2.Effect of percutaneous coronary intervention on prognosis of acute ST-segment elevation myocardial infarction in the elderly
Chunhua LI ; Zhenjiang DING ; Hong WANG ; Jie ZHAO ; Zhimin HAO
Chinese Journal of Geriatrics 2010;29(11):916-919
Objective To investigate the effect of percutaneous eoronary intervention (PCI) on the prognosis of acute ST-segment elevation myocardial infarction (ASTEMI) in the elderly.Methods The 1318 ASTEMI patients in our hospital from June 1998 to June 2008 were retrospectively analyzed. Among them, 338 (25.6%) elderly patients were over 60 years old, and 316patients consistent with inclusion and exclusion criteria were consecutively enrolled in our research.Then they were divided into two groups: PCI group (136 cases, 43.0%) and conservative drug treatment group (180 cases, 57. 0%). The clinical data of study objects were collected. Then they were followed up regularly for two years. Results There were no statistically significant differences between the two groups in mean age, gender, hypertension, diabetes, dyslipidemia, excess smoking,wine and family history (all P> 0.05). And there were no statistically significant differences in anterior wall STEMI, Killip Ⅲ-Ⅳ class, thrombolysis therapy and malignant ventricular arrhythmia (all P>0. 05). Most of the objects proceeded therapeutic lifestyle improvements, such as giving up smoking, restricting wine, regulating diet, losing weight and insisting on exercises, and so on.Secondary prevention drugs of acute myocardial infarction including angiotensin converting enzyme inhibitor, angiotensin receptors blockers, beta receptor, aspirin and statins were regularly administrated in the two follow-up years. In the retrospective research, incidence rates of reinfarction, NYHA (New York Heart Association) Ⅲ-Ⅳ class heart function and one-month mortality were much higher in conservative treatment group than in PCI group (17.2% vs. 2. 2%, OR=9. 224,95% CI: 2. 756-30. 857; 31.1% vs. 8.1%,OR=5.132, 95%CI: 2. 568-10. 257; 8. 3% vs. 1.5%,OR= 6. 091, 95% CI: 1. 369-27. 105, respectively; all P < 0. 01). Above all, one and two-year mortalities were much higher in conservative treatment group than in PCI group (21.1% vs. 2. 2 %,OR=11.864, 95%CI: 3.577-39.349; 32.2% vs. 4.4%, OR=10.301, 95%CI: 4.289-24.736,respectively; all P<0. 01). Conclusions PCI may reduce the re-infarction, NYHA Ⅲ-Ⅳ class heart function and one-month mortality, especially so in view of the one and two-year mortality. PCIcan significantly improve the prognosis of ASTEMI in the elderly.
3.Genetic elements of drug-resistance in a strain of multidrug-resistant Klebsiella pneumoniae isolated from bronchoalveolar lavage fluid
Ying LI ; Yunfang DING ; Shuiyan WU ; Yunzhen TAO ; Long XIANG ; Zhenjiang BO ; Hongmei CHEN
Chinese Journal of Clinical Infectious Diseases 2014;7(2):150-156
Objective To analyze the resistance genes in a muhidrug resistant Klebsiella pneumoniae (MDRKP) strain.Methods A MDRKP strain was isolated from bronchoalveolar lavage fluid in Pediatric Intensive Care Unit of Children's Hospital Affiliated to Soochow University in February 2012.Acquired resistance genes to beta-lactams,aminoglycosides,quinolones,ompK35 and ompK36 gene for outer membrane porin protein,and carbapenems targeting PBP2 gene were analyzed by PCR and verified by DNA sequencing.Results Acquired resistance genes TEM-1,SHV-1 to beta-lactam antimicrobial agents and aac(6′)-I b to aminoglycoside antimicrobial agents were positive in the strain of MDRKP.While 16S rRNA methylase,ompK35 and ompK36 genes for outer membrane porin protein were negative.Compared with susceptible strains,there were 9 synonymous mutations in PBP2 gene sequence of this MDRKP strain,but the amino acid sequences were the same.No mutation in quinolone resistance determining region (QRDR) was observed.Conclusion The multidrug resistance of the isolated Klebsiella pneumoniae strain may be related to 2 kinds of beta-lactam acquired resistance genes,1 kind of aminoglycoside acquired resistance gene,ompK35 and ompK36 genes defects and synonymous mutation in PBP2 gene.
4.Simultaneous esophagectomy and off-pump coronary artery bypass grafting for esophageal cancer:a report of five cases with literature review
Hongtao WANG ; Guolei WANG ; Wenguang WANG ; Yuhang CHEN ; Zhenjiang WU ; Chengzhi DING
Chinese Journal of Thoracic and Cardiovascular Surgery 2017;33(7):394-396
Objective To explore the possibility and safety of the simultaneous esophagectomy and off-pump coronary artery bypass grafting(OPCABG) in patients suffering from esophageal cancer combined with coronary artery and summarize the clinical experiences.Methods We retrospectively analyzed the clinical dates of 5 patients performed at the Henan province Chest Hospital from May 2009 to December 2014.The related literature was reviewed.Results All patients were performed the simultaneous esophagectomy and OPCABG through the single left posterolateral thoracotomy 4cases and through median sternotomy and left thoracotomy 1 case.Instrument anastomosis under aortic arch 2 cases and above aortic arch 1 case , left neck anastomosis by hand 2 cases.Coronary artery three ressel disease 3cases, double-vessel 1 case, left main single vessel 1 case.There was no hospital death in this series.Postoperative complications included arrhythmia,anastomotic fistula and pneumonia.Only one patient was still alive, the other patients died of tumor recurrence or metastasis and median survival time was 20.6 months.Conclusion Simultaneous esophagectomy and OPCABG is a safe and feasible treatment modality in patients with severe CAD and esophageal cancer and it may be more beneficial for the patient with early esophageal cancer.
5.Carboxymethyl chitosan thermosensitive hydrogel induces the differentiation of bone marrow mesenchymal stem cells toward neurons
Zhenjiang LI ; Chenyang XU ; Bingqian DING ; Xinting WEI ; Ming GAO ; Yake XUE ; Honglin LIU
Chinese Journal of Tissue Engineering Research 2017;21(18):2870-2875
BACKGROUND:Chitosan biological materials can induce bone marrow mesenchymal stem cells to differentiate toward neurons. As a derivative of chitosan, carboxymethyl chitosan has a series of excelent properties. However, whether carboxymethyl chitosan can induce the neuronal differentiation of bone marrow mesenchymal stem cells remains unclear.OBJECTIVE:To investigate the effect of carboxymethyl chitosan thermosensitive hydrogel on the differentiation of bone marrow mesenchymal stem cells into neurons and the possible mechanism.METHODS:Passage 3 bone marrow mesenchymal stem cells from rats were selected and cultured in carboxymethyl chitosan thermosensitive hydrogel extracts in different concentrations (0, 50, 100, 150, 200, 500 g/L). Control cells were cultured in culture medium with no addition of carboxymethyl chitosan thermosensitive hydrogel extracts. MTT assay was performed to investigate the effects of different concentrations of carboxymethyl chitosan thermosensitive hydrogel extracts on bone marrow mesenchymal stem cell proliferation. Western blot assay was used to explore the effect of 150 g/L carboxymethyl chitosan thermosensitive hydrogel extracts on the expression of neuron-specific enolase, Nestin, Vimentin, NF-M, microtubule associated protein 2, glial fibrillary acidic protein, β3-tubulin, Notch1 and Jag1 protein.RESULTS AND CONCLUSION:MTT assay showed that carboxymethyl chitosan thermosensitive hydrogel promoted the cell proliferation, and the proliferation rate reached the peak at the concentration of 150 g/L. Western blot assay showed that the cells induced by 150 g/L carboxymethyl chitosan thermosensitive hydrogel extract had significant increases in neuron-specific enolase, Nestin, Vimentin, NF-M, microtubule associated protein 2, glial fibrillary acidic protein, and β3-tubulin protein expression, and obvious decreases in Notch1 and Jag1 protein expression in comparison with the control group. These results indicate that the carboxymethyl chitosan thermosensitive hydrogel induces rat bone marrow mesenchymal stem cells to differentiate toward neurons, and suppresses the activity of Notch signal pathway in the process of differentiation.
6.Design and manufacture of mechanic modeling of fluid dynamics related to the myocardial bridging and mural coronary artery.
Guohui ZHANG ; Junbo GE ; Lixing SHEN ; Keqiang WANG ; Juying QIAN ; Bing FAN ; Genlin XU ; Hao DING ; Feng ZHANG
Journal of Biomedical Engineering 2005;22(3):593-597
A model of fluid dynamics related to the myocardial bridginged and mural coronary artery was designed and manufactured according to the physical principle and characteristic of the mural coronary artery. The model can imitate systematically well the effect of myocardial bridging on hemodynamic change of the mural coronary artery under different controlled experimental parameter. The methodology is proved to be feasible and has good prosperity of experimental study.
Coronary Vessels
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physiology
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Hemodynamics
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Humans
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Models, Cardiovascular
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Myocardial Bridging
7.Advance in studies on phospholipid compound of traditional Chinese medicines.
Dong-Mei DING ; Zhen-Hai ZHANG ; Yan-Rong JIANG ; Xiao-Bin JIA
China Journal of Chinese Materia Medica 2013;38(13):2046-2050
According to Chinese and foreign literatures and reports in recent years, this article introduced the latest advance in studies on phospholipid compound of traditional Chinese medicines in terms of its preparation mechanism, preparation process, characterization and transmembrane absorption. Under appropriate conditions, traditional Chinese medicines could generate phospholipid compound, whose physico-chemical property differs from the original drug, with a better absorption and improved bioavailability. Therefore, there is huge room for further study and development of phospholipid compound with traditional Chinese medicines.
Absorption
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Animals
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Biological Availability
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Humans
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Medicine, Chinese Traditional
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Phospholipids
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chemistry
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pharmacology
9.Relationship between mitochondrial DNA content and acute coronary syndrome
Wenchao DONG ; Zhenjiang DING ; Ruijuan WANG ; Pengfei WANG ; Weina HOU ; Yaqi YAN ; Shuo LI
The Journal of Practical Medicine 2017;33(20):3397-3401
Objective To investigate the relationship between peripheral blood mtDNA content and acute coronary syndrome. Methods A total of 244 patients who received coronary angiography(CAG)was enrolled in this study. They were divided into acute coronary syndrome(ACS)group(n=183)and control group(n=61)ac-cording to the CAG results. A quantitative real-time PCR-based method was used to measure relative content of mtDNA in peripheral blood. According to lesion blood vessel counts ,ACS patients were divided into single lesion group,double lesion group and three lesions group. Gensini score was used to quantitatively evaluate the severity of coronary stenotic lesions. Then we analyzed the relationship of mitochondrial DNA content with the lesion counts and the Gensini score. Results The ACS group had a lower mtDNA content ,as compared to controls (P <0.001).The lesion blood vessel count and mtDNA content in the single ,double and three vascular lesions group were all significanlty lower than that of the control group(P<0.05)and that of the double,three vascular lesions group were both significantly lower than that of the single vascular lesion group(P<0.05). According to the Gensi-ni score,all patients were divided into four groups,where with mtDNA content was decreased with the increase of the Gensini score(P < 0.01). The linear regression analysis showed that Gensini score was negatively correlated with mtDNA content(r=-0.644,P<0.001). ROC curve analysis showed that the area under the curve of mtDNA content for ACS diagnosis was 0.855(P<0.001),with the sensitivity and specificity of 0.756 and 0.833,respec-tively. Conclusion MtDNA content is closely associated with ACS and the Gensini score ,the latter indicating the severity of coronary stenotic lesions. MtDNA content detection has its value in the diagnosis of ACS.
10.Changes and significance of soluble low-density lipoprotein receptor-related protein-1 and regulated upon activation normal T cell expressed and secreted in acute coronary syndrome
Yanan TIAN ; Na HU ; Haijiu SONG ; Fei SHI ; Zhenjiang DING
Clinical Medicine of China 2020;36(3):202-206
Objective:To investigate the concentration of soluble low-density lipoprotein receptor-related protein-1(sLRP-1) and regulated upon activation normal T cell expressed and secreted(RANTES) in the plasma of patients with acute coronary syndrome(ACS) and the correlation with the severity of coronary artery disease, and to explore its clinical significance.Methods:From January 2019 to July 2019, 250 patients in the Department of Cardiology of the Affiliated Hospital of Chengde Medical College were selected for prospective study, including 158 patients with ACS, 42 patients with stable angina pectoris (SAP) and 50 patients in the control group.ACS patients included 92 patients with acute myocardial infarction(AMI) and 66 patients with unstable angina pectoris(UAP). The degree of coronary artery lesions was evaluated according to the Gensini score.The patients in the control group were excluded from coronary atherosclerosis by coronary angiography at the same time.The concentrations of sLRP-1 and RANTES in plasma were measured by enzyme linked immunosorbent assay(ELISA).Results:The plasma levels of lg sLRP-1 and RANTES in AMI group ((0.69±0.20) mg/L and(125.17±34.87 )ng/L) and UAP group ((0.62±0.19) mg/L and(118.51±21.46 ) ng/L) were higher than SAP group ((0.42±0.16) mg/L and(99.56±21.46)ng/L) and control group ((0.27±0.08) mg/L and (98.39±19.37)ng/L)(all P<0.05), while lg sLRP-1 and RNATES levels were not significantly different between AMI group and UAP group, SAP group and control group(all P>0.05). The levels of lg sLRP-1 and RANTES in patients with ACS decreased after PCI treatment(all P<0.05). Plasma lg sLRP-1 and RANTES levels were not correlated with Gensini scores in ACS patients(all P>0.05). Conclusion:SLRP-1 and RANTES are involved in the progression of ACS, and there is a certain correlation between them.Myocardial perfusion therapy improves the inflammatory response of coronary artery.