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Objective: To study the clinical value of total hemihepatic vascular exclusion (THHVE) in liver resection for patients with hepatocellular carcinoma (HCC) and impaired liver function., Methods: The data of 70 patients who underwent liver resection for HCC with impaired liver function between January 2009 and October 2011 were analyzed retrospectively. THHVE was applied in 38 patients (THHVE group), Pringle maneuver in 25 patients (Pringle group) and no vascular occlusion in 7 patients. In the THHVE group, 36 patients were male, 2 were female, average age was (54 ± 9) years. And in Pringle group, 23 patients were male, 2 were female, average age was (53 ± 10) years. Total intraoperative blood loss, blood transfusion rate, clamping time, postoperative complication rate, postoperative hospital stay and postoperative liver function were compared between the THHVE and Pringle group., Results: Total blood loss ((317 ± 186) ml vs. (506 ± 274) ml, t = -3.025, P = 0.004) and transfusion rate (10.5% vs. 32.0%, χ(2) = 4.509, P = 0.034) were significantly lower in the THHVE group than in the Pringle group. Although the clamping time was longer ((21 ± 5) minutes vs. (17 ± 5) minutes, t = 3.209, P = 0.002), the total bilirubin levels on postoperative day 3 and 7 and ALT levels on postoperative day 1, 3, 7 were significantly lower in the THHVE group than in the Pringle group, and the pre-albumin level on postoperative day 7 was higher in the THHVE group than in the Pringle group. Total complication rate (26.3% vs. 52.0%, χ(2) = 4.291, P = 0.038) and major complication rate (7.9% vs. 28.0%, χ(2) = 4.565, P = 0.033) were lower in the THHVE group than in the Pringle group. And postoperative hospital stay duration was shorter in the THHVE group than in the Pringle group ((14.0 ± 2.6) d vs. (16.4 ± 4.0) d, t = -2.625, P = 0.012)., Conclusions: THHVE is a safe and effective technique in liver resection for patients with HCC and impaired liver function. It is associated with less blood loss, lower transfusion requirements, better postoperative liver function recovery, lower postoperative complication rate and shorter postoperative hospital stay.

Objective: To investigate the relationship between smoking and insulin resistance in non-obese male patients with CAD., Methods: 414 consecutive non-obese male patients with angiographically-documented CAD (luminal diameter narrowing > 50%) were recruited, including 113 nonsmokers and 301 smokers. With 99 mild smokers (< 400 packs/year), 95 medium smokers (400 - 799 packs/year) and 107 heavy smokers (≥ 800 packs/year). Insulin resistance index (IRI) was expressed by homeostasis model assessment for insulin resistance (HOMA-IR) calculated by the formula of [fasting serum glucose (mmol/L) × fasting plasma insulin (mU/L)]/22.5. IRI ≥ 2.69 was defined as insulin resistance, while IRI < 2.69 was insulin sensitive. Fasting glucose, fasting insulin and IRI were recorded and odds ratio for the incidence of insulin resistance was calculated., Results: Fasting glucose was higher in heavy smokers (5.86 mmol/L) than that in nonsmokers (5.51 mmol/L, P = 0.037) and mild smokers (5.33 mmol/L, P = 0.014). Fasting insulin and IRI were also significantly higher in heavy smokers (10.25 mU/L) than those in non-smokers (8.72 mU/L, P = 0.0231, respectively) and mild smokers (8.67 mU/L, P = 0.0231). Compared with nonsmokers, the odds ratio for the incidence of insulin resistance was 1.53 (95%CI 0.55 - 2.94; P = 0.027) in medium smokers and 1.89 (95%CI 0.49 - 3.14; P = 0.018) in heavy smokers., Conclusions: The relationship between smoking and insulin resistance is highly dose dependent in non-obese male patients with CAD.

Objective: Intravascular ultrasound (IVUS) was used to compare the effects on neointimal hyperplasia inhibition between national made Firebird stents and Cypher stents in patients with coronary artery disease., Methods: From May 2003 to March 2007, 215 patients with 317 native lesions received either Firebird stent (147 lesions of 108 patients, Firebird group) or Cypher stent implantation (138 lesions of 107 patients, Cypher group). Quantitative coronary angiography (QCA) and IVUS were performed at one-year follow-up., Results: The baseline clinical and angiographic characteristics between the two groups were similar, but post procedural minimal lumen diameter was significantly larger in Firebird group than that in Cypher group [(2.88 +/- 0.43) mm vs. (2.78 +/- 0.33) mm, P < 0.05]. follow-up QCA results showed that in-stent late loss [(0.17 +/- 0.29) mm vs. (0.16 +/- 0.27) mm, P > 0.05] and in-segment late loss [(0.18 +/- 0.36) mm vs. (0.20 +/- 0.32) mm, P > 0.05] was similar between Firebird group and Cypher group, while stent cross sectional area (CSA) [(6.99 +/- 2.25) mm(2) vs. (6.46 +/- 1.71) mm(2), P < 0.05], lumen CSA [(6.89 +/- 2.30) mm(2) vs. (6.36 +/- 1.73) mm(2), P < 0.05], stent volume [(162.5 +/- 68.9) m(3) vs. (140.8 +/- 57.9) mm(3), P < 0.01], lumen volume [(160.4 +/- 69.5) mm(3) vs. (138.6 +/- 57.6) mm(3), P < 0.01] and minimal stent CSA [(5.40 +/- 1.85) mm(2) vs. (4.92 +/- 1.43) mm(2), P < 0.05] were larger in Firebird group than those in Cypher group. IVUS analysis showed that there was no significant difference in neointimal hyperplasia volume [(2.09 +/- 5.46) mm(3) vs. (2.23 +/- 6.50) mm(3), P > 0.05] and percentage of volume obstruction [(1.68 +/- 5.84)% vs. (1.59 +/- 4.10)%, P > 0.05] between the two groups., Conclusion: Implantation of Firebird stent was associated with low restenosis rate and both Firebird and Cypher stents equally and effectively inhibited neointimal hyperplasia.

Objective: To investigate the association between the -1031T/C polymorphism in the promoter of tumor necrosis factor-alpha (TNF- alpha) gene and unstable angina in Chinese Han population., Methods: The genotype of -1031T/C locus was analyzed by MALDI-TOF in 299 patients with unstable angina and 202 healthy controls. The serum TNF-alpha level was measured by enzyme-linked immunosorbent assay(ELISA)., Results: There was no significant difference in the genotype distribution and allele frequencies of the -1031T/C locus between the two groups (P > 0.05). However, stratification by gender showed that the genotype distribution of this locus was obviously different between the two groups in men (P was 0.032). The risk of developing unstable angina in men carrying the CC+TC genotypes were 1.66-fold higher than that in men of TT genotype (95% CI: 1.040 to 2.659). There was no significant difference in the frequencies of the C and T alleles between the two subgroups (P > 0.05). Furthermore, serum TNF-alpha levels of the patients were significantly higher than those of controls (P = 0.028, P = 0.013 in men), but there was no significant difference in the TNF-alpha level among different genotypes., Conclusion: The -1031T/C polymorphism of the TNF-alpha gene might be associated with unstable angina in male Han population, especially the C allele carriers might be more likely to be affected by unstable angina than the rest of the population.

Objective: The impact of late incomplete stent apposition (ISA) post sirolimus eluting stent (SES) implantation in patients with acute coronary syndrome (ACS) on long-term clinical outcomes remains controversial. The aim of the present study was to evaluate the association between late ISA and clinical outcomes in patients with ACS compared with that with stable angina (SA)., Methods: From February 2005 to March 2007, 54 ACS patients and 83 SA patients were enrolled in this study, late ISA was determined by means of three-dimensional volumetric intravascular ultrasound (IVUS) analyses one year after SES implantation and clinical outcomes one year post IVUS were obtained in these patients., Results: In 219 treated lesions of the 137 patients, late ISA was documented in 25 lesions in 16 patients (20 ISA in 12 ACS patients vs. 5 ISA in 4 SA patients, P<0.001). Though lumen area in reference and stented segment, neointimal hyperplasia (NIH) area and percentage of NIH in stented segment, and external elastic membrane (EEM) area in reference segment were similar between two groups, EEM area in stented segment [(15.34+/-5.44) mm2 vs. (13.83+/-4.51) mm2, P=0.026], stented/reference segment EEM area ratio (1.13+/-0.22 vs. 1.02+/-0.18, P<0.001), plaque and media area [(8.43+/-3.93) mm2 vs. (7.01+/-2.93) mm2, P=0.002] was significantly lager in ACS group than that in SA group. Multivariable logistic analysis showed that ACS (OR 6.477 with 95% CI from 2.297 to 18.263, P<0.001) and stent length>or=23 mm (OR 3.680 with 95% CI from 1.181 to 11.469, P=0.025) were main independent factors of occurrence of late ISA. Incidence of main adverse cardiac events (MACE) one year post IVUS was similar between the two groups., Conclusion: Compared with patients with SA, ACS patients had larger stented segment EEM area, plaque and media area as well as increased incidence of ISA. However, the incidence of MACE was similar in ACS and SA patients one year after IVUS.

Objective: To evaluate the value of adenosine tissue Doppler stress echocardiography on ischemic myocardium., Methods: Routine dosage (140 microgxkg(-1)xmin(-1) IV for 6 min) adenosine stress echocardiography was performed on 40 patients with chest pain for diagnosis of coronary artery disease (CAD). The images of left ventricular myocardial motion were acquired by tissue Doppler imaging (TDI) based on traditional 2D stress echocardiography before and 3 min, 6 min after adenosine stress (GE Vivid 7, USA). The myocardial velocity, strain and strain rate in 16 segments were offline measured and analyzed on ECHOPAC software. The results were compared with that of coronary angiography (CAG)., Results: CAG identified 18 CAD and 22 non-CAD patients with 159 ischemic segments and 465 non-ischemic segments. Adenosine significantly increased the systolic velocity (Sm), early diastolic velocity (Em), late diastolic velocity (Am), peak systolic strain (Smax), systolic strain rate (SRs), early diastolic strain rate (SRe) and late diastolic strain rate (SRa) both ischemic and non-ischemic segments (all P < 0.05). The baseline Sm and Em in ischemic segments were significant lower than non-ischemic segments [(3.16 +/- 1.20) cm/s vs (4.03 +/- 1.27) cm/s, P < 0.01; (3.75 +/- 1.67) cm/s vs (4.66 +/- 1.70) cm/s, P < 0.05]. At peak stress the differences in Sm and Em were more significant [(3.98 +/- 1.63) cm/s vs (5.07 +/- 1.52) cm/s; (4.51 +/- 2.32) cm/s vs (6.52 +/- 2.56) cm/s; P < 0.01]. The reductions on Smax and Se were more significant in ischemic segments compared those in non-ischemic segments (16.91% +/- 3.35% vs 19.56% +/- 5.47%, P < 0.01 and 9.53% +/- 2.89% vs 13.06% +/- 4.63%, P < 0.001). The biggest area under curve (AUC) in peak stress was seen in Se by ROC curve analysis (AUC = 0.740, with sensitivity 67% and specificity 83%)., Conclusion: Parameters derived from TDI offer reliable and accurate information on ischemic myocardium during adenosine stress echocardiography.

Employing gfp as a reporter gene and hygromycin gene (hph) as a selection marker, the recombinant vector pKPG was constructed and transformed into fresh conidia of Botrytis cinerea via Agrobacterium tumefaciens. Transformants were identified by PCR analysis of gfp and hph cassette, green fluorescence observation with microscope and Southern hybridization. Results confirmed that target genes were successfully integrated into the genome of Botrytis cinerea.

Objective: The aim of the study is to evaluate the left ventricular (LV) dyssynchrony in chronic heart failure (HF) patients with normal and wide QRS duration., Methods: Time to peak velocity at peak systolic and early diastolic phase (Ts and Te) were determined in 12 segments of LV by echocardiography (GE Vivid 7) in 54 HF patients (28 with wide and 26 with normal QRS duration) and 15 normal controls to evaluate LV systolic and diastolic dyssynchrony. The risk factors related to LV dyssynchrony were also evaluated., Results: LV end systolic and diastolic volumes were significantly larger and 12 segmental mean Ts and maximal Te difference (Te-diff) were significantly higher in HF patients with wide QRS duration than HF patients with normal QRS duration. Using mean Ts >or= 182 ms as the cut-off value, systolic dyssynchrony was present in 46% HF patients with normal QRS and 71% HF patients with wide QRS. Using Te-diff >or= 79 ms as the cut-off value, diastolic dyssynchrony was seen in 58% HF patients with normal QRS and 89% HF patients with wide QRS. Combined systolic and diastolic dyssynchrony was seen in 31% HF patients with normal QRS and in 64% HF patients with wide QRS. Systolic dyssynchrony was significantly correlated to LV end systolic volume and diastolic dyssynchrony was correlated to end diastolic volume., Conclusion: Percentage of LV dyssynchrony was significantly higher in HF patients with wide QRS, especially in HF patients with increased LV end systolic and diastolic volume.

A cDNA clone encoding the ADP/ATP translocase in Helicoverpa armigera has been identified by RT-PCR, 5'and 3'RACE methods. Sequence analysis shows that it is 1,190 bp long and contains a single open reading frame (ORF, 133-1,033 bp) encoding a protein of 300 amino acids (GenBank submission number, AY253868). The protein has a 22 aa signal peptide on its N-terminal, which leads the protein locating onto the inner membrane of the mitochondria. It also has three conserved domains of the mitochondrial carrier protein forming a channel to exchange ATP and ADP energy molecule through the inner membrane of the mitochondria. It shows extensive similarities to the known ADP/ATP translocase poly-peptides. The ADP/ATP translocase similarity was up to 90% in the Lepidoptera.

The LIM domain is found in a wide variety of eukaryotic proteins that regulate gene expression and cell differentiation during development. Muscle LIM protein (MLP) gene in Bombyx mori has been cloned by blasting its EST database and PCR test in present report. The resulting sequence covers 2 327 bp of cDNA (GenBank accession No. DQ311195). It has a complete open reading fragment and encodes a 494 amino acid protein. Genomic DNA sequence contains 11 exons and 10 introns, with intron splicing following the GT-AG rule. M.W. and PI of the predicted MLP in Bombyx mori are 53.03 kDa and 8.29 respectively. A single LIM domain linked to a glyscine-rich region is found in a previously deposited LIM protein (AAR23823) in Bombyx mori. MLP identified in this report encodes a protein with five tandem LIM-glycine modules. The two LIM proteins could be produced by alternative splicing and both are probably involved in muscle cell differentiation. This work provides foundation for further research on the in vivo function of MLP.

The ratio of Z chromosome number to autosomal chromosome (A) is different between male and female lepidoptera insects. In males: 2Z : 2A=1, and in females: Z : 2A=0.5. The ratio of the copies of gene (such as K) on Z chromosome number to the copies of gene (such as N) on autosomal chromosome (K/N) is also different between male and female. In males: 2K : 2N =1, and in females: K : 2N=0.5. The DpKettin gene of the pine caterpillar Dendrolimus punctatus was cloned with the primers designed according to the sequences of the BmKettin of the silkworm and the HaKettin of the cotton bollworm. The ratio of copies between DpKettin and ANT (adenine nucleotide translocator) in male and female was determined by the real-time quantitative PCR technique. They were 1.0 in males and 0.5 in females. These ratios were equal to the ratios of the copies of gene on Z chromosome number to the copies of gene on autosomal chromosome. It indicates that DpKettin is located on Z chromosome in the genome of the pine caterpillar.

Objective: This study assessed cardiac function changes post embryonic stem cells (ESCs) perfusion at different concentrations in the isolated apolipoprotein-E gene deficiency (apo E-/-) and wild type (WT) hearts., Methods: apo E-/- and WT mice hearts were isolated and retrogradely perfused (Langendorff model) and ESCs were infused with different concentrations (Low dose group: 1.0 x 10(6) cells, high dose group: 2.5 x 10(6) cells). Hemodynamic parameters including coronary flow (CF), heart rate (HR), dp/dtmax, dp/dtmin, left ventricular end diastolic pressure (LVEDP), were recorded after stabilization period and at before, 5 min, 15 min and 30 min after cell perfusions. The number of cells in the transudate was counted., Results: Cardiac function parameters were similar before cell perfusion in apo E-/- and WT hearts. Cardiac function was significantly impaired after low dose cell perfusion in apo E-/- hearts while remained unchanged in WT hearts with the exception of lowered HR. Cardiac function was also significantly impaired after high dose cell perfusion in both apo E-/- and WT hearts, especially in apo E-/- murine hearts. Most of the cells perfused into the heart were expelled after 30 min (63.2% - 77.0%)., Conclusion: ESCs perfusion into an isolated heart, especially in the atherosclerosis-prone hearts, in the Langed off model impaired cardiac function in a concentration-dependent manner.

Objective: To explore the preliminary clinical evaluation of hepatectomy with total hemi-hepatic vascular exclusion., Methods: Twenty-eight patients with primary liver cancer were divided into two groups of hepatectomy with total hemi-hepatic vascular exclusion (group A) and total hepatic inflow occlusion (group B). The time of hepatic vascular control, intraoperative blood loss, volume of removed liver, postoperative liver function recovery and complications were compared between the two groups., Results: The intraoperative blood loss in group A was (296 +/- 240) ml, which was less significantly than that in group B [(582 +/- 497) ml] (P<0.05). The serum pre-albumin levels on the day 1, 3 and 7 after operation in group A were (164 +/- 39) mg/L, (111 +/- 17) mg/L and (104 +/- 23) mg/L, which were higher significantly than that in group B [(134 +/- 34) mg/L, (90 +/- 22) mg/L and (82 +/- 35) mg/L] (P<0.05). While the time of hepatic vascular control and volume of lost liver were no difference between the groups (P>0.05). There were no significant difference in other items between the groups., Conclusions: Intraoperative blood loss and liver damage of hepatectomy under the total hemi-hepatic vascular exclusion could be less than that under the other methods of vascular occlusion. It could be worth improving and applying further.

Objective: To investigate the impact of calcified lesion on the intimal hyperplasia after implantation of drug eluting stent., Methods: Ninety-nine rapamycin-eluting stents were implanted into the left anterior descending branches of coronary artery of 97 patients with 99 lesions. Eight months later intravascular ultrasound (IVUS) was used to examine the cross section area (CSA) of the external elastic membrane (EEM) at the stent inlet and at the stent outlet, in-stent CSA, CSA of the lumen, area of neo-intima (in-stent area minus lumen CSA), the maximum and minimum diameters of stent, and symmetry index of stent (minimal diameter of stent/maximum diameter of stent)., Results: Forty-one lesions were calcified and 58 non-calcified. Fourteen of the 99 lesions in the 97 patients developed intimal hyperplasia. The inlet stent CSA of the calcified group was (7.30 +/- 1.94) mm(2), similar to that of the non-calcified group (6.58 +/- 1.96) mm(2); the outlet CSA of the calcified group was (6.74 +/- 2.02) mm(2), similar to that of the non-calcified group (6.14 +/- 1.82) mm(2). The minimum stent CSA of the calcified group was (4.97 +/- 1.51) mm(2), significantly smaller than that of the non-calcified group (6.10 +/- 1.87) mm(2) (P < 0.05), the symmetry index of the calcified group was 0.92 +/- 0.07, significantly lower than that of the non-calcified group (0.92 +/- 0.07, P < 0.05), and the intimal area of the calcified group was (0.02 +/- 0.20) mm(2), significantly smaller than that of the non-calcified group (0.53 +/- 1.50) mm(2) (P < 0.05)., Conclusion: Drug eluting stent implantation in the patients with calcified lesions has a less stent CSA and poor symmetry, and less intimal hyperplasia compared with those in the non-calcified lesions.

Objective: To assess the impact of expansion grade of sirolimus eluting stent on intimal hyperplasia with intravascular ultrasound (IVUS)., Methods: A total of 75 patients implanted with sirolimus eluting stents for at least 8 months were enrolled in this study and IVUS could be performed in 76 stents of 73 patients and 2 patients were excluded due to total coronary occlusion. External elastic membrane (EEM) cross-sectional areas (CSA) at stent inlet and outlet, at in-stent minimal CSA; in-stent CSA, cavity CSA, intimal area (in-stent area-cavity area), maximal and minimal diameter of stent, and symmetry index of stent (minimal diameter of stent/maximal diameter of stent) were measured., Result: Five out of 76 stents of 73 patients developed intimal hyperplasia and intimal proliferation was inhibited by sirolimus eluting stent in patients with either minimal stent CSA/EEM CSA < 0.5 (n = 56) or >or= 0.5 (n = 20), minimal stent CSA/reference CSA < 0.9 (n = 44) or >or= 0.9 (n = 32), minimal stent CSA < 5 mm(2) (n = 25) or CSA >or= 5 mm(2) (n = 51), symmetry index of stent at minimal CSA of stent < 0.9 (n = 37) or >or= 0.9 (n = 39) during IVUS follow up., Conclusion: Sirolimus eluting stent inhibited intimal hyperplasia independent of stent expansion grade.

Objective: To investigate the association between acute coronary syndrome (ACS) and functional matrix metalloproteinase-9 polymorphism (C-1562-T)., Methods: This study was conducted with a case-control design including 101 patients with angiographically documented ACS and 105 control subjects who were free from coronary artery disease and had normal angiograms. Genotype was determined by polymerase chain reaction-restriction fragment length polymorphism for the common C-1562-T functional promoter polymorphism of the MMP-9 gene.The relationship between the polymorphism in the MMP-9 gene and the severity of coronary arterial stenosis was analyzed., Results: The results of individual polymorphisms analysis showed that the frequency of C/T and T/T genotypes of the C-1562-T polymorphism (27.2%) in patients with ACS was significantly higher than that in those with a normal angiogram (13.34%).The frequencies of -1562T allele were 14.9% and 7.2% in ACS group and control group respectively (Chi2 = 5.617, P = 0.018). The frequencies of C/T and T/T genotypes of the C-1562-T polymorphism were not statistically different among ACS patients with normal and one,two,three or more significantly diseased vessels (Chi2 = 0.601, P = 0.896)., Conclusion: The present findings suggest that the genetic polymorphism in MMP-9 promoter (C-1562-T) is associated with the susceptibility to ACS in the Han population of China. And the C-1562-T polymorphism may not be useful as a predictor of the severity of coronary atherosclerosis.

Objective: To assess plasma renin activity (PRA) of renal veins in patients with unilateral renal artery atherosclerotic stenosis and its relationship with blood pressure changes after renal artery stenting., Methods: Fifty patients with significantly unilateral renal artery stenosis (lumen loss > or = 70%) and coronary artery stenosis were included. Bilateral renal vein and peripheral PRA and angiotensin II were determined and their relations with blood pressure changes after stenting were analyzed., Results: All patients were revascularized successfully for both coronary and renal artery stenosis. PRA in the ischemic kidney was significantly higher than that in the contralateral kidney (1.44 +/- 1.73 ng.ml(-1).h(-1) vs 1.27 +/- 1.57 ng.ml(-1).h(-1), P = 0.04). Ischemic and contralateral renal vein renin ratio (RVRR) was > or = 1.5 in 14 patients (28%) (renal vascular hypertension, RVH group). During follow-up (12 +/- 9 months), blood pressure returned to normal in 9 patients after revascularization, 7 were of RVH group (50%) and 2 were in control group (6%) (P < 0.001). Multivariate logistic analysis indicated RVRR > or = 1.5 was significantly related to the decrease of hypertension after renal artery stenting (OR = 3.15, 95% CI = 1.49 approximately 5.97, P = 0.02)., Conclusions: PRA was significantly increased in the ischemic kidney in about one-third of patients with unilateral renal artery stenosis. Hypertension could be controlled easily to normal value after renal artery stenting in half of the patients with RVRR > or = 1.5. Measurement of renal vein renin activity in patients with renal artery stenosis is very useful in evaluating the effects of renal artery stenting on hypertension.

Objective: To analyse the impact of sirolimus-eluting stents (SES) on long-term outcomes in patients with coronary artery disease (CAD) and diabetes., Methods: Among 1004 patients with CAD undergone percutaneous coronary intervention (PCI), 84 diabetic and 250 non-diabetic patients received SES, 168 diabetic and 502 non-diabetic patients had bare metal stent (BMS) implantation. Baseline clinical characteristics, interventional procedures (coronary angiography and PCI), occurrence of major adverse cardiac events (MACE), and MACE-free survival rates at one year during follow-up were compared., Results: During follow-up (average 16.2 months), patients (with and without diabetes mellitus) who received SES had similar occurrence of MACE (4.8% vs. 3.6%, P = 0.744) and MACE-free survival rates at one year (95.0% vs. 96.7%, P = 0.602). However those received BMS had a higher occurrence of MACE in diabetes mellitus than that in non-diabetic patients (31.0% vs. 21.7%, P = 0.015). MACE-free survival rate at one year was lower in diabetic patients with BMS than that in non-diabetic patients with BMS (74.2% vs. 86.8%, P = 0.001)., Conclusion: Implantation of sirolimus-eluting stents may reduce the major adverse cardiac events and the frequency of repeat intervention in patients with diabetes mellitus.

Objective: To investigate whether the number of circulating endothelial progenitor cells (EPCs) correlate with the severity of coronary stenosis in patients with stable coronary artery disease (CAD)., Methods: 80 consecutive patients who underwent coronary angiography (exclusion of acute coronary syndrome and myocardial infarction) were enrolled. Physical examination and blood tests were performed to assess the disease severity and cardiovascular risk factors. Circulating EPCs as measured by the number of CD133/KDR double positive cells were detected by FACS., Results: The number of EPCs inversely correlated with age, creatinine clearance (Ccr) and left ventricular mass index (LVMI) (P = 0.004, 0.015, 0.014 respectively). Patients with hypertension showed significant reduction in number of EPCs compared to those without hypertension (P = 0.004). Moreover, the number of EPCs in patients with coronary artery disease was significantly lower than that of those with normal coronary artery (P < 0.01). EPCs also inversely correlated with angiographic Gensini score (n = 49, r = -0.305, P = 0.039)., Conclusions: In patients with stable CAD, the numbers of circulating EPCs correlate with the severity of CAD as well as cardiovascular risk factors.

Objective: To observe the long-term outcomes following coronary stenting in diabetic patients with coronary artery disease., Methods: This cohort study comprised 808 consecutive patients with coronary artery disease who underwent elective coronary stenting, including 174 diabetic patients and 634 non-diabetic patients. The long-term follow-up outcomes were compared., Results: Procedural success rate was similar (96.0% vs 96.1%). Follow-up rate was 95.3%. Mean follow-up duration was (19 +/- 7.8) months (ranged from 6 to 42 months). Compared with non-diabetic patients, diabetic patients had less improvement of cardiac function (52.2% vs 61.0%), more re-admission (42.7% vs 32.5%), and higher occurrence rates of major adverse cardiac events (30.6% vs 22.2%), angiographic restenosis rate (19.1% vs 12.5%) and mortality (10.2% vs 4.6%). Logistic regression analysis indicated that diabetes mellitus was an independent predicator of death (odd ratio 2.20, 95% CI 1.12 approximately 4.33, P = 0.022) and restenosis (odd ratio 1.66, 95% CI 1.04 approximately 2.67, P = 0.035)., Conclusion: Diabetic patients undergoing elective coronary stenting have acceptable long-term outcomes, but diabetes mellitus is still independently associated with worse late prognosis.

Objective: To evaluate the immediate and mid-term efficacy of coronary stenting in patients with acute coronary syndrome (ACS) and renal dysfunction., Methods: Sixty-three ACS patients with renal dysfunction were included (RD group) and 63 contemporaneous ACS patients with normal renal function served as a control group. The clinical characteristics, stenting procedure and follow-up information were compared between the two groups., Results: Patients in the RD group had higher basic serum creatinine levels [(177 +/- 31) micro mol/L vs (98 +/- 21) micro mol/L, P < 0.001], lower left ventricular ejection fraction (0.45 +/- 0.10 vs 0.50 +/- 0.09, P < 0.05) and increased prevalence of multivessel coronary artery disease (84% vs 65%, P < 0.05) as well as > 50% renal artery stenosis (27% vs 8%, P < 0.05). There was no statistical difference in procedural success rate and major adverse cardiac events occurrence during a mean follow up time of 27 months (13% vs 8%, P = 0.38). In the RD group, the mean level of serum creatinine was significantly decreased [(177 +/- 31) micro mol/L vs (147 +/- 11) micro mol/L, P < 0.05] and 9 (69%) patients with renal artery stent implantation had normal creatinine levels during follow-up., Conclusions: Coronary stenting is a safe and effective therapy for ACS patients complicated with renal dysfunction, two thirds of patients receiving renal stent implantation had normal serum creatinine during follow-up.

Objective: To evaluate the urine microglobulin change after interventional therapy in patients with renal artery stenosis., Methods: According to the results of renal artery angiography, 69 consecutive patients with coronary heart disease were divided into 2 groups, including 44 patients with severe renal artery stenosis RAS (luminal narrowing > 70%, group I) and 25 patients with atherosclerotic lesion in renal artery (luminal narrowing > 50% but < 70%, group II). The urine alpha(1), beta(2)-microglobulin (alpha(1), beta(2)-MG) were measured respectively. The successful procedural rates, rates of complication, serum creatitine and the urine alpha(1), beta(2)-MG 3 months after procedure were also recorded. The acute results and long-term follow-up outcomes were compared between the 2 groups., Results: Urine alpha(1)-MG [(5.2 +/- 2.5) microg/L vs (3.0 +/- 2.7) microg/L, P > 0.001] and beta(2)-MG [(377 +/- 173) microg/L vs (202 +/- 184) microg/L, P > 0.001] were significantly higher in group I than in group II. However, the urine alpha(1)-MG of the 2 groups did not exceed the normal range (<6 microg/L). The urine beta(2)-MG [(237 +/- 187) microg/L vs (377 +/- 173) microg/L, P > 0.01] 3 months after stenting procedure in group I were significantly decreased. There were no significance change in urine alpha(1)-MG in group I and both the microglobulins in group II during follow-up. There was significant difference in improvement of blood pressure between the 2 groups (62.5% vs 9.1%, P > 0.01). As compared with group II, group I patients had more re-admission (22.5% vs 9.1%), renal failure (5% vs 0) and higher mortality (5% vs 0). However, these measurements did not differ significantly. Multivariate analysis revealed that persistent elevation of urine beta(2)-MG was an independent predictor of severe events (including re-admission and renal failure) after renal artery stenting (OR = 3.01, 95% CI 1.01 - 8.95, P = 0.036)., Conclusions: Severe RAS causes damage of tubular reabsorption. Renal artery stenting improves tubular function, but in patients with persistent elevation of beta(2)-MG, the rates of re-admission and renal failure remain high.