Objective To investigate the survival of cells under the microenvironment after trimetazidine ( TMZ) pretreatment bone marrow mesenchymal stem cells (BMSCs)transplanted to ischemia-reperfusion (analog revascularization)and the influence on cardiac func-tion,and the mechanism .Methods The TMZ pretreatment or pretreatment hypoxia/reoxygenation ( H/R) BMSCs supernatant of cultured myocardial hypoxia ,CCK-8 was used to assay cell activity ,RT-PCR was used to detect levels of Bcl-2,Bax gene expression .32 SD rats were randomly divided into Sham,myocardial ischemia and reperfusion (I/R),stem cell transplantation(BMSCs)and TMZ pretreated stem cell transplantation (BMSCs+TMZ)groups.BMSCs survival was observed by fluorescence microscope ,four weeks later,the heart function was as-sessed by echocardiography ,infarct size was tested by TTC ,the protein expressions of Bcl-2 and Bax around the transplanted area were ana-lyzed by Western blot .Results The activities of cultured cells with BMSCs and cardiomyocytes after H /R supernatants were significantly decreased,but it declined after TMZ pretreatment significantly reversed .Compared with that of non-pretreated BMSCs group ,after TMZ pre-treatment,the Bcl-2 gene expression level was increased ,while Bax gene expression levels was decreased .In vivo,after one week treatment , each high magnification double labeled cells was significantly higher in BMSCs +TMZ group than that of BMSCs group .After four weeks,the heart function was significantly improved in BMSCs+TMZ group and BMSCs group than that of I /R group,myocardial infarct size was re-duced.Compared with non-pretreated BMSCs,Bcl-2 expression of BMSCs at TMZ pretreatment group was upregulated ,whereas the expression of Bax was lower .Conclusions Revascularization combined trimetazidine pretreatment BMSCs transplantation on acute myocardial infarction could increase survival of BMSCs and improve recovery of cardiac function .It may be related with upregulating the expression of Bcl-2 and down regulating the expression of Bax .

目的 探讨多功能心脏电生理刺激记录仪的临床应用.方法 应用多功能心脏电生理刺激记录仪(DF-5A型)对1026例被检查者(包括2008年6月至2013年6月在苏州大学第一附属医院门诊、急诊及病房等就诊者),行经食管心房调搏术(TEAP),其中男性362例,年龄:15～85岁.结果 1026例被检查中,912例因“阵发性胸闷心悸不适”行TEAP,695例拟诊阵发性室上性心动过速(PSVT);217例拟诊窦房结功能不良,67例因PSVT发作,为中止PSVT;另有47例因不能配合而拒绝TEAP.695例拟诊PSVT者中,TEAP诱发并终止PSVT 278例(房室结双165例,旁道113例);64例被检查者存在房室结双径路,但未能诱发PSVT.217例拟诊窦房结功能不良者,仅20例符合窦房结功能不良,且大多为老年人.53例被检查者在检查过程中分别出现短阵房速、房扑或房颤,其他被检查者为见明显异常.结论 DF-5A型多功能心脏电生理刺激记录仪给临床医生提供了有效、安全和方便的诊疗措施.

Objective To study the effect of proton pump inhibitors for the prevention of gastrointestinal hemorrhage in patients with acute S-T segment elevation myocardial infarction(STEMI)who underwent emergency percutaneous coronary intervention(PCI). Methods We selected 172 patients(104 males;68 females;means age 62.5±9.5 years)with STEMI who underwent emergency PCI after admitted to the hospital. The subjects randomized into intervention intravenous pantoprazole group(Group A),rabeprazole oral intervention group(Group B)and control group(Group C). Compared these three groups of patients hospitalized with digestive tract hemorrhage incidence and severity while observing the occurrence of cardiovascular events within 7 days. Results The incidence of gastrointestinal injury was 9.26%(5/54),12.07%(7/58), 21.67%(13/ 60)in group A,B and C respectively. group C,gastrointestinal bleeding events occurred in 2 patients,in groups A and B were not ,there was significant difference between group C and other two groups(P<0.05),group A and B were not significant different. The incidence of cardiovascular events was 3.70%(2 cases),3.45%(2 cases),3.33%(2 cases)respectively,no significant difference among the three groups(P>0.05). Conclusion It’s both effective and safe to use proton pump inhibitors to prevent gastrointestinal hemorrhage after in patient with STEMI emergency PCI. And there is no significant difference between intravenous and oral.