Objective To study the correlation of serum adiponectin (ANP) and brain natriuretic peptide (BNP) levels with left ventricular hypertrophy in essential hypertension patients,and to investigate its potential mechanism.Methods 80 patients with essential hypertension in our hospital were recruited.Secondary hypertension,cardiac,brain and renal insufficiency and diabetes mellitus were excluded in the study patients.Patients were divided into 2 groups:left ventricular hypertrophy group (LVH group,n=40) and hypertension group (hypertension patients without left ventricular hypertrophy,n=40).Age-,sex-,body mass matched health subjects were selected as control group (n =40).Serum levels of ANP and BNP were determined by enzyme-linked immunosorbent assay (ELISA).Left ventricular end diastolic dimension (LVEDD),left ventricular posterior wall thickness (LVPWT) and interventricular septum thickness (IVST) were detected by ultrasonic cardiography.Left ventricular mass (LVM) and left ventricular mass index (LVMI) were calculated according to formula of Devereux.Results There were significant differences in serum levels of APN and BNP and LVMI between hypertension,LVH and control groups [(7.9±0.3) mg/L,(6.7±0.1)mg/L vs.(12.0±0.2)mg/L,(116.1±16.1)μg/Lvs.(182.4±18.5)μg/L,(104.0± ±9.6)g/m2,(153.7±21.0)g/m2 vs.(83.1±9.1)g/m2,respectively,all P＜0.01].Serum APN level was negatively correlated with the severity of LVH (r=-0.789,P＜0.01),while serum BNP level was positively correlated with the severity of LVH (r=0.811,P＜ 0.05).Conclusions Serum APN and BNP levels have correlation with hypertension and hypertension related LVH.

Objective To study the feasibility, safety, effectiveness of left atrial circumferential ablation of pulmonary veins for atrial fibrillation(Af) guided by EnsiteNavX mapping system. Methods Seventeen patients with paroxysmal or persistent Af were included. Real time 3-dimensional left artial (LA) and pulmonary veins (PVs) maps were constructed through EnsiteNavX mapping system. Pulmonary veins isolation was performed by encircle the left and right sides PVs at adistance of 1 to 2 cm away from the ostium of PVs. Results Seventeen patients were all reached the endpoint of abalation completely. The mean procedure time and fluoroscopy time were (226.1 ± 36.2) minutes and (41.3 ± 12.8) minutes. Mean radiofrequency energy delivery time was (61.9 ±15.4) minutes. Recur-rence of Af occurred in two patients, one was repeat ablation succnssfully. During 3 ～ 36 months followup, fourteen patients (82.3%) were free of Af without any antiarrhythmic drugs. Recurrence of Af occurred in three(11.7%) patients treated with amiodarone. No complications occurred during the procedure and the following up. Conclusion Left atrial circumferential isolation of pulmonary veins for Af guided by Ensite NavX mapping system was effective and salty.

Objective To evaluate the clinical significance of QT dispersion (QTd),QTcd in dilated cardiomyopathy(DCM).Methods QTd and QTcd on simultaneous recording 12 lead ECG in 60 DCM cases were measured and compared with 60 healthy subjects.Results QTd and QTcd in DCM group were remarkably higher than those in control group (P

Objective To explore the clinical pathological data of the elderly patients with paroxysmal supraventricular tachycardia(PSVT) and the timing of the radiofrequency ablation treatment for PSVT and its clinical efficacy.Methods The clinical pathological data of 45 elderly patients with PSVT for radiofrequency ablation were retrospectivly analyzed,and the information of cardiovascular and cerebrovascular diseases,the duration of PSVT and frequency of attacks,the reason of patients had to accept radiofrequency catheter ablation,the treatment effective of electrophysiological study and radiofrequency ablation were recorded.Results The duration and frequency of attacks with PSVT were positively related with pathogenesis in the elderly patients.Elderly PSVT patients with severe cardiovascular disease accounted for 28.89％.The first radiofrequency ablation treatment success rate was 100％ in this research and the recurrence rate was 4.4％.Conclusion It is recommended that elderly PSVT patients early access to the radiofrequency ablation.

Objective To investigate the effects of different pacing sites of right ventricle on serum N terminal Pro brain natriuretic peptide (NT-ProBNP) and left ventricular systolic function.Methods A total of 76 patients with an implanted DDD pacemaker were randomly divided into right ventricular septal pacing group (RVSP group,n=40) and right ventricular apex pacing group (RVAP group,n=36) according to the ventricular leads position.Serum NT-proBNP level,left ventricular end diastolic dimension(LVEDD)and left ventricular ejection fraction(LVEF)were analyzed before and 6 months after operation in the two groups.Results There was no difference in serum NT-proBNP level between the two groups before operation,but the serum NT-proBNP level increased in both groups 6 months after operation,and it was higher in RVAP group than in RVSP group (P＜0.05).There were no significant differences in LVEDD and LVEF in RVSP group before and after implantation (P＞0.05).Compared with pre-implantation,LVEDD was increased and LVEF was decreased in RVAP group 6 months after implantation (both P＜0.05).Linear correlation analysis showed that serum NT-proBNP level was negatively correlated to LVEF (2γ=-0.76,P＜0.05).Conclusions Compared with RVAP,RVSP can keep the normal sequence of electrical activity and exert less adverse effects on left ventricular systolic function.Therefore,RVS is an ideal pacing location.

Objective To evaluate and analyze relationship of plasma level of N-terminal probrain natriuretic peptides (NT-proBNP) and serum level of cystatin C (CysC) with cardiac and renal functions in patients with chronic heart failure (CHF) , and explore significance of CysC measurement in early diagnosis for renal damage in patients with CHF. Methods Totally, 162 patients with CHF and 150 normal healthy (controls) undergone routine physical check-up at, Taizhou People's Hospital, Jiangsu were enrolled in the study. Their plasma level of NT-proBNP and serum level of CysC, as well as serum levels of creatinine ( SCr) , urea nitrogen ( BUN) were measured and echocardiography was performed. Glomerular filtration rate (eGFR) was evaluated by modification of diet in renal disease (MDRD) study group formula. Results Compared with the control group, blood levels of NT-proBNP, CysC, SCr, BUN and left ventricular end diastolic diameter ( LVEDD) all elevated, both eGFR and left ventricular ejection fraction ( LVEF) decreased (P <0. 05 or P <0. 01 ) in CHF group, and CHF patients were prone to complicate with renal dysfunction (P<0. 01). Blood levels of NT-proBNP and CysC elevated significantly and LVEF lowered significantly in CHF patients with NYHA functional classes II , III and IV than those in control group. There was significant difference in blood levels of NT-proBNP and CysC between patients with varied NYHA functional classes (P<0. 05). Blood levels of NT-proBNP and CysC reversely correlated with LVEF (r = -0. 36, P < 0. 01 and r = - 0. 39, P < 0. 01) . Blood level of CysC correlated with that of NT-proBNP ( r = 0. 87 , P < 0. 01). Results of logistic regression analysis showed that elevated blood levels of NT-proBNP and CysC were risk factors for mortality during hospitalization in patients with CHF. Conclusions Patients with CHF were more likely to complicate with renal dysfunction than controls, with main manifestations of more severe damaged eGFR, more severe heart failure and more obviously renal damage. Blood levels of NT-proBNP and CysC can be used as indicators for evaluating exacerbation of chronic condition, and serumlevel of CysC can be used as marker for early diagnosing renal damage in patients with CHF.

Objective To evaluate the relationship between NT-probrain natriuretic peptide (NT-proBNP) levels and the degree of coronary artery stenosis in elderly patients with non-ST elevation acute coronary syndromes (NST-ACS).Methods The levels of NT-proBNP were determined in 258 elderly patients with NST-ACS divided into 3 quartile groups based on the degree of coronary artery stenosis,and 62 normal controls.And NT-pro BNP were compared among 4 groups.Results The serum levels of NT proBNP were increased in the NST-ACS patients with single,two or three-artery lesion compared with normal controls [(197.3±80.2)ng/L,(381.7±73.5)ng/L,(496.5± 99.8) ng/L vs.(68.2 ± 36.1) ng/L].The level of NT proBNP was enhanced along with increasing severity coronary artery disease (all P＜0.01).And with aging,the NT-proBNP levels were rising [aged＞60-69 years:(182.34±69.13) ng/L; aged≥70-79 years:(302.68±87.51)ng/L; aged≥80 years:(482.09±82.2)ng/L] (all P＜0.01).Conclusions The NT-proBNP level is enhanced along with aging and increasing severity of coronary artery stenosis in elderly NST-ACS patients.

Objective To study whether prostaglandin E1 (LipoPGE1) could prevent contrast medium-induced nephropathy (CIN) in patients with coronary heart disease (CHD) plus diabetes mellitus type 2 (DM).Methods Total 198 CHD patients with DM received coronary angiography (CAG) or PCI were randomly divided into PGE1 group and control group.All patients received routine treatment,and the PGE1 group also received 20 ml normal saline and 20 μg PGE1 (intravenous injection,1 time/d) for 10 days.The rate of CIN and the level of serum urea nitrogen (BUN),creatinine (Scr),cystatin C (Cys C) were measured before and 48 hours and 5 days after contrastmedium administration.Results The level of Scr,BUN and Cys C were lower in PGE1 group [(113.92±54.89)μmmol/ L,(7.85±4.05)mmol/L,(1.38±0.34)mg/L]for 48 hours and[(86.72±35.26)μmmol/L,(6.61 ± 3.09 ) mmol/L,( 1.29 ± 0.29) mg/L]for 5 days than in control group [(129.22±50.18)μmmol/L,(9.26±3.95)mmol/L,(1.56±0.23)mg/L]for 48 hours and[(109.83+31.76)μmmol/ L,(8.07±3.11)mmol/L,(1.37±0.21)mg/L]for 5 days (all P＜0.05).The dose of contrast-medium was positively correlated with the level of Scr and BUN (r=0.74,P＜0.05 and r =0.82,P＜0.01,respectively).The patients' renal function in the PGE1 group was better than in control group after contrast-medium administration (P ＜0.05).BUN and Scr were positively correlated with the volume of contrast-medium (r=0.74,P＜0.05,r=0.82,P＜0.01).Conclusions PGE1 may prevent contrast medium-induced nephropathy in patients with CHD combined with DM.

Objective To investigate the effects of Notch1,2,3 genes silencing by siRNA on Notch signaling pathway (Delta-like 4 (DLL4),Jagged 1 (JAG1)) and nuclear factor-κB (NF-κB) signaling pathway (IκBα,P52) of macrophages derived from patients with coronary artery disease (CAD),thus to explore the potential genetic treatment perspectives for CAD.Methods Peripheral blood mononuclear cells of CAD patients were isolated by density gradient centrifugation and transformed by phorbol-12-myristate-13-acetate (PMA) to macrophages.Macrophages were then transfected with Notch1-small interference RNA (siRNA,Notch1-siRNA group),Notch2-siRNA (Notch2-siRNA group),Notch3-siRNA (Notch3-siRNA group),negative control siRNA (NC group) and none siRNA (control group) respectively.Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis were applied to assess the mRNA and protein expression levels of DLL4,JAG1,IκBα and p52,respectively.Electrophoretic mobility shift assay (EMSA) was used to observe the NF-κB DNA binding activity.Subcellular distributions of NF-κB/p52 were detected through immunofluorescence.Results (1) The mRNA and protein expressions of DLL4,JAG1 and p52 in Notch1-siRNA group,Notch2-siRNA group and Notch3-siRNA group were significantly downregulated,while the mRNA and protein expression of IκBα was significantly upregulated compared with NC group and control group (P ＜ 0.05 or 0.01).The mRNA and protein expressions of DLL4,JAG1 and p52 in Notch1-siRNA group were significantly downregulated,while the mRNA and protein expression of IκBα was significantly upregulated compared with Notch2-siRNA group and Notch3-siRNA group(P ＜0.05 or 0.01).The mRNA and protein expressions of DLL4,JAG1,IκBα and p52 were similar between NC group and control group (all P ＞ 0.05).(2) The binding activity of NF-κB DNA was significantly lower in Notch1-siRNA group (613 ± 57),Notch2-siRNA group (1 169 ± 85) and Notch3-siRNA group (1 454 ± 90) compared with control group (2 643 ± 115) and NC group (2 407 ± 100) (all P ＜0.01),which was also significantly lower in Notch1-siRNA group compared to Notch2-siRNA group and Notch3-siRNA group (P ＜ 0.01);was significantly lower in Notch2-siRNA group compared with Notch3-siRNA group (P ＜ 0.01) and was similar between control group and NC group (P ＞ 0.05).(3) The fluorescence intensity of NF-κB/p52 was significantly lower both in the nucleus and cytoplasm in Notch1-siRNA group,Notch2-siRNA group and Notch3-siRNA group compared with NC group and control group (all P ＜0.01),and the decrease was more obviously in the nucleus than in cytoplasm in Notch1-siRNA group,Notch2-siRNA group and Notch3-siRNA group (P ＜ 0.05 or 0.01).The fluorescence intensity of NF-κB/p52 was similar between control group and NC group (P ＞ 0.05).Conclusion There is a positive regulation between Notch and NF-κB pathway in macrophages derived from CAD patients,the regulation power on NF-κB signaling pathway of Notch1 is stronger than that of Notch2 and Notch 3.

Objective: To explore drug resistance of different viral loads, and investigate the relationship between drug resistance and CD4⁺T cell counts in patients with HIV antiretroviral therapy (ART) in China from 2003 to 2015. Methods: Data were extracted from the Chinese National HIVDR Surveillance database from 2003 to 2015. For this study, the data collected were as follows: having received ART for ≥12 months; 18 years or older; demographic characteristics, information of ART, CD4⁺T cell counts, viral load (VL) and HIV drug resistance of a total of 8 362 patients were collected. Multi-variables non-conditional logistic regression model was used to study the relationship between viral load, HIV drug resistance and CD4⁺T cell counts. Results: Participants with age of (41.8±10.5) years were enrolled in this study. Among them, 59.9% (5 009 cases) were men. The percentage of CD4⁺T cell counts <200 cells/μl in the total population was 17.9% (1 496 cases), the highest was in VL ≥1 000 copies/ml with drug resistance, which was 43.0% (397/923) , followed by VL 50-999 copies/ml with drug resistance, which was 31.1% (69/222), and the lowest was in VL 50-999 copies/ml without drug resistance 13.2% (273/2 068). Compared to VL 50-999 copies/ml without drug resistance, VL<50 copies/ml, VL 50-999 with drug resistance, VL≥1 000 copies/ml without drug resistance, and VL ≥1 000 copies/ml with drug resistance, the OR (95%CI) of CD4 <200 cells/μl were 0.9 (0.7-1.0), 3.2 (2.3-4.4), 2.6 (2.1-3.2), and 4.9 (4.0-5.9), respectively. Among 222 patients with VL 50-999 and HIVDR, the most frequent antiretroviral drugs were EFV and NVP, both of which were NNRTI, and whose percentage both were 94.1% (209 cases). The most frequent mutations were M184V/I (NNRTI), and the percentage was 26.1% (58 cases). The second one was K103N (NNRTI), and the percentage was 22.5% (50 cases). The percentage of V32L/E (PI) and V82A (PI) were lower, they were 0.9% (2 cases) and 0.5% (1 case) respectively. Conclusion Decreased CD4⁺T cell counts were associated with HIV drug resistance at low viraemia. In the case of low viral load, the most vulnerable were the NNRTI antiviral drugs such as EFV and NVP.