Objective To predict the infarction of related artery(IRA)and the site of occlusion by analyzing the diversify of electrocardiographic ST segment and coronary angiography findings in acute inferior myocardial infarction. Methods Sixty-four patients with acute inferior myocardial infarction were divided into two groups by coronary angiography: right coronary artery(RCA)occlusion group(51 patients)and left circumflex coronary artery(LCX)occlusion group(13 patients). RCA occlusion group included proximal,middle and distal components occlusion, and LCX occlusion group included proximal and distal components occlusion. The cases of STⅢ elevation ＞ ST Ⅱ ,STaVL depression ＞ STⅠ ,STV1 depression,STV7-V9 and STV3R-V5R elevation were recorded and compared. Results The percentage of STⅢ elevation ＞ STⅡ, STaVL depression ＞STⅠ, STV1 no depression, STV7-V9 no elevation and STV3R-V5R elevation was significantly higher in RCA occlusion group than those in LCX occlusion group(P ＜ 0.01 or ＜ 0.05). The percentage of ST Ⅲ elevation ≤ ST Ⅱ, ST,VL depression ≤STⅠ ,STV1 depression,STV7-V9 elevation,STV3R-V5R no elevation was significantly higher in LCX occlusion group than those in RCA occlusion group(P ＜0.01 or ＜0.05). In RCA occlusion group:the sensitivity of STⅢ elevation ＞ STⅡ, STaVL depression ＞ STⅠ and STV1 no depression was 90.2%, 80.4% and 80.4%;the specificity of STⅢ elevation ＞ STⅢ and STaVL depression ＞ STⅠwas 84.6% and 84.6% ;the sensitivity of STV3R-V5R elevation was 51.0%, but its specificity was 100.0%. In LCX occlusion group: the sensitivity of STⅢ elevation ≤ ST Ⅲ and STaVL depression ≤ ST Ⅰ was 84.6% and 84.6%, and their specificity was 90.2% and 80.4%;the specificity of STV1 depression and STV7-V9 elevation was 80.4% and 78.4%; the sensitivity of STV3R-V5R no elevation was 100.0% ,and its specificity was 51.0%. In RCA occlusion group, the percentage of STV3R-V5Relevation was higher in proximal components occlusion than that in distal components occlusion[76.9%(10/13)vs. 27.3%(3/11),P=0.015]. Conclusions The IRA can be initially judged by analysis of the characteristics in the ST segment in Ⅰ,Ⅱ ,Ⅲ ,aVL,V1,V7-V9,V3R-V5R lead in acute inferior myocardial infarction. And the ST segment elevation in V3R-V5R is meaningful in the judgment of proximal and distal components occlusion in RCA.

Objective: To investigate the effect of nicotinamide mononucleotide adenosyl transferase 3 (NMNAT3) on the mitochondrial function and anti-oxidative stress of rabbit bone marrow mesenchymal stem cells (BMSCs) under oxidative stress in vitro by regulating nicotinamide adenine dinucleotide (NAD +) levels. Methods: The bone marrow of femur and tibia of New Zealand white rabbits were extracted. BMSCs were isolated and cultured in vitro by density gradient centrifugation combined with adherent culture. The third generation cells were identified by flow cytometry and multi-directional induction. Overexpression of NMNAT3 gene was transfected into rabbit BMSCs by enhanced green fluorescent protein (EGFP) labeled lentivirus (BMSCs/Lv-NMNAT3-EGFP), and then the expression of NMNAT3 was detected by real-time fluorescence quantitative PCR (qRT-PCR) and Western blot and cell proliferation by cell counting kit 8 (CCK-8) method. BMSCs transfected with negative lentivirus (BMSCs/Lv-EGFP) and untransfected BMSCs were used as controls. The oxidative stress injury cell model was established by using H 2O 2 to treat rabbit BMSCs. According to the experimental treatment conditions, they were divided into 4 groups: Group A was normal BMSCs without H 2O 2 treatment; untransfected BMSCs, BMSCs/Lv-EGFP, and BMSCs/Lv-NMNAT3-EGFP in groups B, C, and D were treated with H 2O 2 simulated oxidative stress, respectively. The effects of NMNAT3 on the mitochondrial function of BMSCs under oxidative stress [changes of mitochondrial membrane potential, NAD + and adenosine triphosphate (ATP) levels], the changes of anti-oxidative stress ability of BMSCs [reactive oxygen species (ROS) and malondialdehyde (MDA) levels, manganese superoxide dismutase (Mn-SOD) and catalase (CAT) activities], and the effects of BMSCs on senescence and apoptosis [senescence associated-β-galactosidase (SA-β-gal) staining and TUNEL staining] were detected after 24 hours of treatment. Results: The rabbit BMSCs were successfully isolated and cultured in vitro. The stable strain of rabbit BMSCs with high expression of NMNAT3 gene was successfully obtained by lentiviral transfection, and the expressions of NMNAT3 gene and protein significantly increased ( P<0.05). There was no significant difference in the trend of cell proliferation compared with normal BMSCs. After treatment with H 2O 2, the function of mitochondria was damaged and apoptosis increased in all groups. However, compared with groups B and C, the group D showed that the mitochondrial function of BMSCs improved, the membrane potential increased, the level of NAD + and ATP synthesis of mitochondria increased; the anti-oxidative stress ability of BMSCs enhanced, the levels of ROS and MDA decreased, and the activities of antioxidant enzymes (Mn-SOD, CAT) increased; and the proportion of SA-β-gal positive cells and the rate of apoptosis decreased. The differences in all indicators between group D and groups B and C were significant ( P<0.05). Conclusion: NMNAT3 can effectively improve the mitochondrial function of rabbit BMSCs via increasing the NAD + levels, and enhance its anti-oxidative stress and improve the survival of BMSCs under oxidative stress conditions.

OBJECTIVE:To explore mechanism,prevention and treatment of thrombosis following implantation of coronary artery stent.METHODS:The first author used computer to retrieve Vip Database (http://www.cqvip.com/) for articles concerning thrombosis following implantation of coronary artery stent published from January 2000 to October 2009.The key words included "coronary artery,stent implantation,thrombus".The data were primarily screened,and references of each article were checked.Inclusion criteria:mechanism and risk factor of thrombosis in stent;prevention and treatment of thrombosis in stent.Exclusion criteria:articles addressing duplicated or old contents.Finally,28 articles were included.RESULTS:Thrombosis in stent was a severe complication in interventional therapy of coronary artery disease,could induce severe outcomes for the body.Compared with common mental stent,drug eluting stents can significantly reduce restenosis rate and revascularization rate of target lesions.Following stent implantation,thrombosis in stent can occur in early,late and extremely late phases.The mechanisms are different.Antiplatelet,anticoagulation and lipid-lowering therapy can diminish the occurrence rate of thrombosis in stent.Individual surgery and individual drug therapy not only can solve revascularization in the coronary artery,but also decrease restenosis rate and occurrence rate of thrombosis in stent.CONCLUSION:With the expectation of novel stents,various risk factors for thrombosis in stent should be assessed in detail to achieve individual surgery and individual drug therapy.During revascularization in the coronary artery,restenosis rate and occurrence rate of thrombosis in stent should be reduced.

Objective To report the experience of using R 0 Swartz sheath in patients with tortuous and prolonged aorta. Methods The radiofrequency ablation procedure could not be done in 4 patients (3 patients with left side accessory pathway, and 1 with idiopathic left ventricular tachycardia) because the ablation catheter could not be put in left ventricle due to tortuous and prolonged aorta. We tried to use R 0 Swartz sheath in these patients in order to put the catheter into left ventricle via small curve of the R 0 Swartz.Results The ablation procedures were successful in these 4 patients by using R 0 Swartz.Conclusion Using R 0 Swartz sheath in patients with tortuous and prolonged aorta is helpful in making the left side ablation procedure successful.

OBJECTIVE: To investigate whether hydrogen-rich water exerts a protective effect against cellular injury by affecting the level of autophagy after oxygen glucose deprivation/reoxygenation (OGD/R) in a mouse hippocampal neuronal cell line (HT22 cells). METHODS: HT22 cells in logarithmic growth phase were cultured in vitro. Cell viability was detected by cell counting kit-8 (CCK-8) assay to find the optimal concentration of Na₂S₂O₄. HT22 cells were divided into control group (NC group), OGD/R group (sugar-free medium+10 mmol/L Na₂S₂O₄ treated for 90 minutes and then changed to normal medium for 4 hours) and hydrogen-rich water treatment group (HW group, sugar-free medium+10 mmol/L Na₂S₂O₄ treated for 90 minutes and then changed to medium containing hydrogen-rich water for 4 hours). The morphology of HT22 cells was observed by inverted microscopy; cell activity was detected by CCK-8 method; cell ultrastructure was observed by transmission electron microscopy; the expression of microtubule-associated protein 1 light chain 3 (LC3) and Beclin-1 was detected by immunofluorescence; the protein expression of LC3II/I and Beclin-1, markers of cellular autophagy, was detected by Western blotting. RESULTS: Inverted microscopy showed that compared with the NC group, the OGD/R group had poor cell status, swollen cytosol, visible cell lysis fragments and significantly lower cell activity [(49.1±2.7)% vs. (100.0±9.7)%, P < 0.01]; compared with the OGD/R group, the HW group had improved cell status and remarkably higher cell activity [(63.3±1.8)% vs. (49.1±2.7)%, P < 0.01]. Transmission electron microscopy showed that the neuronal nuclear membrane of cells in the OGD/R group was lysed and a higher number of autophagic lysosomes were visible compared with the NC group; compared with the OGD/R group, the neuronal damage of cells in the HW group was reduced and the number of autophagic lysosomes was notably decreased. The results of immunofluorescence assay showed that the expressions of LC3 and Beclin-1 were outstandingly enhanced in the OGD/R group compared with the NC group, and the expressions of LC3 and Beclin-1 were markedly weakened in the HW group compared with the OGD/R group. Western blotting assay showed that the expressions were prominently higher in both LC3II/I and Beclin-1 in the OGD/R group compared with the NC group (LC3II/I: 1.44±0.05 vs. 0.37±0.03, Beclin-1/β-actin: 1.00±0.02 vs. 0.64±0.01, both P < 0.01); compared with the OGD/R group, the protein expression of both LC3II/I and Beclin-1 in the HW group cells were notably lower (LC3II/I: 0.54±0.02 vs. 1.44±0.05, Beclin-1/β-actin: 0.83±0.07 vs. 1.00±0.02, both P < 0.01). CONCLUSIONS Hydrogen-rich water has a significant protective effect on OGD/R-causing HT22 cell injury, and the mechanism may be related to the inhibition of autophagy.
Mice ; Animals ; Oxygen/metabolism* ; Beclin-1/pharmacology* ; Glucose/metabolism* ; Actins ; Sincalide ; Autophagy/physiology* ; Hydrogen/pharmacology* ; Reperfusion Injury ; Apoptosis

【Objective】 To report the data of 4 cases of Trocar-assisted ureteroscopy in the treatment of transplanted renal ureteral stones, to analyze the effectiveness of this therapy, and provide a reference for the treatment of such patients. 【Methods】 Clinical data of 4 patients with ureteral stones of transplanted kidney treated at the Affiliated Hospital of Guizhou Medical University during Jan.2016 and Jul.2023 were retrospectively analyzed.All patients received auxiliary ureteral soft/rigid endoscopic combined with holmium laser lithotripsy after Trocar-assisted bladder fistula.Renal function was rechecked after surgery and all patients were followed up regularly. 【Results】 All 4 cases had upper ureteral stones.During the follow-up of 24-68 (average 38) months, no residual or recurrent stones were observed.Renal function and creatinine level returned to normal (79.0 μmol, 95.0 μmol, 60.6 μmol, 82.0 μmol, respectively). 【Conclusion】 The treatment of ureteral stones of transplanted kidney should be individualized.Bladder fistula with Trocar-assisted ureteroscopy can effectively protect the function of transplanted kidney, which is worthy of promotion and application.

Objective To observe the protective effect of magnesium gluconate on myocardial apoptosis by ischemia reperfusion injury in isolated rat hearts, and study the possible mechanism. Methods The hearts of 48 Sprague-Dawely rats were isolated, linked to Lange-ndorff perfusion apparatus, and randomly divided into 3 equal groups(n = 16 each) : Control group, ischemia/reperfusion (I/R) group and magnesium gheonate group. 8 rats in each group were perfused. Control group was pedused with modified KH buffer for 110min. I/B group was perfuesd with modified KH buffer for 20 min, then exposed to iscbemia for 30 min, and then reperfused with modified KH buffer for 60 min. Magnesium gheonate group was perfumed with modified KH buffer with magnesium gluconate for 20 min, then exposed to isohemia for 30 min and then reperfused with modified KH buffer with magnesium glueonate for 60 min. Lacate dehydrogenase (LDH) and ereatine kinase (CK) in the effluent liquid from the heart were measured after reperfusion. The concentration of Ca2+ and NO in the left ventricle were determined. The other 8 rats in each group were reperfused for 120 minutes as the method described before. After repeffusion, the myoeyte apoptosis was examined by Annexin-V-FITC/PI. After the two experiments the incidence of ventrieular arrhytlunias during reperfusion was assessed. Results Compared with I/R, magnesium glueonate decreased the incidence of ventricular an'hythmias(P <0. 01). The contents of CK and LDH in the effluent liquid from the heart in magnesium glueonate group was lower than that of I/R group (P <0. 01). The contents of Ca2+ and NO in the left ventricle in magnesium gluconate group was decreased than that of I/R group (P <0. 01). The index of myocyte apoptosis were significanfly lower in magnesium glueonate group than that of I/R group (apoptosis index :27.79±1.59 vs 33.61±2.10, P < 0. 01) . Conclusion Magnesium glueonate has protective effect on myocardial isohemia reperfusion injury in rats. The protective effect may be related to decreasing myocyte apoptosis by increasing the content of NO and relieving calcium overload.

Objective To study the protective effects of crocetin on myocardial ischemia-reperfusion injury, and their correlation with the signaling pathway of serine/threonine protein kinase (Akt)/glycogen synthase kinase (GSK)-3β/nitric ox?ide synthase (eNOS). Methods Forty healthy SD rats were divided into normal group (N), ischemia reperfusion group (IR) and 5, 10 and 15 mg/L of crocetin groups (CRO1, CRO2 and CRO3) by random number table method. The values of heart rate (HR), coronary flow (CF) and left ventricular pressure measurement (LVDP, LV+dp/dtmax, LV-dp/dtmax) 30 minutes after reperfusion were compared between five groups. TTC staining was used to detect the infarct volume. Spectrophotometric method was used to determinate the expression of lactate dehydrogenase (LDH) and creatine kinase (CK-MB). The levels of Akt, the phosphorylation of Akt (p-Akt), GSK-3β, phosphorylation of GSK-3β(p-GSK-3β), eNOS and phosphorylation of eNOS (p-NOS) were detected by Western blot assay. Results The HR, CF, LVDP, LV+dp/dtmax and LV-dp/dtmax were significantly lower 30 min after reperfusion in IR group than those of N group and crocetin groups (P<0.05). The myocardial infarction area was bigger in IR group than that of crocetin groups. The expression levels of LDH and CK-MB were signifi?cantly higher in IR group than those of N group and crocetin groups (P<0.05). The reperfusion index was higher in CRO3 group than that of CRO1 group. The infarction area, LDH and CK-MB expressions were significantly decreased in CRO3 group than those of CRO1 group (P<0.05). There were no significant differences in expressions of Akt, GSK-3βand eNOS between IR group, N group and crocetin groups. But p-Akt, p-GSK-3βand p-NOS were significantly decreased in IR group than those of N group and crocetin groups. The p-Akt, p-GSK-3βand p-NOS were significantly increased in CRO3 group than those of CRO1 group (P<0.05).Conclusion Crocetin has protective effects on myocrdial ischemia reperfusion injury in rats, which may be involved in the enhancing the phosphorylation of signalling pathway of Akt/GSK-3β/eNOS.

Objective: To investigate the application value of one-step scanning of head, neck and heart with dual-source CT in atherosclerosis (AS) patients. Methods: A total of 120 AS patients were randomly divided into group A and B (each n=60). One-step scanning was performed in group A, while conventional coronary CTA and CTA of head and neck vessels were performed in group B. Subjective and objective evaluations of image quality were carried out. The 3-point method was used for subjective scoring. Objective evaluation indicators included the mean SNR of left coronary artery trunk, right coronary artery, common carotid artery near the bifurcation, internal carotid artery C1 segment and M1 segment of the middle artery, as well as CNR relative to the paraspinal muscles. The scanning length of CTA, time of scanning, dose length product (DLP) and effective dose (ED) were recorded to evaluate the radiation dose, and then statistical analysis was done. Results: There was no significant difference of image quality scores (t=0.596, P=0.283), nor of SNR and CNR (t=0.828, 0.761, P=0.104, 0.089) between the two groups. Although no significant difference of scanning length of CTA was found (t=1.351, P=0.621), the time of scanning in group A was shorter than that in group B ([1.30±0.12]s vs [4.08±0.69]s, t=-2.831, P=0.006), and DLP ([146.03±13.05]mGy•cm vs [1 935.04±134.12]mGy•cm, t=-6.743, P<0.01) and ED ([0.88±0.32])mSv vs [9.62±1.64]mSv, t=-4.056, P<0.01) in group A were lower than those in group B. Conclusion: For AS patients, one-step scanning of head, neck and heart with dual-source CT can provide satisfactory imaging quality of coronary artery and arteries of head and neck, meanwhile significantly reduce the radiation dosage.

Objective:To explore the effects of enriched environment on neurological function in cerebral ischemia-reperfusion injury rats and the glucose metabolism in ischemic penumbra. Methods:A total of 72 adult male Sprague-Dawley rats were randomly divided into sham group (n = 24), model group (n = 24) and enriched environment group (n = 24). The latter two groups suffered cerebral ischemia 60 minutes and reperfused with modified Longa's method. The enriched environment group was fed in enriched environment after operation. All the rats were assessed with modified Neurological Severity Score (mNSS) before, and one, seven, 14, 21 and 28 days after operation. One and 28 days after operation, twelve rats from each groups were sacrificed after mNSS assessment, respectively. The histopathology was observed with HE staining. The expressions of hypoxia-inducible factor-1α (HIF-1α), glucose transporter 1 (GLUT1) and 6-phosphofructo-2-kinase/fructose-2-bisphosphatase 3 (PFKFB3) in ischemic penumbra were determined with reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting. The levels of ATP, ADP and AMP in ischemic penumbra were measured with high performance liquid chromatography (HPLC) and the energy charge (EC) was calculated. Results:Compared with the model group, the scores of mNSS decreased in the enriched environment group since 14 days after operation (P < 0.05). The cells in the penumbra presented edema, nuclear pyknosis marginalization, vacuolar arrangement and other pathological changes in the model group and the riched environment group one day after operation; while compared with the model group, the levels of ATP and EC decreased and the mRNAs and protein expression of HIF-1α, GLUT1 and PFKFB3 increased in the enriched environment group (P < 0.05). The pathology improved in the riched environment group compared with that in the model group 28 days after operation; while the mRNAs and protein expression of HIF-1α, GLUT1 and PFKFB3 increased, as well as the levels of ATP and EC (P < 0.05). Conclusion:Enriched environment can promote the recovery of neurological function in rats after cerebral ischemia-reperfusion, which may associate with promoting expression of HIF-1α and downstream GLUT1 and PFKFB3, and improving glucose metabolism.