ABSTRACT
Objective: To study influence of tirofiban on endothelial cell function in patients with myocardial infarction undergoing emergency percutaneous coronary intervention (PCI).Methods: A total of 124 patients with myocardial infarction, who received emergency PCI in our hospital from Jan 2014 to Jan 2016, were selected.According to random number table, patients were randomly and equally divided into routine treatment group (received unfractionated heparin during PCI) and tirofiban group (received tirofiban hydrochloride before PCI).Concentrations of nitric oxide (NO) and von Willebrand factor (vWF) before, and after PCI 2h, 6h and 36h;and incidence of major adverse cardiovascular events (MACE) during hospitalization were measured and compared between two groups.Results: Compared with before PCI, on 2h, 6h and 36h after PCI, there was significant reduction in NO concentration, and significant rise in vWF concentration in routine treatment group (P0.05 all), significant rise in vWF concentrations on 2h and 6h (P<0.01 both), but that of 36h had no significant difference compared with before PCI in tirofiban group, P=0.879.Compared with routine treatment group, on 2h, 6h and 36h after PCI, there were significant rise in NO concentration [6h: (40.46±9.79) μmol/L vs.(54.84±10.76)μmol/L, 36h: (49.42±9.82) μmol/L vs.(55.39±12.34)μmol/L], and significant reduction in vWF concentration [6h: (243.14±19.99) μmol/L vs.(121.58±18.92) μmol/L, 36h: (223.38±19.76) μmol/L vs.(105.32±23.05) μmol/L] in tirofiban group, P<0.05 or <0.01.Incidence rate of MACE during hospitalization in tirofiban group was significantly lower than that of routine treatment group (4.8% vs.16.1%), P=0.040.Conclusion: Application of tirofiban in patients with myocardial infarction during emergency PCI can significantly improve endothelial cell function and reperfusion effect, which is worth extending.
ABSTRACT
Objective To study the homology and clinical characteristics of healthcare-associated infection(HAI) due to Pseudomonas aeruginosa (P.aeruginosa)in medical intensive care unit (MICU),so as to guide the clinical prevention of P.aeruginosa transmission and improve therapeutic effect.Methods 55 P.aeruginosa strains isola-ted from 25 patients with HAI in the MICU of a hospital in January-December 2014 were performed pulsed-field gel electrophoresis (PFGE)homology analysis and clustering analysis,clinical characteristics,antimicrobial resistance, and transmission characteristics were analyzed.Results A total of 25 patients were investigated,with an average age of (69.62±2.13)years,mean hospital stay (49.34±3.18)days;prior to the isolation of P.aeruginosa, 84.00% of patients were treated with broad-spectrum antimicrobial agents for >2 weeks,76.00% of patients had been admitted to MICU,and 52.00% had a ventilator-assisted ventilation.55 strains of P.aeruginosa were mainly A,F,H,K,N,V,and W,which were the main epidemic strains;patients infected with A,F,H and K strains all had cross in their hospital stay;PFGE profiles of isolates from 4 patients during different periods showed different strain patterns;resistance rates of P.aeruginosa to ceftazidime (72.73%), piperacillin/tazobactam (70.91%),and imipenem(70.91%)were all high,resistance rate to amikacin was the lowest(25.45%).Conclusion Management of antimicrobial agents should be strengthened in medical institutions,HAI control meas-ures should be strengthened,so as to prevent the transmission of multidrug-resistant and extensively drug-resistant bacteria in hospitals.