Objective To investigate the incidence of depression of coronary artery bypass grafting before and after surgery in patients with coronary heart disease and the impact of depression on patients undergoing coronary artery bypass grafting.Methods 345 patients treat with CABG were divided into depression and non depression groups based on Serf-rating depression scale(SDS).Compare the change of different degree of depression occurrence rate before and after surgery.All patients were followed up for 24 months after procedure for the occurrence major adverse cardiovascular events(MACE),then make the non MACE survival analysis and Cox regression.Results Baseline data of BMI(body mass index) and history of hypertension,cerebrovascular disease was statistically significant difference between groups.Depression in patients after CABG was significantly higher than that before procedure(40.9％ vs 24.3％,P ＜0.05).The MACE rate was significantly higher in patients with post-procedure depression than that in patients without depression(16.5％ vs 5.2％,P ＜0.01),and the incidences of myocardial infarction and target lesion revascularization were also significantly higher in depression patients than in non-depression patients(6.8％ vs 2.1％,6.6％ vs 1.6％,P ＜ 0.05).There was no significant difference on accumulative mortality between two groups(3.3％ vs 1.6％,P =0.315).The survival analysis curve of Kaplan-Meier show the incidences of non MACE survival rate was significantly lower in depression patients than in non-depression patients (P ＜0.001).There was no significant difference on death survival analysis(P =0.309).Depression,old myocardial infarction and LVEF(left ventricular ejection fraction)were independent risk factors for MACE.Conclusion The proportion was higher in patients with post-procedure and pre-procedure who have different degree of depression,the MACE rate was significantly higher in patients with postprocedure depression than in patients without depression.Depression is dangerous factors for prognosis of patients with coronary artery bypass grafting.

[ABSTRACT]AIM:ToexploretheeffectofretinoidXreceptor(RXR)agonistbexarotene(Bex)andvitaminD receptor (VDR) agonist calcitriol (Cal) on the expression of nuclear factor-kappa B (NF-κB) and the development of atherosclerosis in streptozotocin-induced diabetic apolipoprotein E knockout ( STZ-ApoE-/-) mice.METHODS: Male mice were treated for 12 weeks as follows:(1) C57+vehicle;(2) ApoE-/-+vehicle;(3) STZ-ApoE-/-+vehicle;(4) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1);(5) STZ-ApoE-/-+Cal (10 μg/kg, twice a week);(6) STZ-ApoE-/-+Bex (10 mg· kg-1· d-1) +Cal (10 μg/kg, twice a week).Intraperitoneal injection of STZ was performed to establish the diabetic animal model .Western blotting and immunohistochemical method was used to detect NF-κB level in the thorac-ic aorta.Plaque area in the thoracic aorta was measured using HE staining .RESULTS:Compared with the C57 mice, the fasting blood glucose in the ApoE-/-mice was not remarkably changed .The levels of total cholesterol ( TC) and low-densi-ty lipoprotein ( LDL) were greatly increased .The fasting blood glucose and lipid levels in STZ-ApoE-/-group were much higher than those in ApoE-/-group.Compared with STZ-ApoE-/-group, the fasting blood glucose and lipid levels in Bex group and Cal group were not significantly changed .Compared with the C57 mice, the protein expression of NF-κB in the ApoE-/-mice and the STZ-ApoE-/-mice was remarkably increased .Compared with STZ-ApoE-/-group, the levels of NF-κB in Bex group, Cal group and combination group were greatly decreased .Compared with STZ-ApoE-/-group, the thoracic artery plaque areas in Bex group and Cal group were inhibited (both P<0.05).Compared with Bex group, the plaque area of the thoracic artery in combination group was significantly decreased (P<0.05).CONCLUSION:Bexaro-tene or calcitriol decreases the development of atherosclerosis in streptozotocin -induced diabetic ApoE-/-mice.Bexarotene combined with calcitriol affords greater protection than monotherapy .The mechanism may be involved in down-regulating the expression of NF-κB.

Objective To investigate the effect of CD40/CD40 ligand on the genesis and development of coronary artery disease (CAD),and the inhibitory effect of cyclosporine A (CsA) on CD40/CD40 ligand. Methods A total of 71 patients were divided into four groups:acute myocardial infarction group (AMI, n=19), unstable angina pectoris group (UAP, n=18), stable angina pectoris group (SAP, n=17) and normal control group (N, n=17). Flow cytometry was used to detect the expres?sion of CD40 and CD40L in peripheral blood mononuclear cells (PBMCs) of four groups. The group in which CD40 and CD40L were produced at the highest level was chosen, and a series concentrations of CsA(H1:0 mg/L, H2:0.01 mg/L, H3:0.1 mg/L, H4:1 mg/L)were used to treat the cells. Then the expressions of CD40 and CD40L were measured by flow cytome?try. Results Compared with N group,the expression of CD40 was significant higher in other groups (P<0.05). The expres?sion of CD40 was significant higher in UAP group and AMI group than that of SAP group. There was no significant difference in the expression of CD40 between UAP group and AMI group (P>0.05). The expression of CD40L was elevated and fol?lowed by different severity of CAD. There was significant difference in the expression of CD40L between groups (P<0.05) . AMI group showed the highest expression of CD40 and CD40L. After being treated with CsA, the expression of CD40 was higher in H1 group than that of H3 group and H4 group (P<0.05). The expression of CD40L was significantly higher in H1 group than that of other three groups (P < 0.05). Conclusion CD40 and CD40L may be involved in the development of CAD. Moreover, it might be restrained by CsA via regulation of CD40/CD40L.

clues for interpretation of myocardial ischemia.

【Objective】 To study the location effect of the Mc Ab G9 to human esophageal carcinoma in tumor bearing nude mice. 【Methods】 125　I-G9 was prepared by Chloramine-T method. The distribution of 125 　 I-G9 was detected at different time (24, 48, and 72 h) after peritoneal injecti on. The percentage of the injected dose per gram of tissue(%ID/g) and the ratio of Tumor/non-Tumor were calculated. 【Results】 The distribution of 125　 I -G9 in tumor at the third day was showed by autoradiography obviously higher th an in other organ/tissue (except blood) and the highest is at the 48 h. The T/NT values are 2-7. The autoradiography indicated that radioactivity concentrated in tumor tissue. The concentration in tumor edge is more obvious than in the ce nter. 【Conclusion】 125　I-G9 has a considerable targeting activity and can well locate in esophageal carcinoma tissue in tumor bearing nude mice.

Objective To evaluate the clinical values of dual energy lung perfusion using dual-source CT. Methods Fifty-four patients who underwent chest contrast-enhanced CT were included in this study from May to August in 2007. Dual energy CT scanning was performed in all patients. The patients were divided into four groups: normal group, exudation lesion group, mass lesion group, and pulmonary embolism group. Imaging appearances of dual energy CT perfusion in four groups were analyzed. Results Dual energy CT showed symmetrical homogeneous perfusion in healthy subjects (n = 14), exudation lesions (n =10) appeared as low perfusion, In mass lesions (n =27), peripheral masses presented as local perfusion defect, central masses appeared as segmental perfusion defect because of the involvement of hilar vessels,and pulmonary embolism (n = 3) appeared as perfusion defect in corresponding pulmonary segment.Conclusion Dual energy CT scanning can be used to show the pulmonary perfusion status and assess the pulmonary perfusion abnormalities in central lung cancer and pulmonary embolism.

ObjectiveTo investigate the feasibility and accuracy of dual energy CT (DECT) in detecting acute myocardial ischemic reperfusion injury in a swine model.Methods Acute myocardial ischemic reperfusion injury model was made by ligaturing the left anterior descending coronary artery (LAD)or the first diagonal artery ( D1 ) of swine heart,the first-pass contrast enhanced DECT was performed.And then pigs were sacrificed,and the hearts were removed,triphenyhetrazolium chloride staining was performed.The CT numbers of non-ischemic and ischemic regions were measured.In the short axis of the left ventricle,the ventricular wall was divided into 17 segments for analysis,segments with myocardial perfusion defect in DECT myocardial iodine maps,DECT ( 140,100 kV,weighted average 120 kV) were determined and compared with histopathology.The sensitivity,specificity and inter-modality agreement of DECT in detecting myocardial injury were calculated.One-way ANOVA test was used to analyze the differences between the CT number and weight of infracted myocardium measured on DECT at 140,100 kV,weighted average 120 kV in ischemic and normal regions.ResultsPartial sparse or defective perfusion in the apical anterior and septal wall were demonstrated in DECT myocardial iodine maps.The CT number of injured myocardium was significantly lower than that of normal myocardium at 140,100 kV,weighted average 120 kV.The sensitivity,specificity of DECT myocardial iodine maps were 85.2％ (23/27),86.2％ (94/109),and Kappa value was 0.62,the sensitivity,specificity at 140 kV were 88.9％ (24/27),92.7％ (101/109),and Kappa value was 0.76,the sensitivity,specificity at 100 kV were 85.2％(23/27),89.0％ (97/109),and Kappa value was 0.67,the sensitivity,specificity at weighted average 120 kV were 88.9％ (24/27),91.7％ ( 100/109),and Kappa value was 0.74.There were no significant differences between the weight of infracted myocardium measured on DECT at 140,100 kV,weighted average 120 kV and histopathological results ( F =0.419,P =0.741 ).ConclusionDECT myocardial iodine maps can detect acute myocardial ischemic reperfusion injury in a swine model and have a good correlation with histopathology.

Objective:Rudimental contrast media in the subclavian vein often influence the display of carotid on dual-source computer tomography angiography.This article aimed to investigate this influence,and find a best solution.Methods:One hundred patients were randomly divided into Groups A(n=52) and B(n=48).The former received traditional imaging,with 65 ml contrast media,4.0 ml/s injection flow and caudocranial scanning direction,while the latter kept all the parameters unchanged except the scanning direction,from caudocranial to craniocaudal.Each group was graded by original axial images,maximum intensity projection(MIP),silhouette images and VR images for vascular delineation of the carotid.Results: The carotid artery was clearly displayed in Group B,while the subclavian vein was unsatisfactorily revealed in Group A,with statistically significant differences in extent scores between the two groups(P

Objective To investigate the effects of monocyte chemoattractant protein-1 (MCP-1) on the migration of neural stem cells in vivo. Methods The brain injured rat model was established with cortical micro-injection of lipopolysaccharide in Sprague-Dawley rats. The tissue of brain was immunohistochemistrically stained to detect the expression of MCP-1 and nestin 3 d, 5 d, and 7 d after modeling. Results The expression of MCP-1 increased, and reached a peak 5 d after modeling. The nestin-positive cells was found in the lipopolysaccharide injected area 7 d after modeling. Conclusion MCP-1 may induce the endogenous neural stem cells migrate to lipopolysaccharide injection area in vivo.

Objective To investigate the feasibility and accuracy of dual energy CT myocardial iodine maps in detecting acute myocardial infarction in canine model. Methods Myocardial ischemia model was made by ligaturing left anterior descending coronary arteries (LAD) after thoracotomy in six dogs, while another 3 dogs undergoing thoracotomy not ligaturing LAD as control group. Before and three hours after operation, dual-source CT (DSCT) was performed, followed by resting 99Tcm-MIBI single photon emission computed tomography myocardial perfusion imaging. Then, dogs were sacrificed, and the hearts were removed, triphenyltetrazolium chloride staining and conventional HE staining were performed. CT number of non-ischemic and ischemic regions were measured and analyzed. The wall of the left ventricle in the short axis was divided into 17 segments, the segments of myocardial perfusion defect in DSCT myocardial iodine maps, SPECT, and pathology were determined. Student t test was used to analyze the difference of CT number between infarcted and non-infarcted myocardium. Kappa test was used for the accuracy of DSCT myocardial iodine maps and SPECT in detecting myocardial ischemia according to the pathological results. Results No abnormal regions were detected using DSCT myocardial iodine maps in preoperative control and infarction group. After thoracotomy, partial sparse or defective perfusion was consistently noted in six dogs' apical anterior and partition wall in both DSCT myocardial iodine maps and SPECT. In the infarcted group, the attenuation of infarction region (34.75 ± 16.66) HU was significantly decreased compared with preoperative measurements ( 123. 18 ± 15.38 ) HU ( t = 10. 526, P ＜ 0. 01 ); decreased perfusion in the infarcted region was also noted in the DSCT myocardial iodine maps and SPECT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DSCT myocardial iodine maps and SPECT were 85.0% (34/40) , 84. 1% (95/113) ,65.4% (34/52) ,94. 0%(95/101) ,and 82. 5% (33/40), 90. 3% ( 102/113 ) ,75.0% (33/44) ,93.6% ( 102/109 ), respectively.Kappa values were 0. 63 and 0. 71 for the agreement of DSCT myocardial iodine maps and SPECT.Conclusion DSCT myocardial iodine maps is comparable diagnostic accuracy with rest SPECT myocardial perfusion imaging in detection of acute myocardial infarction in a canine model.