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Objective:To investigate the effects of nicorandil combined with thrombus aspiration during percutaneous coronary intervention on reperfusion arrhythmia in patients with acute ST-elevation myocardial infarction.Methods:180 patients with acute ST-elevation myocardial infarction who received treatment in Yidu Central Hospital, Weifang Medical University, China between January 2019 and June 2020 were included in this study. They were randomly assigned to receive either nicorandil combined with thrombus aspiration during percutaneous coronary intervention (NPCI group, n = 90) or conventional PCI (PPCI group, n = 90). Myocardial perfusion (myocardial blush grade 3 blood flow) and the occurrence of reperfusion arrhythmia within 24 hours after treatment were compared between the NPCI and PPCI groups. Results:The incidence of myocardial blush grade 3 blood flow in the NPCI group was significantly higher than that in the PPCI group [84.44% (76/90) vs. 68.88% (62/90), χ2 = 6.01, P = 0.01]. There was no significant difference in the total incidence of reperfusion arrhythmia between NPCI and PPCI groups ( χ2 = 1.19, P = 0.27). The incidence of severe reperfusion arrhythmia in the NPCI group was significantly lower than that in the PPCI group [13.33% (12/90) vs. 27.77% (25/90), χ2 = 5.75, P = 0.02]. The influential factor of severe reperfusion arrhythmia was analyzed by logistic regression taking whether NPCI treatment was used as the variable ( OR = 0.40, 95% CI 0.18-0.89, P = 0.02). The other factors that affect severe reperfusion arrhythmia included age ( OR = 0.71, 95% CI 0.19-0.92, P = 0.04), time from onset to reperfusion of infarct related artery ( OR = 0.62, 95% CI 0.21-0.98, P = 0.02), dcuhistory of pre-infarct angina pectoris ( OR = 0.67, 95% CI 0.19-0.98, P = 0.03), admission blood glucose level ( OR = 1.96, 95% CI 1.05-5.78, P = 0.03), admission leukocyte count ( OR = 1.99, 95% CI 1.02-6.18, P = 0.03) and cardiac function ( OR = 1.71, 95% CI 1.06-6.91, P = 0.04). Conclusion:Nicorandil combined with thrombus aspiration during percutaneous coronary intervention for the treatment of acute ST-elevation myocardial infarction can not only improve myocardial perfusion, but also reduce the incidence of reperfusion arrhythmia. The combined therapy is superior to monotherapy, has certain clinical significance and is innovative.
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Objective To explore the value of detection of systemic and local oxidation antioxidation level of ascites in the differential diagnosis of benign and malignant ascites.Methods Thirty-five patients with malignant ascites hospitalized in the Yidu Central Hospital of Weifang from December 2012 to November 2013 as the malignant ascites, and 35 cases of benign ascites as the control group.The ascites of malignant ascites group and plasma total antioxidant capacity (T-AOC) level of two group were detected by ferric ion reduction method.Plasma malonaldehyde (MDA) level of two group were detected by thiobarbituric acid content assay.Peripheral blood mononuclear cell (PBMCs) and tumor associated lymphocytes (TALS) in ascites were isolated by Ficoll density gradient centrifugation,the DNA damage of PBMCs and TALS were detected by single cell gel electrophoresis (SCGE) , expressed in the tailing rate.The value in the diagnosis of benign and malignant ascites was judged according to the analysis of above indexes.Results (1) The difference analysis : the levels of T-AOC in plasma in malignant ascites group was (9.26 ± 1.88)mM, significantly lower than that in benign ascites group((11.26± 1.78) mM, t =16.520,P =0.000);T-AOC levels of malignant ascites group ascites was (6.59± 1.38) mM, significantly lower than the plasma levels of T-AOC ((9.22± 1.86) mM, t =13.869, P =0.000);the MDA level of malignant ascites group was (6.26± 1.83) nM, significantly higher than that of serum benign ascites((3.26±1.12) nM,t=18.267,P=0.000);tailing rate of PBMCS in malignant ascites group was (17.9 ± 6.7) ％, significantly higher than that in benign ascites group ((9.6 ± 5.3) ％, P＜ 0.01);tailing rate of TALS in malignant ascites group was (442.6± 10.8) ％, significantly higher than that of PBMCS ((17.2±6.1)％ ,P＜0.01).(2)The correlation analysis: there was a negative correlation between plasma T-AOC and MDA in malignant ascites group (r =-0.518, P ＜ 0.01), tailing rate of T-AOC and TALS ascites (r =-0.566,P＜0.01) ,tailing rate of plasma T-AOC and PBMCS(t =-0.472,P＜0.01);there was a positive correlation between the tailing rate of plasma MDA and PBMCS (r =0.476, P ＜ 0.05).Conclusion In the malignant ascites group, there is oxidative stress in the whole body and the ascites, and the local oxidative stress in the ascites is more obvious.The sensitivity and accuracy of the diagnosis of malignant ascites can be increases by detected by the detection of the local oxidation resistance of the whole body and the ascites.
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This article reports a preliminary observation oh the growth of cercarial embryo of S.japonicum in defined medium cultivated one week in vitro. When extract of head-foot tissue of Oncomelania hupensis was added to the medium contained 1/2 RPMI 1640, the length of cercarial embryo increased. While liver extract of the snail was added to the same medium, the growth was inhibited.It seemed that the extract of snail liver tissue might be poisonous to the cercarial embryo.
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A further observation was conducted on the ultrastructure of mother sporccyst (Ms),daughter sporocyst in the brood chamber (b-Ds),migrating daughter sporccyst (mi-Es) and daughter sporocyst in the liver tissue (1-Ds) of Oncomelania hupensis by scanning and transmission electron microscopy.There are 5 points worthy of mention here,namely:(1)A special structure,microvilli polymerizing cisterna,is found on the tegument of 52-day-old Ms branche in all directions and a tubule-like structure is connected to the matrix of the tegument,The significance of this structure may be dealed with the metabolism and transport of the parasite.(2) The tegumental spines appear on 52-day-old Ms.(3) The function of multilaminated vesicle in the tegument of 1-Ds may be associated with the turning over of the surface coat of the larvae and the copatibiltiy between parasite and molluscan host.(4) Abundant ?-glycogen granules and mitochondria appear in the cytoplasm of parenchyma cell of brood chamber of Ms and Ds.It is proposed that the parenchymal cells not only served as the filling material,but also serve as the nursing cells for the regulation of asexual reproduction of the sporocysts.(5)The orientation of muscle fibers of the head of the mi-Ds and narrow node region of 1-Ds shows a well development of the inner longitudinal fibers adjacent to the outer circular muscle layer.They run anlero-posteriorly or vertically from the dorsal to the ventral.The pattern of muscle fibers may account for the activity of these regions of the parasite.(Figs 1-8)In short,the presentation of microvilli polymerizing cisterna,multilamilated vesicle,?-glycogen granules in parenchymal cell,the genesis of spine and the pattern of muscle fibers of the larval stage of schistosome might be helpful in understanding the asexual reproductive physiology of the parasite.
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Schistosoma japonicum daughter sporocysts in Oncomelania tissue sections were, for the first time, used as antigen in the diagnosis of schistosomiasis japonica by indirect immunoperoxidase assay (IIPA-DS). The most strong peroxidase reaction was localized on the tegument of the daughter sporocysts and cercariae, and at some parts of cercariaf parenchyma, when IIPA-DS was carried out. Of 112 sera from proven cases of schisto-Bomiasis japonica, 106 (94.6%) were positive, the range of titre dilution was from 1:1 to 1:160, the geometrie mean of titres was 1:20. IIPA-DS highly coincided with IHA, COP and ELJSA in both sensitivity and strength of reaction. Sera from 101 blood donors and 24 normal rabbits were all negative. No cross reaction with sera from 24 patients with paragonimiasis was observed.