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Journal of Geriatric cardiology 2010年第2期7卷 101-105页

作者： Shi-Jun Li Zhi-Jun Sun Dan-Dan Li Geng Qian Ting-Shu Yang Xiao-Ying Li Department of Geriatric cardiology Chinese PLA General HospitalBeijing 100853China Department of cardiology Chinese PLA General HospitalBeijing 100853China

Objective Biochemical indicators such as N-terminal pro-brain type natriuretic peptide（NT pro-BNP）and high-sensitivity Creactive protein（hsCRP）predict mortality in acute coronary syndrome（ACS）.However,little is known about the relationship of these factors with severity of coronary artery stenosis in patients *** Three hundred and thirty-one subjects including 246 unstable angina pectoris patients and 85 myocardial infarction patients were recruited and classified into two groups：single-vessel disease group（1-vessel disease,n=93）and multiple-vessel disease group（≥2-vessels disease,n=238）according to selective coronary *** levels of NT pro-BNP and hsCRP were measured and severity of coronary stenosis was determined by Gensini *** NT pro-BNP but not hsCRP level was higher in patients with myocardial infarction than in patients with unstable angina *** patients with multiple-vessel disease had significantly higher NT pro-BNP level but not hsCRP compared with those with single-vessel *** pro-BNP levels increased significantly as left ventricle（LV）function decreased,and only NT proBNP but not hsCRP level was related to Gensini score of severity of coronary stenosis in *** NT proBNP but not hsCRP level is related to severity of coronary artery stenosis in patients in ACS.

关键词： N-terminal pro-brain natriuretic peptide high-sensitivity C-reactive protein coronary artery stenosis acute coronary syndrome

Prevalence of pulmonary embolism at autopsy among elderly patients in a chinese general hospital

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Journal of Geriatric cardiology 2016年第11期13卷 894-898页

作者： Ji-Li YUN Xiao-Ying LI Medical School of chinese PLA General Hospital Beijing China Department of Geriatric cardiology Chinese PLA General Hospital Beijing China

Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.

关键词： Autopsy Epidemiology Pulmonary embolism

Efficacy of Traditional chinese Medicine in patients with acute myocardial infarction suffering from diabetes mellitus

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Journal of Traditional chinese Medicine 2018年第3期38卷 412-418页

作者： Dai Guohua Gao Wulin Bi Dongxue Liu Chunhua Liu Yuhan Wang Ning Zhao Chen Department of cardiology the Affiliated Hospital of Shandong University of Traditional Chinese Medicine First Clinical Medical College Shandong University of Traditional Chinese Medicine Institute of Traditional chinese Medicine Tianjin University of Traditional Chinese Medicine

OBJECTIVE: To investigate the "real world" effectiveness of Traditional chinese Medicine(TCM) in patients with acute myocardial infarction suffering from diabetes mellitus(AMI+DM patients).METHODS: This was a retrospective cohort *** hospitalization, the "exposure group" was defined as patients who had a TCM injection for ≥ 7 *** follow-up, the definition of the exposure group was application of a chinese patent medicine or decoction of chinese medicine for ≥ 28 *** information(age, sex, contact details), TCM use and endpoint events of AMI+DM patients during hospitalization and follow-up were *** correlation between TCM and the end-point events of AMI + DM patients was analyzed using a multiple logistic regression ***: A total of 479 AMI + DM patients were enrolled and 345 cases were followed up. During hospitalization, TCM, age, hypertension and use of an angiotensin-converting enzyme inhibitor(ACEI)or angiotensin receptor blocker(ARB) were associated with cardiac death. During follow-up, TCM was associated with cardiac death. TCM was a relevant factor for a composite endpoint of re-infarction and stroke. TCM, anti-thrombotic therapy and lipid-lowering therapy were related to acute heart failure. TCM, anti-thrombotic therapy, anti-MI therapy and ACEI/ARB use exhibited a strong correlation with re-hospitalization due to cardiovascular ***: TCM reduced the prevalence of cardiac death during hospitalization, and cardiac death, a composite endpoint of re-infarction and stroke, acute heart failure and re-hospitalization due to cardiovascular disease during follow-up.

关键词： Myocardial infarction Diabetes melli-tus Death Medicine chinese traditional Cohortstudies

Androgen deficiency in elderly men with systolic chronic heart failure

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Journal of Geriatric cardiology 2010年第3期7卷 138-142页

作者： Xiao-Fei Wang Jun-Hua Wang Jiang-Yuan Li Department of cardiology the 306th Hospital of Chinese PLA Beijing 100101 China Department of cardiology Chinese PLA Airforce General Hospital Beijing 100036 China Institute of Geriatric cardiology Chinese PLA General Hospital Beijing 100853 China

Objective Several previous studies have shown androgens deficiency in men with CHF, and 2 studies on the prognostic significance of serum levels of androgens in CHF patients have yielded conflicting results. The aim of this study was to examine the relationship between serum concentration of testosterone and mortality in men with systolic CHE Methods A total of 175 elderly （age ≥ 60 years） men with CHF were recruited. Total testosterone fiT） and sex hormone binding globulin （SHBG） were measured, and free serum testosterone （eFT） was calculated. The median follow-up time was 1262 days. Results During follow-up 54 （30.9%） patients died. TT and eFF deficiency was found in 21.7% （38/175） and 27.4% （48/175） patients, respectively. Both TT and eFT were inversely associated with LVEF and NT-proBNP （all P〈0.01）. Kaplan-Meier curves for patients in low, medium and high tertiles according to TF and eFT level showed significantly different cumulative survival rate （both P〈0.01 by log-rank test）. However, after adjustment for clinical variables, there were no significant associations between either Tr or eFT levels or survival time （OR=0.97, 95% CI, 0.84-1.12, P--0.28; and OR=0.92, 95% CI, 0.82-1.06,/＇=0.14, respectively）. Conclusion Our study showed that although levels of TT and eFT are commonly decreased in elderly patients with systolic CHF and related to disease severity, they are not independent predictors for mortality

关键词： Total testosterone free testosterone heart failure prognosis

NADPH Oxidase Accounts for Changes in Cerebrovascular Redox Status in Hindlimb Unweighting Rats

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Biomedical and Environmental Sciences 2015年第11期28卷 799-807页

作者： PENG Liang RAN Hai Hong ZHANG Ying ZHAO Yu FAN Yong Yan PENG Li ZHANG Ran CAO Feng Department of cardiology Chinese People's Liberation Army General Hospital Department of Geriatric Hematology Chinese People's Liberation Army General Hospital

Objective The roles of cerebrovascular oxidative stress in vascular functional remodeling have been described in hindlimb-unweighting （HU） rats. However, the underlying mechanism remains to be established. Methods We investigated the generation of vascular reactive oxygen species （ROS）, Nox2/Nox4 protein and mRNA levels, NADPH oxidase activity, and manganese superoxide dismutase （MnSOD） and glutathione peroxidase-1 （GPx-1） mRNA levels in cerebral and mesenteric smooth muscle cells （VSMCs） of HU rats. Results ROS production increased in cerebral but not in mesenteric VSMCs of HU rats compared with those in control rats. Nox2 and Nox4 protein and mRNA levels were increased significantly but MnSOD/GPx-1 mRNA levels decreased in HU rat cerebral arteries but not in mesenteric arteries. NADPH oxidases were activated significantly more in cerebral but not in mesenteric arteries of HU rats. NADPH oxidase inhibition with apocynin attenuated cerebrovascular ROS production and partially restored Nox2/Nox4 protein and mRNA levels, NADPH oxidase activity, and MnSOD/GPx-1 mRNA levels in cerebral VSMCs of HU rats. Conclusion These results suggest that vascular NADPH oxidases regulate cerebrovascular redox status and participate in vascular oxidative stress injury during simulated microgravity.

关键词： Microgravity Oxidative stress NADPH oxidase Manganese superoxide dismutase Glutathione peroxidase-1

Effect of angiotensin II receptor 1 antisense oligodoexynucleotides on physiological and pathophysiological growth of cardiomyocytes

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Acta Pharmacologica Sinica 2004年第5期25卷 19-27页

作者： Ying WANG2, Jin-ming WANG2, Shu-xun Yan3, Ming-jiang LI2,4, Jian-jun LI22Department of cardiology, Renmin Hospital, Wuhan University, Wuhan 430060, China 3Hubei College of Traditional chinese Medicine, Wuhan 430061,China Department of cardiology Renmin Hospital Wuhan University Wuhan 430060 Hubei College of Traditional chinese Medicine Wuhan 430061

AIM: To evaluate the role of angiotensin II receptor 1 antisense oligodexynucleotides (AT1R-AS-ODNs) on physi-ological and pathophysiological growth of cardiomyocytes from normotensive rats. METHODS: Cardiomyocyteswere transfected with AT1R-AS-ODNs (200 nmol/L) followed by treatment with or without angiotensin II (1 mol/L).In situ hybridization and Western blot were used for AT1R mRNA and protein detection, respectively. c-Jun N-terminal protein kinase (JNK) activity was characterized by immune complex kinase assay. c-Jun protein expres-sion was examined by immunocytochemistry. DNA content was detected by flow cytometric assay. Atrial natri-uretic factor (ANF) expression was identified by radioimmunoassay. RESULTS: Treatment with AT1R-AS-ODNsfor 24 h resulted in 51.2 % decrease in AT1R mRNA and 60.7 % in protein (P<0.05 vs control). However, the basallevel of JNK activity, c-Jun protein expression, and DNA content were not altered by AT1R-AS treatment in absenceof overactive hormonal system. After treatment with angiotensin II for 30 min, both p46JNK and p54JNK wererobustly activated. By 2 h, c-Jun protein expression was increased. By 24 h, angiotensin II caused a markedincrease both in G0/G1 and G2/M DNA content, and increased ANF expression by 1.8-fold. All these were inhibitedby AT1R-AS-ODNs pretreatment. In contrast, sense sequence was ineffective. CONCLUSION: Decrease ofAT1R expression by AS-ODNs did not interfere with normal growth, but protected cardiomyocytes from angio-tensin II-dependent pathophysiological growth.

关键词： antisense oligodeoxynucleotides angiotensin receptors angiotensin II myocardium hypertrophy mitogen-activated protein kinases

Different treatments for different mechanisms in vasovagal syncope

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Journal of Geriatric cardiology 2006年第1期3卷 61-64页

作者： Quan FANG Kangan CHENG Hua DENG Ning WU Department of cardiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Department of Cardiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Department of Cardiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Department of Cardiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences

The treatment of vasovagal syncope has been by far unsatisfactory. Beta-blockers may prevent vasovagal syncope, but they exacerbates heart asystole. Cardiac pacing prevents syncope but notpresyncope. The frequent, serious vasovagal syncope attacks of a 63- year-old woman patient were completely prevented by administration of 100 mg metoprolol (b.i.d) for 3 months until the patient experienced a complete heart block. A DDD pacemaker implantation abolished syncope but not the presyncope, which was eventually prevented in a follow-up period of 24 months by adding 75 mg atenalol twice a day. This case suggests a different mechanism involved in vasovagal syncope.

关键词： vasovagal syncope beta-blocker cardiac pacing tilt table test heart block

C-reactive protein as a predictor for cardiac events in chinese elderly patients with coronary heart disease

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Journal of Geriatric cardiology 2006年第2期3卷 78-81页

作者： Guangyong HUANG Caiyi LU Xingli WU Yuxiao ZHANG Institute of Geriatric cardiology Chinese PLA General Hospital Beijing 100853 China Department of cardiology Liaocheng People''s Hospital Liaocheng Shandong 252000 China Institute of Geriatric Cardiology Chinese PLA General Hospital Beijing 100853 China Institute of Geriatric Cardiology Chinese PLA General Hospital Beijing 100853 China Institute of Geriatric Cardiology Chinese PLA General Hospital Beijing 100853 China

Background and objective To assess the predictive value of C-reactive protein(CRP) for major adverse cardiac events and the association between CRP level and the coronary lesion morphology and extent in patients with coronary heart disease (CHD).Methods CRP was measured on admission in 177 consecutive elderly (age≥60 years) patients with CHD who underwent coronary angiography. Patients were divided into high CRP group (CRP≥3mg/L) and normal CRP group (CRP ＜3mg/L). The association between CRP levels and the coronary lesion features, including severity of stenosis (mild, moderate, severe), extent of lesion (diffused or nondiffused), eccentricity of the plaque (eccentric or non-eccentric) were analyzed. Patients were followed up for a mean of 8 months for the occurrences of major adverse cardiac events (MACE). Results Compared with patients in normal CRP group, patients in high CRP group were more frequently to have unstable angina, multi-vessel, diffuse, eccentric lesions, positive remodeling, and non-smooth plaques (P＜0.01). Kaplan-Meier analysis showed patients in high CRP group had a significantly lower MACE-free survival rate than patients in normal CRP group (Log-rank = 12.0, P＜0.01); Cox regression analysis indicated CRP level as an independent predictor for the occurrence of MACE (OR=3.16, P＜0.05) Conclusions High CRP level is associated with more extend, severe and eccentric coronary lesions and is an independent predictor for MACE in elderly patients with CHD.

关键词： C-reaction protein coronary artery disease angiography major adverse cardiac events

Protective Effect of Propyl Gallate Against Oxidized Low-Density Lipoprotein-Induced Injury of Endothelial Cells

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chinese Journal of Integrative Medicine 2015年第4期21卷 299-306页

作者：马路朱晓法吴育云陈可冀史大卓殷惠军 Department of Geriatric cardiology the Navy General Hospital of Chinese PLA The Lab of Cardiovascular Molecular Biology Xiyuan HospitalChina Academy of Chinese Medical Sciences

Objective： To evaluate the protective effect of propyl gallate （PG）, an alkyl ester of gallic acid which is an active ingredient of Radix Paeoniae, against oxidized low-density lipoprotein （ox-LDL）-induced apoptosis and death in endothelial cells （ECs） and to find out its preliminary mechanism. Methods： The cultured endothelial cells were divided into normal, model （ox-LDL）, control （fetal bovine serum）, PG high dose （20 p,g/mL）, PG middle dose （10 μg/mL）, and PG low dose （5 μg/mL） groups, each derived from three different pools of umbilical cords. The model of injured human umbilical vein endothelial cells （HUVECs） was induced by ox-LDL. The 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyl-2H-tetrazolium bromide （MTT） assay, Hoechst 33258 staining, flow cytometry and measurement of nitrogen monoxidum （NO） release were used to evaluate the protective effect of PG against ox-LDL-induced apoptosis and death in HUVECs. To find out the mechanism of this protective effect, the expression of endothelial nitric oxide synthase （eNOS） mRNA, eNOS protein expression, immunofluorescence of intracellular reactive oxygen species （ROS） and activities of malondialdehyde （MDA）, superoxidedismutase （SOD） and glutathione peroxidase （GPx） were observed. Results： PG significantly reduced ox-LDL-induced apoptosis and cell death. The percentage of cells death and apoptosis was significantly higher in the ox-LDL group than that in the control group （P〈0.05）. Compared with the control group, the cells death and apoptosis of PG group was no different （P〉0.05）. As compared with the ox-LDL group, results of the PG high dose group showed that cell viability was significantly increased （P〈0.05）, the level of NO release, expression of eNOS mRNA, densitometric value of eNOS protein expression, as well as the activities of SOD and GPx were all significantly higher （all P〈0.05）. Conclusion： PG could potentially serve as a novel endothelial protective agent against ox-LDL-induced injury of endothelial cell.

关键词： propyl gallate oxidized low-density lipoprotein endotheliocyte reactive oxygen species Radix Paeoniae chinese medicine

Incomplete revascularization in the drug eluting stent era permits meaningful long-term (12-78 months) outcomes in patients ≥ 75 years with acute coronary syndrome

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Journal of Geriatric cardiology 2012年第4期9卷 336-343页

作者： Jie Chen Qiao Xue Jing Bai Lei Gao Jin-Wen Tian Ke Li Qiang Xu Yan-Hua Li Yu Wang Institute of Geriatric cardiology Chinese PLA General Hospital 28 Fuxing Road 100853 BeijingChina

Objective To compare long-term prognosis between complete revascularization (CR) and incomplete revascularization (IR) in elderly patients with acute coronary syndrome (ACS)who underwent percutaneous coronary intervention (PCI). Methods We prospectively enrolled patients ≥75 yearswith ACS and multi-lesion disease between January 2005 andDecember 2010 at our center (Institute ofGeriatric cardiology, chinese PLA General Hospital). Baseline clinical characteristics, PCI parameters and long-term (12 to 78 months) outcomes includingmain adverse cardiac and cerebral events (MACCE) were compared betweenCR and IR groups. We used the Kaplan-Meier curve to describe the survival rates, and variables reported to be associated with prognosis were included in Cox regression. Results Of the 502 patients, 230 patients obtained CR, and the other 272 patients underwent IR. Higher SYNTAX score was an independent predictor of IR [Odds ratio (OR): 1.141, 95% confidence interval (95% CI): 1.066–1.221, P = 0.000]. A total of 429 patients (85.5%) were followed with a duration ranging from 12 months to 78 months. There were no significant differences in cumulative survival rates and event free survival rates between the two groups, even for patients with multi-vessel disease. Older age (OR: 1.079, 95% CI: 1.007–1.157, P = 0.032), prior myocardial infarction (OR: 1.440, 95% CI: 1.268–2.723, P = 0.001) and hypertension (OR: 1. 653, 95% CI: 1.010–2.734, P = 0.050) were significant independent predictors of long-term MACCE. Conclusions Given that both clinical and coronary lesion characteristics are much more complex in patients ≥75 years with ACS and multi-lesion disease, IR may be an option allowing low risk hospital results and meaningful long-term (12 to 78months) outcomes.

关键词： Elderly patients Incomplete Revascularization Long-term Prognosis Percutaneous Coronary Intervention