Abstract:Aim to investigate the effect of fluid shear stress on tissue factor (TF) high expression in endothelial cells and discuss its possible mechanism. Methods mRNA expression of TF, transcription factors nuclear factor Sp1 and Egr-1 and their relative antigen were analyzed by in sito hybridization and immunohistochemistry staining, respectviely. Functional TF activity was assessed by one-step recalcification clotting time assay, meanwhile, a simple parallel flow chamber system, which can produce 0～4.8 Pa steady laminar flow shear stress, was established in order to study the effect of blood flow shear stress on endothelial cells (EC). Results In hUVEC, TF functional activity, antigen and mRNA are very low; Sp1 protein expression increased in karyon, but the transcriptional activity of Sp1 is high in cytoplasm; Egr-1 mRNA and protein expresion is absent or fewer in karyon and cytoplasm. After 6 h exposed to 1.2, 2.4, 4.8 Pa shear stress, mRNA, protein expresion, the procoagulant activity of TF markedly increased comparing with control group (p<0.05). The mRNA and protein expresion of Egr-1 and Sp1 increased (p<0.05). However, the change of Egr-1 was more significant than that of Sp1 (p<0.05). The change trend of Egr-1 and Sp1 expresion were similar to that of TF. Conclusion The shear is one of a starting regulator of TF expression in endothelium. Their effect is mediated by transcription factors nuclear factor Egr-1 and Sp1.

Abstract:Aim To establish a new animal model of the human type 2 diabetes mellitus complicated with atherosclerosis and investigate the effects of high fat/high sucrose feeding on glucose and lipid metabolism in guizhou minipigs. Methods Minipigs were fed with high fat/high sucrose diet (HFSD) and the levels of fasting blood glucose, insulin, total cholesterol, triglycerides were measured. Dysfunction of the pancreatic β-cell were observed by immunohistochemistry. The aortic fatty streak-lesions were quantified following lipid staining with Sudan IV. Lipid droplets in liver were observed by Oil red O staining. Results During the feeding period, HFSD induced hyperglycemia, hypercholesterolemia and hypertriglyceridemia. At the end of 8 months, in HFSD-fed animals, the adipocytes were hypertrophic. Injured pancreatic β-cells were observed. The aortic fatty streak-lesions were clearly presented in the animals' aortas. Extensive fat deposited in the liver were observed. Conclusion Our study successfully established a new animal model that feeding minipigs with high fat/high sucrose diet without adding dietary cholesterol can induce insulin resistance, mild diabetes, and atherosclerotic lesions. High fat/high sucrose diet-fed minipigs may be a good animal model for research on the treatment of diabetic dyslipidemia complicated with atherosclerosis.

Abstract:Aim To investigate the effects of Shuxin capsule on apoptosis induced by hypoxia and apoptosis-related genes expression in cultured human umbilical vein endothelial cells (HUVECs). Methods HUVECs were cultured and hypoxic models were established. The presence of apoptosis was detected by electron microscope and flow cytometry assessment of Annexin v/PI stain. The protein levels of Fas, bcl-2 and p53 were examined by flow cytometry. Results After cultured 12 h in hypoxic condition, apoptosis of HUVECs was identified with electron microscope and showed by flow cytometry. Apoptosis rate in hypoxia group (13.03%±0.96%) was significantly higher than that in control group (4.47%±0.64%) (p<0.01), and after treated with 5 g/L Shuxin capsule liquid for 12 h in hypoxic condition, apoptosis rate decreased clearly (5.03%±0.54%) (p<0.01). Furthermore, it was revealed by flow cytometry that the apoptpsis process was associated with upregulation of p53 expression and downregulation of bcl-2 expression,but not with the marked change of Fas expression. Shuxin capsule could make expression of p53 down-regulated and expression of bcl-2 upregulated. Conclusion Shuxin capsule can inhibit the apoptosis of HUVECs induced by hypoxia,which is associated with its effects on expression of bcl-2 and p53.

Abstract:Aim To explore the effects of homocysteine (Hcy) on the activity of matrix metalloproteinase-1 (MMP-1) and it's regulatory mechanism in cultured vascular smooth muscle cells. Methods Cultured rat vascular smooth muscle cells were treated with different concentration of Hcy in vitro for 48 h. The activity of MMP-1 was determined using the method of zymography. The expression of MMP-1 mRNA in vascular smooth muscle cells was observed by semi-quantitative reverse transcription polymerase chain reaction. Results Hcy significantly inhibited the activity of MMP-1 and down-regulated the MMP-1 mRNA expression in vascular smooth muscle cells in a dose-dependent manner. Conclusion These data suggested that Hcy can induce collagen accumulation by decreasing the secretion of MMP-1 and inhibiting the activity of MMP-1. It may be the key factor in the pathogenesis of atherosclerosis induced by Hcy.

Abstract:Aim To investigate the effect of apoptotic celiac macrophages of the mouse induced by oxidized very low density lipoprotein (ox-VLDL). Methods Human blood plasma low density lipoprotein (LDL) was oxidized by CuCl2 in order to obtain ox-VLDL. DNA gel electrophoresis was used to observe the DNA ladder pattern of apoptotic macrophages. Flow cytometry and diphenylamine method were used to determine apoptotic macrophage percentage and DNA fragmentation percentage. The morphological changes of apoptotic macrophages were detected by microscope. Results ①ox-VLDL could induce macrophages apoptosis. ②Dimethylol thiourea, an antioxidative agent, could inhibit in part DNA breakage induced by ox-VLDL. ③Pyrrolidine dithio carbamate, an inhibitor of the activity of nuclear factor-κB, could inhibit completely DNA breakage induced by ox-VLDL. Conclusion Macrophages apoptosis induced by ox-VLDL may lead to one of mechanisms of atherosclerosis, and is in relation to free radicals and NF-κB activation.

Abstract:Aim To observe the antiatherogenetic effect of batata glycoprotein (BG) and its mechanisms. Methods Fourty adult male New-Zealand rabbits were randomly divided into normal control group, hyper-cholesterol group, low dose BG and high dose BG group. Each group was fed respectively with common forage, high cholesterol forage, high cholesterol forage andding BG (0.06g/kg.d ) and high cholesterol forage andding BG (0.1g/kg.d ). At week 0 and 12, the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC) and high density lipoprotein cholesterol (HDLC) in the serum were determined. The levels of serum superoxide dismutase (SOD) activity and malonyldialdehyde (MDA)were measured. At the end of the twelfth week, all rabbits were killed to observe aorta pathological changes. Results At the end of the twelfth week, the levels of serum TC, TG, LDLC and MDA were lightly decreased or significantly decreased in low dose group and high dose group compared with those in hypercholesterol group (hypercholesterol group, low dose group and high dose group: TC was respectively 20.26±0.13, 15.27±0.83, 11.28±1.62. TG was respectively 1.85±0.35, 1.71±0.28, 1.51±0.11. LDLC was respectively 18.99±2.65, 14.27±3.04, 12.13±3.56. MDA was respectively 4.53±0.34, 4.13±0.18, 3.83±0.26 p<0.01), while the levels of serum HDLC and SOD activity were increased or significantly increased in low dose group and high dose group compared with those in hypercholesterol group (hypercholesterol group, low dose group and high dose group: HDLC was respectively 0.75±0.10,0.81±0.06,0.94±0.08. SOD was respectively 156±16, 186±21, 231±6, p<0.05 or p<0.01). Plaque area of low dose group and high dose group was smaller than that of hypercholesterol group (p<0.05 or p<0.01). Conclusions Batata glycoprotein can inhibit atherogenesis, and the effect correlates with the amount of adding batata glycoprotein.

Abstract:Aim To study the inhibitory effect and mechanisms of Momordicin on foam cell. Methods Momordicin (28 kDa) was purified from the juice of Momordica charantial by eccentricity, super-filtration and chromatography technology. After incubated with 160 nmol/L PMA for 24 h, THP-1 was induced to macrophage, this macrophage was induced to foam cell by incubated with 25 mg/L ac-LDL for 48 h, and the effect of Momordicin on foam cell was measured, cholesteryl and cholesteryl ester within THP-1 were measured by high performance liquid chromatography (HPLC), and regulated effect of Momordicin on ATP binding cassette transporter A1 (ABCA1) was measured by RT-PCR. Results A positive inhibitory effect of Momordicin on foam cell was found. Total cholesterol (TC) and cholesteryl ester (CE) were reduced remarkably by Momordicin(p<0.01), CE/TC was reduced from 62.9% to 36.2% by Momordicin, ABCA1 was up-regulated by Momordicin (P=0.035) remarkably. Conclusions The inhibitory effect of Momordicin on foam cell may related to it's activity of up-regulating ABCA1.

Abstract:Aim To investigate the effect of selective endothelin A receptor (ETA)antagonist BMS-182874 on myocardial ischemia-reperfusion (I-R) injury in isolated rat hearts. Methods The isolated hearts were perfused in a Langendorff mode and acute myocardial ischemic model was induced by 30 min of global ischemia and 30 min of reperfusion. The effects of ETA receptor antagonist BMS-182874 (10 μmol/L, 50 μmol/L) on heart function during reperfusion, the release of cardiac creatine kinase (CK) in the coronary effluent and the content of myocardial tumor necrosis factorα (TNF-α) were analyzed. Results 30-minute global ischemia caused a dramatic decrease in myocardial function, as shown by decreasing LVP, ±dp/dt max ,, CF (p<0.01) and increasing CK release (23.9±2.2 vs 217.5±14.1, p<0.01) and myocardial TNF-α content (645±45 vs 1 926±141, p<0.01). However, treatment with 10 μmol/L and 50 μmol/L BMS-182874 significantly attenuated the ischemia-induced myocardial injury, increased LVP, ±dp/dt max , and reduced the release of CK (185±14, 143±11, compared with ischemia/reperfusion group, p<0.05, p<0.01 respectively) and the TNF-αcontent in myocardial tissues (p<0.01), but had no effect on HR and CF (1222±67, 1108±57, compared with ischemia/reperfusion group, p<0.01). Conclusions These findings suggest the cardioprotective effects afforded by ETA receptor antagonist BMS-182874 may be related to inhibition of myocardial TNF-αproduction.

Abstract:Aim To investigate the effects of simvastation on the proliferation and migration of rat adventitial fibroblasts as well as collagen synthesis. Metheods Isolated vascular adventitial fibroblast (VAF) of Sprague-Dawley(SD) rats were cultured. VAF proliferation was measured by thiazolyl (MTT) blue assay. The migration of VAF was determined by Sarkar's technique. Collagen synthesis was measured by 3H-proline uptake test. Results (1)MTT colorimetry showed the A490 values were 0.291±0.011, 0.265±0.006, 0.234±0.008 and 0.214±0.006 respectively in the 10 -7 mol/L, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L simvatastin groups, all significantly lower than that in the control group (0.335±0.082, all p<0.01). (2)The distance of migration was 6.5±1.1 mm, 5.3±1.2 mm, 4.1±1.0 mm and 2.9±0.9 mm respectively in the 10 -7 mol/L, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L simvastatin groups, all significantly lower than that in the control group (8.1±1.8, all p<0.01). (3)The 3H proline uptake was (c/min)385±51, 272±48, 161±38 and 141±36 respectively in the 10 -7 mol/L, 10 -6 mol/L, 10 -5 mol/L and 10 -4 mol/L simvastatin groups, all significantly lower than that in the control group (655±58, all p<0.01). Conclusions Simvastatin can effectively inhibit the proliferation,migration and collagen synthesis of rat vascular adventitial fibroblasts in a dose-dependent manner which may play a role in ameliorating vascular remodeling.

Abstract:Aim To investigate the expression of caveolin-1 and vascular endothelial growth factors( VEGF) in vascular endothelial cells(VEC) induced by high glucose. Methods The human umbilical vein endothelial cells(ECV304) were cultured in the media containing glucose 0.0 mmol/L and 5.5, 11.1, 22.0, 33.0 mmol/L respectively. After 24 hour, the proliferation of VEC was determined by a colorimetric 3-[4,5-dimethyl thiazol-2-yl]-2,5 -diphenyltetrazolium bromide (MTT) assay. The level of nitric oxide (NO) was measured by nitrate reductase method. The localization of caveolin-1 and VEGF protein was examined by immunohistochemistry. Western bolt was used to measure the protein level of caveolin-1 and VEGF. Results The proliferation of VEC was inhibited in concentration-dependent manner (r=-0.776,P=0.000). The level of NO was increased in concentration-dependent manner (r=0.698,P=0.000). Caveolin-1 and VEGF were granular brown substance which located mainly in the cytoplasm. The expression of VEGF was induced by high glucose in concentration-dependent manner(r=0.645,P=0.009). High glucose stimulated caveolin-1 expression in concentration-dependent manner(r=0.808,P=0.000). Conclusion High glucose could inhibit proliferation of vascular endothelial cells in vitro. High glucose upregulated the expression of VEGF and caveolin-1 on vascular endothelial cells, which might taken part in development of vascular complications in diabetic.

Abstract:Aim To investigate the effects of Stichopus Variegatus Compound on cell intima hyperplasia of rabbit. Methods Thirty seven male New Zealand rabbits were allocated randomly into 4 group: normal control group, modle group, Stichopus group, Simvastatin group. All rabbits were killed after 6 weeks and iliac arteries were removed. With HE staining, we observed artery morphology alteration and measured the thickness of arterial intima and media. The expression of growth factor basic fibroblast growth factor (bFGF), transfer growth factor β 1 (TGF-β 1) and platelet derived growth factor (PDGF) were observed by hybridization in situ method. Apoptosis gene bcl-2 and bax were tested by immunohistochemistry staining. Results In comparison with modle group, the thickness of intima and ratio of intima to media and the expression of PDGF and TGF-β 1 in treatment group notably decreased (p<0.01, 0.01, 0.05, 0.05, respectively). The expression of bax in treatment group were significantly highter than that in modle group (p<0.05). There were no differences between Simvastatin group and Stichopus group. Conclusions Stichopus Variegatus Compound can effectively relieve stenosis of lumen of blood vessel, which may partly attributed to its function of inhibiting the hyperplasia and promoting the apoptosis of vascular smooth muscle cell (VSMC).

Abstract:Aim To evalute the protective effects of St. Thomas NO.2 cardioplegia and blood cardioplegia in protecting myocardium of immature rabbit hearts from ischemic reperfusion injury. Methods On modified Langendorff apparatus, 12 isolated hearts of 14～21 d immature rabbit were divided in two groups randomly: St.Thomas NO.2 cardioplgeia and blood cardiplegia and subjected to 2 h of ischemia and 1 h of reperfusion. The preischemia and postischemia myocardial function were assessed by the percentage recovery of left ventricle function, myocardial water content, and the leakage of myocardial enzyme. Results Postischemic recovery of left ventricle function were significantly better in blood cardiplegia group than in St.Thomas NO.2 cardioplgeia group, and St. Thomas NO.2 cardioplgeia group had higher percentage of leakage of myocardial enzyme. But there were no differences in myocardial water content. Conclusion The blood cardioplegia can provide better myocardial protection for immature rabbit hearts than the St. Thomas NO.2 cardiolplegia.

Abstract:Aim Comparison of plasma lipids levels of severe acute respiratory syndrome (SARS) patients and control subjects. Methods plasma lipid and lipoprotein levels are reported. Results Compared with control, a marked reduction was observed in SARS group for total cholesterol (TC), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), apolipoprotein A_Ⅰ(apo A_Ⅰ) and apolipoprotein B (apo B) but not for triglyceride (TG) and lipoprotein a [Lp(a)]. Among the seven markers, reductions of HDLC and apo A_Ⅰ were highly significant. HDLC in SARS individual is equal to 50% of that in control, and apo A_Ⅰ 58.9%. Both LDLC and apo B reduced moderately by 35% and 30% each. However, there were no obvious differences in Lp(a) between two groups that suggested that is level might not been affected by the coronavirus. Continuous measurements were provided to several patients to monitor the dynamic variation of lipids and lipoproteins in plasma. The major components of plasma lipoprotein were lower than normal before treatment. While after a therapeutic alliance of traditional Chinese medicine and western medicine, lipoprotein levels of TC, HDLC, LDLC, apo A_Ⅰ and apo B have increased significantly. Conclusions The rise of the five major serum lipids measurements may predict that the patients will be restored to health gradually.

Abstract:Aim To study the relationship between angiotensin-converting enzyme (ACE)gene polymorphism and level of angiotensin Ⅱ (AngⅡ) in plasma with cerebral infarct (CI) in Chinese Han nationality. Methods 173 patients with cerebral infarct and 116 control subjects in Chinese Han were examined using polymorase chain reaction (PCR) and genetic methods. Plasma AngⅡ level determined by enzyme-linked immunosorbent assay (ELISA) method. Results ACE DD genotype appeared more common in patients of cerebral infarct compared with normal controls (0.39 versus 0.24, p<0.01), and it is important in frequency of ACE DD genotype abnormal increase in group of cerebral infarct onset age within 60 years. There were no significantly different in plasma AngⅡ level between cerebral infarct and control subjects, but cerebral infarct with ACE DD genotype group higher plasma AngⅡ level significantly higher than control group and cerebral infarct with ACE DI and II genotype (p<0.01), the level of plasma AngⅡ were increased most remarkably in group of cerebral infarct onset age within 60 years. Conclusions The ACE gene deletion polymorphism might serve as a risk factor for cerebral infarct in Chinese Han nationality while the level of plasma AngⅡ increased might related to group of cerebral infarct onset age within 60 years. Relate to gene deletion polymorphism.

Abstract:Aim To investigate the relationships between essential hypertension, hypertensive left ventricular remodeling, serum total cholesterol and the polymorphism of angiotensin Ⅱ type 1 receptor (AT1R) gene. Methods A case-control study was carried out using 148 hypertensive and 164 normotensive subjects. Blood pressure, body mass index, fasting serum glucose, serum total cholesterol (TC) and triglyceride (TG) were measured in all subjects, and LVMI of the hypertensives were measured. The A/c variant at position 1166 of the AT1R gene was identified by polymerase chain reaction and restriction fragment length polymorphism (PCR/RFLP) analysis. The frequencies of AC/CC genotypes and 1166C allele of AT1R gene between hypertensives and normotensives were analyzed by Chi-Square test. Results The frequencies of AC/CC genotypes and 1166C allele of AT1R gene in hypertensives were higher than that in control (AC/CC genotypes 0.203∶0.0104,p<0.05; Callele 0.111∶0.055,p<0.05),the OR is 1.998(95%CI: 1.073～3.581). More statistically significant of C1166 allele frequency and the AC genotype distribution were obtained in subjects with hypercholesterolemia when serum TC level was hierarchically analyzed (AC/CC genotypes 0.260∶0.092,p<0.01; C allele 0.144∶0.046,p<0.01), the OR reach to 3.46(95%CI: 1.29～9.29). AC/CC genotypes were risk factors to hypertension, and such genotypes and TC were risk factors to hypertensive left ventricular remodeling. Conclusions 1166AC/CC genotypes of AT1R gene and TC have additive relation with essential hypertension and hypertensive left ventricular remodeling, the effective control of TC and blood pressure might decrease the damage of target organs.

Abstract:Aim To evaluate the therapeutic effects of simvastatin probucol and captopril on the atherosclerotic plaques with high-frequency ultrasound imaging. Methods 102 patients with atherosclerosis were randomly divided into 4 groups: the simvastatin group, the probucol group, the captopril group, and the placebo group. Both sides of carotid and femoral arteries were detected with a 4～10 MHz transducer and intima-media thickness (IMT)were determined. IMT of normal segment of each artery was defined as IMTa, the maximal IMT of each artery as IMTb, the mean maximal IMT of 4 arteries as IMTc, the maximal IMTc of 4 arteries as IMTd. The systemic examinations were repeated in 3 years after treatments. Results After 3 years treatment IMT values increased significantly in the atherosclerosis arteries (p<0.05). The change values of IMTa in control group (0.04±0.12 mm) was larger than that of the right carotid artery in probucol group (0.04±0.12 mm) and the left carotid artery(0.04±0.26 mm) and right femoral artery (0.03±0.23 mm)in simvastatin group (p<0.05). The pregression values of IMTb and IMTc in simvastatin group and IMTb in all therapetic groups were singnificantly lowered than that of control group (p<0.05). The pregression rates of IMTc in simvastatin group (0.17±0.12 mm)and captopril group (0.21±0.15 mm) were singnificantly lowered than that of control group (0.25±0.2 mm) (p<0.01). The pregression value and rate of IMTd in all therapetic groups were significantly lower than that of control group (p<0.05). Conclusions The drug theray can decrease the progression of atherosclerosis but had no effect on the normal segment of arteries. The high frequence ultrasound technique provides a reliable routine for monitoring progression or regression of atherosclerosis in carotid and femoral arteries.

Abstract:Aim To study the relationship between carotid atherosclerosis and degrees of coronary artery stenosis. Methods 200 patients with chest pain of various reasons were examined by standard Judkins' selected coronary angiography, meanwhile, they also accepted carotid artery digital subtraction angiography and carotid artery ultrasound. According to the results of coronary angiography, all the patients were divided into two groups: coronary heart disease (CHD) group and non-CHD group (normal group). According to the diameter of coronary artery, the CHD group was divided into three subgroups again. Results Coronary artery stenosis was significantly correlated to carotid atherosclerosis. The incidence of plaques in the carotid arteries was obviously increased, aggravating with coronary artery stenosis. Carotid atherosclerosis had a linear positive correlation with coronary artery stenosis. Although the incidence of carotid artery stenosis was lower than that of coronary artery, carotid artery stenosis was aggravating with the degree exacerbation of coronary artery stenosis. Conclusions Carotid atherosclerosis is close related to coronary artery stenosis. Ultrasonography of carotid artery could be used as a routine method to detect and screen high-risk patients with cardiac and cerebral vascular disease in population of over middle aged in early stage.

Abstract:Aim To determine whether chronic inflammatory status is associated with carotid atherosclerosis in maintenance hemodialysis (MHD)patients. Methods Twenty-five MHD patients and fifteen healthy volunteers were included in this study. The levels of high-sensitive C-reactive protein (hs-CRP) and tumor necrotic factor-α (TNF-α) were used to assess the chronic inflammatory status measured by ELISA. Intima-media thickness (IMT) and prevalence of atherosclerotic plaques of the extracranial common carotid artery were measured by high-resolution B mode ultrasonography. Results The levels of plasma hs-CRP and TNF-α in the MHD patients were higher than those in the healthy volunteers. The prevalence of atherosclerotic plaques and the mean IMT value of carotid artery significantly increased in MHD patients compared with those in age and sex-matched controls. Age and the levels of plasma transformed TNF-α were positively correlated to CCA-IMT (r=0.733,p<0.001;r=0.792,p<0.001) respectively. Multiple stepwise regression analysis showed that in MHD patients, the independent risk factors associated with value of IMT were plasma transformed TNF-α levels, age, high density lipoprotein cholesterol (HDLC), CRP, phosphorus, apolipoprotein B, prior albumin and triglyceride. Conclusion Chronic inflammatory status is really present in MHD patients; inflammation plays a role in the pathogenesis of atherosclerosis in these patients.

Abstract:Aim To evaluate the correlation between three single nucleotide polymorphisms (SNPs) at -217,-20 and -6 locus in the promoter region of angiotensinogen (AGT) gene and myocardial infarction (MI) in south Han Chinese population. Methods ABI PRISM SNaPshot Multiplex Kit was used to genotyping G-217A, A-20C and G-6A polymorphisms in 216 patients with MI and 185 healthy controls. Results The AA, AG and GG genotypes of G-217A polymorphism were obviously different between group of MI and group of controls (10, 77 and 129 to 8, 37 and 140, P=0.002 ). Frequencies of A and G alleles were also significantly different between two groups (22.45%, 77.55% to 14.32%, 85.68%, P=0.003). The AA, AG and GG genotypes of G-6A polymorphism were obviously different between two groups (147, 64 and 5 to 127, 44 and 14, P=0.029). But, frequencies of A and G alleles of G-6A had no significant difference between two groups (P=0.394). The CC, AC and AA genotypes of A-20C polymorphism were different between two groups (6, 51 and 159 to 2, 61 and 122), but no statistical difference was found (P=0.067). Logistic regression analysis showed that age (P=0.001), systolic blood pressure (SBP) (P=0.013) and serum concentration of triglyceride (TG) (P=0.010) were all independent risk factors for MI. Serum concentration of high density lipoprotein-cholesterol (HDLC) (P=0.018) was a protective factor for MI. Conclusions G-217A and G-6A polymorphisms of AGT gene might be associated with the occurrence of myocardial infarction in south Han Chinese population.

Abstract:Aim To investigate changes of insulin resistance after lipid-lowering treatment by bezafibrate in hypertensive patients with hypertriglyceridemia using calcium channel blockers (nifedipine). Methods Fifty-eight hypertensive hypertriglyceridemic patients were enrolled in study. In random order, patients of group A (30 patients) were treated with bezafibrate, nifedipine and dietary control, and those of group B (28 patients) received placebo, nifedipine and dietary control during 8 weeks. The changes of blood pressure (BP), serum lipid, the levels of plasma glucose and insulin had been examined and compared between two groups. Results The bezafibrate-treated group had a greater reduction in diastolic BP, levels of plasma glucose and insulin, and had a increase in insulin sensitive index. Conclusion Bezafibrate maybe improve the patients' insulin resistance by adjusting dyslipidemia,and maybe extra lower the patients' diastolic BP.

Abstract:Aim To explore the characteristics of carotid intima-media thickness (IMT) and plaques and their predictive value among patients with premature coronary heart disease (CHD). Methods The clinical profile, angiographic results were studied. IMT and plaques of the common carotid artery were measured by B-mode ultrasound imaging and their predictive value for premature CHD was evaluated. Results Patients with premature CHD had higher average carotid IMT values [(0.79±0.20) mm vs (0.65±0.13) mm, p<0.05]and plaques were more common. Positive carotid artery ultrasound predicted premature CHD with sensitivity of 55.7%, specificity of 88.9% and accuracity of 87.2%. Multivariate Logistic regression revealed that positive carotid artery ultrasound is an independent predictive factor for premature CHD (Or=7.19, 95%CI: 1.92～ 21.37 , P=0.007). Conclusions Patients with premature CHD had higher values of carotid IMT and more carotid plaques. Positive carotid artery ultrasound predicted premature CHD with high specificity and accuracity. Positive carotid findings is an independent predictive factor for premature CHD.

Abstract:Aim To determine whether electron-beam CT (EBCT) is useful as a noninvasive coronary artery calcification screening examination for differentiating diagnosis of hypertrophic cardiomyopathy (HCM). Methods Ninety and nine consecutive patients with HCM from 33 to 71 years old (48.6±12.7 years), were reviewed to find out clinical characteristics and implication of coronary artery calcification detected with EBCT scanning when simultaneously compared with 102 coronary heart diseases (CHD) patients, 30 to 78 years old (56.2±10.9 years). Results Of the 99 HCM patients, 31 (32.3%) had detectable coronary calcification, and calcium score was 21.1±4.9. There was a significant difference between HCM group and CHD group, which were 66.7%(68/102) and 203.2±34.9, respectively (p<0.01). The prevalence of coronary calcification and calcium score had a increase as age went up in HCM patients, but still in the range scores in normal chinese. The outcome was the same after age and gender adjustment. Conclusion EBCT is helpful to distinguish HCM patients from suspected CHD patients or associated CHD as a noninvasive imaging technique.

Abstract:Aim To evaluate the efficacy of intravascular ultrasound (IVUS) in patients undergoing renal artery intervention therapy. Methods 15 consecutive patients with significant renal artery stenosis (luminal narrowing of renal artery > 50%) underwent IVUS, before and after renal artery stenting. All patients underwent renal artery stenting, the sizes of the stent were chosen according to the results of IVUS. Results IVUS revealed 13 hard plaques with 2 severe calcification and 2 soft plaques in 15 patients; 12 lesions were found with negative remodeling, 3 with positive remodeling. The mean cross sectional areas of external elastic membrane and lumen were 119.7±23.1 mm 2 and 34.5±9.3 mm 2. The mean plaque area was 85.2±26.0 mm 2. All patients underwent renal artery stenting with 100% successful procedure rates. Conclusions IVUS has superiority in determining the lesion characteristics, defining the stenosis, calculating the luminal dimension and inserting the stent.

Abstract:Aim To study vascular endothelial function in patients with metabolic syndrome and relationship between risk factors and endothelial function. Methods Brachial artery vascular diameter and blood flow volume were measured after reactive hyperemia and nitroglycerin sublingual nitroglycerin respectively in 35 patients with metabolic syndrome and 21 subjects as normal control by high-resolution ultrasonography. Results There were significant differences of triglyceride, fasting blood glucose (FBG),postprandial blood glucose (PBG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) between control group and metabolic syndrome group (p<0.05 or p<0.01). There were significant differences of percentage of the brachial artery diameter change of reactive hyperemia,percentage of the diameter change of nitroglycerin sublingual administration and percentage of flow volume change of nitroglycerin sublingual administration (p<0.05 or p<0.01). Endothelium-dependent dilatation in patients with metabolic syndrome was significantly negatively related with age (r=-0.29, p<0.05), triglyceride (r=-0.38, p<0.05), SBP (r=-0.71, p<0.01), DBP (r=-0.61, p<0.01), FBG (r=-0.62, p<0.01), PBG (r=-0.66, p<0.01) and BMI (r=-0.47, p<0.05) respectively. Conclusions Dysfunction of endothelium-dependent and endothelium-independent dilatation in patients with metabolic syndrome are apparent. Endothelium-dependent dilatation was significantly negatively related with age, triglyceride, blood pressure, blood glucose and body mass index.

Abstract:Aim To explore the essentiality of renal angiography while undergoing routine coronary angiography and evaluate the correlated risk factor of atherosclerotic renal artery stenosis (ARAS). Methods Abdominal aortography or slective renal angiography was performed immediately after routine coronary angiography in 491 patients with suspected coronary artery disease. Univariate analysis and multivariate Logistic regression analysis were made to evaluate the association of the clinical variables with renal stenosis. Results Incidence of renal artery stenosis was 20% (44/220) in patients with coronary artery disease who were identified by coronary angiography. Only 7 cases with renal artery stenosis were found in 271 cases whose coronary arteries were normal (2.6%). Multivariable predictors of ARAS included coronary artery disease (p<0.001) and peripheral vascular disease (P=0.003). Conclusions Renal angiography should be routinely performed in patients with suspected coronary artery disease while undergoing routine coronary angiography to identify ARAS, especially in patients associated with peripheral vascular disease.

Abstract:Aim To establish a novel animal model to study the mechanism of autologous vein graft atherosclerosis and methods of preventing vein graft atherosclerosis. Methods 30 male New Zealand White rabbits were randomly assigned to normal control group (rabbits fed by normal diet, n=6), vein graft group (rabbits treated by autologous external jugular vein grafting to common carotid artery and fed by normal diet, n=12) or vein graft plus high-fat diet group (rabbits treated by autologous vein graft and fed by high-fat diet, n=12). Animals were sacrificed at 12 weeks after surgery. Serum lipid levels were measured and vein grafts were investigated by light microscopy and transmission electron microscopy. Results Hyperlipidemia and the typical atherosclerotic lesions of vein grafts were observed in the vein graft plus high-fat diet group. The lesion included intimal hyperplasia, the migration and proliferation of smooth muscle cells, the accumulation of lipid and cholesterol and the formation of foam cells. But only intimal hyperplasia and the migration of smooth muscle cells were observed in the vein graft group. There were no obvious changes in the external jugular veins of the normal control group. Conclusions The autologous typical vein graft atherosclerosis can be induced by autologous external jugular vein graft plus high-fat diet in rabbits. The animal model was suitable for the advanced research in the mechanism and prevention of human autologous vein graft atherosclerosis.

Abstract:Aim To investigate the relationships between transient ischemic attack (TIA) and serum lipoprotein(a) and plasma D-dimer. Methods The serum levels of lipoprotein(a) and the plasma levels of D-dimer were measured in 48 patients with TIA within 24 hours. 25 healthy were set as control group. Results The levels of lipoprotein(a) and D-dimer in patients with TIA were higher than control group (p<0.05). In TIA group, the levels of lipoprotein(a) and D-dimer in those patients with infarction significantly increased compared with those without infarction (p<0.05). Conclusions These results suggest that increased lipoprotein(a) and D-dimer may play roles in the formation of TIA.