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Objective:To explore the effect of online appointment system of standardized patients (SP) in cardiology practice teaching.Methods:The undergraduate students who entered the cardiology department of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine for clinical practice in 2018 and 2019 were selected as teaching objects, and they were divided into traditional teaching group ( n=30) and appointed SP teaching group ( n=30). After the teaching, SPSS 19.0 software was used for data analysis to compare the teaching effect of the two groups. Results:The scores of SP teaching group were higher than those of traditional teaching control group, with statistical significance ( P<0.05). Conclusion:Through constructing SP database and typical case database, online appointment system of SP for medical history inquiry and doctor-patient communication skills training can effectively solve the problems such as lack of clinical practice cases and doctor-patient contradiction, and greatly improve the teaching efficiency.
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Objective:To explore the application of optical coherence tomography (OCT) in the interventional diagnosis and treatment of intermediate coronary disease.Methods:Patients were enrolled during January 2017 to January 2019, in the Department of Cardiology, the Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine.The patient whose diagnosis was confirmed as intermediate coronary artery lesion by coronary angiography then underwent coronary OCT examination.The general information, disease history, drug use, biochemical indicators and OCT imaging indicators were collected.Results:(1)A total of 75 borderline lesions were detected in 69 patients with coronary heart disease, including 52 cases of left anterior descending artery (LAD) (75.4%), 4 cases of left circumflex artery (5.8%, 4/69), and 19 cases (27.5%, 19/69) of right coronary artery (RCA). (2) According to the analysis of the plaque characteristics of borderline lesions OCT, 7 cases were accompanied with thrombosis, 6 cases with plaque rupture, 25 cases with thin fiber cap lipid plaque, 49 cases with macrophages, 35 cases with microvascular, 35 cases with cholesterol crystallization, 3 cases with ulcer and 6 cases with intimal dissection.(3)The median of the minimum lumen area (MLA) determined by OCT was 2.9 mm 2.In the MLA<2.9 mm 2 group, C-reactive protein (CRP) ((2.92±2.44) mg/L vs.(1.98±1.30) mg/L, P=0.045), total cholesterol (TC) ((4.13±0.78) mmol/L vs.(3.74±0.75) mmol/L, P=0.041), low density lipoprotein cholesterol ((2.77±0.83) mmol/L vs.(2.22±0.78) mmol/L, P=0.007), small and dense LDL ((1.02±0.44) mmol/L vs.(0.80±0.34) mmol/L, P=0.024), lipoprotein a ((1.16±0.17) mg/L vs.(0.95±0.09) mg/L, P=0.042) were significantly higher than those in MLA≥2.9 mm 2 group.(4). According to the interventional strategy, patients were divided into two groups: percutaneous coronary intervention (PCI) group (N=16) and non-PCI group (N=59). The area stenosis (AS%) ((68.58±4.90)% vs.(63.10±7.09)%, P=0.001), diameter stenosis (DS%) ((65.65±6.91)% vs.(60.77±8.41)%, P=0.024), lipid plaque curvature ((245.3±41.0)° vs.(189.8±99.6)°, P=0.001), lipid plaque length ((19.11±6.40) mm vs.(14.72±9.30) mm, P=0.035) were deteriorated significantly in the PCI group than those in non-PCI group, the differences were all of them were statistically significant.(5)The incidence of 1-year major cardiovascular adverse events (MACE) was 6.25% in Oct guided PCI group and 5.08% in patients without PCI.There was no significant difference between the two groups ( P=0.317). Conclusion:According to the OCT assessment in the intermediate coronary lesions, it is found that the smaller the luminal area, the higher the serum LDL cholesterol level.More Interventional therapy were performed in the vulnerable plaques with large lipid cores.Decision-making for intermediate lesion was highly depended on the plaque tissue characteristics, rather than just MLA size.
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Objective:To explore the effect of online appointment system of standardized patient in cardiology practice teaching.Methods:The undergraduate students who entered the cardiology department for clinical practice in 2018 and 2019 were selected as teaching objects, and they were divided into traditional teaching group ( n=30) and appointed SP teaching group ( n=30). After the teaching, SPSS 19.0 software was used for data analysis to compare the teaching effect of the two groups. Results:The scores of SP teaching group were higher than those of traditional teaching control group, with statistical significance ( P<0.05). Conclusion:Through constructing standardized patient database and typical case database, online appointment system of standardized patient for medical history inquiry and doctor-patient communication skills training can effectively solve the problems such as lack of clinical practice cases and doctor-patient contradiction, and greatly improve the teaching efficiency.
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Objective:To study relationship among serum homocysteine (Hcy) level ,paraoxonase 1 (PON1) activity and carotid atherosclerosis .Methods:A total of 179 residents from a community of Shanghai ,who participated in cardiovascular risk factor screening from 2012 to 2014 ,were selected .They received carotid ultrasonic examination and measurements of serum Hcy ,PON1 and other biomarkers .According to serum Hcy level ,subjects were divided into elevated Hcy group (n=85) and normal Hcy group (n=94) .Results:Spearman correlation analysis indicated that serum Hcy level was significant inversely correlated with PON1 activity (r= -0.738 ,P=0.001) .Compared with normal Hcy group ,there were signifi‐cant rise in age [(60.66 ± 7.18) years vs .(64.57 ± 7.29) years] ,male proportion (27.66% vs .63.53% ) ,serum creati‐nine [(69.62 ± 12.76)μmol/L vs .(88.47 ± 20.86)μmol/L] ,uric acid [(267.85 ± 63.02)μmol/L vs .(307.51 ± 76.07)μmol/L] ,triglyceride [(1.33 ± 0.79) mmol/L vs .(1.76 ± 1.70) mmol/L]and systolic blood pressure [(134.93 ± 15.82) mmHg vs .(142.72 ± 17.86) mmHg] ,and significant reductions in levels of high density lipoprotein cholesterol [HDL‐C , (1.17 ± 0.26) mmol/L vs .(1.06 ± 0.27) mmol/L]and PON1 [(288.58 ± 73.80) kU/L vs .(187.81 ± 16.31) kU/L]in el‐evated Hcy group , P<0. 05 or <0. 01. Incidence rate of carotid atherosclerosis in elevated Hcy group was significantly higher than that of normal Hcy group (64. 7% vs .44. 7% ) , P=0. 001 .Multi‐variate gradual Logistic regression analysis indicated that serum creatinine and Hcy levels were independent risk factors for serum PON 1 activity(OR=1.055 ,1.139 , P<0.01 ,<0.05);Hcy isn′t an independent risk factor (OR=1.020 ,P=0.497) for carotid atherosclerosis .Conclusion:Serum Hcy level is significant inversely correlated with serum PON 1 activity ,and both of them are related to occurrence of carotid atherosclerosis .
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Objective To investigate the effects of acupoint therapy on inflammatory factors and its clini-cal efficacy in relieving bronchial asthma. Methods Selected patients with bronchial asthma which was in remis-sion were randomly divided into a treatment group that was treated with acupoint therapy and a control group that was given Seretide. Each group had 30 cases. The treatment period was 4 weeks. Both groups were evaluated in terms of Asthma Control Test ( ACT) scores and the serum content of interleukin-5 ( IL-5) and interleukin-10 ( IL-10) before and at one month ( short-term) , as well as three months after the end of the treatment ( long-term) . The asthma control situation ( fully controlled, partially controlled or uncontrolled) was evaluated. Results Before treatment the average ACT scores of the two groups were not significantly different. After the treatment both the short-term and long-term average ACT scores of the treatment group were significantly higher than those of the con-trol group. The total effectiveness rate of asthma control in the treatment group in the short term ( 93%) was signifi-cantly higher than that in the control group ( 70%) . After the treatment the IL-5 and IL-10 levels in the treatment group were improved to a significantly greater extent than those in the control group. Conclusion Acupoint thera-py can reduce airway inflammation, control bronchial asthma symptoms and show good clinical efficacy, probably by regulating IL-5 and IL-10 levels.
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Objective To explore the effects of smoking on serum paraoxonase1 (PON1) activity and carotid atherosclerosis.Methods 478 subjects from residents of health screening for cardiovascular disease were enrolled from June 2012 to July 2014 in Huangpu district,shanghai.Smoking,drinking,exercise and cardiovascular disease risk factor data were recorded and gathered.All subjects accepted carotid artery ultrasound examination and were measured serum PON1 activity.The lowest quartile of serum PON1 activity level was taken as low PON1 activity level.Results (1) Serum PON1 activity in smokers was lower than that in non-smokers ((206.5±25.6) kU/L vs (230.9±38.1)kU/L,P＜0.01),incidence of carotid artery atherosclerosis in smoking group was higher than non-smoking group(75.7％ vs 56.1％,P＜0.01).(2) Multivariate logistic regression analyses indicated smoking,lack of exercise,creatinine,LDL-C were the independence factors of PON1 activity.(3) Multivariate logistic regression analyses indicated smoking,serum PON1 activity,age,gender,systolic pressure,were the independence factors of carotid atherosclerosis.Conclusion Smoking reduces serum activity.Smoking and lower serum PON1 activity level are independent risk factors of carotid atherosclerosis.
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Objective To discuss the anxiety and panic disorder in the patients with cardiovascular diseases. Method To analyze the incidental rate, diagnostic criteria, clinical manifestations and treatment in the anxiety and panic disorders with cardiovascular diseases. Result The incidental rate of anxiety and panic attack in the patients with cardiovascular diseases is high. The common clinical manifestation including chest pain, hypertension, tachycardia, arrhythmia and symptoms similar with left heart failure. Conclusion Physicians ought to improve their ability in identifying the anxiety and panic disorders with cardiovascular diseases.
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Objective: To observe the effects of propofol on lipid peroxides(LPO)and superoxide diomutase(SOD) during open heart surgery. Method: Twenty patients undergoing cardiac valve replacement, were diviced into two groups: propofol group and etomidate group. The serum samples were taken to measure LPO and SOD lerels before and after ischemic reperfusion,and recorded ECG and MAP. Result: The serum LPO level decreased sign ficantly during aortic cannulation,and increased after aortic cross-release in propofol group(P