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Objective To analyze the effect of clinical pharmacists involving in JCI clinical care program certification-AMI(CCPC-AMI) on the compliance rates of clinical drug treatment guideline and the awareness rates of patient medication health education in cardiovascular.Methods Selected cases of acute myocardial infarction(AMI) from March to August in 2015 was as the former group,from September 2015 to March 2016 as the latter group in their hospital,then comparative analysis of two groups was done by statistical method.Results After clinical pharmacists involved in CCPC-AMI,the compliance rates of AMI clinical drug treatment guidelines (after the AMI diagnosis, the 10min was given aspirin, intensified statin therapy and dose selection, the use of ACEI/ARB before discharge and the use of beta blocker before discharge) were increased from 92.7% 67.9%,60.7%,51.8% to 98.1%,85.2%,94.4%,90.7%.The awareness rates of patient medication health education (awareness of safe medication, awareness of self-management, awareness of follow-up knowledge) were all increased to 100% from 75.0%,57.1%,82.1% before participation.Conclusion Clinical pharmacists who carried out pharmaceutical care,has played a critical role in quality control of AMI single disease through the preparing of CCPC-AMI evaluation.
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ObjectiveTo check the isolated heart by coronary angiography to discover the location, na-ture and degree of the coronary artery lesions more accurately and increase the comprehensive evaluation ability of cardiovascular disease.MethodsTen fresh isolated hearts with different causes of death were extracted and injected with barium sulphate as contrast substance by ring injector, then developed under Xper FD20 angiography equipment. The obtained pictures and image data were handled by three-dimen-sional angiography images with the software attached to the angiography equipment. The coronary artery tissues were HE stained and observed by microscope. The HE staining results were compared with the angiographic results.ResultsThe imaging data obtained from the 10 cases for examination showed 8 cases without coronary artery stenosis and 2 cases with Ⅲ, Ⅳcoronary artery stenosis, which were consistent with HE staining results of coronary artery organization and the both results were confirmed. ConclusionIsolated coronary angiography has an unique advantage for accurate grading of classification of coronary artery stenosis, examination of vascular malformation and tiny lesions, which can provide reference for the localization of small lesions and basis during the autopsy for identification conclusion.
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Objective: To explore the correlation between genetic polymorphism of matrix metalloproteinase-9 [MMP- 9] in patients with coronary artery disease [CAD] and cardiac remodeling. Methods: A total of 272 subjects who received coronary angiography in our hospital from July 2008 to September 2013 were selected, including 172 CAD patients [CAD group] and another 100 ones [control group]. Both groups were subjected to MMP-9 and ultrasonic detections to determine vascular remodeling and atherosclerotic plaques. C1562G polymorphism of MMP-9 gene was detected, and correlation with vascular remodeling and atherosclerotic plaque was analyzed. Results: Serum MMP-9 level of CAD group [330.87+/-50.39 ng/ml] was significantly higher than that of control group [134.87+/-34.02 ng/ml] [P<0.05]. Compared with control group, CAD group had significantly higher intima-media thickness, and significantly lower systolic peak velocity, mean systolic velocity and end-diastolic velocity [P<0.05]. Total area of stenotic blood vessels was 67.34+/-22.98 mm2, while that of control blood vessels was 64.00+/-20.83 mm2. G/G, G/C and C/C genotype frequencies of MMP-9 differed significantly in the two groups [P<0.05]. G and C allele frequencies of CAD group [70.9% and 29.1%] were significantly different from those of control group [50.0% and 50.0%] [P<0.05]. G/G, G/C and C/C genotypes were manifested as lipid-rich, fibrous and calcified or ulcerated plaques respectively. Total area of stenotic blood vessels of G/G genotype significantly exceeded those of G/C and C/C genotypes [P<0.05], whereas the latter two had no significant differences. Conclusion: CAD promoted 1562C-G transformation of MMP-9 gene into genetic polymorphism, thus facilitating arterial remodeling and increasing unstable atherosclerotic plaques
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Objective To explore the effect of NPY on activation of primary microglia and the production of in?terleukin-1β. Methods Rat primary cortical microglia was cultured and divided into control group, LPS group, NPY+LPS group, NPY group and BIBP3226+NPY+LPS group. Microglia in control group were incubated with serum-free me?dium for 6 h;microglia in LPS group were incubated with serum-free medium plus LPS for 6 h;microglia in NPY+LPS group were incubated with serum-free medium plus NPY and LPS for 6 h; microglia cells in NPY group were incubat?ed in serum-free medium plus NPY for 6 h; microglia cells in BIBP3226+NPY+LPS group were incubated in se?rum-free medium including BIBP3226 、NPY and LPS for 6 h. After 6 h , Primary cultured microglia were stained us?ing IBA-1 antibody and examined under the fluorescence microscope. The protein levels of IL-1βin the culture media and the mRNA expression levels of IL-1βin the microglia of different groups were detected using the methods of Elisa and RT-PCR. Results After 6 h, the contents of IL-1 βin the culture media and the mRNA expression levels of IL-1βin the cells of LPS group increased remarkably compared with control group (P<0.05) and the microglia were activat? ed. Compared with LPS group, the contents of IL-1 βin the culture media. the mRNA expression levels of IL-1β and the activity of microglia in LPS+NPY group were significantly decreased .Compared with LPS+NPY group, the contents of IL-1βin the culture media. the mRNA expression levels of IL-1β and the activity of microglia in BIBP3226+NPY+LPS group were increased (P<0.05). There were no significant differences in the contents of IL-1βin the culture media. the mRNA expression levels of IL-1βand the activity of microglia between BIBP3226+NPY+LPS group and LPS group or between NPY group and the control group. Conclusion NPY can inhibit the biological activity of microglia and IL-1βproduction through NPY Y1 receptorin the microglia.
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Objective To summarize the clinical experience of one stage hybrid operation for aortic arch replacement and explore the indication. Methods From July,2009 to March,2010, 22 consecutive patients received one stage hybrid operation in our hybrid suite for aortic dissection or aortic aneurysm involving aortic arch. Two operative methods are used. (1)Bypass from ascending aorta to brachiocephalic arteries using midstemotomy and normothermia with antegrade aortic arch endovascular stented graft implantation. (2) Ascending aorta replacement and/or aortic valve replacement and/or coronary artery bypass grafting using midstemotomy and cardiopulmonary bypass with antegrade aortic arch endovascular stented graft implantation. Results All patients were technically successful. Angiography during the operation showed 100% patency of all the bypass grafts and no obvious translocation or endoleak of the stents. One patient in the first group died on sixth day after operation due to distal dissection rupture. There was one case of mediastinal lymph effusion in the second group and one case of death due to renal failure and respiratory failure 12 days after operation in the second group. The ICU stay and hospital stay were obviously shorter in hybrid open chest group than that in traditional open chest operation group(P ＜0.05). The blood product consumption and expenditure were also obviously less in hybrid open chest group than that in traditional open chest operation group (P ＜0.05). All the patients were followed up with a mean period of (14.45 ±2.33) months (range: 12 -20 months). All other patients were recovered with normal social life. CT showed neither endoleak nor translocation of the stented grafts. Faulse lumen closure rate at stented-graft segment is 100%. There was no obvious change of distal part of the dissection three months after operation except some thrombosis formation in some of the false lumen. Conclusion One stage hybrid operation for aortic arch replacement is safe and effective in shortening the duration of the operation and reducing the surgical trauma and risk of interval between procedures, shortening the hospital stay and reducing the blood product consumption compared with conventional operation with satisfactory early results. The midterm and long term results are still needed to be followed up.