Objective The coronary anatomic feature and development after thrombolysis in acute myocardial infarction (AMI) were studied.Mehtods 100 patients with AMI received urokinase and strepokinase. Coronary angiography (CAG) was performed at 90 minuts and again at 3 to 4 weeks.Results Successful thrombolysis occurred in 60 cases,but failed in 40. The ratio of reperfusion was 60％.CAG showed there were residual thrombi in 84 patients (84％) and complete coronary occlusion in 40(40％ ).Angiography at 3 to 4 weeks after thrombolysis showed the stenosis worsened in 8 patients and improved in 10.Conclusion AMI is caused by sudden coronary thrombotic occlusion and can be repeffused by using thrombolytic agent or mechanical methods. Thrombolytic agents usually can not resolve thrombi completely. So percutaneous transluminal coronary angiography (PTCA) is recommended as an important method to improve serious residual stenosis.

Objective Forty cases of IAMI were examined with coronary angiography in order to study the relationship of the vessels with the ECG of IAMI. Methods For coronary angiography Judkin' s method was used; IAMI was diagnosed by the 1979WHO's standard of ISHD and ECG was separately measured by two doctors. Results Most of IAMI with polybranch coronary or its collateral disease (32.5％and 42.5％ ) and only 10 cases (25％) with single branch coronary disease, whose ECGs were untypical.Conclusion IAMI with single-branch coronary disease might express as mild symptoms and have no typical ECG change. While typical ECG change emerges, the coronary artery always showed poly-branch disease or collateral branch obstruction and the disease would be advanced. It is important to pay more attention to the cases of IAMI without classic ECG change so as to give diagnosis and treatment them in time.

Objective To further improve the rate of reperfusion of infarction related artery in AMI, remove the stricture, rescue ischemic myocardiurn, protect cardiac function and ameliorate the longterm prognosis. Method Among 73 patients with AMI, 50 underwent direct PTCA, 15 immediate PTCA,8 rescue PTCA and 20 braces were implanted. Result The proportion of recanalization is 94.5％ (69/73) .The grade of blood flow (TIMI) improved to grade 3 in 20 patients with brace implantation, while 44 to grade 3 and 5 to grade 2 among 49 patients with simple PTCA. Residualstenosis in vessel was 1.8 ± 5.9(-10-10)％ in patients with brace implantation versus 15.4 ± 11. (0 -30)％ with simple PICA. The incidence of reperfusive cardiac arrythmia was 18.1％(10/62). There was mainly frequent ventricular premature beat and short paroxysmal ventricular tachycardia, if left anterior decending branch was reopened,while bradycardia and atrial ventricular block usually occurred after right coronary reperfused. Conclusion Emergency PTCA and brace implantation can apparently improve the proportion of reperfusioa of IRA in AMI. It is necessary to popularize and apply these treatment in medical units with available conditions.

Heart rate variaty (HRV) of 85 cases with AMI was observed in the early phase after onset and rehabilitation phase at first month and sixth month, and was contrasted with six time threshold indices of 111 cases with coronary heart disease and that of 35 normal control. We found the HRV of AMI was apperantly lower in the acute phase than that of coronary heart disease and normal controls. HRV recovered gradually with inclining to be stable after half a year, but it was still lower than that of controls. Low HRV in early phase of AMI suggested the poor prognosis.

In 1985 the International Natural Medicine Society declared the Hoten area, Xinjiang (a province of China) as one of the areas of most pronounced longevity in the world. Why are there more elderly people in Hoten? There are many factors. On the basis of our many years of research, our claim is that diet is the most important factor. Now I will discuss the following factors to illustrate.

Ojbective To find the independent predictors for restenosis after coronary stenting.Methods Quantitative angiography was performed on 60 cases (67 successfully dilated lesions) after angioplasty over 6-months follow-up, and both univariate and multivariate logistic regression analysis were done to identify the correlations of restenosis with clinical factors. Results The total restenosis rate was 31.3％(21 of 67 lesions), and according to univariate analysis the patients who underwent coronary stenting ≥3.5mm had a lower rate of restenosis ( P ＜ 0. 01).Collateral circulation to the obstruction site, high maximal inflation pressure, smoking and the less minimal lumen diameter after PTCA made the rate of restenosis higherower ( P ＜ 0.05) . Multivariate logistic regression analysis showed that coronary stenting ≥ 3.5mm had a low rate of restenosis, but high maximal inflation pressure and smoking made the restenosis rate higher. Conclusion Coronary stent size, maximal inflation pressure and. smoking were independent predictors for restenosis.

6 371 cases of acute myocardial infarction from 1984 to 1992 in Guangdong Province are reported in this article. The results show that the prevalence rate of acute myocardial infarction (AMI)has been increasing. The anterior walls are involved more often than the inferior ones are. The first symptom in 87.4％ of cases is pectoral pain. The most common complications are arrhythmia, heart failure and cardiac shock successively occurring in order. The mortality rate is 19.9％. The predominant causes of death is pump failure.

Objective To investigate the changes of serum vascular endothelial growth factor (VEGF) concentration in a rat model of acute myocardial infarction (AMI) and in patients with AMI before and after thrombolytic therapy. Methods Eighty-eight male Sprague-Dawley rats were used and sixteen patients with AMI were studied in this study.AMI was produced by left coronary arterial ligation in 80 animals, and eight rats undergoing thoracotomy but not coronary ligation served as sham controls. The blood samples of rats were drawn from the right atrium before (0 hour, sham animals) and 1, 3, 6, 12 or 24hours and 2, 3, 5, 7or 14 days after AMI (n = 8, respectively) . The blood samples of patients with AMI were collected from an antecubital vein before and 3hours after thrombolytic therapy. Serum VEGF concentrations were measured by a sensitive and specific enzyme-linked imrnunosorbent assay (ELISA) . Results The mean serum VEGF concentration in 8 sham animals was 66.99 ± 17.83pg/ml. Six hours after AMI, the level of serum VEGF significantly increased to 125.68 ± 28.07 pg/ml (P ＜ 0.01 vs Sham controls),and reached a peak (240.61 ±70.63 pg/ml, P ＜ 0.01vs Sham controls) at 24 hours after ligation, and then decreased gradually over the remaining 2 weeks.However, the level remained significantly elevated for 14 days (107.64±30.13 pg/ml, P＜ 0.01 vsSham controls) . The basal serum level of VEGF in patients with AMI was significantly higher than that in 16healthy control subjects (285.92 ± 125.12 vs 80.44 ± 24.57 pg/mL, P ＜ 0.01), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents (r =0. 866, P ＜0.001 and r=0.948, P＜ 0.001; respectively)Three hours after thrombolysis, the level of VEGF had fallen to 111.57 ±31.29 pg/mL (P ＜0. 01 vs Before thrombolytic therapy; P ＜ 0.05 vs control subjects) .Conclusion The present study shows that the concentrations of serum VEGF are markedly and permanently increased in the rat model of AMI and in patients with AMI. Serum VEGF concentrations may serve as a sensitive target in diagnosing AMI and judging reperfusion.

The effect of U50488, a selective k-opioid receptor agonist, on cardiac rhythm in the isolated perfused rat heart and intracellular calcium ([Ca2+] i) in the single ventricular myocyte were studied. The results showed that U50488 can induce arrhythmias dose-dependently in the isolated perfused rat heart and increase [Ca2+] i in the single ventricular myocyte. The effect of U50488 can be blocked by a selectivek-receptor antagonist, nor-binaltorphimine.The arrhythmogenic effects and the increase of [ Ca2 + ] i induced by U50488 were blocked by U73122, neomycin and streptomycin, which are selective phospolipase C inhibitors, but not by U73433, the inactive structural analog of U73122. These results demonstrated that the arrhythmogenic effect of cardiac k-receptor is due to activation of phosphoinositol/Ca2+ pathway.

Objective To investigate whether antioxidants inhibit adhesion of leukocytes to endothelium and furthermore, whether all antioxidants regulate NF-κB activation through a redox sensitive mechanism. Methods The effect of the antioxidative substances pyrrolidin dithiocarbamat (PDTC),dichloroisocumarin (DCI), chrysin and probucol on the endothelial leukocyte adhesion were examined under near physiological flow conditions. The antioxidative activity of antioxidants was measured in a DCF fluorescence assay with flow cytometry. The activation of NF-κB in endothelial cells was investigated in a gel shift assay. Results PDTC and probucol did not show an inhibitory effect to the formation of intracellular H2O2 in TNFct activated human vascular endothelial cells (HUVEC) . Chrysin showed a moderate effect.DCI showed a strong antioxidative effect. In contrast,PDTC and chrysin inhibited the adhesion of HL 60 cells to TNFa-stimulated HUVEC. DCI and probucol did not have influence on the adhesion within the area of the examined shear stresses. Only PDTC inhibited the TNFα-induced activation of NF-kB in endothelial cells.Conclusion The inhibition of the endothelial leukocyte adhesion by antioxidative substances is not to be explained by its antioxidative characteristics only. The inhibitory effect of PDTC on NF-kB activation was probably not related to its antioxidative properties.

Kawasaki disease (muco-cutaneous lymph node syndrome, MCLS) was first reported by Kawasaki in 1967. It was characteried by nonvascular polymorphous rash, fever, ulcer in oral mucosa, edema of hands of feet, cervix lymphadenopathy and desquamations in peripheral extremities. Because of unknown pathogens, no lab examination was available as a single easily recognized diagnostic marker; the diagnosis is based on clinical features. The main complication of Kawasaki disease is coronary artery (CA) lesion; the prognosis is determined by the degree of pathological change of the coronary artery[1.2].

Objective To observe the relationship between serum creatine kinase isoenzyme MM sub-bands (CKMM3/MM1 ratio) and the gradation of coronary stenosis and provide a simple, reliable, and economical method for identifying high-risk unstable angina pectoris (UAP). Mehtods Blood samples were drawn at different time after onset of chest pain in 21 patients with UAP and only once in 20 each volunteers for control. CKMM3/MM1 ratio was detected by nonserial buffer agarose gel electrophoresis. CKMB and CK were observed by velocity method. An emergent coronary arteriography was performed as soon as patients were admitted into hospital. Results Patients with UAP were divided into two subgroups:patients with elevated serum enzyme [P( + )] and patients with normal serum enzyme [P( - ) ] according to CKMM3/MM1 ratio ＜ 0.5. Patients with UAP(+)had higher serum CKMM3/MM1 ratios from 0.5 to 12hrs and serum CKMB from 2 to 12 hrs than those with UAP( - ) and control ( P ＜ 0.05) . Serum enzyme concentrations of patients with UAP whose coronary lumen had 90％ or more than 90％ stenosis were significantly higher than those whose coronary lumen had less than 90％ stenosis (P＜0.01) . AnyCKMM3/MM1 ratio was less than 1.0 and CK within the normal range in patients with UAP( + ) group. Conclusions CKMM3/MM1 ratios in patients with UAP can reflect severity of myocardial ischemia. Serum CKMM3/MM1 ratio provides a simple, reliable, and economical method for identifying high-risk UAP.

To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12.5 -75mg/24hrs);Group C was treated continuously with SNP (continuous infusion of 100-300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group.The results showed that the highly effective rates of the three groups were 46.9％ (15/32), 90.5％ (19/21)and 100％ (12/12) respectively. The effective rates were 81.3％ (26/32), 100％ (21/21), 100％(12/12) respectively. The highly effective rates of group B and C were much higher than that of group A (P＜0.005, P＜ 0.005) . The reduction of blood pressure of group B and C was greater than that of group A ( P ＜ 0. 025) . Among the patients we studied, no body had severe side effects. We concluded that the use of SNP in the treatment of chronic congestive heart failure is safe, with better effect than routine treatment,and continous infusion of SNP is the best choice.

1.Establishment of the Experimental Animal Models To study myocardial hibernating phenomenon, chronic occlusive multi -vessel coronary stenosis were made by placing amiroid constrictors on proximal LAD and LCX in canine models. Rabbit artery restenosis models were created by balloon injury of iliac artery and high lipid diet. Acute coronary artery occlusive models were performed in closed chest canines by putting polyvinyl chloride emboli to LAD or LCX via catheter and external counterpulsation on conscious pig models were made to observe the long term effect.

South China Journal of Cardiology (English Edition) is sponsored by the Guangdong Cardiovascular Association as an international journal in the field of cardiology and distributed wordwide. The journal will be twice a year,and will publish papers related to clinical research of cardiovascular disease, including clinical trials, preventive or therapeutic studies, basic research with clinical applications, and advances in new techniques and knowledge.However, the augmentation and promotion of communication of medical information between China and world is also among our objectives. Manuscripts are welcome from any where in the world.

Hypertension survey was carried out in Guangdong Province in 1991, according to a national sampling survey program. 42 899 urban and rural men and women aged ≥ 15 were involved in the survey. The results revealed that the standardized prevalence rate of hypertension was 8.99％ (definite 4. 24％, borderline 4.75％ ) . It was higher in men than in women, in urban than in rural samples.Compared with the survey in 1979, the prevalence rate increased by 90％ and the curve of aged- prevalence rates shifted leftward. This article also discuss the possible factors that lead to the increase of hypertension.

Objective The current study was designed to investigate the features of a family with familial hypercholesterolemia(FH). Methods Twenty members of three generations in a family with FH were enrolled in the study. The data collected were from clinical observation and subjected to pedigree analysis.Results The proband was a 41 years old male who suffered from angina pectoris with multi-vessel stenosis of coronary artery at the age of 40. Among 20 members,8 individuals were demonstrated with hypercholesterolemia in this family with the total incidence of 40％[54.5％ (6/11) in male and 22.2％ (2/9) in female ]The serum total cholesterol level was elevated in childhood from 7.1 to 10. 8 mmol/L and tended to be raised with increasing age. In addition, the level of total cholesterol was found to be elevated both in a monozygote twin brothers and their offspring in the family.Conclusion FH appears to be a hereditary disease of autosomal dominance inheritance and the outcome of FH patients with coronary heart disease seems to be poor in prognosis.