ABSTRACT
Objective@#To investigate the value of fibrinogen to albumin ratio (FAR) at admission on predicting spontaneous recanalization of infarct-related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI).@*Methods@#Clinical data from 255 acute STEMI patients ((61.1±11.2) years old, 189 males) who underwent emergency coronary angiography within 12 hours in our hospital from December 2015 to April 2018 were retrospectively analyzed. The acute STEMI patients were divided into non-spontaneous recanalization group (thrombolysis in myocardial infarction (TIMI) flow grade 0-1, 203 cases) and spontaneous recanalization group (TIMI flow grade 2-3, 52 cases). Multivariate logistic regression analysis was used to evaluate related factors of IRA spontaneous recanalization. The receiver operating characteristic (ROC) curve was used to evaluate the value of FAR in predicting spontaneous coronary recanalization.@*Results@#There was no significant difference in age,gender, hypertension, diabetes, smoking,systolic blood pressure,diastolic blood pressure,heart rate, duration of chest pain, type of infarction, infarct-related artery, door-to-balloon time, and drug used before admission between non-spontaneous recanalization group and spontaneous recanalization group (all P>0.05). The FAR and high-sensitivity C-reactive protein levels were significantly lower in the spontaneous recanalization group than in the non-spontaneous recanalization group (8.20±1.85 vs. 11.02±2.75, P<0.001; (6.87±3.36) g/L vs. (8.51±3.72) g/L, P=0.004). Multivariate logistic regression analysis showed that FAR (OR=0.492, 95%CI 0.354-0.686, P<0.001), serum uric acid (OR=0.994, 95%CI 0.989-0.999, P=0.018) and high-sensitivity C-reactive protein (OR=0.774, 95%CI 0.614-0.975, P=0.030) were independent negative correlation with spontaneous recanalization of infarct-related artery in patients with acute STEMI. The ROC curve showed that the area under the curve of FAR predicting spontaneous recanalization of infarct-related artery in patients with acute STEMI was 0.807 (95%CI 0.630-0.758, P<0.001), and the diagnostic threshold was 9.26, the sensitivity was 76.9%, the specificity was 75.9%.@*Conclusion@#The level of admission FAR has certain predictive value for spontaneous recanalization of infarct-related arteries in patients with acute STEMI.
ABSTRACT
[ ABSTRACT] AIM:To evaluate the effect of rosuvastatin combined with irbesartan on the remodeling of myocar -dial hypertrophy in the rats.METHODS:Male SD rats (n=50) were randomly divided into control group, model group, rosuvastatin group , irbesartan group and combination group .The model of myocardial hypertrophy was established by sub-cutaneous injection of isoproterenol at dose of 2.5 mg/kg for 14 d.From the first day of modeling , the rats in control group and model group received intragastrical saline , and the rats in rosuvastatin group , irbesartan group and combination group were treated with rosuvastatin (4 mg· kg-1 · d-1 ), irbesartan (15 mg· kg-1 · d-1 ) and rosuvastatin (4 mg· kg -1 · d-1)+irbesartan (15 mg· kg-1· d-1), respectively.The interventions continued for 4 weeks.After the interventions, the cardiac mass index and left ventricular mass index of the SD rats were measured .Besides, the degree of myocardial hy-pertrophy was observed with HE staining .The mRNA expression of hypertrophy-related factors, such as ANF,β-MHC and AT1R was determined by RT-PCR, and the protein expression of AT1R was determined by Western blot .RESULTS:Compared with control group , the cardiac mass index , left ventricular mass index , as well as the mRNA expression of ANF andβ-MHC in model group were significantly increased (P<0.05).Compared with model group, the above factors in ro-suvastatin group and irbesartan group were decreased ( P<0.05 ) , and the factors in combination group were lower than those in rosuvastatin group and irbesartan group (P<0.05).In addition, the expression of AT1R at mRNA and protein levels in rosuvastatin group and irbesartan group was lower than that in model group ( P<0.05 ) , while the expression AT1R at mRNA and protein levels in combination group was lower than that in rosuvastatin group and irbesartan group (P<0.05).CONCLUSION:Rosuvastatin and irbesartan are equally effective drugs to resist the formation of myocardial hypertrophy by decreasing the expression of AT 1R.Moreover, combination of the 2 drugs is more effective to improve the degree of myocardial hypertrophy than the 2 drugs alone .
ABSTRACT
To evaluate the effectiveness and recent safety of emergency and selective percutaneous coronary intervention [PCI] in elderly patients [ >/= 80 years old] with acute myocardial infarction [AMI]. 120 elderly patients with coronary heart disease [CHD] were divided into AMI group [with 55 cases] and non-myocardial infarction group [control group with 65 cases]. Among the AMI group, there were 18 cases underwent emergency PCI within 12 hours after the onset, [AMI emergency PCI group], the rest 37 cases were AMI selective PCI group. In the control group, 2 cases had stable angina pectoris, 59 cases unstable angina pectoris and 4 patients old myocardial infarction. The lesions were classified according to the practice guidelines of American College Of Cardiology/American Heart Association [ACC/AHA]. The hospitalized major adverse cardiac events [MACE] and complications in the patients were recorded and statistically analyzed. The AMI group had a higher total Gensini score, lower left ventricular ejection fraction [LVEF], less mean stents and contrast agent dosage and shorter operation time, compared with the control group. The difference was statistically significant. Though the average postoperative length of stay in AMI emergency PCI group was longer than that of AMI selective PCI group, but the difference had no statistical significance. To all the included patients, there were 50 cases with lesions in one branch, 43 cases in two branches and 27 cases in three branches. And the immediate PCI success ratio in AMI group was lower than that in control group [80% VS. 96.9%, P= 0.003], without significant difference in the distribution number of diseased vessels and complete reconstruction ratio [P>0.05]. The incidence of the total complications in AMI emergency PCI group was higher, compared with the non-emergency group [with 102 cases] and AMI selective PCI group [P<0.001, P=0.039]; and the occurrence rate of complication in AMI group was higher than that of the control group [P<0.001]. The emergency PCI for elder patients with AMI is safe and worthy of promotion
ABSTRACT
Objective To evaluate the clinical efficacy and safety of catheter ablation for atrial fibrillation in elderly patients.Methods From September 2008 to October 2011,a total of 420 consecutive patients undergoing catheter ablation of atrial fibrillation (AF) were selected.The patients were divided into 3 age groups:30 59 yr group (n=279),60-74 yr group (n=100),and 75-87 yr group (n =41).The effect of operation and complications during operative and postoperative periods were evaluated.Patients were followed up for at least 6 months,and the rate of atrial fibrillation reocurrence and life quality were recorded.Results Among 480 catheter ablation procedures,in 7 (1.5％) patients occurred main complications,while in 5 (1.0％) patients appeared other complications.The incidence of main complications in 3 groups were 1.1％ (3 patients),2.0％ (2 patients) and 4.9％ (2 patients) respectively,other complication rates in 3 groups were 0.7％ (2 patients),1.0％ (1 patient) and 4.9％ (2 patients) respectively and there were no differences between groups (all P＞0.05).During follow-up,the cases without AF relapse were 68.5％ (191 patients),66.0％ (66 patients) and 57.1％ (23 patients) respectively,and the patients with AF paroxysm were 21.1％ (59 patients),21.0％ (21 patients),29.3％ (12 patients) respectively,and there was no significant difference between groups (all P＞0.05).And no difference was found in improvement degree of life quality among three groups (P＞0.05).Conclusions Catheter ablation is safe and effective in elderly patients.For patients over 75 years with many types of cardiovascular diseases,catheter ablation is effective to control the relapse of AF,can significantly improve the quality of life,and has no increased risk of complications.
ABSTRACT
BACKGROUND: Uncoupling of major histocompatibility complex (MHC) is the main cause for transplantation rejection, and it is the best way to prevent transplantation rejection by induce immunological tolerance of the recipient to the donor organ. Self-tolerant T cells can be obtained by negative selection in thymus, whether the intrathymic injection of allogenic antigen can get the immunological tolerance to the antigen?OBJECTIVE: To observe the effects of intrathymic injection of allogenic antigen on inducing immunological tolerance in nerve transplantation.DESIGN: A comparative observation.SETTINGS: Department of Immunology, Harbin Medical University; Department of Orthopaedics, Fourth Clinical Hospital of Harbin Medical University.MATERIALS: Thirty donor C57BL/6 mice (H-2b), male, aged from 6-8 weeks, weighing 18-22 g, were purchased from the Veterinarian Institute of Heilongjiang Province; While 60 recipient Balb/c mice (H-2b) female, aged from 6-8 weeks, weighing 18-22 g, from Beijing Experimental Animal Center. MHC (H-2b) antigen was prepared by the Department of Immunology, Harbin Medical University, and the concentration of protein was 4.4 g/L.METHODS: The experiments were carried out in the Department of Immunology, Harbin Medical University from June to November 2002. The recipient Balb/c mice were randomly divided into four groups: intrathymic injection group, syngenic transplantation group, allogenic transplantation group and immunosuppressant drug group. MHC (H-2b) antigen was extracted from splenic cells of donor C57BL/6 mice and injected intrathymically into recipient Balb/c mice (H-2d). Two weeks later, the sciatic nerve was transplanted to the recipient mice. Mixed lymphocyte reaction and delayed-type hypersensitivity (DTH) were detected at 3 weeks after transplantation.MAIN OUTCOME MEASURES:The differences of mixed lymphocyte reaction and DTH were compared among the groups.RESULTS: All the 30 donor C25BL/6 mice (H-2b) and 60 recipient Balb/c mice (H-2d) were involved in the analysis of results.①Results of mixed lymphocyte reaction: The cell proliferations in the syngenic transplantation group and intrathymic injection group were obviously lower than that in the allogenic transplantation group [(546.1±75.1), (2 668.3±533.8), (3 101.3±429.1), (4 312.3±534.1) minutes-1, P＜0.05].②Results of DTH: The thicknesses difference between two pads in the syngenic transplantation group and intrathymic injection group were obviously lower than that in the allogenic transplantation group [(41.1±3.7), (72.1±5.1), (57.6±11.3), (86.2±13.2)μm, P＜0.05].CONCLUSION:The intrathymic injection of donor H-2b antigen could induce immunological tolerance of nerve transplantation.
ABSTRACT
Objective To Investigate the important perennial inhaled allergens for children with allergic asthma in Daqing.Method Analyzing the data from 134 patients between 4 and 14 years of age with asthma who have a positive skin test to perennial aeroallergen and also have been carried out Allergen-specific immunotherapy in the last four years.Results The important perennial inhaled allergens for children with allergic asthma in Daqing were house dust,dust mites,polyvalent molds Ⅰ(PMⅠ),animal epithelium and polyvalent molds Ⅱ(PMⅡ).Among them the most important allergens were house dust and dust mites.Conclusion It will have practical significance to prevent and treatment children's asthma by taking measures for these allergens.
ABSTRACT
Purpose:To clarify roles of overexpression of phosphorylated Akt(p-Akt) and loss of phosphatase and tensin homologue deleted on chromosome 10(PTEN) expression in biological behavior of non-small-cell lung cancer(NSCLC). Methods:Immunohistochemical staining was used to determine the expression of p-Akt and PTEN in 20 cases of normal lung tissues and 102 patients with NSCLC.Results:Negative p-Akt expression and positive PTEN expression were found in normal lung tissues, while the positive incidences of p-Akt expresssion and loss of incidences of PTEN expresssion in NSCLC were 41.2% (42/102) and 46.1% (47/102)respectivtly.The overexpression of p-Akt and loss of PTEN expression were correlated to degree of differention of cancer, metastasis(including lymph node), and clinical stages. A significant negative correlation was observed between expression of p-Akt and PTEN(Phi r=-0.425,P