Objective To study the effect of intracoronary adenovirus vector-mediated transforming growth factor ?_1 (Ad.TGF-?_1) gene transfer on discordant cardiac xenograft in the setting of acute vascular rejection. Methods In a cervical heterotopic cardiac transplantation model by cuff technique, after harvest, guinea pig donor hearts’coronary arteries were perfused ex vivo with Stanford University solution containing 5?1010 plaque-forming units/g of donor heart of Ad.TGF-?_1, then implanted in the necks of complement depleted and immunosuppressed rat recipients. As controls, other hearts were perfused with Stanford University solution containing 5?1010 plaque-forming units/g of donor heart adenoviral blank-vector or with virus-free Stanford University solution by the same method.Results The exogenous TGF-?_1 gene transcripts and expression in the Ad.TGF-?_1 infected grafts were confirmed. The number of inflammatory cells and macrophages and nature killer cell infiltration in the cardiac xenografts of Ad.TGF-?_1 infected grafts was less than that of other groups (P

Objective To study the effects of intracoronary transfer of adenovirus vector-mediated transforming growth factor ?_1 gene on acute rejection of cardiac allograft in rats. Methods In a cervical heterotopic cardiac transplantation model, donor hearts coronary arteries were perfused ex vivo after harvest with Stanford University solution containing 5?10~ 10 plaque-forming units/gram of donor heart of donor heart of Ad. TGF-?_1, then implanted in the necks of recipients. As controls, other hearts were perfused with Stanford University solution containing 5?10~ 10 plaque-forming units/gram of donor heart adenoviral bland-vector or with virus-free Stanford University solution by the same method. Results The exogenous TGF-?_1 gene transcripts and expression in the Ad.TGF-?_1 infected grafts were confirmed. The expression of CD_ 68 and the apoptosis index in the cardiac allografts of Ad. TGF-?_1 group were less than that of other two groups (P

Objective To observe the effect of comprehensive community intervention on cardiovascular risk factors in metabolic syndrome (MS) high risk group.Methods One hundred MS high risk patients were divided into intervention group (50 patients) and control group (50 patients) by random digits table.The intervention group accepted intervention on health education,health action,health habit and individual intervention on drug.The control group accepted natural intervention.The changes of waistcircumference,body mass index (BMI),blood pressure,fasting plasma glucose (FPG),lipids and serum uric acid (UA) were observed.Results In intervention group,the number of physical exercise,alimentary control and medication compliance increased 12％,16％ and 18％,and the number of smoking and alcohol drinking decreased 8％ and 6％.But in control group,the number of physical exercise,alimentary control,medication compliance increased 2％,0 and 4％,and the number of smoking and alcohol drinking decreased 4％ and 2％.There was significant difference (P＜ 0.05).Before treatment,the level of waist circumference,BMI,systolic pressure,diastolic pressure,FPG,total cholesterol,triacylglycerol,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and UA between two groups had no significant difference (P ＞ 0.05).After 1 year's intervention,except HDL-C,the level of other index had significant difference between two groups (P ＜ 0.05 or ＜ 0.01).Conclusion Comprehensive community intervention can improve the status of obesity and dyslipidemia,and reduce blood pressure,plasma glucose and UA.

Objective To study the possible cause and the feasibility of diagnosis and treatment of coronary disease after heart transplantation.Methods An 8-year survivor of heart transplantation received close follow-up. The clinical symptoms were recorded. Blood laboratory tests, electrocardiogram, endomyocardial biopsy, left ventricular Tc scintigraphy, endothelium-dependent vasodilatation of the brachial artery and coronary angiography were performed.Results The patient had good life quality without any symptoms such as chest discomfort, palpitation, dyspnea. Serum lipid and lipoprotein levels remained normal range. No any myocardial ischemic signs were detected in electrocardiogram. Endothelium-dependent vasodilatation was normal. No any acute rejective manifestation was observed in endomyocardial biopsy samples. Left ventricular Tc scintigraphy showed that left ventricular wall perfusion was progressively decreased. Coronary angiography showed that a typical vasculopathy with diffuse stenosis involved all coronary braches to some extent and right coronary had a proximal local severe stenosis with distal mild diffuse stenosis. Coronary angioplasty and stent placement of proximal right coronary was performed. The perfusion of the left ventricular wall was improved by this angioplasty.Conclusion Chronic rejection is probably the main cause of coronary disease after heart transplantation. Serial left ventricular scintigraphy can detect the change of myocardial perfusion. Local severe stenosis of coronary after heart transplantation can be treated by coronary stenting.

AIM and METHODS: To investigate the cardioprotective effect of adenosine infusion before ischemic preconditioning on immature myocardial reperfusion injury in rabbit heart. Isolated perfused working heart model were performed, all hearts were subjected to 2-hour global hypothermic ischemia and received intermittent cold cardioplegia perfusion. RESULTS:During reperfusion, the recovery of left ventricular systolic pressure, left ventricular end-diastolic pressure, +d p /d t max, and -d p /d t max of hearts received adenosine infusion before ischemic preconditioning were significantly improved, myocardial adenosine triphosphate and adenosine diphosphate content and superoxide dismutase activity were higher, the leakage of myocardial creatine kinase and the malondialdehyde content were lower, and myocardial water content was obviously less. CONCLUSION: These results suggest adenosine infusion before ischemic preconditioning enhances cardioprotection of ischemic preconditioning against immature myocardial reperfusion injury in the rabbit heart.

Objective To investigate living quality of patients after orthotopic cardiac transplantation and to provide scientific evidence for specific strategy of therapy and improvement of living quality of patients with cardiac transplantation. Methods SF-36 and the social support questionnaire were used to analyze living quality of 79 patients who received orthotopic cardiac transplantation in the Department of Cardiovascular surgery of Affiliated Union Hospital of Fujian Medical University. The mode of SF-36 was from the investigative numerical value of residents in Sichuan province. Description, t-test and Spearman correlation analysis were used to study the related factors. Results Compared with a reference general population, the heart transplant recipients showed a significantly worse living quality score on all domains of the SF-36 scales (P＜0. 05), except the domain of somatic pain. Among the patients after cardiac transplantation, living quality was more significantly improved in ＞2-year survival group than that in ＜one-year survival group (P＜0. 05),except the domain of somatic pain. The relationships between the social support and living quality were analyzed,and it was found that as compared with a reference general population, the heart transplant recipients showed significantly lower scores on all domains of the social support questionnaire (P＜0. 01 ). The total social support scores were positively related to mental health related living quality (P＜0.05, r = 0.223 - 0.710), except the domain of somatic pain. Conclusion Compared with a general population, heart transplant recipients demonstrated a significantly worsened living quality. But evidence showed the living quality can be improved gradually with the prolongation of the survival time after heart transplantation. Social support was related to the living quality of heart transplantation patients. Improvement of availability on social support will probably improve living quality.

Objective To retrospectively analyze the clinical management and follow-up of 13 recipients with survival of over ten years after cardiac transplantation. Methods Thirteen male recipients underwent orthotopic heart transplantation between August 1995 and June 2001 in our center and received standard immunosuppressive therapy protocols (8 cases) or induction therapy protocols (5 cases). Cyclosporine, azathioprine or mycophenolate mofetil, and prednisolone were applied as maintenance immunosuppressive regimens. Six recipients switched from azathioprine to mycophenolate mofetil when mycophenolate mofetil was available. Perioperative complications were prevented and treated. After operation, the recipients were followed up regularly to set up personnel long-term follow-up files. The incidence of acute rejection (AR) and (cardiac allograft vasculopathy (CAV) was monitored. Results The 13 survived recipients accounted for 48. 1 % of the total number in the corresponding period (13/27). All survivals recovered well and had a good quality of life. The recent (1 year) complications included acute allograft rejection (3 cases), infection (4 cases), renal insufficiency (3 cases), allograft right ventricular dysfunction (5 cases), post-transplant diabetes (2 cases) and liver dysfunction (5 cases). The long-term (1 year later) complications included acute allograft rejection (2 cases), CAV (2 cases), hypercholesterolemia (5 cases), hypertension (4 cases), hyperuricemia (10 cases) and chronic renal impairment (3 cases). One hepatitis B virus carrier died of liver cancer 13 years after transplantation. Conclusion The long-term survival of cardiac allograft recipients is closely associated with psychological state, financial condition, compliance and follow-up medical system, while the sociological and environmental factors may play important roles.

OBJECTIVE:To study the bioequivalence of Levodopa micro-capsule floating tablets in Beagle dogs after multi-dose administration. METHODS:6 dogs were collected and divided into Levodopa micro-capsule floating tablets group and Com-pound levodopa preparation group (Benserazide tablet,reference preparation). They were given levodopa 200 mg intragastrically, every 8 h,for consecutive 4 day. In two-period crossover test,HPLC method was established to determine the concentration of le-vodopa in dog. The pharmacokinetic parameter,bioequivalence and plasma concentration fluctuation of steady state were calculated. RESULTS:The main pharmacokinetic parameters of Levodopa micro-capsule floating tablets and reference preparation were as that cmax were(4.23±0.75)and(8.47±1.18)μg/ml;AUC0-∞ were(12.18±1.16)and(13.81±2.12)μg·h/ml;tmax were(1.83±0.26) and(0.67±0.13)h,respectively. 90% confidence intervals for the geometric mean ratio of AUC0-∞ for test and reference prepara-tion were 80.61%-97.90%,and that for cmax were 42.75%-57.63%,respectively. There was statistical significance in tmax between test and reference preparation. Degree of fluctuation of test and reference preparation at steady state were(283.914±43.217)% and (506.489±78.965)%,and fluctuation coefficient were(177.463±7.873)% and(187.405±1.650)%,respectively. The degree of fluctuation of test preparation was significantly less than that of reference preparation. CONCLUSIONS:Levodopa micro-capsule floating tablets show good sustained-release property,and are bioequivalent with reference preparation in absorption after multiple dose administration. It also has lesser fluctuation of blood concentration.

Underlying both the angles of norm-referenced test and criterion-referenced test, the qualitative or(and)quantitative analysis and evaluation were made on the tests of 10 medical academic courses in recent 4 years in reliabil-ity and item quality. From the angle of norm-referenced test, 67.4 percent of the items had good quality, 60 percent ofthe tests could differentiate the classes and 12.5 percent of the papers could differentiate the individual person accord-ing to their reliability. However, from the angle of criterion-referenced test, approximately 90 percent of the items werequalified; 87.5% had high reliability to determine whether an examinee passes the test or not.[

AIM: The aim of this study was to investigate the hemodynamic characteristics of the denervated orthotopic transplanted hearts. METHODS: Eighteen patients with end - stage cardiopathy underwent orthotopic cardiac transplantation received immunosuppressive induction therapy. The changes of hemodynamics were closely monitored during the perioperative period and the periodic check-up of echocardiogram and electrocardiograph were followed up in the postoperative long-term period. RESULTS: All recipients were received vasoactive drug and active diuretic therapy during the perioperative period. An increase in central venous pressure in concomitance with decrease in cardiac output, cardiac index and mixed venous oxygen saturation within 24 to 48 hours and tend to stable 48 hours postoperation were detected. In the follow - up period, the cardiac functions of allografts were all recovered well. No recipient complained angina pectoris. CONCLUSIONS: The hemodynamic characteristics and clinical pharmacological therapeutic implications of cardiac denervation are very unique. Rational application of inotropic support and diuretic therapy and vasodilatation combined with prudent administration of some agents, which affect the physiology of denervated heart, are the most effective measures for the prevention of postoperative complications of cardiac allograft.