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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.

Aim: To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma (ICC)., Methods: We retrospectively evaluated 5311 liver cancer patients who received resection between October 1999 and December 2003. Of these, 429 (8.1%) patients were diagnosed with ICC, and their clinicopathological, surgical, and survival characteristics were analyzed., Results: Upper abdominal discomfort or pain (65.0%), no symptoms (12.1%), and hypodynamia (8.2%) were the major causes for medical attention. Laboratory tests showed 198 (46.4%) patients were HBsAg positive, 90 (21.3%) had alpha-fetoprotein > 20 microg/L, 50 (11.9%) carcinoembryonic antigen > 10 microg/L, and 242 (57.5%) carbohydrate antigen 19-9 (CA19-9) > 37 U/mL. Survival data was available for 329 (76.7%) patients and their mean survival time was 12.4 mo. The overall survival of the patients with R0, R1 resection and punching exploration were 18.3, 6.6 and 5.6 mo, respectively. Additionally, CA19-9 > 37 U/mL was associated with lymph node metastases, but inversely associated with cirrhosis. Multivariate analysis indicated that radical resection, lymph node metastases, macroscopic tumor thrombi and size, and CA19-9 were associated with prognosis., Conclusion: Surgical radical resection is still the most effective means to cure ICC. Certain laboratory tests (such as CA19-9) can effectively predict the survival of the patients with ICC.

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.

Background: Current guidelines support primary percutaneous coronary intervention (primary PCI) as the first treatment of choice (as opposed to thrombolytic therapy) for patients with acute ST-segment elevation myocardial infarction (STEMI) especially when delivered within 12 hours of symptom onset. We aimed to evaluate the impact of different clinical pathways on reduction of reperfusion delay and subsequent improvement in outcomes in patients with STEMI., Methods: From November 2005 to November 2007, 546 consecutive patients with definite STEMI, who upon arrival at the emergency room were triaged to undergo primary PCI, were included. Of them, 271 patients were brought directly to catheterization laboratory (rapid group), and 275 patients were admitted to the coronary care unit (CCU) or cardiac ward first, and then transferred to the catheterization laboratory (non-rapid group). Primary endpoint was door-to-balloon (D2B) time, and secondary endpoints included infarct size assessed by peak CK-MB level and rates of major cardiac adverse events (MACE) including death, reinfarction, or target-vessel revascularization during hospitalization and at 30-day clinical follow-up., Results: Baseline clinical characteristics, angiographic features and procedural success rates were comparable between the two groups, except that more patients received glycoprotein IIb/IIIa receptor inhibitors before angiography (84.0% and 77.1, P = 0.042) and had TIMI 3 flow in the culprit vessel at initial angiogram (17.1% and 9.2%, P = 0.007) in the non-rapid group. The D2B time was shortened ((108 +/- 44) minutes and (138 +/- 31) minutes, P < 0.0001), and number of patients with D2B time < 90 minutes was greater (22.6% and 10.9%, P < 0.0001) in the rapid group. The advantages associated with rapid intra-hospital transfer were enhanced if the patients presented to the hospital at regular hours. Peak CK-MB level was significantly reduced in the rapid group. In-hospital mortality (4.1% and 5.8%) and cumulative MACE rate (7.0% and 9.8%) did not significantly differ between rapid and non-rapid groups. At 30 days, cumulative death- and MACE-free survival rates were improved in the rapid group (94.5% and 89.5%, P = 0.035; 90.1% and 84.0%, P = 0.034, respectively)., Conclusions: Clinical pathway with bypass of CCU/cardiac ward admission was associated with rapid reperfusion, smaller infarct size, and improved short-term survival for patients with STEMI undergoing primary PCI. In the future, it is essential to reduce the time delay for patients presenting at off-hours.

Objective: The RIFT study aimed to observe the impact of renal insufficiency (RI) on the incidence of stent thrombosis (ST) after percutaneous coronary intervention., Methods: The RIFT study enrolled 1,174 patients undergoing revascularization exclusively with sirolimus-eluting stents. The occurrence of ST and major adverse cardiac events were compared between patients with (n = 309) and without (n = 865) RI, and independent predictors of ST were also identified., Results: During follow-up (mean 18.9 +/- 9.2 months), the rate of ST was significantly higher in patients with than without RI [5.5% (n = 17) vs. 1.7% (n = 15), p < 0.001], and the presence of severe RI (estimated glomerular filtration rate <30 ml/min.1.73 m(2)) was an independent predictor of ST (odds ratio = 4.5, 95% confidence interval 1.4-15, p = 0.011). In patients with RI and diabetes or left ventricular ejection fraction (LVEF) <50%, the incidence of ST was significantly increased [13.0% (n = 10) vs. 3.6% (n = 7), p = 0.010; 11.6% (n = 8) vs. 1.9% (n = 3), p = 0.004, respectively] compared to those with diabetes or LVEF <50% alone. The influence of RI on ST was not significant in patients with multivessel disease, calcified or bifurcation lesions, and target lesion revascularization., Conclusions: These findings substantiate the importance of long-term antiplatelet therapy for patients with RI after drug-eluting stent implantation., (Copyright 2008 S. Karger AG, Basel.)

Background: rs1333049 polymorphism on chromosome 9p21 has been shown to affect susceptibility to coronary artery disease (CAD) in Caucasians. This study examined the association of rs1333049 with myocardial infarction (MI), angiographic severity of CAD and clinical outcome after a first acute MI in Han Chinese., Methods: rs1333049 polymorphism was genotyped in 520 patients with a first acute MI and in 560 controls. The number of angiographically documented diseased coronary arteries (luminal diameter stenosis > or = 50%), echocardiographic left ventricular ejection fraction (LVEF), and major adverse cardiac events (MACE) during follow-up (mean, 29+/-15 months) were recorded., Results: Patients with MI had higher frequencies of the CC genotype (30.0% vs. 20.7%) or C allele (55.5% vs. 46.2%) compared with controls (all p<0.01). rs1333049 polymorphism was strongly associated with MI [odds ratio (OR) 1.48, 95% confidence interval (CI) 1.22-1.79] after adjusting for traditional risk factors. Although longer hospitalization stay was observed in patients with the rs1333049-C allele, this polymorphism was not related to angiographic severity of CAD, LVEF, and occurrence of MACE after MI., Conclusions: This study demonstrates an association of rs1333049 polymorphism locus on chromosome 9p21 with risk for MI, but not with post-MI prognosis in Han Chinese.

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.

Background: Late incomplete stent apposition (ISA) may occur after drug-eluting stent implantation, affecting long-term clinical outcomes. This study aimed to evaluate the impact of clinical presentations of coronary artery disease on late ISA after percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES) by means of three-dimensional volumetric intravascular ultrasound (IVUS) analyses., Methods: One hundred and thirty-seven patients with coronary artery disease received SES implantation during PCI and had repeat angiography with IVUS examination. All patients were followed up one year after the procedure., Results: In overall 219 treated lesions (137 patients), late ISA was identified in 25 lesions (16 patients). Clinical diagnosis of acute coronary syndrome (ACS) and use of long stents were more common in patients with than in those without late ISA. Patients with late ISA had greater external elastic membrane (EEM) area in stented segment ((15.34 +/- 5.44) vs (13.83 +/- 4.51) mm(2), P = 0.026), stented-to-reference segment EEM area ratio (1.13 +/- 0.22 vs 1.02 +/- 0.18, P < 0.001), and plaque and media area ((8.43 +/- 3.93) vs (7.01 +/- 2.93) mm(2), P = 0.002) than in those without late ISA. Multivariate Logistic regression analysis showed that clinical diagnosis of ACS and use of long stents were independent risk factors for late ISA (OR 6.477, 95% CI 2.297 - 18.263, P < 0.001; OR 3.680, 95% CI 1.181 - 11.469, P = 0.025; respectively). During one-year follow-up after IVUS examination, the rate of very late stent thrombosis tended to be higher in patients with than in those without late ISA (18.7% vs 3.3%, P = 0.051)., Conclusions: The occurrence of late ISA after SES implantation may be related to clinical status, use of long stents, and marked positive vessel remodeling. Late ISA tended to increase the rate of very late stent thrombosis during follow-up, highlighting the importance of long-term dual antiplatelet therapy for these patients.

Background: Serum high sensitive C-reactive protein (hs-CRP), adiponectin levels and urine albumin excretion rate (UAER) are probably associated with inflammation and atherosclerosis. The aim of this study was to determine the three markers in coronary artery disease (CAD) subjects with different glucose tolerance status in a Chinese population and further explore the levels of the three markers in these subjects and the possible association of these markers with CAD risk factors and the severity of CAD as well., Methods: A total of 242 subjects with angiographically documented CAD were recruited, and then assigned to three groups: the normal glucose tolerance (NGT) + CAD group, including 100 CAD patients with NGT; the impaired glucose tolerance (IGT) + CAD group, 40 CAD patients with IGT; the type 2 diabetes mellitus (T2DM) + CAD group, 102 CAD patients with T2DM. Serum hs-CRP, adiponectin levels as well as UAER were measured in all subjects., Results: Serum hs-CRP levels were increased in the T2DM + CAD group compared with the NGT + CAD group (4.71 +/- 2.59) vs (3.60 +/- 2.46) mg/L, P = 0.037. Serum adiponectin levels were gradually decreased from the NGT + CAD to IGT + CAD to T2DM + CAD groups, (5.99 +/- 1.84), (5.82 +/- 1.72) and (4.65 +/- 1.71) mg/L, P = 0.002 and 0.040 for NGT + CAD and IGT + CAD groups vs T2DM + CAD group, respectively. While the UAER was gradually increased from the NGT + CAD to IGT + CAD to T2DM + CAD groups, (6.42 +/- 2.51), (6.89 +/- 2.94) and (15.03 +/- 4.22) microg/min (P < 0.001) for NGT + CAD and IGT + CAD groups vs T2DM + CAD group. Multiple linear stepwise regression analysis showed that waist-hip ratio (WHR) and low density lipoprotein cholesterol (LDL-C) were the significant determinants of serum hs-CRP levels; triglyceride (TG), high density lipoprotein cholesterol (HDL-C), age, WHR, T2DM, 2-hour serum insulin (2hINS), sex, and apolipoprotein B were the significant determinants of serum adiponectin levels; and systolic blood pressure (SBP), T2DM, and hemoglobin A1c (HbA1c) were the significant determinants of UAER in all subjects (R(2) = 0.070, 0.352, and 0.214, respectively). However, no significant correlation was seen for hs-CRP, adiponectin and UAER with the severity of CAD. Hs-CRP levels were significantly correlated with UAER., Conclusions: There was a trend of increased serum hs-CRP levels from the NGT + CAD to IGT + CAD to T2DM + CAD groups, though it only showed significance in the T2DM + CAD group compared with the NGT + CAD group. Serum adiponectin levels were decreased and UAER was increased from the NGT + CAD to IGT + CAD to T2DM + CAD groups. Increased UAER and serum hs-CRP, and decreased adiponectin levels were associated with traditional CAD risk factors but failed to be correlated with the severity of CAD. Hs-CRP levels were significantly correlated with UAER.

Background: Prognosis of patients with acute ST-elevation myocardial infarction (STEMI) and renal dysfunction (RD) who received primary percutaneous coronary intervention (PCI) has not been fully investigated in the drug-eluting stent (DES) era. This study aimed to evaluate the impact of admission serum creatinine level on short-term outcomes in patients with acute STEMI undergoing DES-based primary PCI., Methods: Primary PCI with DES implantation was attempted in 619 consecutive STEMI patients within 12 hours of symptom onset. Among them, 86 patients had a serum creatinine level > or = 115 micromol/L on admission (RD group), and the remaining 533 patients had normal renal function (non-RD group). The primary endpoint was 30-day major adverse cardiac events (MACE, including death, non-fatal reinfarction, and target vessel revascularization), and the secondary endpoint was subacute stent thrombosis., Results: Patients in the RD group were older than those in the non-RD group. There are more female patients in the RD group and they had a history of hypertension, myocardial infarction and revascularization. The occurrence rates of Killip class > or = 2 (29.1% vs 18.6%, P = 0.02) and multi-vessel (62.8% vs 44.5%, P = 0.001) and triple vessel disease (32.6% vs 18.2%, P = 0.002), in-hospital mortality (9.3% vs 3.8%, P = 0.03), and MACE rate during hospitalization (17.4% vs 7.7%, P = 0.006) were higher in the RD group than those in the non-RD group. At a 30-day clinical follow-up, the MACE-free survival rate was significantly reduced in the RD group (76.7% vs 89.9%, P = 0.0003). Angiographic stent thrombosis occurred in 3 (3.5%) and 7 (1.3%) of patients in the RD group and non-RD group, respectively (P = 0.15). Multivariate analysis revealed that the serum creatinine level > or = 115 micromol/L on admission was an independent predictor for MACE rate at a 30-day follow-up (Hazard ratio (HR) 3.31, 95% CI 1.19 - 9.18, P < 0.001)., Conclusion: Despite similar prevalence of stent thrombosis at a 30-day clinical follow-up, the short-term prognosis of STEMI patients with elevated serum creatinine on admission undergoing DES-based primary PCI remains unfavorable.

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.

Background: Mutations of human cardiac sodium channel alpha subunit gene (SCN5A) have been implicated in risk of various cardiac arrhythmias. The present study aimed to investigate whether SCN5A polymorphism was related to the occurrence of idiopathic ventricular arrhythmia (IVA) in Chinese Han patients., Methods and Results: Genotyping for polymorphic variance of SCN5A was performed by polymerase chain reaction and automated gene scan sequencing analysis in 31 unrelated Chinese patients with IVA (IVA group) and 103 healthy controls (control group). The allele frequencies of c.87G>A (p.Ala29Ala) and c.1673A>G (p.His558Arg) were higher in men than in women for control group (p=0.023 and p=0.027, respectively). For women, patients with IVA had higher allele frequency of c.87G>A than controls (0.455 vs 0.198, p=0.013, odds ratio (OR) 3.382), whereas for men, minor allele c.1673A>G was significantly less prevalent in IVA patients compared with controls (0.025 vs 0.175, p=0.017, OR 0.121). Significant difference existed in occurrence of ventricular arrhythmia between female patients with 87GA/AA and those with 87GG genotypes (0.348 vs 0.097, p=0.039, OR 4.978) and between male patients with 1673AA and those with 1673AG/GG genotypes (0.311 vs 0.053, p=0.031, OR 8.143). The frequency of haplotype GG (87G-1673G) was significantly lower in IVA patients than in controls (0.016 vs 0.128, p=0.009, OR 0.109)., Conclusions: The present study indicates that Chinese Han people have significant difference in distribution of 2 single nucleotide polymorphisms (c.87G>A and c.1673A>G) between healthy male and females. The 87A allele might be associated with an increased risk of IVA in females, whereas 1673G allele might have been positively selected because of its protective effects against ventricular arrhythmia in males.

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.

Objectives: To investigate the association between matrix metalloproteinase (MMP)-1(-1607 1G/2G), MMP-3(-1171 5A/6A), and MMP-9(-1562 C/T) polymorphism and susceptibility to idiopathic dilated cardiomyopathy (IDCM)., Design and Methods: MMP-1, -3, -9 genotypes were determined by PCR-RFLP analysis., Results: Genotype frequency of MMP-3, but not MMP-1 and MMP-9 in IDCM patients, was significantly different from that in healthy controls., Conclusions: Our data suggested that MMP-3 5A/6A polymorphism could be a risk factor for the susceptibility to IDCM.

Background: Drug-eluting stent (DES) has been used widely for the treatment of patients with acute coronary syndrome with or without diabetes mellitus during percutaneous coronary intervention (PCI), but its long-term safety and efficacy in diabetic patients with acute ST elevation myocardial infarction (STEMI) remain uncertain. This study aimed to investigate the clinical outcomes after primary coronary intervention with DES implantation for diabetic patients with acute STEMI, compared with non-diabetic counterparts., Methods: From December 2004 to March 2006, 56 consecutive diabetic patients (diabetic group) and 170 non-diabetic patients (non-diabetic group) with acute STEMI who underwent primary PCI with DES implantation in 3 hospitals were enrolled. Baseline clinical, angiographic, and procedural characteristics, as well as occurrence of major adverse cardiac event (MACE) including cardiac death, non-fatal recurrent myocardial infarction (re-MI) and target vessel revascularization (TVR) during hospitalization and one-year clinical follow-up were compared between the two groups., Results: Patients in diabetic group were more hyperlipidemic (69.6% and 51.8%, P = 0.03) and had longer time delay from symptom onset to admission ((364 +/- 219) minutes and (309 +/- 223) minutes, P = 0.02) than those in non-diabetic group. The culprit vessel distribution, reference vessel diameter, and baseline TIMI flow grade were similar between the two groups, but multi-vessel disease was more common in diabetic than in non-diabetic group (82.1% and 51.2%, P < 0.001). Despite similar TIMI flow grades between the two groups after stenting, the occurrence of TIMI myocardial perfusion grade (TMPG) = 2 was lower in diabetic group (75.0% vs 88.8% in non-diabetic groups, P = 0.02). The MACE rate was similar during hospitalization between the two groups (5.4% vs 3.5%, P = 0.72), but it was significantly higher in diabetic group (16.1%) during one-year follow-up, as compared with non-diabetic group (6.5%, P = 0.03). The cumulative one-year MACE-free survival rate was significantly lower in diabetic than in non-diabetic group (78.6% vs 90.0%, P = 0.02). Angiographic stent thrombosis occurred in 5.4% and 1.2% of the patients in diabetic and non-diabetic group, respectively (P = 0.19). All of these patients experienced non-fatal myocardial infarction., Conclusions: Although the early clinical outcomes were similar in diabetic and non-diabetic patients with acute STEMI treated with DES implantation, the cumulative MACE-free survival at one-year follow-up was worse in diabetic than in non-diabetic patients. More effective diabetes-related managements may further improve the clinical outcomes of diabetic cohort suffering STEMI.

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.

Background: Glycated albumin is the predominant circulating Amadori-type glycated protein in vivo and plays a major role in the development of diabetic vascular complications. The aim of this study was to assess the relationship between increased serum glycated albumin level and the presence and severity of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM)., Methods and Results: In a total of 320 consecutive patients with T2DM, coronary angiography revealed normal coronary arteries in 83 patients (control group) and significant coronary stenosis (> or = 70% luminal diameter narrowing) in 237, of whom 51 patients had 1-vessel disease (Group I), 80 had 2-vessel disease (Group II), and 106 had 3-vessel disease (Group III). Serum glycated albumin, hemoglobin A(1c) (HbA(1c)) and tumor necrosis factor (TNF)-alpha levels, lipid profile, and renal function were measured. Logistic regression analysis was performed to determine the relative risk of serum glycated albumin level for the presence and severity of CAD. Multivariate stepwise linear regression analysis was done to identify independent determinants of the glycated albumin level. Serum glycated albumin (21.2+/-5.3% vs 19.4+/-4.3%, p=0.005) and TNF-alpha levels (123 +/-115 pg/ml vs 65+/-59 pg/ml, p<0.001) were significantly higher in patients with CAD than in controls, but serum HbAlc level did not significantly differ between them (7.6+/-1.3% vs 7.4+/-1.2%, p=0.19). There was a significant difference in serum glycated albumin level between Groups I and III (19.5+/-3.3% vs 21.8+/-5.7%, p<0.001). The serum glycated albumin level correlated with the number of diseased arteries (Spearman r=0.205, p<0.001), and was closely related to serum levels on admission of glucose (r=0.495, p<0.001), TNF-alpha (r=0.123, p=0.028), blood urea nitrogen (r=0.167, p=0.004), triglycerides (r=0.129, p=0.021), and HbA(1c) (r=0.795, p<0.001). Multivariate analysis indicated that serum levels of glucose (p<0.0001), TNF-alpha (p=0.001), blood urea nitrogen (p=0.004) and triglycerides (p=0.035) were independent determinants for glycated albumin. Logistic regression analysis revealed that glycated albumin > or = 19% (odds ratio (OR) 2.9, p<0.001) was an independent predictor for CAD and glycated albumin > or = 21% (OR 2.3, p=0.032) for 3-vessel disease prediction. The area under the receiver-operating characteristic curve for glycated albumin (0.620, 95% confidence interval (CI) 0.548 to 0.691, p=0.001) was superior to that for HbA(1c) (0.543, 95% CI 0.473 to 0.613, p=0.243)., Conclusions: An increased serum level of glycated albumin is associated with the presence and severity of CAD, and may be useful in screening patients with T2DM.

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.

Objectives: This study aimed to determine whether elevated serum levels of glycated albumin, high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor (TNF)-alpha were related to an increased risk for coronary artery disease (CAD) and renal insufficiency in patients with type 2 diabetes mellitus (T2DM)., Design and Methods: Serum levels of glycated albumin, hsCRP, TNF-alpha and blood glycosylated hemoglobin A1c (HbA1c) were measured in 317 consecutive patients with T2DM and 309 normal controls. Patients with T2DM were grouped based upon coronary angiographic findings (Group I: 151 patients with normal coronary arteries; Group II: 166 patients with significant coronary stenosis [>70% luminal diameter narrowing]) and renal functional status evaluated by estimated creatinine clearance (CrCl) (normal renal function group: 187 patients with CrCl >90 mL/min; mild renal insufficiency group: 103 patients with CrCl 60-90 mL/min; moderate renal insufficiency group: 27 patients with CrCl 30-60 mL/min). Multivariate analysis was performed to determine independent risk factors for CAD and renal insufficiency in patients with T2DM., Results: Serum levels of glycated albumin, hsCRP and TNF-alpha were significantly higher in Group II than in controls (P<0.01) and Group I (P<0.01). A significant difference was found in glycated albumin, hsCRP and TNF-alpha levels among diabetic patients with mild, moderate renal insufficiency and normal renal function (P<0.05). These biochemical measurements correlated significantly with number of diseased coronary vessels (P<0.01) and status of renal function (P<0.05). No difference existed in HbA1c levels between Group II and Group I, and among patients with various CrCL stages. Multivariate analysis revealed that male gender, old age and serum levels of glycated albumin, hsCRP, TNF-alpha and lipoprotein (a) were independent risk factors for CAD, and older age, hypertension and glycated albumin were for CrCl <60 mL/min in diabetes., Conclusions: Increased serum levels of glycated albumin, hsCRP and TNF-alpha are associated with the presence and severity of CAD and renal impairment in patients with T2DM.

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.

Background: The emergence of drug-eluting stents (DES) has dramatically reduced the incidence of in-stent restenosis. This study was conducted to evaluate the safety and efficacy of sirolimus-eluting cobalt-chrome stents (Firebird 2) for treating patients with coronary artery disease., Methods: Sixty-seven patients with de novo or non-stented restenostic coronary lesions were chosen to receive the Firebird 2 stent as the final treatment (Firebird 2 group). Another 49 consecutive patients were implanted with bare cobalt alloyed stents (Driver, Medtronic) within the previous six months and served as historical controls (control group). Baseline clinical characteristics, angiographic features, procedural results, 30-day, 6-month and 12-month clinical follow-up regarding the occurrence of major adverse cardiac events (MACE), as well as the primary endpoint of late lumen loss at 6-month angiographic follow-up were compared between the two groups., Results: The demographic characteristics were similar between the two groups despite more patients in the Firebird 2 group who underwent previous percutaneous coronary intervention (22.4% vs 8.2%, P = 0.0418) and who had diabetes mellitus (29.9% vs 12.2%, P = 0.0253). In the Firebird 2 group, the mean diameter of the reference vessel was smaller ((2.79 +/- 0.46) mm vs (2.98 +/- 0.49) mm, P = 0.0175) and more stents were implanted for each lesion (1.28 +/- 0.52 vs 1.10 +/- 0.30, P = 0.0060). Other angiographic, procedural results and the device success rate were similar between the two groups. The MACE rate at 30-day and 3-month was the same, but significantly fewer MACE occurred in the Firebird 2 group at 6- and 12-month follow-up (1.5% vs 12.2% at 6 month, P = 0.0168; 1.5% vs 26.5% at 12 month, P < 0.0001). The primary endpoint of late lumen loss at 6-month angiographic follow-up was significantly reduced in the Firebird 2 group (in-stent: (0.05 +/- 0.09) mm vs (0.98 +/- 0.61) mm; in-segment: (0.05 +/- 0.18) mm vs (0.72 +/- 0.59) mm; P < 0.0001) than the control group. One patient in the Firebird 2 group had in-segment restenosis (1.3%) while the rate in the control group (38.1%) was significantly higher, P < 0.0001. Intravascular ultrasound examination was performed in 70.1% of patients in the Firebird 2 group and revealed that the percentage of volumetric obstruction was (1.26 +/- 1.05)%. No stent thrombosis was observed in either group at 12-month follow-up., Conclusion: The Firebird 2 sirolimus-eluting cobalt alloyed stent is safe and feasible in treating patients with coronary artery disease.

Background: Large animal models with toxin-mediated pancreatic damage have been used extensively in researches with respect to diabetes mellitus and cardiovascular diabetic complications. The present study aimed to establish Chinese Guizhou minipig models with streptozotocin (STZ)-induced diabetes and characterize the animal models by analyzing inflammatory cytokine levels in aortic wall, such as tumor necrosis factor (TNF)-alpha, interleukin-1beta (IL-1beta) and interleukin-6 (IL-6)., Methods: Twenty-two male Chinese Guizhou minipigs (age, 4 to 6 months; weight, 20 kg to 30 kg) were divided into STZ-induced diabetic group (n = 12) and control group (n = 10). STZ (125 mg/kg) was administrated to induce hyperglycemia and afterwards insulin was used to control fasting blood glucose levels below 10 mmol/L. Oral glucose tolerance test (OGTT) was performed before and one month after STZ administration and serum concentrations of alanine transaminase, asparagine transaminase, albumin, blood urea nitrogen, creatinine, lipids and white blood cell count were measured before and six months later. Animals in both groups were euthanized after six months and pancreas was examined immunohistochemically for islet beta cells. Aortic intima of diabetic minipigs and controls was analyzed for TNF-alpha level in tissue conditioned medium by Western blot. TNF-alpha, IL-1beta and IL-6 mRNA levels in aortic intima were assayed by reverse transcription and polymerase chain reaction (RT-PCR)., Results: Significant elevation in serum glucose levels was observed one month and six months after STZ induction (P < 0.001) and markedly increased OGTT values were noted, compared with baseline data. The normal pancreas had many irregular sized islets and small clusters of islet beta cells, while in pancreas of diabetic minipigs islet beta cells almost disappeared. No statistical difference was notified in serum concentrations of biochemical examinations before and six months after STZ induction. Western blot demonstrated dramatically increased TNF-alpha level in aotic intima conditioned medium, and significant elevation of TNF-alpha, IL-1beta and IL-6 mRNA levels was revealed by RT-PCR., Conclusions: The present study has established Chinese Guizhou minipig models with STZ-induced diabetes. Inflammatory cytokines (TNF-alpha, IL-1beta and IL-6) significantly elevated in aortic intima of diabetic minipigs.

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.

Background: Drug-eluting stents (DES) constitute a major breakthrough in restenosis prevention after percutaneous coronary intervention (PCI). This study compared the clinical outcomes of PCI using DES versus coronary artery bypass graft (CABG) in patients with multivessel coronary artery disease (MVD) in real-world., Methods: From January 2003 to December 2004, 466 consecutive patients with MVD underwent revascularization, 235 by PCI with DES and 231 by CABG. The study end-point was the incidence of major adverse cardiovascular events (MACEs) at the first 30 days after procedure and during follow-up., Results: Most preoperative characteristics were similar in the two groups, but left main disease (24.7% vs 2.6%, P<0.001) and three-vessel disease (65% vs 54%, P = 0.02) were more prevalent in CABG group. The number of coronary lesions was also greater in CABG group (3.7 +/- 1.1 vs 3.3 +/- 1.1, P<0.001). Despite higher early morbidity (3.9% vs 0.8%, P = 0.03) associated with CABG, there were no significant differences in composite MACEs at the first 30 days between the two groups. During follow-up (mean 25+/-8 months), the incidence of death, myocardial infarction, or cerebrovascular event was similar in both groups (PCI 6.3% vs CABG 5.6%, P = 0.84). However, bypass surgery still afforded a lower need for repeat revascularization (2.8% vs 10.4%, p = 0.001). Consequently, overall MACE rate (14.5% vs 7.9%, P = 0.03) remained higher after PCI., Conclusion: PCI with DES is a safe and feasible alternative to CABG for selected patients with MVD. The reintervention gap was further narrowed in the era of DES. Aside from restenosis, progression of disease needs to receive substantial emphasis.

We sought to investigate whether numbers and activity of circulating endothelial progenitor cells (EPCs) correlate with severity of coronary stenosis as well as cardiovascular risk factors in patients with stable coronary artery disease (CAD). Number of circulating EPCs was analyzed in 104 consecutive patients with proven or clinically suspected CAD. Adhesive and migratory activity was also determined. The number of EPCs was lower in patients with a single diseased coronary artery (Group II, n=35, p<0.05 vs. Group I) or multiple diseased arteries (Group III, n=25, p<0.01 vs. Group I, p<0.05 vs. Group II) compared to those with normal coronary arteries (Group I, n=44). The number of EPCs was also related with angiographic Gensini score (r=-0.355, p=0.006). In addition, concentrations of C-reactive protein (CRP) were elevated in patients with CAD, and positively correlated with Gensini score (r=0.476, p=0.001). As for the risk factors, the number of EPCs was also inversely correlated with age (p=0.001), high sensitivity-CRP (p=0.012), hypertension (p=0.042) and family history of CAD (p=0.043). Most importantly, the migratory capacity of EPCs was compromised in patients with CAD, and inversely correlated with the angiographic Gensini score (r=-0.315, p=0.021). EPCs isolated from patients with CAD also showed an impaired adhesive activity (p<0.05). In conclusion, in patients with stable CAD, reduction in the number and impairment in the function of circulating EPCs were correlated with the severity of coronary stenosis. CRP may play an important role in reducing the number of EPCs and accelerating atherosclerosis. Given the important role of EPCs in neovascularization of ischemic tissue, a decrease in the number and activity of EPCs may contribute to the impaired vascularization in patients with CAD.

Background: Coronary artery disease (CAD) is a major vascular complication of diabetes mellitus and reveals high mortality. Up to 30% of diabetic patients with myocardial ischemia remain asymptomatic and are associated with worse prognosis compared to non-diabetic counterpart, which warrants routine screening for CAD in diabetic population. The purpose of this study was to evaluate the clinical value of serum glycated albumin and high-sensitivity C-reactive protein (hs-CRP) levels in predicting the presence of CAD in patients with type 2 diabetes., Methods: Three hundred and twenty-four patients with type 2 diabetes were divided into two groups based on presence (CAD group, n = 241) or absence (control group, n = 83) of angiographically-documented CAD (lumen diameter narrowing > or =70%). Serum levels of glycated albumin and hs-CRP as well as serum concentrations of glucose, lipids, creatinine, blood urea nitrogen and uric acid were measured in both groups. Predictors of CAD were determined using multivariate logistic regression model and receiver-operating characteristic (ROC) curves., Results: Serum glycated albumin and hs-CRP levels were significantly increased in diabetic patients with CAD. Multivariate regression analysis revealed that male gender, age, serum levels of glycated albumin, hs-CRP, creatinine and lipoprotein (a) were independent predictors for CAD. Areas under the curve of glycated albumin and hs-CRP and for regression model were 0.654 (95%CI 0.579-0.730, P < 0.001), 0.721 (95%CI 0.658-0.785, P < 0.001) and 0.824 (95% CI 0.768-0.879, P < 0.001), respectively. The optimal values of cut-off point were 18.7% (sensitivity 67.9%, specificity 60.0%) for glycated albumin and 5.2 mg/l (sensitivity 72.2%, specificity 60.0%) for hs-CRP to predict CAD. Logistic regression model was defined as: P/(1-P) = EXP(-1.5 + 1.265 gender + 0.812 age + 1.24 glycated albumin + 0.953 hs-CRP + 0.902 lipoprotein(a) + 1.918 creatinine). The optimal probability value for predicting CAD in type 2 diabetic patients was 0.648 (sensitivity 82.3%, specificity 68.6%)., Conclusion: Serum glycated albumin and hs-CRP levels were significantly elevated in patients with type 2 diabetes and CAD. The logistic regression model incorporating with glycated albumin, hs-CRP and other major risk factors of atherosclerosis may be useful for screening CAD in patients with type 2 diabetes.

Background: The optimal reperfusion strategy in elderly patients with ST-elevation myocardial infarction (STEMI) remains unclear. The purpose of this study was to evaluate the safety, in-hospital and one-year clinical outcomes for patients > 75 years of age with STEMI receiving primary percutaneous coronary intervention (PCI), compared with those treated by conservative approach., Methods: One hundred and two patients > 75 years of age with STEMI presented < 12 hours were randomly allocated to primary PCI (n = 50) or conservative therapy only (n = 52). The baseline characteristics, in-hospital outcome and major adverse cardiac events (MACE), including death, non-fatal myocardial infarction and target vessel revascularization at one-year clinical follow-up were compared between the two groups., Results: Age, gender distribution, risk factors for coronary artery disease, infarct site and clinical functional status were similar between the two groups, but the patients in primary PCI group received less low-molecular-weight heparin during hospitalization. Compared with conservative group, the patients in primary PCI group had significantly lower occurrence rate of re-infarction and death and shortened hospital stay. The composite endpoint for in-hospital survivals at 30-day follow-up was similar between the two groups, but one-year MACE rate was significantly lower in the primary PCI group (21.3% and 45.2%, P = 0.029). Left ventricular ejection fraction was not significantly changed in both groups during follow-up. Multivariate analysis revealed that primary PCI (OR = 0.34, 95% CI: 0.21 - 0.69, P = 0.03) improved MACE-free survival rate for STEMI patients aged > 75 years., Conclusion: Our results indicated that primary PCI was safe and effective in reducing in-hospital mortality and one-year MACE rate for elderly patients with STEMI.

Background: Patients with end-stage renal disease have a high mortality from coronary artery disease, but the impact of moderate renal insufficiency on clinical outcomes after percutaneous coronary intervention (PCI) and the effect of drug-eluting stent implantation in these patients remain unclear. This study determined the long-term effect of moderate renal insufficiency on death and major adverse cardiac events (MACE) after stent based PCI and examined whether drug-eluting stent implantation could favourably influence clinical outcome., Methods: Major adverse cardiac events and causes of mortality were determined for 1012 patients undergoing percutaneous intervention from January 1, 2002 to December 31, 2004 at Shanghai Ruijin Hospital. Based on estimated creatinine clearance levels, long term outcomes were compared between patients with estimated creatinine clearance < 60 ml/min (renal insufficiency group; n = 410) and those with estimated creatinine clearance > or = 60 ml/min (control group; n = 602). Subgroup analysis was also made for patients with renal insufficiency between drug eluting stent (n = 264) and bare metal stent implantation (n = 146) during PCI., Results: During follow-up (average 17 months) after successful PCI, all causes of death (7.1% vs 2.3%, P < 0.01) and cardiac death (3.4% vs 1.0%, all P < 0.01) were significantly higher in renal insufficiency group than in control group. For patients with moderate renal insufficiency, drug-eluting stent implantation reduced significantly all causes of death (5.3% vs 10.9%, P < 0.05) and occurrence of major cardiac adverse events (15.1% vs 24.6%, P < 0.05) compared with bare metal stents., Conclusions: Moderate renal insufficiency is an important clinical factor influencing the mortality after PCI in patients with coronary artery disease and the use of drug-eluting stents should be the preferred therapy for the improvement of long-term outcomes in such patients.

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.

Background: Nominal atrioventricular (AV) interval in dual chamber pacemaker (DDD) is not the best AV delay in the majority of patients with atrioventricular block. To find a simple method for optimizing AV delay adjustment, we assessed surface electrocardiography (ECG) for optimizing AV delay during dual chamber pacing., Methods: DDD pacemakers were implanted in 46 patients with complete, or almost complete, AV block. Optimal AV delay was achieved by programming an additional delay of 100 ms, to the width of intrinsic P wave or to the interval between pacing spike to the end of P wave on surface ECG. Left ventricular (LV) end diastolic and end systolic volumes, ejection fraction and diastolic parameters were measured by Doppler echocardiography during both nominal and optimal AV delay pacing., Results: Compared to nominal AV delay setting, LV end diastolic volume increased [to (53.2 +/- 11.3) ml from (50.2 +/- 10.2) ml, P < 0.05], end systolic volume decreased [to (26.1 +/- 9.0) ml from (27.9 +/- 8.2) ml, P < 0.05] during adjusted AV delay pacing, resulting in an increase in LV ejection fraction [to (68.2 +/- 5.3)% from (64.5 +/- 4.3)%, P < 0.05]. LV diastolic filling and isovolumic relaxation time were not significantly changed., Conclusion: Optimization of AV delay by surface ECG is a simple method to improve LV systolic function during dual chamber pacing.

Background: The long term prognosis of unprotected left main coronary artery (LMCA) stenting is controversial. This study was conducted to evaluate the immediate and long term outcomes of LMCA stenting in Chinese patients and to determine which factors affect the outcomes., Methods: From May 1997 to March 2003, 224 patients in 23 hospitals underwent elective unprotected LMCA stenting with bare metal stents. Their clinical records were analysed to ascertain immediate and long term outcomes of LMCA stenting as well as factors influencing the prognosis., Results: Stents were implanted into LMCA successfully in 223 cases (99.6 %). One death (0.5%) and one case of non-Q wave nonfatal myocardial infarction (MI) occurred in hospital. The mean follow-up time was (15.6 +/- 12.3) months. Cardiac death developed in 10 cases (4.5%), noncardiac death in 2 cases (0.9%), nonfatal MI in 4 cases (1.8%), target lesion revascularization (TLR) of LMCA in 26 cases (11.7%) and TLR of nonLMCA in 37 cases (16.5%). Univariate analysis showed that cardiac death correlated with left ventricular ejection fraction (LVEF < 40%), female gender and LMCA combined with multivessel disease; that major adverse cardiac events (MACE) correlated with LVEF < 40%, bifurcation lesion and incomplete revascularization. Logistic regression analysis revealed that LVEF < 40% and female gender were independent predictors of cardiac death and MACE. Follow-up angiography was performed in 102 cases (45.7%). The restenosis rate was 31.4%., Conclusions: Long-term outcomes of stenting for selected patients with unprotected LMCA stenosis is acceptable. It should be performed in inoperable or low risk patients with LVEF > or = 40% and isolated LMCA disease or LMCA combined with multivessel diseases in whom complete revascularization can be obtained.

We have identified Bombyx mori transformer-2 gene (Bmtra-2) cDNA by blasting the EST database of B. mori. It was expressed in the whole life of the male and female silkworm and was observed as a band of 1.3 kb by Northern blot analysis. By comparing corresponding ESTs to the Bmtra-2 DNA sequence, it was revealed that there were eight exons and seven introns, and all splice sites of exons/introns conformed to the GT/AG rule. Bmtra-2 pre-mRNA can produce multiple mRNAs encoding six distinct isoforms of BmTRA-2 protein using an alternative splicing pathway during processing. Six types of Bmtra-2 cDNA clones were identified by reverse transcription-polymerase chain reaction. All isoforms of BmTRA-2 protein contain two arginine/serine-rich domains and one RNA recognition motif, showing striking organizational similarity to Drosophila TRA-2 proteins.

The three links theory applied in trauma emergency care system refers to an integrated system with the three important components of trauma emergency care system, viz. prehospital trauma services, hospital trauma services and critical care services. The development of the trauma emergency care system should be guided by the three links theory so as to set up a practical and highly efficient system: a prompt operating and monitoring transportation system, a smooth and real-time information system, a rational and sustainable system of regulations and contingency plans, and a system for cultivating all-round trauma physicians.

Fusarium head blight (FHB) caused by Fusarium graminearum is a devastating disease that results in extensive yield losses to wheat and barley. A green fluorescent protein (GFP) expressing plasmid pRP22-GFP was constructed for monitoring the colonization of two biocontrol agents, Brevibacillus brevis ZJY-1 and Bacillus subtilis ZJY-116, on the spikes of barley and their effect on suppression of FHB. Survival and colonization of the Brevibacillus brevis ZJY-1 and Bacillus subtilis ZJY-116 strains on spikes of barley were observed by tracking the bacterial transformants with GFP expression. Our field study revealed that plasmid pRP22-GFP was stably maintained in the bacterial strains without selective pressure. The retrieved GFP-tagged strains showed that the bacterial population fluctuation accorded with that of the rain events. Furthermore, both biocontrol strains gave significant protection against FHB on spikes of barley in fields. The greater suppression of barley FHB disease was resulted from the treatment of barley spikes with biocontrol agents before inoculation with F. graminearum.

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.