Management and outcome of 47 patients with acute myocardial infarction complicating cardiogenic shock / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the clinical outcomes of patients with acute myocardial infarction (AMI) complicating cardiogenic shock underwent various treatments.</p><p><b>METHODS</b>From January, 2002 to May, 2007, 47 AMI patients with cardiogenic shock were treated in our department by optimal medication (dopamine, epinephrine, norepinephrine, etc.), intra-aortic balloon pump (IABP), mechanical ventilation when indicated, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Outcome and factors related to mortality for these patients were analyzed in this retrospective study.</p><p><b>RESULTS</b>Besides optimal medication and IABP in all patients, 31 patients underwent PCI (66.0%), 6 patients received emergency CABG (12.8%). The overall in-hospital mortality rate was 36.2% (17/47), 6 patients (14.9%) died before coronary revascularization and 11 patients (21.3%) died after revascularization. Nine patients died of pump failure and 8 patients died of renal and (or) respiratory failure. Regression analysis showed that acute renal failure (r = 0.734, P = 0.000), acute respiratory failure (r = 0.606, P = 0.000) and diabetes (r = 0.372, P = 0.012) were positively related to in-hospital mortality.</p><p><b>CONCLUSION</b>Despite improvements in treatment options for AMI patients complicating cardiogenic shock, in-hospital mortality remained high, especially for patients complicating further with acute renal failure and acute respiratory failure.</p>

Protective effects of pretreatment with Radix Paeoniae Rubra on acute lung injury induced by intestinal ischemia/reperfusion in rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effect of pretreatment with Radix Paeoniae Rubra (RPR) on acute lung injury induced by intestinal ischemia/reperfusion in rats and its protective mechanism.</p><p><b>METHODS</b>Thirty-two Wistar rats were randomly divided into four groups: Sham-operation group, ischemia/reperfusion group (I/R group), RPR-pretreatment group and hemin group. The model of intestinal ischemia/reperfusion was established by clamping the superior mesenteric artery for 1 hour followed by 2-hour reperfusion. The effect of RPR on the expression of heme oxygenase-1 (HO-1) in lung tissues was detected by immunohistochemistry and morphometry computer image analysis. Arterial blood gas analysis, lung permeability index, malondialdehyde (MDA) and superoxide dismutase (SOD) contents in lungs were measured. The histological changes of lung tissue were observed under light microscope.</p><p><b>RESULTS</b>The expression of HO-1 in RPR-pretreatment group and hemin group was obviously higher than that in sham-operation group and I/R group (P < 0.01). The level of MDA and lung permeability index in RPR-pretreatment and hemin group were significantly lower than those in I/R group (P < 0.01 or P < 0.05), while the activity of SOD in RPR-pretreatment and hemin group was obviously higher than that in I/R group (P < 0.01). Under light microscope, the pathologic changes induced by I/R were significantly attenuated by RPR.</p><p><b>CONCLUSION</b>Intestinal ischemia/reperfusion may result in acute lung injury and pretreatment with RPR injection can attenuate the injury. The protective effect of RPR on the acute lung injury is related to its property of inducing HO-1 expression and inhibiting lipid peroxidation.</p>