Celecoxib after the onset of reperfusion reduces apoptosis in the amygdala

Reperfused myocardial infarction induces an inflammatory response that is responsible for local and systemic alterations. Among these, apoptosis observed in the amygdala following myocardial infarction has been pointed out as a consequence of such an inflammatory process. We hypothesized that inhibition of the inducible inflammatory enzyme Cox-2 during the reperfusion period may attenuate the apoptotic process in the amygdala. Anaesthetized rats were subjected to left anterior descending coronary artery occlusion for 40 min, followed by reperfusion. The Cox-2 antagonist Celecoxib (3 mg/kg i.p.) was administered 10 min after the onset of the reperfusion period. After 72 h of reperfusion, infarct size was determined and the lateral and medial amygdala were dissected from the brain. Infarct size was similar between untreated and Celecoxib-treated animals (40–45% of the area at risk). Cox-2 expression was significantly reduced in both parts of the amygdala in the Celecoxib group. Apoptosis regression was observed in the amygdala of the Celecoxib group as shown by decreased number of TUNEL positive cells and by decreased of caspase-3 activation. Bax/Bcl-2 ratio was not significantly altered by Celecoxib while Akt activation was increased in the lateral amygdala but not in the medial amygdala. This data indicates that inhibition of Cox-2 by Celecoxib is associated with regression of apoptosis in the amygdala following myocardial infarction.     

丹酚酸B对大鼠离体工作心脏血流动力学的影响

目的 研究丹酚酸B对离体大鼠工作心脏血流动力学的影响.方法 采用Langendorff离体心脏灌流的方法,以左室内压( LVSP)、左室舒末压(LVEDP)、室内压最大上升速率(+dp/dtmax)、室内压最大下降速率(- dp/dtmax)、心率(HR)等血流动力学参数为指标,观察丹酚酸B对心肌收缩性能的影响.结果 不同剂量(10、5、2.5 mg/L)的丹酚酸B可使LVSP、±dp/dtmax明显升高,同时使HR减慢,并呈剂量依赖性,但对LVEDP无明显作用.结论 丹酚酸B对离体工作心脏有剂量依赖性正性肌力作用.     

siRNA干扰HIF-1α表达对高糖高胰岛素诱导的肥大心肌细胞的影响

目的 研究胰岛素受体底物1(insulin receptor substrate 1,IRS1)和缺氧诱导因子1a(hypoxia inducible factor 1a,HIF-1a)在高糖高胰岛素诱导的肥大心肌细胞中的表达及其之间的关系;观察siRNA沉默HIF-1a基因对高糖高胰岛素诱导的心肌细胞肥大的影响.方法 新生大鼠心肌细胞培养48h后,换用无血清DMEM培养液并分别加入高糖高胰岛素、高糖高胰岛素+HIF-1a-siRNA培养48h,未加入任何药物的心肌细胞在无血清DMEM培养液中继续培养48h作为对照.通过心肌细胞表面积、总蛋白含量指标检测心肌细胞肥大,并利用Real time PCR检测转染前后HIF-1a mRNA表达变化及免疫细胞化学方法检测HIF-1a及IRS1蛋白水平的表达.结果 高糖高胰岛素可增加心肌细胞表面积、总蛋白含量、HIF-1a mRNA以及HIF-1a表达,并降低IRS1表达.转染siRNA后使HIF-1a基因的表达下降,能部分抑制心肌细胞的肥大,降低心肌细胞表面积和总蛋白含量,但对IRS1表达的影响不明显.在对正常对照组和高糖高胰岛素组中IRS1表达量与HIF-1a表达量进行相关分析表明,两者的表达量成负相关.结论 通过siRNA技术对HIF-1a的有效沉默可明显地抑制高糖高胰岛素诱导大鼠乳鼠心肌细胞肥大,并且这种作用可能是通过作用于IRS1/PI3K/ Akt/MTOR途径来实现的.     

Long-term Clinical Outcome and MIBI SPECT Parameters in Percutaneous Coronary Interventions

Background and Aim

Primary percutaneous coronary intervention (PCI) is the preferred treatment option for acute myocardial infarction (MI). Off-site PCI reduces time-to-treatment, which could potentially lead to enhanced clinical outcomes. Therefore, we investigated whether off-site PCI improves 5-year clinical outcomes compared with on-site PCI and whether this is related to in-hospital ^99mTc-sestamibi single photon emission computed tomography (MIBI SPECT) parameters.

Methods

We describe the 5-year follow-up for a combined endpoint of death or re-infarction in 128 patients with acute MI who were randomly assigned to undergo primary PCI at the off-site centre (n = 68) or to transferral to an on-site centre (n = 60). Three days after PCI, MIBI SPECT was performed to estimate infarct size. A multivariate Cox regression model was created to study the relation between MIBI SPECT parameters and long-term clinical outcomes.

Results

After a mean follow-up of 5.8 ± 1.1 years, 25 events occurred. Off-site PCI significantly reduced door-to-balloon time compared with on-site PCI (94 ± 54 versus 125 ± 59 min, p = 0.003). However, infarct size (17 ± 15 versus 14 ± 12%, p = 0.34) and 5-year death or infarct rate (21% versus 18%, p = 0.75) were comparable between treatment centres. With multivariate analysis, only Killip class ≥2 and Q wave MI, but not scintigraphic data, predicted long-term clinical outcomes.

Conclusion

Off-site PCI reduced door-to-balloon time with a comparable 5-year death or infarct rate. Parameters from resting MIBI SPECT on day 3 after MI did not predict long-term clinical outcomes.     

The cardioprotective effects of a combination of quercetin and α-tocopherol on isoproterenol-induced myocardial infarcted rats

The present study aims to evaluate the combined protective effects of quercetin and α-tocopherol on isoproterenol-treated myocardial infarcted rats. Male albino Wistar rats were pretreated with a combination of quercetin (10 mg/kg) and α-tocopherol (10 mg/kg) daily for 14 days. After the pretreatment, rats were injected isoproterenol (100 mg/kg) to induce myocardial infarction. Isoproterenol-treated rats showed increased levels of serum troponins and increased intensities of serum lactate dehydrogenase-1 and -2 isoenzyme bands. Isoproterenol treatment also showed significant decreased levels of antioxidant system and significant increased levels of plasma lipid peroxidation, plasma uric acid, and the heart calcium. Furthermore, isoproterenol-treated rat's electrocardiogram showed elevated ST segments. Combined pretreatment with quercetin and α-tocopherol normalized all the biochemical parameters and minimized the alterations in electrocardiogram. Histopathology of myocardium also confirmed the cardioprotective effects of quercetin and α-tocopherol. In vitro studies confirmed the mechanism of action of quercetin and α-tocopherol. Thus, quercetin and α-tocopherol exhibited cardioprotective effects against isoproterenol-induced cardiotoxicity due to their scavenging free radicals, improving antioxidants and maintaining Ca(2+) levels. Our study also showed that combined pretreatment (quercetin and α-tocopherol) was highly effective than single pretreatment (quercetin or α-tocopherol).     

左旋精氨酸在冠脉搭桥术中心肌保护作用研究进展

冠状动脉搭桥术（Coron aryartery bypass grafting,CABG）中发生心肌缺血再灌注损伤是难以避免的,而冠状动脉内皮损伤导致一氧化氮（nitrogen monoxidum NO）合成及释放减少是导致心肌缺血／再灌注损伤（Myocardia lischemia／reperfusion injuryM／RI）的重要因素。本文通过对左旋精氨酸（1eft-arginine,L-Arg）与NO、MI／RI之间的联系、L-Arg对MI／RI的保护作用及其机制、L-Arg-NO的心肌保护作用与剂量之间关系以及L-Arg在CABG中的临床应用等方面的研究进行综述,阐明提供外源性L-Arg通过L-Arg-NO通路促进体内NO的合成及释放,探讨左旋精氨酸在冠脉搭桥术中心肌保护作用的可行性。     

急性脑梗死患者血清心肌酶学变化的临床意义及相关危险因素分析

目的：探讨急性脑梗死患者血清心肌酶学变化与预后的关系及导致急性脑梗死患者心肌酶学变化的相关危险因素。方法：回顾性分析临床及影像资料齐全且确诊的140例急性脑梗死患者（发病14天内）,根据有无血清心肌酶学升高分为血清心肌酶学升高的急性脑梗死组A组（43例）,血清心肌酶学正常的急性脑梗死组B组（97例）,应用美国国立卫生研究院卒中量表评分（NIHSS）比较两组神经功能缺损情况,并对两组病人血清心肌酶学（包括天冬氨酸氨基转移酶（AST）、肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、血糖、血脂、纤维蛋白原和血压等结果进行分析。结果：A组（31%）患者血清心肌酶学均增高,与B组比较均有显著性差异（P〈0.01）;发病后1天A、B两组患者临床神经功能缺损程度评分无显著性差异,发病后4、8、10天A、B两组患者临床神经功能缺损程度评分有显著性差异（P〈0.01）;A组高血压、糖尿病与B组比较有显著性差异（P〈0.05）;而血脂及纤维蛋白原两组比较无显著性差异。结论：急性脑梗死患者血清心肌酶学升高者预后不良;高血压、糖尿病是急性脑梗死患者血清心肌酶学升高的相关危险因素。     

血液流变学在心肌梗死诊断、治疗和预后判断方面的研究进展

血液流变学是一门研究血液流动与变型的新型学科,其范围包括血液流量、流速、流态、血液凝固性,血液中有形成分及血管变形性与弹性、微循环、微血管血液流变性等。它是心肌梗死发病的一个重要因素之一,其突出表现是红细胞聚集症和高粘滞血症。血液流变学不但在心肌梗死疾病中的诊断,药物、介入等方面作为临床治疗与疗效的评估指标,而且对心肌梗死疾病的预后及对临床观察病情变化及疗效判定等具有重要意义。     

基质金属蛋白酶在心肌缺血再灌注损伤中的作用

肌缺血再灌注损伤是指缺血心肌组织在恢复血流供给后,其细胞代谢功能障碍及结构破坏反而加重的现象,主要表现在心肌收缩与舒张功能障碍、血管内皮功能障碍、微循环血流紊乱、细胞代谢失调、电解质平衡紊乱、细胞凋亡与坏死等,并伴随着氧自由基的大量产生和毒性损伤以及炎症反应的激活,是一个极其复杂的病理过程。基质金属蛋白酶（MMPs）及其组织抑制物（TIMPs）是心肌组织中多种细胞分泌的内源性细胞因子,其作用涵盖了细胞外基质降解、炎症反应激活、调节血管功能、影响细胞凋亡与存活等众多病理生理过程,而这些过程均在心肌缺血再灌注损伤中发挥着重要的作用。     

瑞舒伐他汀对兔心肌梗死后心室重构及细胞凋亡的影响

目的:观察瑞舒伐他汀对新西兰大白兔心肌梗死后左室重构及心肌细胞凋亡的影响。方法:45只雄性新西兰大白兔随机分成三组,即:假手术组(S,n=15),心肌梗死对照组(MI,n=15),心肌梗死瑞舒伐他汀干预组(R,n=15)MI组和R组大鼠结扎左冠状动脉前降支建立AMI模型。心肌梗死对照组及假手术组术后24h灌等量的生理盐水。瑞舒伐他汀干预组于术后24h直接灌胃法给药,给药剂量以10mg/kg*d计算。干预2周后,进行心脏超声测定,随即处死新西兰大白兔、取出心脏,观察病理组织形态,并通过Western blot方法检测Bcl-2,Bax在心肌梗死边缘区的蛋白表达。结果:①心脏超声检测表明干预组左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)较心肌梗死对照组降低而左室射血分数(LVEF)较心肌梗死对照组增高②干预组心肌梗死边缘区Bax表达与心肌梗死对照组比较未见统计学差异,而Bcl-2表达高于心肌梗死对照组。结论:瑞舒伐他汀上调Bcl-2的表达,改善心室重构