目的 比较Nice结缝线联合解剖锁定钢板与普通螺钉联合解剖锁定钢板内固定治疗锁骨中段斜形骨折的临床疗效.方法 回顾性分析自2018-01-2021-06诊治的39例锁骨中段斜形骨折,其中18例采用Nice结缝线联合解剖锁定钢板内固定治疗(Nice结组),21例采用普通螺钉联合解剖锁定钢板内固定治疗(普通螺钉组).比较Nice结组与普通螺钉组手术时间、术中出血量、骨折愈合时间,以及末次随访时肩关节UCLA评分和上肢功能DASH评分.结果 39例均获得随访,随访时间平均24(12～30)个月.随访期间均无切口感染、深部感染、内固定失效等并发症发生.Nice结组与普通螺钉组手术时间、术中出血量、骨折愈合时间、末次随访上肢功能DASH评分、肩关节UCLA评分比较差异无统计学意义(P＞0.05).结论 采用Nice结缝线辅助解剖锁定钢板内固定治疗锁骨中段斜形骨折是一种安全、有效的固定方法,与普通螺钉辅助固定相比,Nice结缝线辅助固定不会影响骨折愈合,也不会增加内固定失败风险.

Objective:To investigate the effectiveness of a new tibial plateau posterolateral column universal locking anatomical plate (hereinafter referred to as "new universal locking anatomical plate") in the treatment of tibial plateau posterolateral column fractures. Methods:Between October 2020 and December 2021, 14 patients with tibial plateau posterolateral column fracture were treated with a new universal locking anatomical plate. There were 7 males and 7 females with an average age of 59 years ranging from 29 to 75 years. There were 5 cases on the left side and 9 cases on the right side. The causes of injury included falling from height in 5 cases, traffic accident in 7 cases, and other injuries in 2 cases. The time from injury to operation ranged from 3 to 10 days, with an average of 6 days. According to Schatzker classification, there were 4 cases of type Ⅱ, 8 cases of type Ⅴ, and 2 cases of type Ⅵ. All fractures involved the posterolateral tibial plateau. Three column classification: two columns (anterolateral column+posterior column) in 4 cases, three columns in 10 cases. The operation time, intraoperative blood loss, fracture healing, and complications were recorded. The reduction of tibial plateau fracture was evaluated by Rasmussen radiographic score, and the recovery of knee function was evaluated by Hospital for Special Surgery (HSS) score. Results:All 14 cases completed the operation successfully. The operation time was 95-180 minutes, with an average of 154 minutes, and the intraoperative blood loss was 100-480 mL, with an average of 260 mL. All patients were followed up 6-19 months, with an average of 12.5 months. All fractures healed, and the healing time was 15-24 weeks, with an average of 18.7 weeks. During the follow-up, there was 1 case of common peroneal nerve palsy and 1 case of traumatic osteoarthritis. There was no other complication such as vascular injury, incision infection, deep venous thrombosis of lower limbs, heterotopic ossification, bone nonunion, and failure of internal fixation. The reduction of tibial plateau fractures was good immediately after operation, and the Rasmussen radiological score was 10-18, with an average of 15.7; 3 cases were excellent, 10 cases were good, and 1 case was fair, with an excellent and good rate of 92.9%. The scores and grades of HSS at 3 months after operation and at last follow-up significantly improved when compared with those before operation ( P<0.05). There was no significant difference between 3 months after operation and last follow-up ( P>0.05). Conclusion:For the fractures involving the posterolateral column of the tibial plateau, the new universal locking anatomical plate can provide strong fixation, satisfactory postoperative fracture reduction, and good recovery of knee function.

Objective:To explore the morphology of coronoid process fracture in terrible triad injury based on Adams classification.Methods:A retrospective cross-sectional study was used to analyze the three-dimensional CT data of 51 patients with terrible trind injury treated at First Affiliated Hospital of Fujian Medical University from January 2013 to August 2021, including 33 males and 18 females, aged 18-88 years [(44.7±12.0)years]. The model of ulna coronoid process fracture was established by three-dimensional CT reconstruction technology and was classified according to Adams coronoid process fracture classification. Type I was the coronoid process tip fracture, type II the coronoid process transverse fracture, type III the base fracture of the coronoid process, type IV anterior internal fracture the anteromedial oblique fracture of the coronoid process, and type IV anterior external fracture the anterolateral oblique fracture of the coronoid process. According to the characteristics of the coronoid fracture fragment, type IV anterior external fracture was divided into two subtypes: α subtype involving the coronoid tip and β subtype without involving the coronoid tip. Then, the proportion, height, surface area and volume of different types of coronoid fractures were measured. The proportion, height, surface area and volume of fracture fragments of two subtypes of type IV anterior external fracture were measured, as well as the area of ulnar trochlear joint, area of trochlear joint of ulnar fracture fragment, proportion of the area of trochlear joint affected by the ulnar fragment, area of proximal radioulnar joint, area of proximal radioulnar joint of ulnar fracture fragment and proportion of the area of proximal radioulnar joint affected by the ulnar fragment.Results:Among the patients with terrible triad injury, the ulnar coronoid process fracture was Adams type I in 17 patients (33%), type II in 4 (8%), type III in 4 (8%), type IV anterior internal fracture in 4 (8%) and type IV anterior external fracture in 22 (43%). The height of fracture fragment of type I, type II, type III, type IV anterior internal fracture and type IV anterior external fracture was (3.7±1.9)mm, (10.8±1.1)mm, (14.4±1.2)mm, (5.2±2.4)mm and (6.7±2.6)mm, respectively; the surface area was 63.7(21.4, 221.0)mm 2, 1 086.8(606.8, 1 434.2)mm 2, 1 658.8(1 335.6, 1 695.4)mm 2, 437.3(185.6, 437.3)mm 2 and 511.8(198.8, 646.5)mm 2, respectively; the volume was 46.3(21.4, 180.5)mm 3, 938.7(629.8, 1 011.3)mm 3, 1 797.4(1 520.2, 1 903.7)mm 3, 429.3(138.1, 992.4)mm 3 and 461.9(144.9, 707.1)mm 3, respectively. There were significant differences in the height, surface area and volume of coronoid process fracture with different Adams classification (all P<0.01). Among 22 patients with type IV anterior external fracture, 12 patients were with α subtype and 10 with β subtype. The fracture height of α and β subtypes was (8.6±2.6)mm and (5.0±2.4)mm, respectively; the surface area was 633.2 (530.3, 727.4)mm 2 and 181.4 (136.7, 450.3)mm 2, respectively; the volume was 692.8 (477.6, 778.0)mm 3 and 128.0 (74.2, 405.1)mm 3, respectively. The height, surface area and volume of fracture fragment were significantly different between the two subtypes (all P<0.01). The area of ulnar trochlear joint of α and β subtypes were 901.4(755.1, 1 060.6)mm 2 and 835.2(767.7,909.3)mm 2, respectively; the area of trochlear joint of α and β subtype fragment was 104.1(79.4, 139.9)mm 2 and 38.8(21.3, 58.1)mm 2, respectively; the proportion of the area of trochlear joint affected by α and β subtype fragment was 0.12(0.09, 0.15) and 0.05(0.03, 0.07), respectively. There was no significant difference between α and β subtypes in the area of trochlear joint of ulna ( P>0.05), but the area of trochlear joint of α subtype fragment and proportion of the area of trochlear joint affected by α subtype fragment were higher than those of β subtype fragment (all P<0.01). The area of proxima radioulnar joint of α and β subtypes was 147.9(111.7,164.2)mm 2 and 137.0(118.7,166.7)mm 2, respectively; the area of proximal radioulnar joint of α and β subtypes fragment was 17.7(13.4, 52.2)mm 2 and 6.1(2.6, 20.0)mm 2, respectively; the proportion of the area of proximal radioulnar joint affected by α and β subtypes fragment was 0.12(0.10, 0.35) and 0.05(0.03, 0.15), respectively. There were no significant differences between the two subtypes in proximal radioulnar joint damage (all P>0.05). Conclusions:Adams type IV fracture of the coronoid process of the ulna occupies a large proportion in terrible triad injury, and the type IV anterior external fracture is the main type containing two subtypes with differences in fragment size and shape. However, the injuries to the proximal radioulnar joint surface are similar for the two subtypes, so the injuries of type IV anterior external fracture with different sizes to the proximal radioulnar joint surface should not be neglected in clinical treatment.

目的 探讨带血管蒂游离腓骨移植术治疗股骨远端骨缺损的临床安全性和有效性.方法 回顾性分析自2007-03-2019-08采用带血管蒂游离腓骨移植术治疗的12例股骨远端骨缺损,交通事故伤导致股骨远端粉碎性骨折并骨缺损6例,高处坠落伤导致股骨远端粉碎性骨折并骨缺损3例,股骨远端骨折术后骨不愈合导致骨缺损2例,股骨远端骨折术后骨髓炎导致骨缺损1例.将带血管蒂腓骨瓣植入股骨缺损区,近端插入股骨干髓腔,远端插入股骨髁间,恢复股骨干长度后持骨钳钳夹固定,C型臂X线机透视确认下肢力线及股骨长度恢复良好后将股骨外侧解剖型钢板置于股骨外侧并使之贴伏,确保植骨端及内固定物稳定.结果 12例均获得随访,随访时间平均24(12～78)个月.移植的带血管蒂腓骨于术后9～20周与股骨远端骨缺损处骨性愈合,骨性愈合时间平均15.7周.随访期间所有患者均未出现移植腓骨骨折、骨折不愈合、内固定失效、感染等并发症.末次随访时膝关节功能采用HSS评分标准评定:优7例,良4例,可1例.结论 在严格把握手术适应证、选择适当的手术时机及合适内固定物的前提下,带血管蒂游离腓骨移植术治疗股骨远端骨缺损具有良好的可行性,能够为骨缺损处提供足够强度的支撑力和骨愈合能力.

Objective:To analyze the types of ulnar coronoid process fractures in terrible triad injury (TTI) using three coronoid fracture classification systems and to explore the characteristics of coronoid process fractures and compare the reliability of different coronoid process fractures classification systems in TTI.Methods:A retrospective case series study was used to analyze the CT data of 43 patients with typical TTI admitted to First Affiliated Hospital of Fujian Medical University from January 2013 to October 2020. There were 26 males and 17 females, aged from 18 to 88 years [(41.8±15.6)years]. An independent three-dimensional model of the proximal ulna was established using the CT three-dimensional reconstruction technology. The characteristics of the coronoid process fractures were observed. The Regan-Morrey classification, O'Driscoll classification and Adams classification were used to classify the ulnar coronoid process fractures. The reliability of the three classification systems of coronoid fractures was analyzed.Results:The fracture line of the coronoid process was mostly located anterolaterally. Among all patients with ulnar coronoid fractures, there were 17 patients (40%) with type I, 19 (44%) with type II and 7(16%) with type III according to Regan-Morrey classification; there were 34 patients (79%) with type I, 2(5%) with type II and 7(16%) with type III according to O'Driscoll classification; there were 12 patients (28%) with type I, 3(7%) with type II, 7(16%) with type III, 18(42%) with type IV AL and 2(5%) with type IV AM according to Adams classification. Through reliability analysis, the Kappa coefficients of the inter-observer and intra-observer 1, 2, 3 of Regan-Morrey classification were 0.752, 0.813, 0.772 and 0.703, respectively; the Kappa coefficients of the inter-observer and intra-observer 1, 2, 3 of O'Driscoll classification were 0.797, 0.774, 0.837 and 0.775, respectively; the Kappa coefficients of the inter-observer and intra-observer 1, 2, 3 of Adams classification were 0.805, 0.835, 0.837 and 0.875, respectively.Conclusions:Most of the coronoid process fractures locate anterolaterally in TTI. Compared with Regan-Morrey classification and O'Driscoll classification, the reliability of Adams classification is best. Adams classification further subdivides the anterolateral fractures of the coronoid process, which may be more suitable in evaluating the classification of ulnar coronoid process fractures in TTI.

目的:探讨增强型体外反搏(EECP)对冠心病患者支架置入术后 3 年临床预后的影响. 方法:选择行经皮冠状动脉支架置入治疗的冠心病患者200 例,随机分为 EECP 组(100 例)和对照组(100 例), EECP 组在常规西药治疗的同时行积极的 EECP 治疗,36 次 / 疗程,每年2个疗程.对照组行常规西药治疗和消极的EECP治疗.随访 3 年,比较两组患者颈动脉内膜中层厚度、心脏功能、支架内再狭窄的发生率、主要不良心血管事件(MACE)发生率及全因死亡率.

目的 观察增强型体外反搏(EECP)对不稳定型心绞痛(UA)患者动脉弹性和血清一氧化氮(NO)水平的影响.方法 140例UA患者随机分为两组:常规药物治疗+EECP治疗设为EECP组(n=70);常规药物治疗设为对照组(n=70).观察治疗前后患者加拿大心血管病学会(Canadian Cardiovascular Society,CCS)心绞痛分级、肱-踝动脉脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)、颈-股动脉脉搏波传导速度(carotid-femoral pulse wave velocity,cfPWV)和血清一氧化氮水平.结果 治疗前,EECP组与对照组CCS心绞痛分级、肱动脉baPWV、cfPWV、血清NO水平比较无差异性(P＞0.05).治疗后EECP组的CCS心绞痛分级为(1.4±0.4),明显低于对照组的(1.6±0.5)(P＜0.05).治疗后EECP组的baP-WV和cfPWV分别为(13.38±1.43)m/s和(9.64±1.11)m/s,明显低于对照组的(14.76±1.48) m/s和(10.34±1.29) m/s(P＜0.05).治疗后EECP组的血清NO水平为(66.30±14.52) μmol/L,明显高于对照组的(58.68±12.66) μmol/L (P＜0.05).结论 EECP能够降低不稳定性心绞痛患者动脉僵硬度,增加血清NO水平,减少心绞痛发作次数.

目的 本研究旨在探讨降钙素原(PCT)对老年急性心衰患者合并肺部感染的诊断价值.方法 收集我院自2013年6月—2016年6月收治的老年急性心衰患者128例,根据患者是否合并肺部感染,将患者分为感染组(观察组,n=50)及非感染组(对照组,n=78),采用全自动荧光免疫分析仪比较两组血浆PCT水平.结果 感染组患者血清PCT水平较非感染组升高(P<0.05),以PCT≥0.5μg/L判断老年急性心衰患者合并肺部感染的敏感性及特异性,分别为90.0%、96.2%.结论 血清PCT可作为早期判断老年急性心衰患者是否合并肺部感染的一项有价值的炎性指标.

目的 通过测定血清一氧化氮(NO)和内皮素-1(ET-1)水平,观察增强型体外反搏(EECP)联合瓜蒌薤白半夏汤对不稳定性心绞痛(UA)患者血清NO和ET-1水平的影响.方法 选择2017年5—10月在本院就诊的100例UA患者为研究对象,随机分为研究组和对照组各50例.对照组患者接受EECP治疗+西药治疗,研究组患者接受EECP治疗+瓜蒌薤白半夏汤+西药治疗.通过抽血测定血清NO和ET-1水平,观察治疗前后两组患者血清NO和ET-1水平的变化.结果 治疗前,两组患者的血清NO和ET-1水平比较,差异无统计学意义(P>0.05).治疗后,两组患者的血清NO水平均高于治疗前,且研究组患者血清NO(37.2±8.6)umol/L,显著高于对照组的(31.3±6.5)umol/L,研究组患者的血清ET-1(54.6±8.2)pg/ml,显著低于对照组(62.5±8.8)pg/ml,研究组患者NO/ET-1比值(0.69±0.11),显著高于对照组患者(0.45±0.13),差异有统计学意义(P<0.05).结论 增强型体外反搏联合瓜蒌薤白半夏汤治疗能够增加NO的生成,减少ET-1的产生,这可能是其治疗UA的机制之一.

目的 观察心痛贴膏对心肾阳虚型慢性心力衰竭患者的临床疗效. 方法 102例心肾阳虚型慢性心力衰竭患者随机分为2组,对照组50例采用西医常规治疗,治疗组52例采用西医常规治疗加心痛贴膏外用,选取穴位为双心俞、膻中、内关、足三里,每天1次,每次持续2h.2组疗程均为14 d.观察2组纽约心功能分级(NYHA)、6rmin步行试验(6MWT)步行里程数、左室射血分数(LVEF)值及N末端B型利钠肽原(NT-proBNP)水平的变化. 结果 2组治疗后NYHA分级的级别较治疗前明显下降(P＜0.01),治疗组较对照组下降幅度更明显(P＜0.05);2组6MWT步行里程数较治疗前明显增加(P＜0.01),治疗组6MWT步行里程数增加幅度优于对照组(P＜0.05);2组LVEF值治疗前后及组间比较均无统计学意义(P＞0.05);2组NT-proBNP水平均较治疗前明显下降(P＜0.01),2组比较无统计学意义(P＞0.05),但治疗组NT-proBNP下降水平较对照有进一步下降趋势.结论 心痛贴膏能改善心肾阳虚型慢性心力衰竭患者的心功能,提高6MWT步行里程数,改善患者生活质量.

目的 观察瓜蒌薤白半夏汤联合增强型体外反搏(EECP)对不稳定性心绞痛(UA)患者心脏室壁运动的影响.方法 选择2014年9月至2016年9月在本院内科住院的90例UA患者为研究对象,随机分为观察组和对照组各45例.观察组患者接受西药治疗+瓜蒌薤白半夏汤+EECP治疗,对照组患者接受西药治疗+EECP治疗.比较两组患者观察治疗前后加拿大心血管病学会(CCS)心绞痛分级、心脏室壁运动情况.结果 治疗后,两组患者的CCS心绞痛分级均显著降低,且观察组患者的CCS心绞痛分级评分(1.69±0.56)分,显著低于对照组患者(2.00±0.54)分,差异有统计学意义(t=-2.183,P=0.033).两组患者心脏室壁运动评分均较治疗前降低,且观察组心脏室壁运动评分(1.00±0.60)分显著低于对照组患者(1.37±0.58)分,差异具有统计学意义(t=-2.428,P=0.018).两组患者在EECP治疗过程中,收缩压110～ 150 mmHg,舒张压60～ 90 mmHg,心率60～95次/min,D/S比值1.2～ 1.3.结论 瓜蒌薤白半夏汤联合体外反搏治疗能够改善不稳定性心绞痛患者心脏室壁运动,减轻心绞痛症状.

目的 观察瓜蒌薤白半夏汤合四君子汤对痰浊闭阻型冠心痛患者经皮冠状动脉腔内成形术(PCI)后生活质量的影响. 方法 122例痰浊闭阻型冠心病PCI术后患者按数字表法随机分为2组.对照组60例采用西医常规治疗,治疗组62例在对照组治疗基础上加服瓜蒌薤白半夏汤合四君子汤,疗程1个月.采用简明健康调查问卷(SF-36)及西雅图心绞痛量表(SAQ)评价2组生活质量. 结果 2组治疗后1个月生活质量均较术前明显改善(P＜0.01);其中治疗组SF-36量表中的生理机能、生理职能、总体健康、情感职能及SAQ量表中的心绞痛稳定状态、心绞痛发作情况、治疗满意程度各纬度计分升高幅度均优于对照组(P＜0.05). 结论 瓜蒌薤白半夏汤合四君子汤能改善痰浊闭阻型冠心痛患者介入术后的生活质量.

ObjectiveTo observe the effect of enhanced external counterpulsation (EECP) combined with TCM syndrome (phlegm and blood stasis obstructing) in treatment of unstable angina pectoris (UA).Methods Randomly divided into control group, medication group and ECP treatment group. The control group was treated with routine western medicine plus EECP, drug treatment group was treated with routine western medicine and traditional Chinese medicine phlegm and promoting blood circulation, regulating qi Kuanxiong therapy, counterpulsation in the treatment group based on conventional western medicine and traditional Chinese medicine treatment plus EECP. 12 days for a course of treatment, enhanced external counterpulsation 1 hour/ times, continuous treatment of 3 courses. Observed the angina pectoris of improving symptoms and ECG changes and the occurrence of adverse reactions before and after treatment.Results All treatment groups of angina pectoris symptoms and ECG changes were improved, the control group, drug treatment group curative effect close, counter pulsation therapy group was better than control group, drug group.Conclusion The therapeutic effect of enhanced external counter pulsation combined with traditional Chinese medicine treatment is good, and no adverse events occured.

目的 观察通脉畅心汤治疗寒瘀痹阻型恶化劳力型心绞痛临床疗效. 方法 将80例恶化劳力型心绞痛患者采用随机数字表法分成治疗组和对照组各40例,对照组予西药常规治疗,治疗组在对照组治疗基础上加用通脉畅心汤口服,治疗7d,观察2组心绞痛发作时的症状、硝酸甘油用量及清晨静息心率、心电图ST段压低总和(∑ST)和ST段下降导联数(NST)变化情况. 结果 治疗组心绞痛疼痛程度减轻,持续时间和频率缩短,硝酸甘油用量减少,清晨静息心率降低,心电图指标明显改善,2组比较差异有统计学意义(P＜0.05). 结论 通脉畅心汤治疗寒瘀痹阻型恶化劳力型心绞痛可以有效缓解心绞痛症状,改善心肌缺血状况,阻止病情恶化.

目的:观察联合“心痛贴膏”穴位贴敷治疗冠心病不稳定性心绞痛与单纯西药治疗之间的疗效差别.方法:将冠心病不稳定性心绞痛患者随机分成联合“心痛贴膏”穴位贴敷治疗组和单纯西药治疗组,治疗一周,观察心绞痛发作疼痛程度、持续时间、频率及硝酸甘油用量、心电图ST段下降导联数(NST)和ST段压低总和(ΣST)以及生活质量改善状况.结果:联合“心痛贴膏”穴位贴敷治疗组较单纯西药治疗组心绞痛发作程度减轻,持续时间、频率减少(P＜0.05)、硝酸甘油用量明显减少(P＜0.05),心电图显著改善(P＜0.05).结论:联合“心痛贴膏”穴位贴敷治疗冠心病不稳定性心绞痛,具有增强疗效、改善生活质量的作用.

Objective: To observe the curative effects of gualouxiebaibanxia decoction on the cardiac ventricular wall motion abnormalities in unstable angina pectoris. Methods: 120 cases of patients with ustable angina pectoris and cardiac ventricular wall motion abnormalities were randomly divided into two groups, treatment group and control group, 60 cases in each group. Control group was treated with western medicine and treatment group with gualouxiebaibanxia decoction and western medicine for one month. Results: Compared with the control group, the efficacy of treatment group was better in relieving angina pectoris(81.6% VS 63.3%), improving chest syndrome(86.6% VS 73.3%), improving electrocardiograph (81.6% VS 63.3%), and improving cardiac ventricular wall motion abnormalities(78.3% VS 65%). The differences were significant (P <0.05). Conclusion: It is effective that treating unstable angina pectoris with gualouxiebaibanxia decoction, which can significantly improve electrocardiograph and cardiac ventricular wall motion abnormalities.

Objective To study the relationship between serum ischemia modified album(IMA) and blood lipid in patients with acute coronary syndrome(ACS).Methods The levels of serum IMA,TC,LDL-C,HDL-C and TG were determined in 190 patients with unstable angina pectoris(UAP) and 66 patients with acute myocardial infarction(AMI) within 3 hours after onset of chestpain and 144 healthy people as controls.And the level of serum IMA was indicated with the value of album cobalt binding(ACB).Results The value of ACB was lower in UAP and AMI groups than that in control group [control(65.0±5.7),UAP(59.1±5.2) vs AMI(52.5±3.1)U/L](P0.05 respectively).The level of TC was increased in UAP and AMI groups,compared with control group[control(3.9±0.6),UAP(4.7±0.9) vs AMI(4.8±1.0)mmol/L](P0.05 respectively).The level of LDL-C was increased in UAP and AMI groups,compared with control group[control(2.6±0.4),UAP(3.1±0.8) vs AMI(3.3±1.0)mmol/L](P0.05 respectively).The value of ACB was negatively correlated with the levels of TC and LDL-C in UAP(r=-0.49 and-0.47,P0.05 respectively) and AMI groups(r=-0.64 and-0.59,P0.05 respectively).Conclusion The value of ACB was decreased and was negatively correlated with the levels of TC and LDL-C in patients with ACS,which indicated that not only TC and LDL-C prompted the development of ACS,but affected the metabolism of IMA.

Introduction: To evaluate the effects of diltiazem and benazepril on monocrotaline-induced pulmonary arterial remodeling in rats. Methods: Forty Sprague-Dawley rats were randomly assigned into four groups: normal control (Ctr), pulmonary arterial hypertension (PAH), diltiazem (Dil) and benazepril treated group(Ben). The rats were given a dose of 40 mg/Kg monocrotaline intraperitoneally in PAH, diltiazem and benazepril treated groups and untreated rats were given 1 ml NS intraperitoneally as control. After 4 weeks, the rats were given 25 mg/Kg/d of diltiazem and 10 mg/Kg/d of benazepril by gavage respectively in diltiazem and benazepril treated groups for 4 weeks. 4 weeks after medication, mean of pulmonary arterial pressure(MPAP) and right ventricular hypertrophy index (RVHI) were measured, and WT% and WA% of pulmonary arterioles were evaluated. The protein analysis for Cav1c, SERCA-2a, IP3R-1 and RyR-3 in pulmonary artery was evaluated by Western-Blot. Results: MPAP and RVHI were significantly increased in PAH. MPAP and RVHI were significantly decreased after diltiazem and benazepril treatment(P < 0.05 respectively). Compared with Ctr group, WT% and WA% were significantly increased in PAH. Administration of diltiazem and benazepril, WT% and WA% were significantly reduced.[MPAP: Ctr(23.22+/−3.27), PAH(36.12+/−4.17), Dil(25.27+/−6.18) vs Ben(28.11+/−6.02)mmHg; RVHI: Ctr(25.58+/−2.94), PAH(45.60+/−3.81), Dil(39.96+/−2.61) vs Ben(39.50+/−4.90)%; WT: Ctr(37.63+/−3.63), PAH(58.48+/−4.59), Dil(43.04+/−4.96) vs Ben(37.41+/−4.35)%; WA: Ctr(51.37+/−6.40), PAH(76.84+/−7.04), Dil(61.74+/−4.90) vs Ben(53.86+/−5.53)%, P < 0.05 respectively] Cav1c and RyR-3 expression was significantly downregulated after diltiazem and benazepril treatment(P < 0.05 respectively). And RyR-3 expression in benazepril treated group was less than that in diltiazem treated group (P < 0.05). There were no significant differences in the expression of SERCA-2a between diltiazem and benazepril treated groups and PAH(P > 0.05 respectively). As to IP3R-1, diltiazem and benazepril treated groups also showed downregulated expression compared with PAH(P < 0.05 respectively). Conclusion: Diltiazem, as effective as benazepril, could reduce pulmonary arterial pressure, attenuate right ventricular hypertrophy and pulmonary arterioles remodeling and regulate calcium channels expression in pulmonary artery in monocrotaline-induced pulmonary arterial hypertensive rats.

Introduction: Structural remodeling of pulmonary artery plays an important role in the maintaining of sustained pulmonary arterial hypertension (PAH). The anti-remodeling effects of statins has been reported in systemic hypertension. In this study, we investigated the effects of atovastatin (Ato) and losartan (Los) on monocrotaline-induced pulmonary artery remodeling in rats. Methods: Forty SD rats were assigned into: normal control (Ctr), PAH, Los, Ato treated groups. The rats were given a dose of 40 mg/Kg monocrotaline intraperitoneally in PAH, Los and Ato treated groups and untreated rats were given 1 ml normal saline intraperitoneally as control. After 4 weeks, the rats were given 50 mg/Kg/d of Los and 5 mg/Kg/d of Ato by gavage respectively in Los and Ato treated groups for 4 weeks. 4 weeks after medication, mean of pulmonary arterial pressure(MPAP) and right ventricular hypertrophy index(RVHI) were measured, and WT% and WA% of pulmonary arterioles were evaluated. The protein analysis for 1C subunit of voltage-gated calcium channel(Cav1c), sarcoplasmic/endoplasmic reticulum calcium-ATPase(SERCA-2a), inositol 1,4,5 triphosphate receptor 1(IP3R-1) and Ryanodine receptor 3(RyR-3) in pulmonary artery was evaluated by RT-PCR and Western-Blot. Results: The MPAP was reduced by Los and Ato treatment (mmHg: Los, 29.8+/−4.8, Ato, 27.6+/−4.1, PAH, 36.1+/−4.2, P < 0.05). There was a reduction in the RVHI in Los and Ato treated groups (Los, 38.5+/−6.4%, Ato, 37.7+/−6.0%, PAH, 45.6+/−3.8%, P < 0.05). The ratio of wall/lumen thickness (WT%) and wall /lumen area (WA%) was lower in Los and Ato treated group (WT%: Los:44.9+/−5.7%, Ato:42.8+/−2.9% vs PAH:58.5+/−4.6%; WA%: Los:61.3+/−5.5%, Ato:59.3+/−3.4% vs PAH:76.8+/−7.0%; P < 0.05) than that of PAH group. The expression of 1C subunit of voltage-gated calcium channel (Cav1c) was down-regulated, while sarcoplasmic/endoplasmic reticulum calcium-ATPase(SERCA-2a) and inositol 1,4,5 triphosphate receptor 1 (IP3R-1) up-regulated both in mRNA and protein levels in pulmonary arteries after Los and Ato treatment. Conclusion: We concluded that atorvastatin and losartan may regress remodeling of pulmonary artery and calcium regulating channels in pulmonary hypertensive rats.