Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or o...Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.展开更多
Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(...Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.展开更多
Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.Howeve...Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.展开更多
Background A newer generation bioresorbable scaffold Firesorb(MicroP ort,Shanghai,China),with thinner-strut(100~125μm),is constructed from a PLLA backbone abluminally coated with a PDLLA layer eluting sirolimus.FUTUR...Background A newer generation bioresorbable scaffold Firesorb(MicroP ort,Shanghai,China),with thinner-strut(100~125μm),is constructed from a PLLA backbone abluminally coated with a PDLLA layer eluting sirolimus.FUTURE-I study intended to assess the feasibility,preliminary safety and effectiveness of the Firesorb BRS in patients with single de novo coronary artery lesions.We evaluated the long-term performance of the new generation BRS with thinner struts serially(post-procedure,at 6 months,1,2 year)after implantation.展开更多
Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive u...Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive use of a CE-marked filter embolic protection device.Methods This study was a prospective multi-center, single-arm trial. Between June and October 2003, 77 patients were enrolled in 8 investigational centers throughout Europe. The primary endpoint was the incidence of Major Neurological Events (MANE) through one month. Other endpoints were the ability to properly place the stent, and primary patency and MANE after six months. Eligible for the study were patients with a de novo or restenotic target lesion located in the common and/or internal carotid artery (>70% stenosis for asymptomatic and >50% stenosis for symptomatic patients). The ev3 Spider (Embolic Protection Filter was used in 75 of 77 cases. Results In 76 out of the 77 patients (99%), the stent could be successfully implanted with a residual stenosis ≤30% as criterion. Of the 74 patients that had a carotid ultrasound at one month follow-up, none had a re-stenosis of the target lesion. There were three MANEs during or immediately after the procedure (3.9%), two were major and one was a minor stroke. There were eight severe complications (9.1%); six of these happened during or immediately after the procedure and were related to the procedure, none was related to the device. They are resolved without sequelae. No deaths have occurred.Conclusions The Protégé stent is safe and performs well in the treatment of carotid artery stenosis. The technical success rate for placement of the Protégé stent as assessed by the residual stenosis post implant was very high and all stents were successfully deployed. The incidence of MANE was comparable with that in other recent carotid stent studies and still lower than standard CEA.展开更多
Objective According to the report from American Heart Association(AHA),cardiovascular diseases(CVDs)are the leading causes of death globally,and coronary artery disease(CAD),known as coronary atherosclerotic plaques,a...Objective According to the report from American Heart Association(AHA),cardiovascular diseases(CVDs)are the leading causes of death globally,and coronary artery disease(CAD),known as coronary atherosclerotic plaques,accounts for over 30%of cardiovascular diseases.Therefore,it is of great clinical significance to study the relationship between coronary bifurcations morphometrical feature change and coronary artery disease.Although coronary atherosclerosis has been extensively investigated,there is a lack of in-deep study on the differences in morphometric features between optimal and realistic geometry of coronary arterial trees.The purpose of the present paper is to determine the morphological changes in patients with CAD lesion compared with non-coronary artery disease(non-CAD)subjects.Methods Due to the difficulty of studying the coronary bifurcations in vivo,image-based in vitro anatomical 3D models have been widely used as a noninvasive method for morphometric measurement and clinical diagnosis of the coronary bifurcations.With the development of coronary computed tomography angiography(CTA)hardware and software technologies,the CTA imaging technique has been shown a promising application in the characterization,visualization,and identification of coronary artery disease in recent decades.The CTA images used to reconstruct three-dimensional(3D)coronary arterial trees are from Asia populations(Southern Chinese populations),including five cadavers without CAD lesion and 102 patients with CAD lesion.The best fit artery diameter was calculated as twice the average radius between the points in the centerlines and the points on the coronary arterial inner wall.The bifurcation angles between larger daughter artery and smaller daughter artery were determined by the intersection angle of their centerlines.Murray’s law was introduced to assess the deviation of the realistic vascular networks from its optimal state.Results Based on the morphometric analysis of coronary artery bifurcations in non-CAD subjects and patients with CAD lesion subjects,the most important finding is that morphological feature parameters of non-CAD subjects are closer to the optimal values than those of patients with CAD lesion.Moreover,by comparing the morphometric data between the left and right coronary arteries,the right coronary artery exhibits a structure closer to the optimal one in morphological feature than the left coronary artery.In addition,coronary arterial trees with CAD lesion have higher asymmetry and larger area expansion ratio(AER)than those of the coronary arterial trees without CAD lesion.Conclusions We morphologically found that the coronary arterial trees with CAD lesion and left are more likely to deviate from the optimal structure predicted by Murray’s law than those without CAD lesion and right.The degree to which coronary arterial system deviating from their optimal state may directly affect the incidence of coronary artery disease.This computer morpho-logical analysis strategy is illustrated to be effective in the distinguishing of the geometric differences between the healthy and diseased coronary arteries,and the analysis method may have a large potential in cardiovascular disease earlier diagnosis.展开更多
Background Coronary artery stenting is commonly used for the treatment of coronary atherosclerosis,but it causes serious clinical complications,such as the in-stent restenosis(ISR).The main reason leading to ISR is th...Background Coronary artery stenting is commonly used for the treatment of coronary atherosclerosis,but it causes serious clinical complications,such as the in-stent restenosis(ISR).The main reason leading to ISR is the neointimal hyperplasia(NH),which is related to the stresses of plaque and artery,and to the altered local hemodynamic environment due to the presence of stents.Different stent structures indeed have various impacts on the stresses of plaque and artery,and the local hemodynamic environment,such as the wall shear stress(WSS),average WSS(AWSS),and WSS gradient(WSSG).Thus,it is important to evaluate the performance of stents with different structures by the mechanical factors after coronary stenting.Methods Six stents implanted into a stenotic curved coronary artery were treated separately,and they included three typical commercial stents(Palmaz-Schatz,Xience,and Cypher)and three author-developed stents,which were constructed by reducing the numbers of link(C-Rlink)and crown(C-Rcrown),and aligning the strut(C-Astrut)of the commercial Cypher Solid mechanical analyses of the balloon-stent-plaque-artery system in Abaqus were first performed to assess the performance of different stent structures and provide the deformed boundary of lumen for the subsequent hemodynamic analysis.With the deformed boundary,then hemodynamic analyses in Ansys were conducted to quanti-fy the hemodynamic parameters induced by different stent structures.Combining the solid mechanical and hemodynamic analyses,the performance of the six stents was evaluated.Results The results show that among the three commercial stents,the Palmaz-Schatz stent has the least stent dogboning and recoiling,which corresponds to the greatest maximum plastic strain as well as the largest diameter.However,it induces the greatest maximum stress of plaque,intima,and media.From the viewpoint of hemodynamics,the Palmaz-Schatz stent also performs better and it has smaller areas of adverse low WSS(<0.5 Pa),high WSS(>15 Pa),low AWSS(<0.5 Pa),and high WSSG(>5 000 Pa/m).Compared to the commercial Cypher stent,the author-developed Cypher-based C-Rcrown and C-Astrut stents have smaller recoiling,greater maximum plastic stain and larger diameter,which indicates the improved mechanical performance of the Cypher stent.Moreover,both C-Rcrown and C-Astrut have smaller areas of adverse low WSS,high WSS,and low AWSS,but only C-Rcrown has smaller area of adverse high WSSG.Nevertheless,the C-Rlink stent is inferior to the commercial Cypher stent.In both senses of the solid mechanical and local hemodynamic analyses,the C-Rcrown stent is superior to the commercial Cypher stent and other Cypher-based stents.Conclusions In this study,solid mechanical and hemodynamic analyses were carried out to study the effects of six stents with different structures on their performances after stenting.It was found that the Palmaz-Schatz stent performed better than other two commercial stents,and the performance of the Cypher stent could be improved by reducing the number of crowns of its strut.The present study comparatively evaluates the performance of different stents inside a curved artery,and could be used as a guide to select a suitable commercial stent for clinical application,and provide a way to improve the performance of the existing commercial stents.展开更多
Aim To evaluate the vasorelaxant effects of the flavonone pinocembrin in isolated rat basilar artery rings and to investigate its possible mechanisms. Methods The isotonic contractions of the basilar artery rings from...Aim To evaluate the vasorelaxant effects of the flavonone pinocembrin in isolated rat basilar artery rings and to investigate its possible mechanisms. Methods The isotonic contractions of the basilar artery rings from SD rats were recorded. Results Pinocembrin exerted vasorelaxation in a close-dependent manner in KCL （60 mmol · L^-1 ） or 5-HT （ 1 μmol · L^- 1）-induced sustained contraction and partial loss of the vasorelaxation in endothelium- denuded rings. Pretreatment with pinocembrin （30 or 50 μmol · L^-1 ） attenuated contractile responses to KC1 （ 10 - 60 mmol · L^-1 ） and 5-HT （0. 001 - 10 μmol · L^-1 ）. The pinocembrin -induced vasorelaxation was significant- ly reduced by the nitric oxide synthase inhibitor Nco-nitro-L-arginine methyl ester （L-NAME, 100 μmol · L^-1） , the guanylate cyclase inhibitor ODQ （5 μmol · L^-1） and the cyclooxygenase inhibitor indomethacin （5 μmol · L^-l）. The voltage-dependent K＋ channel blocker 4-aminopyridine （100 μmol · L^-1）, the ATP-sensitive K ＋ channel blocker glibenclamide （10μmol · L^-1） and Ca2＋-activated K ＋ channel blocker tetraethylammonium （1 retool· L^-1） remarkably attenuated pinocembrin-induced relaxations. Pinocembrin also inhibited contraction in- duced by increasing external calcium in Ca2＋-free medium plus 60 mmol · L^-1 KC1. Conclusion These results demonstrate that pinocembrin has a vasorelaxant effect on isolated rat basilar artery rings and may exert its action through an endothelium-dependent pathway, involving NO-cGMP, and also through an endothelium-independent 2＋ pathway, opening K ＋ channels and blockade of Ca channels.展开更多
Aim This work is to provide a network approach to identify the potential therapeutic targets in molecular level for xuefu-zhuyu decoction （XZD） and gualou-xiebai-banxia decoction （GXBD） in treating Coronary artery...Aim This work is to provide a network approach to identify the potential therapeutic targets in molecular level for xuefu-zhuyu decoction （XZD） and gualou-xiebai-banxia decoction （GXBD） in treating Coronary artery dis- ease （CAD）. Methods The networks between the ingredients/drugs and relevant target proteins for XZD, GXBD, and modern anti-CAD drugs were constructed, respectively. A master network based on the three established networks was further generated. By comparing the similarities and the differences of the targets containing in the master net- work between the individual formula and the modern drugs, the potential anti-CAD targets for XZD and GXBD were i- dentified for further pharmacological investigations. Results Although the herbal formulations and the chemical con- stituents of XZD and GXBD were significant different, both formulas presented the great similarity on target proteins and with the Tanimoto coefficient of 0. 7225. Comparison the formula-specific targets to modem drugs targets, 50 mu- tual targets with higher possibility were modulated. Moreover, a total amount of 114 mutual targets between formulas derived from the master network were identified to be not yet related to those of the approved anti-CAD drugs. Among them, the top 10 targets were identified to be NOS3, PTPN1, GABRA1, PRKACA, CDK2, MAOB, ESR1, ADH1C, ADH1B and AKR1B1. The formula-specific targets of XZD or GXBD which were not yet covered by the current anti- CAD drugs provided the potential opportunities to discovery of the new drug candidates from the two formulas for CAD treatment. Conclusion The established method of network analysis provides a novel approach for screening of the potential therapeutic targets based on the chemical constituents in traditional Chinese medicines or formulas. It is cru- cial for this work to select relatively favorable therapeutic areas of traditional Chinese medicines, syndrome-oriented formulas and syndrome differentiation of same diseases. Meanwhile, this kind of work is helpful for unveiling the mo- lecular mechanism of TCM formulas.展开更多
Aim Thromboxane A2（TXA2） is assumed to contribute to the process of renal dysfunction. The pres- ent study was designed to investigate whether terutroban, a specific antagonist of thromboxane/prostaglandin？ （TP） ...Aim Thromboxane A2（TXA2） is assumed to contribute to the process of renal dysfunction. The pres- ent study was designed to investigate whether terutroban, a specific antagonist of thromboxane/prostaglandin？ （TP） receptor, protects against renal damage in 5/6 nephrectomy. Methods C57/BL6 mice were randomly grouped into sham-operated （2K）, 5/6 nephroectomy groups （5/6K-off） and 5/6 nephroectomy treated with ter- utroban （10 mg · kg^-1 · d^-l） groups （Yerutroban）. Renal artery and kidney were collected for vascular function study, Western blot, immunohistochemistry （IHC） assay and enzyme-linked immunosorbent assay （ELISA）, re- spectively. Results Four weeks after the surgery, arterial blood pressure was comparable among the three groups. However mice in terutroban group had higher levels of serum creatinine and lower survival. Compared with 2K groups, 5/6K-off mice had significantly higher levels of renal blood flow as well as a blunted relaxation to acetyl- choline. Production of prostacyclin （PGI2） and thromboxane B2 （ TXB2）, but no prostaglandin E2 （ PGE2）, were significantly increased in the renal artery of 5/6K-off group. Terutroban restored the renal blood flow, but not the acetylcholine-induced relaxation in the renal artery. It is probably due to the blockade effect of terutroban on the smooth muscle since terutroban treatment significantly reduced U46619-induced vasconstriction in renal arteries. Interestingly, terutroban increased the production of TXB2, but not PGI2 or PGE2, in the renal artery. This proba-bly is a compensatory effect on prostaglandins production. In kidney cortex, 5/6K-off group had significantly lower levels of PGE2 and TXB2 when compared with 2 K group. Terutroban markedly increased all three prostaglandins levels. Conclusion Terutroban restores renal artery function, but not renal function in mouse with 5/6 nephrecto- my. It suggests that kidney has more complicated regulations than renal artery. High levels of prostanoids in kid- neys may contribute to renal damage in terutroban group. Further experiments will focus on examining the underly- ing mechanisms.展开更多
Objective Coronary artery disease(CAD) is a global problem.Every year, there was millions of patients suffered from CAD. With the fast development of coronary revascularization therapy, the mortality has decreased dra...Objective Coronary artery disease(CAD) is a global problem.Every year, there was millions of patients suffered from CAD. With the fast development of coronary revascularization therapy, the mortality has decreased dramatically, while there still some forts needed to be conquered, such as multi-vessel coronary artery disease(MVD).展开更多
DAI Jiong, WEN Jie-qing, LI Shan-quan. Department of Neurosurgery, Renji Hospital, Shanghai 200001, China The patient is a 79 years old male. He was admitted for recurrent dizziness accompanied tinnitus during the las...DAI Jiong, WEN Jie-qing, LI Shan-quan. Department of Neurosurgery, Renji Hospital, Shanghai 200001, China The patient is a 79 years old male. He was admitted for recurrent dizziness accompanied tinnitus during the last 2 weeks. These symptoms were aggravated during the last 4 days. He had a history of hypertension. Murmur was detected on the left subclavian artery. Left upper limb had IVth grade muscle force. The pulse of left radial artery was reduced. The systolic blood pressure of left upper limb was 30 mmHg lower than the right counter part. The Doppler sonography of vertebral artery revealed that there was inverse blood flow in the left vertebral artery. The angiography of left subclavian artery revealed that the left subclavian artery near the opening site(proximal to vertebral artery) was stenosed by approximatel 90%. Left vertebral artery was not detected. The angiography of right vertebral artery revealed that there was partial cerebral bolld flow steal to left subclavian artery via left vertebral artery. We treated this patient with percutaneous transluminal angiogrplasty(PTA)and stent implantation. Detailed description: Femoral artery was punctured, 8F artery theca was introduced. The 8F guiding catheter was introduced to the opening site of left subclavian artery. The 0.014 microwire was passed through the stenosis. The 3*30mm and 6*30mm balloon was introduced subsequently to widen the stenosis to guarantee the stent can pass the stenosis. Finally the 9*30mm Wallstent was introduced. Postoperative angioaphy revealed that there was approximately 5% stenosis remained and the left vertebral artery was patent. The patient’s symptoms and signs were all improved. From literatures, PTA and stent implantation is a safe and effective treatment and a first-line management in foreign countries for the subclavian artery stenosis. This is our first case. We feel that the most appropriate position of the guiding catheter is the key issue in successful treatment. We also think how to reduce the risk of stroke and upper limb ischemia more effectively.展开更多
Background Recent studies have shown that the mortality of patients with coronary artery bypass grafting(CABG)can be reduced by ticagrelor,but the effect on the vascular patency of the bridge and other cardiovascular ...Background Recent studies have shown that the mortality of patients with coronary artery bypass grafting(CABG)can be reduced by ticagrelor,but the effect on the vascular patency of the bridge and other cardiovascular events is not clear.Methods A database of patients with coronary artery bypass grafting in our hospital from October 2013 to December 2016,40 patients with ticagrelor and aspirin after the surgery.展开更多
Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronar...Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronary intervention (PCI).展开更多
Objective The utility of non-obstructive coronary artery diseases(NOCAD) in cardiovascular events (CVE) among Chinese patients has less been evaluated. Our objective was to investigate the prognostic value of NOCAD in...Objective The utility of non-obstructive coronary artery diseases(NOCAD) in cardiovascular events (CVE) among Chinese patients has less been evaluated. Our objective was to investigate the prognostic value of NOCAD in patients with angina-like chest pain detected by coronary angiography (CAG) in a large Chinese cohort study.展开更多
Objective To summarize the clinical characteristics and the effect of pulmonary endarterectomy(PEA)in CTEPH patients with unilateral main pulmonary artery occlusion.Methods Of 160 CTEPH patients operated between Janua...Objective To summarize the clinical characteristics and the effect of pulmonary endarterectomy(PEA)in CTEPH patients with unilateral main pulmonary artery occlusion.Methods Of 160 CTEPH patients operated between January2004 and March 2018 at our center,13(8.1%)had complete main pulmonary artery occlusion.Patients were included if the ventilation/perfusion(V/Q)scan revealed nonperfusion of an entire lung and the pathological examination showed chronic thromboembolic.展开更多
Objective The study aimed to compare quality of saphenous vein(SV)grafts,wound complications,and clinical outcomes between endoscopic vein harvesting(EVH)technique and open vein harvesting(OVH)technique of coronary ar...Objective The study aimed to compare quality of saphenous vein(SV)grafts,wound complications,and clinical outcomes between endoscopic vein harvesting(EVH)technique and open vein harvesting(OVH)technique of coronary artery bypass graft(CABG)surgery.Methods One hundred patients with multi-vessel coronary disease underwent elective CABG using SV grafts were prospectively recruited and randomized into two groups.展开更多
The purpose of this paper is to study the changes of deformabilityof erythrocytes and 2.3-DPG(2.3-diphosphoglycerate acid)in the patients with coro-nary artery stenosis and the effects of some factors on them.It is sh...The purpose of this paper is to study the changes of deformabilityof erythrocytes and 2.3-DPG(2.3-diphosphoglycerate acid)in the patients with coro-nary artery stenosis and the effects of some factors on them.It is showed that:de-formability of crythrocyte and 2.3-DPG were inversely proportional to the degreeof the lesions of coronary vessels(P【0.01);there was a significant decrease of de-formability of erythrocytes after using contract agents(P【0.01);Salvia increaseddeformability and 2.3-DPG significantly(P【0.01).In conclusion,our data suggestthat the possible existence of microcirculation dysfunction in coronary artery dis-eases with parallelism to the impairement deformability of erythrocytcs and Salviabca good drug to action in deformability and 2.3 DPG in patients.展开更多
OBJECTIVE To investigate regulatory effects of hyperoside(Hyp)on IP3/PKC/TRPV4 pathway in rat cerebral basilar artery(CBA)subjected to global cerebral ischemia-reperfusion(I/R).METHODS The model of global cerebral I/R...OBJECTIVE To investigate regulatory effects of hyperoside(Hyp)on IP3/PKC/TRPV4 pathway in rat cerebral basilar artery(CBA)subjected to global cerebral ischemia-reperfusion(I/R).METHODS The model of global cerebral I/R in rats was established by four-vessel occlusions methods.The treated rats were administrated with Hyp(50 mg·kg^-1)group,Hyp(50 mg·kg^-1)+HC-067047(10 mg·kg^-1),Hyp(50 mg·kg^-1)+2APB(2 mg·kg^-1),Hyp(50 mg·kg^-1)+BisI(2.5 mg·kg^-1),Hyp(50 mg·kg^-1)+2APB(2 mg·kg^-1)+BisI(2.5 mg·kg^-1).Hematoxylin-eosin(HE)and Nissl staining were performed and the contents of methane dicarboxylic aldehyde(MDA),neuron-specific enolase(NSE),S100β and the activity of lactic dehydrogenase(LDH)in serum were measured by enzyme-linked immunosorbnent assay(ELISA).The specific blocker N-nitro-L-arginine-methyl-ester(L-NAME)and indomethacin(Indo)were used to delete the prostacyclin(PGI2)and nitric oxide(NO)dependent relaxation.The protein expression level of TRPV4 was detected by Western blotting.Ca2+intensity in vascular smooth muscle cells was measured by confocal laser scanning microscope and flow cytometry was performed to observe the apoptosis of CBA endothelial cells after in vivo administration.RESULTS Hyp induced a dose-dependent relaxation of CBA in IR rats via a PGI2 and NO independent manner,as evidenced by alleviated patho⁃logical changes and up-regulated expression of TRPV4 protein in the endothelial cells from cerebral vessels.Hyp signifi⁃cantly reduced the contents of MDA,NSE,S100βand the activity of LDH in serum and decreased the fluorescence intensity of Ca2+in cerebral vascular smooth muscle cells by in vivo administration.The apoptotic rate of endothelial cells in Hyp treated group was significantly less than that in IR group.CONCLUSION Hyp does in fact ameliorate I/R injury by regulatingIP3/PKC/TRPV4 pathway.展开更多
Objective To probe the clinic feasibility of percutaneous coronary intervention(PCI) via transulnar artery approach (PCI TRU).Methods Fourty patients with unstable ischemic manifestation(male 34,female 6;age 59.3 ...Objective To probe the clinic feasibility of percutaneous coronary intervention(PCI) via transulnar artery approach (PCI TRU).Methods Fourty patients with unstable ischemic manifestation(male 34,female 6;age 59.3 ±9.10 years)whose radial artery of right hand was thin with a weak pulse that was not suitable to transradial artery PCI while whose ulnar artery was thick with a strong pulse based on their larger diameter in ulnar artery as compared with those in radial artery ( 3.30 ±0.22mm vs 2.43 ±0.33 mm, P <0.05 ) by the investigation of vessel echography,but revesered Allen’s test for radial and ulnar artery was positive,were selected as the subjects for PCI TRU. The radio of ulnar artery versus radial artery was 1.35:1.00 and the time of Allen’s test in ulnar artery side was shorter than that in radial artery side ( 2.70 ±0.36 s vs 4.68 ±0.52s , P <0.05 ) before PCI. The efficiency of PCI TRU was evaluated. The time of manipulative duration for each procedure of PCI TRU was recorded. The time of Allen’s test, luminal diameter (mm) , cross area of vessel lumin (mm 2), blood velocity (Vs max), blood resistance (RI) in ulnar artery and radial artery and the level of blood oxygen in finger (PaO 2、SatO 2) were measured and recorded , respectively , as well were compared quantitatively before and after 1 month of procedure . Results Fourty eight lesion segments of 42 vessels in all patients were angioplasticized successfully via TRU by 6F guiding catheter including 23 segments of type B1 , 14 segments of type B2 and 11 segments of type C. PCI TRU in all of 40 patients was performed successfully. Fourty eight stents were implanted including 2 lesions of intrastent restenosis angioplasticized with cutting balloon technique before re stenting . The average time of manipulative duration of guiding catheters engaging in osicum of target coronary, crossing the vessel lesions of guidewire, dilatation and implantation of stents,and under X ray fluoroscopy were 4.30 ±0.59 min , 2.52 ±0.40min , 2.66 ±0.40 min ,and 25.9 ±0.49 min , respectively, and the total time of the whole procedure was 56.6 ±14.8 min . When the ulnar introducer was taken off, the access site in ulnar artery was suppressed by tourniquet with no bleeding in the access site and no limitation of physical activation under maintaining infusion of heparin immediately after procedure . There was no significant change in the diameter of ulnar artery and the time of Allen’s test after 1 month of PCI procedure as compared with those before procedure ( 3.22 ±0.48mm vs 3.26 ±0.22 mm , P >0.05 ; 2.96 ±0.98 s vs 2.72 ±0.47 s , P >0.05 ). No significant change was found in the parameters of blood velocity , cross area of vessel lumin, blood resistance and the level of blood oxygen in finger after 1 month of PCI procedure. The average total hospital stay was 5.21 ±0.43 days. Following up 1 month, no complications such as occlusion of ulnar artery, abnormal sensitivity and movement disability were found in right hands in all patients.Conclusions The ulnar artery might be selected as one approach of antebrachial artery for PCI in the patients with coronary heart disease whose radial artery was difficulty as access vessels of PCI, while reversed Allen’s test for radial and ulnar artery are positive and the luminal diameter of ulnar artery was larger than that of radial artery.展开更多
文摘Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.
文摘Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.
文摘Background Triglyceride glucose (TyG) index is a novel marker for metabolic disorders, and recently it has been reported to be associated with cardiovascular disease (CVD) risk in apparently healthy individuals.However the prognostic value of TyG index in patients with stable coronary artery disease (CAD) is not determined.
文摘Background A newer generation bioresorbable scaffold Firesorb(MicroP ort,Shanghai,China),with thinner-strut(100~125μm),is constructed from a PLLA backbone abluminally coated with a PDLLA layer eluting sirolimus.FUTURE-I study intended to assess the feasibility,preliminary safety and effectiveness of the Firesorb BRS in patients with single de novo coronary artery lesions.We evaluated the long-term performance of the new generation BRS with thinner struts serially(post-procedure,at 6 months,1,2 year)after implantation.
文摘Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive use of a CE-marked filter embolic protection device.Methods This study was a prospective multi-center, single-arm trial. Between June and October 2003, 77 patients were enrolled in 8 investigational centers throughout Europe. The primary endpoint was the incidence of Major Neurological Events (MANE) through one month. Other endpoints were the ability to properly place the stent, and primary patency and MANE after six months. Eligible for the study were patients with a de novo or restenotic target lesion located in the common and/or internal carotid artery (>70% stenosis for asymptomatic and >50% stenosis for symptomatic patients). The ev3 Spider (Embolic Protection Filter was used in 75 of 77 cases. Results In 76 out of the 77 patients (99%), the stent could be successfully implanted with a residual stenosis ≤30% as criterion. Of the 74 patients that had a carotid ultrasound at one month follow-up, none had a re-stenosis of the target lesion. There were three MANEs during or immediately after the procedure (3.9%), two were major and one was a minor stroke. There were eight severe complications (9.1%); six of these happened during or immediately after the procedure and were related to the procedure, none was related to the device. They are resolved without sequelae. No deaths have occurred.Conclusions The Protégé stent is safe and performs well in the treatment of carotid artery stenosis. The technical success rate for placement of the Protégé stent as assessed by the residual stenosis post implant was very high and all stents were successfully deployed. The incidence of MANE was comparable with that in other recent carotid stent studies and still lower than standard CEA.
基金sponsored by the National Natural Science Foundation of China ( 11432006 ( J. Wu) , 11672109 ( Y. Fang) and 31500759 ( J. Lin) )the Fundamental Research Funds for the Central Universities
文摘Objective According to the report from American Heart Association(AHA),cardiovascular diseases(CVDs)are the leading causes of death globally,and coronary artery disease(CAD),known as coronary atherosclerotic plaques,accounts for over 30%of cardiovascular diseases.Therefore,it is of great clinical significance to study the relationship between coronary bifurcations morphometrical feature change and coronary artery disease.Although coronary atherosclerosis has been extensively investigated,there is a lack of in-deep study on the differences in morphometric features between optimal and realistic geometry of coronary arterial trees.The purpose of the present paper is to determine the morphological changes in patients with CAD lesion compared with non-coronary artery disease(non-CAD)subjects.Methods Due to the difficulty of studying the coronary bifurcations in vivo,image-based in vitro anatomical 3D models have been widely used as a noninvasive method for morphometric measurement and clinical diagnosis of the coronary bifurcations.With the development of coronary computed tomography angiography(CTA)hardware and software technologies,the CTA imaging technique has been shown a promising application in the characterization,visualization,and identification of coronary artery disease in recent decades.The CTA images used to reconstruct three-dimensional(3D)coronary arterial trees are from Asia populations(Southern Chinese populations),including five cadavers without CAD lesion and 102 patients with CAD lesion.The best fit artery diameter was calculated as twice the average radius between the points in the centerlines and the points on the coronary arterial inner wall.The bifurcation angles between larger daughter artery and smaller daughter artery were determined by the intersection angle of their centerlines.Murray’s law was introduced to assess the deviation of the realistic vascular networks from its optimal state.Results Based on the morphometric analysis of coronary artery bifurcations in non-CAD subjects and patients with CAD lesion subjects,the most important finding is that morphological feature parameters of non-CAD subjects are closer to the optimal values than those of patients with CAD lesion.Moreover,by comparing the morphometric data between the left and right coronary arteries,the right coronary artery exhibits a structure closer to the optimal one in morphological feature than the left coronary artery.In addition,coronary arterial trees with CAD lesion have higher asymmetry and larger area expansion ratio(AER)than those of the coronary arterial trees without CAD lesion.Conclusions We morphologically found that the coronary arterial trees with CAD lesion and left are more likely to deviate from the optimal structure predicted by Murray’s law than those without CAD lesion and right.The degree to which coronary arterial system deviating from their optimal state may directly affect the incidence of coronary artery disease.This computer morpho-logical analysis strategy is illustrated to be effective in the distinguishing of the geometric differences between the healthy and diseased coronary arteries,and the analysis method may have a large potential in cardiovascular disease earlier diagnosis.
基金supported by the Natural Science Foundation of China ( NSFC) ( 31300780,11272091, 11422222,31470043)supported by the National 973 Basic Research Program of China ( 2013CB733800)China scholarship Council ( 201706090121) ,and ARC ( FT140101152)
文摘Background Coronary artery stenting is commonly used for the treatment of coronary atherosclerosis,but it causes serious clinical complications,such as the in-stent restenosis(ISR).The main reason leading to ISR is the neointimal hyperplasia(NH),which is related to the stresses of plaque and artery,and to the altered local hemodynamic environment due to the presence of stents.Different stent structures indeed have various impacts on the stresses of plaque and artery,and the local hemodynamic environment,such as the wall shear stress(WSS),average WSS(AWSS),and WSS gradient(WSSG).Thus,it is important to evaluate the performance of stents with different structures by the mechanical factors after coronary stenting.Methods Six stents implanted into a stenotic curved coronary artery were treated separately,and they included three typical commercial stents(Palmaz-Schatz,Xience,and Cypher)and three author-developed stents,which were constructed by reducing the numbers of link(C-Rlink)and crown(C-Rcrown),and aligning the strut(C-Astrut)of the commercial Cypher Solid mechanical analyses of the balloon-stent-plaque-artery system in Abaqus were first performed to assess the performance of different stent structures and provide the deformed boundary of lumen for the subsequent hemodynamic analysis.With the deformed boundary,then hemodynamic analyses in Ansys were conducted to quanti-fy the hemodynamic parameters induced by different stent structures.Combining the solid mechanical and hemodynamic analyses,the performance of the six stents was evaluated.Results The results show that among the three commercial stents,the Palmaz-Schatz stent has the least stent dogboning and recoiling,which corresponds to the greatest maximum plastic strain as well as the largest diameter.However,it induces the greatest maximum stress of plaque,intima,and media.From the viewpoint of hemodynamics,the Palmaz-Schatz stent also performs better and it has smaller areas of adverse low WSS(<0.5 Pa),high WSS(>15 Pa),low AWSS(<0.5 Pa),and high WSSG(>5 000 Pa/m).Compared to the commercial Cypher stent,the author-developed Cypher-based C-Rcrown and C-Astrut stents have smaller recoiling,greater maximum plastic stain and larger diameter,which indicates the improved mechanical performance of the Cypher stent.Moreover,both C-Rcrown and C-Astrut have smaller areas of adverse low WSS,high WSS,and low AWSS,but only C-Rcrown has smaller area of adverse high WSSG.Nevertheless,the C-Rlink stent is inferior to the commercial Cypher stent.In both senses of the solid mechanical and local hemodynamic analyses,the C-Rcrown stent is superior to the commercial Cypher stent and other Cypher-based stents.Conclusions In this study,solid mechanical and hemodynamic analyses were carried out to study the effects of six stents with different structures on their performances after stenting.It was found that the Palmaz-Schatz stent performed better than other two commercial stents,and the performance of the Cypher stent could be improved by reducing the number of crowns of its strut.The present study comparatively evaluates the performance of different stents inside a curved artery,and could be used as a guide to select a suitable commercial stent for clinical application,and provide a way to improve the performance of the existing commercial stents.
文摘Aim To evaluate the vasorelaxant effects of the flavonone pinocembrin in isolated rat basilar artery rings and to investigate its possible mechanisms. Methods The isotonic contractions of the basilar artery rings from SD rats were recorded. Results Pinocembrin exerted vasorelaxation in a close-dependent manner in KCL （60 mmol · L^-1 ） or 5-HT （ 1 μmol · L^- 1）-induced sustained contraction and partial loss of the vasorelaxation in endothelium- denuded rings. Pretreatment with pinocembrin （30 or 50 μmol · L^-1 ） attenuated contractile responses to KC1 （ 10 - 60 mmol · L^-1 ） and 5-HT （0. 001 - 10 μmol · L^-1 ）. The pinocembrin -induced vasorelaxation was significant- ly reduced by the nitric oxide synthase inhibitor Nco-nitro-L-arginine methyl ester （L-NAME, 100 μmol · L^-1） , the guanylate cyclase inhibitor ODQ （5 μmol · L^-1） and the cyclooxygenase inhibitor indomethacin （5 μmol · L^-l）. The voltage-dependent K＋ channel blocker 4-aminopyridine （100 μmol · L^-1）, the ATP-sensitive K ＋ channel blocker glibenclamide （10μmol · L^-1） and Ca2＋-activated K ＋ channel blocker tetraethylammonium （1 retool· L^-1） remarkably attenuated pinocembrin-induced relaxations. Pinocembrin also inhibited contraction in- duced by increasing external calcium in Ca2＋-free medium plus 60 mmol · L^-1 KC1. Conclusion These results demonstrate that pinocembrin has a vasorelaxant effect on isolated rat basilar artery rings and may exert its action through an endothelium-dependent pathway, involving NO-cGMP, and also through an endothelium-independent 2＋ pathway, opening K ＋ channels and blockade of Ca channels.
文摘Aim This work is to provide a network approach to identify the potential therapeutic targets in molecular level for xuefu-zhuyu decoction （XZD） and gualou-xiebai-banxia decoction （GXBD） in treating Coronary artery dis- ease （CAD）. Methods The networks between the ingredients/drugs and relevant target proteins for XZD, GXBD, and modern anti-CAD drugs were constructed, respectively. A master network based on the three established networks was further generated. By comparing the similarities and the differences of the targets containing in the master net- work between the individual formula and the modern drugs, the potential anti-CAD targets for XZD and GXBD were i- dentified for further pharmacological investigations. Results Although the herbal formulations and the chemical con- stituents of XZD and GXBD were significant different, both formulas presented the great similarity on target proteins and with the Tanimoto coefficient of 0. 7225. Comparison the formula-specific targets to modem drugs targets, 50 mu- tual targets with higher possibility were modulated. Moreover, a total amount of 114 mutual targets between formulas derived from the master network were identified to be not yet related to those of the approved anti-CAD drugs. Among them, the top 10 targets were identified to be NOS3, PTPN1, GABRA1, PRKACA, CDK2, MAOB, ESR1, ADH1C, ADH1B and AKR1B1. The formula-specific targets of XZD or GXBD which were not yet covered by the current anti- CAD drugs provided the potential opportunities to discovery of the new drug candidates from the two formulas for CAD treatment. Conclusion The established method of network analysis provides a novel approach for screening of the potential therapeutic targets based on the chemical constituents in traditional Chinese medicines or formulas. It is cru- cial for this work to select relatively favorable therapeutic areas of traditional Chinese medicines, syndrome-oriented formulas and syndrome differentiation of same diseases. Meanwhile, this kind of work is helpful for unveiling the mo- lecular mechanism of TCM formulas.
文摘Aim Thromboxane A2（TXA2） is assumed to contribute to the process of renal dysfunction. The pres- ent study was designed to investigate whether terutroban, a specific antagonist of thromboxane/prostaglandin？ （TP） receptor, protects against renal damage in 5/6 nephrectomy. Methods C57/BL6 mice were randomly grouped into sham-operated （2K）, 5/6 nephroectomy groups （5/6K-off） and 5/6 nephroectomy treated with ter- utroban （10 mg · kg^-1 · d^-l） groups （Yerutroban）. Renal artery and kidney were collected for vascular function study, Western blot, immunohistochemistry （IHC） assay and enzyme-linked immunosorbent assay （ELISA）, re- spectively. Results Four weeks after the surgery, arterial blood pressure was comparable among the three groups. However mice in terutroban group had higher levels of serum creatinine and lower survival. Compared with 2K groups, 5/6K-off mice had significantly higher levels of renal blood flow as well as a blunted relaxation to acetyl- choline. Production of prostacyclin （PGI2） and thromboxane B2 （ TXB2）, but no prostaglandin E2 （ PGE2）, were significantly increased in the renal artery of 5/6K-off group. Terutroban restored the renal blood flow, but not the acetylcholine-induced relaxation in the renal artery. It is probably due to the blockade effect of terutroban on the smooth muscle since terutroban treatment significantly reduced U46619-induced vasconstriction in renal arteries. Interestingly, terutroban increased the production of TXB2, but not PGI2 or PGE2, in the renal artery. This proba-bly is a compensatory effect on prostaglandins production. In kidney cortex, 5/6K-off group had significantly lower levels of PGE2 and TXB2 when compared with 2 K group. Terutroban markedly increased all three prostaglandins levels. Conclusion Terutroban restores renal artery function, but not renal function in mouse with 5/6 nephrecto- my. It suggests that kidney has more complicated regulations than renal artery. High levels of prostanoids in kid- neys may contribute to renal damage in terutroban group. Further experiments will focus on examining the underly- ing mechanisms.
文摘Objective Coronary artery disease(CAD) is a global problem.Every year, there was millions of patients suffered from CAD. With the fast development of coronary revascularization therapy, the mortality has decreased dramatically, while there still some forts needed to be conquered, such as multi-vessel coronary artery disease(MVD).
文摘DAI Jiong, WEN Jie-qing, LI Shan-quan. Department of Neurosurgery, Renji Hospital, Shanghai 200001, China The patient is a 79 years old male. He was admitted for recurrent dizziness accompanied tinnitus during the last 2 weeks. These symptoms were aggravated during the last 4 days. He had a history of hypertension. Murmur was detected on the left subclavian artery. Left upper limb had IVth grade muscle force. The pulse of left radial artery was reduced. The systolic blood pressure of left upper limb was 30 mmHg lower than the right counter part. The Doppler sonography of vertebral artery revealed that there was inverse blood flow in the left vertebral artery. The angiography of left subclavian artery revealed that the left subclavian artery near the opening site(proximal to vertebral artery) was stenosed by approximatel 90%. Left vertebral artery was not detected. The angiography of right vertebral artery revealed that there was partial cerebral bolld flow steal to left subclavian artery via left vertebral artery. We treated this patient with percutaneous transluminal angiogrplasty(PTA)and stent implantation. Detailed description: Femoral artery was punctured, 8F artery theca was introduced. The 8F guiding catheter was introduced to the opening site of left subclavian artery. The 0.014 microwire was passed through the stenosis. The 3*30mm and 6*30mm balloon was introduced subsequently to widen the stenosis to guarantee the stent can pass the stenosis. Finally the 9*30mm Wallstent was introduced. Postoperative angioaphy revealed that there was approximately 5% stenosis remained and the left vertebral artery was patent. The patient’s symptoms and signs were all improved. From literatures, PTA and stent implantation is a safe and effective treatment and a first-line management in foreign countries for the subclavian artery stenosis. This is our first case. We feel that the most appropriate position of the guiding catheter is the key issue in successful treatment. We also think how to reduce the risk of stroke and upper limb ischemia more effectively.
文摘Background Recent studies have shown that the mortality of patients with coronary artery bypass grafting(CABG)can be reduced by ticagrelor,but the effect on the vascular patency of the bridge and other cardiovascular events is not clear.Methods A database of patients with coronary artery bypass grafting in our hospital from October 2013 to December 2016,40 patients with ticagrelor and aspirin after the surgery.
文摘Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronary intervention (PCI).
文摘Objective The utility of non-obstructive coronary artery diseases(NOCAD) in cardiovascular events (CVE) among Chinese patients has less been evaluated. Our objective was to investigate the prognostic value of NOCAD in patients with angina-like chest pain detected by coronary angiography (CAG) in a large Chinese cohort study.
文摘Objective To summarize the clinical characteristics and the effect of pulmonary endarterectomy(PEA)in CTEPH patients with unilateral main pulmonary artery occlusion.Methods Of 160 CTEPH patients operated between January2004 and March 2018 at our center,13(8.1%)had complete main pulmonary artery occlusion.Patients were included if the ventilation/perfusion(V/Q)scan revealed nonperfusion of an entire lung and the pathological examination showed chronic thromboembolic.
文摘Objective The study aimed to compare quality of saphenous vein(SV)grafts,wound complications,and clinical outcomes between endoscopic vein harvesting(EVH)technique and open vein harvesting(OVH)technique of coronary artery bypass graft(CABG)surgery.Methods One hundred patients with multi-vessel coronary disease underwent elective CABG using SV grafts were prospectively recruited and randomized into two groups.
文摘The purpose of this paper is to study the changes of deformabilityof erythrocytes and 2.3-DPG(2.3-diphosphoglycerate acid)in the patients with coro-nary artery stenosis and the effects of some factors on them.It is showed that:de-formability of crythrocyte and 2.3-DPG were inversely proportional to the degreeof the lesions of coronary vessels(P【0.01);there was a significant decrease of de-formability of erythrocytes after using contract agents(P【0.01);Salvia increaseddeformability and 2.3-DPG significantly(P【0.01).In conclusion,our data suggestthat the possible existence of microcirculation dysfunction in coronary artery dis-eases with parallelism to the impairement deformability of erythrocytcs and Salviabca good drug to action in deformability and 2.3 DPG in patients.
基金National Natural Science Foundation of China(81173596)Natural Science Foundation of the Department of Education of Anhui Province(KJ2015A157)
文摘OBJECTIVE To investigate regulatory effects of hyperoside(Hyp)on IP3/PKC/TRPV4 pathway in rat cerebral basilar artery(CBA)subjected to global cerebral ischemia-reperfusion(I/R).METHODS The model of global cerebral I/R in rats was established by four-vessel occlusions methods.The treated rats were administrated with Hyp(50 mg·kg^-1)group,Hyp(50 mg·kg^-1)+HC-067047(10 mg·kg^-1),Hyp(50 mg·kg^-1)+2APB(2 mg·kg^-1),Hyp(50 mg·kg^-1)+BisI(2.5 mg·kg^-1),Hyp(50 mg·kg^-1)+2APB(2 mg·kg^-1)+BisI(2.5 mg·kg^-1).Hematoxylin-eosin(HE)and Nissl staining were performed and the contents of methane dicarboxylic aldehyde(MDA),neuron-specific enolase(NSE),S100β and the activity of lactic dehydrogenase(LDH)in serum were measured by enzyme-linked immunosorbnent assay(ELISA).The specific blocker N-nitro-L-arginine-methyl-ester(L-NAME)and indomethacin(Indo)were used to delete the prostacyclin(PGI2)and nitric oxide(NO)dependent relaxation.The protein expression level of TRPV4 was detected by Western blotting.Ca2+intensity in vascular smooth muscle cells was measured by confocal laser scanning microscope and flow cytometry was performed to observe the apoptosis of CBA endothelial cells after in vivo administration.RESULTS Hyp induced a dose-dependent relaxation of CBA in IR rats via a PGI2 and NO independent manner,as evidenced by alleviated patho⁃logical changes and up-regulated expression of TRPV4 protein in the endothelial cells from cerebral vessels.Hyp signifi⁃cantly reduced the contents of MDA,NSE,S100βand the activity of LDH in serum and decreased the fluorescence intensity of Ca2+in cerebral vascular smooth muscle cells by in vivo administration.The apoptotic rate of endothelial cells in Hyp treated group was significantly less than that in IR group.CONCLUSION Hyp does in fact ameliorate I/R injury by regulatingIP3/PKC/TRPV4 pathway.
文摘Objective To probe the clinic feasibility of percutaneous coronary intervention(PCI) via transulnar artery approach (PCI TRU).Methods Fourty patients with unstable ischemic manifestation(male 34,female 6;age 59.3 ±9.10 years)whose radial artery of right hand was thin with a weak pulse that was not suitable to transradial artery PCI while whose ulnar artery was thick with a strong pulse based on their larger diameter in ulnar artery as compared with those in radial artery ( 3.30 ±0.22mm vs 2.43 ±0.33 mm, P <0.05 ) by the investigation of vessel echography,but revesered Allen’s test for radial and ulnar artery was positive,were selected as the subjects for PCI TRU. The radio of ulnar artery versus radial artery was 1.35:1.00 and the time of Allen’s test in ulnar artery side was shorter than that in radial artery side ( 2.70 ±0.36 s vs 4.68 ±0.52s , P <0.05 ) before PCI. The efficiency of PCI TRU was evaluated. The time of manipulative duration for each procedure of PCI TRU was recorded. The time of Allen’s test, luminal diameter (mm) , cross area of vessel lumin (mm 2), blood velocity (Vs max), blood resistance (RI) in ulnar artery and radial artery and the level of blood oxygen in finger (PaO 2、SatO 2) were measured and recorded , respectively , as well were compared quantitatively before and after 1 month of procedure . Results Fourty eight lesion segments of 42 vessels in all patients were angioplasticized successfully via TRU by 6F guiding catheter including 23 segments of type B1 , 14 segments of type B2 and 11 segments of type C. PCI TRU in all of 40 patients was performed successfully. Fourty eight stents were implanted including 2 lesions of intrastent restenosis angioplasticized with cutting balloon technique before re stenting . The average time of manipulative duration of guiding catheters engaging in osicum of target coronary, crossing the vessel lesions of guidewire, dilatation and implantation of stents,and under X ray fluoroscopy were 4.30 ±0.59 min , 2.52 ±0.40min , 2.66 ±0.40 min ,and 25.9 ±0.49 min , respectively, and the total time of the whole procedure was 56.6 ±14.8 min . When the ulnar introducer was taken off, the access site in ulnar artery was suppressed by tourniquet with no bleeding in the access site and no limitation of physical activation under maintaining infusion of heparin immediately after procedure . There was no significant change in the diameter of ulnar artery and the time of Allen’s test after 1 month of PCI procedure as compared with those before procedure ( 3.22 ±0.48mm vs 3.26 ±0.22 mm , P >0.05 ; 2.96 ±0.98 s vs 2.72 ±0.47 s , P >0.05 ). No significant change was found in the parameters of blood velocity , cross area of vessel lumin, blood resistance and the level of blood oxygen in finger after 1 month of PCI procedure. The average total hospital stay was 5.21 ±0.43 days. Following up 1 month, no complications such as occlusion of ulnar artery, abnormal sensitivity and movement disability were found in right hands in all patients.Conclusions The ulnar artery might be selected as one approach of antebrachial artery for PCI in the patients with coronary heart disease whose radial artery was difficulty as access vessels of PCI, while reversed Allen’s test for radial and ulnar artery are positive and the luminal diameter of ulnar artery was larger than that of radial artery.
