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OBJECTIVE： To observe the efficacy and safety of Bufei huoxue capsules combined with Azithromycin tablets in the treatment of patients with stable COPD. METHODS： Totally 140 patients with stable COPD were collected from Anhui Chest Hospital during Jun. 2014-Feb. 2018， and then divided into control group and observation group according to random number table， with 70 cases in each group. Both groups received smoking cessation intervention and symptomatic treatment. Control group was additionally given Tiotropium bromide powder for inhalation， once a day+Azithromycin tablets 0.25 g， twice a week. Observation group were additionally given Bufei huoxue capsules 4 pills， 3 times a day， on the basis of control group. Both groups were treated for 180 d continuously. The clinical efficacies of 2 groups were observed， and the levels of serum inflammatory factors （CRP， IL-6 and TNF-α）， lung function related indexes （PEF， FEV1 and FEV1/FVC） and COPD related symptoms （time of AECOPD attack and 6MWT） were observed before and after treatment. The occurrence of ADR was recorded. RESULTS： Totally 9 cases withdrew from the study in control group， and 3 cases in observation group. A total of 128 cases （61 cases in control group， 67 cases in observation group） completed the study. Total response rate was 92.54％ in observation group， which was significantly higher than 80.33％ in control group（P＜0.05）. Before treatment， there was no statistical significance in the levels of serum inflammatory factors， lung function related indexes or COPD related symptoms （P＞0.05）. After treatment， the levels of CRP， IL-6 and TNF-α in 2 groups were decreased significantly， and the times of AECOPD attack were decreased significantly； observation group was significantly lower or less than control group. PEF， FEV1 and FEV1/FVC were increased significantly in 2 groups and 6MWT was prolonged significantly； observation group was significantly higher or longer than control group （P＜0.05）. One case suffered from skin rash in control group， and two cases had mild nausea in observation group； no severe ADR was found in both groups. CONCLUSIONS： Bufei huoxue capsules combined with Azithromycin tablets can significantly reduce the level of serum inflammatory factors of stable COPD patients， improve their lung function， and relieve clinical symptoms with good safety.
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Objective To understand the status of Toxoplasma gondii infection in the population of Pu er City so as to pro-vide the evidence for formulating the strategy of toxoplasmosis control. Methods The population from Jingdong Jinggu and Menglian counties in Pu er City was surveyed IgG of T. gondii in serum was detected by ELISA. Results Totally 906 resident serum samples were detected and the IgG positive rate was 24.2%. The positive rates were higher in the aged groups of 30-39 years and 60-69 years and the difference among different aged groups was significant χ2=17.77 P 0.01 . There were no si-gnificant differences between different sexualities and among different educational levels and living habits P 0.05 . The posi-tive rates were 26.6% 194/730 15.5% 22/142 and 8.8% 3/34 in farmers students and other occupations respectively and there was a significant difference among them χ2=12.51 P 0.01 . The positive rates were 23.3% 198/849 and 36.8%21/57 in the farmers who had the habit of rearing pigs in pens and the farmers who had the habit of free ranging pigs respec-tively and there was a significant difference between them χ2=5.33 P 0.05 . Conclusion The IgG positive rate of T. go-ndii is very high in Pu er City and therefore the health education for toxoplasmosis control should be strengthened.
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Objective To analyze the clinical features of patients with acute ST-elevation myocardial infarction treated with percutaneous coronary intervention (PCI) complicating to intraoperative reperfusion arrhythmias (RA).Methods A total of 175 patients with acute ST-elevation myocardial infarction were treated with PCI performed from January 2008 to September 2013.According to the occurrence of RA following PCI,the patients were divided into RA group and non-RA (NRA) group.Comparison of myocardial enzymes,peak troponin,the elevated ST segment returning back,length of hospital stay,incidence of adverse events such as cardiac death,shock,heart failure during hospitalization and within a month of postoperative period was carried out between groups,and the findings from echocardiography on the 30th day after PCI were also compared between two groups.Results PCI time window in RA group was significantly earlier than that of NRA group,and reperfusion arrhythmia was effectively controlled.Compared with NRA group,RA group had greater extent of ST segment normalized,and tbe incidence of adverse events was lower.On the 30th day after PCI,RA group had shorter duration of left ventricular diastole,and reduced left ventricular cavity dimensions and higher ejection fraction (LVEF) value.Conclusions Reperfusion arrhythmias occur immediately after PCI in patients with acute myocardial infarction,but as long as the PCI carried out timely,the prognosis is good.
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Objective To study the prognostic value of fragmented QRS (fQRS) in the recurrence of cardiac events in acute STEMI patients underwent emergency percutaneous coronary intervention (PCI). Methods Ninety-two acute STEMI patients who underwent emergency PCI were enrolled. The presence of fQRS was evaluated by a 12-lead ECG in 72 h after PCI. Cardiac events (myocardial infarction, need for revascularization or cardiac death) and all-cause mortality were recorded in all patients during 12 months follow-up. Results Cardiac event rate[15 (31.3%) vs. 4 (9.1%)]were higher in the fQRS group (n=48) compared with the non-fQRS group (n=44) during a mean follow-up of 12 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events in the fQRS group (P < 0.004). The results of Cox regression model analysis revealed that signiifcant fQRS was an independent signiifcant predictor for cardiac events (HR 2.19, 95%CI 1.38-3.50, P=0.023). Conclusions The presence fQRS is an independent risk factor for poor prognosis in STEMI patients undergoing emergency PCI.
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Objective To understand the prevalence of human intestinal parasite infections in Lahu Ethnic residents so as to provide the evidence for effective control. Methods The prevalence of soil-transmitted nematode infections in local people was determined by Kato-Katz technique and individual sanitary behaviors and habits were requested by a standardized questionnaire in 3 villages of Xiaojie Township,Jinghong City,Yunnan Province. The relationship between intestinal parasite infections and behav-ioral characteristics was analyzed. Results Of 289 subjects,255 individuals were infected with soil-transmitted nematodes;the prevalence was 88.24%. Among the infected individuals,210 were found infected with hookworm and the infection rate was 72.66%;154 subjects were infected with Ascaris lumbricoides and the infection rate was 53.29%;13 were infected with Trichuris trichura,and the infection rate was 4.50%;16 were infected with other parasites and the infection rate was 5.54%. The percentag-es of people with light infection of hookworm,A. lumbricoides and T. trichura were 90.48%,97.40%and 100%,respectively. Con-clusions There is high prevalence of soil-transmitted nematode infections in Lahu Ethnic residents in Jinghong City,but the in-fection intensity was generally low. The control and monitoring of soil-transmitted parasite infections should be strengthened in this area.
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Objective To evaluate role of intracoronary electrocardiogram (IcECG) in examining early myocardial damage during elective percutaneous coronary intervention (PCI). Methods Eighty-six patients of coronary heart disease with normal serum levels of creatine kinase-myoglobin (CK-MB) and cardiac troponin T (cTnT) before the procedure and undergone elective PCI were enrolled in the study.Their IcECG were recorded by a intracoronary guidewire and serum levels of CK-MB and cTnT were measured at baseline and eight and 24 hours after the procedure, respectively. The patients were divided into two group, abnormal and control, according to whether they had significant shift at ST-segment in IcECG.Cardiac events after intervention in the patients were followed-up and recorded. Myocardial damage was defined as serum level of cTnT increased to above the upper normal value after intervention. Results Significant shift at ST-segment in IcECG during PCI in 30 (35%, abnormal group) and no shift in other 56patients (65%, control group) of 86 patients with normal serum levels of cardiac markers before the procedure was observed, and all the procedure were successful Serum levels of cTuT and CK-MB significantly increased after intervention in 30 patients of abnormal group than those in control one ( P <0. 01 ). Sensitivity of intracoronary ST-segment shift was 77 percent for predicting myocardial damage, and specificity was 94 percent, with positive and negative predictive values of 90 percent and 86 percent,respectively. More cardiac events were observed at 4-week follow-up after intervention in abnormal group than those in control one (P<0. 05) and major coronary event-free survival was significantly lower in those with post-procedural ST-segment elevation in IeECG (P < 0. 05). Conclusions ST-segment shift in IcECG may be helpful for predicting myocardial damage during PCI procedure on time.
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Objective To evaluate, the long-term results of pacemaker implantation in 122 elderly patients. Methods A long-term follow-up was carried out in 122 elderly patients (≥ 70 years old, elderly group)and 109 non-elderly patients (< 70 years old,non-elderly group)who received pacemaker implantation. The elinical characteristics, complications and quality of life were compared. Results The mean follow-up time was (8.22±6.01) years and (7.74±5.82) years respectively. The successful rate of the follow-up was 100%. The overall postoperative complications about pacemaker pocket and the prevalence of atrial fibrillation occurred in elderly group were higher than those in non-elderly group (4.10% vs 0, 21.31% vs 10.09%, P< 0.05).The heart function failure was the main cause of the death in elderly group. The stroke and uremia were the main causes of the death in non-elderly group. There was no significant difference in the improvement of the life quality in both groups (P>0.05). Conclusions The pacemaker implantation is a safe and effective therapy for treatment of elderly patients with bradyeardia, and can improve the quality of elderly patients' life. Optimal mode for elderly patients will be given according to the physiological characteristics and the types of bradycardia.