Aged ; Angina, Unstable ; blood ; drug therapy ; pathology ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Endothelial Cells ; drug effects ; pathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

OBJECTIVETo evaluate the effects of aspirin, clopidogrel, and their combination on the progression of aortic atherosclerosis.

METHODSForty-nine male rabbits were randomly divided into five groups. One group of control rabbits (group N, n=9) was fed on normal diets. Four other groups were fed on high cholesterol diets and injected with 10% albumin bovine received no drug therapy (group M, n=10), aspirin (group A, n=10), clopidogrel (group C, n=10), or the combination (aspirin+clopidogrel, group B, n=10) for 12 weeks. Serum lipids and C-reactive protein (CRP) were detected. The aortas were harvested for histomorphometry and quantitative analysis. The positive percentage of macrophage cells and smooth muscle cells in the plaque were analyzed by immunohistochemistry.

RESULTSThese antiplatelet drugs significantly reduced the extent of atherosclerosis. Aortic vascular lesions of group A, C, and B showed 28.70%, 28.82%, and 57.69% of reduction in the amount of macrophage cells, and 39.86%, 42.60%, and 100.70% of increase in smooth muscle cells. No significant differences existed between group A and group C. However, the combination of aspirin and clopidogrel had better effect than aspirin or clopidogrel alone. Meanwhile, aspirin, clopidogrel, and their combination also decreased serum CRP (P < 0.05-0.01), without affecting lipid levels. There was a trend, not significantly, to lower serum C-reactive protein in group B compared with group A or group C.

CONCLUSIONSAspirin and clopidogrel inhibit neointimal proliferation and prevent the development of atherosclerosis with equivalent effects. Their combination shows synergic effects.

Animals ; Aorta ; pathology ; Aspirin ; pharmacology ; Atherosclerosis ; blood ; pathology ; C-Reactive Protein ; metabolism ; Cell Count ; Cyclooxygenase Inhibitors ; pharmacology ; Drug Synergism ; Macrophages ; drug effects ; Male ; Myocytes, Smooth Muscle ; drug effects ; Platelet Aggregation Inhibitors ; pharmacology ; Rabbits ; Random Allocation ; Ticlopidine ; analogs & derivatives ; pharmacology

Objective To investigate the polymorphism of human cytomegalovirus（HCMV）UL146 gene in clinical strains,and to evaluate its clinical diagnostic and therapeutic value of gene.Methods The UL146 gene of clinical strains was examined by quantitative polymerase chain reaction（Q-PCR）or general polymerase chain reaction（PCR）.Positive samples of PCR amplification were sequenced and analyzed.Results High variability of UL146 gene was found among 28 HCMV strains.According to phylogenetic analysis,all sequences of UL146 in clinical strains could be divided into three types and four subtypes.Chemokine ELRCXC region was highly conserved in all sequences.Conclusion HCMV-UL146 genes showed a high degree of polymorphism,and its encoded chemokine ELRCXC region was highly con-served.The relationship between HCMV-UL146 gene′s polymorphism and different clinical symptoms of HCMV infection was unclear.

OBJECTIVETo investigate the protective and therapeutic effects of pulmonary surfactant in the pathogenesis of chronic obstructive pulmonary disease (COPD) in hamsters.

METHODSCOPD animal model was established by smoke inhalations and intratracheal instillations of pancreatic elastase in hamsters. Ninty hamsters were divided into 9 groups as follows: normal group (N), two groups received smoke inhalations for 1 and 3 months (S1 and S3), one group received intratracheal instillation of surfactant (10 mg/100 g BW) for once after 1 month smoking (SP1), one group was treated with surfactant after 1.5, 2 and 2.5 months of smoking (SP3), and two groups received intratracheal administration of elastase (40 U/100 g BW) and were killed after 1 month and 3 months, respectively (E1 and E3). The surfactant was injected intratracheally after 1 week, 0.5, 1.0, 1.5, 2.0, and 2.5 months, followed by administration with elastase (EP1 and EP3). EP1 group were killed at the first month, and EP3 at the third month. Light microscopy and electromicroscopy observations were performed in each group. Pulmonary mean linear intercept (MLI), mean alveolar numbers (MAN), and pulmonary alveolar area (PAA) was measured by image analysis. The expression of surfactant protein A (SP-A) were observed by immunohistochemistry.

RESULTSSmoking for 3 months and instillations of elastase resulted in chronic bronchitis and emphysema. MLI and PAA increased and MAN decreased in all the experimental groups compared with in the normal group (P < 0.05 or P < 0.01). Administration of surfactant for 3 months resulted in statistically significant inhibition of pulmonary injury. MLI and PAA decreased and MAN increased in SP3 compared with in S3. Only MLI decreased in EP3 compared with E3. The expressions of SP-A in the type II alveolar epithelia decreased in S3 and E3 (compared with the normal group P < 0.01). After pulmonary surfactant intervention, the expression of SP-A increased significantly.

CONCLUSIONPulmonary surfactant may have a long-term protective effect on chronic smoking and elastase-induced COPD.

Animals ; Cricetinae ; Male ; Mesocricetus ; Pancreatic Elastase ; Pulmonary Alveoli ; ultrastructure ; Pulmonary Disease, Chronic Obstructive ; metabolism ; prevention & control ; Pulmonary Surfactant-Associated Protein A ; metabolism ; Pulmonary Surfactants ; therapeutic use ; Smoking

OBJECTIVETo study the effect of exogenous pulmonary surfactant (PS) on the acute lung injury to ischemia-reperfusion injury.

METHODSThe model of ischemia-reperfusion was established. Thirty male Sprague-Dawley rats were randomly divided into control (n = 10), I/R (n = 10), and PS (n = 10) groups.

CONTROL GROUPthe isolated rat lungs were reperfused for 4 hours. I/R group: the isolated rat lungs were reperfused for 2 hours after 2 hours ischemia. PS group: exogenous pulmonary surfactant (10 mg/100 g BW) were given to the ischemic lungs through bronchus 2 hours before reperfusion. Wet to dry lung weight ratio (W/D) and pulmonary artery pressure (PAP) were checked. Immunohistochemical technique was used to determine the immune reactivity of lung tissues to endothelia nitric oxide synthase (eNOS) and surfactant protein A (SP-A). The pulmonary changes were also observed by light and electronic microscopes.

RESULTSW/D and PAP in I/R group were significantly higher than in PS group (P < 0.01). The expression of eNOS and SP-A in I/R group were significantly lower than those in PS group (P < 0.05).

CONCLUSIONSPS can significantly protect lung injury induced by ischemia-reperfusion in the isolated rat lungs. This protective effect is associated with the mechanism that the exogenous PS may reduce SP-A loss in the ischemia-reperfusion and activate the up-regulation of eNOS.

Animals ; In Vitro Techniques ; Lung ; blood supply ; pathology ; Male ; Nitric Oxide Synthase ; metabolism ; Nitric Oxide Synthase Type III ; Pulmonary Surfactant-Associated Protein A ; metabolism ; Pulmonary Surfactants ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; pathology

OBJECTIVEIn order to provide pathologic reference for therapeutic rationale, the pathological changes of the pulmonary vasculature in patients with pulmonary atresia with ventricular defect and patent ductus arteriosus were observed by contrast with normal control group.

METHODSLung biopsies were taken in the operation in 10 children suffered from pulmonary atresia with ventricular septal defect associated with patent ductus arteriosus (PA group). Autopsy specimens were obtained from 10 children died of non-cardiovascular diseases as normal control group. The tissue was fixed with buffered formalin, routinely prepared by impregnated in wax. Sections were stained by hematoxylin-eosin, Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters were obtained including percentage of media thickness (MT%), percentage of media section area (MS%), numbers of vascular per square centimeter (VPSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA), and alveolar/vascular ratio per unit area (AVR) by a computer image processor by quantitative analysis.

RESULTSThere were significant difference between the two groups in MAN, VPSC, and AVR (P < 0.05). VPSC was significantly lower in PA group than in control group (P < 0.01). Other parameters had no significant difference. The mean alveolar diameter had an increased trend in PA group, although there was no significant difference. MS% of nearly 50% patients was closed to the normal value in PA group. The shape of pulmonary arteriole was irregular. There were few muscular arteries in a field of vision.

CONCLUSIONSThe density of muscular arteries decreases in patients with pulmonary atresia with ventricular septal defect and patent ductus arteriosus, but percentage of media thickness and percentage of media section area of pulmonary arterioles are close to the normal value. Diminished flow in pulmonary circulation has a significant effect on numbers of pulmonary arterioles per square centimeter that impact the selection of surgical method and the effect of operation because of the reduction pulmonary arterioles. The decrease of mean alveolar number results in compensatory enlargement of alveolar diameter. The impaired lung development is a major cause of abnormal lung function. Feasible and earlier operation, which can increase pulmonary flow and promote development of pulmonary vasculature will be helpful to restore lung function.

Abnormalities, Multiple ; pathology ; Child, Preschool ; Ductus Arteriosus, Patent ; pathology ; Female ; Heart Septal Defects, Ventricular ; pathology ; Humans ; Infant ; Male ; Pulmonary Artery ; pathology ; Pulmonary Atresia ; pathology

OBJECTIVETo compare the effect of different antegrade pulmonary blood flow on the further development of pulmonary artery after Glenn procedure in cyanotic congenital heart defects (CHD) patients.

METHODSBetween October 2000 and December 2006, 132 CHD patients with decreased pulmonary artery blood flow underwent bidirectional Glenn shunt, among them 18 patients received intraoperative lung biopsy. Patients were divided into two groups according to their different sources of antegrade pulmonary blood flow: antegrade arterial blood flow group (n = 33) and antegrade venous blood flow group (n = 99). The percutaneous oxygen saturation (SpO2), hemoglobin (Hb) concentration, and hemotocrit (Hct) value were examined and recorded before and after operation. The diameters of left pulmonary artery (LPA) and right pulmonary artery (RPA) were measured with two-dimensional echocardiography and the results were used to calculate the pulmonary artery index (PAI). The method of half-quantitative morphometric technique and an image analyzer were used to measure the following indicators of pulmonary microvessels: the percentage of media thickness (MT%), the percentage of media section area (MS%), vascular numbers of per square centimeter (VPSC), and mean alveolar number (MAN).

RESULTSBefore the operation, obvious cyanosis was found in both groups, while SpO2, Hct, and Hb were not significantly different (P > 0.05). LPA, RPA, and PAI were not significantly different between two groups (P > 0.05). The MT% and MS% in antegrade venous blood flow group were significantly less than those in antegrade arterial blood flow group (P < 0.05), but VPSC and MAN were not significantly different (P > 0.05). After Glenn procedure, hypoxia and cyanosis were remarkably improved in both two groups. There was a significantly negative correlation between SpO2 and Hct (r = -0.49, P < 0.01) or Hb (r = -0.196, P < 0.01 ). The PAI increased by 22% in antegrade arterial blood flow group and 44% in antegrade venous blood flow group (P < 0.05). The diameters of LPA and RPA in antegrade venous blood flow group were significantly larger than those in antegrade arterial blood flow group (P < 0.05) and the growth of RPA in antegrade arterial blood flow group was not significant.

CONCLUSIONA better pulmonary artery growth occurs in the patients of pulmonary stenosis after Glenn shunt than in those of pulmonary atresia, and it contributes to an earlier completion of Fontan procedure.

Blood Flow Velocity ; Cardiac Surgical Procedures ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital ; physiopathology ; surgery ; Humans ; Infant ; Male ; Pulmonary Artery ; growth & development ; physiopathology ; surgery ; Pulmonary Veins ; physiopathology ; Treatment Outcome

OBJECTIVETo explore the UL139 gene polymorphism of human cytomegalovirus (HCMV), and the relationship between polymorphisms of HCMV UL139 ORF and Hirschsprung's disease (HD).

METHODSForty-three specimens of the aganglionic intestinal segment and 6 urine samples of HD infants were amplified by nested polymerase chain reaction (PCR) method. The amplicons were sequenced in both strands directly. The control group consisted of 10 asymptomatic HCMV infected infants, and their urine specimens were also analyzed using the same method.

RESULTSHCMV UL139 genes of 28 clinical strains from HD 1 patients were successfully amplified and sequenced. UL139 was hypervariable and was clustered into 3 major groups and 5 genotypes. The predominant genotype of HCMV in HD infants was UL139 Group 3 (48 percent). Comparison of strains distribution between the two groups did not reach statistical significance using chi square test (chi square=7.378, P=0.194). The results of correlation analysis between UL139 and UL144 genes showed a p value 0.05 by Kendall test. Clinically, strains from the rectosigmoid segment, total colon aganglionosis, and long-segment were distributed sporadically in UL139 genotypes.

CONCLUSIONUL139 gene displayed polymorphisms. No linkage was found between UL139 genotype and clinical phenotype of HD. There was no correlation between HCMV UL144 and UL139.

Cytomegalovirus ; genetics ; Female ; Genotype ; Hirschsprung Disease ; etiology ; virology ; Humans ; Male ; Membrane Glycoproteins ; genetics ; Open Reading Frames ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Viral Proteins ; chemistry ; genetics

OBJECTIVEThe present study was designed to evaluate the clinical manifestations, surgical findings, pathologic types and treatment of cardiac tumor and to analyze the echocardiographic characteristics of the cases.

METHODSRecords of 19 patients with cardiac tumors confirmed by operations and pathology at Fuwai Cardiovascular Hospital in Beijing, China between Jan, 1983 and Dec, 2003 were reviewed. Clinical and echocardiographic data of all patients were analyzed.

RESULTSThe median age of patients was 7 +/- 5 years, ranging from 5 months to 14 years. There were 8 male and 11 female cases. The surgical findings revealed that 57.9% (11 cases) of cardiac tumors were found in left heart, 36.8% (7 cases) in right heart, 5.3% (1 case) in two ventricles. The pathological study revealed that 17 cases (89.5%) were diagnosed as primary cardiac benign tumors including myxoma in 10 cases (52.6%), rhabdomyoma in 4 cases (21.1%), fibroma in 2 cases (10.5%) and lipoma in 1 case (5.3%). Two cases were diagnosed (10.5%) as cardiac malignant tumors including a primary cardiac rhabdomyosarcoma and a metastatic epithelioid sarcoma. By using echocardiography 11 cases were diagnosed as myxomas and rhabdomyoma (11/19, 57.9%), 8 cases were diagnosed as space occupying lesions of the heart or myxoma (8/19, 42.1%).

CONCLUSIONSMyxomas are the most common heart tumors seen in infancy and childhood, followed in frequency by rhabdomyomas, fibromas and lipomas. Surgery is recommended for patients with refractory and severe clinical symptoms.

Adolescent ; Child ; Child, Preschool ; Echocardiography ; Female ; Fibroma ; diagnostic imaging ; Heart Neoplasms ; diagnostic imaging ; Humans ; Infant ; Lipoma ; diagnostic imaging ; Male ; Myxoma ; diagnostic imaging ; Rhabdomyoma ; diagnostic imaging

OBJECTIVETo analyse the relationship between the quantitative structural study of lung and right ventricle outflow tract reconstruction in infants with tetralogy of Fallot.

METHODSLung biopsies were taken during the operations in 16 infants suffered from tetralogy of Fallot. Autopsy specimens were obtained from 5 infants died of non-cardiovascular diseases as normal control group. All patients underwent one staged repair. The techniques of right ventricular outflow tract reconstruction included pulmonary valve commissurotomy (n = 3), transanular pericardial patch (n = 4), and transannular homologous monocuspid valve patch (n = 8); homograft was used in one patient because of the abnormal coronary artery. The diameters of main pulmonary artery (MPA), left pulmonary artery (LPA), and right pulmonary artery (RPA) were measured during operation. The tissue was fixed with buffered formalin and routinely impregnated in wax. Sections were stained by hematoxylin-eosin, and Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters of the small pulmonary arteries were obtained, including percentage of media thickness (% MT), percentage of media section area (% MS), numbers of pulmonary small artery per square centimeter (APSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (% PPA), and alveolar/ small arterial ratio per unit area (AAR) by a computer-based image processor for quantitative analysis.

RESULTSIn the TOF group, % MT, % MS, and APSC significantly decreased, while MLI and AAR significantly increased (P < 0.05, compared with the control group). APSC decreased in turn after separately using three different techniques of right ventricular outflow tract reconstruction (i. e. pulmonary valve commissurotomy, transannular pericardium patch, and transannular homologous monocuspid valve patch), which was paralleled with the diameters of MPA, LPA, and RPA. RPA correlated with APSC (r = 0.754, P = 0.001).

CONCLUSIONSThe development of pulmonary small arteries and alveoli are directly affected by the diminished pulmonary flow in infants with tetralogy of Fallot. Right ventricle outflow tract reconstruction may be indicated according to the developmental degree of central pulmonary artery.

Biopsy, Needle ; Child, Preschool ; Heart Ventricles ; surgery ; Humans ; Infant ; Lung ; pathology ; Reconstructive Surgical Procedures ; methods ; Tetralogy of Fallot ; pathology ; surgery