With the increasing incidence and mortality of coronary heart disease (CHD) in China, the prevention and treatment of CHD is no time to delay. Since Professor Gruentzig completed the first human case of percutaneous transluminal coronary angioplasty (PTCA) in 1977, percutaneous coronary intervention (PCI) had reached to a new page. After three decades of development and change, PCI has been improved and matured gradually from the early PTCA to the current stent era. With the advent of stents, the rate of restenosis after PCI was significantly reduced from 30%-50% to 10%-20%. But stent restenosis was still with no total cure. The issue of how to prevent the stent restenosis has become a long-term major issue for the exploration in both clinical and preclinical medicine. Therefore, this paper reviewed the etiology, pathology, related risk factors, latest diagnosis methods, prevention and treatment of stent restenosis by integrative medicine.

Objective To investigate the relationship between body mass index (BMI) and coronary artery calcification in order to provide theoretical and clinical basis for the prevention and treatment of coronary artery calcification.Methods Ninety hundred and eighty-three cases were selected as our subjects who were hospitalized in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from Jan.2010 to Jul.2010 and undergone dual source CT coronary angiography.Of them,419 cases were male(male group),and 564 female (female group).The general information,clinical and biochemical indexes and coronary CTA results were collected.The patients were divided according to the BML Multivariate logistic regression analysis was applied to analyzed the relationship between BMI and coronary artery calcification,and multiple linear regression analysis was applied to analyzed the relationship between coronary artery calcification and BMI.Results There were significant differences between male group and female group in terms of age,height,body mass,BMI,smoking history,glomerular filtration rate (eGFR),triglyceride (TG),high density lipoprotein (HDL-C),left ventricular ejection fraction (LVEF),serum calcium,with peripheral vascular disease,as well as the baseline drugs,angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB),calcium antagonists (CCB),statins compared the differences were statistically significant (P ＜ 0.05).The rate of slight coronary artery calcification in male group and female groups were not statistically significant(x2 =0.714,P =0.398),while the rate of no calcification,severe calcification were statistically significant (P ＜ 0.05).Multivariate Logistic regression analysis showed that high BMI(regression coefficient was-1.670,OR =0.967,95％ CI =0.953 ～ 0.980,P =0.005),age (regression coefficient was 1.422,OR =4.416,95％ CI:1.015 ～ 16.927,P =0.001),history of hypertension (regression coefficient was 0.128,OR =1.521,95％ CI:1.262 ～ 1.830,P =0.002),history of diabetes mellitus (regression coefficient was 0.364,OR =1.439,95 ％ CI:1.098 ～ 1.885,P =0.008),eGFR (regression coefficient was-0.5420,OR =0.004,95％ CI:0.001-0.019,P =0.014),LVEF (regression coefficient was-1.153,OR =0.316,95％ CI:0.127-0.787,P =0.002) and statins(regression coefficient was-6.745,OR:0.323,95％ CI:0.138-0.754,P =0.032) were correlated with coronary artery calcification.Multiple stepwise linear regression analysis showed that only eGFR(r =0.79,95％ CI:0.69-0.92,P =0.001) was in the equation.Conclusion High BMI is a protective factor for severe coronary artery calcification,but there is on linear correlation between BMI and moderate to severe coronary artery calcification score in patients.

Objective To explore the method and efficiency of percutaneous transluminal septal tunnet myocardial ablation(PTSTMA) in treatment of 26 cases hypertrophic obstructive cardiomyopathy (HOCM) who were not suitable for conventional technology.Methods Firstly,we used a monorail Balloon which was slightly bigger than the interventricular septal branch of coronary artery and dilated it until posterior septal.After that,an OTW Balloon with larger size than the monorail was used to dilate again until made aventricular septum tunnel.Then,some alcohol was injected and PTSTMA was performed.Finally,we did the other and/or another interventricular septal branch by above method until the left ventricular outflow tract pressure gradient (LVOTPG) reduced ≥50％.The clinical indexes of the 26 cases HOCM immediately pest-operation of PTSTMA were observed and the follow up data during short term and metaphase were analyzed.Results The LVOTPG reduced ≥50％ in the26 cases HOCM,immediately after PTSTMA,the LVOTPG reduced from (75.6 ±22.4)mm Hg to (21.4 ± 5.8) mm Hg (t =11.94,P ＜ 0.01).At three months after ablation,the thickness of septal myocardium reduced from (22.8 ± 5.8) ram before ablation to (16.8 ± 4.2) mm(t =4.27,P ＜ 0.01),left atrium dimension reduced from(48.0 ±7.0) mm to (42.0 ±8.6) mm (t =2.76,P ＜0.01).Followed up 6.0to 60.0 months,the patients suffering from chest pain reduced from 14 cases before to 4 cases after the procedure(53.8％ (14/26) vs 15.4％ (4/26),x2 =8.49,P ＜ 0.01),the patients with expiratory dyspnea reduced from 26 cases to 5 cases(100％ (26/26) vs 19.2％ (5/26),x2 =35.22,P ＜ 0.01),NYHA functional class improved from (2.4 ± 0.6) to (1.4 ± 0.7) (t =5.53,P ＜ 0.01).Conclusion The PTSTMA was a supplemental method of PTSMA on treating HOCM,which was safe and useful during the short term and metaphase.

Objective To investigate the characteristics of coronary vessel re-endothelialization after placement of drug-eluting stents (DES), and to provide clinical evidence for the double anti-platelet treatment. Methods Optical coherence tomography (OCT) was performed in 43 patients in 1 year after DES implantation. Characteristics of re-endothelialization and percentage of neointimal coverage of stent struts were evaluated by OCT. Results The rate of stent struts intimal coverage was 90.70%, and the remain was lack of endothelial coverage; The ratio of neointimal thickness (NIT) between 0-99, 100-199 and above 200 microns was 19.92%, 37.55% and 42.53%, respectively. The rate of neointimal coverage was higher and the degree of neointimal hy-perplasia was more extensive in patients with DM and in patients with ACS than those of patients without DM and of patients with stable angina pectoris. Conclusion One year after stent placement, most of the stent struts were covered with neointima and few struts obtained poor coverage of endothelial. DM and ACS may be impact factors for the progress of re-endothelialization after DES placement.

This study was aimed to observe the safety and effectiveness ofShugan Jieyu Capsules in the treatment of vasovagal syncope (VVS) with mild-to-moderate depression and anxiety, and to compare the effect with Flupentixol and Melitracen Tablets. A total of 89 VVS cases with mild-to-moderate depression and anxiety were randomly divided into 3 groups, which were group A (Shugan Jieyu Capsules group), group B (Flupentixol and Melitracen Tablets) and group C (control group). Based on the conventional therapy of VVS treatment, treatments were given to all three groups for 8 weeks. And the negative conversion ratio of VVS in each group was observed. Hamilton Depression Scale (HAMD 24 items) and Hamilton Anxiety Scale (HAMA) were evaluated for the calculation of reductive rate. Treatment emergent symptoms scale (TESS) was used in the evaluation of adverse reactions of both medications during the treatment. In the 12-month follow-up after treatment, the recurrence rate of syncope was observed in each group. The results showed that compared with pretreatment, HAMD-24 and HAMA scores of group A and group B after treatment were significantly reduced (P < 0.05). Compared with group C, the heat-up tilt testing-negative rate, HAMD-24 and HAMA reductive rate of group A and group B after treatment were significantly increased (P < 0.05). Compared with group B, the negative rate, HAMD-24 and HAMA reductive rate of group A were more significant (P < 0.05). After treatment, scores for TESS of group A was significantly lower than group B (P< 0.05). In the 24-month follow-up, the recurrence rate of syncope of group A and group B was significantly lower than group C (P < 0.05); and group A was obviously better than group B (P < 0.05). It was concluded thatShugan Jieyu Capsules can be used in the treatment of VVS with mild-to-moderate depression and anxiety. Its effectiveness and safety may be better than Flupentixol and Melitracen Tablets.

This study was aimed to investigate the effect ofDanlou pills on prevent atherosclerosis from hypercholesterolemia rabbit and its relationship with inflammatory factors as well as PI3K/AKT signal pathways. A total of 24 Japanese male white rabbits were randomly divided into the control group (CL), model group (M) and Danlou group (DL), with 8 in each group. Normal diet was given to CL rabbits. High-fat diet was given to rabbits in other groups to establish the atherosclerosis model. Danlou pills (0.5 g·kg-1·d-1) were also given to DL rabbits. Rabbits were sacrificed after 9-week medication. The contents of blood lipid, TNF-α and IL-6 were detected. HE staining was used in the observation of histological changes in the aorta. Western blot was used to observe PI3K and p-AKT expression in the aorta. The results showed that compared with CL, the contents of TG, TC, LDL, IL-6 and TNF-α were significantly increased in M (P < 0.01); PI3K and p-AKT expression in the aorta were significantly decreased (P < 0.01). Compared with M, blood lipid, IL-6 and TNF-α were significantly reduced in DL (P < 0.05, orP < 0.01); PI3K and p-AKT expression were significantly increased (P < 0.01). It was concluded thatDanlou pills had prevention effects on atherosclerosis through reducing blood lipid and inflammatory factors. The action mechanism maybe related to the activation of PI3K/AKT signal pathways.

Objective To investigate the mechanism and prevention of syncope on patients with hypertrophic cardiomyopathy (HCM). Methods Seventy-six cases of HOCM (obstruction group) were successfully operated by PTSMA and oral ACEI/ARB. After six months , they were treated with β-receptor blocker. Another 29 patients (control group) with LVOTPG < 50 mmHg or < 70 mmHg after pharmacologic stress test (PST), have being treated with β-receptor blocker. The results was observed as follow: (1) the difference of between syncope incidence and positive incidence induced by PST in control group; (2) the difference of syncope incidence at half year, a year and admission in control group; (3) the difference of syncope incidence in obstruction group before and after operation; (4) the difference of syncope incidence after six months between two groups at same period; (5) the difference of syncope incidence one year between two groups. Results In control group, the syncope positive incidence induced PST was 55.5%. Treating with medications for half a year , syncope incidence significantly dropped than that on admission (P < 0.05); Obstruction group syncope incidence in the history obviously lower than the control group syncope positive induced PST (P < 0.05), and half a year after takingβ-receptor blocker syncope incidence was significantly dropped than before (P < 0.01). Conclusions The mechanism of syncope with HOCM is not only obstruction but also neuronal reflex. PST is an very useful inspection item for screening the ablation indication, analysis syncope mechanism, and guiding clinical medication.β-receptor blocker is an effective drug on treating and preventing syncope with HCM.

Objective To observe the short-term quality of life in patients with obstructive hypertrophic cardiomyopathy (OHCM) after percutaneous transluminal septal tunnel myocardial ablation (PTSTMA). Methods The quality of life in patients with OHCM were assessed by the SF-36 before and three months after PTSTMA. Results Three months after the procedure , quality of life was markedly improved at different variances in patients with OHCM as compared with the baseline. The linear regression analysis showed the factors influencing quality of life were character, coexistence with other diseases, and 6-minute walk test. Conclusions Percutaneous transluminal septal tunnel myocardial ablation can improve the short-term quality of life in patients with OHCM. Postoperative psychological counseling and rehabilitation guidance can practically enhance quality of life.

Objective: To compare the percutaneous transluminal septal myocardial ablation (PTSMA) and percutaneous transluminal septal tunnel myocardial ablation (PTSTMA) on cardiac function in experimental canines.
Methods: According to CAG determined coronary septal branches, a total of 25 hybrized canines were divided into 2 groups:PTSMA group, n=13 canines with the bigger septal branches and PTSTMA group, n=12 canines with the smaller or uneven septal branches. Alcohol ablation model was established. Electrocardiograph (ECG) at before and after the operation, biomarkers for myocardial injury, echocardiography and hemodynamic changes were recorded. The animals were scariifes at 1 week after operation, the pathological changes in ventricular septal were observed by HE and Masson staining.
Results: Myocardial infarction (MI) could be induced by either PTSMA or PTSTMA and the thickness of septal was decreased. LVEDd, LVEF and hemodynamic indexes were similar between 2 groups. The alcohol volume used in operation, EKG and echocardiography ifndings were similar between 2 groups, P>0.05. Pathological staining indicated that there was a well-demarcate between the ablation focal and normal myocardium, merging area had neutrophiles invasion, infarcted cells were partially having the ghost cell sample and they were gradually replaced by ifbrous tissue. There was nest-like necrosis in ablated lumen and the normal vessel wall disappeared. PTSMA group had vessel lumen conifguration in septal branch and the necrosis limited inside the lumen;while in PTSTMA group, the vessel wall of was discontinued and some necrosis materials move out to from lumen.
Conclusion: Both PTSMA and PTSTMA were effective for alcohol septal ablation in different coronary septal branches, the impacts on cardiac function and hemodynamic changes were similar in experimental canines.

Objective: The purpose of the present study was to evaluate of continuous metabolic syndrome score (cMetS) in screening metabolic syndrome (MetS) and to determine the cut-off values in a representative sample of Xinjiang population aged 15 to 18 years old. Methods: A stratified cluster sampling was used to select participants aged 15-18 years from 13 cities in Xinjiang. cMetS was calculated by summing up the Zscores of standardized waist circumference, mean arterial pressure, high-density lipoprotein, triglyceride, and fasting blood glucose by age and gender. Results: Totally 16.3% of subjects were overweight, and 5.2% were obese. The proportion of overweight and obesity in males was significantly higher than that in females (18.1% vs 13.8%)(6.0% vs. 4.1%)(χ2=15.36，7.89，P<0.05). The prevalence of total MetS was 6.1%, with 6.6% and 5.4% for men and women, respectively. There was a correlation between cMetS and MetS components, and the average cMetS value increased with increasing MetS component(P<0.05). The total cut-off value of cMetS was 0.99 (sensitivity 68.0%, specificity 80.7%), and the area under the ROC curve was 84.9%. The cMetS scores for boys and girls were 0.80 and 1.48, respectively. Conclusion Compared with MetS, cMetS shows more accuracy in screening MetS among youth aged 15-18 years in both gender.