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Objective:To investigate the effect of the application of "internet +" disease management based on the AISAS model on the young and middle-aged patients after PCI therapy.Method:A total of 90 young and middle-aged patients hospitalized in cardiological department of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) were enrolled between June 2018 to October 2019, and they were randomly divided into observation group and control group with 45 cases in each group. Patients in the control group received telephone follow-up while "internet +" disease management based on the AISAS model was applied in the observation group. The drug therapy compliance, acquisition of the disease knowledge, quality of life, anxiety and depression levels, return to workand incidence of cardiovascular events.Results:One year after the intervention, the drug therapy compliance score, disease-related knowledge score, quality of life score, SAS and SDS scores of the observation group were 7.55±1.21, 7.29±1.27, 701.17±74.86, 32.55± 4.31, 34.74±4.16, the scores of patients in the control group were 6.48±1.56, 6.12±1.94, 670.58±65.29, 41.72±4.33, 40.79±4.17. The difference was statistically significant ( t value was 2.066-11.203, P<0.05). The comparison between the return of the patients and the incidence of cardiovascular events in the two groups was statistically significant ( χ2 value was 5.031, 11.275, P<0.05). Conclusion:This management model can increase the knowledge of disease PCI postoperative patients, improve their quality of life, make patients return to society earlier, and promote the improvement of the quality of continuous nursing service.
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Objective To investigate the effect of optimizing rescue time for patients with acute st-elevation myocardial infarction (STEMI) in the hospital. Methods A retrospective analysis of the clinical data of 133 patients with ST-elevation myocardial infarction who were hospitalized in the first affiliated hospital of university of science and technology of china during July,2016 to June,2017 was performed. Timeline in the rescue, the result of coronary reperfusion and satisfaction degree of patients were analyzed. Results The rapid evaluation time (F=2.609, P=0.046),emergency handling time(F=7.581, P=0.032), login and logout time (F=5.667, P=0.017)and visit-ballon time (F=8.942, P=0.007) were shortened quarter by quarter . The average time of each project in the four quarters showed a statistically significant difference. The difference of TIMI classification of coronary flow reperfusion among the four quarters was statistically significant (H=8.402, P=0.038). The satisfaction degree of each quarter showed a statistically significant difference (the third quarter of 2016:94.68±2.38, the fourth quarter of 2016:96.72± 5.10, the first quarter of 2017:97.23 ± 7.64,the second quarter of 2017:98.36 ± 4.86;F=7.891,P=0.048). Conclusions Enhancing timeliness of emergency care can remarkably shorten rescue time, improve satisfaction degree of patients and help to improve the success rate of emergency treatment for patients with STEMI.
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BACKGROUND:Bone morphogenetic protein-2 (BMP-2) is a key to bone formation and repair.However,it has some disadvantages such as easy to lose and degrade and difficult to sustain continuous effect.OBJECTIVE:To study the preparation and properties of silk fibroin/chitosan/nano-hydroxyapatite (SF/CS/nHA) scaffold loading BMP-2.METHODS:After silk degumming,dissolution and purification,2％ SF solution was obtained.BMP-2 was dissolved in 2％ CS solution,and then fully mixed with equal volume of SF solution and proper amount of nHA.At last,the SF/CS/nHA scaffold loading BMP-2 was prepared using freeze-drying method as experimental group.The SF/CS/nHA scaffold was soaked in the BMP-2 solution as control group.The scaffold porosity was measured by Archimedes method,the surface morphology of the scaffold was observed by scanning electron microscope,the compressive strength was measured by universal testing machine.Scaffolds in the two groups were soaked in PBS,and the release of BMP-2 was measured by ELISA method at different time points.RESULTS AND CONCLUSION:(1) The scaffolds in the two groups had irregular porous structure,interconnected pores and uneven pore wall.There was no significant difference between the two groups in mean pore diameter,porosity and maximum compressive strength.(2) On the 1st day,the release rate of BMP-2 was 4.63％ in the experimental group,and the release curve increased slowly.After 28 days,the release curve of BMP-2 was transferred to the plateau stage.But in the control group,the release rate of BMP-2 on the 1stday was 58.84％,and it was a significant initial burst release.The release curve increased rapidly,and was transferred to the platform stage on the 10th day.The release rate of BMP-2 release was significantly different between the two groups at days 1,2,4,10 (P ＜ 0.05).These results show that the SF/CS/nHA scaffold loading BMP-2 could sustainably and slowly release BMP-2.
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Objective To investigate the influence of recombinant human bone morphogenetic protein‐2(rhBMP‐2)of poly lactic acid(PLA) release microspheres for compatibility of rabbit bone marrow mesenchymal stem cells(BMSCs) .Methods The rh‐BMP‐2‐PLA release microspheres were prepared by w/o/w multiple emulsion volatilizing method and then cocultured BMSCs .The effects of rhBM P‐2‐PLA release microspheres on the cytotoxicity and relative proliferation rate by MTTassay .Evaluation of mate‐rials biocompatibility by inverted microscope and scanning electron microscope(SEM) .Results The rhBMP‐2‐PLA release micro‐spheres in various concentration of leaching solution and BMSCs training of uninfected cells .Experimental group and control group in 4 different time cell proliferation OD values by analysis of repeated measurement variance between time OD values were statisti‐cally significant(P=0 .000) ,the experimental group and control group OD values are statistically significant(P=0 .025) ,the exper‐imental group higher than the control group ,experimental group OD value time there was a significant interaction effect and the group number ,the change trend are obviously different(P=0 .006) .Inverted microscope to observe materials normal cell prolifera‐tion ,SEM found that vaccination cells surrounding rhBMP‐2‐PLA release microspheres of 7 days later ,the cells grew well and split proliferation activity .Conclusion rhBMP‐2‐PLA release microspheres of BMSCs has non‐toxic and has compatibility .
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Objective: To observe the efifcacy and safety of bivalirudin on primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). Methods: A total of 159 patients with acute STEMI treated by emergent PCI in our hospital from 2011-09 to 2014-01 were retrospectively studied. The patients were divided into 2 groups according to procedural bivalirudin application as Bivalirudin group and Heparin group, and the application of GPI (glycoprotein IIb/IIIa inhibitor) was decided by the operator. The baseline condition, coronary artery imaging condition, peri-operative and 30-day post-operative bleeding, the occurrence rate of MACE were compared between 2 groups. Results: There were 153 patients completed the follow-up study including 72 in Bivalirudin group and 81 in Heparin group. The peri-operative bleeding rates in Bivalirudin group and Heparin group were 6.5% vs 11.0%, the in-stent thrombosis rates were 0% vs 1.2%, 30-day post-operative bleeding rates were 9.7% vs 13.5% and the occurrence of MACE were 1.4% vs 7.4% allP>0.05. Conclusion: THE application of bivalirudin in emergent PCI is safe and effective in patients with acute STEMI, it has certain trend to reduce bleeding in relevant patients.
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BACKGROUND:The low oxygen environment after femoral fracture and cerebral trauma wil induce series of related cytokines expression, including hypoxia-inducible factor 1αand core binding factorα1, which play key roles in regulating bone healing. However, whether the accelerated bone healing is correlated with the expression of hypoxia-inducible factor 1αand core binding factorα1 is stil unknown. OBJECTIVE:To construct rat models of brain injury, to compare the expression level of hypoxia-inducible factor 1αand core binding factorα1 in femoral fracture combined with cerebral trauma rats and simple femoral fracture rats, and to assess the influence of cerebral trauma on bone healing. METHODS:Rats were randomly divided into blank group, simple femoral fracture group and femoral fracture combined with cerebral trauma group. At 1, 2, 3 and 5 weeks after modeling, rats were executed. Bone healing was evaluated using femoral fracture end X-ray score and hematoxylin and eosin staining at cal us tissues. Besides, the expression levels of hypoxia-inducible factor 1αand core binding factorα1 of three groups were determined with immunohistochemistry. RESULTS AND CONCLUSION:Bone healing in the femoral fracture combined with cerebral trauma group was better than that of simple femoral fracture group. There was significant difference in the expression level of hypoxia-inducible factor 1αand core binding factorα1 between the simple femoral fracture group and femoral fracture combined with cerebral trauma group (P<0.05). At the same time, the level of simple femoral fracture group and femoral fracture combined with cerebral trauma group was significantly higher than that of blank group, and that in femoral fracture combined with cerebral trauma group was significantly higher than that of simple femoral fracture group (P<0.05). Results verified that the expression levels of hypoxia-inducible factor 1αand core binding factorα1 of rats with femoral fracture combined with cerebral trauma were significantly high, which may be the major reason why the bone healing was accelerated after fracture combined with brain injury.
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Objective To study the relationship between histological activity index and serum of tumor nec-rosis factor-α( TNF-α) ,peripheral blood T cell subsets in patients with chronic hepatitis B.Methods Histopatholog-ical examinations were performed in 237 patients with chronic hepatitis B and 12 controls.The histological activity index( HAI) were analyzed by knodels method.These patients were divided into the four groups according to histologi-cal activity index classification:the control group(n=12),mild group(n=67),moderate group(n=89),and severe group(n=81).The serum levels of TNF-αwere determined by ELISA,and peripheral blood T cell subsets were ana-lyzed by flow cytometry.Results The serum level of TNF-αin the mild group[(29.65 ±10.15)μg/L],moderate group[(38.96 ±7.32)μg/L]and severe group[(47.73 ±6.99)μg/L]were higher than those in the control group [(13.78 ±6.40)μg/L](q=14.38,19.97,24.83,all P<0.05),significant positive correlation lied between the histological activity index classification and the serum level of TNF-α(r=0.708,P<0.05).The rate of CD8+cells in the moderate group[(27.66 ±6.63)μg/L]and the severe group[(28.98 ±5.92)μg/L]were higher than those in the control group[(22.32 ±1.84)μg/L](q=3.84,4.76,all P<0.05),and the ratio of CD4+/CD8+in the moderate group(1.32 ±0.37) and the severe group(1.19 ±0.30) were lower than those in the control group(1.67 ±0.14) (q=4.20,5.72,all P<0.05),but the rate of CD8+cells and the ratio of CD4+/CD8+showed no significance among the mild group,moderate group and severe group.Conclusion TNF-αand disorder of cellular immunity may play an important role in the development and progression of intrahepatic vascular lesion.
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BACKGROUND:Poly lactic acid as an excellent delivery has good biocompatibility. OBJECTIVE:To prepare recombinant human bone morphogenetic protein-2 (rhBMP-2)/poly lactic acid (PLA) sustained release microspheres, and to study its physical and chemical properties. METHODS:The rhBMP-2/PLA sustained release microspheres were prepared using w/o/w solvent evaporation method. Scanning electron microscopy, laser particle size, zeta potential, and swel ing properties were detected. ELISA kit was utilized for measurement of encapsulation efficiency, drug-loading rate and in vitro drug release rate. RESULTS AND CONCLUSION:Under the scanning electron microscope, rhBMP-2/PLA sustained release microspheres were approximately circle with excellent dispersion. The uniform spheres were visible with a mean particle size of 839.6 nm. The zeta potential were (-32.93±3.74) mV. The swel ing coefficient was 1.157±0.059. The drug-loading rate and encapsulation efficiency of rhBMP-2/PLA sustained release microspheres were (88.943±2.878)%and (0.026±0.001)%respectively. The drug release rate at 1 day was about 10.199%, then the drug release was relatively constant, and til 19 days, the cumulative drug release rate was 54.643%. These findings indicate that the constructed rhBMP-2/PLA sustained release microspheres meet the requirement of the Chinese Pharmacopoeia (10th edition) that the encapsulation efficiency is not less than 80%and the microspheres have a good slow-release function in vitro.
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BACKGROUND:Silk fibroin/chitosan/nano hydroxyapatite (SF/CS/nHA) composite scaffold constructed in preliminary experiments has good physical and chemical properties. OBJECTIVE:To study the capacity and mechanism of SF/CS/nHA composite scaffold for repair of rabbit radial bone defects. METHODS:Thirty-six New Zealand white rabbits were selected to make animal models of right radial bone defects, and then randomly divided into SF/CS/nHA group, SF/CS group and blank control group. Blank control group had no treatment after modeling. X-ray radiography, gross observation and histopathological observation were performed at 4, 8, 12, 16 weeks postoperatively. RESULTS AND CONCLUSION:Sixteen weeks after surgery, bone defects in the SF/CS/nHA group were completed replaced by normal bone tissue on X-ray images, and the bone marrow cavity showed complete recanalization with new bone formation;hematoxylin-eosin staining showed bone trabecula and many fusiform bone cells. In the SF/CS group, the bone mineral density in the defect area was slightly lower than that of the normal bone tissues, the bone marrow cavity was partly rehabilitated, and many chondrocytes were seen around bone cells that arranged irregularly with no bone trabecula or bone lamel a. In the blank control group, the images of bone calcification were consistent with normal bone tissues, and a closed bone ununion was formed at each end;hematoxylin-eosin staining showed that the blank control group was fil ed by fibrous connective tissue and a smal amount of bone-like tissues. SF/CS/nHA composite scaffold is better for repair of rabbit radial bone defects.
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BACKGROUND:Silk fibroin, chitosan, and nano hydroxyapatite are natural materials, and they al have good biological activity and physical or chemical properties. As tissue engineering materials, they have been already widely used in clinic or research work, but there are some defects in the application of these three kinds of materials. OBJECTIVE:To discuss the preparation and characteristics of silk fibroin/chitosan/nano hydroxyapatite complicated scaffolds which could be used in bone tissue engineering. METHODS:Silk fibroin, chitosan, and nano hydroxyapatite were separately prepared into 2%solution, and then mixed at the ratio of 1:1:0.5, 1:1:1, 1:1:1.5 respectively. The three-dimensional complicated scaffolds were prepared by those mixed liquids through repeated freeze drying and chemical crosslinking technology. Scanning electron microscope was used to detect the pore size of the scaffolds. Porosity, water absorption rate, and hot-water loss rate were determined. Mechanical tester was used to measure the tensile and compressive modulus of dried three-dimensional scaffolds. RESULTS AND CONCLUSION:The silk fibroin/chitosan/nano hydroxyapatite complicated scaffold in the dry state had no special smel , appeared to be a stabilized solid cylinder, and exhibited clear resiliency and flexibility with a touch. With the increased content of nano hydroxyapatite, the porosity, water absorption rate and average pore size of the scaffolds appeared to be decreased, while the hot-water loss rate and compressive strength were increased. The scaffold prepared at 1:1:1 was better for bone tissue engineering, and the average pore size, water absorption rate and hot-water loss rate were 85.67 μm, (135.65±4.56)%and (22.84±1.06)%, respectively, closer to the needs of the bone tissue engineering. Uniform pores were found within the scaffold at 1:1:1, showing the network structure, developed transport among pores, and the network structure was approximately 10μm.
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AIM: To investigate the effects and mechanisms of atorvastatin on myocardial fibrosis induced by aldosterone in SD rats. METHODS: Forty male uninephrectomized SD rats were limited to drink 1% NaCl water for 4 weeks and assigned to the follow groups: vehicle control rats (CON group);aldosterone treated rats (ALD group);spironolactone + aldosterone treated rats(SPI+ALD group);atorvastatin + aldosterone treated rats (ATO+ALD group). Blood pressure was measured by catheterization. Expression of platelet-derived growth factor (PDGF-A, PDGF-B), platelet-derived growth factor receptor (PDGFR-α, PDGFR-β) and ectodermal dysplasia-1 (ED-1) were analyzed by immunohistochemistry. Collagen volume fraction (CVF) and perivascular collagen area (PVCA) were analyzed by Sirius-Red staining. Myocardium osteopontin protein was detected by Western blotting analysis. RESULTS: Mean arterial blood pressure in ALD group, SPI+ALD group and ATO+ALD group was elevated, and significant difference was observed between the three groups and vehicle control group (P<0.01 or P<0.05). Myocardial fibrosis was observed in ALD group. Compared to other three groups, the index of CVF and PVCA was increased significantly (P<0.01 or P<0.05). No significant difference of the index of CVF and PVCA between ATO+ALD group and SPI+ALD group was observed (P>0.05). Compared to other groups, the levels of PDGF-A, PDGF-B, PDGFR-α, ED-1 and OPN in ALD group were significantly increased (P<0.01 or P<0.05). The levels of PDGF-A, PDGF-B, PDGFR-α and OPN were no significant difference between ATO+ALD group and SPI+ALD group (P<0.01 or P<0.05). However, the level of ED-1 in ATO+ALD group was significantly decreased compared to SPI+ALD group (P<0.05). No significant difference of PDGFR-β level among four groups was found (P>0.05). CONCLUSION: These results suggest that atorvastatin may attenuate myocardial fibrosis induced by aldosterone. The mechanisms concern with reduction of macrophage infiltration, expression of inflammatory cytokines OPN, partially inhibition of platelet-derived growth factor and its receptor expression.
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Objective To evaluate the association between parameters of heart rate turbulence (HRT) and the severity of the coronary arteries disease. Methods 60 patients with unstable angina pectoris (UAP) who under-went angiographic examination and 40 healthy controls were chosen. HRT including turbulence onset (TO), turbu-lence slope (TS) and turbulence dynamicity (TD) were determined by 24 h ambulatory electrocardiogram(Hoher) in all the patients. The value of above indices were compared between UAP group and control group,and between subgroups of UAP. The correlation of HRT with the severity of coronary arteries diseases was analyzed. Results The levels of TO and TD in patients with UAP were significantly higher than those in controls [(1.18±0.88) % vs lower TS (P<0.05) and higher TD (P<0.05 ) than those in patients with coronary single vessel lesion. The same -0.296, P<0.05 ) and coronary artery stenosis score (r=-0.372, P<0.05 ) ; TD was positively correlated with number of abnormal coronary artery (r=0.353, P<0.01 ) and coronary artery stenosis score (r=0.510, P < 0.05). Conclusion . HRT is impaired in patients with UAP,especially the changes of TS and TD is signflcant,and is correlated with the severity of coronary arteries disease. TD is not influenced by premature ventricualr contractionheart rate so the combinatoin of TD and TS might be used as objective index in predicting the severity of the coronary arteries disease.
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Objective To investigate the effect of persistent ST-segment elevation after successful direct percutanous coronary intervention (PCI) on the late phase of left ventricular (LV) systolic function in acute anterior wall myocardial infarction.Methods Serial electrocardiograms were record before PCI and 1 hour after reperfusion in 72 patients with acute anterior wall myocardial infarction. The reduction of ST-segment elevation after successful PCI more than 50% was defined as ST-segment resolution (ST reduction group). Persistent ST-segment elevation was defined as ≥50% of peak ST elevation (ST elevation group). Echocardiography was performed on 2 to 3 weeks (early phase) and 5 to 6 months(late phase)after PCI to evaluate the LV function and ventricular wall motion abnormality (VWMA). Results Fifty-three patients (74%) had early ST segment elevation resolution and 19 patients (26%) did not. The LV function and VWMA were similar in two groups during early phase. But during the late phase, ST elevation group patients had lower LVEF and higher LVEDVI, LVESVI, VWMA index compared with ST reduction group (P
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0.05).MMP-9 reached the peak at 1 month after PCI in DM group,and had significant difference compared with the concentration before or 24h after PCI in DM group 34.74?10.70 ?g/L vs 19.64?6.03 ?g/L,20.00?7.06 ?g/L(P
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AIM:To observe the protective effect of Nano-Se on myocardium of experimental diabetes mice.METHODS:Sixty healthy male KM mice were chosen,ten of which were selected randomly as the normal control group.After fasted for 24 h,the rest 50 mice were injected with streptozotocin(STZ,50 mg/kg)intraperitoneally for 5 d.At 7th d,the blood-sugar was measured from vena caudalis,40 mice,of which blood-sugar exceeded 16.65mmol/L,were selected and randomized into 4 groups:the positive control group,low dose(25 ?g/kg)Nano-Se group,mid dose(50 ?g/kg)Nano-Se group,high dose(50 ?g/kg)Nano-Se group.All mice were given intragastric administration of 0.2 mL normal saline and corresponding dose of Nano-Se.The body weights were measured every week,and the dose of which was adjusted according to the change of the body weights.8 weeks later,the mice were killed and cardiac muscle of the left ventricle was taken.The myocardium was prepared to 10% homogenate for measuring SOD,GSH-Px activity and MDA content.The myocardial cell apoptosis was measured by TUNEL.The expressions of Bc1-2 and Bax proteins were determined by immunohistochemistry.RESULTS:Compared to normal group,the SOD and GSH-Px activities in positive control group decreased,MDA level increased,the rate of myocardial cell apoptosis increased significantly,Bc1-2 protein expression deceased and Bax protein expression increased.Compared to positive control group,the SOD and GSH-Px activities in low and mid dose Nano-Se groups expression increased,MDA level decreased,myocardial cell apoptosis rate decreased,Bc1-2 protein expression increased and Bax protein expression decreased.Moreover,the SOD and GSH-Px activities in high dose Nano-Se group decreased obviously compared to those in mid dose Nano-Se group.MDA level and myocardial cell apoptosis rate increased,Bc1-2 protein expression decreased and Bax protein expression increased,no significant difference in SOD,GSH-Px activity,MDA level and myocardial cell apoptosis rate was observed compared with positive control group.CONCLUSION:The damage of cardiac muscle is alleviated when a certain dose of Nano-Se is supplied to diabetes mice.The protective mechanism may be related to antioxidation,blood-sugar adjustment and the increase of Bc1-2 expressing.
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Aim To investigate the cardioprotective effects and the possible mechanism of trimetazidine in the risky areas during late reperfusion after acute myocardial infarction in canine.Methods Twenty-four adult dogs were randomized into three groups:sham operation group(n=8),late reperfusion group(LR,n=8),late reperfusion after trimetazidine treatment group(LR+TMZ,n=8).Physiological saline was orally given in the sham operation group and LR group and trimetazidine(2 mg?kg-1?d-1) in the LR+TMZ group for fourteen days.After that later,all chests were opened and coronary areteries were exposed.Exceptly shame operation group,the late reperfusion of acute myocardial infarction model was made by ligating the coronary for 10 h,followed by reperfusion of 10 h.Apoptotic index were detected by TUNEL.The Bcl-2,Bax,Cytochrome C and apoptosis-inducing factor(AIF) proteins were detected by immunohistochemistry.Results Compared with those of LR group,myocardial apoptotic index and the expression of Bax,Cytochrome C and AIF proteins in LR+TMZ decreased significantly(all P
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Aim To compare cardioprotection effects between carvedilol and metoprolol in canine late reperfusion of acute myocardial infarction.Methods Eighteen anesthetized dogs were randomly divided into three groups: late reperfusion group(LR,n=6),late reperfusion after metoprolol treatment group(LR+M,n=6),and late reperfusion after carvedilol treatment group(LR+C,n=6),respectively orally giving physiological saline,metoprolol(1 mg?kg~(-1)?d~(-1)),and carvedilol(1 mg?kg~(-1)?d~(-1)) for seven days,and then late reperfusion of acute myocardial infarction model was made by ligating the coronary for 6 h,followed by reperfusion for 6 h.SOD,GR activity and MDA content of infarction brim myocardium were detected by colorimetry,Fas/FasL were detected by immunohistochemistry,apoptosis index(AI) were detected by TUNEL.Results Compared with LR,Myocardial MDA content in LR+C was decreased,and SOD and GR activities were significantly higher,but LR+M did not change.The expression of Fas/FasL and apoptosis index were significantly lowered in LR+M and LR+C,especially in LR+C.Conclusion Carvedilol and metoprolol have cardioprotection on late reperfusion of acute myocardial infarction,and carvedilol is superior to metoprolol and the pharmacological effects may due to its antioxidant effect.