OBJECTIVE： To optimize the water extraction technology of Chaihu anxin capsules. METHODS： Taking comprehensive scoring value of  the contents of gallic acid，chlorogenic acid，puerarin，glycoside，rutin，cinnamic acid， quercetin and the yield of extract as investigation index， using multiple of adding liquid， soaking time， reflux time and extraction times as factors， water extraction technology of Chaihu anxin capsule was optimized by Box-Behnken response surface method based on single factor test. Validation test was conducted. RESULTS： The optimal extraction technology of Chaihu anxin capsules was adding 11 times of water， soaking for 10 h， extracting for 2 times， refluxing for 1.5 h each time. In validation test， the relative deviation of comprehensive scoring value to predicted value was 1.87％ for 3 batches of samples （RSD＜2％， n＝3）. CONCLUSIONS： The optimal extraction technology is simple， stable and suitable for further production of Chaihu anxin capsules.

BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol(TCL), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG)]and right ventricle end diastolic diameter (RVEDD), left ventricle end diastolic diameter (LVEDD), right atrium diameter (RA), left atrium diameter (LA), or left ventricle ejection fraction (LVEF) were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD (r=-0.34,P<0.001) and RA (r=-0.36,P<0.001). Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.

Objective To study The effect of anti-depression treatment on endothelial function of coronary artery disease (CAD)and depressive disorder.Methods 120 CAD patients with depressive disorder treated in our hospital from September 2007 to February 2009 were ran-domized to control group (n =58)and treatment group (n =62).The patients in both groups were given conventional treatment and psychological intervention,and the patients in treatment group were added 20 mg Citalopram tablets every night.Scores of Hamilton Depression Rating Scale(HAMD)of the patients were measured and endothelial function of the patients were evaluated at 8 weeks before and after the treatment.Results After 8 week treatment,the HAMD score was (7.60±3.49)in treatment group and (20.58±3.20)in control group,the difference was signifi-cant after comparison of two groups (P <0.01).The values of FMD% were respectively (4.69± 0.58)in treatment group and (4.45±0.69)in control group which revealed that the difference was significant (P <0.05).Conclusion Citalopram can significantly improve depression and en-dothelial function of CAD patients with depression.

Objective To study The effect of anti-depression treatment on endothelial function of coronary artery disease (CAD)and depressive disorder.Methods 120 CAD patients with depressive disorder treated in our hospital from September 2007 to February 2009 were ran-domized to control group (n =58)and treatment group (n =62).The patients in both groups were given conventional treatment and psychological intervention,and the patients in treatment group were added 20 mg Citalopram tablets every night.Scores of Hamilton Depression Rating Scale(HAMD)of the patients were measured and endothelial function of the patients were evaluated at 8 weeks before and after the treatment.Results After 8 week treatment,the HAMD score was (7.60±3.49)in treatment group and (20.58±3.20)in control group,the difference was signifi-cant after comparison of two groups (P <0.01).The values of FMD% were respectively (4.69± 0.58)in treatment group and (4.45±0.69)in control group which revealed that the difference was significant (P <0.05).Conclusion Citalopram can significantly improve depression and en-dothelial function of CAD patients with depression.

Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001). Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.

BACKGROUND: Pharmacological researches demonstrate that Chinese crude drugs of invigorating the kidney contain flavonoids such as prepared rhizome of rehmannia and kudzuvine root, they possess phytoestrogenic effect, among them, isoflavone acts as a regulator of estrogen receptor.OBJECTIVE: To approach the effects of self-planned Bushen Huoxue Fang (BSHXF) on the serum estradiol and estrogen receptor α mRNA expression in pituitary gland in rats with collagen-induced arthritis. DESIGN, TIME AND SETTING: Randomized grouping controlled animal experiment was performed in the central laboratory of Bethune Intemational Peace Hospital of Chinese PLA between May 2006 and May 2008. MATERIALS: Sixty female and healthy Wistar rats were randomly divided into sham operated group (n=10) and operation group (n=50). Operation group was reproduced collagen-induced arthritis model at 2 weeks following ovariectomy. The rats of arthritic index ≥ 5 were assigned into model group, BSHXF group, methotrexate (MTX) group, and MTX + BSHXF group, each group included 10 rats. The Chinese crude drugs were bought from LERENTANG drugstore in Shijiazhuang, including rhizoma drynariae, safflower, prepared rhizome of rehmannia, Herba Epimedii, danshen root, kudzuvine root and so on. After routine decoction, centrifugalization, rogue and condensing 1.3 kg/L decoction, the solution was sealed up, divided pack and reserved at 4℃.METHODS: Sham operated group and model group were intragastrically administered with normal saline 2 mL per day; BSHXF group with BSHXF decoction 2 mL per day; MTX group with MTX 2.6 mg/kg (2 mL) once a week, and normal saline 2 mL per day at other time points; MTX + BSHXF group with MTX 2.6 mg/kg (2 mL) once a week and BSHXF juice 2 mL per day. Each group was given 6 weeks.MAIN OUTCOME MEASURES: After blooding by abdominalis aorta, magnetic-split enzyme linked immunosorbent assay was applied to detect the level of serum estradiol. Reverse transcription-polymerase chain reaction detected the expression of estrogen receptor a mRNA in rat pituitary gland.RESULTS: Compared with model group, the expression of estrogen receptor a mRNA in pituitary gland increased in the MTX group, but there was not statistically significant. BSHXF + MTX group showed a significantly increased expression (P < 0.01). The expression of estrogen receptor α mRNA in BSHXF group was higher than MTX group, but lower than BSHXF + MTX group (P < 0.05). No significant difference existed between BSHXF group, BSHXF + MTX group and sham operation group. Compared with sham operation group, there were statistically significant decrease of estradiol in the model group. Compared with model group, the estradiol levels were shown to increase in three treatment groups. Among them, MTX group had slightly slower level with no significant difference (P > 0.05), while BSHXF + MTX group had the most obvious increase, which was close to normal level (P < 0.01). There was a significantly positive correlation between estradiol and the expression of estrogen receptor o mRNA (r=0.483, P < 0.05).CONCLUSION: Serf-planned BSHXF possessing oestrogenic hormonelike role can elevate the level of serum estradiol and upregulate the expression of estrogen receptor a mRNA in pituitary gland.

BACKGROUND: It is difficult to cover aneurysm-like ventricular septal defect (VSD) of large inlet and multiple outlets completely with symmetrical type occluders or eccentric type occluders. OBJECTIVE: To investigate the feasibility of A4B2 occluder devices for covering aneurysm-like VSD, and to observe the effects of proper occhiders selected according to pseudoaneurysm size on coveting aneurysm-like VSD. DESIGN: Case analysis.SETTING: the First Hospital of Hebei Medical University. PARTICIPANTS: From August 2004 to May 2006, 226 patients with the pseudoaneurysm of petimembranous VSD, who underwent interventional therapy in the First Hospital of Hehei Medical University, were recruited in the study. According to the results of the left ventricular angiography, 36 patients of pseudoaneurysm of petimembranous VSD with large inlet and multiple outlets were closured with A4B2 occluder devices. According to the results of the left ventricular angiography, the mean diameter of the left inlet of VSD was (10.6+8.7) mm (ranged from 8 to 21 mm), the mean diameter of the right outlet of VSD was (3.1 ± 2.9) mm (ranged from 2 to 8 ram). Main materials: Occluder device and delivery mechanism were offered by Shanghai Shape Memory Alloy Materials Company and Beijing Starway Medical Technology Inc. They were processed into double disks using nickel-titanium shape memory alloy wires by a special technology to close VSD by a transcatheter approach. The size of the occluder was denoted with the diameter of the waist, and the Size ranged from 4 to 16 mm in the present study. METHODS: All the occluders were transferred by a 7-10 F transferring sheath from right heart system, and the mean diameter of the occluders was (6.364-2.48) nun (ranged from 4 to 16 ram). Fifteen minutes after the procedure, left ventricular angiography and transthoracic echocardiography (TIE) were performed again to evaluate the efficacy. After the procedure, electrocardiogram (ECG) monitoring lasted for 5 successive days in all patients, and ECG and TIE were performed 1, 3, 6 and 12 months later. MAIN OUTCOME MEASURES: Residual shunt, arrhythmia and valve function as well as blood compatibility. RESULTS: Sixteen cases were closured by placing the occhiders into left inlet of VSD, 16 cases were closured by placing the occluders into the pseudoaneurysm completely, and 4 cases were closured at the outlet of the defects. The results of the left ventricular angiography and TTE that performed fifteen minutes after the procedure demonstrated that 32 cases were completely closured and slightly residual shunts (< 3 mm) was found in other 4 patients. And confirmed by TIE, the residual shunts completely disappeared in 2 of the 3 patients 24 hours later while in the other one in 1 month after the procedure. Temporary left bundle branch block was found in 3 cases while temporary right bundle branch block was found in 2 cases, and all of them recovered within one week. Without severe complications, all of the 36 patients were treated successfully with A4B2 (thin waist shape) occluder devices made in China. Critical appraisal in blood compatibility of the implantation materials used in this research had been performed. The hemolysis ratio was less than 5%, the platelet adhesion was less, and the blood coagulation function ,the immune system response( immunoglobulin and complement)and the re-endothelialization of material surface were all normal. CONCLUSION: Transcatheter interventional therapy with domestic A4B2 occluder devices for VSD with pseudoaneurysm is safe, effective, promising, and has fewer complications. The key to the procedure is to select suitable occluders and suitable positions where to plant them according to the size, morphologic characteristics, position, and maturity of the pseudoaneurysm.

BACKGROUND:The early reperfusion of the infarct-related artery in acute myocardial infarction (AMI) may significantly improve the symptoms and prognosis of patients.However,reperfusion is also followed by ischemia-reperfusion injury and there are no very effective ways to manage this severe problem at present.OBJECTIVE:To evaluate the protective effects of intracoronary adenosine infusion on myocardium in patients with AMI during percutaneous coronary intervention(PCI).DESIGN:Double-blinded and randomized controlled study.SETTING:First Hospital of Hebei Medical University and Third Hospital of Shijiazhuang City.PARTICIPANTS:The clinical triel was performed in 50 eligible patients at the Department of Cardiology,the First Hospital of Hebei Medical University and the Third Hospital of Shijiazhuang City from December 2004 to April 2006.Patients were eligible if they were age 30 years or older and admitted with ST-segment elevation myocardial infarction (STEMI).The diagnosis of STEMI was based on episodes of chest pain persisting at least 30 minutes but no longer than 12 hours and proving unresponsive to nitrates,electrocardiogram (ECG) ST-segment elevation of at least 2 contiguous ECG leads,and 2-fold creatine kinase (CK) elevation above the maximum peak in the normal range.The physicians obtained written informed consent from each patient.The patients were randomly assigned into two groups:those who received intra-coronary adenosine (23 patients) and those who received placebo (saline,27 patients).There were no significant differences between two groups in general condition,characteristics of coronary angiograms and intervention procedure(P＞0.05).METHODS:After the patients were admitted in hospital,general emergence managements were given.All patients received 300 mg aspirin and 300 mg clopidogrel. While the patients remained stable,the left and right coronary arteriography was done before the balloon was inflated.10 mL saline (control group) or adenosine (300 μg+10 mL saline) was immediately given by intracoronary injection within one minute.Then the stenting was performed.Coronary flow of the infarct-related artery (IRA) was assessed by the method of thrombolysis in myocardial infarction (TIMI) grading.MAIN OUTCOME MEASURES:①The peaks of serum levels of cardiac biomarkers were assessed every 4 hours in the first day of admission and then every day up to discharge.②The 12-lead ECG was done 1 hour before coronary angiography and after PCI,the sum of ST-segment resolution (STR) was calculated.③The left ventricular ejection fraction (LVEF) was calculated and measured by echocardiogram on the 3rd day and the fourth week after PCI in modified Simpson's method.RESULTS:All of 50 patients with AMI were involved in the final analysis.①Cardiac biomarkers and sum of STR:The peak levels of serum CK,CK-MB and cardiac troponin Ⅰ (cTnI) in adenosine group were significantly lower than those in control group (t=2.31,z=2.83,2.22;P＜0.05).Sum of STR in one hour after PCI of adenosine group were significantly higher than those in control group (z=2.10,P＜0.05).The lower level of the markers in adenosine group showed the mild myocardial injury.The infarcted patients with more rapid ST-segment resolution in adenosine group meant the better recovery in the electrocardiogram.②Left ventricular function:LVEF at the fourth week of PCI (both adenosine and control group) were better than those on the third day (t=1.45,2.30;P＜0.01).LVEF in adenosine group were significantly higher than control group on the fourth week after PCI.TIMI flow:TIMI 3 flow in the two groups was 22 patients for control group and 19 patients for adenosine group.There was no significant difference between the two groups(P＞0.05).③Side-effect:Four(17.39%) patients in adenosine group and 1(3.70%) patient in control group developed significant sinus bradycardia requiring pacing.However,the incidence of bradycardia requiring pacing was not significantly different between the two groups(Fisher exact,P=0.129).CONCLUSIONS:Intracoronary adenosine infusion during PCI significantly alleviated ischemia-reperfusion injury and improved the left ventricular function in AMI.Intracoronary adenosine infusion in patients with AMI during PCI was safe and feasible.

Objective To explore a method for rapid bedside temporary pacing by the right internal jugular vein approach.Method The right internal jugular veni puncture was taken by Jernigan technique and self made J tipped introducer was introduced to get to the high right atrium by the vein approach,then the J curvature of the introducer at the distal end is turned and directed at the tricusped valve outside the body,the lead attached to external pacemaker was inserted and advanced through the introducer until continuous ventricular captures appeared on the fluoroscopy.Results 30 patients in total were paced rapidly and successfully at bedside without Roentgenography.Continuous right ventricular pacing was got within 1～3 (median 2) minutes from vein puncture and within 6～30(median 13) seconds after the placement of the introducer had been completed,respectively.Conclusions The rapid bedside temporary pacing can be performed safely and rapidly through the J tipped introducer by the right internal jugular vein approach without Roentgenography.

Objective To determine the changes of L-type calcium currents(I Ca-L ) of rabbit ischemic myocytes in peri-infarcted zone.Methods Rabbit AMI models were made by ligation of branches of left coronary artery. After 1 week and 2 months, single pericardial myocytes were isolated enzymatically from ischemic zone adjacent to infarcted area and the normal control cells from similar regions in normal rabbit hearts. I Ca-L were recorded by using patch clamp techniques in the whole cell configuration. Results Peak of I Ca-L density of ischemic cells from the peri-infarcted zone was significantly reduced in AMI onc week later ( 3 52 0 93 pA/pF, n=6) compared to control cells ( 5 58 1 53pA/pF,n=10), P0 05 The steady-state inactivation curves were shifted to the hyperpolarizing direction in ischemic cells,the half-maximal voltage dependence of inactivation(V 1/2 ) in ischemic cells was 25 9 7 0 mV in AMI 1W , 21 3 5 6mV in AMI 2M and 13 1 4 2mV in the control cells(compared with control group,P