Abstract:Aim To investigate the effect of simvastatin on reactive oxygen species(ROS) expression in stretch stress(SS) induced macrophage cells. Methods RAW264.7 macrophage cells were cultured in vitro, treated with SS, or pretreated with simvastatin for 60 min and then stimulated with SS, the expression of ROS was detected by Hoechst33342 and H2DCFDA fluorescent probe, the fluorescence intensity of ROS was detected and the positive ratio of ROS was analysed by SPSS statistical software. The expression of NADPH oxidase 1(NOX1) was evaluated by Western blot.Results SS increased the expression of ROS in a time dependent manner, and the expression of ROS reached the most significant at 60 min(P<0.05). Simvastatin could inhibit the effect induced by SS in a concentration dependent manner, the inhibition effect of simvastatin was the most significant in 0.3 μmol/L(P<0.05). The expression of NOX1 was significantly inhibited by simvastatin after SS. Conclusion Simvastatin repressed ROS expression of RAW264.7 macrophage cells induced by SS through inhibiting the expression of NOX1.

Abstract:Aim To explore the effect of sitagliptin on the expression of endothelin-1(ET-1) and endothelial nitric oxide synthase(eNOS) in human aortic endothelial cells(HAEC) and its underlying mechanism in high glucose environment. Methods HAEC were cultured in high glucose environment(25 mmol/L), and treated with different concentrations of sitagliptin(0, 5, 10 and 20 μmol/L, respectively). The mRNA and protein expressions of eNOS, ET-1, iNOS and phosphate nuclear factor-kappa B p65(p-NF-κB p65) were measured. The measurements for eNOS, ET-1, iNOS, NF-κB p65 on mRNA and protein levels in HAEC were evaluated after incubation with tumor necrosis factor-α(TNF-α) and sitagliptin. Results Compared with normal medium(glucose concentrations for 7 mmol/L), both the mRNA and the protein expression of eNOS in HAEC significantly decreased in high glucose medium, while those of ET-1, iNOS and p-NF-κB p65 protein significantly increased(P<0.05). Compared with 0 μmol/L sitagliptin, 20 μmol/L sitagliptin significantly increased mRNA and protein expressions of eNOS, while decreased those of ET-1, iNOS and p-NF-κB p65 protein(P<0.05). Compared with sitagliptin alone treated HAEC, both the mRNA and the protein expressions of eNOS significantly decreased in HAEC treated with TNF-α and sitagliptin, while those of ET-1, iNOS and p-NF-κB p65 protein expressions significantly increased(P<0.05). Conclusions Sitagliptin enhances eNOS, represses ET-1, iNOS expressions at the level of transcription and translation through inhibiting NF-κB p65 phosphorylation in HAEC in high glucose environment. This may contribute to the improvement of endothelial function and prevention of subsequent atherogenesis.

Abstract:Aim To investigate whether all-trans retinoic acid(atRA) combined with collagen Ⅳ can promote mouse embryonic stem cells(mESC)to differentiate into smooth muscle cell. Methods The totipotency and chromosome of ES cells were examined by ALP staining, SSEA-1 staining, and in-vivo teratoma formation test. After forming EBs by suspending in EB media for 3 days, EBs were divided into four inducted groups:none induction(Control group); atRA group; collagen Ⅳ group; atRA+collagenⅣgroup. They were differentiated for 7 d and 14 d. Then, they were harvested at 7 d and 14 d to analysie by Western blot and immunostaining. Results ①The successful culture of the ESCs was identified by the totipotent function. ②Compared with the other three groups, the expression of SM-α actin in group atRA+collagenⅣ significantly increased(P<0.05). Meanwhile, the proportion of SM-α actin⁺/SM-MHC⁺ cells in group atRA+collagen Ⅳ was higher than the other three groups. Conclusion atRA combined with collagen Ⅳ could do better in inducing the differentiation of mouse embryonic stem cells to smooth muscle cell than both alone.

Abstract:Aim To observe and evaluate the effect of intermittent hypoxia(IH) on plasma lipoprotein-associated phospholipase A₂(Lp-PLA₂), interleukin-6(IL-6) and vascular cell adhesion molecule-1(VCAM-1) by the rabbit model of chronic intermittent hypoxia and the atherosclerosis formation. Methods Using randomized controlled study, prospective animal, variance analysis and so on. 36 New Zealand White rabbits(4 months old) were divided into two groups randomly. According to intermittent hypoxia time at 4, 8, 12 weeks, intermittent hypoxic group and control group were divided into 3 groups separately. There were 3 groups in the control group(C1, C2, C3) and the intermittent hypoxia group(IH1, IH2, IH3). There were 6 rabbits in each groups. Intermittent hypoxia group were placed in hypoxic chamber to treat by intermittent hypoxia for 8 hours per day. Weighting is at the fourth week, eighth week and twelfth week separately. The content of Lp-PLA₂, IL-6 and VCAM-1 was tested by ELISA method. At the same time, the abdominal aorta was stained by HE staining to observe the formation of atherosclerosis. Results (1) The plasma levels of Lp-PLA₂, IL-6 and VCAM-1 increased as time among IH1, IH2, IH3 and all control groups(P<0.05), which was the most obvious at 12th week.(2) At the 4th week, 8th week and 12th week, the plasma levels of Lp-PLA₂, IL-6 and VCAM-1 had no difference in control groups.(3) The plasma levels of Lp-PLA₂, IL-6 and VCAM-1 had a positive correlation with each other(P<0.05). The correlation coefficient was 0.75, 0.55 and 0.76 among Lp-PLA₂, IL-6 and VCAM-1(P<0.001).(4) The formation of atherosclerosis in aortic tissue can be observed by HE staining after intermittent hypoxia intervention. Conclusion The plasma levels of Lp-PLA₂, IL-6 and VCAM-1 was increased by intermittent hypoxia and had a correlation. IH may mediate the aggregation of inflammatory cytokines to lead to vascular endothelial injury and participate the formation of atherosclerosis.

Abstract:Aim To investigate the effect and discuss its potential mechanism of sirolimus induced calcium overload and apoptosis in vascular endothelial cells. Methods Human umbilical vein endothelial cells(HUVEC) were exposed to sirolimus with or without intervention treatment with ryanodine. Effects on cell viability were assessed by the MTT assay. Effects on the production of nitric oxide(NO) were detected by nitric oxide assay kit. The intracellular calcium ion(Ca²＋) concentration was assayed with Fluo-3 AM staining, changes of mitochondrial membrane potential were detected by JC-1 fluorescence labeling, HUVEC apoptosis rate was analyzed by Annexin V FITC/PI staining. ResultsCompared with the normal control group, the cell survival rate was decreased significantly in the treatments of sirolimus injury group(P<0.01). In sirolimus 500 nmol/L injury group, cell swelling, cytoplasm vacuoles, part of the nucleus pycnosis, nuclear fragmentation were observed by HE staining, levels of intracellular free Ca²＋and cell apoptosis rate were increased(P<0.01), levels of NO and mitochondrial membrane potential were reduced(P<0.01). The intervention treatments, ryanodine, significantly reduced the sirolimus 500 nmol/L treatment-induced Ca²＋(P<0.05) and cell apoptosis(43.3%±2.0% reduced to 30.7%±0.9%, P<0.01). Ryanodine also increased the sirolimus-treated cells’ viability(P<0.01), production of NO(28.33%±4.18 μmol/L increased to 47.03±3.87 μmol/L, P<0.01) and the level of mitochondrial membrane potential(0.24±0.03 increased to 0.45±0.04, P<0.01). Conclusion The possible mechanism of sirolimus induced calcium overload and apoptosis in HUVEC might be related to the increase of intracellular Ca²＋ via ryanodine receptor pathway.

Abstract:Aim To construct the apolipoprotein CⅢ(ApoCⅢ) transgenic mice, and to hybridize with low density lipoprotein receptor(LDLR) knockout mice susceptible to atherosclerosis； To obtain the ApoCⅢ transgene＋LDLR defect(ApoCⅢ＋LDLR―/―) mice model； To study the effect of ApoCⅢ on atherosclerosis and its potential mechanism.Methods ApoCⅢ＋LDLR―/― mice and LDLR―/― mice were fed with high fat diet for 3 months. Plasma triglyceride, total cholesterol, lipid peroxidation products(8-isoprostane, malondialdehyde) and glutathione levels were detected. The whole aorta and aortic sinus of the mice were stained with oil red O and dihydroethidium(DHE). The RNA and protein in aorta were extracted and the expressions of related genes were analyzed. Results After feeding high fat diet, plasma triglyceride level in ApoCⅢ＋LDLR―/― mice was apparently higher than that in LDLR―/― mice, but there was no significant difference in total cholesterol levels. Whole aorta and aortic sinus dyeing showed a significant increase of atherosclerotic plaque. Plasma lipid peroxidation products(8-isoprostane, malondialdehyde) increased significantly and antioxidant glutathione reduced significantly in ApoCⅢ＋LDLR―/― mice. Aortic DHE staining showed that the level of reactive oxygen species increased significantly. The mRNA and protein expressions of the genes related to oxidative stress and endoplasmic reticulum stress were significantly increased in the aorta. The results prompted that ApoCⅢ could increase arterial oxidative stress and endoplasmic reticulum stress, thereby promoting the formation of atherosclerotic plaque. Conclusion ApoCⅢ has the role of promoting atherosclerosis, and its mechanism may be related to the increases of overall oxidative stress level and arterial wall oxidative stress, endoplasmic reticulum stress level.

Abstract:Aim To study the influence of omentin on the expression of collagen Ⅰ/Ⅳin the human aortic smooth muscle cells subjected to oxidative stress. Methods Human aortic smooth muscle cells were cultured in vitro.When cell density reached above 90%, cells were randomly divided into 5 groups:control group, oxidative stress group, omentin group, ERK(extracellular regulated protein kinases) inhibitor group and p38MAPK(p38 mitogen-activated protein kinases) inhibitor group. Among them, the control group did not receive any treatment, oxidative stress group were treated with tert-butyl hydroperoxide(t-BHP, 87.1 μmol/L) to simulate the state of oxidative stress; omentin group were treated,except for 87.1 μmol/L t-BHP,with 600 μg/L omentin; except for t-BHP(87.1 μmol/L) and omentin(600 μg/L),ERK inhibitors(PD98059,60 μmol/L) and p38MAPK inhibitors(SB203580,100 μmol/L )were used in ERK inhibitor group and p38MAPK inhibitor group respectively. The expression of collagen Ⅰ/Ⅳ were detected by Western blot hybridization. Results MMT method was used to screen the optimal concentration and the best action time of t-BHP.(1)The optimal concentration was 87.1 μmol/L;(2)Compared with the control group, the expression of collagen Ⅰ/Ⅳin human aortic smooth muscle cells in oxidative stress group decreased significantly(P<0.01);(3)Compared with the oxidative stress group, the expression of type Ⅰ/Ⅳcollagen in human aortic smooth muscle cells increased significantly in omentin group(P<0.01);(4)Compared with the omentin group, the expression of collagen Ⅰ/Ⅳin ERK inhibitor group and p38MAPK inhibitor group were decreased significantly(P<0.05). Conclusion Omentin could improve oxidative stress-induced down-regulation of Ⅰ/Ⅳcollagen in the human aortic smooth muscle cells,and probably promote the stabilization of atherosclerotic plaque through the mechanism. ERK/p38MAPK signaling pathway may be involved in omentin effect in vivo.

Abstract:Aim To investigate the effect of insulin on expression of MMP-9,TIMP-1 and sES. Methods Primary cultured smooth muscle cells from the internal carotid artery and endothelial cells from the aorta of SD rats treated with different doses of insulin,MMP-9, TIMP-1 and sES released by cells into medium were quantified by ELISA. Results MMP-9 and SES levels were higher in insulin group compared with control group,while TIMP-1 was less than control group(P＜0.05). Significant positive correlation was observed between insulin and MMP-9(r=0.815,P＜0.001)as well as sES(r=0.841,P＜0.001), negative correlation was observed between insulin and TIMP-1(r=-0.740,P＜0.001). Conclusion Insulin augmented the secretion of SES and MMP-9, attenuated the secretion of TIMP-1 in dependence on the concentration.

Abstract:Aim To investigate the effect of Paclitaxel on TNF-α induced human umbilical vein endothelial cells expression of Cat K and NF-κB and explore the mechanism of paclitaxel inhibiting intimal hyperplasia. Methods HUVEC in the third to sixth generation were used in the present study. The cells were treated with different concentrations of paclitaxel for 1 hour and then with 10 μg/L TNF-α were added into it for 24 hours,mRNA and protein level of Cathepsin K and NF-κB were measured by reverse transcription polymerase chain reaction(RT-PCR) and Western blot respectively in these HUVEC. Results Paclitaxel could inhibit TNF-α induced Cathepsin K mRNA and Cathepsin K protein expression in a dose-dependent manner. There was no significant difference between 1 nmol/L paclitaxel group and TNF-α group；Paclitaxel could inhibit TNF-α induced Cathepsin K protein expression in a dose-dependent manner, comparing 1 nmol/L paclitaxel group and TNF-α group. Paclitaxel could inhibit TNF-α induced NF-κB mRNA and NF-κB protein expression in a dose-dependent manner. Conclusion Paclitaxel could decrease the expression of Cathepsin K and NF-κB stimulated with TNF-α in a dose-dependent manner,paclitaxel may inhibit the activation of NF-κB to reduce Cat K expression.

Abstract:Aim To investigate the correlation of Th17 cells and Th17-associated cytokines with carotid artery intima-media thickness(IMT) in essential hypertensive patients. Methods After carotid ultrasound examination, 206 essential hypertensive patients were categorized into three groups by the tertiles of IMT, namely, high tertile group, middle tertile group and low tertile group. Peripheral blood Th17 cell frequency and serum levels of Th17-associated cytokines interleukin-17(IL-17), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were tested and compared in three groups. The correlation between the various factors and carotid IMT was analyzed. Results In high tertile group, middle group and low group, respectively, Th17 cell frequency was 1.45%±0.30%, 1.19%±0.29%, 1.03%±0.28%; IL-17 was 24.03±6.38, 18.85±6.23, 15.84±5.36 ng/L; IL-6 was 87.09±13.65, 75.26±17.21, 68.40±16.15 ng/L; TNF-α was 77.24±14.91, 65.39±17.62, 60.30±17.51 ng/L. Th17 cell frequency, IL-17, IL-6, and TNF-α in high tertile group were higher than those in middle tertile group and low tertile group(P<0.05). Th17 cell frequency, IL-17, and IL-6 in middle tertile group were higher than those in low tertile group(P<0.05). Pearson correlation analysis showed that Th17 cell frequency, IL-17, IL-6, and TNF-α were positively correlated with carotid IMT(P<0.01). Multivariate linear stepwise regression analysis showed that Th17 cell frequency, IL-17, IL-6, and TNF-α were main risk factors for carotid IMT. Conclusion Th17 cell and Th17-associated cytokines are closely related to carotid artery IMT in patient with essential hypertension.

Abstract:Aim To investigate the plaque distribution in the bifurcation site of left anterior descending coronary artery(LAD) by means of volumetric intravascular ultrasound analysis. Methods The atherosclerotic plaque volumes in LAD were measured at LAD-diagonal bifurcation site in 53 cases. According to the position of diagonal branch, the vessel was divided into 4 quadrants:the carina side of bifurcation(quadrant 1), the pericardial side(quadrant 2), the opposite side of bifurcation(quadrant 3) and the myocardial side(quadrant 4). The relative distribution of plaque(the volume percent of each quadrant plaque in total plaque) was compared in each quadrant. Eccentricity index of plaque distribution(the ratio of plaque volume in quadrant 3 to plaque volume in quadrant 1) was compared in distal and proximal bifurcation section. Results The relative volumetric plaque distribution was the largest in the quadrant 3, followed by quadrant 4 and quadrant 2, and that was the smallest in the quadrant 1. Meanwhile, relative volumetric plaque distribution in the quadrant 4 was larger than that in the quadrant 2. In addition, the degree of vascular stenosis, the length of lesion and the eccentricity index of plaque distribution in distal bifurcation section were greater than that in proximal bifurcation section. Conclusions Whatever in the distal or proximal bifurcation site of LAD, the relative plaque distribution is the largest in the opposite side of bifurcation, and the smallest in the carina side of bifurcation. Furthermore, the lesion is more serious and the plaque distribution is more asymmetric in the distal bifurcation site.

Abstract:Aim To investigate the relationship between HSP70-hom(2437 T/C) single nucleotide polymorphism and hypertension, and to analyze the population distribution of this polymorphism. Methods Samples were collected through epidemiological surveys. The HSP70-hom single nucleotide polymorphisms were detected by the method of polymerase chain reaction-restriction fragment length polymorphism. Samples of 1291 cases(male 446 cases, female 845 cases) were analyzed, including 359 cases(male 138 cases, female 221 cases) in hypertension group, and 455 cases(male 134 cases, female 321 cases) in control group, excluding 477 cases with diabetes, liver, kidney, heart disease and cancer etc. Results The distributions of HSP70-hom single nucleotide polymorphism in the population were genotype CC 6%, CT 38% and TT 56%, allele C 25% and T 75%. The distribution of the 3 genotypes had statistical difference between men and women(χ²＝7.96, P＝0.029), and the distribution of alleles also had significant difference between men and women(χ²＝3.97, P＝0.046). The distribution of CC＋CT and TT genotypes had significant difference(χ²＝4.25, P＝0.039), and the distribution difference of allele C and T also had statistical significance(χ²＝4.769, P＝0.029), between male hypertension group and male control group. While all genotypes and alleles had no significant difference between female hypertension group and female control group. Conclusion HSP70-hom single nucleotide polymorphism is associated with male hypertension, and TT genotype and T allele may be the susceptible factors.

Abstract:Aim To explore the association between 4A4B insert/deletion polymorphism of endothelial nitric oxide synthase(eNOS) and coronary heart disease. Methods Genotypes of 4A4B locus were detected in 842 coronary heart disease patients and 842 age and gender matched healthy individuals using polymerase chain reaction and Gel electrophoresis and the association between them was analyzed. Results The frequency distributions of patients with smoking, diabetes, hypertension, obesity and lipid metabolic abnormity were significantly higher than those in controls. Genotype distributions in controls were in consistence with Hardy-Weinberg inheritance model. Allele 4A(10.2% vs. 6.9%, OR＝2.03, 95%CI＝1.39~2.44), genotype AA(3.0% vs. 0.9%, OR＝2.08, 95%CI＝1.45~2.67) and AA＋AB(17.4% vs. 13.1%, OR＝1.58, 95%CI＝1.08~1.94) of the locus were significantly associated with conorany heart disease. Stratifiying analysis results showed that genoytpe AA and 4A allele were significantly associated with the disease in each subgroup excluding non-drinking subgroup, respectively, and the disease risk of individuals carring AA genotype and 4A allele were 2.34, 2.59, 3.13 fold and 2.55, 2.77, 3.10 fold than those with BB genoytpe or 4B allele in diabetes, hepertension, and fact subgroups, respectively. Conclusions 4A allele and AA, AA＋AB genotypes of 4A4B locus within eNOS gene might be genetic susceptible factors for coronary heart disease, and these genetic factor of the locus could interact with status of smorking, drinking, diabetes, hypertension and fat to further increase susceptibility to the disease.

Abstract:Aim To investigate the relationship between brachial-ankle pulse wave velocity(baPWV) and aortic valve sclerosis(AVS) and the association of their severity, and the predictive value of AVS and baPWV in the diagnosis of coronary heart disease and three-vessel coronary artery disease among a group of hospital patients who underwent coronary angiography. Methods Performing coronary angiography, transthoracic echocardiography and the measurement of baPWV on 485 in-hospital patients, including 297 male cases and 188 female cases(average age 62.52±10.28 years). According to the results of echocardiography, patients were divided into AVS group and non-AVS group. They were also grouped by the number of valves involved and AVS scores. BaPWV was compared between each group. Patients were divided into 5 groups based on the results of coronary angiography:normal coronary, coronary atherosclerosis, 1-vessel disease, 2-vessel disease, 3-vessel±left main disease. To compare sensitivity, specificity, positive predictive value and negative predictive value of baPWV, AVS and their combination in the prediction of coronary heart disease and three-vessel coronary artery disease. To explore whether combining baPWV and AVS can improve the predictive value. Results There were 305 cases in AVS group and 180 cases in non-AVS group. BaPWV of AVS group(1536.57±285.06 cm/s) was significantly higher than non-AVS group(1484.92±241.75 cm/s, P<0.05). With different number of valves involved, baPWV value in 0-valve group was 1484.92±241.75 cm/s, in 1-valve group was 1499.61±259.57 cm/s, in ≥2-valve group was 1593.55±313.07 cm/s, and it had statistically significant difference(P<0.05). With the AVS scores, baPWV value in 0 score group was 1484.92±241.75 cm/s, in 1 score group was 1500.23±271.70 cm/s, in ≥2 scores group was 1586.16±296.26 cm/s, and it had statistically significant difference(P<0.05). AVS was superior to baPWV both in the prediction of coronary heart disease and three-vessel coronary artery disease. AVS had a positive predictive value of 91.1% in predicting coronary heart disease. BaPWV and AVS both positive had a high specificity in the prediction of coronary heart disease and three-vessel coronary artery disease(85.5% and 66.9%), better than separate prediction. High sensitivity appeared in the predicition of coronary heart disease and three-vessel coronary artery disease(90.4% and 95.3%) when either of baPWV and AVS was positive. Although AVS score ≥2 had a low sensitivity(33.6%) in the prediction of coronary heart disease, yet its specificity and positive predictive value were rather high(97.3% and 97.7% respectively). Conclusion BaPWV in AVS group was higher than in non-AVS group. With different number of valves involved, baPWV value in ≥2-valve group was significantly higher than baPWV value in 0-valve group and 1-valve group. With the AVS scores, baPWV value in 2 score group was significantly higher than baPWV value in 0 score group and 1 score group. With the combined application of baPWV and AVS in the prediction of coronary artery disease, both positive had higher specificity, either positive showed higher sensitivity. In the prediction of coronary heart disease, AVS score ≥2 showed low sensitivity but it had very high accuracy.

Abstract:Aim To investigate influence of probucol combined with rosuvastatin on carotid atherosclerotic plaque, blood lipid, inflammatory factor in patients with cerebral infarction complicated with diabetes mellitus. Methods146 patients with cerebral infarction complicated with diabetes mellitus were selected in hospital from December 2011 to December 2013, who were randomly divided into two groups. 73 patients were treated with rosuvastatin as control group. 73 patients were treated with probucol combined with rosuvastatin as observation group. Carotid artery ultrasound results, serum lipid index changes, inflammatory factor changes, S100β and NIHSS score changes, adverse reactions were compared between two groups. Results After treatment, carotid artery intima-media thickness(CAIMT), carotid intimal plaque area, detection rate of vulnerable plaque, total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDLC), high sensitivity C reactive protein(hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), S100β, urine micro albumin, NIHSS score reduced significantly in two groups, while high density lipoprotein cholesterol(HDLC) increased significantly. CAIMT, carotid intimal plaque area, detection rate of vulnerable plaque, TC, TG, LDLC, hs-CRP, IL-6, TNF-α, S100β, urine micro albumin, NIHSS score in observation group were significantly lower than control group, while HDLC was significantly higher than control group. Differences were statistically significant(P<0.05). There were no significant difference between observation group and control group in incidence of adverse reactions(abnormal liver and kidney function, dizziness headache, rash, myalgia, nausea and vomiting, gastrointestinaltract reaction, P>0.05). Conclusion Probucol combined with rosuvastatin is an effective method in treatment of cerebral infarction complicated with diabetes mellitus, which can reduce carotid atherosclerotic plaque and improve blood lipid status, decrease inflammatory factor level and has high safety.

Abstract:Aim To research the clinical significance of red blood cell distribution width(RDW) and mean platelet volume(MPV) on the formation of coronary collateral circulation(CCC) in patients with non-ST segment elevation myocardial infarction. Methods 166 patients with non-ST segment elevation myocardial infarction from Department of Cardiology of Nanyang Central Hospital and Henan Provincial People's Hospital were divided into impired group(n=98) and CCC good group(n=68) according to retrop classification method for grading CCC. RDW and MPV value were measured by automatic blood cell analyzer. Results RDW values were significantly higher in patients with impaired CCC than that in those with good CCC(18.20%±1.83% vs 13.17%±0.84%, P<0.05),and MPV values were observably lower in patients with impaired CCC than that in those with good CCC(8.16±1.22 fl vs 11.31±1.34 fl, P<0.05). In multivariate logistic regression analysis, high RDW, low MPV, high creatine kinase isoenzyme-MB(CK-MB), absence of preinfarction angina were closely related with impaired CCC. Conclusion In non-ST segment myocardial infarction, high RDW, low MPV, high CK-MB, absence of preinfarction angina were found to be independent predictors of impaired CCC.

Abstract:Aim To analyze the prognostic value of hypoalbuminemia for long-term outcome in elderly patients with chronic heart failure after propensity score stratification. Methods 1271 consecutive elderly patients with chronic heart failure were enrolled and divided into two groups according to serum albumin concentration on admission ＜35 g/L(hypoalbuminemia group) and ≥35 g/L(normoalbuminemia group). Propensity score stratification was conducted to reduce confounding bias. And then COX proportional-hazards regression modeling was used to evaluate the prognostic value of hypoalbuminemia for long-term outcome for the pre-stratification and post-stratification data. Results Before stratification, hypoalbuminemia group was older, had higher NYHA status, direct bilirubin, alkaline phosphatase, creatinine, BNP, less hypertension; lower hemoglobin, indirect bilirubin, TC, serum sodium on admission, EF on admission; faster heart rate on admission. During the median 23.9-month follow-up, there were 165 deaths(13.0%) for all causes, 76 in hypoalbuminemia group(46.1%), 260 in normoalbuminemia group(23.5%). The univariate COX regression analysis indicated that hypoalbuminemia was the strong independent risk for long-term mortality in elderly patients with chronic heart failure(HR was 2.540, 95% CI was 1.966~3.282, P<0.001). Adjusted for propensity score, the multivariate COX regression analysis indicated that the risk of long-term mortality in hypoalbuminemia patients increased 56.1% than the normoalbuminemia patients(HR was 1.561, 95%CI was 1.186~2.054, P＝0.001). After adjustment using propensity score stratification, the overall HR was 1.724, 95%CI was 1.311~2.268, which indicated that the risk of long-term mortality in hypoalbuminemia patients increased 0.724-time than the normoalbuminemia patients. Conclusions Hypoalbuminemia indicated the increasing of long-term mortality in elderly patients with chronic heart failure. It was possible to improve the prognosis of elderly patients with chronic heart failure by correcting hypoalbuminemia.

Abstract:Aim To analyze the clinical characteristics, interventional therapy effect and prognosis for the 70 patients with unprotected left main coronary artery(UPLM) lesion. Methods Clinical data of 70 patients who accepted the interventional therapy for UPLM lesion were collected from January 2012 to July 2013 in our hospital. Telephone or clinic follow-up was carried out after the operation. The clinical characteristics and effect of interventional therapy for patients were analyzed, and the related factors that influenced the clinical prognosis of interventional therapy were explored.Results The 70 patients included 74.3% male and 25.7% female. The average age was 69.30±9.95 years. The average of the left ventricular ejection fraction(LVEF) was 49.0%. The median value of the estimated glomerular filtration rate(eGFR) was 56 mL/(min·1.73 mm²). The average Syntax score was 26.5 and the median value of stents length was 34 mm. All patients were followed up for average of 13.3 months. The cumulative incidence of the major adverse cardiovascular event(MACE) estimated by Kaplan-Meier was 24.5%. No severe hemorrhage complication was observed after inteventional therapy. Univariate regression analysis with COX proportional hazards model revealed that the increase of LVEF would decrease the incidence of MACE(P=0.01), and the elevation of Syntax score would increase the incidence of MACE(P=0.03). Age≥70 years tended to increase the incidence of MACE(P=0.053), while the increase of eGFR tended to reduce the incidence of MACE(P=0.05). Multivariate regression analysis with COX proportional hazards model demonstrated that LVEF and eGFR had predictive value for the MACE(P=0.016 and P=0.17), while the predictive effect of Syntax score and age≥70 years were attenuated. Conclusions The interventional therapy of UPLM disease is effective and safe. The LVEF and eGFR are the major predictors of the MACE.

Abstract:Aim To establish the animal model of vein graft restenosis after coronary artery bypass grafting in patients with coronary artery disease. Methods 26 New Zealand rabbits were randomly divided into three groups:(1)high fat graft group(n＝10):rabbits treated by autologous external jugular vein grafting to common carotid artery and fed by high fat diet;(2)pure graft group(n＝10):rabbits treated by autologous external jugular vein grafting to common carotid artery and fed by normal diet;(3)normal control group(n＝6):rabbits fed by normal diet. The graft groups were performed by the external jugular vein anastomosis to the carotid artery bypass surgery. Blood flow was detected by color Doppler ultrasound, and the patency of vein graft was proved. Two months later, Doppler was used to detect the blood flow and intima thickness of vein graft, and the tissue specimens were taken for pathological examination, in order to understand whether there is thrombus in vein graft, proliferation and transfer of endothelial cell and smooth muscle cell, and proliferation of vascular matrix, etc. Results (1)All vein grafts were unobstructed after operation.(2)Two months after operation, color Doppler ultrasound examination showed that there were plaque formation, obvious stenosis and intima thickening of the vein grafts in high fat graft group, compared with the pure graft group and the normal control group.(3)The pathological examination showed that there were typical atherosclerotic changes such as shedding of the endothelial cells, intimal hyperplasia, smooth muscle cell migration, proliferation and lipid deposition on vein grafts in high fat graft group, while the changes in pure graft group and normal control group were not obvious. Conclusions The animal model of rabbit external jugular vein anastomosis to the carotid artery is reliable. It provides a simple and ideal model for the study of restenosis after vein grafts.

Abstract:Myocardial infarction is a common disease of the cardiovascular system which affects human health seriously. Pathogenesis of myocardial infarction is not fully clarified yet. Currently,interleukin-8 is believed to plays an important role in the development of myocardial infarction. Interleukin-8 not only modulates inflammation,but also stimulates angiogenesis. This review elaborates the progress of research of interleukin-8 in myocardial infarction.

Abstract:Macrophage can polarize two subtypes, pro-inflammatory M1 and anti-inflammatory M2,which affect the development process of atherosclerosis through regulatory inflammation. Studies suggest, although macrophage polarization plays an important role in pathophysiology of atherosclerosis, it is not clear that mechanism of regulatory macrophage polarization determines the outcome of inflammation in atherosclerosis. In this review, we can provide a new direction of preventing atherosclerosis and controlling inflammation through influence factors of macrophage polarization in atherosclerotic inflammation.

Abstract:Notch1 signaling pathway, as an evolutionarily conserved system of signal transduction, plays an important role in cardiovascular development and vascular repair throughout the embryonic period and postnatal day. Vascular calcification results not from a passive deposition of hydroxyapatite on vascular wall, but rather is an active cell-mediated process involving vascular smooth muscle cell(VSMC) transforming into osteoblast-like cells. It can be regulated by multiple factors and many signaling pathway. Recent studies indicate that Notch1 signaling pathway is significantly associated with vascular calcification. In this paper, the composition, effect and physiological function of Notch1 signaling pathway, the mechanism and regulation of vascular calcification, and the relationship between Notch1 signaling pathway and vascular calcification are summarized.