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Objective:To explore the factors influencing the clinical outcome of complex high-risk indicated patients percutaneous coronary intervention (CHIP-PCI) assisted by extracorporeal membrane oxygenation (ECMO).Methods:The clinical data of patients with CHIP-PCI assisted by ECMO in the First Affiliated Hospital of Zhengzhou University from April 2018 to April 2022 were retrospectively collected and analyzed. Patients were divided into the survival and death groups according to the in-hospital survival status. The baseline characteristic, the results of coronary angiography, and the use of ECMO, blood products and drug were compared between the two groups. The 24-h rate of change of biochemical test indicators after the use of ECMO were calculated and the univariate analysis was analyzed using rank sum test. According to the univariate analysis, the variables ( P<0.05) were included in multivariate logistic regression to analyze the factors affecting the clinical outcomes of patients. Results:A total of 67 CHIP patients who completed PCI with ECMO were included. In the survival group ( n=36), the duration of ECMO treatment was 59 (41, 87) h, 9 cases received continuous renal replacement therapy, and 11 cases received IABP. In the death group ( n=31), the duration of ECMO treatment was 31 (19, 80) h, 12 cases received continuous renal replacement therapy and10 cases received IABP. The proportion of patients with chronic total occlusion lesions (CTOs) in the survival group was lower than that in the death group, the duration of ECMO of the survival group was longer than that of the death group ( P<0.05). Multivariate logistic regression analysis showed that 24-h lactate change rate ( OR=2.864, 95% CI: 1.185-6.918, P=0.019), 24-h eGFR change rate ( OR=0.050, 95% CI: 0.003-0.871, P=0.040), 24-h D-dimer change rate ( OR=1.497, 95% CI: 1.044-2.146, P=0.028) and 24-h direct bilirubin change rate ( OR=2.617, 95% CI: 1.121-6.111, P=0.026) were associated with in-hospital mortality. Conclusions:Within 24 h after CHIP-PCI assisted by ECMO, the rapid decline in lactic acid, D-dimer and direct bilirubin, and the rapid recovery of eGFR, are associated with the decreased risk of hospital mortality from CHIP.
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Objective:To investigate the correlation between endothelial dysfunction and cardiomyocyte apoptosis during myocardial ischemia-reperfusion.Methods:A total of 63 male rats were selected to establish the rat model of myocardial ischemia-reperfusion by the ligation of the left anterior descending(LAD)coronary artery to simulate myocardial ischemia.Rats were divided into the control group and group Ⅰb, group Ⅰa, group Ⅱb, group Ⅱa, group Ⅲb and group Ⅲa.Control rats were treated only with LAD threading without ligation.In observation group, at 30, 90, 120 min after LAD ligation(marked as Ⅰ, Ⅱ, Ⅲ group respectively), loosen the ligation to simulate ischemia-reperfusion.In the observation group, captopril sublingual injection of 0.25 mg/kg before ligation were marked as group b, and as group a with no captopril injection.The circulating endothelial cells(CEC), endothelin(ET), nitric oxide(NO)and the apoptosis rate of cardiomyocytes in each group were measured.Results:The CEC and ET levels showed a continuous upward trend, and a NO level showed a continuous downward trend from group Ⅰa to Ⅱa to Ⅲa as compared with the control group( P<0.05). After using preventive intervention of captopril, the CEC and ET levels were lower and NO levels were higher in group Ⅱb and Ⅲb than in group Ⅱa and Ⅲa, respectively( P<0.05). The apoptotic rate of cardiomyocytes was higher in group Ⅰa than in the control group, and the apoptotic rate from high to low were from group Ⅲa[(235.71±40.25)%]to group Ⅱa[(197.28±43.56)%]to group Ⅰa[(138.55±32.87)%]and to the control group[(5.81±2.02)%]( P<0.05). The apoptotic rate of cardiomyocytes was lower in group Ⅱb[(125.67±26.51)%]and Ⅲb[(124.91±33.28)%]than in group Ⅱa and Ⅲa, respectively( P<0.05). Conclusions:The ischemia-reperfusion can cause endothelial dysfunction and the apoptosis of cardiomyocytes, and there is a close relationship between the degree of this lesions and the duration of ischemia-reperfusion.While, the appropriate application of angiotensin converting enzyme inhibitor can inhibit the damage of cardiomyocytes to a some extent.
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OBJECTIVE@#To study the effect of down-regulating miR-488 targeting Jag1 on the injury of hypoxia-reoxygenation myocardial H9c2 cells.@*METHODS@#A hypoxic-reoxygenated myocardial H9c2 cell injury model was constructed. miR-488 inhibitor was used to transfect the cells. CCK-8 method and flow cytometry were used to detect cell proliferation and apoptosis in each group. Lactate dehydrogenase (LDH), superoxide dismutase (SOD), malonaldehyde (MDA), catalase (CAT) levels were detected. Western blotting was used to detect the expression of Bcl-2 associated X Protein (Bax) and B cell lymphoma/lewkmia-2 (Bcl-2). Target genes of miR-488 were predicted, and a luciferase reporter system was used to verify the targeting relationship between the two. Myocardial H9c2 cells were co-transfected with miR-488 inhibitor and Jag1 siRNA, and treated with hypoxia and reoxygenation, cell proliferation, apoptosis, LDH, SOD, MDA, CAT levels, and Bax, Bcl-2 protein expression were detected.@*RESULTS@#The expression of miR-488 in the hypoxia-reoxygenated myocardial H9c2 cells was increased, along with reduced cell proliferation, increased apoptosis, increased Bax protein expression, decreased Bcl-2 protein expression, increased MDA, decreased CAT and SOD, and increased LDH level in the supernatant of cell culture. When myocardial H9c2 cells were transfected with miR-488 inhibitor and treated with hypoxia and reoxygenation, the expression of miR-488 was decreased, along with increased cell proliferation, decreased apoptosis, decreased Bax protein expression, increased Bcl-2 protein expression, decreased MDA, increased CAT and SOD, and decreased LDH level in the supernatant of cell culture. Down-regulation of miR-488 could target and down-regulate Jag1 expression. And Jag1 siRNA could reverse the effect of miR-488 inhibitor on the proliferation, apoptosis, LDH, SOD, MDA, CAT levels and the expression of Bax and Bcl-2 of hypoxic-reoxygenated myocardial H9c2 cells.@*CONCLUSION@#Down-regulating miR-488 targeted Jag1 can attenuate hypoxia-reoxygenation induced myocardial H9c2 cell injury.
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Humans , Apoptosis/genetics , Down-Regulation , Hypoxia/genetics , Jagged-1 Protein/genetics , MicroRNAs/genetics , Myocardial Reperfusion Injury , Myocytes, CardiacABSTRACT
Objective To provide reference and ideas for information service in hospital library by analyzing the influencing factors for its service satisfaction.Methods The satisfaction of hospitalized patients for information service was investigated.The characteristics of patients,their requirements for information service and the influencing factors for their satisfaction were analyzed by logistic regression analysis.Their satisfaction for information service was assessed according to the IPA method and analyzed using the SPSS19.0.P0.05).The importance of information service and the satisfaction of patients for information service were rather high.IPA analysis showed that the patients considered high the importance of library-provided personal bibliography and departments-provided health pamphlets with a low satisfaction,which should thus be solved.Conclusion The satisfaction of patients for information service is good.However,the importance of library-provided personal bibliography and departments-provided health pamphlets is high and the satisfaction for them is low.It is thus necessary for librarians to improve their service and encourage more medical staff to participate in information service for patients.
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<p><b>OBJECTIVE</b>To investigate the expression of SFRP4 and DKK1 in cervical squamous cell carcinoma and explore the clinicopathological implications.</p><p><b>METHODS</b>Immunohistochemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) were used to detect the expressions of SFRP4 and DKK1 in 66 cervical squamous cell carcinoma and 26 normal cervical specimens.</p><p><b>RESULTS</b>SFRP4 expression was significantly higher (P<0.01) and DKK1 expression was significantly lower (P<0.05) in the carcinoma tissues than in normal cervical tissues. DKK1 was negatively correlated with SFRP4 in the carcinoma tissues (P<0.01), and their expressions were associated with the clinical stages, tumor differentiation, depth of invasion and lymph node metastasis of the tumors (P<0.05).</p><p><b>CONCLUSION</b>SFRP4 and DKK1, the upstream components of the Wnt pathway, play a key role in the tumorigenesis of cervical squamous cell carcinoma, and their expressions are associated with the clinicopathological features of the malignancy.</p>
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Female , Humans , Carcinoma, Squamous Cell , Metabolism , Immunohistochemistry , Intercellular Signaling Peptides and Proteins , Metabolism , Lymphatic Metastasis , Proto-Oncogene Proteins , Metabolism , Uterine Cervical Neoplasms , MetabolismABSTRACT
Objective: To investigate the incidence of coutrast media iodixanol-induced delayed adverse reaction with the risk factors in general clinical practice. Methods: A total of 20,185 patients with contrast iodixanol were recruited from 95 medical centers in China. The risk factors for adverse drug reaction as hypertension, asthma, previous contrast reaction were assessed;the administrative processes as route, injection manner, lfow rate of injection, prior heating of iodixanol were monitored and the demographic information was documented. The immediate adverse reaction within 1 hour of media administration and the delayed adverse reaction from 1 hour to 7 days after administration were recorded. The risk factors for iodixanol-induced delayed adverse reaction were studied by singlevariate and multivariate logistic regression analysis. Results: The overall iodixanol-induced adverse reaction rate was 1.52%, of which the immediate reaction was 0.58%and delayed reaction was 0.97%. The major delayed reaction was mild and it mostly happened in skin (0.68%) including rash, pruritus and urticaria. Multivariate logistic regression analysis revealed that male gender (OR=0.71, P=0.036), age (OR=0.82, P=0.001), route of administration (OR=0.21, P<0.001), prior heating of iodixanol (OR=1.44, P=0.036), lfow rate of injection (OR=1.28, P=0.001) and previous contrast reaction (OR=16.04, P<0.001) were the independent risk factors for delayed adverse reactions.
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Objective To assess the change of left ventricular wall motion at ventricular pacing(VP)by using global circumferential strain (GCS) and segmental circumferential strain of speckle tracking imaging(STI). Methods Seven adult pigs were sedated,followed by median sternotomy and opening of the pericardium. Temporary pacing leads were placed on the right ventricular (RV) epicardium and LV epicardium for RV or LV pacing. A LV short axis view at the mid-level LV was acquired at sinus and VP rhythm. Analysis of circumferential strain by STI was performed offline. The onset of QRS wave was used to characterize the beginning of the cardiac cycle, and the ratio of beginning systolic time, end systolic time and total systolic time to cardiac cycle dyssynchrony was analyzed at sinus and VP rhythm. Results Compared with sinus rhythm,in VP rhythm all of the ratio of the beginning systolic time,end systolic time and total systolic time to cardiac cycle were increased (all P ＜0.05), and the construction of six segments were dyssynchrony,even segmental paradoxical movement. At VP ≥130 beats/min,both LV global and LV segments sometimes showed irregular motion while the EKG remained normal, which included: ( 1 ) multiple construction and diastole in one heart cycle; (2) A large variability of construction amplitude in several consecutive cardiac cycles. Conclusions VP can lead to several kinds of disturbance of left ventricular wall motion, including delay and lengthening of LV systole, dyssynchrony, and irregularity of systole and diastole.
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Objective To evaluate the effects of cardiac resynchronization therapy with pacemaker (CRT- P) and cardiac resynchronization therapy with defibrillator (CRT -D) on the outcomes of patients with heart failure.Methods MEDLINE,Cochrane Controlled Trials Register,EMBASE and Chinese Wan Fang,CNKI database were searched to collect data from randomized controlled trials and cohort trials of CRT - P versus CRT - D for the treatment of heart failure from January 1,1990 through September 30,2011.Meta - analysis of data including all causes leading to mortality and mortality of sudden cardiac arrest and heart failure was carried out by using the RevMan 5.0 package.Results A total of 3 404 patients were collected from seven studies.Pooled analysis demonstrated CRT - D significantly reduced mortalities of all causes in comparison with CRT - P [ odds ratio (OR) =0.61,95％ confidence interval (CI) =0.47 ～0.79,P =0.0001 ].Sub - group analysis showed that an increased benefit was seen after extended follow -up period ( after 1 year,OR =0.56,95 ％ CI =0.41 ～ 0.77,P =0.0004),but not after relatively short follow - up period ( within one year,OR =0.76,95 ％ CI =0.54 ～ 1.06,P =0.11 ).Mortalities of sudden cardiac arrest ( OR =0.20,95％ CI =0.07 ～ 0.59,P =0.003) and heart failure ( OR =0.72,95％ CI =0.54 ～ 0.96,P =0.02) of patients treated with CRT - D were lower than those of patients treated with CRT- P.Conclusions This study suggests that CRT - D is superior over CRT - P in respect of better outcome of patients with heart failure.
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Currently,the overall situation of information literacy level of researchers in hospitals is generally low.This paper explores the connotation of information literacy and stresses the importance of information literacy cultivation for scientific researchers.Suggestions are also made for cultivation of information literacy.
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Coronary heart disease(CHD) is the leading cause of death among women worldwide.Recent technological advances in cardiovascular diagnosis and treatment have not led to significant declines in mortality for women with CHD when compared to the dramatic declines for men.Owing to the gender differences of physiology and social circumstances,women with CHD may have different manifestations as compared to men with CHD.Recently,research has shown that women with CHD had mainly the following characteristics:special risk factors,atypical ischemia symptoms,multiple risk factors and comorbidities at initial physician consultation,higher under-treatment rate and higher mortality rate.At the same time,most CHD researches have paid little attention to women.Therefore,the current CHD guidelines may not be completely suitable for women.In order to improve the prevention and treatment of CHD in women,we advocate to enhance research and clinical work for women with CHD. Abstract:Summ ary:Coronary heart d isease(CHD) is the lead ing cause of death among wom en worldw ide.Recent technological advances in card iovascu lar d iagnosis and treatm ent have not led to sign ificant dec lines in mortality for wom en w ith CHD when compared to the dram atic dec lines form en.Ow ing to the gender d ifferences of physiology and soc ial c ircum stances,wom en w ith CHD m ay have d ifferent m an ifestations as compared to m en w ith CHD.Recently,research has shown that wom en w ith CHD had m ain ly the follow ing characteristics: spec ial risk factors,atyp ical ischem ia symptom s,mu ltip le risk factors and comorb id ities at in itial physic ian consu ltation,h igher under-treatm ent rate and h igher mortality rate.At the sam e tim e,most CHD researches have paid little attention to wom en.Therefore,the current CHD gu idelines m ay not be comp letely su itab le forwom en.In order to improve the prevention and treatm ent of CHD in wom en,we advocate to enhance research and c lin ical work for wom en w ith CHD.
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Antithrombotic therapy is essential to success of percutaneous cardiovascular intervention(PCI)and reduction of postprocedural thrombotic complications.Antiplatelet and anticoagulant therapies are central to current antithrombotic therapy.The mechanism of thrombogenesis,related factors,clinical guidelines and considerations associated with antithrombotic drugs are illustrated in this paper.
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0.05), which were lower than that with manual compression. The failure rates were 8.3% and 9.2% respectively, but the vascular complications were less than 1%. Hematoma and femoral artery infection were seen in the PCI group, but happened less compared with manual compression. The removing of the arterial sheaths will not be limited by the anticoagulation and antiplatelet therapies, and it could be performed immediately after CAG and PCI, making hemostasis more easy to archeive. It could also reduce the burden of the medical staff, and be accepted by the patients. Conclusion Femoral arterial closure following PCI using regular and intensive anticoagulation and antiplatelet therapies could be safe and effective with vascular complication rates similar to or lower than with manual pressure.
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Objective To study the effect of circumferential pulmonary vein isolation(CPVI) guided by Carto-Merge and Lasso catheter for the treatment of atrial fibrillation(AF).Methods Fifty-six drug refractory patients(41 male) with paroxysmal AF were enrolled into this study with a mean age of(58.5?12.7) years.Ostia of pulmonary veins(PVs) were identified by Carto-Merge.Then circumferential pulmonary vein isolation was performed.The endpoint of ablation was abolishment or dissociation of the pulmonary vein potentials(PVPs).Results Mean distance between electroanatomic mapping points and MRI surfaces was(1.79?0.33) mm as a whole in this group.Abolishment or dissociation of PVPs was accomplished in 52 patients(92.9%) during the first procedure.After a mean(18.3?5.7) months of follow up,41 patients(73.2%) maintained sinus rhythm.Ten patients received a second ablation procedure,and 8 were free of atrial tachyarrhythmias after a mean(8.2?6.9) months of the second follow up.No PV stenosis was identified after ablation procedure.Conclusion Combination of Lasso catheters with Carto-Merge to guide the CPVI procedure can confirm the isolation of PVs and lower the incidence of PVs stenosis.