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Calculation of Coronary Angiographic Total Blush in Patients with Coronary Artery Disease and its Prognostic Implication

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Chinese Medical Journal 2015年第18期128卷 2485-2490页

作者： Jing-Jing gai lu-yue gai Jian-Jun Yan Qin-Hua Jin Department of Cardiology Chinese People's Liberation Army General Hospital Beijing 100853 China

Background： Myocardial perfusion grade （MPG） is an accepted method of evaluating myocardial perfilsion. However, it does not take into the account, the extent of the perfusion. We hypothesized that myocardial blush area times MPG （total blush） would be more accurate than simple MPG, and yield better prognostic information. Methods： About 34 patients were recruited alter they had consented to both coronary angiography （CAG） and single photon emission computed tomography （SPECT）, and divided into two groups. A special dedicated computer was employed to calculate the total blush. The CAG was performed as a conventional way. Scintigraphic technetium 99m methoxyisobutyl-isonitrile rest and stress images were evaluated quantitatively. The comparison was made between stenosis versus chronic total occlusion （CTO）, MPG 1, 2 versus MPG 3, percutaneous intervention （PC1） successful versus failure. A correlation was made between ejection traction （EF） and myocardial perfusion by MPG, total blush, SPECT, and syntax score. Results： The perfusion indices of total blush, summed difference score （SDS） and syntax score were insignificant between the two groups （P 〉 0.05）. However, the left ventricular end diastolic volume was significantly larger in CTO （P 〈 0.05）. The patients with stenosis had better MPG than with CTO （P 〈 0.05）. The increased MPG was associated with increased total blush, higher syntax score, and EF （P 〈 0.05）. Successful PCI resulted in better perfusion indicated by increased total blush, and MPG （P 〈 0.05） but successful PC1 did not change syntax score. EF and SDS significantly. Multivariate linear analysis with EF as the dependent factor and syntax score, SDS, total blush, blush area, and MPG as the independent factors showed a significantly higher degree of correlation （R = 0.87, P 〈 0.05）. Conclusion： Alter PCI the total blush and EF improved significantly indicating its potential application in the thture.

关键词： Coronary Heart Disease: Ejection Fraction Myocardial Perfusion Percutaneous Coronary Intervention: Single PhotonEmission Computed Tomography Syntax Score

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Four-year clinical outcome in asymptomatic patients undergoing coronary computed tomography angiography

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Chinese Medical Journal 2013年第9期126卷 1630-1635页

作者： ZHANG Kai-yi gai lu-yue gai Jing-jing HE Bin GUAN Zhi-wei Department of Cardiology Chinese People's Liberation Army General Hospital Beijing 100853 China Hospital of General Political Department of Chinese People's Liberation Army Beijing 100120 China

Background Percutaneous coronary intervention （PCI） is indicated for angina with coronary stenosis. However, PCI for asymptomatic coronary stenosis remains controversial. We prospectively followed a group of patients for four years who underwent coronary computed tomography angiography （CCTA） for major adverse cardiac events （MACE）. We hypothesized that the results of this trial would reliably reflect the natural outcome of the coronary disease. Methods Consecutive patients who underwent CCTA from June 2008 to May 2009 were selected. Those who could not be reached by telephone, had significant angina, had CT images that were not interpretable, or poor kidney and left ventricular （LV） function were excluded. The patients were divided into five groups： group A normal CCTA without stenosis, group B mild stenosis （1%-49%）, group C moderate stenosis （50%-74%）, group D severe stenosis （≥75%） and they were treated with optimal medical therapy （OMT） or PCI. The group E had PCI before the CCTA examination. The patients were then followed for MACE after different treatments. MACE included acute myocardial infarction （MI）, heart failure （HF） and death. Results The patient population consisted of 419 patients. The follow-up time was （51±5） months. The age was （60±31） years. Male made up 67.78% of the population （n=284）. A total of 51 cases of MACE occurred including 25 MI, eight HF and 18 all-cause deaths. There was no MACE in group A. Although MACE occurred in two patients in group B, they were not attributed to cardiac death. We further compared the MACE in groups C-E and no significant difference was found （P 〉0.05）. However, a difference was detected among patients with unstable angina pectods （UAP）, stable angina pectoris （SAP）, re-hospitalization, and cerebrovascular events from groups A-E （P 〈0.05）. The plaque scores were used to predict MACE. The scores progressively increased significantly with lesion severity （P 〈0.05）. Receiver operating curve （ROC） was performed to

关键词： coronary computed tomography angiography optimal medical therapy percutaneous coronary intervention coronary artery disease

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Deep Insight of Design,Mechanism,and Cancer Theranostic Strategy of Nanozymes

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Nano-Micro Letters 2024年第2期16卷 165-217页

作者： lu Yang Shuming Dong Shili gai Dan Yang He Ding Lili Feng Guixin Yang Ziaur Rehman Piaoping Yang Key Laboratory of Superlight Materials and Surface Technology Ministry of EducationCollege of Materials Science and Chemical EngineeringHarbin Engineering UniversityHarbin 150001People’s Republic of China Yantai Research Institute Harbin Engineering UniversityYantai 264000People’s Republic of China Key Laboratory of Green Chemical Engineering and Technology of Heilongjiang Province College of Material Science and Chemical EngineeringHarbin University of Science and TechnologyHarbin 150040People’s Republic of China Department of Chemistry Quaid-i-Azam UniversityIslamabad 45320Pakistan

Since the discovery of enzyme-like activity of Fe3O4 nanoparticles in 2007,nanozymes are becoming the promising substitutes for natural enzymes due to their advantages of high catalytic activity,low cost,mild reaction conditions,good stability,and suitable for large-scale ***,with the cross fusion of nanomedicine and nanocatalysis,nanozyme-based theranostic strategies attract great attention,since the enzymatic reactions can be triggered in the tumor microenvironment to achieve good curative effect with substrate specificity and low side ***,various nanozymes have been developed and used for tumor *** this review,more than 270 research articles are discussed systematically to present progress in the past five ***,the discovery and development of nanozymes are ***,classification and catalytic mechanism of nanozymes are ***,activity prediction and rational design of nanozymes are focused by highlighting the methods of density functional theory,machine learning,biomimetic and chemical ***,synergistic theranostic strategy of nanozymes are ***,current challenges and future prospects of nanozymes used for tumor theranostic are outlined,including selectivity,biosafety,repeatability and stability,in-depth catalytic mechanism,predicting and evaluating activities.

关键词： Nanozymes Classification Prediction and design Catalytic mechanism Tumor theranostics

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Transplantation of autologous adipose-derived stem cells ameliorates cardiac function in rabbits with myocardial infarction

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Chinese Medical Journal 2007年第4期120卷 300-307页

作者： ZHANG Duan-zhen gai lu-yue LIU Hong-wei JIN Qin-hua HUANG Jian-hua ZHU Xian-yang Department of Cardiology General Hospital of Shenyang MilitaryRegion Shenyang 110016 China Department of Cardiology Chinese PLA General Hospital Beijing 100853 China. Department of Basic Medical Research Chinese PLA ~eneral Hospital Beijing 100853 China.

Background Adipose-derived stem cells （ADSCs） are capable of differentiating into cardiomyogenic and endothelial cells in vitro. We tested the hypothesis that transplantation of ADSCs into myocardial scar may regenerate infracted myocardium and restore cardiac function. Methods ADSCs were isolated from the fatty tissue of New Zealand white rabbits and cultured in Iscove＇s modified dulbecco＇s medium. Three weeks after ligation of left anterior descending coronary artery of rabbits, either a graft of untreated ADSCs （UASCs, n=14）, 5-azacytidine-pretreated ADSCs （AASCs, n=13）, or phosphate buffer saline （n=13） were injected into the infarct region. Transmural scar size, cardiac function, and immunohistochemistry were performed 5 weeks after cell transplantation. Results ADSCs in culture demonstrated a fibroblast-like appearance and expressed CD29, CD44 and CD105. Five weeks after cell transplantation, transmural scar size in AASC-implanted hearts was smaller than that of the other hearts. Many ADSCs were differentiated into cardiomyocytes. The AASCs in the prescar appeared more myotube-like. AASCs in the middle of the scar and UASCs, in contrast, were poorly differentiated. Some ADSCs were differentiated into endothelial cells and participate in vessel-like structures formation. All the ADSC-implanted hearts had a greater capillary density in the infarct region than did the control hearts. Statistical analyses revealed significant improvement in left ventricular ejection fraction, myocardial performance index, end-diastolic pressure, and peak ＋dP/dt, in two groups of ADSC-implanted hearts relative to the control hearts. AASC-implanted hearts had higher peak -dP/dt values than did control, higher ejection fraction and peak ＋dP/dt values than did UASC-implanted hearts. Conclusions ADSCs transplanted into the myocardial scar tissue formed cardiac islands and vessel-like structures, induced angiogenesis and improved cardiac function. 5-Azacytidine pretreatment before

关键词： adipose stem cells transplantation myocardial infarction neovascularization

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Intravascular Ultrasound Classification of Plaque in Angiographic True Bifurcation Lesions of the Left Main Coronary Artery

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Chinese Medical Journal 2016年第13期129卷 1538-1543页

作者： Li Li Debabrata Dash lu-yue gai Yun-Shan Cao Qiang Zhao Ya-Rong Wang Yao-Jun Zhang Jun-Xia Zhang Department of Cardiology Guangzhou Red Cross Hospital Jinan University Guangzhou Guangdong 510020 China Department of Cardiology S. L. Raheja (A Fortis Associate) Hospital Mumbai Maharashtra India Oepartment of CardiologY'Chinese People's Liberation Army' General Hospital Beijing 100851 China Department of Cardiology Gansu Provincial People's Hospital Lanzhou Gansu 730000 China Department of Cardiology Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu 210006 China

Background： Accurately, characterizing plaques is critical for selecting the optimal intervention strategy for the left main coronary artery （LMCA） bifurcation. Coronary angiography cannot precisely assess the location or nature of plaques in bifurcation lesions. Few intravascular ultrasound （IVUS） classification scheme has been reported for angiographic imaging of true bifurcation lesions of the unprotected LMCA thus far. In addition, the plaque composition at the bifurcation has not been elucidated. This study aimed to detect plaque composition at LMCA bifurcation lesions by IVUS. Methods： Fifty-eight patients were recruited. The location, concentricity or eccentricity, site of maximum thickness, and composition of plaques of the distal LMCA, ostial left anterior descending （LAD） coronary artery and, left circumflex （LCX） coronary artery were assessed using IVUS and described using illustrative diagrams. Results： True bifurcation lesions of the unprotected LMCA were classified into four types： Type A, with continuous involvement from the distal LMCA to the ostial LAD and the ostial LCX with eccentric plaques; Type B, with concentric plaques at the distal LMCA, eccentric plaques at the ostial LAD, and no plaques at the LCX; Type C, with continuous involvement from the distal LMCA to the ostial LCX, with eccentric plaques, and to the ostial LAD, with eccentric plaques; and Type D, with continuous involvement from the distal LMCA to the ostial LAD, with eccentric plaques, and to the ostial LCX, with concentric plaques. The carina was involved in only 3.5% of the plaques. A total of 51.7% of the plaques at the ostium of the LAD were soft, while 44.8% and 44.6% were fibrous in the distal LMCA and in the ostial LCX, respectively. Conclusions： We classified LMCA true bifurcation lesions into four types. The carina was always free from disease. Plaques at the ostial LAD tended to be soft, whereas those at the ostial LCX and the distal LMCA tended to be fibrous.

关键词： Intravascular Ultrasound Left Main True Bifurcation Lesion Plaque

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Prognostic Value of gai＇s Plaque Score and Agatston Coronary Artery Calcium Score for Functionally Significant Coronary Artery Stenosis

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Chinese Medical Journal 2016年第23期129卷 2792-2796页

作者： Chuang Zhang Shuang Yang lu-yue gai Zhi-Qi Han Qian Xin Xiao-Bo Yang Jun-Jie Yang Qin-Hua Jin Department of Cardiology Chinese People's Liberation Army General Hospital Beijing 100853 China Department of Rheumatism Medical College of Qing Hal University Xining Qinghai 810016 China

Background： The prognostic valtles of the coronary computed tornography angiography （CCTA） score for predicting future cardiovascular events have been previously demonstrated in numerous studies. However, few studies have used the rich information available from CCTA to detect functionally significant coronary lesions. We sought to compare the prognostic values of gai＇s plaque score and the coronary artery calcium score tCACS） of CCTA for predicting functionally significant coronary lesions, using fractional flow reserve （FFR） as the gold standard. Methods： We retrospectively analyzed 107 visually assessed significant coronary lesions in 88 patients （mean age, 59.6 ± 10.2 years： 76.14% of males） wino underwent CCTA, invasive coronary angiography, and invasive FFR nneasurement. An FFR 〈0.80 indicated hemodynamically significant coronary stenosis. Lesions were divided into two groups using an FFR cutoffvalue of 0.80. We compared gai＇s plaque scores and CACS between the two groups and evaluated the correlations of these scores with FFR. The statistical methods included unpaired t-test, Mann-Whitney U-test, and Spearman＇s correlation coefficients. Results： Coronary lesions with FFR 〈0.80 lind Inigtner gai＇s scores than those with FFR 〉0.80. gai＇s score had the strongest correlation with FFR （r= 0.48, P 〈 0.01 ） and lind a greater area under tlne curve 0.72 （95% confidence interval： 0.61 0.82： P 〈 0.01 ） than the CACS of whole arteries and a single artery. Conelusions： Botin CACS in a single artery and gai＇s plaque score demonstrated a good capacity to assess functionally significant coronary artery stenosis when compared to the gold standard FFR. However, gai＇s plaque score was more predictive of FFR 〈0.80. gai＇s score cain be easily calculated in daily clinical practice and could be used when considering revascularization.

关键词： Conlputed Tomography Coronary Angiography Coronary Calcification: Coronary Stenosis: Fractional Flow Reserve

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Coronary plaque response after drug eluting stent implantation assessed by serial optical coherence tomography analysis

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Chinese Medical Journal 2011年第22期124卷 3752-3756页

作者： TIAN Feng CHEN Yun-dai CHEN Lian SUN Zhi-jun LIU Chang-fu GUO Jun JIN Qin-hua WANG Jin-da gai lu-yue Department of Cardiology Chinese People＇s Liberation Army General Hospital Beijing 100853 China

Background In general, percutaneous coronary intervention （PCI） relieves vessel stenosis by implantation of a stent, however, the relationship between plaque characteristics and response after stenting is not clear. Methods We enrolled 68 patients （68 vessels） with diagnosed unstable angina pectoris that prospectively underwent PCI and an optical coherence tomography （OCT） examination was done before and after stenting. Coronary plaques were classified as fibrous, lipid-rich and calcified plaque according to OCT examination, and fibrous cap thickness, lumen eccentricity, stent expansion, stent malapposition, tissue prolapse, thrombosis, dissection and stent symmetry were noted. Results The frequency of prolapse was higher in lipid-rich plaques than fibrous plaques （85% vs. 40%, P 〈0.001）. Dissection most often occurred in fibrous plaque compared with lipid-rich and calcified plaques （60% vs. 32% vs. 29%, P 〈0.001）. The frequency of stent strut malapposition in calcified plaques was higher than firous and lipid-rich plaques （71% vs. 40% vs. 5%, P 〈0.001）. In-stent micro-thrombosis was detected only in lipid-rich plaques, with a frequency of 37% （15/41）. The risk factors of micro-thrombosis after PCI were cap thickness （OR 0.903, 95% CI 0.829-0.985）, lumen eccentricity （OR 1.147, 95% CI 1.012-1.30）, and stent length （OR 1.495, 95% CI 1.032-2.166）. Conclusion Plaque response after PCI is associated with its characteristics, and of those, micro-thrombosis after stenting in lipid-rich plaques was the most significant finding and can be predicted.

关键词： coronary heart disease, optical coherence tomography plaque, stent

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Thrombosis and morphology of plaque rupture using optical coherence tomography

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Chinese Medical Journal 2013年第6期126卷 1092-1095页

作者： GUO Jun CHEN Yun-dai TIAN Feng LIU Hong-bin CHEN Lian SUN Zhi-jun REN Yi-hong JIN Qin-hua LIU Chang-fu HAN Bao-shi gai lu-yue YANG Ting-shu Department of Cardiology Chinese People's Liberation Army General Hospital Beijing 100853 China

Background Thrombosis following plaque rupture is the main cause of acute coronary syndrome, but not all plaque ruptures lead to thrombosis. There are limited in vivo data on the relationship between the morphology of ruptured plaque and thrombosis. Methods We used optical coherence tomography （OCT） to investigate the morphology of plaque rupture and its relation to coronary artery thrombosis in patients with coronary heart disease. Forty-two patients with coronary artery plaque rupture detected by OCT were divided into two groups （with or without thrombus） and the morphological characteristics of ruptured plaque, including fibrous cap thickness and broken cap site, were recorded. Results The fibrous cap of ruptured plaque with thrombus was significantly thinner compared to caps without thrombus （（57.00＋17.00） Bm vs. （96.00＋48.00） Bm; P=0.0076）. Conclusions Plaque rupture associated with thrombosis occurs primarily in plaque covered by a thin fibrous cap. Thick fibrous caps are associated with greater stability of ruptured plaque.

关键词： optical coherence tomography thrombosis plaque rupture

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Optical coherence tomography assessment of edge dissections after drug-eluting stent implantation in coronary artery

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Chinese Medical Journal 2012年第6期125卷 1047-1050页

Background Edge dissections after coronary stent implantation are associated with increased short-term risk of major adverse cardiovascular events. The incidence and outcome of edge dissections after coronary stent implantation were reportedly different using different imaging techniques. We used optical coherence tomography （OCT） to assess the incidence, morphological findings and related factors of edge dissections after drug-eluting stent （DES） implantation. Methods Totally 42 patients with 43 de novo lesions in 43 native arteries undergoing DES implantation with OCT imaging were enrolled in this study. Results Nine edge dissections were detected in 43 arteries after DES implantation. There were four morphological patterns of stent edge dissections indentified in this study：（1） superficial intimal tears （n=3）, （2） subintimal dissections （n=4）, （3） split of media （n=1）, （4） disruption of the fibrotic cap of plaque （n=1）. Stent edge expansion and stent expansion were both higher in the group with dissections than those in the group without dissections （1.682±0.425 vs. 1.229±0.285, P=0.0290; 1.507±0.445 vs. 1.174±0.265, P=0.0072）. Conclusions The incidence of stent edge dissections detected by OCT was 21%. Stent edge dissection is related with stent edge expansion and stent expansion.

关键词： optical coherence tomography stent dissections

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影响经皮冠状动脉介入治疗术后心肌酶及炎症指标变化的多因素研究

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中国循环杂志 2008年第5期23卷 332-335页

作者：李萍盖鲁粤中国人民解放军总医院心内科北京市100853

目的:分析对于择期经皮冠状动脉介入治疗(PCI)术后心肌酶及炎症指标有显著影响意义的危险因素。方法:对2007-03至2007-09于我院心内科行择期经皮冠状动脉介入治疗的冠心病患者178例术后12～24小时取血查肌酸激酶(CK),肌酸激酶MB同工酶(C... 详细信息

目的:分析对于择期经皮冠状动脉介入治疗(PCI)术后心肌酶及炎症指标有显著影响意义的危险因素。方法:对2007-03至2007-09于我院心内科行择期经皮冠状动脉介入治疗的冠心病患者178例术后12～24小时取血查肌酸激酶(CK),肌酸激酶MB同工酶(CK-MB),心肌肌钙蛋白T(cTnT)以及高敏C反应蛋白(hsCRP)。结果:共178例入选。其中CK-MB增高27例(15.2%),cTnT增高44例(24.7%),hsCRP升高66例(37.1%)。Lo-gistic多元回归分析显示:对CK-MB值增高有显著影响的因素为:左心室射血分数(P=0.0223);术中出现心肌梗死溶栓治疗临床试验(TIMI)血流<3级(P=0.0250)。对cTnT值增高有显著影响的因素为:既往冠状动脉旁路移植术(CABG)史(P=0.0203)。对hsCRP值增高有显著影响的因素为:使用钙离子拮抗剂类药物(P=0.0340);左心室射血分数(P=0.0504);支架离散度(P=0.0465)。结论:左心室射血分数降低,术中出现TIMI血流<3级,是造成择期冠状动脉介入治疗术后心肌酶增高的独立危险因素,既往冠状动脉旁路移植术史是造成择期冠状动脉介入治疗术后cTnT增高的独立危险因素。左心室射血分数降低,支架离散度增加是造成择期冠状动脉介入治疗术后hsCRP增高的独立危险因素。使用钙离子拮抗剂类药物可以使增高的hsCRP降低,可能对患者的预后有益处。

关键词：择期经皮冠状动脉介入治疗术心肌酶学高敏C反应蛋白多因素分析

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