Objective:To introduce our experience on extra-operating room anesthesia of children with grave congenital heart diseases during cardiac catheterization an d ventriculography. 　　Methods:Three hundred and sixty-nine children with grave congenital heart d iseases undergoing cardiac catheterization or ventriculography were selected for this study,among whom 86 are presented with left to right shunt and pulmonary a rtery hypertention,11 with pulmonic stenosis and primary pulmonary artery hypert ention,and 272 with right to left shunt.They were routinely fasted before the pr ocedure.O2 Saturation(SpO2) and electrocardiogram were monitored and blood p ressure were recorded.With oxygen inhalated by mask and venous route established ,the children were injected with scolapamine (0.02 mg/kg) and ketamine (1-2 mg /kg) for anesthesia induction.When patients lost conciousness,ketamine (6-8 mg/ kg) and droperidol (0.15-0.30 mg/kg) were given intromascularly for maintaine nce.During the procedure,ketamine (1-2 mg/kg) were given to deepen anethesia. 　　Results:The procedures were fufiled steadily.Eighteen patients presented wit h different kinds of complications such as abdomen distention,vomitting,arrhymia and refractory anoxia to defferent degrees.One patient died,and the mortality w as 0.27%. 　　Conclusions:Anesthesia of children with grave heart diseases during cardiac catheterization and ventriculography is particular.It is important for the anest hesiologists to be familiar with the pathophysiology of heart diseases,and suppl y sufficiant oxygen,keep airway open and unobstructed,avoid stomach regurgitatio n and inhalation and maintain sufficient sedation during the procedure.Oxygen sh ould be given continuously and SpO2 monitored posoperatively to avoid any comp lication.

Objective:To introduce the experience of using the fresh autologous pericard ium in cardiac operation. 　　Methods:Fresh autologous pericardium unprepared by 0.5% glutardaldehyde was used in cardiac operations in 321 patients.It was used not only in repair of at rial septal defect and ventricular septal defect,but also in operations of many complicated congenital heart diseases,such as tetralogy of Fallot,double outlet of right ventricle,atrioventricular canal,single atrium anomalous pulmonary veno us connection,Ebstein's anomaly,tricuspid atresia,pulmonary atresia,single vent ricle,complete transposition of the great ateries.Autologous pericardium was als o used for enlargement aortic root in rheumatic heart disease and repairing of a trial septium after resection of the left atrial myxoma. 　　Results:Twenty patients (6.1%) died within 30 days after operation.The resi dual shunt was found in one patient with tetralogy of Fallot and three patients with ventricular septal defect.Two hundred and fourty-three patients (75.7%) w ere followed-up.No patient had hemolysis,embolism,infectious endocarditis,patch calciflcation or other complications concerned with the use of the autologous p ericardium after operation. 　　Conclusion:The fresh autologous pericardium is a good material for repairing cardiac defects.

Objective:To research expression and function of c-myc gene in hyperacute r ejection of xenotransplantation. 　　Method:Through the model of hyperacute rejection of xenotransplantation wit h isolated rat heart perfused with human plasma,we detected c-myc mRNA expressi on and cell localization with in situ hybridization in hyperacute rejection. 　　Result:c-myc mRNA increased expression in the endothelium cell of heart.Th e value of signal is 450.09±409.99.The value of signal of group of control is 1 74.40±51.50(p＜0.05)。 　　Conclusion:From these study findings,it would appear that hyperacute rejecti on is associated with the elevation of c-myc mRNA expression.

Objectives:The present study in vestigated the presence and significance of serum antibody against human myocardial mitochondria in patients with virus myocarditis (VMC) and dilated cardiomyopathy (DCM). 　　Methods:The human myocardial mitochondtia were used as antigen to detect serum autoantibody by immuno-dot blot in 29 VMC patients,24 DCM patients,33 patients with other cardiac (OCD) and 20 healthy blood donor (HBD).The antigen molecular weight was detected by Western blot. 　　Results:①Positive autoantibody against human myocardial mitochordria was found in 41.4% in VMC and 41.7% in DCM patients,which were much higher than 6.1% in OCD or 0% in HBD patients.②Cardiac troponin T was elevated in 43.8% of autoantibody-positive VMC and DCM patients,which was much higher than 12.0% in autoantibody-negative VMC and DCM patients (p＜0.05).③The antigen molecular weight of human myocardial mitochondria was 30KD. 　　Conclusions:①The presence of autoantibody against supports that concept that is responsible for the development of VMC and DCM.Autoantibody is one of the factors that give rise to cardiac injury.The antibody detection may serve as a diagnostic index for VMC and DCM.②The specific antigen is probably human myocardial adenine nucleotide translocator.

Objective:To evaluate the effects of losartan、fosinopril and captopril on the excretion rate of urinary albumin (UAER) and the clearance of endogenous creatinine (Cr-C) in elderly patients. 　　Methods:In this study,162 elderly patients with stage of the 2—3 class hypertension were included,The patients were divided into 3 groups,that were losartan group and the fosinopril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment. 　　Results:The hypertensive effect rates were 94% in losartan group and 93%、93% in fosinopril group and captopril group respectively.Decrease of UAER was observed in 89% of patient in losartan group and 59%、50% in fosinopril group、captopril group.Cr-C were improved in 94%、78% of patient in losartan group and in fosinopril group and 63% in captopril group. 　　Conclusions:Losartan has better effects on UAER and Cr-C than captopril in elderly hypertensive patients.

Objective:To observe the clinical effects of oral Tedral SA on the elderly patients with sinus bradycardia. 　　Methods:Tedral SA(1/2 to one tablet/day in two divided doses)was administered orally to 14 elderly patients with sinus bradycardia.Twenty-four-hour Holter monitoring was performed before and one month after oral Tedral SA. 　　Results:After oral Tedral SA,resting heart rate of 14 patients was maitained between 50 to 70 beats/min.The minimum heart rates before and during therapy has significant difference statistically(34.93±2.79 vs.44.21±2.91,p＜0.001).The heart rate during oral Tedral SA was significantly increased.A few patients complained of palpitation,which disappeared as the dosage of Tedral SA was decreased.Subjective symptoms associated with sinus bradycardia such as dizziness,faintness disappeared completely in 14 patients. 　　Conclusion:Tedral SA was a effective and safe drug for treatment of elderly patients with severe sinus bradycardia.

Objective:To observe the characteristics of 24 hour ambulatory electrocardiogram in patients with chronic atrial fibrillation (AF) and optimal ventricular rate control. 　　Methods:Holter monitoring was performed in 122 hospitalized patients,aged 17—85 (mean 51.57±11.94) years,with organic heart disease and chronic AF (New York Heart Association functional class Ⅱ-Ⅲ) in whom the ventricular rate were well-controlled by digoxin.Maximum,minimum and mean ventricular rates,the number of ventricular pauses of ＞1.5 second,and the longest ventricular pauses during the monitoring were recorded.Follow-up data were collected in 72 patients. 　　Results:The mean,fastest and lowest ventricular rates over 24 hours were 78.53±8.12(65—90)，143.79±28.85(90-183) and 51.04±7.52(34—71) bpm,respectively.Bradycardia of less than 50 and 45 bpm occurred in 62 and 32 of the 122 patients,respectively.Ventricular pauses of more than 1.5 and 3.0 seconds were noted in 95 and 14 of the 122 patients,respectively.The longest ventricular pause was 2.38±0.55(4.64—1.60) seconds.During follow-up,there were no worsening in these patients. 　　Conclusion:Ventricular pauses at rest and nocturnal bradycardia were common in patients with chronic atrial fibrillation who had ventricular rates controlled.The dosage of digoxin should not be changed,nor pacemaker insertion is needed.

Objective: To explore the relationship between ambulatory arterial stiffness indexes (AASI), AASI-blood pressure variability (AASI-BPVR) and left ventricular mass index (LVMI) left atrium diameter (LAD) in patients with hypertension.
Methods: A total of 286 hypertensive patients were enrolled in this study. The AASI, AASI-BPVR were calculated from 24-hour ambulatory blood pressure monitoring. Left ventricular internal dimension in diastole (LVIDd), interventricular septal thickness in diastole (IVSd), posterior wall thickness in diastole (PWd), LAD were detected by echocardiography and LVMI, relative wall thickness (RWT) were calculated. The fasting blood glucose, blood lipids were examined. According to 24 h AASI, the patients were divided into 2 groups, Group A, the patients with AASI > 0.51, n=133 and Group B, the patients with AASI ≤ 0.51,n=153. Pearson and multi regression analysis were conducted to analyze the relevant correlations.
Results: Group A had increased LVMI than that in Group B,P<0.05, the left ventricular masses were similar between 2 groups,P=0.384. Pearson correlation analysis indicated that LVMI and LAD were not related to arterial stiffness index, the coefifcient between 24 h-AASI and LAD was atr=0.111,P=0.057.
Conclusion: AASI and AASI-BPVR were not the independent factors for left ventricular hypertrophy and left atrial enlargement, therefore, they were not the predictors for cardiac damage in patients with hypertension at present time.

Objective: To investigate the effect of endocannabinoid system on cardiac hypertrophy in experimental rats with chronic intermittent hypoxia and to study the impact of endocannabinoid antagonist, rimonabant in such pathological processing.
Methods: A total of 48 male Wistar rats were divided into 6 groups. 4 and 6 weeks of Normal control group, 4 and 6 weeks of Hypoxia group, 4 and 6 weeks of Hypoxia with rimonabant intervention group. n=8 in each group. The rats were sacrificed to measure left ventricular mass index (LVMI), the myocardial cell morphological changes were observed by optical microscope, the expression of cardiac calcium/calmodulin-dependent protein kinase II (CaMKII) and cardiotrophin-1 (CT-1) were detected by immunohistochemistry at 4 and 6 weeks respectively.
Results: Compared with 4 and 6 weeks of Normal control group, the LVMI, cardiac hypertrophy condition, CaMKII and CT-1 were increased in 4 and 6 weeks of Hypoxia group, all P<0.001. Compared with Normal control group and Hypoxia group, the above indexes in Hypoxia with rimonabant intervention group were higher than those in Normal control group while lower than those in Hypoxia group, all P<0.001.
Conclusion: The Chronic intermittent hypoxia could induce myocardial hypertrophy via endocannabinoid system disorders, such pathological processing could be reduced by rimonabant intervention.

Objective: To explore the regulative role of extracellular regulated protein kinase-5 (ERK5)/Bcl-2 interacting mediator of cell death (Bim) pathway in hypothermal stimulation induced neonatal rat’s cardiomyocytes (CMs) damage and apoptosis.
Methods: CMs were cultured for hypothermal stimulation and the speciifc siRNA was used to down-regulate the ERK5 or Bim in CMs. The cell apoptosis was detected by lfow cytometry, protein expression was examined by Western blot analysis, the intracellular Ca2+, reactive oxygen species (ROS) and mitochondrial membrane potential (ΔΨm) were evaluated by lfuorescent labeling and lfow cytometry.
Results: In hypothermal stimulated CMs, ERK5 siRNA could promote Bim protein expression, but Bim siRNA could not inlfuence ERK5, while attenuated p-ERK5 expression. ERK5 siRNA induced higher apoptosis rate, while Bim siRNA could decrease such effect. ERK5 siRNA increased the intracellular Ca2+overloading, ROS activation andΔΨm damage, while Bim siRNA played the role to against those effects in hypothermal stimulated CMs.
Conclusion: Our study revealed that ERK5/Bim pathway played the important regulative roll in hypothermal stimulation induced neonatal rat’s CMs damage and apoptosis.