急性脑梗塞患者粘附分子CD_(18)、CD_(54)表达的研究

[目的]探讨粘附分子CD18、CD54粘附功能及其表达变化与急性脑梗塞(ACI)关系.[方法]用流式细胞术检测88例ACI患者白细胞粘附分子CD18、CD54含量与脑梗塞发生时程、部位、面积及治疗前后表达。并与30例正常人作对照.[结果]ACI患者CD18、CD54表达明显增高,与正常对照组比较差异显著(P<0.05),与梗塞面积、部位关系不大;ACI患者CD18、CD54表达在7d内均可有较高水平的表达,治疗10d后表达降低,治疗前后比较CD18、CD54差异有意义(P<0.05).[结论]CD18、CD54参与脑梗塞发生发展病理过程.可做为诊断脑梗塞、评估预后的一项辅助指标.     

脑梗塞患者血中一氧化氮对血小板功能的影响

[目的]研究脑梗塞患者血中一氧化氮(NO)的含量与血小板功能之间的关系.[方法]将20例脑梗塞患者分别于发病急性期和稳定期采用硝酸还原酶法测血中NO含量;用光电比浊法和免疫荧光分析法分别测定血小板聚集率(PAgT)和血小板α-颗粒膜蛋白(GMP-140)水平;同时检测正常对照15例[结果]血清中NO含量在发病急性期较正常对照明显增高(P<0.01).同时,PAgT与正常对照有显著性差异(PADP<0.05,PADR<0.01);而血小板GMP-140在急性期和稳定期较正常对照均有显著性差异(P<0.01).[结论]脑梗塞发病急性期随着血中NO含量的增高,导致PAgT受抑,血小板GMP-140水平减低.     

Long-term inhibition of Na+/H+ exchange attenuates cardiac remodeling after myocardial infarction in rats

Objective: In addition to pH regulation, Na⁺/H⁺ exchange (NHE) has been shown to facilitate cell growth and proliferation. However, the effects of long-term inhibition of Na⁺/H⁺ exchange on cardiac structural and functional remodeling post myocardial infarction (MI) are still controversial. The present study was therefore carried out to further investigate the effects of long-term treatment with cariporide, a specific inhibitor of NHE-1, on cardiac remodeling after MI in rats; Methods: Male Wistar rats that underwent coronary ligation were randomly selected for cariporide treatment starting 6 h after induction of MI or no treatment. Treatment was continued up to 6 weeks post MI, after which, the arterial, venous and left ventricular catheters were chronically implanted. Twenty-four h later, after hemodynamic signals were recorded in conscious rats, they were sacrificed and hearts were taken out for morphological examinations; Results: Cariporide treatment decreased the heart weight and heart weight to body weight ratio (bothP<0.05), decreased left ventricular end-diastolic pressure (P<0.001), improved myocardial contractility (dP/dt _max) (P<0.05) and tended to increase the survival of treated rats compared to that of untreated infarct rats; Conclusion: The results of the present study indicate that the long-term inhibition of NHE with cariporide can attenuate cardiac structural remodeling and improve left ventricular dysfunction in infarcted rats, and suggest that Na⁺/H⁺ exchange inhibition could be an effective therapeutic strategy for myocardial infarction-induced heart failure.     

Creation of reversed phase high-performance liquid chromatographic technique to assay platelet-activating factor

Objective: To establish a new assay for platelet-activating factor (PAF), to compare it with bio-assay; and to discuss its significance in some elderly people diseases such as cerebral infarction and coronary heart disease. Methods: To measure PAF levels in 100 controls, 23 elderly patients with cerebral infarction and 65 cases with coronary heart disease by reversed phase high-performance liquid chromatographic technique (rHPLC). Results: rHPLC is more convenient, sensitive, specific, and less confusing, compared with bio-assay. The level of plasma PAF in patients with cerebral infarction was higher than that in the controls (P<0.01), and in patients with coronary heart disease. Conclusion: Detection of PAF with rHPLC is more reliable and more accurate. The new assay has important significance in PAF research.     

Homocysteine status and acute myocardial infarction among Tamilians

Myocardial infarction is a major consequence of coronary artery disease. Apart from the traditional risk factors of myocardial infarction, recently many reports have suggested that hyperhomocysteinemia plays important role in myocardial infarction. Plasma homocysteine level was determined in 60 myocardial infarction patients and in 35 age matched healthy individuals. Statistically significant differences (p<0.01) were observed in the mean of plasma homocysteine concentrations between the acute myocardial infarction patients (24.59±6.14 mM/L) and in normal healthy individuals (13.73 ±3.54 mM/L). The level of homocysteine in myocardial infarction patients is significantly high (p <0.01) among myocardial infarction patients when compared to that of the controls. The the present study indicates a strong association between plasma homocysteine and acute myocardial infarction among Tamilians, thus implying plasma homocysteine as a possible risk factor for myocardial infarction.     

Renal insufficiency is an independent predictor of in-hospital mortality for patients with acute myocardial infarction receiving primary percutaneous coronary intervention

Objective:To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infarction (ASTEMI), who were treated with emergency percutaneous coronary intervention (PCI). Methods: 420 patients hospitalized in Peking University First Hospital, diagnosed with ASTEMI treated with emergency (PCI) from January 2001 to June 2011 were enrolled in this study. Estimated glomerular filtration rate (eGFR) was used as a measure of renal function. We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function. Results:There was a significant increase in the concentrations of fibrinogen and D-Dimer (P<0.05) and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease (CKD; eGFR<60 ml/(min·1.73 m2)) (P<0.01). CKD (eGFR<60 ml/(min·1.73 m2)) was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly (P=0.032, odds ratio (OR) 4.159, 95% confidence interval (CI) 1.127-15.346). Conclusions:Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.     

老年慢性肺心病伴发急性心肌梗死的分析

目的探讨老年慢性肺心病伴发急性心肌梗死(AMI)的临床特点.方法对66例老年慢性肺心病伴发AMI的病人(A组)进行分析,并与老年单纯冠心病AMI152例(B组)作比较.结果A组疼痛发生率(45.4%)显著低于B组(83.9%)(p＜0.01),A组急性左心衰、心源性休克发生率显著高于B组,分别为53.1%与25.0%,48.4%与21.7%(p＜0.05),A组病死率(42.4%)显著高于B组(15.7%),肺心病对其伴发AMI的发生部位无影响.结论对老年肺心病患者突然发生的急性左心衰和/或心源性休克应高度警惕伴发AMI的可能.     

Review:Cell therapy in congestive heart failure

Congestive heart failure (CHF) has emerged as a major worldwide epidemic and its main causes seem to be the aging of the population and the survival of patients with post-myocardial infarction. Cardiomyocyte dropout (necrosis and apoptosis) plays a critical role in the progress of CHF; thus treatment of CHF by exogenous cell implantation will be a promising medical approach. In the acute phase of cardiac damage cardiac stem cells (CSCs) within the heart divide symmetrically and/or asym-metrically in response to the change of heart homeostasis, and at the same time homing of bone marrow stem cells (BMCs) to injured area is thought to occur, which not only reconstitutes CSC population to normal levels but also repairs the heart by dif-ferentiation into cardiac tissue. So far, basic studies by using potential sources such as BMCs and CSCs to treat animal CHF have shown improved ventricular remodelling and heart function. Recently, however, a few of randomized, double-blind, pla-cebo-controlled clinical trials demonstrated mixed results in heart failure with BMC therapy during acute myocardial infarction.     

Serum Paraoxonase (PON1) Activity in North-West Indian Punjabi’s with Acute Myocardial Infarction

Human serum paraoxonase-1 (PON1), an enzyme on HDL prevents oxidation of LDL thereby preventing the development of atherosclerosis. Studies done so far have lead to conflicting results. As studies are lacking in North-West Indian Punjabi’s, a distinct ethnic group with high incidence of coronary artery disease, we determined PONase activity in this population. It has been postulated that sudden lowering of serum PONase may lead to precipitation of acute myocardial infarction. We determined serum PONase activity and lipids in 100 patients each of AMI (within 24 h of onset), stable CAD and 100 age and sex matched healthy controls. These were again determined after 6 weeks in AMI patients. The mean serum PONase activity was lowest in AMI patients (23.26 U/ml) followed by stable CAD patients (102.0 U/ml) where as in controls was highest (179.8 U/ml). In patients with AMI, activity was significantly higher at 6 weeks as compared to that after acute event (49.39 %; p < 0.05). Sudden lowering of serum PONase activity in a population which already has lower activity may be one of the risk factors for development of AMI.     

三七总皂甙对大鼠脑出血灶周围神经元Bcl-2/Bax及脑含水量变化的影响

研究大鼠脑出血给予三七总皂甙治疗后,神经元Bcl-2和Bax的表达有无变化,并观察脑出血大鼠在不同时间点相干/湿重法测定脑含水量的变化.神经行为学检测结果表明,脑出血组大鼠的神经功能评分分值升高;2d后治疗组大鼠与脑出血组相比分值下降（P＜0.01）.免疫组织化学结果显示,治疗组Bcl-2的阳性表达较脑出血组高（P＜0.01）、Bax的阳性表达较脑出血组低（P＜0.01）,Bcl-2/Bax蛋白比值增高;脑含水量即12 h开始增加,24 h后比较明显,48 h达高峰,7d之后与正常组无明显差异.三七总皂甙治疗组48 h ～72h干预后,脑含水量明显低于其脑出血组（P＜0.05）.