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ASurvey on Treatment of Hyperlipidemia inPatients with Coronary Artery Disease

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The Journal of Biomedical Research 1999年第2期23卷 86-89页

作者： yang zhijian(杨志健)\ yang Bing(杨兵) Zhu Tiebing(朱铁兵) Huang Jun(黄峻) Wang Haiyan(王海燕) cao kejiang(曹克将)\ Zhang Fumin(张馥敏) Ma Wenzhu department of cardiology, the first affiliated hospital of nanjing medical university, nanjing 210029, P. R. china

A retrospective analysis was made on the lipid level and management of those patients who experienced coronary angiography for suspected coronary artery disease and those who suffered from acute myocardial infarction admitted to our department from 1994 to 1997. It revealed: ①Incidence of elevated serum lipids (especially total cholesterol) was higher in patients with CHD than those without CHD; ② No significant difference of serum lipids in patients with single or multi vessel disease was seen except higher serum lipids in patients with multi vessel disease; ③Management for elevated lipid in our cases was not active, even neglected in our clinic practice. Attention should be paid on these problems.

关键词： survery hyperlipidemia coronary artery disease lipid lowing

Activation of calcium-sensing receptors is associated with apoptosis in a model of simulated cardiomyocytes ischemia/reperfusion

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The Journal of Biomedical Research 2010年第4期24卷 301-307页

作者： ling Yan Tlebing Zhu Tingting Sun liansheng Wang Shiyang Pan Zhengxlan Tao zhijian yang kejiang cao department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 Jiangsu Province China department of Clinical Key Laboratory the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 Jiangsu Province China department of Biochemistry Nanjing Medical University Nanjing 210029 Jiangsu Province China

Objective： Calcium-sensing receptors （CaSRs） are G-protein coupled receptors which maintain systemic calcium homeostasis and participate in hormone secretion, activation of ion channels, cell apoptosis, proliferation, and differentiation. Previous studies have shown that CaSRs induce apoptosis in isolated adult rat heart and in normal neonatal rat cardiomyocytes by G-protein-PLC-IP3 signaling transduction. However, little knowledge is presently available concerning the role of CaSRs in the apoptosis induced by ischemia and reperfusion in neonatal cardiomyocytes. Methods： Primary neonatal rat ventricular cardiomyocytes were incubated in ischemiamimetic solution for 2 h, and then re-incubated in normal culture medium for 24 h to establish a model of simu- lated ischemia/reperfusion （I/R）. Cardiomyocyte apoptosis was detected by terminal deoxynucleotidyl transferase- mediated dUTP nick end labeling （TUNEL）. The expression of CaSRs mRNA was detected by real-time reverse transcription polymerase chain reaction （RT-PCR）. In addition, the expressions of caspase-3 and Bcl-2 were analyzed by western blot. Results： The simulated I/R enhanced the expression of CaSRs and cardiomyocyte apoptosis. GdCl3, a specific activator of CaSRs, further increased the expression of CaSRs and cardiomyocyte apoptosis, along with up-regulation of caspase-3 and down-regulation of Bcl-2. Conclusion： CaSRs are associated with UR injury and apoptosis in neonatal rat ventricular cardiomyocytes via suppressing Bcl-2 and promoting caspase-3 expression.

关键词： calcium sensing receptors apoptosis cardiomyocyte ischemia/reperfusion

The V264M polymorphism of tissue factor pathway inhibitor gene in patients with acute coronary syndrome

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Journal of nanjing medical university 2006年第5期20卷 271-274页

作者： Tiebing Zhu Jun Wang Leming Fan Yong li zhijian yang kejiang cao Jun Huang department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 Atherosclerotic Reaserch Center of nanjing medical university Nanjing 210029 China

Objective： To investigate V264M polymorphism of tissue factor pathway inhibitor （TFPI） in patients with acute coronary syndrome （ACS） in Chinese. Methods ： The genotypes of V264M were detected by polymerase chain reaction （PCR） and restriction fragment length polymorphism （PCR-RFLP） in 136 patients with ACS and 106 healthy controls with their plasmal f-TFPI tested by enzyme linked immunosorbent assay （EliSA）. Results： Two genotypes were found in V264M： GG and GA. The distribution frequencies of alleles and genotypes were in accordance with those predicted by Hardy Weinberg equilibrium in the present study （χ2 = 0.437, P 〉 0.05）. Plasma f-TFPI level was lower in A allele bearer than that in non-A allele carriers and higher in ACS than control subjects （P〈0.05）. No relationship was found between ACS and V264M polymorphism （P〉0.05）. Conclusion： The V264M polymorphism may have an impact on the plasma level of free TFPI（f-TFPI）, but it has no relationship with ACS.

关键词： acute coronary syndrome TFPI polymorphism plasma

HGF percutaneous endocardial injection induces cardiomyocyte proliferation and rescues cardiac function in pigs

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The Journal of Biomedical Research 2010年第3期24卷 198-206页

作者： Zhengxian Tao Bo Chen Yingming Zhao Hongwu Chen liansheng Wang Yonghong Yong kejiang cao Qifeng Yu Danian Ke` Hua Wang Zuze Wu zhijian yang department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 Jiangsu Province China. MieroPort medical (Shanghai) CO. Ltd. Shanghai 201203 China department of Experimental Hematology Beijing Institute of Radiation Medicine Beijing 100850 China

Objective：To investigate the effect of cardiomyocyte proliferation induced by human hepatocyte growth factor（HGF）in pigs with chronic myocardial infarction（CMI）.Methods：A steerable,deflectable 7F catheter incorporating a 27-guage needle was advanced percutaneously to the left ventricular myocardium of 18 pigs with *** were randomized（1：1：1）to receive adenoviral vector HGF（total dose,1×10^10 genome copies）,which was administered as five injections into the infarcted myocardium（total,1.0 mL）,or saline,or Ad-null（control groups）.Injections were guided by Ensite NavX left ventricular electroanatomical *** and cyclin proteins were detected by western blot and immunoprecipitation *** and immunohistochemical analysis determined proliferating *** perfusion and cardiac function were estimated by Gated-Single Photon Emission Computed Tomography（G-SPECT）.Results：Western blot analyses showed that HGF were predominantly expressed in the infarct core and border in the myocardium of the infarcted heart.G-SPECT analysis indicated that the HGF group had better cardiac function and myocardial perfusion four weeks after the injection of Ad-HGF than before the injection of *** treatment there were more proliferating cardiomyocytes in the HGF group compared to either of the control ***,the HGF group myocardial samples expressed higher levels of p-Akt,cyclin A,cyclin E,cyclin D1,cdk2,cdk4 than those in the control ***：The over-expression of HGF activates pro-survival pathways,induces cardiomyocyte proliferation,and improves the perfusion and function of the porcine CMI heart.

关键词： HGF EnSite NavX cardiac function gene therapy proliferation myocardial infarction

Clopidogrel improves aspirin response after off-pump coronary artery bypass surgery

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The Journal of Biomedical Research 2014年第2期28卷 108-113页

作者： Xuezhong Wang Xiaoxuan Gong Tiantian Zhu Qiu Zhang yangyang Zhang Xiaowei Wang zhijian yang chunjian lia department of cardiology the First Affiliated HospitalNanjing Medical University department of cardiology Maanshan people's Hospital department of cardiology Jiangning People's Hospital department of cardiology the Second People's Hospital of Changzhou City department of Cardiac-thoracic Surgery the First Affiliated HospitalNanjing Medical University

We sought to assess the incidence of aspirin resistance after off-pump coronary artery bypass （OPCAB） surgery, and investigate whether clopidogrel can improve aspirin response and be safely applied early after OPCAB surgery. Sixty patients who underwent standard OPCAB surgery were randomized into two groups. One group （30 patients） received mono-antiplatelet treatment （MAPT） with aspirin 100 mg daily and the other group received dual anfiplatelet treatment （DAPT） with aspirin 100 mg daily plus clopidogrel 75 mg daily. Platelet aggregations in response to arachi- donic acid （PLAA） and adenosine diphosphate （ADP）（PLADP） were measured preoperatively and on days 1 to 6, 8 and 10 after the antiplatelet agents were administered. A PLAA level above 20% was defined as aspirin resistance. Postoperative bleeding and other perioperative variables were also recorded. There were no significant differences between the two groups in baseline characteristics, average number of distal anastomosis, operation time, postoperative bleeding, ventilation time and postoperative hospital stay. However, the incidence of aspirin resistance was significantly lower in the DAPT group than that in the MAPT group on the first and second day after antiplatelet agents were given （62.1% vs, 32.1%, 34.5% vs. 10.7%, respectively, both P 〈 0.05）. There was no significant difference in postoperative complication between the two groups. DAPT with aspirin and clopidogrel can be safely applied to OPCAB patients early after the procedure. Moreover, clopidogrel reduces the incidence of OPCAB-related aspirin resistance.

关键词： aspirin clopidogrel aspirin resistance off-pump coronary artery bypass (OPCAB)

Comparison of efficacy and safety of native eptifibatide vs. tirofiban in patients with acute coronary syndrome undergoing percutaneous coronary intervention

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Journal of nanjing medical university 2008年第4期22卷 238-242页

作者： Jianjin Tang liansheng Wang Hui Wang Mingwei Wang kejiang cao zhijian yang department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 Jiangsu province China

To compare clinical outcomes and safety of eptifibatide or tirofiban in patients with acute coronary syndrome（ACS） undergoing percutaneous coronary intervention（PCI）. Methods：Thirty-six patients with ACS（unstable angina/non-ST-segment elevation myocardial infarction, UA/NSTEMI） who underwent PCI were randomly divided into two groups to receive eptifibatide or tirofiban treatment. Eptifibatide or tirofiban was predominantly initiated in the catheter laboratory before the intervention. In-hospital and 30-day MACE outcomes; bleeding as well as platelet counting were investigated in those two groups. Results：No in-hospital and 30-day MACE event occurred in the two groups. The number of ischemia leads after treatment reduced compared to that before PCI in the two groups. There was improvement in the number of ischemia leads for 24 h after administration in the tirofiban group than those in eptifibatide group（4.21 ± 2.46 vs. 3.89 ± 3.31, P =0.03）. The two groups showed no incidence of massive bleeding. Minor bleeding rates were 16.7% and 22.2% in the two groups respectively. Conclusion：Eptifibatide as an adjunct to PCI may further decrease the incidence of ischemia event in patients with ACS and improve the safety, but its long-term efficacy and side effects need further observation.

关键词： acute coronary syndrome percutaneous coronary intervention glycoprotein(GP Ⅱb/Ⅲ a) antagonist eptifibatide tirofiban

The changes of Hs-CRP and WBC count after percutaneous coronary intervention in different types of coronary heart diseases

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Journal of nanjing medical university 2008年第4期22卷 246-249页

作者： Xiaobing Ji zhijian yang chunjian li Enzhi Jia Zhuowen Xu Sheng Zhang Keijiang cao Wenzhu Ma department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210020 Jiangsu Province China

Objective： To investigate the regulation of High sensitive C-reactive protein（Hs-CRP） and WBC count in patients with coronary heart disease（CHD） by percutaneous transluminal intervention（PCI） and to discuss the mechanism of inflammatory reaction after coronary stenting. Methods：127 patients who received successful percutaneous transluminal coronary stenting, were divided into groups of stable angina（SAP）, unstable angina（UAP）, and acute myocardial infarction（AMI） according to their clinical types. Another 41 stable angina patients with more than 70% of coronary artery tenosis who did not receive PCI served as control. Serum Hs-CRP levels and WBC count were determined before intervention, 3 days and 7 days post PCI and the data were analyzed statistically by t-test. Results： There showed no difference in clinical baseline characteristics between groups. The serum Hs-CRP level and WBC count was gradually raised in the UAP and AMI group（how about SAP group, andhad no difference in CAG group and SAP group）. After PCI serum HsCRP levels and WBC counts were significantly higher in the SAP group than in the coronary angiography group（CAG） at 3 days and had no difference at 7 days. In the UAP and AMI group, the serum Hs-CRP level at 3 days and 7 days declined obviously, however serum WBC count did not decrease apparently. Conclusion： The serum Hs-CRP level and WBC count elevate transiently after PCI. There are different inflammatory reactions in different types of coronary heart diseases after coronary stenting procedure.

关键词： high sensitive C-reactive protein(Hs-CRP) coronary heart disease percutaneous transluminal intervention(PCI) WBC count

Acute and mid-term results of pecutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy

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Journal of nanjing medical university 2007年第3期21卷 143-146页

作者： Tiebing Zhu zhijian yang liansheng Wang Hui Wang kejiang cao Jun Huang Wenzhu Ma department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China

Objective： To assess the acute and mid-term results of cardiac function improvements and left ventricular outflow tract gradient （LVOTG）changes in 30 patients displaying hypertrophic obstructive cardiomyopathy （HOCM） treated with percutaneous transluminal septal myocardial ablation （PTSMA）. Methods： PTSMA was intended for 32 patients comprising of 13 women and 19 men （average years being 54.1 ± 15.5） to be treated in accordance with the following inclusion criteria： The New York Heart Association（NYHA） definition for cardiac functional class Ⅲ or Ⅳ ,or class Ⅱ but for whom medical therapies were not tolerated or with syncope; intraventricular septal（IVS） and left ventricular posterior wall（LVPW） hypertrophy asymmetrically associated with ratio of IVS to LVPW≥1.3 and LVOTG≥50 mm Hg at rest or ≥100 mm Hg at provocation （Valsalva maneuver）. The target vessels were determined by coronary arteriography that demonstrated more than one septal branch and probatory balloon occlusion produced greater than 50% decrease of LVOTG. Once the target vessel established, the alcohol was administrated into septal ventricular via over-the-wire balloon. LVOTG was assessed by means of echocardiography measurements immediately after procedure and 3 months. Simultaneously, cardiac function class was also evaluated. Results： Two patients were abandoned prior to intervention due to inappropriate septal target vessels and DDD Pacemakers were chosed. Immediately after the procedure, resting LVOTG was reduced from 73.8 ± 35.5 to 16.6 ± 7.8 mmHg, at provocation LVOTG from 149.3 ± 42.5 to 61.9 ± 63.0 mmHg（P 〈 0.0001 each） by echocardiography measurements. After 3 months, the mean New York Heart Association class was reduced from 2.8 ± 0.6 to 1.1 ± 1.0（P 〈 0.0001） and the LVOTG also remained decrease（28.5 ± 6.4 mmHg at rest and 75.3 ± 11.6 mmHg at provocation）. Conclusion： PTSMA is a promising nonsurgical technique for relief of symptoms and reduction of LVOTG in hypertrophic obstructive cardiomyo

关键词： hypertrophy cardiomyopathy ablation echocardiography

Comparative study of effects of bone marrow cell vs. Ad_5-HGF administration via non-infarct-related artery injection in myocardial infarction in swine

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Journal of nanjing medical university 2007年第2期21卷 72-76页

作者： liansheng Wang zhijian yang Wei Wang Dongchao Ma Shunlin Xu Yuqing Zhang Fang Zhou Bo Chen kejiang cao Jun Huang department of cardiology the First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China department of cardiology the Third Hospital of Beijing University Beijing 100083 China

Objective： To evaluate the effect of transplanting bone marrow-derived mesenchymal stem cells （BM-MSCs） or adenovirus5- hepatocyte growth factor（Ad5-HGF） via non-infarct-related artery injection in swine myocardial infarction models. Methods：BMMSCs were obtained from swine bone marrow and expanded in vitro to a purity of 〉50%. A myocardial infarction（MI） was created by ligating the distal left anterior descending artery in swine. Either BM-MSCs （5 × 10^6/ml） or Ad5-HGF （4 × 10^9 pfu） were transfused via the right coronary artery （non-infarcted artery） four weeks after MI. Gate-controled cardiac perfusion imaging was performed at the end of four and seven weeks after LAD ligation, to evaluate heart function and cardiac perfusion. Morphologic and histologic characteristics of the hearts were also studied. Results：（1）The gate-controlled cardiac perfusion imaging showed that the improvement in LVEF was greater in both treatment groups than in control group at the 4^th weeks. （2）In both treatment groups, capillary density was significantly higher than that of control group（P 〈 0.05）. Conclusion ：BM-MSCs or Ad5-HGF transplantation via non-infarcted artery administration can stimulate angiogenesis and improve heart function, but there was no difference in therapeutic efficacy between BM-MSCs and Ad5-HGF.

关键词： Bone marrow-derived mesenchymal stem cells hepatocyte growth factor angiogenesis