Objective:To determine the relationship between serum resistin levels and carotid intima media(IMT)thickness in patients with essential hypertension. Methods:This study consisted of 272 patients with essential hypertension. The patients were divided into three groups according to their serum resistin levels. Group 1,n=91,serum resistin level 1.233-3.701 ng/ml;Group 2,n=91,serum resistin level 3.728-8.777 ng/ml;and Group 3,n=90,serum resistin level 8.809-28.658 ng/ml. Results:The carotid IMT and maximum carotid IMT of Group 3 were the highest in three groups.(P＜0.05).As shown in multivariate analysis for factors affecting carotid IMT,serum resistin level(β=0.220,t=5.793,P=0.000)was independently associated with the carotid IMT after controlling the age,blood glucose,uric acid,low-density lipoprotein cholesterol,systolic blood pressure and diastolic blood pressure. Serum resistin level(β=0.189,t=4.733,P=0.000)was independently associated with the maximum carotid IMT after controlling the age,blood glucose,body mass index,diastolic blood pressure,diabetes mellitus,high sensitivity C reactive protein,total cholesterol and triglyceride. Conclusion:Serum resistin was independently associated with the increased carotid IMT in essential hypertension patients.

Objective:To observe the levels of serum endothelin(ET),nitric oxide(NO),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in prehypertension and hypertension patients.Methods:Three groups were recruited from 3050 subjects of regular health checkup in Tangshan Railway Hospital from June to September,2007. Prehypertension (PH) group: n=106,Essential hypertension (EH) group: n=91,and Normotensive (NT) control group: n=98.The levels of ET,TNF-α,IL-6 and NO were compared by radioimmunoassay and biochemical tests. Results: ①Compared with NT group,body mass index (BMI) and serum lipids (TC,TG,LDL-C) were significantly increased in PH and EH groups (P<0.05),high-density lipoprotein cholesterol (HDL-C)was decreased in EH groups (1.59±0.15 vs. 1.77±0.19,P<0.05). ②Compared with NT group,ET,IL-6,TNF-α were increased in PH and EH groups (P<0.05).NO was increased in PH group (6.55±0.94 vs. 5.87±0.80,P<0.05) while decreased in EH group (5.28±0.81 vs. 5.87±0.80,P<0.05). ③Logistic analysis indicated that BMI,ET,NO,TNF-α and IL-6 were related to the hypertension. Conclusion: ET,NO,TNF-α,IL-6 were elevated in prehypertension patients and those might be used to predict the risk of hypertension.

Objective: To detect the systolic and diastolic velocity in patients with idiopathic premature ventricular beat(PVB)by pulsed wave-tissue Doppler imaging (PW-TDI) techniques.Methods: There were two groups involved in this study. PVB group,n=30,patients with idiopathic PVB,and Control group,n=30,of healthy subjects. The changes of cardiac function were measured and compared between two groups by the index of myocardial motion velocity using PW-TDI techniques.Results: A total of 7 sites were studied,there were no significant differences in systolic peak velocities (Sm),time velocity integral (TVI),peak velocity of the early relaxation wave (Em),peak velocity of the later relaxation wave (Am) and Em/Am ratio (Em/Am) between the Control group and PVB group in the normal sinus beat (P＞0.05).Compared with the normal sinus beat,Sm,TVI,Em and Em/Am were significantly lower in PVB (P<0.01),while Sm,TVI,Em in the post-PVB sinus beat were significantly higher than that in normal sinus beat (P<0.01). However,there were no significant differences of Am in each site among the normal sinus beat,PVB and the post-PVB sinus beat. Conclusion: PVB and PVB-induced compensational interval could significantly influence the systolic and diastolic function of the ventricle.

Objective: To analysis the clinical characteristic and pathogenic bacterium of infective endocarditis (IE),and to compare the pathogenic microorganism and vegetation localization between the prosthetic valve endocarditis (PVE) and the native valve endocarditis (NVE).Methods: The data was collected from 266 in-patients who fulfilled Duke Criteria for IE from May 2003 to May 2008 in our hospital.The demographics and clinical data were analyzed retrospectively.Results: There were 243/266 of IE patients suffered from basic heart disease,among them,101 patients with congenital heart disease,77 patients with non-rheumatic valvular heart disease,62 with rheumatic heart disease and 3 with other heart disease.There were 218 (82%) patients with identified vegetation,and the most common vegetation localized at aortic valve,mitral valve,and aortic plus mitral valve in turn.Bacterial cultures were positive in 49.5% of patients.The proportion of Gram-Negative bacillus and Fungi infection had risen in IE.Detection rate of vegetation was lower in PVE patients than that in NVE patients (P<0.01).However,the positive bacterial culture rate was higher in PVE than in NVE (P<0.01).Streptococcus,coagulase negative staphylococcus,gram-negative bacteria showed significant difference between the two groups (P<0.05).The spectrum of microorganism was different between the early and the late PVE patients.The in-hospital mortality rate of PVE was higher than NVE.Conclusion: The spectrum and pathogenic bacterium of IE had changed obviously during the past years.Early diagnosis,bacterial culture with correct antibacterial treatment,transesophageal echocardiography,and active prevention of nosocomial infection should be essential for the disease control.

Objective:To investigate the mRNA expression of β_2-adrenergic receptor(β_2-AR) and the receptor post signaling materials cyclic AMP(cAMP) and cAMP-dependent protein kinase (PKA) activity in myocardial infarction(MI)rats.Methods:MI model was made by ligation of rats'left anterior descending coronary artery.A total of 48 adult Wistar rats were randomly divided into four groups:Control group,the rats were sham operated,and 2 weeks post MI group,4 weeks post MI group and 8 weeks post MI group.The myocytes suspensions were untreated or treated in each group by salbutamol,isoproterenol,ICI118,551,atenolol,propranolol and pertussis toxin(PTX)respectively.The mRNA expression of β_2-AR and β_1-AR from left ventricular myocardium were detected by RT-PCR,the concentration of cAMP was determined by competitive enzyme immunoassay and the activity of PKA was determined by non-radioactive protein kinase assay.Results:Compared with Control group,the mRNA expression of β_1-AR was lower in MI groups(P<0.05),and the ratio of β_2-AR to β-AR increased from 19% to 38%(P<0.01)after MI.Compared with the untreated cells,cAMP concentration was increased by salbutamol treatment in Control group and 2 weeks,4 weeks,8 weeks post MI group by 98.1%,133.6%,147.7% and 150.7% respectively(P<0.05).Compared with isoproterenol treatment,ICI118,551 decreased cAMP concentration in 8 weeks post MI group(P<0.05).Atenolol decreased cAMP in Control group,2 weeks and 4 weeks post MI groups(P<0.05);Propranolol decreased cAMP concentration in Control and three MI groups(P<0.05).β-receptor inhibitor inhibited PKA activity in 8 weeks post MI group(P<0.05),Atenolol inhibited PKA activity in Control group and 2 weeks post MI group(P<0.05),Propranolol inhibited PKA activity in Control group and three MI groups(P<0.05,respectively).Conclusion:The ratio of β_2-AR to β-AR increased after MI.β_2-AR agonist increased cAMP concentration and PKA activity in myocytes in post MI rats.

Objective:To investigate the effect of rapamycin eluting coronary stent for inhibition of neointimal hyperplasia in diabetic porcine model.Methods:There were two groups in this study. Diabetic group, n=12, diabetic porcine model was established by a single dose of streptozotocin, and rapamycin eluting coronary stents were randomly implanted into 2 of the major epicardial coronary arteries. Control group, n=12, with non-diabetic porcine. The degree of neointimal hyperplasia evaluated by coronary angiography, intravascular ultrasound (IVUS) and histopathology were compared between two groups respectively at 6 months of the event. Results:The distribution of vessels received stents, reference vessel diameters and post-procedural minimal luminal diameter were comparable between two groups. All animals received angiographic follow-up at 6 months of time. In Diabetic group, the degree of stent stenosis (35.6%±9.2% vs. 7.9%±3.1%,P<0.001), late lumen loss (0.32±0.09 mm vs. 0.09±0.04 mm,P<0.001), the thickness of neointima by IVUS examination (0.35±0.12 mm vs. 0.11±0.08 mm,P<0.05) and area stenosis by IVUS (1.29±0.51 mm~2 vs. 0.26±0.11 mm~2, P<0.001); and histopathological examination (1.24±0.76 mm~2 vs. 0.19±0.08mm~2, P<0.05) were significantly higher than those in Control group. Conclusion: The neointimal hyperplasia after rapamycin eluting stent implantation was significantly severe in the diabetic porcine models than those in non-diabetic ones.

Objective:To observe the effect of "Qishen Yiqi Droplet" on serum concentrations of high sensitivity C reactive protein(hs-CRP),plasminogen activator inhibitor-1(PAI-1),endothelin-1(ET-1)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention (PCI).Methods:A total of 100 consecutive ACS patients ready to receive PCI therapy in our hospital from june 2007 to August 2008 were randomly assigned into two groups:Qishen group,n=50,with Qishen Yiqi Droplet 5.0 g three timee a day+conventional therapy after PCI;and Control group,n=50 with conventional therapy after PCI.The concentrations of hs-CRP,PAI-1 and ET-1were detected and compared 24 hours before PCI,and 24 hours,4weeks after PCI between two groups respectively.Results:There were no obvious differences of hs-CRP,PAI-1 and ET-1 24 hours after PCI in two groups.The levels of hs-CRP,PAI-1,ET-1 were lower in Qishen group than in Control group 4 weeks after PCI (0.219±0.143)ng/dl vs.(0.366±0.132)ng/dl,P<0.001,(104.252±26.038)ng/dl vs.(118.419±28.849)ng/ml,P<0.05,and (37.411±12.977)ng/dl vs.(45.755±12.305)pg/ml,P<0.01,respectively.Conclusion:Qishen Yiqi Droplet could decrease the levels of hs-CRP,PAI-1 and ET-1 in ACS patients who underwent PCI,and it might have the protective role in preventing the neointimal hyperplasia and thrombogenesis after stent implantation.

Objective:To observe the correlation of platelet activation and the inflammatory factors in patients with coronary heart disease (CHD).Methods:A total of 150 patients with CHD were divided into three groups according to the guideline of ACC/AHA:Stable angina pectoris (SAP) group (n=47,aspirin 100 mg/d); Unstable angina pectoris(UAP) group (n=50,aspirin 100 mg/d+Dalteparin 5000 U Q12 h); Acute myocardial infarction (AMI) group (n=53,aspirin 100 mg/d+Dalteparin 5000 U Q12 h+Plavix 75 mg/d).53 healthy adults served as the Control group.The fast blood sugar,lipid,platelet count,platelet aggregation of plasma,fibrinogen,high sensitivity C reactive protein (hs-CRP) of plasma,and 11-dehydro thromboxane B_2 (11-DH-TXB_2) of urine were detected upon patients' admission.Results:The level of plasma hs-CRP in groups of SAP,UAP and AMI(4.25±2.95 mg/l,7.61±6.11 mg/l,15.46±8.22 mg/l)were significantly higher than that in Control group(2.07±1.28 mg/l,P<0.05).The max rate of platelet aggregation induced by ADP in groups of UAP and AMI were significantly higher than that in Control and SAP groups(74.35±8.91%,73.88±8.35% vs.66.22±7.51%,68.67±6.87%,P<0.05).There were significant differences in the max rate of platelet aggregation induced by arachidonic acid (AA) and 11-DH-TXB_2 of urine in different groups (P<0.05).The level of plasma hs-CRP in all patients with CHD were significantly positively correlated with the max rate of platelet aggregation induced by ADP (r=0.473,P=0.000),AA(r=0.434,P=0.000) and 11-DH-TXB_2 of urine (r=0.554,P=0.000).Conclusion:There were significant relationship between the levels of plasma hs-CRP,11-DH-TXB_2 and the max rate of platelet aggregation,which indicating inflammation might induce platelet aggregation in CHD patients.

Objective: To determine the long-term prognostic value of ~(99m)Tc-sestamibi (MIBI) Gated myocardial perfusion imaging(G-MPI)in patients with coronary artery disease.Methods: A total of 1345 consecutive symptomatic coronary artery disease patients who underwent ~(99m)Tc-MIBI G-MPI were studied.1250 patients were followed-up by telephone interview, the median follow-up time was 26.7±13.6 months.Events were defined as cardiac death, nonfatal myocardial infarction and revascularization by coronary artery bypass graft or percutaneous coronary artery intervention.Results: Cox regression analysis indicated that summed stress score (3.8±6.1,χ~2=67.25), summed different score (1.1±3.0,χ~2=21.09) and left ventricular ejection fraction (LVEF) (0.667±0.097,χ~2=42.26) were independent predictive factors of cardiac events (P<0.01).Kaplan-Meier analysis indicated that cardiac event free survival was significantly lower in the patient with LVEF≤50%.Conclusion: In Patients with symptomatic coronary artery disease, the summed stress score, summed rest score, summed different score and LVEF had prognostic value, and low LVEF indicated worse prognosis.

Objective: To evaluate the influence of recombinant human brain natriuretic peptide(rhBNP)on ventricular remodeling and ventricular systolic synchrony in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods: A total of 48 patients with AMI after PCI were randomized into two groups: rhBNP Group (n=25) and Routine treatment Group (n=23).Two dimension echocardiography was used to measure the index of left ventricular end-diastolic volume (LVEDVI), the index of left ventricular end-systolic volume (LVESVI), left ventricular ejection fraction (LVEF), the index of left ventricular mass (LVMI), the movement index of infarcted regional wall (RWMI) at 1 week, 4 weeks and 24 weeks after the treatment procedure.And at 1 week and 24 weeks period, equilibrium radionuclide angiography was performed respectively to evaluate the ventricular systolic synchrony.Results: ①1 week after PCI, LVESVI in rhBNP group was decreased and LVEF was increased than that in Routine treatment group (P<0.05, respectively).4 and 24 weeks after PCI, LVEDVI, LVESVI, LVEF were significantly different in rhBNP group than those in Routine treatment group (P<0.05,respectively).24 weeks after PCI, RWMI and LVMI were significantly decreased in rhBNP group than those in Routine treatment group(P<0.05,respectively).②24 weeks after PCI, phase shift, full width at half maximum and peak phase standard deviation were significantly improved in rhBNP group than those in Routine treatment group (P<0.05, respectively).Conclusion: Intravenous injection of rhBNP could inhibit left ventricular remodeling and improve left ventricular function.