Objective:To explore therapeutic effects of sodium nitroprusside (SNP) combined verapamil on no-reflow during percutaneous coronary intervention (PCI).Methods: A total of 106 patients, who suffered from no-reflow during PCI in our department from Jan 2011 to Dec 2013, were selected.According to random number table method, patients were divided into SNP group (n=55, received SNP based on routine treatment) and combined treatment group (n=51, received verapamil based on SNP group).Cardiac troponin I (cTnI) level before and 16h~18h after PCI, cardiac function indexes after 12-month follow-up, incidence of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before PCI, there were significant rise in cTnI level in both groups on 16~18h after PCI, P=0.001 both;compared with SNP group, there were significant reductions in cTnI level [(1.31±0.44)μg/L vs.(0.11±0.02)μg/L] and percentage of cTnI>0.10μg/L (94.5% vs.54.9%) in combined treatment group, P=0.001 both.Compared with SNP group after 12 months, there was significant rise in left ventricular ejection fraction [(62.29±3.06)% vs.(65.65±3.94)%], and significant reductions in left ventricular end-diastolic dimension[(50.24±3.73)mm vs.(47.60±4.72)mm] and left ventricular end-systolic dimension [(33.29±2.11)mm vs.(31.00±4.33)mm] in combined treatment group, P<0.05 all.There were no significant adverse reactions during hospitalization and follow-up in both groups.Conclusion: When no-reflow occurs during PCI, intracoronary injection of SNP combined verapamil can improve cardiac function, and its safety is good, which is worth extending.

Objective: To explore the effect of probucol on enzyme and receptors of high density lipoprotein (HDL) during reverse cholesterol transportation in experimental rabbits with atherosclerosis. Methods: A total of 24 New Zealand rabbits were randomly divided into 3 groups: Control group, the rabbits were fed by normal diet, High cholesterol group, the rabbits were fed by high cholesterol diet and Probucol group, the rabbits were fed by high cholesterol diet with probucol.n=8 in each group, all animals were treated for 12 weeks. Blood levels of lipids were examined by colorimetric method, serum lecithin cholesterol acyltransferase (LCAT) and cholesterol ester transfer protein (CETP) were detected by ELISA, expressions of ATP binding cassette transporter A1 (ABCA1) and scavenger receptor class B type I (SR-BI) in aortic plaque were measured by immunohistochemistry; the above indexes were compared among different groups.
Results: ① for blood lipids by mmol/L, the following indexes in Probucol group were lower than High cholesterol group: TC (15.95±1.51 vs 21.95±3.71), LDL-C (13.01±2.28 vs 17.90±3.51), HDL-C (0.56±0.10 vs 1.13±0.12), all P<0.01.② the following perimeters in High cholesterol group were lower than Control group: for CETP by μg/ml (1.24±0.54 vs 2.07±0.64), for LCAT by μg/ml (15.02±3.81 vs 27.01±8.26), all P<0.05; compared with High cholesterol group, Probucol group had increased CETP (3.43±1.01) and LCAT (38.10±7.96), all P<0.05. ③ positive expressions of ABCA1 and SR-BI in aortic plaque in Probucol group were higher than High cholesterol group: for ABCA1 by % (46.81±10.01 vs 24.10±8.48), for SR-BI by % (48.04±10.90 vs 18.61±6.77), all P<0.01.
Conclusion: Probucol may increase blood levels of LCAT, CETP via up-regulating the expressions of ABCA1, SR-B1 and elevating the reverse cholesterol transportation of HDL, therefore improve HDL function in experimental rabbits with atherosclerosis.

OBJECTIVE:To investigate the pharmacokinetic characteristics of puerarin and puerarin lobate extract in rats and compare the difference of pharmacokinetic behavior of them. METHODS:24 SD rats were randomly divided into high-dose and low-dose groups of puerarin (300,100 mg/kg) and puerarin lobate extract (equal to 300,100 mg/kg of puerarin). 0.2 ml blood sample were collected from posterior venous plexus of bulbus oculi before intragastric administration and 0.083,0.17,0.33,0.5, 0.67,1,1.5,2,3,4,6,8,10 h after administration,respectively. The pharmacokinetic parameters were calculated by using DAS 3.0 software. RESULTS:Compared with puerarin high-dose group,AUC0-t and cmax of puerarin low-dose group increased sig-nificantly,while CL decreased significantly;MRT0-t of puerarin low-dose group and puerarin lobate extract high-dose and low-dose groups decreased significantly (P<0.01). There was no statistical significance in pharmacokinetic parameters between puerarin lo-bate extract low-dose group and puerarin lobate extract high-dose group (P>0.05). CONCLULSIONS:There is difference in the pharmacokinetic behavior between puerarin and puerarin lobate extract in rats. Some components of puerarin lobate extrats maybe speed up the elimination of puerarin in rats,so as to shorten the average retention time of it.

Objective:To explore therapeutic effect of esmolol hydrochloride combined amlodipine on patients with hyper-tension complicated aortic dissection (AD) and its influence on patient's blood pressure (BP) and heart rate (HR) .Meth-ods:A total of 110 patients with hypertension complicated AD were randomly and equally divided into amlodipine group and combined treatment group (received amlodipine and esmolol) .Results:Compared with before treatment , after treat-ment 0. 5 ,1. 5 and 7h ,there were significant reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both groups ,P<0.01 ,on 7h after treatment ,SBP level of combined treatment group significantly reduced than that of amlodipine group [(101.5 ± 7.8) mmHg vs .(123.4 ± 10.2) mmHg ,P<0.01];on 0.5 ,1.5 and 7h after treatment ,HR and rate pressure product (RPP) of combined treatment group significantly reduced than those of amlodipine group , P<0. 01 all. Compared with amlodipine group after treatment , there were significant rise in standard-reaching rates of BP (56.36% vs .87.27% ) ,HR (38.18% vs .92.73% ) and BP+HR (25.45% vs .81.82% ) in combined treatment group , P<0.01 all. Conclusion:Esmolol combined amlodipine can control blood pressure and heart rate rapidly ,safely and effec-tively in patients with hypertension complicated aortic dissection .

Objective To compare the efficacy and safety of singular double antithrombotie therapy (DT) using warfarin plus clopidogrel and the combined antithrombotie therapy of 3-month triple antithrombotie therapy (TT) using warfarin, aspirinand clopidogrel and 9-month double antithrombotie therapy (DT) for the patients with atrial fibrillation undergoing PCI. Methods Ninety patients with atrial fibrillation undergoing PCI were randomly divided into two groups evenly: one group was treated with dual antithrombotic therapy group (DT) and the other group with the combined therapy, e. g. 3-month triple antithrombotie therapy (TT) and 9-month double antithrombotie therapy (DT + TT for short). All patients were followed-up by 12 months. The two groups were compared in terms of incidences of death , myocardial infarction , stroke , target-vessel revascularisation , stent thrombosis and bleeding adverse events. Results The incidences of myocardial infarction, stroke, target-vessel revascularisation , stent thrombosis and bleeding adverse events in the TT + DT group were all significantly lower than the DT group (P < 0.05). The follow-up on the safety indicated that the rate of bleeding in the TT +DT group was insignificantly higher than the DT group (P > 0.05). Conclusion There is no significant difference in safety between the two groups. However, the therapy of TT + DT is more effective.

Obgective To investigate the impact of different ways and doses of recombinant human interferon o1b(rhIFN-α1b) on antiviral effect on respiratory syncytial virus(RSV)-effected mice and signal pathway of JAK/ STAT.Methods Forty-eight mice were divided randomly into 6 groups,negative control group,RSV-infection model group,12.5,25.0,50.0 μg rhIFN-α1 b atomization inhalation of intervention group,and 12.5 μg rhIFN-α 1 b injection of intervention group.After continuous drug therapy for 5 days,the left lung tissues of mice were aseptically dissected in the sixth day.Then it were observed lung tissue pathology changes by optical microscope,and expression of STAT1 and STAT2 protein with laser scanning confocal microscopy.Results It was observed that RSV-infection model mice's lungs had significant inflammatory injury under light microscope.After treatments of rhIFN-α 1b,it showed that the mice lung tissue had recovery of inflammation on different degrees.The group of inhaled rhIFN-o1b 50.0 μg was damaged on lightest degree.There were statistically significant differences between each group (all P ＜ 0.05).The expression of STAT1 and STAT2 protein in RSV-infection model mice's lungs decreased remarkably under fluorescene microscopy.Treatments of rhIFN-α 1b increased the expression of STAT1 and STAT2 inhibited by RSV-infection.The expression of STAT1 and STAT2 protein of the inhaled rhIFN-α1b 50.0 μg group increased significantly.The differences between groups were statistically significant(all P ＜ 0.05).Conclusions rhIFN-α 1 b played an important role in anti-RSV effects,simultaneously,it could improve the activity of JAK/STAT signal pathway inhibited by RSV-infection.The treatment effect of rhIFN-α 1b deliveried by atomization inhalation was better than that of intraperitoneal injection.And curative effect is proportional to the atomization inhalation dose within a certain range.

Objective To assess the diagnostic value of cardiac magnetic resonance (CMR) in patients with acute viral myocarditis.Methods Thirty patients with suspected acute viral myocarditis admitted in first people's hospital of Shunde from June 2011 to June 2013 were included in this prospective study.The diagnostic sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and accuracy of acute viral myocarditis were evaluated by clinical diagnosis.Diagnostic value among different scan methods and Lake Louise criteria were compared.Results Acute viral myocarditis was diagnosed in 63.33％ (19/30) patients.Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 57.89％,72.73％,78.57％,50.00％,63.33％,respectively by edema imaging(ER).Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 78.95％,63.64％,78.95％,63.64％,73.33％,respectively using global relative enhancement (gRE).Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 78.95％,54.55％,75.00％,60.00％,70.00％,respectively using late gadolinium enhancement (LGE) criteria.Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 84.21％,81.82％,88.89％,75.00％,83.33％ using Lake Louise criteria.The sensitivity,specificity,PPV,NPV,and diagnostic accuracy using Lake Louise criteria were significantly higher than using ER,gRE,LGE alone (all P ＜ 0.05).Specificity was higher using ER than using gRE and LGE(both P ＜ 0.05).The sensitivity,NPV,and diagnostic accuracy were significantly higher using gRE than using ER (all P ＜ 0.05) and was similar as using LGE (all P ＞ 0.05).Conclusion Cardiac magnetic resonance is an excellent imaging modality for the diagnosis of acute viral myocarditis.

OBJECTIVETo investigate the correlation of the occurrence and prognosis of coronary slow flow phenomenon (CSF) with blood homocysteine (Hcy) levels in patients receiving emergency percutaneous coronary intervention therapy (PCI).

METHODSFrom January, 2010 to December, 2011, 138 patients with ST-elevation myocardial infarction received emergency angioplasty, among whom 46 patients developed CSF and 92 did not (control group). Blood Hcy levels were determined in these patients. The patients with CSF were classified into two groups with mild and moderate Hcy elevations (32 and 14 cases, respectively), and the left ventricular ejection fraction (LVEF) during hospitalization and at 3 months of follow-up as well as major adverse cardiac events (MACE) were compared between the two groups and analyzed for their association with Hcy level.

RESULTSThe patients with CSF showed significantly higher blood Hcy levels than the control patients (P=0.001). At 3 months of follow-up, the patients with CSF and moderate Hcy elevation had significantly lower LVEF (P=0.031) and higher incidence of MACE (P=0.019) than those with mild Hcy elevation. Hcy levels were negatively correlated with LVEF (r=-0.310, P=0.036) and positively with MACE (r=0.342, P=0.02).

CONCLUSIONA high blood Hcy level is closely correlated with the occurrence of CSF in emergency PCI, affects the recovery of LVEF and increases the incidence of MACE.

Adult ; Aged ; Coronary Artery Disease ; blood ; diagnosis ; therapy ; Emergency Treatment ; Female ; Homocysteine ; blood ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Prognosis ; Stroke Volume ; Treatment Outcome ; Ventricular Function, Left

Objective To explore the feasibility of right ventricular outflow tract (RVOT) septal pacing. Methods Fifty-two patients implanted with pacemaker were randomly divided into two groups. One group underwent the RVOT septal pacing with active fixation electrodes (active fixation electrodes group, 22 cases),and the other group underwent the right ventricular apical pacing with passive fixation electrodes (passive fixation electrodes group, 30 cases). The parameters of two groups in operation were recorded. Results The successful rate of RVOT septal pacing was 100%, active fixation electrodes group took more time to plant electrodes and expose in X-ray than passive fixation electrodes group [ (56.13±1.18)min vs (15.42±1.24) min, (18.77±6.14) min vs (10.12±8.14) min, P<0.05]. The width of the QRS wave of active fixation electrodes group was narrower than that of passive fixation electrodes group [(0.14±0.02)ms vs (0.16±0.04) ms, P< 0.05]. The parameters of two groups were stable in follow-up period and none of electrodes was extracted. Conclusion The usage of active fixation electrodes in patients with RVOT septal pacing is feasible and safe.

Objective To observe the clinical effect and safety of platdet GP Ⅱb/Ⅲa receptor antagonist firofiban on acute coronary syndrome(ACS)patients with nO reflow after intevention procedure.Methods 48 ACS patients with no reflow were randomly divided into tirofiban group(n=26)and control group(n=22),the tirofiban group received intravenous tirofiban for 48-36homs,control group received nitroglycerin and urokinase.The rate of the TIMI grade offorward flow and the primary end pints(death,persistent myocardial isehemic and new onset myocardial infarction)and adverse reactions of drags were observed Resalts Tirofiban improved target vessel TIMI flow significantly than control groug(73.8%vs 18.2%,P＜0.01),the rate of the main end point events significantly decreased(15.4%vs 63.6%,P＜0.05),the bleeding complications was similar between two groups,no severe bleeding events occurred.Condusion Tirofiban is effecfive and safe in treating ACS patients with no reflow.