The relationship between carotid intima-media thickness and coronary atherosclerosis plaque in asymptomatic individuals / 中国医师进修杂志

Objective To investigate the relationship between carotid intima-media thickness (IMT) and coronary atherosclerosis plaque through coronary CT angiography (CTA) in asymptomatic individuals.Methods Two hundred and fifty cases with CTA screened were selected in asymptomatic individuals,and according to the inspection result they were divided into no plaque group (detection of no coronary atherosclerosis plaque,180 cases) and plaque group (detection of coronary atherosclerosis plaque,70 cases).All cases were checked carotid IMT with B-ultrasonic.Results ANOVAs analysis showed that age and body mass index (BMI) had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).x2 test was used to show the smoking and family history of coronary heart disease had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Univariate Logistic regression analysis showed that carotid IMT,systolic pressure,diastolic pressure,low density lipoprotein cholesterol,fasting serum glucose and creatinine had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Multifactor Logistic regression analysis showed that carotid IMT had correlation with coronary atherosclerosis plaque (P ＜ 0.05).Conclusion There is significant relationship between carotid IMT and coronary atherosclerosis plaque in asymptomatic individuals.

Integrated regional network construction for ST-segment elevation myocardial infarction care / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of establishing an integrated regional network for ST-segment elevation myocardial infarction (STEMI) care in China and evaluate the implementation effect of this network.</p><p><b>METHODS</b>Based on real-time electrocardiogram transmission technology, we established an integrated regional network for STEMI care (IRN-STEMI) with Xiamen Heart Center as the core center, 120 Emergency Systems, PCI-capable hospitals and other community health units as core elements of this network. Reperfusion treatment data of Xiamen Heart Center including the number of patients receiving primary percutaneous coronary intervention (PCI), the mean first medical contact to balloon (FMC-to-B) time, the mean door to balloon (D-to-B) time, the mean length of hospital stay, the mean medical cost and in-hospital mortality were compared before (n = 165) and at 1 year after the built-up of IRN-STEMI (n = 343).</p><p><b>RESULTS</b>Compared to pre-IRN-STEMI era, primary PCI ratio (84.5% (290/343) vs. 75.5% (185/245)) were significantly increased post establishment of IRN-STEMI within the network (P = 0.06). STEMI patients admitted in Xiamen Heart Center was significantly increased from 165 to 256, the annual mean FMC-to-B time ((110.3 ± 34.0)min vs. (137.9 ± 58.5) min, P < 0.01) and D-to-B ( (76.5 ± 33.0) min vs. (107.3 ± 38.0) min, P < 0.01) , as well as the mean medical cost were significantly decreased ( (51 398 ± 22 100) RMB vs. (56 970 ± 24 593) RMB, P < 0.05), while the mean length of hospital stay ((9.0 ± 4.3)d vs. (9.7 ± 4.8)d, P > 0.05) and in-hospital mortality (3.1% (8/256) vs. 3.0% (5/165) , P > 0.05) remained unchanged before and after the setting of IRN-STEMI in Xiamen Heart Center.</p><p><b>CONCLUSION</b>Establishment of an integrated regional network system for STEMI patients in China is feasible. With collaboration of qualified heart center, EMS and PCI-capable and non-PCI capable local hospitals, establishment of IRN-STEMI effectively increased the ratio of primary PCI for STEMI patients, it also significantly shortened the FMC-to-B and D-to-B time, decreased mean medical cost, thus, the regional IRN-STEMI network might be an effective working system for improving the medical care for STEMI patients.</p>

Apoptosis and expression of PCNA and distribution of TUNEl positive cells in human vulnerable atherosclerotic plaque / 中国实用内科杂志

ObjectiveTo investigate the roles of apoptosis and express io n of PCNA in human vulnerable atherosclerotic plaque.MethodsAp optosis was detected by TUNEL.Expessions of PCNA were detected in samples of vul nerable plagues From 23 cases of coronary heart disease.by SP immunohistochemica l technique.ResultsThe expession level of PCNA in the smooth m uscle cells (SMCs) on fibrous cap region was significantly elevated than that of the other three regions.The expession level of PCNA in the inflammatory cells ( ICs) on fibrous cap and shoulder region were significantly elevated than that of the other two regions.The amount of apoptosis in the SMCs on lipid-rich core wa s much more than that of the other three regions.The amount of apoptosis in the ICs on lipid-rich core was more than the other three regions.The expression leve ls of PCNA in fibrous cap and shoulder were significantly higher than TUNEL posi tive cell (P