Objective To determine the related facuors of side branch occlusion after stent implantion in the main branch of biburcation lesions.Methods We retrospectively analyzed 121 bifurcation lesions in 92 patients who accepted percutaneous coronary interventional therapy in our hospital from 2005 September to 2006 January.We employed quantitive coronary angiography analysis after stenting in the main branch and then evaluated the factors related to side branch stenosis.Results After stenting in the main branch of bifurcation lesions,four factors were found to be involved in causing side branch stenosis,which included:the plaque burden of both branches,the angle of bifurcation and the diameter of the side branch.The plaque burden of both branches was positively correlated but the biburcation angle and the diameter of the side branch were correlated to the formation of side branch stenosis.The severity of side branch stenosis after PCI could be represented by the regression equation:Y=0.48A-11.4B-0.23C+0.22D(Y:the degree of side branch stenosis after main branch stenting,unit:%;A:degree of pre-procedural side branch stenosis;B:diameter of the side brance;C:biburcation angle;D:the degree of pre-procedural main branch stenosis).Conclusion In bifurcation lesions,side branch stenosis after stenting in the main branch is related to plaque burden of both branches,diameter of the side branch and the bifurcational angle.Serious plaque burden in both branches,small side branch and sharper biburcation angle are more likely to cause side branch occlusion after main branch stenting.

Objective To explore the possibility of dynamic pulse pressure (DPP) being used to predict cardiovascular events in old men with normotension. Methods During May 1995 to September 2001, a 24h DPP monitoring was carried out on 858 old men with normotension (60-91 years old, BP60 mmHg, respectively. The first attack of cardiovascular event was recorded. Results In the 3 groups of subjects, the incidence of total cardiovascular events (100 persons per year) was 3.7, 5.8, and 9.1 respectively (log-rank test, P=0.000 9, 0.000 2, 0.000 0). After adjustment for the other risk factors including age, hypertension history, diabetes and previous cardiovascular disease, it has been found that the data of dynamic pulse pressure is of a significant value for predict cardiovascular events (P

Objective To study the anticoagulant activity of hirulog. Methods Rabbits blood samples were collected before and after injecting hirulog. Thrombin clot time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) were measured to investigate the dose-effect and time-effect relationship of hirulog and compared the efficacy with heparin. Results TT, PT and APTT of rabbits blood samples were prolonged remarkably by hirulog, and the action duration was about 60 min, that was similar to heparin. Conclusion Hirulog showed obvious anticoagulant effects with clear dose-effect relationship.

Objective To analyze the clinical characteristics of patients with cardiac amyloidosis.Methods The clinical data of 14 patients with cardiac amyloidosis were retrospectively analysed.Results The patients with cardiac amyloidosis had characteristics of large atriums and hypertrophic ventricular walls in echocardiography.And they also had low limb lead voltage in ECG.The ratio of(SV5+RV1)and left ventricle crossing area of all patients were obviously lower than 1.5.Biopsy behaved staining of congo red.And most patients had renal,dermatic and gastrointestinal involvements.Conclusion The patients of cardiac dysfunction with the characteristics of restrictive cardiomyopathy in echocardiogram and feature of low limb lead voltage in ECG,have the possibility of cardiac amyloidosis and need to prove it through biopsy.(SV5+RV1)/CSA may be a promising method for screening cardiac amyloid.

Objective:To investigate the effect of angiotensin II (ang II), aldosterone (ald) and their receptor antagonists losartan (los) and spironolactone (spi) on the proliferation and collagen production of cardiac ifbroblasts (CFs) in rats.
Methods:CFs were isolated from neonatal SD rats by collagenase II method and puriifed with differential attachment and detachment method. The 3 or 4 passages of the CFs were divided into the following groups:angiotensin II, angiotensin II+aldosterone, aldosterone, angiotensin II+losartan, and aldosterone+spironolactone. The cell viability of the CFs was assessed by Cell Counting Kit-8 (CCK-8) after the drug administration. The mRNA and protein expression levels of COL1A1, COL3A1, MMP1 and TIMP1 were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot respectively.
Results:Ang II and Ald facilitated the proliferation rate of the CFs independently compared with that in the control group (38.5%vs 28.5%;P<0.05), and the proliferation rate in the ang II+ald group was higher than that in the ang II group and ald group alone (54.4%, P<0.05). Los and spi inhibited the effect induced by ang II and ald respectively (P<0.05). Compared with the control group, ang II and ald signiifcantly enhanced COL1A1, COL3A1 and MMP1 expression both at the mRNA and protein levels (P<0.05), but the TIMP1 expression was inhibited (P<0.05), which could be abolished by corresponding receptor antagonists los and spi (P<0.05).
Conclusion:Ang II and ald can promote the proliferation of CFs, and the COL1A1 and COL3A1 expression is enhanced both at mRNA and protein levels. Ang II and ald have synergistic effect when they are used together, while los and spi may restrain the effect. The mechanism is probably linked with the balance of MMPs/TIMPs.

Objective To investigate the relationship between the content of ET-1, CGRP, NO in myocardium and cardiac function in chronic renal ischemia of rats caused by abdominal aortic banding. Methods Male wistar rats (weight 180 - 200g) were randomly divid-ed into 2 groups, operation group (n=30) and sham operation group (n=10). Abdominal aorta ligation between right and left renal ar-tery was made with silk suture in operation group, and the narrow degree of aorta was about 50% which was controlled by ligateing with a syr-inge needle (7#). The aorta was not ligated in sham operation group. After 16 weeks of operation, invasive measurement of blood pressure and cardiac function were performed, and content of ET-1, CGRP and NO in myocardium were determined. Results Compared with sham operation group, the blood pressures of rats in operation group were significantly elevated, with cardiac systolic and diastolic function de-creased and left ventricular mass index increased. After 16 weeks, compared with sham operation group, the content of ET-1 in cardiac tissue were significantly elevated in operation group (P<0.01), while the content of CGRP (P<0.01)and NO (P>0.05)were decreased. There were negative correlation between the content of ET-1 in cardiac tissue and LV +dp/dt max(r = -0.37, P<0. 05). Conclusions In the state of chronic kidney iachemia caused by abdominal aorta ligation, content of ET-1 in cardiac tissues were increased while CGRP and NO were decreased. There were negative correlation between the content of ET-1 in cardiac tissues and LV systolic function.

Objective To evaluate the left ventricular systolic function of the patients who received coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI), in order to compare the clinical effectiveness of these two operations. Methods 61 patients with coronary artery disease were enrolled in this study. 28 patients received CABG and 33 patients PCI. The left ventricular systolic function was assessed by two-dimensional (2D) echocardiography and Doppler tissue imaging (DTI) (Aspen imaging systems). Results The left ventriculus ejection fraction (EF) and the average velocity of systolic wave (S) of mitral annular were increased after CABG or PCI. There was no statistical significant difference in degree of improvement in the left ventricular systolic function between two operations. Conclusions The results of this study suggested that the global left ventricular systolic function was improved after either successful CABG or PCI, with no signiticant difference in clinical efficaciousness.

Objective To investigate the diagnostic accuracy of 3-dimensional reconstruction(3DR) coronary angiography in the evaluation of coronary artery disease compared with conventional quantitative coronary angiography with IVUS result as the reference standard.Methods Twenty vessel segments in nineteen patients who underwent coronary angiography and IVUS were studied.With the IVUS result as the reference standard,the 3D reconstruction images and the single plane(2D) images of each angiograph were retrospectively studied and compared.Results In all the 20 segments,the minimal vessel diameter/area rate of the stenosed vessels and the reference vessels,and the minimal cross-sectional stenosis rate had no significant differences among the conventional 2D angiograph the 3DR angiograph and the IVUS results.According to the IVUS results,all the 20 vessel/segments were further divided into two groups which were:the eccentric stenosis group(n=7) and the centripetal stenosis group(n=13).In the centripetal stenosis group,all the angiographic parameters detected by the three methods had no statistical difference.In the eccentric stenosis group,the 3DR angiograph showed more consistent results as detected by IVUS compared with the 2D angiograph in terms of cross-sectional stenosis rate.Conclusion Three dimentional reconstruction of coronary angiography showed higher accuracy in the quantitative analysis of coronary artery stenosis compared with conventional coronary angiography,especially in eccentric stenosis.

Objective To discuss the feasibility of endovascular treatment for traumatic arterial lesions.MethodSix patients treated by endovascular stent grafts were retrospectively reviewed.Result Patients consisted of left common carotid artery pseudoaneurysm, right subclavian arteriovenous fistula,thoracic aortic pseudoaneurysm, righ iliac arteriovenous fistula,left iliac arterial pseudoaneursym and femoral arterial pseudoaneurysm. All of the patients abtained the blood flow reconstruction without any complications after endoluminal therapy under local anesthesia. No occlusion appeared during follow up.Conclusion The stent grafts appear to be associated with a low morbidity, high success rate, and less traumatic procedure. Endovascular management is an important tool for the treatment of vascular trauma.

12 months in 31.3% (15/48). The graft lesions were found in 72.9% (35/48) of the patients, the worsened native lesions in 8.3% (4/48) and incomplete revascularization in 12.5% (6/48). Total occlusion was found in 33.3% (45/135) of the grafts and stenosis in 5.9% (8/135). LIMA total occlusion was 46.4% (13/28), stenosis was 8.6% (3/35) and competitive flow was 8.6% (3/35). Stenosis was found in 5.2% (5/97) of the SVG and total occlusion in 35.1% (34/97). Two of the five radial arteries were stenotic. Except for the chronic total occlusions, PCI treated the above problems with a high success rate. Conclusion Reoccurrence of angina is not uncommon after CABG. The causes are mainly due to the graft problem, and secondly due to worsened native lesion and incomplete revascularization. PCI can be used to treat the above problems except for the chronic total occlusions of the native vessels and graft.