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Objective To investigate the effects of Tirofiban combined with thrombus aspiration on myocardial reperfusion and no-reflow after percutaneous coronary intervention (PCI)in elderly patients with ST-segment elevation myocardial infarction (STEMI).Methods A total of 185 patients with STEMI were randomly divided into a control group(n=93)and a study group(n=92).The control group received direct stenting or percutaneous coronary angioplasty before stent placement.The study group received an intracoronary injection of Tirofiban 10 μg/kg,thrombus aspiration,and then balloon dilatation or direct coronary stenting.Postoperative recovery was compared between the groups,and major adverse cardiovascular events(MACE) were recorded.Results The incidence of no-reflow,the thrombolysis in myocardial infarction,the corrected (TIMI)frame count (CTFC)and the peak of plasma creatine kinase MB isoenzyme(CK MB)were lower in the study group than in the control group[(no reflow,8 cases or 8.7 ％ vs.21cases or 22.6 ％,x2 =6.752,P ＜0.05;CTFC,(26.4±8.7)frame vs.(34.5± 8.2)frame,t =6.517,P＜0.05;CK-MB peak,(114.5±25.7)U/L vs.(226.3 ± 27.6) U/L,t =28.506,P ＜ 0.05].The proportion of patients with descent of ST segment elevation of more than 50％ and the left ventricular ejection fraction(LVEF)were higher in the study group than in the control group[83 cases or 90.2％ vs.72 cases or 77.4％,x2=5.581,P＜0.05;(56.2±8.6) ％ vs.(48.8±10.5)％,t =5.241,P＜0.05].The TIMI grading was better in the study group than in the control group (Z =1.984,P ＜ 0.05).The incidence of mild bleeding during treatment had no significant difference between the study group and the control group(20.7％ or 19 cases vs.15.1％ or 14 cases,x2 =0.99,P =0.32).There was no significant difference in the incidence of MACE events during hospitalization or one-year follow-up between the two groups(x2=2.394,0.452,P ＞ 0.05).Conclusions Tirofiban combined with thrombus aspiration can improve myocardial reperfusion in elderly patients with STEMI after PCI,and has excellent clinical value.
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Objective To investigate the bilateral flow-mediated dilation of brachial artery (BA-FMD) and nitroglycerin mediated dilation (BA-NMD) in patients with cerebral infarct, and to find out if the vasodilation of internal catotid artery after sublingual administration of nitroglycerin can be detected as a more direct way to reflect the vasodilation in patients with cerebral vascular diseases. Methods High resolution ultrasonic system was used to measure 13 patients with acute cerebral infarction. The diameter of brachial artery, internal carotid artery and common carotid artery was measured at relaxation, reactive congestion in the brachial artery and after sublingual administration of nitroglycerin. Meanwhile, the intima media thickness (IMT) and plaques of carotid artery was detected. Results Paralysis did not lead to differences in vasodilation of brachial artery (r=0.52, P=0.07). There was a correlation between ICA-NMD and BA-NMD (r=0.83, P=0.01). Conclusion There were no significant differences between brachial vasodilation in paretic and non-paretic limbs of patients with acute cerebral infarction. Ultrasonic measurement of ICA-NMD can be a more direct measure of the vasodilation of patients with cerebral infarction.
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Objective To study the anatomical characteristics of the stellate ganglion (SG) for providing morphological data for SG block. Methods The shape, size, position, and relation of 30 cases of SG in 15 adult cadavers were observed and measured. Results Most of the SG was stellate-shaped. The average volume of the stellate ganglion was (0.86?0.07)cm3. The position of the SG could be localized according to the adjacent bone or muscle marks, and the shortest distance was between the SG and the transverse process of the 7th cervical vertebrae. There were many important structures around the SG, in which the vertebral artery was closely related to the SG. Conclusion During performance of the SG block, the surface projection, puncture point, and medication dosage could be judged on the basis of these quantitative anatomic data.
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Objective To investigate the effects of chronic periodontitis on heart attack and stability of coronary artery disease (CAD). Methods Number of missed teeth was recorded and periodontal index evaluated in 266 patients with CAD, including 72 cases of acute mycocardial infarction (AMI sub-group), 91 cases of unstable angina pectoris (UAP sub-group) and 103 cases of stable angina pectoris (SAP sub- group ), and 266 healthy controls. Comparison was made between the both groups and between each sub-group and controls. Results Periodontal index in CAD group was higher than that in control group ( P 0.05). Conclusions Chronic periodontitis can affect heart attack and stability of CAD, which may be an independent risk factor for CAD.
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To observe the effects of diabetogenic (high fat high sucrose, lacking choleserol) diet on atherogenesis in New Zealand white rabbits. Two groups of New Zealand white rabbits received regular rabbit chow (the normal control), or high fat high sucrose diet for 4 months. The levels of plasma total cholesterol, HDL cholesterol, triglycerides, insulin, and glucose were investigated, the areas of fatty streak of the aortae were measured after staining with Sodan IV, and the aortic, coronary specimens were observed with light and electron microscopies. The plasma glucose, triglycerides, and total cholesterol were increased significantly by high fat high sucrose feeding. At the end of 4 months, the early charateristics of atherosclerosis were present in the animals' vascular specimens. Our findings suggest that high fat high sucrose feeding can induce hyperglycemia, hypertriglyceridemia and atherosclerosis in New Zealand white rabbits, and this could be a potential animal model for studying the mechanisms of diabetes-accelerated atherosclerosis. This study raised a question: What is the mechanism by which high fat high sucrose feeding induces atherosclerosis?. The related hypothesis was given in this article.