Objective To assess the effects of hypothermia induced by 4 ℃ normal saline (NS) on biochemical function, enzymology and morphology of liver in swine after the success of cardiopulmonary resuscitation (CPR) for cardiac arrest(CA). Method The swine were resuscitated with standard CPR 4 minutes after ventricular fibrillation(VF) ,and the survived swine were randomly(random number) divided into two groups. In hypothermia(LT) group (n = 5), swine were treated with continuous infusion of 4 ℃ NS at the speed of 1.33 mL/(kg·min) for 22 min, and then slow the speed to 10 mL/(kg·h) for 4 h. In normothermia (NT) group ( n= 5) swine were treated with the infusion of NS with room temperature instead of cryogenic NS at the same speed as the LT group. The hemodynamics and the changes of blood gas were monitored until 4 h after restoration of spontaneous circulation (ROSC), and blood samples were taken to detect serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) before VFand 10 min, 2 h and 4 h after ROSC. All swine were sacrificed 24 hours after ROSC, and their liver tissues were taken away for detecting Na+ -K + -ATP enzyme and Ca2+ -ATP enzyme as well as the histological changes under both light and electron microscopy. ResultsThe heart rate, MAP, cardiac output(CO) and coronary perfusion pressure(CPP) of swine were stable in LT group ( P ＞ 0.05). The AST, ALT and LDH increased in both groups but less in LT group. The hepatic ATP enzyme activity was much higher in LT group ( P ＜ 0.05). Compared with the NT group, there were less cellularedema,necrosis or inflammatory cells infiltration, and better morphosis of mitochondria of livers found in swine of LT group. Conclusions The continuous administration of 4 ℃ NS after ROSC could quickly lower the core body temperature, and it could keep hemodynamics and oxygen metabolisms stable, protecting the biochemical function,enzymology and morphology of liver in swine after CPR.

Objective To explore the perioperative antithrombotic strategy in percutaneous coronary intervention(PCI)for the patients with coronary heart disease(CHD)who were treated with long-term warfarin anticoagulation,and to evaluate the safety of the strategy and short-term efficacy.Methods The clinical data of 76 patients were analyzed,who underwent coronary stenting while treated with long-term warfarin anticoagulation.All of them had unstable angina.The reasons of requiring warfarin anticoagulation were cardiac valve replacement [51(67.1%)],pulmonary embolism within half a year [6(7.9%)],and sustained atrial fibrillation at high risk of stroke [19(25.0%)].Warfarin was withdrawn and low molecular weight heparin(LMWH)was administered as alternative anti-thrombus drugs before PCI.PCI was performed when international normalized ratio(INR)went less than or equal to 1.3.LMWH was administered combined with low dose aspirin(100mg/d)and clopidogrel(75mg/d)post PCI,while warfarin was resumed too.When INR arrived at 1.8,LMWH was withdrawn.Warfarin was administered in a dose adjusted to achieve the target INR of 1.8 to 2.3.Clopidogrel was withdrawn 1 month later.Aspirin(75-100mg/d)was continued,and then warfarin was resumed to the dose before PCI.The data of the incidence of ischemic events,major adverse cardiac events(MACE),subacute instent thrombus(SAT),and hemorrhage events during hospital period were analyzed.Results The incidence of hemorrhage events was 5.3%(4/76),one of them was secondary hemorrhage events.The rate of MACE was 1.3%(1/76).No main hemorrhage events and SAT occurred during hospitalization related to regulating antithrombotic strategy.Conclusions As alternatives of warfarin,LMWH is taken before PCI,and then the low dose of aspirin,clopidogrel,LMWH and warfarin are admitted in a short period after PCI,the dosage of warfarin should be accurately adjusted according INR post PCI,and then the LMWH is taken out of service timely,such a strategy is safe and efficient in peri-percutaneous coronary intervention for the patients with CHD who were treated with maintaining warfarin anticoagulation.

China ; Humans ; Tinnitus

Objective To evaluate the application of chromogranin A (CgA) as a marker in the diagnosis of prostate cancer. Methods Serum chromogranin A were detected by means of ELISA technique in 35 cases of prostate carcinoma,10 cases of benign prostate hyperplasia and 30 cases of healthy subjects. Results Serum CgA [(162?12.5)ng/ml] of patients with prostatic carcinoma was significantly higher than those of healthy subjects and of BPH( P

0.05),as well as in the composite of MACCE(2.51% vs 3.10%,P=0.523)between the two groups.Also,no significant difference existed in the rate of SAT(0.16% vs 0.16%,P=1.000)and hemorrhagic events(2.51% vs 2.12%,P=0.652)between the two groups.Kaplan-Meier survival analysis showed the cumulative hazard rate for the MACCE was similar(P=0.523).Conclusions Short-term therapeutic effects of atorvastatin 20mg/d combined with clopidogrel for the patients undergoing coronary stenting is similar to that of provastatin combined with clopidogrel.Long-term therapeutic efficiency and safety of the two strategies need to be further investigated.

T was genotyped by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)in all the patients.Results The occurrence of CR in this population was 23.3%(70/300).There was CYP3A4 894C/T polymorphism in the study population.The frequencies of the three kinds of genotypes(CC,CT,TT)in CR group and non-CR(NCR)group were 45.7%,50.0%,4.3% and 63.5%,31.7%,4.8%,respectively.The frequency of TT genotype was significantly higher in NCR group than that in CR group(OR=2.06,95% CI:1.201-3.547,P=0.020).C allele carriers were more likely to develop clopidogrel resistance compared with that of T allele carriers(OR=1.59,95% CI:1.037-2.442,P=0.023).Conclusion CYP3A4 gene 894C/T polymorphism is associated with the risk of CR,and C allele carriers may be a possible genetic susceptibility factor for patients with CR.

Objective To evaluate the long-term effect and safety of triple antiplatelet therapy(cilostazol,aspirin and clopidogrel)for the patients with diabetes and acute coronary syndromes(ACS)undergoing percutaneous coronary intervention(PCI).Methods Between December 2004 and February 2006,a randomized,single center trial was conducted in General Hospital of Shenyang Command for comparison of dual and triple antiplatelet therapy after PCI for the patients with ACS.Of 263 diabetic patients enrolled in present study,122 were randomly assigned to standard dual antiplatelet treatment with aspirin and clopidogrel,141 were assigned to triple antiplatelet therapy with aspirin,clopidogrel and cilostazol.Primary endpoint was a composite of cardiac death,non-fatal myocardial infarction(MI),stroke or target vessel revascularization(TVR)at 1 year.Results Baseline clinical and angiographic characteristics were comparable between the two groups.No definite stent thrombosis or MI occurred in either group during the period of follow-up,and no significant difference existed yet in the rates of 1-year cardiac death(4.1% vs 1.5%,P=0.255),stroke(3.3% vs 0.7%,P=0.186)and TVR(12.3% vs 7.8%,P=0.223)between the patients received dual or triple antiplatelet therapy.The rate of primary events was 9.9%(14/141)in triple group,which was significantly lower than that in dual group [18.9%(23/122),P=0.038].Patients receiving hypoglycemic medicine got more benefits from triple antiplatelet treatment.There was no significant difference between the two antiplatelet regimens regarding the risk of hemorrhagic events and premature discontinuation of aspirin or clopidogrel.Conclusion The regimen of cilostazol plus aspirin and clopidogrel for diabetic patients undergoing PCI is effective and safe in reducing long-term adverse cardiac and cerebral-vascular events,especially for the patients with high dangerous DM complicated with ACS.

Objective To explore the feasibility and efficacy of an optimized antiplatelet therapy according to laboratory test after coronary stenting.Methods Between June 2006 and February 2007,a total of 305 patients who underwent coronary stenting in General Hospital of Shenyang Command were enrolled.Patients were randomly assigned to receive optimized(optimal group,n=154)or standard antiplatelet therapy(standard group,n=151).Clopidogrel resistance(CR)was defined as a less than 10% reduction of platelet aggregation at 24h after clopidogrel treatment.The antiplatelet regimen for standard group was dual antiplatelet therapy with aspirin and clopidogrel.In optimal group,CR patients received cilostazol for 6 months in addition to dual anitplatelet therapy,whereas non-CR patients received standard dual antiplatelet therapy.The primary endpoint of present study was the composite analysis of death,myocardial infarction(MI)or stroke.Secondary endpoint was the composite analysis of death,MI,stroke,revascularization or peripheral artery occlusion.Results There were 41 and 33 CR patients in optimal and standard group,respectively.Cilostazol in addition to dual antiplatelet therapy decreased significantly the PAR of CR patients in optimal group(77.5%?12.1% vs 64.5%?12.1%,P

Objective The aim of this investigation is to explore the effects of hypoxia on the biological activity of endothelial progenitor cells(EPC)and to improve the efficacy of EPC transplantation.Methods Rat bone marrow derived EPC were isolated and cultured either under normoxic or hypoxic conditions.The proliferation,migration and angiogenic ability of EPC were observed.Results In hypoxic group,the number of attached cells per high power field(hpf)was significantly more than that in normoxic group (91.0?8.0)vs(42.5?5.3),P

Objective To compare the short-term efficiency and safety of high loading dose (600 mg) clopidogreal pretreatment with that of routine loading dose (300 mg) before coronary stenting in patients with acute coronary syndromes (ACS). Methods Prospective registry method was used in this study. Between February 2003 to July 2004, a total number of 316 hospitalized patients with ACS received 600 mg clopidogrel pretreatment, before coronary stenting. 309 patients with the same disease conditions who received 300 mg clopidogrel pretreatment between October 2001 to January 2003 were included as the control. The primary endpoints were the presence of subacute in-stent thrombosis. 30 days after the procedure. The composite endpoints were death of all causes, myocardial infraction and revascularization of the target ressel. The secondary endpoint was hemorrhagic events at 30 days after the stenting procedure. Results The baseline clinical and angiographic characteristics and the result of stenting between the two groups had no significants difference. Rate of subacute in-stent thrombosis was significantly lower in 600 mg group than that of 300 mg group (0.0% vs 2.6%, P=0.003). An interval of