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The potential of probiotics for treating ulcerative colitis (UC) has attracted increasing attention. However, more studies are still needed to guide physicians on the proper selection and use of probiotics. Here, we propose that combination of multiple probiotics with different functions can reduce intestinal inflammation. In this study, the effects of probiotics (Lactobacillus reuteri, Bacillus coagulans, Bifidobacterium longum, and Clostridium butyricum) on the physiology and histopathology of colon were evaluated in a dextran sulfate sodium (DSS)-induced colitis mouse model. The combined species, as well as the species individually, were tested and compared with sulfasalazine (SASP) and two Chinese herbal therapies. Results show that the functions of the four probiotic strains were different in regulating intestinal immunity and barrier function. The four-species probiotic cocktail was more effective than the species individually and anti-inflammatory drugs in repairing the dysbiosis of mucosal microbial ecology and reducing intestinal inflammation. The multi-strain probiotic mixture increased the proportion of beneficial bacteria and decreased the proportion of pro-inflammatory bacteria in the colonic mucosa. In addition, probiotic mixture significantly enhanced the expression of IL-10 and intestinal barrier function. These results suggest that a combination of multiple probiotics with different functions has synergistic effects and can restore the balance of interactions between microorganisms and immunological niches.

Weaning stress has serious negative effects on piglets' health and the swine industry. Probiotics-fermented Chinese herbal medicines are potential feed additives to ameliorate weaning stress. In this study, the effects of probiotics-fermented Massa Medicata Fermentata (MMFP) on intestinal homeostasis were evaluated in weaning piglets. Dietary supplementation with MMFP promoted the development of the intestinal structure and elevated the concentrations of lactic acid and short-chain fatty acids (SCFAs) in the intestinal contents and antioxidant capacities in serum. MMFP reduced the levels of inflammatory factors in the intestinal mucosa. Microbial community analysis demonstrated that MMFP led to the selective and progressive enrichment of lactic acid- and SCFA-producing bacteria along the gastrointestinal tract, in particular, OTUs corresponding to Lactobacillus, Streptococcus, Acetitomaculum, Roseburia, and Eubacterium xylanophilum group, while MMFP reduced the relative abundance of pathogenic bacteria. On the contrary, antibiotics had negative effects on intestinal histology and increased the relative abundance of pro-inflammatory bacterium, such as Marvinbryantia, Peptococcus, Turicibacter, and Blautia. Correlation analysis reflected that the bacteria enriched in MMFP group were positively correlated with enhanced intestinal homeostasis, which suggested that dietary supplementation with MMFP enhanced host intestinal homeostasis by modulating the composition of gut microbiota and the levels of beneficial SCFAs, thus ameliorating weaning stress in piglets.

Pseudomonas fluorescens and Shewanella baltica are specific spoilage organisms (SSOs) of most seafood products. Both of them can cell-to-cell communicate through quorum sensing (QS), facilitating the spoilage activities such as protease secretion, flagellar movement, and biofilm formation. Thus, it is important to screen the quorum sensing inhibitors (QSI) of P. fluorescens and S. baltica. In this study, we tried to apply a high-throughput virtual screening technology to select QSIs candidates. Three amino acid sequences from the key QS regulator–LuxR/I family (the LuxR and LuxI proteins of P. fluorescens, and the LuxR of S. baltica) were targeted and analyzed. Their 3D structures were subsequently constructed for the QSIs candidates' screen of both P. fluorescens and S. baltica. The candidates of cytidine-5′-monophosphate (5′-CMP) and 5′-adenylic acid (5′-AMP) with high scores exerted strong antagonistic effects against both P. fluorescens and S. baltica QS. The addition of 5′-CMP and 5′-AMP also inhibit QS-controlled phenotypes (swimming motility, protease activity, EPS, and biofilm formation) in P. fluorescens and S. baltica. Furthermore, the exogenous addition of 5′-CMP and 5′-AMP could retard the spoilage process of salmon slices during low-temperature storage by inhibiting the production of extracellular protease, siderophores, and Total Volatile Basic Nitrogen (TVB-N).

We evaluated the effects of the dead probiotic Bacillus coagulons as a diet additive on growth performance, survival rate, digestive enzymes, and meat quality of the white shrimp Litopenaeus vannamei. Two treatment groups (T-1 and T-2) and a control group, each with 3 replicates, were established. The shrimp in the control were fed a basal diet, and those in T-1 and T-2 were fed with a basal diet containing viable and dead probiotic cells, respectively. After 50 days of culture, the addition of the probiotic resulted in greater (P < 0.05) final weight and daily weight gain, and survival rate. As for growth performance, the highest values (P < 0.05) were observed in T-1. Higher activities (P < 0.05) of protease, amylase, and lipase were also found in T-1 compared with T-2 and the control. No significant differences appeared in the muscle compositions of moisture, crude protein, and ash. However, the group that received viable probiotic showed greater (P < 0.05) muscle crude fat composition than th...

The transforming growth factor beta (TGF-β) signaling pathway is a tumor-suppressor pathway that is commonly inactivated in colorectal cancer (CRC). The inactivation of TGFBR2 is the most common genetic event affecting the TGF-β signaling pathway. However, the mechanism by which cancer cells downregulate TGFBR2 is unclear. In this study, we found that the TGFBR2 protein levels were consistently upregulated in CRC tissues, whereas its mRNA levels varied in these tissues, suggesting that a post-transcriptional mechanism is involved in the regulation of TGFBR2. Because microRNAs (miRNAs) are powerful post-transcriptional regulators of gene expression, we performed bioinformatic analyses to search for miRNAs that potentially target TGFBR2. We identified the specific targeting site of miR-135b in the 3'-untranslated region (3'-UTR) of TGFBR2. We further identified an inverse correlation between the levels of miR-135b and TGFBR2 protein, but not mRNA, in CRC tissue samples. By overexpressing or silencing miR-135b in CRC cells, we experimentally validated that miR-135b directly binds to the 3'-UTR of the TGFBR2 transcript and regulates TGFBR2 expression. Furthermore, the biological consequences of the targeting of TGFBR2 by miR-135b were examined using in vitro cell proliferation and apoptosis assays. We demonstrated that miR-135b exerted a tumor-promoting effect by inducing the proliferation and inhibiting the apoptosis of CRC cells via the negative regulation of TGFBR2 expression. Taken together, our findings provide the first evidence supporting the role of miR-135b as an oncogene in CRC via the inhibition of TGFBR2 translation.

We retrospectively reviewed the outcomes after laparoscopy versus an open procedure for the resection of pheochromocytoma.Forty-nine patients were enrolled into the study between June 2004 and December 2008 having been diagnosed with pheochromocytoma. The selection criteria were patients who were diagnosed with pheochromocytoma on admission based on clinical manifestations, imaging examinations and laboratory tests. Twenty-six patients underwent a retroperitoneal laparoscopic resection of their pheochromocytoma (LRP), and another 23 patients underwent an open resection of the pheochromocytoma (ORP).The ORP was similar to the LRP on the incidence of intraoperative blood pressure fluctuation. While compared to ORP, the process of LRP could effectively control the degree of fluctuations in intraoperative blood pressure(P0.05). Patients who received LRP had a significantly reduced volume of fluid in their drain on the first postoperative day than those who received ORP(P0.05), and due to the drain being removed sooner, they were consequently able to mobilize earlier(P0.05). The LRP cohort consisted of four patients with tumors ranging from 6 to 7 cm and three of them were successfully achieved. Intraoperatively or within 24 h postoperatively, 10 out of 23 patients who had undergone ORP received a transfusion, while none of those in the LRP cohort received a transfusion.Retroperitoneal LRP allowed patients to mobilize earlier and minimized the occurrence of intraoperative blood pressure fluctuations and transfusion events. Adequate preoperative preparation and skilled laparoscopic manipulation appeared to guarantee the safety of the procedure, and large tumors did not absolutely contraindicate the use of laparoscopy.

Tilapias (Oreochromis niloticus) juveniles (total length 4.9 +/- 0.2 cm and weight 1.8 +/- 0.2 g) were exposed to several nitrite concentrations (0, 10, 18, 32, 56 and 100 mg l(-1)) for 96 h, using a semi-static renewal method at chloride levels of 35.0 and 70.0 mg l(-1). At the end of the 96-h period, the median lethal concentration (LC(50)) of nitrite was 28.18 mg l(-1) in water with low chloride content (35.0 mg l(-1)) and 44.67 mg l(-1) with high chloride content (70.0 mg l(-1), respectively). It indicated that high concentrations of chloride ions could reduce the toxicity of nitrite. During the toxicity experiments, the behaviour and clinical signs of tilapias were also observed. Furthermore, the test of toxic mechanism was designed taking five test concentrations, viz., 5, 10, 15 and 20 mg l(-1) and a nitrite-free control. Nitrite exposure produced high levels of methaemoglobin (MHb) but did not seem to cause mortality, as surviving tilapias showed high levels (85.37 +/- 2.23 and 53.82 +/- 3.44 at 35.0 and 70.0 mg l(-1) chloride, respectively). The percentage of MHb exposed to nitrite was significantly higher (P0.05) than the control (0 mg l(-1) nitrite) and increased with the increasing nitrite concentration. However, the percentage of MHb decreased with the increasing chloride concentration.

Objective To probe the clinical effect, safety, economic benefit and cost of early PCI after thrombolysis with reteplase in the treatment of STEMI. Methods Patients with STEMI who admitted in our hospital from June 2009 to December 2010 were included in this study. A total of 71 patients whose symptom and ECG indicated the sign of repatency with residual stenosis of IRA>75% was divided into early PCI group (35 cases) and elective PCI group (36 cases). PCI was performed 6 h after thrombolysis in early PCI group, and 7 to 10 days after onset of AMI in elective PCI group. The clinical data, rate of coronary repatency, stenosis degree of coronary, thrombolysis in myocardial infarction flow grade pre-PCI and post-PCI, as well the TIMI myocardial perfusion grading (TMPG) were compared between the two groups. Echocardiography was performed 1 week and 3 months after onset of AMI respectively to evaluate the left ventricular function. The major adverse cardiac events (MACE) in hospital after AMI were followed up and compared between the two groups. The in-hospital stay and charges were also calculated and compared between the two groups. Results There were no statistic significances between the two groups in baseline characteristics. There were no significant differences in TIMI flow grade before PCI between the two group (all p>0.05). The repatency rate of IRA (TIMI flow grade 2 and 3) before PCI in early PCI group was 96.9%, while it was 89.5% in elective PCI group (p>0.05). The complete repatency rate (TIMI flow grade 3) in early PCI group was higher than that in elective PCI group (p 0.05). The left ventricular function in early PCI group at 1 week after AMI was no significant difference compared with that in elective PCI group (all p>0.05). Though the LVEDVI, LVESVI and LVEF 3 months after PCI were not significantly different between the two groups (all p>0.05), the value of LVEDVI and LVESVI at 3 months after AMI decreased significantly compared with that 1 week after AMI in early PCI group (both p 0.05). The in-hospital stay in early PCI group was shorter than that in elective group (p Conclusions Early PCI after thrombolysis repatency with reteplase in STEMI patients can improve the coronary blood flow and myocardial perfusion. There is also improvement in heart function and inhibit myocardial remodeling, as well as decrease in the in-hospital stay and cost compared with elective PCI.

Objective To investigate anisodamine for the prevention of Contrast Induced Nephropathy (CIN) in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary PCI. Methods Consecutive patients undergoing primary PCI were randomly assigned to one of two groups: (1) patients in anisodamine group (ANI group) were assigned to receive anisodamine (3–4 ug/kg/min intravenous infusion of anisodamine within 30 min before primary PCI), (2) control group (CON group) to isotonic saline (0.9%) with the same volume. All patients were hydrated with intravenous isotonic saline (0.9%) for 12 h after PCI. The Serum creatinine (SCr) concentrations, estimated glomerular filtration rate (eGFR) and incidence of CIN were measured and compared at admission, 24, 48 and 72 h after PCI between the two groups. Results A total of 126 consecutive STEMI patients were randomly assigned to receive anisodamine (n=60) or placebo (control, n=66) from admission to 24 h after PCI. The renal function of all patients after PCI underwent a course from injury to recovery. The incidence of CIN was 5.0%, 8.3%, and 6.7% at hour 24, 48 and 72 respectively after primary PCI in ANI group, while in CON group it was 16.7%, 22.7%, and 19.7% respectively. The incidence of CIN in ANI group was lower than that in CON group within 72 h after PCI (all p Conclusions Intravenous infusion of anisodamine prior to primary PCI may prevent the incidence of CIN in STEMI patients.

Objectives To evaluate the protective effects of higher dose statin on renal function and the incidence of CIN. Methods 228 patients with acute coronary syndrome undergoing delayed percutaneous coronary intervention were randomly divided into standard statin group (SSG n=115) and intensive statin group (ISG n=113). Patients in SSG were given simvastatin 20 mg/day and patients in ISG were given simvastatin 80 mg/day for at least 7 days before PCI, Serum creatinine was measured at admission, 24 h and 48 h after PCI, and the Creatinine clearance was calculated. The levels of hs-CRP, ICAM-1 and P-selectin were also measured. Results Serum creatinine underwent significant increase after PCI, the peak value occurred at 24 h, and then began to decrease. At 48 h after PCI, the creatinine level significantly decreased (p Conclusion Pretreatment with intensive statin dosage before PCI can further decrease the occurrence of CIN. This benefit may be associated with the lowering of hs-CRP, P-selectin and ICAM levels.

Objective To investigate the efficacy and safety of platelet glycoprotein IIb/IIIa inhibition (tirofiban) during PCI in AMI patients performed primary PCI. Methods A total of 96 patients with AMI were randomised to divide into two groups: the tirofiban group (TG, n=44,) and the control group (CG, n=52). Tirofiban was only administrated in the tirofiban group. Before the CAG, enough clopidogrel, aspirin and heparin be used in both groups. The MACE and the haemorrhage events were collected in each group during in-hospital. The lesion and reperfusion of the IRA and myocardial were analyses by QCA and TMPG. The platelet aggregation rate were recorded All patients received UCG 1 week and 24 weeks after PCI to evaluate the heart function. Results There was no significant differences in age, gender, risk factors, pre-angina, the location of the AMI, heart function, and the mean interval from onset to PCI between the two groups. A greater percentage of TIMI 1 flow of IRA was achieved in TG compared with the control group before PCI (p Conclusion Intravenous administration of trofiban can inhibit the platelet aggregation, improve the coronary flow of IRA, decrease the incidence of NRP in AMI patients performed PCI, which in turn will improve the heart function and decrease the incidence of MACE. Tirofiban can make more IRA patent before PCI, but do not increase the haemorrhage events.

Objective To assess the effects of RA-URIS dual chamber sequential pacing on left ventricular remodelling and cardiac function in SSS or AVB patients with chronic heart dysfunction. Methods 32 patients with SSS or AVB associated chronic heart dysfunction were divided two groups RA-URIS pacing group (13 cases) and RA-RVA pacing group (19 cases). The parameters including left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and 6 min walk test (6-MWT) were compared between two groups in pre-pacing and in follow up 24 months after pacing. Results There were no difference on LVEF, LVMI and 6-MWT between two groups before pacemaker implanted. But after 24 months for pacing therapy in RA-URIS group, there was significant increase in LVEF (48.3±10.1 vs 40.7±8.4, p Conclusion The results showed that RA-URIS pacing may reverse left ventricular remodelling in patients with chronic heart dysfunction as well as improving life quality.

Objective To assess the beneficial efficacy and safety of the high maintenance dose of clopidogrel in acute anterior myocardial infarction (AMI) patients undergoing selective percutaneous coronary intervention (PCI). Methods Fifty two patients were enrolled into this study. These cases were randomly divided into the high maintenance dose group (n=26, 14 males, 150 mg clopidogrel per day) and the control group (n=26, 15 males, 75 mg clopidogrel per day). QCA and TIMI Myocardial perfusion grading (TMPG) were used to analyse the lesion and reperfusion of the culprit vessel and myocardium. Record the information of patients in-hospital, in the 1 month and 6 months including the level of BNP, left ventricular ejection fraction (LVEF), the left ventricular peak ejection rate (LPER), the left ventricular peak filling rate (LPFR), the left ventricular time to peak ejection rate (LTPER) and left ventricular time to peak filling rate (LTPFR). Result 1. The CTFC of the high maintenance dose group after PCI was smaller than the standard dose group. The percentage of TMPG 3 grade was higher in the high maintenance dose group. 2. The left ventricular peak ejection rate (LPER), the left peak filling rate (LPFR) 6 months after PCI in the high maintenance dose group was higher than the control group. The left ventricular time to peak ejection rate (LTPER), left ventricular time to peak filling rate (LTPFR) 1 month after PCI in the high maintenance were lower than the control group. 3. There were less acute and subacute thrombosis cases in the high maintenance dose group than the standard dose group. There was no significant difference in haemorrhage events between two groups. Conclusion The high maintenance dose clopidogrel can improve cardiac function. There is potential benefit in increasing coronary blood flow and improving myocardium perfusion. High maintenance dose clopidogrel decreases the acute and subacute thrombosis but do not increase the haemorrhage events.

Objective To evaluate the method of yorkpig model of AMI-ADHF by coronary occlusion with balloon and injecting of microembolus and evaluate the change of coronary and renal haemodynamic parameters on York pig model on AMI-ADHF. Methods 10 York pigs were selected in this trial. LAD was occluded by balloon which was placed on mid-distal for 30–45 min until ST segment elevation for 15 min. After deflating the balloon, the sterile microembolus were injected into LAD intermittently and injecting stopped until LVEDP>18 mm Hg. The coronary pressure and flow velocity were recorded simultaneously at baseline, instant, 30 min and 60 min after AMI-ADHF model success. Average peak velocity (APV), coronary resistance and coronary flow reserve were obtained at basic and maximal hyperaemia. Renal artery angiography was performed and renal artery diameter and pressure was measured. Doppler flowire was placed in renal artery for measure of APV of renal artery (APV ra ), renal artery vascular resistance and renal blood flow. At the same time ECG were recorded per 15 min. CK-MB and TnI were measured in all York pigs at baseline, 2 h, 4 h, 8 h, 12 h and 24 h after reperfusion. Cardiac ultrasonograph was performed to evaluate the heart function. Results (1) According to the standards of AMI-ADHF, eight models were successfully established. (2) Basic and hyperaemia APV were all decreased significantly, they were lower than that of before AMI-ADHF. coronary resistance was increased after AMI-ADHF model success. coronary flow reserve was lower than that of baseline. (3) Renal artery pressure has increased trend than baseline. renal artery vascular resistance was increased, APVr and renal blood flow was decreased than baseline. Conclusion A stable experimental method of York pig model of AMI-ADHF was established successfully by coronary occlusion with balloon and injecting of microembolus in LAD. The method had advantages of closed chest, higher succeed rate and stablility to those of drug induced, tachycardia-pacing induced, coronary artery ligation induced or microsphere injection alone.

Objective To evaluate the immediate protective effects of intensive statin pretreatment on myocardial perfusion and myocardial ischaemic injury during PCI. Methods A total of 228 acute coronary syndrome (ACS) patients were randomly divided into standard statin group (SSG, n=115) and intensive statin group (ISG, n=113). Patients in SSG received 20 mg simvastatin and patients in ISG received 80 mg simvastatin for 7 days before PCI. TIMI grade flow (TGF), corrected TIMI frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) of the intervened vessel were recorded before and after stent deployment. Plasma level of CK-MB and cTnI were measured before and 24 h after the procedure. Results The TFG after stent deployment was significantly improved with less TIMI 0–1 patients and more TIMI 3 blood flow in ISG than in SSG (all p Conclusion Intensive statin pretreatment for 7 days before PCI can further improve myocardial blood perfusion, protect myocardium from ischaemic injury.

Objective To assess the adverse effects of glibenclamide on the myocardium, for investigating more effective and rational therapy. Methods 115 consecutive patients were enrolled into the study. All patients had clinical histories of acute myocardial infarction and losed the chance of thrombolysis and emergency PCI; Each patient was assigned to either insulin or glibenclamide group according to which treatment he accepted outside hospital regularly. The patients who took glibenclamide for group A, insulin for group B and diet for group C. Collected the basical clinical informations of all patients. One month after PCI all patients took SPECT to evaluate the condition of myocardial perfusion, and ERNA for LVEF. Results The ratio of the patients with Conclusion Glibenclamide would increase myocardial ischaemic area in patients with acute myocardial infarction and type 2 diabetes mellitus. Glibenclamide increases the possibility of malignant arrhythmias in the patients with acute myocardial infarction and type 2 diabetes mellitus.

Objective To investigate clinical effects of clopidogrel combined with simvastatin or fluvastatin on the platelet aggregation rate (PAR), platelet activation marker CD62P and the incidence of major adverse cardiovascular events (MACE) in patients with ACS. Methods From April 2008 to December 2009, one hundred patients (79 male and 21 female, average age 61.46±12.84 years) who had been diagnosed as ACS were enrolled into this study. These cases were randomly divided into two groups, the Group A (n=50, treated with simvastatin 20 mg per night); the Group B (n=50, treated with fluvastatin 40 mg per night). Detailed clinical information was collected. PAR, CD62P, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) of the two groups were measured. All cases received clopidogrel (a loading dose of 300 mg and then 75 mg daily), aspirin and Low molecular weight heparin. The MACE within 14 days were recorded. Results There was no significant differences in baseline between the Group A and Group B. There was no significant differences in the PAR and expression rate of CD62P after 300 mg clopidogrel (p>0.05). 1h after treated with statins the expression rate of CD62P and PAR in the two groups were lower than that before treated with statins (p 0.05). After the above-mentioned medical treatment, the expression rate of CD62P and PAR in the two groups were similar (p>0.05). There were no significant differences in the incidence of MACE between two groups. Conclusion ACS patients with loading dose clopidogrel combined with simvastatin or fluvastatin could decrease the MACE, the results in two groups are similar. Neither simvastatin with clopidogrel nor fluvastatin with clopidogrel decreases the platelet activity of clopidogrel.

Objectives Anisodamine is widely used in the therapy of acute glomerulonephritis and diabetic nephropathy because it can improve renal microcirculation. We performed a study to evaluate the preventive effects of anisodamine against contrast-induced nephropathy (CIN) in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty. Methods A total of 260 patients with type 2 diabetes and an estimated glomerular filtration rate of (eGFR) 60 ml/min/1.73 m 2 or less undergoing coronary angiography or angioplasty were randomly assigned to receive infusion of either sodium chloride (control group, n = 128) or anisodamine (treatment group, n = 132). Patients in treatment group received infusion of anisodamine at a rate of 0.2 μg/kg/min from 12 hours before to 12 hours after coronary angiography or angioplasty, while patients in control group received infusion of sodium chloride as the same volume as treatment group. All patients received intravenous sodium chloride hydration. Contrast-induced nephropathy is defined as a 25% increase in serum creatinine from baseline or an absolute increase of > 0.5 mg/dl within 3 days after contrast exposure. The primary end point was the incidence of CIN. The secondary end point was 25% or greater reduction in eGFR. Results There were no significant differences between two groups with regard to age, gender, risk factors, laboratory results, medications and intervention. The incidence of CIN was 9.8% (13/132) in treatment group and 20.3% (26/128) in control group ( P P Conclusions These results indicate the preventive effects of anisodamine against contrast-induced nephropathy in type 2 diabetics with renal insufficiency undergoing coronary angiography or angioplasty.

Objectives To evaluate the additional benefit of preventive administration of anisodamine to tirofiban during primary PCI on myocardial reperfusion. Methods This study was prospectively observed the hemodynamic effects of anisodemine in STEMI patients undergoing early PCI following thrombolysis. From March 2010 to December 2010, consecutive STEMI patients within 12 h after thrombolysis were enrolled. All eligible patients were randomly assigned to anisodamine group (ANI) and control group (CON). Patients in ANI group received intracoronary bolus injection of anisodamine (2000 µg, 10 ml) over 2 min according to the heart rate and blood pressure, and the same volume of 0.9% sodium chloride in the CON group. The other medications and laboratory examinations were the same as phase 1. The primary end point was the level of TMPG after PCI, and the second end points were including the hemodymanic parameters, STR, peak level of CK-MB, TIMI flow grade and major adverse cardiac events after PCI. Results Seventy-six patients were prospectively enrolled, with 39 in ANI group and 37 in CON group. No significant differences in baseline clinical data and baseline angiography data were found (all p>0.05). Compared to CON group, the rate of TMPG 3 was higher in ANI group, while the CTFC was lower (both p Conclusions Intracoronary administration of anisodamine before PCI could improve the myocardil perfusion which may be result in the hemodynamic effects of anisodamine.

Objectives This study was to investigate the safety and efficacy of thrombolysis followed by early PCI via transradial artery approach in patients with ST-segment elevation myocardial infarction (STEMI). Methods From September 2009 to March 2010, all consecutive STEMI patients within 12 h from symptom onset or thrombolysis in the Department of Cardiology of the Second Hospital of Hebei Medical University were enrolled. All eligible STEMI patients were divided into two groups according to patients received thrombolysis or not: early PCI group (E-PCI group, patients received thrombolytic agents in non-PCI capable hospital and immediately transferred to receive early PCI) and primary PCI group (P-PCI group, patients received primary PCI). Coronary angiography (CAG) and PCI were performed immediately after admission via transradial artery approach for patients in both groups with standard technique. According to the results of angiography, PCI was performed unless the blood flow of IRA achieved TIMI flow grade 3 without significant stenosis. Thrombus score, TIMI flow grade (TFG) of IRA before and after PCI, corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG) post PCI were analysed. Bleeding complications was also observed and evaluated. All patients were followed up for 6 months to assess major adverse cardiac events (MACE). Results A total of 161 cases were enrolled, with 53 cases in E-PCI group and 108 cases in P-PCI group. The patients in E-PCI group were younger than those in P-PCI group (51.36±12.24 vs 57.31±9.87, p=0.003). The other baseline clinical characteristics such as gender distribution, baseline levels of serum BNP, SCr and Hb, and the medication therapies were similar between the two groups (all p>0.05). The mean time from symptom onset to thrombolysis was 3.62±1.85 h in E-PCI group, and the time from thrombolysis to PCI was 5.13±3.03 h. Compared to P-PCI group, the mean time from onset to PCI was longer in E-PCI group (8.75±2.86 vs 6.03±3.19 h, p 0.05). However, cTFC of IRA post PCI in E-PCI group was lower than that in P-PCI group (28.12±5.06 vs 30.89±8.74, p 0.05). There was a trend toward lower in the peak value of serum CK-MB in E-PCI group. No significant differences were found in the incidence of bleeding complications and hospital stay between the two groups. There was a trend of better left ventricular function 7 days after PCI in E-PCI group than that in P-PCI group. After 6-month follow-up, the left ventricular function was improved in both the two groups (all p Conclusions The myocardial perfusion and left ventricular function were better in patients underwent thrombolysis followed by early PCI, without increases of bleeding complications and incidence of MACE. It is safe and efficacious for STEMI patients to receive thrombolysis followed by early PCI via transradial artery approach.

Objective To explore preventive effects of intracoronary administration of Anisodamine on myocardial microcirculation perfusion after primary PCI in STEMI patients. Methods From March 2009 to August 2010, a total of 86 consecutive patients with first STEMI who underwent primary PCI within 12 h of symptom onset were enrolled in this study. Patients were divided into anisodamine group (n=43) and saline control group (n=43) randomly. The lesion of IRA was treated by percutaneous transluminal coronary angioplasty with over the wire balloon. In anisodamine group, 2000 ug anisodamine (concentration 500 ug/ml) was injected into the coronary artery as a preventive measure via over-the-wire-balloon. In control group, equal volume of saline was injected into the coronary artery in the same way. After that the lesion was predilated with the balloon. Angiography was done after 5 min of stent implanted, CTFC and TMPG were recorded and compared. 200 ug nitroglycerin was bolus injected intracoronary before angiography to exclude spasm of coronary artery. The major adverse cardiac events (MACE) in hospital of the two groups were compared. Results There was no significant difference between the two groups in baseline characteristics (all p>0.05). There were no significant differences in IRA distribution, multi-vessel lesion and the use of tirofiban between the two groups. No significant differences were found in the oral drugs used after pPCI in the two groups (all p>0.05). Compared to control group, the proportion of patient with TMPG 3 grade in anisodamine group was much higher (83.72% vs 62.79%, p 0.05). The heart rate increased significantly, but no reperfusion arrhythmia happened in anisodamine group, while 10 cases of reperfusion arrhythmia (23.26%) happened in the control group (p Conclusion Preventive intracoronary administration of anisodamine can effectively improve myocardial microcirculation perfusion after primary PCI in acute STEMI, and decrease the incidence of reperfusion arrhythmia and MACE in hospital.

Objective To explore the safety and efficacy of early application of tirofiban in STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods From September 2008 to march 2011, 157 STEMI patients who were preparing for PCI were enrolled into this study. All patients were randomly divided into early group (patients received tirofiban in emergency room) and late group (patients received tirofiban immediately before PCI in catheterisation laboratory). The patients in each group were divided into different subgroups after coronal artery angiography on the basis of characteristic of infarction related artery (IRA). The clinical information, the result of PCI, and the incidence of major cardiovascular adverse events (MACE) during the hospitalisation were compared between two subgroups. Results There were no significant difference in percentage of TIMI3 flow of IRA before PCI between early and late LAD group (p>0.05). However, TIMI 3 flow was significantly less frequent with late RCA group compared with that in early RCA group (p>0.05). After dilation with balloon, cTFC was significantly lower in early LAD group (p>0.05). In the RCA comparison group, early application of tirofiban was associated with lower cTFC in culprit vessel compared with late application of tirofiban (30.00±6.32 vs 36.36±8.83, p 0.05), and TMPG2/3 perfusion was significantly less frequent with late RCA group (74% vs 47%, p 0.05). There were no significant difference in the percentage of no-flow and slow-flow between early and late LAD group during the PCI (p>0.05), and percentage of no-flow and slow-flow was significantly lower in early group than in late group (6% vs 22%, p Conclusions Early application of tirofiban could improve the effect of primary PCI and could effectively limit the expansion of infarction area. Early application of tirofiban dose not increases the incidence of MACE during the hospitalisation.

Objective To evaluate the protection effects of preinfarction angina (PA) on patients with first acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). Methods From 2009–2006 to 2010–2009, a total of 104 AMI patients undergoing emergency PCI within 12 h after sympotom onset were enrolled in the study (74 male and 30 female). Each patient was assigned to without angina group (A group 38 cases), PA group (B group, 31 cases) according to occurrences of typical angina within 24 h before AMI and a group with angina but without PA (C group 35 cases). Coronary angiography was performed immediately after admission. Characteristics of lesion, infarction related artery (IRA), TIMI, spontaneous recanalisation and collateral circulation were recorded. Baseline clinical information of each patient was collected and compared. Echocardiography at 1 week and 3 month after PCI were performed. Results There were no significantly differences in baseline clinical characteristics among the three groups (p>0.05). The peak value of CK-MB was higher in group A and group C than that in group B (266.12±197.49 vs 177.29±73.85 vs 232.31±90.93, p=0.001). The blood flow of the IRA before the stent implanation was lower in group A and group C than that in group B. The incidence of ventricular arrhythmia in the three groups was similar, and the score of ventricular arrhythmia in group B was lower than that in group A and C (42 vs 29 vs 38, p=0.035). There was no significantly difference in the value of BNP in the three groups (413.99±207.69 vs 302.49±146.73 vs 396.57±189.81, p=0.035). The value of BNP in group B was lower then that in group A and group B. There was a significantly difference in EF among the three groups (45.70±5.16 vs 51.37±4.45 vs 45.93±5.94, p=0.000) at 1 week after PCI, and EF in group A and group C was lower than that in group B. EF in group B and group C was higher than that in group A, group B was higher than group C at the thr month after PCI. Conclusion Preinfarction angina can reduce the injure extent of myocardium in patients with first AMI undergoing primary PCI.

Objectives To investigate the safety and efficacy of early percutaneous coronary intervention (early PCI) in patients with non-ST Segment elevation infarction (NSTEMI) undergoing elective PCI. Methods Ninety-one patients (79 males) who suffered from first NSTEMI within 24 h from symptom onset during October 2009 and July 2010 were enrolled in this study. All the cases were randomly divided into early PCI group (n=44) and elective PCI group (n=47). PCI was performed immediately after admission in early PCI group. Patients in elective PCI group received the same medical therapies with those in early PCI group, and PCI was performed 7–10 days after admission. TIMI flow of IRA before and after PCI, as well as TIMI Myocardial perfusion grading (TMP) after PCI were compared between the two groups. The differences of left ventricular function and MACE during hospitalisation and 6-month follow-up were analysed. Results Baseline characteristics were similar between the two groups. There were no differences in the rates of IRA total occlusion, TIMI flow grade 1, and TIMI flow grade 2 before PCI between the two groups (all p>0.05), while the rate of TIMI flow grade 3 in early PCI group was lower than that in elective group (22.73% vs 42.55%, p 0.05). After 6-month follow-up, both LVEDV and LVESV decreased significantly, and LVEF increased. The incidence of cardiac rehospitalisation was lower in early PCI group, while the cardiac death, severe heart failure, reinfarction, malignant arrhythmias, revasculisation of IRA, and bleeding complications were similar. Conclusions Both early and elective PCI can improve the heart function in NSTEMI patients at 6 months, and the effects of early PCI on improving heart function is better without increase of bleeding complications.

Objective To analysis the relationship between BNP levels and CK-MB, cTNI concentrations, the degree of coronary artery disease and heart function in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 86 patients with AMI got intravenous thrombolysis within 6 h after myocardial infarction were divided into group A (BNP 500pg/ml) according to the BNP peak level. The BNP level, CK-MB, and the cTNI peak concentrations within 24 h were examined. The heart function was examined by UCG within one week, cardioangiography was performed within 7–10 days after AMI, so that to evaluate the relationship between BNP levels and CK-MB, cTNI concentrations, the degree of coronary artery disease, heart function. Result There were no statistical differences in baseline data among A, B, C groups, the higher the BNP level. The higher the CK-MB level (p Conclusion The higher the BNP peak levels, the higher the CK-MB, cTNI levels and the lower the LVEF in acute myocardial infarction patients. The between BNP peak levels had positive with CK-MB, cTNI peak concentrations and the degree of coronary artery disease, negative correlation-ship with LVEF.

Objectives To evaluated the preventive effect of simvastatin combined with anisodamine on myocardial perfusion in no reflow, and to probe the possible mechanism. Method Totally 16 minipig of 30–40 Kg were randomly divided into anisodamine groups (A, n=8) and anisodamine plus simvastatin group (A+S, n=8). Pigs in Group A+S were pretreated with oral simvastatin for 7 days, while pigs in A groups were given placebo. Seven days later, CAG was performed, and the dopper wire was used to record blood velocity. The pressure of aorta (Pa) was monitored. PMBS was injected to establish no reflow model. Anisodamine was injected into the LAD 2 min before PBMS was injected. The TIMI blood flow, TMPG and CTFC were recorded to evaluate the myocardial perfusion. The sample of myocardium in ischaemic zone and normal zone were measured. Blood sample was taken before and after the expeiment to measure the level of CK-MB, cTnI and hs-CRP. The percent of necrostic myocardium was calculated by myocardium stain method. Results The TIMI blood flow and TFCs were better in Group A+S (p Conclusion Simvastatin combined with anisodamine can significantly improve myocardial blood perfusion and porotect the myocardium against ischaemic injury during PCI. The possible mechanism involves improving of coronary haemodynamics, antiinflammation and antioxidation.

Objective To study the efficacy and safety of recombinant human B-type natriuretic peptide (rhBNP) in AMI-ADHF patients undergoing PCI, especially changes in renal function and the impact of short-term outcome during BNP treatment. Methods 87 consecutive patients with AMI-ADHF entrolled in the study. All patients were randomly assigned to the rhBNP group and control group. rhBNP was given at 1.5 μg·kg −1 intravenously and then infused intravenously (0.0075–0.030 μg·kg −1 ·min −1 ). 0.9% Saline was used intravenously in control group as control. Clinical symptoms and killip grade were recorded. Plasma BNP levels were meaured before and after stopping the drug 6 h, 14 days, 30 days. LVEDD and LVEF was measured. Serum creatinine (Scr) was measured before and after administered the medication 24 h, 48 h, 72 h, 7 days and 14 days using simplified MDRD equation to calculate estimated glomerular filtration rate. Recording the major adverse cardiac events occurrence within 30 days. Results rhBNP group has a less dyspnoea time than the control group; The plasma BNP levels significantly lower than before treatment at different time point in the two groups. The LVEF was significantly higher in treatment group compared with baseline levels after treatment 24 h, while LVEDD significantly decreased even after discontinuation the treatments, which remain so when the 30 days. The LVEF and LVEDD improvements in rhBNP group were significantly better than in the control group after treatment 24 h, 14 days. At day 7 after PCI, the SCr had lowered to the baseline level in the rhBNP group. The estimated glomerular filtration rate after PCI was higher in the rhBNP group than that in the control group. The occurrence of CIN was significantly lower in the rhBNP group than in the control group. The MACE event of 30d in rhBNP group was significantly lower than the control group. Conclusion rhBNP can promptly and effectively improve the heart function, reduce the incidence of major adverse cardiac events rate in acute myocardial infarction with heart failure patients, which also had a renal function protective effect in patients with and decreased incidence on CIN.

Objectives The purpose of this study was to establish an rat model of CIN and to evaluate its efficacy. Methods Totally 24 SD rats were randomly allocated into experimental group (group A, n=12) and control group (group B, n=12). After dehydration for 3 days, rats in group A were given intravenous MDDS, while rats in group B were given intravenous normal saline. Then, all rats got normal water-drinking to the end of study. Renal ultrasonic examination was performed to observe the morphologic changes, diameters of renal artery and blood flow in renal artery. Blood samples were taken to measure the level of serum creatinine. The tissue of kidney were incised for microscope and electron microscope study. Results The dimensions of the two groups before and after dehydration were not different. It gradually enlarged after CM injection. These changes were the most obvious at 6 and 12 h, which did not recover at 24 h. The PSV, EDV, S/D and VTI were lowerest at 6 h and then recover to normal level at 24 h. RI was increased after CM injection, the lowest occurred at 6 h, and recovered to normal level at 24 h. Serum creatinine was significantly elevated after dehydration, the highest level occurred at 12 h and then began to recover at 24 h. Microscope examination to renal sample at 12 h found patch disappearance of tubular structure, widely congestion at medullar area. No pathological glomerular changes were found under microscope. Electron microscope examination found desquamation, sparseness of microvillous of tubular endothelium, membrane confusion, disappearance, swelling, fragmentation of the MIT, with obstructed tubular lumen and basal membrane swelling. Conclusion Combined with dehydration, intravenous injection of contrast lead to obvious acute kidney injury, with the changes of kidney tissue pathology, haemodynamics and kidney functions which are similar to the characteristics of CIN in human beings.

Objective 1. To investigate the relationship between sleep apnea syndrome (SAS) and myocadial ischaemic events in patients with coronary heart disease (CHD). 2. To compare the differences of age, gender distribution, coronary angiography results in CHD patients with and without SAS. 3. To compare the differences of C-reactive protein (CRP) and haemoglobin levels in CHD patients with and without SAS. Methods 25 CHD patients with typical symptoms of angina and ECG changes were enrolled in this study. After overnight polysomnography (PSG), all the cases were monitored by portable device at night for 7 days in order to exclude the conditions that the cases did not sleep or had waked, apnea and hypopnoea events were recorded during 24: 00–4:00. Blood samples were collected 5–10 min after monitoring, and the levels of haemoglobin and C-reactive protein were examined. Results 1. The incidence of myocardial ischaemia caused by apnea and low ventilation was significantly higher in CHD patients with SAS. 2. There were significant differences between the two groups in the decrease of oxygen desaturation and the increase of heart rate. 3. BMI in CHD patients was significantly higher in those with SAS. There were more multi-vessel lesions and long lesions in CHD patients with SAS (p Conclusion 1. The incidence of SAS is much higher in patients with CHD, and the incidence of myocardial ischaemic events is higher in CHD patients with SAS. and the more seriuos respiratory disorders, the more easily myocardial ischaemia happens. With apnea related to myocardial ischaemia and oxygen reduction, has nothing to do with the heart rate. 2. Lesions of SAS in patients with coronary heart disease are heavier than Simple CHD group in coronary angiography. BMI of SAS in patients with coronary heart disease are high than Simple CHD group. 3. The levels of CRP and haemoglobin are higher in CHD patients with SAS.

Objective To investigate the clinical characteristics of acute myocardial infarction (AMI) in young patients. Methods We carried out the contrasting analysis in the clinical data between 45 young patients (age≤45 years old) and 52 old patients (age≥60 years old). Results Young AMI patients were often male, and had the typical clinical manifestations. The smoking rate, hyperfibrinogenemia rate and positive family history rate of the young people group were markedly higher than those of the old people group (p Conclusion Smoking, hyperfibrinogenemia and positive family history are main causes of AMI in young patients. Young AMI patients had the typical clinical manifestations with simple coronary lesion. The complications in the young people group are less than those in the old people group, and the prognosis was better than old cases.

Objective To evaluate the impact of intravenous administration of rhBNP on coronary and renal artery haemodynamics in York pigs model of AMI-ADHF. Methods Fourteen York pigs were included in this study. After the AMI-ADHF models were established, pigs were randomised into saline group and rhBNP group. Coronary pressure (P c ), the average peak velocity (APV), coronary vascular resistance (CR), coronary flow reserve (CFR) and coronary diameter were recorded simultaneously at baseline, instant after the model established, 60 min after continuous infusion of 0.01 μg·kg −1 ·min −1 rhBNP and the time point of LVEDP ra ) was recorded, determination of quantitative angiography of renal artery diameter, renal vascular resistance. LVEDP and LVEF was measured. Results 1. Coronary artery diameter increased after rhBNP administration. APV and CBF were significantly increased and CR decreased after rhBNP administration. CFR was significant rebound after continuous infusion of 0.01 μg·kg −1 ·min −1 rhBNP for 30min. APV and CBF significantly increased and CR significantly decreased at the stage of infusion 0.010 μg kg −1 min −1 rhBNP in rhBNP Group. 2. Renal artery pressure was significantly lower after rhBNP administration. RhBNP exerts renal vasodilator effects in a dose related relationship. RBF increased gradually after administration of rhBNP and was significantly higher than control group. RVR decreased after administration of rhBNP. LVEF was lower than baseline after the models established and tended to increase after administration of rhBNP. Conclusion It could increase blood flow of injury coronary artery, improve CFR and improve the coronary and renal haemodynamics after intravenous administration of rhBNP in pigs with AMI-ADHF.

Objective To evaluated the safety and efficacy of Endeavor Stent in patients with coronary heart disease (CHD) and diabetes performed percutaneous coronary intervention (PCI) via trans-radial artery approach for de novo lesions by comparing with Cypher stent. Methods A total of 96 in-hospital patients with CHD and diabetes who performed PCI via trans-radial approach for de novo lesions were randomised into two groups: Endeavour group (EG, n=52), Cypher group (CG, n=44). The minimal luminal diameter, diameter stenosis, incidence of restenosis and major adverse cardiac events of two groups instant and 6 months’ follow-up after PCI were compared. Results There are no significant differences between the two groups in baseline characteristics. There was no significant differences between the two groups in target-vessel distribution and ACC/AHA classification. 62.95% lesions treated were Type B2/C and 57.26% lesions were in left anterior descending artery. The average length of lesion, diameter of reference vessel, multivessel lesions, release pressure were no significant difference between the two group. Success rate of PCI was 100% in both of the two groups. All of the 96 patients were finished clinical follow up, among them, CAG were reperformed in 52 patients, 28 cases in EG and 24 cases in CG. The average follow-up period was no obvous difference between the two groups. There was no patient died in hospital. Each group had 1case happened AMI (for subacute thrombosis 3 days post-PCI in CG, and infarction of another vessel in EG. Three patients in EG, while four in CG occurred angina, two of which in each group were suffered from intra-stent restenosis. There was no significant difference between the two groups in minimal luminal diameter and diameter stenosis (p>0.05) before, instantly after and 6 months after PCI, as well in early gain and late loss, restenosis rate and major adverse cardiac events (p all>0.05). Conclusion Endeavour Stent was as safe and efficient as Cypher stent in patients with CHD and diabetes.

Objective To investigate the change of brain natriuretic peptide (BNP) in plasma and the relationships with the left ventricular aneurysm (LVA) and cardiac performance in acute myocardial infarction (AMI) patients using left ventriculography (LVG). Methods A total of 64 patients with primary anterior AMI accompanied LVA diagnosed by LVG were enrolled in this study and divided into LVA group (33 patients) and non-LVA group (31 patients). Plasma BNP was measured. At the immediately after PCI and 6th month after AMI, the parameters of LVEDVI, LVESVI, LVEF, WMS and LVEDP were measured by LVG. The main adverse cardiac events (MACE) were recorded during 24 week after PCI. Results The peak value of plasma BNP in LVA group was higher and the arrived time of peak values of peak time of plasma BNP was earlier than those in the non-LVA group (p Conclusions The value of plasma BNP in the AMI patients with LVA was higher than that with non-LVA, and significantly correlated with left ventricular remodelling status and homodynamic change. It is indicated that the over secretion of BNP is involved in the left ventricular remodelling and the process of LVA formation.

Objective To address the relationship between low antiplatelet response of clopidogrel and Obstructive Sleep Apnea Syndrome (OSAS) in patients with unstable angina pectoris. Methods Total of 112 patients hospitalised with unstable angina pectoris from February 2008 to December 2009 were enrolled in this randomised consecutive study. All patients accepted routine treatment including clopidogrel, aspirin, low molecular weight heparin daily. Platelet aggregation (PAR) parameters were measured on samples obtained at baseline and 2 nd , 4 th , 6 th day. All patients were examined for the presence of sleep-disordered breath into 4 quartiles by ApneaLink. The concentration serum adrenaline and norepinephrine were measured in the morning at 6 a.m. after the sleep study. Result There were no significant differences in the baseline data in all 4 quartiles. However, there was a significant differences in the number of diabetes patients in the first quartibesity, heale (p=0.0038) compared with other quartiles. At day 2 PAR were inhibited to 63.91% of baseline (p 0.05) of baselinctively, in the first quartile. At each of these time points, platelet activity was significantly higher than in patients in other quartiles. At day 6 platelet aggregation were reduced to 32.37%, and 29.75% of baseline respectively in group 2 through 4 (p 0.05). Compared with that in thebidity of OSAS in the second and third were 25.0% and 14.3% (p Conclusion OSAS is aicator of low clopidogrel response in unstable angina patients, and higher concentration of epinephrine and norepinephrine in OSAS pa reliable ind tients plaorepinephry a more important role in this situation.

Objective To evaluate the effect of intracoronary anisodamine to correct the no-reflow phenomenon during AMI on no-reflow minipig model made by superselective LAD with 4F catheter then injection of micro thrombus. Method 14 no-reflow minipig models were randomised to intracoronary saline (4 ml), diltiazem (1 mg diluted to 4 ml) and anisodamine (2 mg to 4 ml) groups. CAG was performed at 1, 3, 5, 10th minute after intracoronary injection. Corrected TIMI frame count and coronary artery diameter were obtained by QCA, meanwhile ECG and homodynamic parameters (HR, LVEDP, intracoronary MAP,) were recorded. Results The corrected TIMI frame count in Anisodamine group was significantly decreased by 13.2%, 25.3%, 35.6%, 33.6% at 1, 3, 5, 10th minute compared with saline group, while decreased by 10.6%, 20.4%, 14.3%, 21.5% at 1, 3, 5, 10th minute compared with diltiazem group, (respectively). The medial LAD diameter in Anisodamine group increased from 2.12±0.38 mm to 2.60±0.43 mm (p Conclusions Intracoronary anisodamine might reduce and correct the no-reflow phenomenon after PCI-AMI with the dilation of coronary vessel and homodynamic improvement, as well as no serious side effect and toxic reaction.

Objective To investigate the clinical characteristics of acute myocardial infarction (AMI) in young patients. Methods We carried out the contrasting analysis in the clinical data between 45 young patients (age≤45 years old) and 52 old patients (age≥60 years old). Results Young AMI patients were often male, and had the typical clinical manifestations. The smoking rate hyperfibrinogenemia rate and positive family history rate of the young people group were markedly higher than those of the old people group (p Conclusion Smoking, hyperfibrinogenemia and positive family history are main causes of AMI in young patients. Young AMI patients had the typical clinical manifestations with simple coronary lesion. The complications in the young people group are less than those in the old people group, and the prognosis was better than old cases.

Objective To evaluate the efficacy and safety of r-SAK (recombinant staphylokinase) for acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 48 patients with acute STEMI randomised into r-SAK group and r-tPA group (each with 24 patients). In r-SAK group, 10mg r-SAK diluted up to 50ml with saline before administration, 2mg bolus over 2 min, followed by an infusion of the remaining 8mg over 30 min. While in r-tPA group, first 8mg bolus over 6 min, then 42 mg over a 90-min period. A 75U/kg heparin bolus was given as r-SAK or r-tPA was infusing for anti-coagulation treatment. CAG were performed at 90 min to confirm infarction location and IRA, stenosis was analysed by QCA, IRA flow was evaluated by TIMI grades, myocardial tissue reperfusion was assessed by TMPG. Acute complications and adverse events were recorded during 30 days after thrombolysis. Results There was no significant difference in baseline data between r-SAK and r-tPA group. There was no difference in IRA distribution between the two groups, the IRA repatency rate (p=0.308), TIMI 3 flow (p=0.355), myocardial tissue reperfusion (p=0.530) in r-SAK group are slightly higher than those in r-tPA group, but the differences was not significant. The acute complications during 30-day period after thrombolysis, include allergic reaction (p=0.317), serious arrhythmias (p=0.775), heart failure (p=0.530), cardiac shock (p=1.000), IRA re-occluded (p=0.555), postinfarction angina (p=0.734) and death (p=0.317), have no significant difference between the two groups. The bleeding complications of r-SAK group were slightly less (p=0.125). No statistic difference in adverse events was found between the two groups. Conclusions r-SAK proved to be at least as effective as alteplase in inducing early coronary artery patency for STEMI with higher fibrin specificity than r-tPA, r-SAK, and less bleeding complications. The safety of r-SAK thrombolysis therapy is at about the same level of that of r-tPA, not associate with excess mortality and complications of arrhythmia, postinfarction angina and haemorrhage.