Tian-chang Li

Capital Medical University, Peping, Beijing, China

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Publications (14)4.58 Total impact

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    ABSTRACT: Aims. To evaluate the efficacy of Chinese herbal medicines (CHMs) plus conventional treatment in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods and Results. Participants (n = 808) with ACS who underwent PCI from thirteen hospitals of mainland China were randomized into two groups: CHMs plus conventional treatment group (treatment group) or conventional treatment alone group (control group). All participants received conventional treatment, and participants in treatment group additionally received CHMs for six months. The primary endpoint was the composite of cardiac death, nonfatal recurrent MI, and ischemia-driven revascularization. Secondary endpoint was the composite of readmission for ACS, stroke, or congestive heart failure. The safety endpoint involved occurrence of major bleeding events. The incidence of primary endpoint was 2.7% in treatment group versus 6.2% in control group (HR, 0.43; 95% CI, 0.21 to 0.87; P = 0.015). The incidence of secondary endpoint was 3.5% in treatment group versus 8.7% in control group (HR, 0.39; 95% CI, 0.21 to 0.72; P = 0.002). No major bleeding events were observed in any participant. Conclusion. Treatment with CHMs plus conventional treatment further reduced the occurrence of cardiovascular events in patients with ACS after PCI without increasing risk of major bleeding.
    Evidence-based Complementary and Alternative Medicine 01/2013; 2013:741518. · 1.72 Impact Factor
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    ABSTRACT: To screen the cardiac troponin T (TNNT2) mutations in Chinese patients with hypertrophic cardiomyopathy (HCM) and to analyze the potential link between the genotype and the phenotype. Clinical features of 100 probands with HCM and some family members were evaluated, 200 unrelated normal subjects served as control. The exons and flanking introns of TNNT2 were amplified with PCR and direct sequencing was used to screen TNNT2 mutations/polymorphisms. Two novel missense mutations were detected in 2 HCM patients: R92W and R286H. These 2 mutations were not found in 200 non-HCM controls. A five-basepair insertion/deletion polymorphism in intron 3 of TNNT2 was identified in this HCM cohort but was not related to the phenotype. Two missense mutations, R92W and R286H, were found in 2/100 patients with HCM, TNNT 2 mutation is relatively low in Chinese patients with HCM.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 10/2011; 39(10):909-14.
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    ABSTRACT: To study the correlation of blood stasis syndrome or its accompanied syndromes with Gensini score in patients with coronary heart disease (CHD) in stable condition. The syndrome types of traditional Chinese medicine (TCM) and blood stasis score in 131 CHD patients confirmed by coronary angiography were recorded. Gensini score was calculated according to the coronary pathological characteristics showed by angiography. The correlations of blood stasis syndrome and its accompanied syndromes with coronary lesion and Gensini score were analyzed. Among the TCM syndrome types, blood stasis, turbid phlegm and qi deficiency were the most common syndromes, revealed in 85 patients (64.9%), 83 patients (63.4%) and 85 patients (64.9%), respectively. The coronary lesion length and Gensini score in the patients with blood stasis syndrome were much higher than those in the patients with non-blood stasis syndrome (P<0.05 or P<0.01). In the subtypes of blood stasis, the coronary lesion length and Gensini score in the patients with blood stasis accompanied by turbid phlegm syndrome were higher than those in the patients with non-blood stasis syndrome (P<0.05). And in the patients whose blood stasis syndrome score was more than 9 points, the coronary lesion length was higher than that in the patients whose blood stasis syndrome score was less than 9 points (P<0.05). Besides, with bivariate analysis, the blood stasis syndrome score showed no correlation with Gensini score (Pearson correlation coefficient was 0.104, P=0.241). Blood stasis syndrome is the most common TCM syndrome in CHD patients in stable condition. The blood stasis syndrome score is proportional to coronary lesion length, and reflects the severity of coronary lesion.
    Journal of Chinese Integrative Medicine 09/2010; 8(9):848-52.
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    ABSTRACT: To investigate K(ATP) channel function of cardiomyocytes isolated from the left ventricular wall of rats with or without abdominal aortic constriction at different time points under normal or simulated ischemic conditions. Male Wistar rats were randomized into 4 groups (n = 10 - 13): 4-week sham-operated group (F4), 4-week aortic-banded group (T4), 12-week sham-operated group (F12), 12-week aortic-banded group (T12). Chronic pressure overload model was established by abdominal aortic constriction. Left ventricular myocytes were isolated by modified Langendorff perfusion method post in vivo hemodynamical measurements. The whole-cell patch-clamp technique was used to record transient outward current of K(ATP) channel on myocytes under normal and simulated ischemic perfusion conditions. The current densities of K(ATP) channel between F4 and T4 group, F12 and T12 group were compared under 0 mV of test potential. SBP, DBP and MBP were significantly increased in T4 group compared to F4 group, but were similar between T12 and F12 groups. LVEDP and +/- dp/dtmax were similar between T4 and F4 groups and LVEDP was significantly increased while +/- dp/dtmax significantly reduced in T12 group than that in F12 group. Whole-cell membrane current densities were similar between F4 and T4 group or F12 and T12 group under normoxic condition, the K(ATP) current densities increased dramatically in T12 group [(28.11 +/- 3.91) pA/pF vs (11.55 +/- 1.17) pA/pF, P < 0.01], but not in T4 group [(14.09 +/- 5.74) pA/pF vs (11.74 +/- 3.68) pA/pF, P > 0.05] in myocytes exposed to ischemic solution for 25 minutes. The total number of K(ATP) channel in ventricular myocytes was similar between F4 and T4 group or F12 and T12 group. The sarcolemmal K(ATP) channel was more sensitive to ischemia and the current magnitude was significantly increased at the stage of congestive heart failure. The functional change of K(ATP) channel occurred before the increase of total number of K(ATP) channel.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 03/2010; 38(3):220-4.
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    ABSTRACT: To screen the MYBPC3 gene mutations in Han Chinese patients with hypertrophic cardiomyopathy (HCM). Sixty-six patients with HCM were enrolled for the study. The exons in the functional regions of MYBPC3 were amplified with PCR and the products were sequenced. Four novel mutations and four common polymorphisms were identified in this patient cohort. A Lys301fs mutation in exon10 was evidenced in a H30, and when he was 47 years old, he had the chest tightness, shortness of breath with septal hypertrophy of 18.7mm; a Asp463stop mutation in exon17 was detected in a H48, he was 24 years old 24-year-old when a medical examination showed ventricular septal hypertrophy of 15.4 mm; both Gly523Arg mutation in exon18 and Tyr847His mutation in exon26 were found in a H53 with onset age 36 years old, feeling chest tightness after excise and his ventricular septal hypertrophy was 27 mm that time. MYBPC3 mutations occurred in 4.5% patients in this cohort. These mutations were not found in 100 non-HCM control patients. MYBPC3 mutation is presented in a small portion of Han Chinese patients with HCM.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 08/2009; 37(8):734-8.
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    ABSTRACT: To observe the effects of Chinese drugs for supplementing qi, nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction (AMI) patients after revascularization. Eighty patients with anterior or inferior ventricular wall AMI, who had received revascularization by intravenous thrombolysis or coronary bypass, were randomized into the treated group and the control group equally, both treated with conventional Western medical treatment, but combined, respectively, with Xinyue Capsule (, XYC) plus Composite Salvia Tablet (CST) and placebo for 3 months. Dobutamine stress echocardiography (DSE) was performed 14 days and 3 months after revascularization, respectively on every patient to observe blood perfusion extent (b value), myocardial perfusion velocity (k value) and local blood fl ow volume (k x b) in left ventricular infarction-related vascular segments under stressed state. With 5 cases dropping out in the observation period (3 in the treated group and 2 in the control group), the trial was completed in 75 patients in total. The 14-day DSE shows that the b value and k x b value of left anterior ventricular wall mid segment and apex segment, and the k value of apex segment in patients with anterior wall AMI, as well as the b value and k x b of basal segment in patients with inferior wall AMI in the treated group were significantly higher than those in the control group (P<0.05 or P<0.01). The 3-month DSE shows that the b value of apex segment, k x b value of basal segment, mid segment and apex segment of left anterior ventricular wall in patients with anterior wall AMI as well as the b value and k x b value of basal segment of left inferior ventricular wall in patients with inferior wall AMI were all higher in the treated group than those in the control group, respectively (P<0.05). The comparison between 14-day DSE and 3-month DSE in the treated group showed that the b value of apex segment of left anterior ventricular wall in patients with anterior wall AMI and the k x b value of apex segment and mid segment of left inferior ventricular wall in patients with inferior wall AMI significantly increased along with the on-going treatment (P<0.05). Therapy with Chinese drugs for supplementing qi, nourishing yin and activating blood circulation in combination with conventional Western medical treatment could obviously improve the blood perfusion at the myocardial tissue level in infarction-related vascular segments.
    Chinese Journal of Integrative Medicine 03/2009; 15(1):19-25. · 1.06 Impact Factor
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    ABSTRACT: To investigate the effect of pravastatin on blood lipids and serum high sensitive C-reactive protein (HsCRP) in patients undergoing conventional coronary artery bypass grafting under on-pump bypass (CCABG). Eighty-one patients underwent CCABG. Among which 40 took orally pravastatin 20 mg once daily to at least 28 days after operation, and 41 were used as control group. The serum levels of total cholesterol (TC), triglyceride (TG), HDL-C cholesterol (HDL-C), LDL-C cholesterol (LDL-C), and HsCRP were monitored before and 24 h, 72 h, 7 days, 10 days, 14 days, and 28 days postoperatively. In the control group the levels of different blood lipids after operation remarkably decreased after operation compared with those before operation (all P < 0.05), reached the lowest levels 24 h after operation, then gradually increased, however, still lower than those before operation (all P < 0.05), and recovered to the baseline level 28 hours after operation; and the HsCRP level increased 24 h after operation and peaked 72 h after, then gradually decreased, and recovered to the baseline level 28 days after operation. In the pravastatin group the TC level reached its lowest level 24 h after operation, then gradually increased, however, still lower than that before operation, and recovered to the baseline level 28 days after operation; and the TG level reached the lowest level 24 h after operation (P < 0.05), and then gradually increased 3 d after operation (P > 0.05). The TC, TG, and LDL-C levels 7, 10, 14, and 28 d after operation of the pravastatin group were all significantly lower than those of the control group (all P < 0.05). The HsCRP levels at different time points of the pravastatin group were all significantly lower than those of the control group (all P < 0.05). The use of pravastatin in the early stage of CCABG is safe and can decrease systemic inflammatory reaction.
    Zhonghua yi xue za zhi 01/2008; 88(2):101-4.
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    ABSTRACT: The aim of this study was to screen the disease-causing gene mutations and investigate the genotype-phenotype correlation in 10 Chinese pedigrees with familial hypertrophic cardiomyopathy (HCM). There are 91 family members from these 10 pedigrees and 5 members were normal mutated carriers, 23 members were HCM patients (14 male) aged from 1.5 to 73 years old. The functional regions of myosin heavy chain gene (MYH7), cardiac myosin-binding protein C (MYBPC3) and cardiac troponin T gene (TNNT2) were screened with PCR and direct sequencing technique. Clinical information from all patients was also evaluated in regard to the genotype. Mutations were found in 5 out of 10 pedigrees. Mutations in MYH7 (Arg663His, Glu924Lys and Ile736Thr) were found in 3 pedigrees and 3 patients from these pedigrees suffered sudden death at age 20-48 years old during sport. Mutations in MYBPC3 were found in 2 pedigrees, 1 with complex mutation (Arg502Trp and splicing mutation IVS27 + 12C > T) and 1 with novel frame shift mutation (Gly347fs) and the latter pedigree has sudden death history. No mutation was identified in TNNT2. Although the Han Chinese is a relatively homogeneous ethnic group, different HCM gene mutations were responsible for familiar HCM suggesting the heterogeneity nature of the disease-causing genes and HCM MYH7 mutations are associated with a higher risk of sudden death in this cohort. Furthermore, identical mutation might result in different phenotypes suggesting that multiple factors might be involved in the pathogenesis of familiar HCM.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 03/2006; 34(3):202-7.
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    ABSTRACT: XS0601, consisting of active ingredients (Chuangxiongol and paeoniflorin), has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human studies. The objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention (PCI). A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 patients were randomized into treatment with the oral administration of XS0601, or a placebo for 6 months after successful PCI. Angiographic follow-up was scheduled at 6 months, and clinical follow-ups performed at 1, 3 and 6 months after PCI. The primary end point was angiographic restenosis. The secondary end points were the combined incidence of death, target lesion nonfatal myocardial infarction, repeat angioplasty, and coronary artery bypass graft surgery. A total of 308 patients (91.9%) completed the study and 145 cases (47.1%) received angiographic follow-up. The restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group (26.0% vs. 47.2%, P < 0.05), and the minimum lumen diameter (MLD) was greater [(2.08 +/- 0.89) mm for XS0601 vs. (1.73 +/- 0.94) mm for placebo, P < 0.05]. XS0601 also significantly reduced the combined incidence of major adverse cardiac event (10.4% in the XS0601 group vs. 22.7% in the placebo group, P < 0.05). The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group (7.1% and 11.0%) as compared with those in placebo group (19.5% and 42.9%) (P < 0.05). No significant side effects occurred within the 6-month follow-up period in the XS0601 group. Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.
    Chinese medical journal 01/2006; 119(1):6-13. · 0.90 Impact Factor
  • Chinese medical journal 12/2005; 118(21):1838-42. · 0.90 Impact Factor
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    ABSTRACT: To evaluate the curative effects of transcatheter closure on perimembranous ventricular septal defects (PMVSDs) using unbalanced Amplatzer asymmetric ventricular septal defect occluder (AAVSDO). The data of 68 patients of PMVSDs with a diameter of 6.7 mm (3 to 12 mm) and the diameter of ventricular septal rim below the aortic valve of 2.7 +/- 1.1 mm (1-5 mm), 27 males and 41 females, aged 15.6 +/- 11.5 (1.5-44), weighing 42.8 +/- 15.2 kg (10-72 kg), treated with AAVSDO, the diameter of which was 1-2 mm larger than the largest diameter of the defects determined by angled left ventriculography, from September 2002 to January 2005 were prospectively analyzed. The patients were followed up for 221 +/- 130 days (90 to 750 days). Seventy-one procedures were performed. The device was implanted successfully in 65 of the 68 patients (95.6%). The selected device diameter was 8.4 mm (4 to 14 mm). Device was lost in one patient during the procedure, which was successfully managed by recapturing the device with a snare device and redeploying it. During the procedure, transient complete left bundle branch block and right bundle branch block occurred in 6 and 5 patients respectively. On follow-up evaluation, transient junctional rhythm occurred in one patient, and accelerated ventricular rhythm in 1. After deployment of the device, the immediate complete closure rate was 43% (28/68), increased to 81.5% (53/68) on the day next to the procedure, and reached 100% 6 months after. One patient adopted surgical reparation because hemolysis occurred after the device implanted. The hospitalization time was 4.5 +/- 3.6 days (2-8 days). The X-ray exposure time was 14.8 +/- 10.7 min (6-48 min). The procedure time 72.6 +/- 38.7 min (35-186 min). One patient was diagnosed as with deep vein thrombosis because of right leg swelling at the seventh day after the procedure. The symptoms disappeared after anticoagulation treatment with low molecule weight heparin. During the scheduled long-term follow-up all patients were doing well. No episode of endocarditis, procedure-related death, or wire disruption was recorded. The initial and long-term follow-up results of transcatheter closure of PMVSDs are promising with high success and occlusion rates. Transcatheter closure of PMVSDs using AAVSDO appears to be the first line choice for suitable patients with such defects.
    Zhonghua yi xue za zhi 11/2005; 85(40):2846-9.
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    ABSTRACT: To investigate the risk factors and the values of early invasive intervention in patients with acute coronary syndromes (ACS) without ST-segment elevation. Five hundred and forty-five patients of ACS without ST-segment elevation were randomly assigned to an early conservative strategy or early invasive strategy who had been admitted to hospitals consecutively from Oct. 2001 to Oct. 2003. The combined cardiovascular events (a combination of cardiac death, nonfatal myocardial infarction, nonfatal heart failure and re-hospital admission due to recurrent ischemia angina) within 30 days and 6 months were analyzed and the primary high risk factors for combined cardiovascular events were evaluated by means of multivariate logistic regression analysis among baseline clinical characteristics and laboratory data, meanwhile, the effects of an early conservative strategy or early invasive strategy on outcomes were also investigated. The incidences of combined cardiovascular events within 30 days and 6 months among 513 cases were 14.0% and 25.7% respectively. Multivariate logistic regression analysis implied ST-segment depression, elevation of troponin I level, increased C-reactive protein, lower ejection fraction of left ventricular and higher TIMI risk scores were all associated with an increases in cardiovascular events within 6 months, and they were respectively independent predictive factor for the increases of cardiovascular events. Early invasive strategy was associated with a lower rate of re-hospital admission due to recurrent ischemia angina within 30 days and a decreased incidences of combined cardiovascular events within 30 days and 6 months compared with early conservative strategy (all P < 0.05). ST-segment depression, elevation of troponin I level, increased C-reactive protein, lower ejection fraction of left ventricular and higher TIMI risk scores are high risk factors for patients with ACS without ST-segment elevation, and early invasive strategy can have a substantial impact in reducing combined cardiovascular events.
    Zhonghua xin xue guan bing za zhi [Chinese journal of cardiovascular diseases] 02/2005; 33(2):153-7.
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    ABSTRACT: To study the disease-causing gene mutation in Chinese with hypertrophic cardiomyopathy (HCM), and to analyze the correlation between the genotype and phenotype. Samples of peripheral blood were collected from five Chinese patients with HCM in whose families at least 2 HCM patients existed. The exon in the functional regions of the beta myosin heavy chain gene (beta-MHC) were amplified with PCR and the products were sequenced. The relation between the genotype and phenotype was analyzed. Two mutations were first identified. Eighty controls were normal in the genetic test. beta-MHC may be the main disease-causing gene. Two mutations have different phenotypes. In one family, the identical mutation has different phenotypes and prognoses. The heterogeneity of phenotype suggests that multiple factors be involved in the pathogenesis.
    Zhonghua yi xue za zhi 11/2004; 84(19):1610-3.
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    ABSTRACT: The purpose of the study is to prospectively investigate the safety and efficacy of anticoagulation with enoxaparin (Clexane) in UA/NQMI patients undergoing PCI procedures. UA/NQMI patients received Clexane 1 mg/kg, subcutaneously, q12h for at least 48 hours, the coronary angiography was immediately followed by PCI when indicated and is performed within 8 h after the morning injection. No additional UFH or LMWH was used during or after PCI. Blood samples were taken for further measurement of the anti-Xa activity in 176 patients. 507 UA/NQMI patients were included in the study. 176 patients (93.2%) of the average anti-Xa activity value was > 0.5 IU/ml. During follow-up within 30 days, 3.2% of the patients experienced AMI and 6.7% of the patients recurrent UAP. One patient (0.2%) received revascularization and another died of duodenum perforation. The rate of minor hemorrhage was 4.7% (24 patients). In 30-days follow up, one experienced NQMI and 1 recurrent UA among angiography patients. Subcutaneous Enoxaparin given at least for 48 hours before PCI with out additional UFH or LMWH during or after PCI was both safe and effective in high risk UA/NQMI patients.
    Zhonghua nei ke za zhi [Chinese journal of internal medicine] 02/2003; 42(2):91-3.