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Objective:To establish a modified controlled abciximab and device investigation to lower late angioplasty complication (CADILLAC) score, and to compare the predictive value of modified CADILLAC score, the global registry of acute coronary event (GRACE) score and the thrombolysis in myocardial infarction (TIMI) score in predicting the risk of short-term death after percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI).Methods:A retrospective study was conducted. The clinical data of 169 STEMI patients under going PCI admitted to the department of cardiology of Guizhou Provincial People's Hospital from September 2019 to December 2020 through emergency chest pain fast track were enrolled. A multivariate Logistic regression analysis was used to screen the factors closely related to the mortality risk within 30 days of STEMI, and a modified CADILLAC scoring system was established by referring to CADILLAC scoring settings. The score of modified CADILLAC, GRACE and TIMI scores of patients were calculated after admission, and the number of deaths due to cardiovascular disease (CVD) within 30 days after onset was recorded. The receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of three scoring systems on the risk of death within 30 days after PCI in patients with STEMI.Results:In 169 STEMI patients, 16 patients died of CVD within 30 days after PCI, and the actual case mortality was 9.47%. Multivariate Logistic regression analysis showed that age > 75 years old, cardiac function Killip ≥ Grade Ⅲ, ventricular arrhythmia, ST segment elevation ≥ 0.2 mV, cardiac troponin I (cTnI) increase, systolic blood pressure (SBP) < 90 mmHg (1 mmHg ≈ 0.133 kPa) were all independent predictors of death after PCI in STEMI patients. The improved CADILLAC scoring system was constructed based on the above predictive factors combined with left ventricular ejection fraction (LVEF) less than 0.40. The GRACE, TIMI and modified CADILLAC scores of dead patients were significantly higher than those of survival patients (GRACE score: 197.60±31.83 vs. 149.81±36.72, TIMI score: 11.21±2.13 vs. 7.27±1.97, modified CADILLAC score: 12.60±2.52 vs. 6.96±2.17, all P < 0.05). The higher the risk stratification of the three scores, the higher the mortality of patients with CVD within 30 days after PCI [the mortality of patients with low, medium and high risk in GRACE score were 2.41% (2/83), 9.61% (5/52) and 26.47% (9/34); the mortality of patients with low, medium and high risk in TIMI score were 3.12% (3/96), 12.82% (5/39) and 23.53% (8/34); and the mortality of patients with low, medium and high risk in modified CADILLAC score were 3.19% (3/94), 7.69% (4/52) and 39.13% (9/23), respectively, all P < 0.01]. The area under the ROC curve (AUC) of the GRACE, TIMI and the modified CADILLAC scores predicting the risk of death 30 days after PCI in STEMI patients were 0.855 [95% confidence interval (95% CI) was 0.702-0.923], 0.725 (95% CI was 0.666-0.812) and 0.882 (95% CI was 0.732-0.936), respectively, all P = 0.000; the sensitivity of its prediction accuracy were 81.59%, 78.65% and 89.26%, and the specificity were 78.62%, 57.12% and 75.54%, respectively. Conclusions:The GRACE and the modified CADILLAC scores have predictive value for the short-term mortality risk of STEMI patients after PCI, and the modified CADILLAC score is more accurate. But the TIMI score has a poor predictive effect on the short-term mortality risk of STEMI patients after PCI.
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Objective: To investigate and analyze the performance of informed consent of self-expense medical expenses by medical staff. Methods: By using stratified random method, a sample of 480 medical records of medical insurance patients was selected from 40 wards of a third class A hospital in Zhejiang province in 2016. Combined with semi-open questionnaire, the performance of medical staff was investigated to do informed consent of self-expense medical expenses. Results: In general, the rate of informed consent was low, and only the rate of informing bed fee was over 70％. Medical staff thought that the effective performance of informed consent was affected by many factors, such as subjective and objective factors. Conclusion: There are still some problems in the performance of informed consent of self-expense medical expenses. It is necessary to take multi-party linkage and multi-measures interventions to improve the rate of informed consent.
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Objective To study the regulation effect of estrogen in expression of matrix metalloproteinase-9 (MMP-9) in the central nervous system (CNS) in mice with experimental autoimmune encephalomyelitis ( EAE).Methods The 60 mice were overiectomized and 2 weeks later EAE was induced with MOG35-55 peptide in these mice.They were divided into a treatment group and a control group.The treatment group was treated with estrogen and the control group was given PBS.Clinical symptoms in these two groups were scored and compared.HE staining was used to observe inflammation in the brain and spinal cord.The MMP-9 expression in the CNS was examined by quantitative real-time PCR and immunofluorescence staining.Results The incidence of disease was lower (treatment and control group were 8/30 and 28/30 respectively) and clinical symptoms were milder (treatment and control group were 3.23±0.83 and 1.62 ±1.00 respectively,t=3.811 and P＜0.05) in the treatment group than those in the control group.HE staining showed the decreased infiltration of inflammatory cell in the treatment group (Treatment group:inflammatory score were 0.895 ±0.206,0.752 ±0.302,0.732 ±0.183 in acute,relief and chronic phase respectively;Control group:inflammatory score were 3.472 ±0.635,2.881 ±0.662,1.891 ± 0.482 in acute,relief and chronic phase respectively.t = 8.622,6.543 and 5.027,all P ＜ 0.05).The quantitative real-time PCR and immunofluorescence staining showed that the expression of MMP9 in the CNS was decreased in the treatment group.Conclusion Estrogen may decrease MMP-9 expression in the CNS,reduce inflammation and clinical symptoms in mice with EAE.
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<p><b>OBJECTIVE</b>To study the hypolipidemic active compounds from Crataegus pinnatifida and mechanism of action of those.</p><p><b>METHOD</b>Guided by the inhibitory activity to HMG-CoA reductase, the active compounds were separated and purified with macroporous resin and silica gel.</p><p><b>RESULT</b>Four active compounds were obtained, which were quercetin, hyperoside, rutin and chlorogenic acid, the sum of their inhibitory rate was 50.01%, and the total inhibitory rate of the mixture of four active compounds matched was 79.48%.</p><p><b>CONCLUSION</b>Quercetin and hyperoside were the principle active components inhibiting HMG-CoA reductase in Hawthorn fruit, and there were synergistic action among them.</p>
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Crataegus , Chemistry , Fruit , Chemistry , Hydroxymethylglutaryl CoA Reductases , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Pharmacology , Plant Extracts , PharmacologyABSTRACT
Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The "rim enhancement sign" might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.
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Objective To evaluate the clinical indicat ion and effect of inferior vena cava filter. Methods 17 cases of deep venous thrombosis were treated w ith insertion of the inferior vena cava filter. In 4 cases the thrombosis were d rawn by Hydrolyser catheter with popliteal vein punction, in another the thrombo sis were analysed by Urokinase with vena dorsalis pedis injection.Results The filters were successfully inserted. No seious complication were observed. The thrombosis were discharged in 2 cases with Hydr olyser catheter ,and in 4 cases with Urokinase analyse. No pulmonary thromboembo lism was observed.Conclusion The inferior vena cava filter insertion is a e ffective method to provent pulmonary thromboembolism, and a safe step for the in tervenional therapy to the deep venous thrombosis.