bral watershed infarctions and 93 MRI-diagnosed cerebral watershed infarctions (CWI)(including External CWI and In?ternal CWI)in Department of Neurology of our hospital and compare the related variations and types of Willis circle be?tween these groups. Results Compared with non-cerebral watershed infarctions, the prevalence of Uni-FTP (short for“fetal type of the Posterior cerebral artery”) in E-CWI (36.4%, P<0.05) and Bi-FTP in I-CWI (0%, P<0.05) was signifi?cantly higher in cerebral watershed infarctions. Conclusion FTP is probably an unique risk factor in Chinese patients with CWI.

Objectives To study the predictive value of Toll-like receptors 3,4(TLR3,TLR4),fructosamine(FMN)and glycated hemoglobin A1c(HbA1c)in the in-stent restenosis and re-occlusion after primary percutaneous coronary intervention(PCI)in patients aged 70-85 years with old myocardial infarction.Methods 51 patients aged 70-85 years with in-stent restenosis after primary PCI from Jan 2007 to Sep 2016 were selected.Serum level changes in TLR3,TLR4 were detected by flow cytometry.The levels of FMN and HbA1c were tested by colorimetric endpoint reaction and high-pressure liquid chromatography respectively.Results The levels of TLR3,TLR4,FMN and HbA1c were gradually elevated along with the increases of artery numbers(0,1,2,>2)and percentage(0%,70-89%,90-99%,100%)of in-stent restenosis,LVEF(%)decrease and NYHA(Ⅰ,Ⅱ,Ⅲ,Ⅳ)increase(all P<0.01).The examples of data were selected in the following groups of artery numbers(0,1,2,>2)of in-stent restenosis in TLR3,and group of percentage(0%,70-89%,90-99%,100%)in the in-stent restenosis in TLR4,group of LVEF(%)in FMN,and group of NYHAⅠ,Ⅱ,Ⅲ,Ⅳ in HbA1c(%)(all P<0.01).The levels of TLR3(%)in artery numbers of restenosis(0,1,2,>2)groups were(7.6±0.5),(18.9±0.6),(32.0±0.9),(51.3±0.8),respectively(all P<0.01).The levels of TLR4(%)in the in-stent restenosis percentage(0%,70-89%,90-99%,100%)groups were(10.5±7.0),(20.1±7.2),(33.3±9.7),(69.0±11.3%)respectively(all P<0.01).The levels of FMN(mmol/L)in LVEF[(49~59%),(37~48%),(25~36%)]groups were(0.6±0.4),(9.4±0.6),(18.1±0.8),respectively(all P<0.01).And the level of HbA1c(%)in groups of NYHA Ⅰ,NYHA Ⅱ,NYHA Ⅲ,NYHA Ⅳ were(6.1±0.4),(5.9±0.6),(8.9±0.9),(12.0±0.8),respectively(all P<0.01).Conclusions Serum level changes in TLR3,TLR4,FMN and HbA1c may become the new indicators to forecast the degree of in-stent restenosis in very old patients with old myocardial infarction after primary coronary intervention.

Objective To study the clinical value of anti-oxidative stress biomarkers for diagnosing in-stent restenosis and in-reocclusion after coronary stent implantation in aged patients.Methods A total of 72 advanced-aged patients with in-stent restenosis and in-stent reocclusion after coronary stent implantation were successively recruited in this retrospective study from February 2010 to November 2017.Changes in serum superoxide dismutase 3(SOD3),nitric oxide(NO),endothelial cell nitric oxide synthase(eNOS)and malondialdehyde(MDA)levels were measured.Results Serum 1evels of SOD3,NO and eNOS decreased and serum MDA levels were elevated in advanced-aged patients with in-stent restenosis.There were significant differences in serum levels of SOD3,NO,eNOS and MDA between the advanced-aged patients without in-stent restenosis and the advanced-aged patients with multivessel in-stent restenosis or reocclusion[(20.0±3.2) × 103U/L vs.(10.9±3.9) ×103U/L,(61.2±14.2)μmol/L vs.(28.3±17.2)μmol/L,(75.9±24.7)ng/L vs.(33.0±119.6)ng/L,(2.2±1.4)nmol/L vs.(11.7±3.1)nmol/L,respectively,P＜0.01].Patients with 50-69％ restenosis had higher serum levels of SOD3,NO and eNOS and lower levels of MDA than patients with 100％ restenosis[(21.3 ± 2.9) × 103 U/L vs.(10.3 ± 4.0) × 103 U/L,(59.7 ± 16.7) μmol/L vs.(38.3 ±16.3)μmol/L,(74.5±21.1)ng/L vs.(41.9±26.8)ng/L,(2.6±3.9 nmol/L)vs.(10.1±3.1)nmol/L,respectively,P ＜ 0.01].Patients with left ventricular ejection fraction (LVEF) ≥ 55 ％ had higher serum levels of SOD3,NO and eNOS and lower levels of MDA than patients with LVEF＜30％ [(21.0±4.1) × 103 U/L vs.(5.3±1.9) × 103 U/L,(60.1 ± 14.2)μmol/L vs.(29.0± 13.2)μmol/L,(74.7±25.1)ng/L vs.(39.3 ± 20.3) ng/L,(2.3 ± 1.5) nmol/L vs.(10.0 ± 3.9) nmol/L,respectively,P ＜0.01].Serum levels of SOD3,NO and eNOS were higher and MDA levels were lower in patients with New York Heart Association(NYHA)Class Ⅰ than in patients with NYHA Class Ⅳ[(22.1±3.5)×103U/L vs.(9.7±2.9) × 103 U/L,(62.9± 13.9)μmol/L vs.(24.9± 13.3)μmol/L,(76.7±26.7) ng/L vs.(41.9±21.5)ng/L,(2.7± 1.9)nmol/L vs.(8.7±3.8)nmol/L,respectively,P＜0.01].Conclusions Serum level changes of anti-oxidative stress biomarkers such as SOD3,NO and eNOS may have clinical value in diagnosing in-stent restenosis and in-reocclusion after coronary stent implantation in aged patients.