Purpose:To develop a risk prediction model for left ventricular thrombus (LVT) formation in patients with acute ST-segment elevation myocardial infarction (STEMI). Patients and methods:We performed a retrospective analysis of patients with STEMI in our hospital between October 2017 to October 2020. According to transthoracic echocardiography, these patients were included in the LVT group (n = 50) or no-LVT group (n = 130). Clinical data were collected from both groups. The comparison between groups, single-factor logistic regression analysis, Lasso regression analysis and multi-factor logistic regression analysis were performed successively to screen the risk factors and to establish risk prediction models. After evaluation and internal verification, we obtained an optimal risk prediction model. A nomogram was constructed to visualize the optimal model. Results:The risk prediction model contained seven variables including MCV (OR = 1.251, 95% CI = 1.021-1.531, P = 0.030), D-Dimer (OR = 9.798, 95% CI = 2.630-36.503, P = 0.001), CRP (OR = 1.033, 95% CI = 1.011-1.055, P = 0.003), LVEF (OR = 0.903, 95% CI = 0.819-0.995, P = 0.040), A wave velocity (OR = 0.044, 95% CI = 0.002-0.906, P = 0.043), pericardial effusion (OR = 16.926, 95% CI = 2.767-103.522, P = 0.002) and anterior wall infarction (OR = 12.275, 95% CI = 2.136-70.548, P = 0.005). The C-index value was 0.966 and the area under the ROC curve was 96.6% (95% CI = 0.9399-0.9914). Simple cross-validation, k-fold, leave-one-out, and bootstrap analyses were used to internally verify the model. The accuracy of the model were 0.926, 0.9, 0.9, and 0.899, and Kappa values were 0.807, 0.744, 0.744, and 0.739. The area under the ROC curve was 94.7%, as verified by bootstrapping. Conclusion:MCV, D-dimer level, CRP level, LVEF, A-wave velocity, pericardial effusion, and anterior wall infarction were independently related to the occurrence of LVT in STEMI at the acute stage. The multivariate logistic regression risk prediction model developed in this study demonstrates good discrimination and calibration, enabling preliminary risk stratification for LVT in patients with acute STEMI.

PAH is marked by excessive PASMCs and resistance to apoptosis. ERS drives pulmonary vascular remodeling. Betaine from Lycium barbarum L. protects against PAH, is orally available to humans and shows no obvious toxicity for humans and animals at 100, 200, 400 mg/kg. However, the ERS link remains unexplored. This study investigates betaine's PAH protective mechanisms. SD rats received a single subcutaneous injection of notaline to induce PAH and received betaine and sildenafil avenate for 21 d. Betaine significantly improved abnormal changes in echocardiography, hemodynamics, and pathomorphology. Betaine inhibited the proliferation of HPASMCs induced by PDGF-BB. Moreover, betaine suppressed the protein expression of GRP78 and improved the protein expression of p-PERK in rat lungs. It also significantly upregulated PERK and eIF2 alpha phosphorylation in HPASMCs. Upon PERK siRNA knockdown, betaine restores PERK and eIF2 alpha phosphorylation. Betaine activates PERK-eIF2 alpha, mitigates ERS, and targets PERK, as a potential PAH therapy.

Background: Liquiritin, a flavonoid present in the traditional Chinese medicine Radix Glycyrrhizae, reduces myocardial damage and improves cardiac function. However, it remains unclear what effect it has on the thoracic aortic rings. Purpose: Use of rat thoracic aortic rings to study the vasodilatory effects of liquiritin and its associated mechanisms. Methods: The arterial tension of rat thoracic aortic rings was measured in vitro using the perfusion method. Precontraction of the thoracic aortic rings with phenylephrine (PE) 1 mu M and changes in vascular ring tension were observed and recorded after cumulative administration of liquiritin (1, 3, 10, 30, 100, and 300 mu M). The effects of liquiritin on the tension of thoracic aortic rings with intact or denuded endothelial that were precontracted with PE or potassium chloride were determined, as well as how NG-nitro-l-arginine methyl ester (L-NAME), 4-aminopyridine (4-AP), indomethacin (INDO), tetraethylammonium (TEA), barium chloride (BaCl2), and glibenclamide (Gli) affected the vasodilatory function of liquiritin. Results: Liquiritin exerts a diastolic effect on PE-induced contraction of the thoracic aortic ring, and this effect is independent of the integrity of the vascular endothelium. L-NAME and INDO pretreatment also did not influence the vasodilatory function of liquiritin, illustrating that it might not be endothelium-dependent. Furthermore, pretreatment with TEA, a Ca2+-activated K+ channel inhibitor, and BaCl2, an inwardly rectifying K+ channel inhibitor, did not affect the vasodilatory effects of liquiritin. Nevertheless, pretreatment with the voltage-dependent K+ (K-v) channel inhibitor, 4-AP, and the ATP-sensitive K+ (K-ATP) channel inhibitor, Gli, significantly reduced the vasodilatory effect of liquiritin, indicating that the vasodilatory effects of liquiritin may have a bearing on the activation of K-v and K-ATP channels. Conclusion: Overall, we confirmed for the first time that liquiritin has vasodilatory effects that are endothelium-independent, and the mechanism of its vasodilatory effect may include activation of K-v and K-ATP channels.

Purpose This study mainly made use of network pharmacology and molecular docking to analyze the therapeutic mechanism of pulmonary arterial hypertension (PAH) by the traditional medicinal food plant Lycium barbarum L. in Ningxia. Methods The related targets and active compounds in PAH and Lycium barbarum L. were analyzed through the Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform (TCMSP), GeneCards databases, Online Mendelian Inheritance in Man (OMIM) databases,Cytoscape (3.7.1) software,the STRING database,the Database for Annotation Visualization and Integrated Discovery (DAVID) database. In addition, the main active compounds were molecularly docked with key targets. Results The results showed that 35 active ingredients of Lycium barbarum L. were obtained. The protein-protein interaction (PPI) network includes 140 potential target proteins. Gene Ontology (GO) enrichment analysis yielded 34 entries from three parts: biological processes, cell composition, and molecular function. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis obtained 157 pathways, mainly involving Chemical carcinogenesis receptor activation, Lipid and atherosclerosis, Hepatitis B/C, Chemical carcinogenesis reactive oxygen species, as well as Signaling pathways such as HIF-1, TNF, PI3K-Akt, and MAPK. Molecular docking results showed that the affinity of the key targets to quercetin is less than -5 kcal/mol, and the affinity with betaine is less than 0. Conclusion In conclusion, it was preliminarily predicted that the active compounds of Lycium barbarum L., such as quercetin and betaine, acted on key targets such as AKT1, EGFR, MYC played an intervention role in PAH by regulating multiple signaling pathways, which provided a theoretical basis for the development and application of Lycium barbarum L. and the treatment of PAH.

Background: Coronary artery disease is a prevalent global cardiovascular ailment, with percutaneous coronary intervention (PCI) standing out as a crucial method for relieving symptoms and enhancing the quality of life in patients with coronary heart disease. However, the presence of concurrent chronic total occlusion (CTO) and bifurcation lesions within coronary arteries elevates the complexity and treatment risks, especially when the entry point of the CTO is ambiguous. Objective: This study aims to present an innovative approach for treating CTO complicated with bifurcation lesions, focusing on true cavity pathfinding assisted by a balloon. Methods: Two cases of CTO patients with concomitant bifurcation lesions are described. One case involves CTO of the left anterior descending artery) combined with anterior non-angle trigeminal lesions, while the other entails CTO of the posterior left artery combined with posterior angle trigeminal lesions. True lumen identification using a balloon and subsequent opening of the CTO blood vessel were performed in both cases. Results: In both cases, the true lumen was successfully located with the assistance of a balloon, leading to the successful opening of the CTO blood vessel. This approach not only simplified the procedure but also reduced procedural difficulty and associated risks of complications compared to traditional guide wire operations. Conclusion: The application of true cavity pathfinding assisted by a balloon offers a novel and effective strategy for managing CTO complicated with bifurcation lesions. The method simplifies the procedure, decreases procedural difficulty, and lowers the risk of complications associated with guide wire operations. However, further studies and long-term follow-up data are warranted to validate the reliability and long-term efficacy of this innovative approach.

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经皮冠状动脉介入治疗(percutaneous coro-nary intervention,PCI)过程中,由指引导管所致冠脉开口夹层时有发生,多由AL、SAL系列指引导管所致.慢性完全闭塞性病变(chronictotal oc-clusion,CTO)手术过程中常需要强支撑指引导管,因此发生血管夹层风险较高,且往往只能改为逆向技术,甚至失去手术机会.现报道 1 个利用并发症巧妙处理右冠脉复杂慢性闭塞病变的治疗案例.

Objective To assess the effectiveness and safety of an IVUS-guided rotational atherectomy (RA) percutaneous coronary intervention (PCI) in chronic renal patients with complex coronary calcification who are at risk for contrast-related acute kidney injury (AKI). Methods From October 2018 to October 2021, 48 patients with chronic renal disease who were receiving PCI with RA at the General Hospital of NingXia Medical University were informed for data collection for this research. They were randomly assigned to the IVUS-guided RA group and the Standard RA group, which did not use IVUS. According to a clinical expert consensus document on rotational atherectomy in China, both PCI procedures were performed. The intravascular ultrasound (IVUS) results from the study group were used to describe the morphology of the lesion and to guide the selection of burrs, balloons, and stents. IVUS and angiography were used to evaluate the outcome in the end. IVUS-guided RA PCI and Standard RA PCI groups’ effects and results were contrasted. Results There were no appreciable differences in the clinical baseline characteristics between the IVUS-guided RA PCI group and the Standard RA PCI group. The average estimated glomerular filtration rate (eGFR) of two groups was (81.42 ± 20.22 vs 82.34 ± 22.19) mL/min/1.73 m2. Most of them (45.8% vs 54.2%) was in stage 60–90 mL/min/1.73m2. When compared to the standard RA PCI group, RA in IVUS-Guided group was more performed electively (87.5% vs 58.3%; p = 0.02). The IVUS-guided RA PCI group was associated with shorter fluoroscopy time (20.6 ± 8.4 vs 36 ± 22; p<0.01) and less contrast amount (32 ±16 vs 184 ±116mL; p<0.01) than Standard-RA group. Five patients in the Standard RA PCI group developed contrast-induced nephropathy, which was 5 times than the IVUS-guided RA PCI group (20.8% VS 4.1%; p=0.19). Conclusion In chronic renal patients with complex coronary calcification, an IVUS-guided RA PCI technique is effective and safe. It can also lower the volume of contrast and perhaps the incidence of contrast-related AKI.

The onset and progression of pulmonary arterial hypertension (PAH), a malignant disease, are associated with environmental and epigenetic factors. Recent advancements in transcriptomics and proteomics technology have provided new insights into PAH and identified novel gene targets involved in the development of the disease. Transcriptomic analysis has led to the discovery of possible novel pathways, such as miR-483 targeting several PAH-related genes and a mechanistic link between the increase in HERV-K mRNA and protein. Proteomic analysis has revealed crucial details, including the loss of SIRT3 activity and the significance of the CLIC4/Arf6 pathway in PAH pathogenesis. Gene profiles and protein interaction networks of PAH have been analyzed, clarifying the roles of differentially expressed genes or proteins in the occurrence and development of PAH. This article discusses these recent advances.

目的:基于PI3K-AKT-mTOR信号通路探讨参附注射液对心力衰竭大鼠的作用及其机制.方法:60只SD大鼠随机分为正常对照组(n=20)、心力衰竭模型组(n=20)、参附注射液治疗组(n=20),正常对照组不做任何处理,其余两组采取腹主动脉缩窄法构建心力衰竭模型,给予心力衰竭模型组氯化钠溶液,参附注射液治疗组给予参附注射液.比较各组大鼠心脏功能、氧化应激、炎症因子、P13K-Akt-mTOR表达.结果:与正常对照组相比,参附注射液治疗组、心力衰竭模型组左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)水平依次升高,而左心室射血分数(LVEF)水平依次下降(P＜0.05).与正常对照组相比,参附注射液治疗组、心力衰竭模型组血清丙二醛(MDA)水平依次升高,血清超氧化物歧化酶(SOD)水平依次下降(P＜0.05).与正常对照组相比,参附注射液治疗组、心力衰竭模型组血清白介素6(IL-6)、白介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平依次升高(P＜0.05).与正常对照组相比,参附注射液治疗组、心力衰竭模型组P13K-Akt-mTOR表达依次下降(P＜0.05).结论:参附注射液能够保护心力衰竭大鼠心脏功能,并可减轻氧化应激反应、抑制炎症因子表达,其作用机制可能与激活P13K-Akt-mTOR信号通路有关.

目的 分析急性心肌梗死(AMI)患者发生心力衰竭(HF)的影响因素,并构建风险预测模型.方法 纳入1 061例AMI患者,分为模型构建的训练集(786例)和模型验证的测试集(275例).利用Lasso回归和多因素Logistic回归构建AMI患者发生HF的预测模型,并绘制列线图.采用受试者工作特征(ROC)曲线和校准曲线评价模型的区分度和校准度.结果 利用Lasso回归和多因素Logistic回归筛选出年龄、心率(HR)、ST段偏移、N端脑利钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)、纤维蛋白原(Fib)、左心室射血分数(LVEF)共7个变量建立模型.多因素Logistic回归构建预测模型的回归方程为Logit(P)=0.718×ST段偏移+0.042×年龄+0.037×HR+0.000 294×NT-proBNP+ 0.040×Hcy+0.220×Fib-5.617×LVEF-5.781.预测模型训练集的ROC曲线下面积(AUC)为 0.846(95%CI:0.817～0.875),敏感度为78.50%,特异度为76.60%.校准曲线显示训练集患者HF的发生率与实际发生率基本相符.利用测试集对模型进行外部验证,AUC为0.848(95%CI:0.801～0.896),敏感度76.40%,特异度78.00%.结论 AMI患者发生HF与ST段偏移、年龄、入院HR、NT-proBNP、Hcy、Fib、LVEF有关,利用以上变量构建的预测模型具有较高的预测效能,有助于早期识别此类患者.

目的 研究急诊经皮冠状动脉介入术(PCI)术前服用负荷剂量的替格瑞洛或氯吡格雷对不同ST段抬高型急性心肌梗死(ASTEMI)患者冠状动脉血流的影响.方法 回顾性研究收治的行急诊PCI的ASTEMI患者207例资料,依据术前用药状况,将其分为替格瑞洛组(n=113)和氯吡格雷组(n=94).比较有关病例的基本资料;入院时各项血液学检验结果;PCI手术情况;术后不同人群心肌灌注情况;住院期间发生的主要心血管不良事件和出血事件.结果 2组患者的一般临床资料、入院时各项血液学检验结果、PCI手术情况、住院期间主要不良心血管事件及出血事件的发生情况的比较,差异均无统计学意义(P＞0.05).替格瑞洛组术后TIMI分级、TMPG分级、高危组术后TIMI分级、高龄组术后TIMI分级、合并糖尿病组术后TIMI分级均高于氯吡格雷组(P＜0.05).结论 替格瑞洛组急诊PCI术后TIMI血流及TMPG分级优于氯吡格雷组,且高危、高龄、合并糖尿病的亚组患者均呈现同样趋势.

Pulmonary arterial hypertension (PAH) is a life-threatening disease characterised by elevated pulmonary pressure, right ventricular failure (RVF) and ultimately death. Aggressive treatment of RVF is considered an important therapeutic strategy to treat PAH. Previous studies have indicated that betaine may be may a promising therapeutic approach for PAH-induced RVF. Therefore, in this study, betaine solution for injection was prepared and characterised using various techniques. The therapeutic efficacy of three different methods of administration (intragastric, nebulised inhalation and intravenous injection) were comprehensively evaluated in terms of pharmacokinetics, tissue distribution and pharmacodynamics. The pharmacokinetic results demonstrated that betaine injection administered via nebulised inhalation significantly prolonged betaine's half-life and increased its internal circulation time compared to the intragastric and intravenous routes. Biodistribution experiments verified that the betaine formulation accumulated in the lung tissue when administered via inhalation. The results of the pharmacodynamic analysis further confirmed that right ventricular systolic pressure, mean pulmonary artery pressure and right ventricular hypertrophy index increased in the model group and that inhaled betaine suppressed these pathological changes to a level comparable to those observed in the control group. Taken together, these results indicate that betaine administered by inhalation is a promising strategy for the treatment of PAH-induced RVF.

目的 探讨心电图aVR导联T波形态在急性前壁心肌梗死患者的病情评估及近期预后中的价值.方法 回顾性分析322例进行急诊经皮冠状动脉介入术(PCI)的急性前壁ST段抬高型心肌梗死患者的相关资料,根据aVR导联T波形态分为T波直立组和T波非直立组,通过比较组间相关指标的差异来评估2组患者的病情及判断预后.结果 T波直立组较T波非直立组:年龄更大,血白细胞、超敏CRP更高,心功能更差,多部位心肌梗死比例更高,冠脉病变程度更重,住院天数更长及院内不良事件发生率更高,上述指标组间比较差异均具有统计学意义(P＜0.05).aVR导联T波直立是院内不良心血管事件的独立危险因素.结论 急性前壁心肌梗死患者入院后即刻床旁心电图中aVR导联T波直立者病情更重、预后更差.

目的 探讨急诊经皮冠状动脉介入治疗(P C I)术前服用负荷剂量的替格瑞洛与氯吡格雷对急性ST段抬高型心肌梗死STEMI患者抗血小板治疗效果及预后的影响.方法 回顾性研究本院心内科2017年10月至2018年10月收治的行急诊PCI的STEMI患者207例,依据术前用药状况,将其分为替格瑞洛组113例和氯吡格雷组94例.比较两组患者在住院期间使用抗血小板药物治疗的效果及对患者预后的影响.结果 两组患者的一般临床资料,差异无统计学意义(P>0.05).两组术后替格瑞洛组血小板计数低于氯吡格雷组,差异有统计学意义(P<0.05);术后,替格瑞洛组血小板平均体积高于氯吡格雷组(P<0.05).两组术后替格瑞洛组二磷酸腺苷(ADP)途径抑制率高于氯吡格雷组(P<0.05);替格瑞洛组术后MAADP值低于氯吡格雷组(P<0.05).两组患者在住院期间主要心血管不良事件及出血事件的发生情况均无统计学差异(P>0.05).结论 对于血小板ADP途径的抑制率,替格瑞洛组高于氯吡格雷组;两组患者在住院期间主要心血管不良事件和出血事件的发生无差异.

Excessive pulmonary arterial smooth muscle cells (PASMCs) proliferation and anti-apoptosis are vital pathophysiological components of pulmonary arterial remodeling in pulmonary arterial hypertension (PAH). Endoplasmic reticulum stress (ERS) is increasingly recognized as a common pathophysiological reaction to lead to pulmonary vascular remodeling. Betaine is an anti-inflammatory and improve immunity alkaloid, which extracted from Lycium barbarum L. In our previous studies have demonstrated that betaine has protective effects on PAH. Nevertheless, whether the therapeutic effect betaine on PAH is related to ERS remains unclear. Therefore, this study aimed to investigate the effects and mechanisms of betaine on PAH. In vivo, betaine significantly improved abnormal changes in echocardiography, hemodynamics and pathomorphology. The results of CCK-8 showed betaine inhibited proliferation of HPASMCs induced by PDGF-BB of HPASMCs. Furthermore, betaine suppressed protein expression of GRP78, CHOP and Caspase-12 and improved protein expression of p-PERK in rat lungs. Betaine significantly upregulated PERK phosphorylation and eIF2α phosphorylation in HPASMCs. After PERK was intervened with siRNA, betaine could restore the reduction of PERK and eIF2α phosphorylation level caused by PERK siRNA. Betaine played a therapeutic role in treating pulmonary arterial hypertension by enhancing PERK-eIF2α signaling pathway, inhibiting ERS and its target was PERK.

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者入院D-二聚体(D-D)水平与经皮冠状动脉介入治疗(PCI)后ST段回落率(STR)的相关性.方法:选取2017年10月—2018年10月STEMI且行急诊PCI及冠状动脉血栓抽吸术患者共46例,完成术前D-二聚体、肌钙蛋白I(cTNI)、磷酸肌酸激酶同工酶(CKMB)、肌酐(Cr)水平检测.采集首次医疗接触和术后90min的12或18导联体表心电图;术中进行冠状动脉血流的评估;收集冠状动脉血栓并行病理学检测.按术前D-二聚体水平四分位数间距分为四组,即D-D≤0.150mg/L组(n=12)、D-D 0.150～0.335mg/L组(不含0.150mg/L,n=11)、D-D 0.335～0.750mg/L组(不含0.335mg/L,n=12)、D-D>0.750mg/L组(n=11),比较四组间基层临床数据及冠脉血栓抽吸物成分.依据PCI术后心电图STR分为<30％组(n=17),30％～70％组(n=15),>70％组(n=14),并观察STR与术前D-二聚体水平的关系.应用ROC曲线判断D-二聚体对心肌灌注不足的预测价值.结果:46例STEMI患者心血管事件(主要表现为急性心肌梗死、急性左心衰竭、心律失常)发生率在D-D≤0.150 mg/L、D-D 0.150～0.335mg/L、D-D 0.335～0.750mg/L、D-D>0.750mg/L中有显著性差异(P=0.022),且冠状动脉血栓抽吸物中红细胞及血小板含量在D-D>0.750mg/L组显著高于D-D≤0.150mg/L组(P<0.05).术前D-二聚体水平在STR<30％组显著高于STR 30％～70％组、STR>70％组(P<0.05),心血管事件发生率在三组间有显著性差异(P=0.024).ROC曲线显示,术前D-二聚体对于STEMI患者直接PCI治疗术后发生心肌灌注不足现象具有一定的预测价值[STR<30％ 时ROC曲线下面积(AUC)=0.767,95％CI 0.622～0.912,P=0.003].以STR<30％评估心肌灌注不足指标时,D-二聚体临界值为0.835mg/L,灵敏度0.52,特异度0.93.结论:术前D-二聚体水平与STEMI患者PCI术后的STR水平相关,可能有预测PCI术后心肌灌注不足的价值.

The aim of this study was to investigate the vasodilatory effects of betaine, an alkaloid isolated from Lycium barbarum, on isolated pulmonary artery rings in rats and its possible mechanisms. Pulmonary vessels of normal Sprague-Dawley rats were isolated and pre-contracted using norepinephrine. Then, betaine was cumulatively added in differing concentrations (0.02-0.14 mg/mL), and the tension curve was observed and recorded. Changes in the tension of the pulmonary artery rings with an intact endothelium and a dissected endothelium were recorded. The interactions among betaine and NG-nitro-L-arginine methyl ester, indomethacin, 4-aminopyridine, barium chloride, and glibenclamide were evaluated. The experimental results show that betaine can relax the pulmonary artery rings pre-contracted by norepinephrine. Furthermore, pre-incubation with NG-nitro-L-arginine methyl ester and indomethacin did not inhibit betaine vasodilation, demonstrating that vasodilation by betaine is endothelium-dependent. Additionally, pretreatment of pulmonary artery rings with 4-aminopyridine and glibenclamide had no effect on betaine. However, pretreatment of pulmonary artery rings with barium chloride attenuated the effects of betaine. In conclusion, the vasodilatory effects of betaine on pulmonary artery rings is associated with inward rectifier potassium channels.

Pulmonary vascular remodeling was shown to lead to pulmonary arterial hypertension (PAH), further trigger excessive apoptosis of cardiomyocytes, and ultimately cause right ventricular failure (RVF), which involves the activation of Rho A/ROCK signaling pathway. Betaine has been found efficacious for attenuating PAH through its anti-inflammatory effects in our previous research while its effects on RVF due to PAH remains inconclusive. Thus, we attempted to elucidate the protective effects of betaine on PAH, RVF due to PAH as well as the potential mechanisms. To this end, male Sprague Dawley rats received a single subcutaneous injection of monocrotaline (50 mg/kg) to imitate PAH and RVF, and subsequently oral administration of betaine (100, 200, and 400 mg/kg/day). Betaine treatment improved the hemodynamics and histomorphological parameters and echocardiographic changes. Moreover, betaine also alleviated the pulmonary vascular remodeling and cardiomyocyte apoptosis. The mechanisms study revealed that administration of betaine significantly increased the expression of Rho A, ROCK1, and ROCK2. Furthermore, betaine alleviated the changes of its downstream molecules P53, Bcl-2, Bax, phosphorylated MYPT1 (p-MYPT1), total MYPT1 (t-MYPT1), p27kip1, and Cleaved Caspase-3. According to what we observed, this study indicated that betaine treatment could protect RVF due to PAH, which may be achieved through an altered Rho A/ROCK signaling pathway.

目的:探讨不同剂量氯吡格雷对急诊PCI术的急性ST段抬高型心肌梗死(STEMI)患者血清血管舒张剂刺激磷蛋白(VASP)磷酸化水平的影响.方法:选取32例非冠心病患者作为对照组,134例行急诊PCI术的STEMI患者作为治疗组.对照组及治疗组均未曾服用过氯吡格雷.将STEMI患者治疗前随机分为A(68例)、B(66例)两组,A组、B组分别于急诊PCI术前首次给予负荷量氯吡格雷300mg、600mg,随后再次将A、B组随机分为A1(36例)、A2(32)和B1(33例)、B2组(33例),A1、B1组均给予维持剂量氯吡格雷75mg/d、A2、B2组均给予维持剂量氯吡格雷150mg/d,各组于服用氯吡格雷前、负荷剂量氯吡格雷24h、维持剂量氯吡格雷1周后取肘静脉血,通过Elisa法测定血清VASP磷酸化水平.结果:对照组血清VASP磷酸化水平高于治疗组治疗前血清VASP磷酸化水平(P<0.05).负荷量氯吡格雷24小时,B组血清VASP磷酸化水平高于A组(P<0.05).服用不同维持剂量氯吡格雷1周,B1、B2组血清VASP磷酸化水平高于A1、A2组,但无统计学差异(P均>0.05).结论:STEMI组患者血清VASP磷酸化水平低于非冠心病组患者.STEMI患者急诊PCI术前给予600mg负荷量氯吡格雷VASP磷酸化更充分,给予维持剂量氯吡格雷75mg/d与150mg/d均可提高STEMI患者血清VASP磷酸化水平,且两者之间无统计学差异.