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转甲状腺素蛋白心脏淀粉样变（ATTR-CA）是由转甲状腺素蛋白发生异常解离并聚集在心肌间质所导致，其中野生型（ATTRwt）为无TTR基因突变者。由于该病临床表现缺乏特异性，易被漏诊、误诊。该文报道了1例初诊为肥厚型心肌病最终确诊为ATTRwt患者的诊治过程。.

冠状动脉粥样硬化是一种慢性动脉炎症性疾病，是导致心血管疾病发生的重要原因，严重威胁人类健康。冠状动脉周围脂肪组织由于与冠状动脉邻近，而逐渐受到研究者的重视。近年来，越来越多的研究表明血管周围脂肪组织与血管壁之间具有复杂的双向通讯，动脉粥样硬化斑块的形成始于脂肪组织释放的因子，而冠状动脉周围脂肪组织感受到冠状动脉炎症后也会发生形态和分泌特征的变化，这些变化可以被冠状动脉计算机断层扫描血管造影识别。本文对近年来血管周围脂肪组织在冠状动脉粥样硬化中的作用和评价指标进行了综述。.

该文报道1例少见的左心室中部梗阻性肥厚型心肌病患者，该患者经微创射频消融介入治疗后血流动力学和临床症状均明显改善。.

To observe the expression of neural axon guidance molecules Slit3 and Robo receptors in mouse aortic smooth muscle cell(MASMC) and investigate the effect of exogenous Slit3 protein on migration and proliferation of MASMC.The primary cultured MASMC were identified by immunofluorescent assay. The expression of Slit3/Robo signal pathway was detected by RT-PCR and immunocytochemical staining. MASMC were divided into 6 groups: the negative control group (DMEM medium containing bovine serum albumin 86 μg/L), Slit3 0 μg/L group (DMEM medium without Slit3), Slit3 24 μg/L group (DMEM medium containing Slit3 24 μg/L), Slit3 40 μg/L group (DMEM medium containing Slit3 40 μg/L), Slit3 80 μg/L group (DMEM medium containing Slit3 80 μg/L) and the positive control group (DMEM medium containing platelet derived growth factor 10 μg/L). The effects of exogenous Slit3 on MASMC proliferation and migration were detected by CCK-8 and scratched cells and transwell chambers respectively.(1) The mRNA and protein expressions of Slit2, Slit3, Robo1 and Robo4 were detected in MASMC. mRNA level of Slit2 was lower than Slit3 (P0.05) and there were no significant difference between mRNA level of Robo1 and Robo4. (2) The mitogenic responses of MASMC were significantly enhanced in Slit3 24 μg/L group, Slit3 40 μg/L group and Slit3 80 μg/L group compared with negative control group (1.13±0.04, 1.19±0.02, 1.18±0.08 and 0.64±0.10 respectively, all P0.05). The mitogenic activity of MASMC was the strongest in Slit3 40 μg/L group (compared with positive control group 1.27±0.05, P0.05). (3)The autonomous migration activity of MASMC were significantly increased in Slit3 24 μg/L group, Slit3 40 μg/L group, Slit3 80 μg/L group compared with negative control group (cell scratch width were (0.40±0.03)cm, (0.32±0.03)cm, (0.30±0.02)cm and (0.49±0.01)cm respectively, all P0.05). The autonomous migration activity of MASMC was the strongest in Slit3 80 μg/L group (compared with positive control group (0.22±0.01)cm, P0.05). The transmembrane migration activity of MASMC were significantly increased in Slit3 24 μg/L group, Slit3 40 μg/L group, Slit3 80 μg/L group compared with negative control group (the number of cell migration were 46.67±2.23, 65.33±3.43, 81.67±4.22 and 39.33±2.03 respectively, all P0.05). The transmembrane migration activity of MASMC was the strongest in Slit3 80 μg/L group (compared with positive control group 84.00±2.02, P0.05).Slit2, Slit3, Robo1 and Robo4 were expressed in MASMC, and exogenous Slit3 could promote proliferation and migration of MASMC in vitro.

To observe the efficacy and safety of bivalirudin use in Chinese patients with coronary heart disease (CHD) during the peri-percutaneous coronary intervention(PCI) period.A total of 3 271 patients who underwent PCI and received periprocedural bivalirudin treatment between July 2013 and October 2015 from 88 centers of China were involved in this study. The primary outcome was 30-day net adverse clinical events (NACE a composite of major adverse cardiac or cerebral events (MACE, all-cause death, reinfarction, urgent target vessel revascularization, or stroke) or bleeding), the secondary outcome was stent thrombosis at 30 days.The mean age of enrolled patients was (65.12±12.44) years old, 27.4%(889/3 244) of them were female. Percent of stable coronary disease (SCD), non-ST segment elevation acute coronary syndrome (NSTE-ACS) and ST elevation myocardial infarction (STEMI) was 5.0%(162/3 248), 44.6%(1 450/3 248) and 50.4%(1 636/3 248) respectively. Radial access was performed in 89.5% (2 879/3 271) patients, and 9.7% (316/3 271) and 34.1% (1 115/3 271) patients also received ticagrelor and tirofiban medication. 69.3% (2 266/3 271) patients received post-procedural bivalirudin infusion, in which 46.3% (1 050/2 266) was treated at PCI-does, with a median duration of 2.5(1.0, 4.0) h. During the 30-day follow-up, NACE occurred in 3.45% (103/2 988) patients, the incidence of MACE, death was 2.17% (65/2 994) and 1.03% (31/3 017), respectively and bleeding events were recorded in 1.37% (41/2 996) patients. Four cases (0.13%) of stent thrombosis (3 acute stent thrombosis) were recorded.Peri-PCI Bivalirudin use is safe and related with low bleeding risk in Chinese CHD patients.

104 patients of hypertensive left ventricular hypertrophy (LVH) were studied by two-dimensional echocardiography. According to the changes of left ventricular wall thickness, wall mass, end-diastolic volume and ejection fraction, they were divided into three types (concentric, dilated, disproportionate): (1) Concentric LVH 83 cases (79.8%) with thickened ventricular wall and augmented mass. (2) Dilated LVH 13 cases (12.5%) with left ventricular cavity enlarged and both ventricular mass and volume increased, ejection fraction decreased. (3) Disproportionate LVH 8 cases (7.7%), similar to hypertrophic cardiomyopathy with excess increase in interventricular septal thickness. The thickness ratio between interventricular septal and left ventricular posterior wall was greater than or equal to 1.3.