AIM: To explore the effects of CD40-CD40 ligand (CD40L) interaction on endothelial cells (ECs) procoagulant activity. METHODS: A co-incubation system of macrophage membrane with ECs was established. The changes in ECs procoagulant activity and tissue factor (TF) expression were studied by anti-CD40L antibody blocking analysis. RESULTS: Coincubation with macrophage membrane (cell ratio 1∶1) for 6 hours resulted in a 10.9-fold increase ( P

Objective To observe the effects of 131I treatment on circulating granulocyte colonystimulating factor (G-CSF) and leucocyte levels of patients with Graves' disease (GD).Methods Enzyme-linked immunosorbent assay (ELISA),coulter three assortments,and radioimmunoassay were used to test the levels of circulating G-CSF,leucocytes and thyroid hormones of 65 incipient and untreated GD patients,all females,aged 21 -50,43 with normal leucocyte level and 22 with leucopenia before and after 131I treatment.Thirty age-matched healthy female subjects were used as controls.Results Before 131I treatment,the serous G-CSF level of the GD patients with normal leucocyte level was (28.4 ± 11.7)μg/L,significantly higher than that of the control [ ( 18.3 ± 6.98) μg/L,t =2.376,P ＜ 0.05 ].The serous G-CSF level of the GD patients with leucopenia was (40.1 ± 13.8 ) μg/L,significantly higher than that of the patients with normal leucocyte level ( t =2.788,P ＜ 0.01 ) and that of the control ( t =3.672,P＜0.01 ).180 d after the initiation of 131 I treatment,the G-CSF level of the patients with normal leucocyte level was (18.9 ± 8.32) μg/L,not significantly different from that of the normal controls,however,the G-CSF level of the GD patients with leucopenia was (25.7 ± 11.5) μg/L,still significantly higher than that of the normal control (t =2.103,P ＜ 0.05).The serous G-CSF level was negatively correlated with the titer of leucocyte ( r =- 0.38,P ＜ 0.05 ),however,not significantly correlated with such clinical parameters,as free triiodothyronine (FT3),free thyroxine (FT4) and thyrotropin-stimulating hormone (TSH).Conclusions Abnormal increment of G-CSF is observed in the GD patients,which may be related to the decrease of leucocyte.Effectively suppressing the auto-immune status in the GD patients,131I treatment is a safe and reliable therapy for GD patients with leucopenia and should be used as early as possible.

Objective To elucidate the association of plasma factor Ⅷ oagulant activity(FⅦc)with me risk of myocardial infarction (MI) and to assess the influence of factor Ⅶ gene Mspl polymorphism and lipid metabolism on FⅦc in the Chinese. Methods A total of 137 patients with angiographically confirmed MI and 125 healthy individuals were evaluated retrospectively. Plasma FⅦC was measured by one-stage prothrombin time,and FⅦ genotype was determined after Mspl digestion of polymerase chain reaction-amplified genomic DNA.Serum lipidlevels were assessed by routine methods.Results MI patients had significantly higher levels of FⅦc (119.5%±22.7% vs 99.9%±21.8%,P＜0.01) and total serum cholesterol (5.80±1.06mmol/L vs 5.53±1.08 mmol/L, P＜0.05) than controls, but only FⅦc independently correlated with the risk of MI (OR=1.04, P＜0.01). There were no significant differences in FⅦ genotype or allele frequency between patients and controls (P＞0.05).Subjects with the Gln353 allele were associated with significantly lower FⅦc levels than Arg353homozygotes (99.7%±19.3% vs 111.4%±24.6%,P＜0.05). Serum triglyceride was positively correlated with plasma FⅦc in both control(r=0.25, P＜0.01)and case (r=0.87, P＜0.01) groups, but this correlation was restricted to Arg/Arg genotypa (r=0.68, P＜0.01).A significant correlation of total serum cholesterol with FⅦc only appeared in Arg/Arg homozygotes (r=0.17, P＜0.01). Conclusions Our findings support the role of plasma FⅦc as a risk factor for MI in Chinese. Plasma triglyceride and FⅦ gene Mspl pclymorphism are two independent determinants of FⅦc. Assay of this polymorphism will be helpful in determining who will benefit most from lipid-lowing therapy.

OBJECTIVETo examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy.

METHODSA total of 790 patients who underwent successful PTCA and PTCA + stent in this hospital were followed by direct interview or letter. The rate of follow-up was 84.2% and the period of follow-up was 0.9 - 12.7 (3.5 +/- 2.4) years.

RESULTSDuring follow-up, 4 (0.5%) patients died, 22 (2.8%) had nonfatal acute myocardial infarction, 10 (1.3%) had coronary artery bypass surgery, and 98 (12.4%) had repeat PTCA. The rate of recurrent angina pectoris was 31.1%. The cardiac event-free survival rate calculated by the Kaplan-Meier method was 88.2% at 1 year and 80.6% at 12.7 years. Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events. Compared to the PTCA group, patients with PTCA + stent had significantly lower rates of total cardiac events.

CONCLUSIONThe long-term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA + stent therapy should be the major treatment for revascularization in patients with coronary heart disease.

Adult ; Aged ; Angina Pectoris ; etiology ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Stenosis ; mortality ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; etiology ; Retrospective Studies ; Stents ; adverse effects ; Survival Rate ; Treatment Outcome