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Objective@#To evaluate the efficacy and safety of intravascular ultrasound guidance drug-coated balloon (DCB) in percutaneous coronary intervention (PCI) of situ coronary artery lesions in patients with acute coronary syndrome (ACS), and its effect on thrombus precursor protein (TpP).@*Methods@#Seventy-eight patients with ACS in Central Hospital of Changchun City from January 2015 to January 2019 were selected, including 46 cases with unstable angina pectoris and 32 cases with acute non-ST-segment elevation myocardial infarction. The patients were divided into DCB group (38 cases) and drug-eluting stent (DES) group (40 cases) by random digits table method. Intravascular ultrasound was used to guide PCI in both groups, and DCB and DES were used respectively. Coronary angiography was performed immediately and 6 months after PCI in both groups. Minimum lumen diameter (MLD) was measured by QCA system, and the lumen loss (LLL) was calculated at 6 months after PCI. Plasma TpP before PCI, 1 and 6 months after PCI was measured by enzyme-linked immunosorbent assay (ELISA). Major adverse cardiovascular events (MACE) including cardiac death, myocardial infarction and target lesion revascularization (TLR) were followed up 1, 3, 6 and 12 months after PCI.@*Results@#Immediately after PCI, there was no statistical difference in MLD between DCB group and DES group: (1.87 ± 0.23) mm vs. (2.16 ± 0.15) mm, P>0.05; 6 months after PCI, the LLL in DCB group was significantly smaller than that in DES group: (0.31 ± 0.28) mm vs. (0.48 ± 0.19) mm, and there was statistical difference (P<0.05). There were no significant differences in the incidences of myocardial infarction, TLR and cardiac death in DCB group (P>0.05). Before PCI and 6 months after PCI, there was no statistical difference in TpP between 2 groups (P>0.05); 1 month after PCI, the TpP in DCB group was significantly lower than that in DES group: (15.31 ± 6.13) mg/L vs. (19.46 ± 8.24) mg/L, and there was statistical difference (P<0.05).@*Conclusions@#DCB is an accurate and effective treatment for ACS patients with situ coronary artery disease under the intravascular ultrasound guidance, and it can reduce the risk of thrombosis.
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Objective@#To evaluate the effect of intracoronary injection of recombinant human urokinase on plasma P-selectin in AMI patients with no-reflow during acute PCI.@*Methods@#Ninety-two patients with acute ST-segment elevation myocardial infarction or acute non-ST-segment elevation myocardial infarction admitted to Center Hospital of Changchun City in January 2017 and December 2018 were randomly divided into two groups: 47 patients with intracoronary injection of sodium nitroprusside as control group and 45 patients with intracoronary injection of recombinant human urokinase as treatment group. Among them, 58 were males and 36 were females. The onset time was less than 12 h. The basic data, serum P-selectin, myocardial perfusion index and major adverse cardiovascular events were compared between the two groups.@*Results@#In the treatment group, the corrected TIMI frame number, instant TIMI grade 3 blood flow, myocardial chromogenic grade 3 blood flow, myocardial necrosis marker CTnI, serum P-selectin were significantly lower than those in the control group: 31.26 ± 4.58 vs. 35.15 ± 6.25, 71.1%(32/45) vs. 51.1%(24/47), 64.4%(29/45) vs. 55.3%(26/47), (28.46 ± 3.95) ng/ml vs. (30.18 ± 3.47) ng/ml, (13.26 ± 4.58) ng/ml vs. (15.04 ± 3.98) ng/ml, and EF function was better. In the control group. The incidence of major adverse cardiac events in the treatment group was lower than that in the control group within one month after operation, but there was no statistical significance.@*Conclusions@#There is no reflux in patients with AMI during PCI. Intracoronary injection of recombinant human urokinase can improve myocardial perfusion without reflux and has no effect on fibrinolytic system in vivo. It does not increase the risk of systemic hemorrhage and the incidence of serious adverse cardiovascular events.
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Objective To evaluate the effect of intracoronary injection of recombinant human urokinase on plasma P-selectin in AMI patients with no-reflow during acute PCI. Methods Ninety-two patients with acute ST-segment elevation myocardial infarction or acute non-ST-segment elevation myocardial infarction admitted to Center Hospital of Changchun City in January 2017 and December 2018 were randomly divided into two groups: 47 patients with intracoronary injection of sodium nitroprusside as control group and 45 patients with intracoronary injection of recombinant human urokinase as treatment group. Among them, 58 were males and 36 were females. The onset time was less than 12 h. The basic data, serum P- selectin, myocardial perfusion index and major adverse cardiovascular events were compared between the two groups. Results In the treatment group, the corrected TIMI frame number, instant TIMI grade 3 blood flow, myocardial chromogenic grade 3 blood flow, myocardial necrosis marker CTnI, serum P-selectin were significantly lower than those in the control group: 31.26 ± 4.58 vs. 35.15 ± 6.25, 71.1%(32/45) vs. 51.1%(24/47), 64.4%(29/45) vs. 55.3%(26/47), (28.46 ± 3.95) ng/ml vs. (30.18 ± 3.47) ng/ml, (13.26 ± 4.58) ng/ml vs. (15.04 ± 3.98) ng/ml, and EF function was better. In the control group. The incidence of major adverse cardiac events in the treatment group was lower than that in the control group within one month after operation, but there was no statistical significance. Conclusions There is no reflux in patients with AMI during PCI. Intracoronary injection of recombinant human urokinase can improve myocardial perfusion without reflux and has no effect on fibrinolytic system in vivo. It does not increase the risk of systemic hemorrhage and the incidence of serious adverse cardiovascular events.
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Objective Observe the synergy nerve protective effect and its mechanism of Sodium Ferulate (SF) and Ginseng saponins Rg1.Methods Ischemia-reperfusion injury models of rats were copied.The effects of SF,Ginsengsaponins Rg1 and the combination on infarction volume,lectin markers positive cells,peroxidase proliferation of activated receptorγ(PPAR-γ) mRNA expression,SOD activity and MDA content were observed.Results The blank control group didn't show infarction areas under TTC staining,and the cerebral infarction volume percentage of model control group,sodium ferulate group,ginsenoside Rg1 group and combination group was 44.2％,25.0％,20.4％,6.2％ respectively.The lectin positive cells number of blank control group,model control group,sodium ferulate group,ginsenoside Rg1 group and combination group were 11.4,44.6,27.8,23.0,13.4/500μm2 respectively; the PPAR-γmRNA expression were1883,1022,1473,1537,1843 respectively; the MDA content was 1.52,3.50,2.62,2.38,1.66 mmol/mg respectively; and the SOD acitivity was 71.54、73.14、81.72、82.22、91.10 U/mg respectively.Compared with model control group,sodium ferulate group,ginsenoside Rg1 group and combination group reduced the volume of cerebral infarcts (P＜0.01),inhibited the microglia activation(P＜0.01),increased the p PPAR-γ mRNA expression(P＜0.01),decreased the MDA content(P＜0.01) and increased SOD activity(P＜0.05,P＜0.01)significantly,and the effect of combination group was better than either sodium ferulate group or ginsenoside Rg1 group(P＜0.05,P＜0.01).Conclusion SF and Ginseng saponins Rg1 had collaborative neural protection and its activation on PPAR-γ may be one of the mechanisms.
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Objective To observe the clinical effect of Guizhi decoction combined with reduced glutathione in the treatment of pulmonary heart failure patients with acute liver injury.Methods 72 patients with pulmonary heart failure and acute liver injury were divided into treatment group and control group.Patients in the control group were given conventional treatment for pulmonary heart disease,patients in the treatment group were treated with Guizhi decotion and reduced glutathione for three weeks.After three weeks,the clinical efficacy and clinical indicators were evaluated.Results In the treatment group,clinical symptoms,signs,liver function improvement,and oxidized antioxidant indicators,the difference were statistically different compared with those in the control group (t =10.25,5.45,3.23,17.34,11.49,11.61,all P ＜0.05).The total effective rate of the treatment group was 88.9％,which was significantly higher than thant of the control group 52.8％ (x2 =11.36,P ＜ 0.05).After treatment,the plasma lipid peroxide (LPO),superoxide dismutase(SOD) had statistically significant differences between the two groups (t =53.08,-9.03,all P ＜ 0.05).Conclusion Guizhi decoction combined with the reductive glutathione can improve symptoms of pulmonary heart failure patients with liver dysfunction,and have good clinical efficacy.