Objective To compare the coronary lesions between patients with stable angina and those with unstable angina using intravascular ultrasound. Methods One hundred and five patients who underwent coronary angiography and intravascular ultrasound (IVUS) were divided into stable angina group (group SA) and unstable angina group (group UA). Angiographic features and ultrasound images were compared between the groups. Results Coronary angiography showed no significant differences in the diseased artery and the degree of stenosis between the groups. Intravascular ultrasound revealed that there were significantly more soft lesions in group UA than in group SA, and that fibrous and calcific lesions were more prevalent in group SA. The extent of coronary calcification was significantly greater in group SA than in group UA. Spontaneous dissection and thrombus were more frequently found in group UA than in group SA. Conclusion Intravascular ultrasound demonstrates that there are significant differences in morphology and quality of the coronary lesions between stable and unstable angina pectoris.

Objective To probe the relationship between Helicobacter py lori(Hp) IgG antibody components and coronary heart disease(CHD). Meth ods Hp serum specif ic IgG antibodies (Hp-IgG) and antibody components were measured by immunoblot ( IBT) methods in 209 CHD patients and 191 healthy controls from Mar.2001 to Sep 2 003. Results Of the 209 patients with CHD, 152(73%) were serop ositive to Hp comp ared with 113(59%) of the 191 healthy controls(P=0.0042). The Hp antibody co n tained different antibody components, such as cytotoxin-associated gene product A (CagA), vacuolating cytotoxin protein A (VacA), urease A (UreA), urease B (UreB ) etc,and only seropositivity to component UreB66 in CHD group was significantl y higher than that in healthy control (P=0.0001). Multiple Logistic Regression analysis revealed that the Hp antibody component UreB66 was significantly correl ated with CHD (P

Objective To evaluate the predisposition effects of angiotensin-converting enzyme (ACE) ,angiotensinogen (AGT) and endothelial nitric oxide synthase (eNOS) gene polymorphisms on coronary disease (CHD) as well as their possible synergistic effect in the development of CHD in Chinese aged people. Methods The study included 191 subjects (100 CHD and 91 controls). Gene chip technology was performed. The allele frequency and genotype distribution were compared between groups. Results A significantly higher frequency of the DD genotype of ACE gene was observed in CHD group (28.0% vs 15. 4%, P0. 05). Subjects carrying ACE DD and AGT TT genotypes or those carrying AGT TT and eNOS TT genotypes showed a stronger association withCHD(OR=2. 9, P

Objective To investigate the efficacy and safety of cool-tipped saline-irrigated catheter ablation of epicardial accesso-ry pathway in the patients after failure of conventional radiofrequency ablation .Methods 30 patients with epicardial accessory path-way after failuer of conventional radiofrequency ablation were included in this study ,among them ,25 cases of the left accessory pathway and 5 cases of the right accessory prathway used the cool-tipped catheter for conducting ablation through the endocardium (ventricular side or atrial side) or coronary sinus .Results All patients achieved success ,no intraoperative and postoperative related complications occurred .Conclusion The cool-tipped saline-irrigated catheter ablation of epicardial accessory pathway is effective and safe in the patients after failure of conventional radiofrequency ablation ,which may improve the success rate of epicardial acces-sory pathway ablation .

Objective To compare the changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes in CHD patients with impaired glucose tolerance (IGT) before and after statin therapy. Methods A total of 196 CHD with IGT and 160 controls were included. The changes of plasma lipid indexes and coronary artery atherosclerotic plaque in TaqI B genotypes were analyzed before and after Rosovastatin therapy. Sequenom Mass ARRAY platform was used to detect the CETP TaqI B SNPs. Results The genotype frequency of the B1B1, B1B2 and B2B2 in CHD with IGT group was 35.7%, 48.0% and 16.3% respectively, while in control group was 31.3%, 53.1% and 15.6% respectively. HDL-C, PA and MLA levels increased after Rosuvastatin therapy, while LDL-C, TG, TCH, Lpa, PA, EEMA and PB levels decreased. Conclusions CETP gene polymorphisms TaqI B would have association with the effects of Rosuvastatin therapy in the CHD with IGT.

Objective To study the characteristics and clinical significance of the coronary plaques in patients with benign prostatic hyperplasia (BPH).Methods A total of 91 patients undergoing coronary artery angiography (CAG) were selected and divided into two groups according to with or without BPH,56 cases in BPH group,46 cases in control group.The qualitative and quantitative characteristics of 102 lesions area were analyzed by intravascular ultrosound (IVUS),including external elastic membrane-cross-sectional area (EEM-CSA),minimal lumen area (MLA),plaques area (PA),plaques burden (PB),reference external elastic membrane-cross-sectional area (REEM-CSA),reference minimal lumen area (RMAL),reference plaques area (RPA) and reference plaques burden (RPB).Results IVUS showed a higher rate of area stenosis than did the CAG [(58.2± 7.1)％ vs.(55.9 ± 5.2)％,P＜0.01].BPH group had more soft plaques,eccentric plaques,positive remodeling and less calcified than did the control group (P＜0.05).The MLA and RMAL of BPH group were smaller than those of control group:MAL [(5.61±0.96) mm2 vs.(6.06±0.75) mm2,P＜0.05],RMAL[(9.26±1.05) mm2 vs.(10.02±1.10) mm2,P＜0.05]； while the EEM-CSA,PA,PB,RPA,RPB were larger than those of control group:EEM-CSA[(14.51±1.10)mm2 vs.(13.37±1.02)mm2],PA[(8.90±1.24) mm2 vs.(7.31±1.04) mm2],PB[(61.26±6.53)％ vs.(54.53±5.69)％],RPA[(4.26±1.15) mm2 vs.(3.73±1.33) mm2],RPB [(31.30±8.37) ％ vs.(26.81±8.75) ％,P＜0.05].Conclusions IVUS has a higher value on evaluation of mild to moderate coronary artery stenosis.Evidence of myocardial ischemia in patients with BPH needs further excludeing coronary heart disease.

Objective To evaluate the value of glycogen phosphorylase isoenzyme BB (GPBB) in the diagnosis of early acute myocardial infarction (AMI). Methods The plasma levels of GPBB were mea-sured by sandwich ELISA in 115 patients with suspected AMI at admission within 6 hours after onset of chest pain and 55 normal healthy subjects. The plasma concent of cardiac troponin-Ⅰ (cTnI), creatine kinase-MB (CK-MB) and myoglobin (MYO) was assayed at the same time by using corpuscle chemiluminescence. The patients were classified retrospectively into AMI group (n = 45) , unstable angina pectoris (UAP) group (n =40) , stable angina pectoris (SAP) group (n = 13) and non-cardiac chest pain (NCCP) group (n =17).The diagnostic validity was evaluated in terms of sensitivity and specificity. Results The diagnostic sensitivity of GPBB for AMI was 64.29 % within 3 hours and 88.89 % within 6 hours after onset of chest pain,which is significantly higher than that of cTnI (28.57 %, 60.00 %) and CK-MB (21.43 %, 64.44 % ). There was no significant difference in specificity among the four markers. The diagnostic accuracy of GPBB within 3hours and 6 hours (80.77 %, 89.57% ) was significantly higher than that of cTnI (61.54%, 81.74% ),CK-MB (50.00%, 75.65%) and MYO (73.08% ,73.91%). Conclusions GPBB seems to be a sensitive and specific biochemical cardiac marker for AMI in the early stage. Its diagnostic accuracy is higher than that of cTnI, CK-MB, MYO.

OBJECTIVETo study the drug resistance of Acinetobacter baumannii (AB) producing VIM-2-type metallo-β-lactamase (MBL) isolated from burn patients of our ward against carbapenem antibiotics and its homology.

METHODSA total of 400 strains of AB (identified) were isolated from sputum, urine, blood, pus, and wound drainage. of burn patients hospitalized in our ward from September 2011 to March 2014. Drug resistance of the 400 strains of AB to 15 antibiotics, including compound sulfamothoxazole, aztreonam, etc. , was tested using the automatic microorganism identifying and drug sensitivity analyzer. Among the carbapenems-resistant AB isolates, modified Hodge test was applied to screen carbapenemase-producing strains. The carbapenemase genes of the carbapenemase-producing strains, and the mobile genetic elements class I-integron (Intl1) gene and conserved sequence (CS) of carbapenemase-producing strains carrying blaVIM-2 gene were determined with PCR and DNA sequencing. For carbapenemase-producing strains carrying blaVIM-2 gene, synergism test with imipenem-ethylene diamine tetraacetic acid (EDTA) and enhancement test with imipenem-EDTA and ceftazidime-EDTA were used to verify the MBL-producing status. Drug resistance of the VIM-2-type MBL-producing AB strains was analyzed. For VIM-2-type MBL-producing AB strains, plasmid conjugation experiment was used to explore the transfer of plasmid; outer membrane protein (OMP) CarO gene was detected by PCR. For VIM-2-type MBL-producing AB strains carrying CarO gene, the protein content of CarO was analyzed with sodium dodecyl sulfate polyacrylamide gel electro- phoresis. The repetitive consensus sequence of Enterobacteriaceae genome PCR (ERIC-PCR) was carried out for gene typing of VIM-2-type MBL-producing AB strains to analyze their homology.

RESULTS(1) The resistant rates of the 400 strains of AB against levofloxacin and compound sulfamethoxazole were low. A total of 381 carbapenems-resistant AB strains were screened, including 240 carbepenemase-producing strains. (2) Out of the 240 carbepenemase-producing strains, 18 strains were found to harbor the blaVIM-2 gene, accounting for 7.5%; 133 strains carried the blaTEM-1 gene, accounting for 55.42%; 195 strains carried the blaOXA23 gene, accounting for 81.25%; 188 strains carried the bla(armA) gene, accounting for 78.33%. (3) Eighteen carbepenemase-producing strains which carried the bla(VIM-2) gene were found to carry the Intl1 gene, showing the Intl1-VIM linkage. Simultaneously, Intl1 variable area CS showed diversity. (4) Eighteen carbepenemase-producing strains which carried the blaVIM-2 gene were verified to produce MBL. The resistant rates of the 18 strains of AB against compound sulfamethoxazole were the lowest, followed by levofloxacin and cefoperazone/sulbactam, and those against the other antibiotics were above 60.00%. (5) Through multiple joint tests, plasmid conjugation experiment positive transfer strain was not found in 18 VIM-2-type MBL-producing AB strains. (6) Nine out of the 18 VIM-2-type MBL-producing AB strains were found to carry CarO gene. The OMP CarO of VIM-2-type MBL-producing AB strains carrying CarO gene was lost or lowered in the protein content. (7) The 18 VIM-2-type MBL-producing AB strains were classified into 6 genotypes by the ERIC-PCR. There were respectively 6, 4, 3, and 1 stain (s) in genotypes A, B, C, and F, and there were 2 strains in genotypes D and E respectively.

CONCLUSIONSThe resistance mechanism of AB against carbapenems is mainly mediated by blaTEM-1, blaOXA-23, and bla(arma); meanwhile, VIM-2-type MBL-producing and lack or change in OMP CarO are attributable to carbapenems resistance of clinically isolated AB from burn wards, and the Intl1 gene may take a part in blaVIM-2 gene transmission.

Acinetobacter baumannii ; drug effects ; enzymology ; genetics ; isolation & purification ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Bacterial Proteins ; Burns ; drug therapy ; microbiology ; Carbapenems ; pharmacology ; Drug Resistance, Bacterial ; Genes, Bacterial ; Humans ; Imipenem ; pharmacology ; Microbial Sensitivity Tests ; Sulbactam ; pharmacology ; beta-Lactamases ; genetics

Objective To study the CYP2C19 genotype in patients with acute coronary syndrome(ACS) complicated with diabetes mellitus(DM)receiving percutaneous coronary intervension(PCI)by polymerase chain reaction(PCR),and to evaluate the efficacy of Ticagrelor in CYP2C19 gene polymorphism. Methods A total of 494 ACS patients with DM were enrolled. The patients were divided into routine treatment group and individual treatment group. Routine treatment group received 0.1 g/d aspirin/d and 75 mg/d of Clopidogrel. CYP2C19 gene polymorphism was examined in individual treatment group.(*1/*1)was classified into fast metabolic type,mutant heterozygous type(*1/*2,*1/*3)into intermediate metabolic type and mutant pure type (*2/*2,*2/*3,*3/*3) into slow metabolic type. Fast metabolic type received aspirin 0.1 g/d and Clopidogrel 75 mg/d,and intermediate and slow metabolic type received aspirin 0.1 g/d and Ticagrelor 90 mg bid for 12 months or more to observe the inci-dence of adverse cardiovascular events ,bleeding and other adverse reactions in 2 groups. Results The incidence of cardiac death ,recurrent myocardial infarction and angina pectoris ,stroke ,stent thrombosis and target vessel revascularization in routine treatment group was significantly higher than that in individual treatment group(P <0.05). There was no significant difference between two groups in terms of major bleeding and secondary bleeding (P > 0.05). The minimum bleeding rate was slightly higher in intermediate metabolic type in individual treatment group but without significantly difference when compared with that in fast metabolic type and slow metabolic type (both P>0.05). Conclusion Without elevating the risk of bleeding within 12 months,the efficacy of Ticagrelor is not affected by CYP2C19 gene polymorphism in patients with ACS complicated with DM after PCI.

Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.