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Objective To investigate the effect of trimetazidine combined with atorvastatin on cardiac function and the level of hs-CRP,IL-6,and Fib in patients with coronary heart disease.Methods Patients (120 cases) with coronary heart disease in the first people's Hospital of Xianyang City from January 2014 to January 2016 were selected and randomly divided into two groups.The observation group was treated with trimetazidine combined with atorvastatin,the control group was treated with trimetazidine,the curative effect,left ventricular ejection fraction,left ventricular diastolic end systolic diameter,left ventricular posterior wall thickness and serum hs-CRP,IL-6,and Fib levels were compared.Results The effective rate of observation group was 91.67％ (55/60),significantly higher than the control group 76.67％ (46/60) (P ＜ 0.05);The left ventricular ejection fraction,left ventricular end-diastolic diameter,and left ventricular posterior wall thickness of two groups were significantly improved (P ＜ 0.05),and the improvement of the observation group was significantly better than that of control group (P ＜ 0.05);The serum levels of hs-CRP,IL-6,and Fib were significantly lower (P ＜ 0.05),and the observation group was more obvious (P ＜ 0.05);The incidence of adverse reactions of two groups had no significant difference.Conclusion Trimetazidine combined with atorvastatin have high curative effect on coronary heart disease,and can improve cardiac function,significantly reduce the levels of hs-CRP,IL-6,and Fib,worth clinical promotion.
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Objective:To investigate the efficacy and safety of different doses of tirofiban combined with coronary artery intervention in treatment of Non ST-segment elevation acute coronary syndromes (NST-ASC).Methods:110 cases with NST-ACS from October 2014 to January 2016 in our hospital were chosen and divided into the all dose group and half dose group.The TIMI blood grade before and after treatment,cardiac function before and after treatment for 30 d,major adverse cardiac events and bleeding events,hospitalization expenses and hospitalization days were recorded and compared between two groups.Results:Compared with before treatment,the TIMI 2 grade and 3 grade were obvious decreased,and the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) after treatment for 30 d were all obvious decreased,while the left ventricular ejection fraction (LVEF) were significant increased,P＜0.05.And the TIMI blood flow grading,LVEDV,LVESV and LVEF before and after treatment in two groups had no significant difference (P＞0.05),and the major adverse cardiac events and hospitalization days of two groups had no significant difference,P＞0.05.While the bleeding events and hospitalization expense of all dose group was obvious higher than those of half dose group,P＜0.05.Conclusions:The half dose group of tirofiban combined with coronary artery intervention in treatment NST-ACS has obvious efficacy,it can decrease the bleeding events and hospitalization expense.
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Objective:To explore the influence of embryonic stem cells-derived neural stem cells on the proliferation and secretion cytokines of bone marrow-derived macrophages. Methods:Mouse bone marrow derived macrophages were isolated and cultured in L929 medium. After macrophages were treated with NSCs supernatant for 3 days,SRB method was used to detect the proliferation of macrophages. The phagocytosis of macrophages were detected by incubating with RFP-Beads for 1 h. Meanwhile,the expression of TNF-α and IL-1β were detected by ELISA. Results:NSCs were successfully induced from ESC. In control group and NSC group, the proliferation rate of macrophages were 100 % and (126. 29 ± 5. 41)%,the phagocytosis rate were (70. 23 ± 2. 57)% and (90. 32 ± 8. 49)%. Compared to the control group,the levels of IL-6,IL-1βin macrophage treated with NSCs decreased (P<0. 05). Conclusion:ESC-derived NSCs can promote the proliferation and phagocytosis of bone marrow-derived macrophage, and suppress the secretion of pro-inflammatory cytokines.
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Objective To explore the risk factors influencing the prognosis by analyzing clinical data of patients with acute paraquat intoxication, and to assess the prognostic values of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, and Acute Kidney Injury Network (AKIN) stage.Methods The clinical data of patients with acute paraquat intoxication admitted into the First People's Hospital of Xianyang City during October 2005 to May 2015 were retrospectively analyzed.The patients were divided into death group and survival group according to 28-day outcome after poisoning.The gender, age, body weight index, toxin dose, time elapsed from poisoning to gastric lavage, time elapsed from poisoning to hemoperfusion (HP), times of HP treatment, white blood cell count (WBC), alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBil), serum creatinine (SCr), blood urea nitrogen (BUN), creatine kinase (CK) were determined at admission.Arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial lactate (Lac), and APACHE Ⅱ score, SOFA score and AKIN stage were recorded and compared between two groups.The receiver operating characteristic (ROC) curve was plotted for APACHE Ⅱ score, SOFA score and AKIN stage to analyze the prognostic value for patients with acute paraquat intoxication.Results There were 118 cases in total,with 64 survivors and 54 deaths in 28 days, and the fatality rate was 45.76％.Compared with survival group, the toxic dose (mL: 66.29 ± 27.40 vs.29.16 ± 19.40), time elapsed from poisoning to gastric lavage (minutes: 60.37 ± 26.68 vs.41.17± 14.82), WBC count (× 109/L: 16.86±2.77 vs.10.25 ± 2.60), ALT (U/L: 53.94± 10.85 vs.36.40±9.21),SCr (μmol/L: 159.69±42.85 vs.81.73±34.40) at admission as well as Lac (mmol/L: 3.06± 1.33 vs.1.71 ±0.88),APACHE Ⅱ score (6.46±2.38 vs.3.31 ± 1.51), SOFA score (3.31 ± 1.06 vs.2.21±0.76) 48 hours after admission were significantly higher in the death group (all P ＜ 0.01).PaO2 and PaCO2 48 hours after admission were significantly lower in death group than those in the survival group [PaO2 (mmHg, 1 mmHg =0.133 kPa): 64.07± 13.04 vs.75.40 ± 13.27, PaCO2 (mmHg): 26.20 ± 8.89 vs.31.25 ± 6.29, both P ＜ 0.01].There were 18, 15, 11 and 10 patients in AKIN 0, 1, 2, 3 stage 48 hours after admission respectively in death group, and 38, 15, 7, 4 in survival group.The difference between two groups was statistically significant (P ＜ 0.01).There were no statistically significant differences in gender, age, body mass index, time elapsed from poisoning to HP, levels of HP, and AST, TBil, BUN and CK at admission between the two groups.At 48 hours after admission, the area under the ROC curve (AUC) of APACHE Ⅱ score predicting the prognosis of patients with acute paraquat poisoning was 0.875 [95％ confidence interval (95％CI) =0.814-0.935, P =0.000].When the cut-off point of APACHE Ⅱ score was 4, the sensitivity and specificity were 79.6％ and 79.7％, and the best Youden index was 0.593.The AUC of SOFA score was 0.776 (95％CI=0.692-0.859, P =0.000).When the cut-off point of FOFA score was 3, the sensitivity was 72.2％, the specificity 67.2％, and the best Youden index 0.394.The AKIN stage of ROC curve had an area of 0.656 (95％CI =0.556-0.755, P =0.004).When the cut-off point of AKIN stage was 1, the sensitivity was 66.7％, the specificity was 59.4％, and the best Youden index was 0.261.Conclusions Amount of the poison, time elapsed from poisoning to gastric lavage, and WBC, ALT, SCr at admission as well as PaO2, PaCO2 and Lac 48 hours after admission are the risk factors for prediction of the prognosis of acute paraquat intoxication.APACHE Ⅱ score, SOFA score and AKIN stage can be used to assess the prognosis of acute paraquat poisoning, and APACHE Ⅱ score is better than SOFA score and AKIN stage.