Value of hs-TnI combined with GRACE2 .0 score in predicting short term death risk in patients with ACS / 重庆医学

Objective To evaluate the value of high sensitive troponin I (hs-TnI) combined with the Global Registry of A-cute Coronary Events (GRACE) 2 .0 score in the prediction of death risk in the patients with acute coronary syndrome (ACS) . Methods The hs-TnI levels and GRACE2 .0 scores at admission in 347 ACS patients treated in the hospital from December 2015 to December 2016 were retrospectively analyzed .The follow up was performed for observing the effect of hs-TnI level and GRACE2 . 0 score on the short term (30 d) mortality rate of cardiovascular diseases .And the Kapian-Meier survival curve analysis was also used to analyze the effects of hs-TnI level and GRACE2 .0 score on the short term mortality rate of cardiovascular diseases .Results In this study ,the average value of hs-TnI level in the death group was (7 .5 ± 5 .6)μg/L ,which was significantly higher than (1 .2 ± 2 .9)μg/L in the survival group (P<0 .01) .The short term cardiovascular morality rate in ACS patients was positively cor-related with the hs-TnI level (P<0 .01) .The effect of hs-TnI level on short term cardiovascular morality rate in ACS patients was analyzed by the Kapian-Meier survival curve ,the patients with hs-TnI >0 .014 μg/L had significantly poor short term prognosis (Log rank 62 .81 ,P<0 .01);the GRACE2 .0 score showed positive correlation with the 30 d cardiovascular morality in ACS pa-tients(P<0 .01) ,the short term survival rate in the patients with extremely high risk ACS was significantly decreased (Log rank 116.56,P<0.001).Buttheareaunderthesurvivalcurve(AUC)ofhs-TnIwas0.079(95% CI:0.75-0.83,P<0.01),andAUCof GRACE2 .0 score was 0 .81(95% CI:0 .79-0 .84 ,P<0 .01) .In the comparison between them ,the predictive value of GRACE2 .0 risk score was slightly higher than that of hs-TnI .Therefore ,the combination of hs-TnI and GRACE risk score could increase the value for predicting recent cardiovascular morality in ACS patients [AUC=0 .84(0 .81-0 .91)] .Conclusion hs-TnI combined with GRACE2 .0 score has an important prediction value in short term cardiovascular death risk in ACS patients .

Protective Effects of Cornus Officinalis Total Glycosides and Cornus Polysaccharides on Myocardial Mitochondria of Acute Myocardial Infarction Rats: an Experimental Study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Cornus Officinalis total glycosides (COTG) and Cornus polysaccharides (CP) on myocardial mitochondria and expression levels of glycogen synthase kinase-3β (GSK-3β) of acute myocardial infarction (AMI) rats.</p><p><b>METHODS</b>The AMI rat model was established by ligating the left anterior descending branch of coronary artery. Rats were divided into 5 groups according to random digit table, i.e., the sham-operation group, the model group, the COTG prevention group, the CP treatment group, the COTG treatment group, 12 in each group. Normal saline was administered to rats in the normal control group and the model group by gastrogavage. Corresponding medication was respectively administered to rats in the rest 3 groups by gastrogavage. The cardiac function was detected by echocardiography and hemodynamics. The infarct size was determined by Masson trichrome staining. The expression of mitochondrial biogenesis genes such as a subunit of peroxisome proliferators-activated receptor-γ coactivator-1 (PGC-1α), PGC-1β, nuclear respiratory factor-1 (NRF-1), and GSK-3P mRNA were detected by Real-time PCR.</p><p><b>RESULTS</b>Compared with the sham-operation group, the myocardial infarction size increased, cardiac function decreased, the expression of PGC-1α, PGC-1β, and NRF-1 mRNA decreased, and the expression of GSK-3β mRNA increased (all P <0. 05). Compared with the model group, myocardial infarction sizes were reduced, cardiac function was improved, the expression of NRF-1 mRNA was elevated in the COTG prevention group, the CP treatment group, the COTG treatment group; the expression of the PGC-1α and PGC-1β mRNA was elevated in the COTG prevention group and the CP treatment group; the expression of GSK-3β mRNA was reduced in the CP treatment group (all P <0. 05). Compared with the CP prevention group, fractional shortening (FS) and aortic systolic blood pressure (SBP) increased in the CP treatment group; ejection fraction (EF) decreased in the CP treatment group; the expression of PGC-1α, PGC-1β, NRF-1 mRNA were reduced in the the CP treatment group and the COTG treatment group; the expression of GSK-3β mRNA decreased in the CP treatment group (all P <0. 05). Compared with the COTG treatment group, FS, EF, left ventricular end systolic pressure (LVESP), SBP, and the expression of GSK-3β mRNA were reduced in the CP treatment group (P <0. 05).</p><p><b>CONCLUSIONS</b>COTG and CP could improve cardiac function, reduce the myocardial infarction area, and promote biogenesis of myocardial mitochondria. Their protective effects on the mitochondria of cadiocytes might be achieved by GSK-3β signalina pathway.</p>

Application of evidence-based nursing in patients with acute myocardial infarction undergoing PTCA and intracoronary stenting / 中国实用护理杂志

Objective To validate the clinical effect of evidence-based nursing on early rehablilitation of patients with acute myocardial infarction undergoing PTCA and intracoronary stenting. Methods 47 patients with acute myocardial infarction undergoing PTCA and intracoronary stenting were divided into the nursing group(24 cases)and the control group(23 cases).The nursing group received nursing with evidence-based nursing pattern while the control adopted routine nursing method. The nursing effect in the two groups was compared in the following aspects such as the incidence rate of adverse effect,average hospitalization days, athletic ability and psychological status. Results The incidenece rate of adverse effect Was lower(P＜0.05)and the average hospitalization days were shorter(P＜0.01)than those of the control group with addition of cardiovascular complications(P＞0.05).The athletic ability and psychological status were also superior to those of the control group(P＜0.05).Conclusion Application of evidence-based nursing could hasten the rehabilitative process of patients undergoing PTCA and intracoronary stenting.

Three-dimensional finite element initial analysis on the structure defect restoration of mandibular first molar under static and impact loads / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To make a mechanical analysis on three-dimensional finite element models of the mandibular first molar with the maximum distal occlusal (DO) structure defect after the root canal therapy and filling and crown restoration under static and impact loads and to provide a guideline for planning restoration for the clinic.</p><p><b>METHODS</b>The research adopted reverse engineering technology to build the model of three-dimensional finite element. The form of the intercuspal occlusion and cusp to cusp occlusion during the circulation of posterior teeth occlusion movement were simulated. Half-sine pulse/impact was chosen for the impact dynamic. The impact ratio was indicated to the stress change between impact loads and static loads.</p><p><b>RESULTS</b>Under the two kinds of loads, the maximum Mohr stress values of the metal crowns were shown in all models. The restoration effects between the two kinds of models were compared, the maximum Mohr stress value of the crown metal and dentin was not obviously difference. The maximum Mohr stress values of dentin were all obviously smaller than the stretch limit strength of dentin. The impact ratio closed to 1.</p><p><b>CONCLUSION</b>The impact loads accorded with the oral actual situation more than the static loads, but the suitable analysis of the static loads could be accepted. The restoration of metal crown is necessary. The effects between the amalgam filling and full crown restoration and composite resin filling and full crown restoration is not difference obviously.</p>