Effects of target value management for quality control indexes in chest pain center on efficiency and effectiveness of in-hospital treatment for STEMI patients / 中华急诊医学杂志

Objective To explore the effects of target value management for quality control indexes in chest pain center on the efficiency and effectiveness of in-hospital treatment for STEMI patients.Methods The database of Chest Pain Center in General Hospital of Guangzhou Military Command was retrospectively analyzed.STEMI patients who visited our hospital from March 2011 to March 2018 were selected as the research subjects.During the review period,the target values of quality control indexes were adjusted 4 times.Before and after the 4 adjustment,the efficiency indexes of in-hospital treatment STEMI patients were compared,including the first medical contact to the first electrocardiogram (FMC2ECG) time,catheter lab activation time and Door-to-Balloon (D2B) time.Length of hospital stay,in-hospital mortality and hospitalization cost were compared as well.Results A total of 332 STEMI patients were included in the study.As the quality control target values became stricter,the median and the average value of FMC2ECG time,catheter lab activation time and D2B time showed a downward trend.Among these data,the D2B time decreased from 95 (74,134.5) min to 50 (44.5,71) min,and its differences were of the most significance.However,there is no significant difference in the hospitalization cost,length of hospital stay and in-hospital mortality of STEMI patients.Conclusions The target value management of quality control indexes can improve the in-hospital treatment efficiency for STEMI patients,but the improvements of treatment efficiency and effectiveness cannot be immediately revealed.It takes a certain amount of time and needs enough cases to reach a significant difference.

Effect of combined anesthesia on Wuzhishan miniature pigs in surgery lasting up to 8 hours / 中国比较医学杂志

Objective To explore the effect of general anesthesia on Wuzhishan miniature pigs induced by a mixture of ketamine, Sumianxin II and midazolam, and maintained by ketamine and propofol in surgery lasting up to 8 hours. Methods A total of 18 Wuzhishan miniature pigs (body weight (20. 3 ± 1. 9) kg, 14 male and 4 female) were used in this study. The induction of anesthesia was performed with intramuscular injection of ketamine (8 -10 mg/kg) Sumianxin II (1. 5 mL) and midazolam (10 mg) behind the ear, and the general anesthesia was maintained with a mixture containing 0. 9％ sodium chloride 8 mL, ketamine 100 mg/2 mL and propofol 200 mg/40 mL, continuously injected through the marginal ear vein through a syringe infusion pump. The time spent for anesthesia induction and the duration time of anesthesia were recorded. Physiological indexes including body temperature, blood pressure, heart rate and respiratory rate, the reflex activities, and the effects of analgesia, sedation and muscular relaxation of the miniature pigs under anesthesia at 0, 0. 5, 1, 1. 5, 2, 4, 6, 8 h were observed. Results All the 18 pigs were successfully anaesthetized, but 4 pigs died during surgery due to hypovolemic shock, anesthesia accident, left main coronary thrombosis and reperfusion arrhythmia, respectively. During anesthesia, the analgesia, sedation and muscular relaxation effects on the pigs were obvious. The average time spent for anesthesia induction was (4. 8 ± 1. 2) min and the duration time of anesthesia was (54. 1 ± 5. 8) min. The eyelid reflex, corneal reflex and anal reflex in the pigs were weak or disappeared during 1 -8 h after the anesthesia was induced. The body temperature of the pigs was decreased gradually, with a significant difference between 1 h and 0 h (P＜ 0. 05), reaching the lowest point at 4 h, and then maintained stable. The blood pressure was gradually decreased, reaching the lowest level at 2 h (P ＜ 0. 05), then somehow increased, and maintained at a stable level until the end of surgery. The respiratory rate fluctuated during the anesthesia, with no significant difference. Conclusions The anesthesia induced by a combination of ketamine, Sumianxin II and midazolam and maintained with a combination of ketamine and propofol is simple to operate, shows effects fast, and has good effects of analgesia, sedation and muscular relaxation, keeping the circulatory system and respiratory system relatively stable throughout the anesthesia. Thus it is suitable for general anesthesia for miniature pigs.

A Case-control Study for Smoking on the Risk of Acute ST-Segment Elevation Myocardial Infarction Morbidity in Different Gender and Age Population / 中国循环杂志

Objective: To access the risk for smoking on morbidity of acute ST-segment elevation myocardial infarction (STEMI) at different gender and age population. Methods: A case-control study was conducted in 2026 STEMI patients and 2026 control subjects with matched gender and age (±2 years) in our hospital from 2010-01-14 to 2016-02-27. The relationship between smoking and STEMI morbidity was analyzed. Results: Smoking was an important risk factor for STEMI morbidity in male gender and it was negatively related to age, as STEMI in young male smokers (≤45 years): adjusted OR=7.000, 95% CI 4.235-11.570; in middle age male smokers (46-59 years):adjusted OR=5.296, 95% CI 3.904-7.185 and in elder male smokers (≥60 years): adjusted OR=4.686, 95% CI 2.860-4.751. Conclusion: Smoking is a major risk factor for STEMI morbidity, while it is different from age and gender; the young male smokers have the highest risk to suffer from STEMI.

Correlation betwe en single nucleotide polymorphism in FBN-1 gene (rs2118181) and sporadic acute aortic syndrome in Chinese Han population / 中国介入心脏病学杂志

Objective To investigate the association of the rs 2118181 polymorphism of FBN-1 gene ( encoding Fibrillin-1 ) and the risk of acute aortic syndrome ( AAS ) in Chinese Han population. Methods Genomic DNA was extracted from the blood of 206 patients suffering AAS and 209 individual-matched controls.The dideoxy chain termination method was used to determine the genotypes of rs 2118181 single nucleotide polymorphisms .Results The TT frequency of rs 2118181 genotype was significantly higher in the patients with AAS , especially with Intramural Haematoma ( IMH ) than in the controls ( 62.1%, 70.4% vs.52.5%, P<0.05).Carriers of CT or CC genotype had a less risk for AAS , especially for IMH, compared with carriers of TT genotype.The odds ratio were 0.66 (95%CI:0.45-0.98, P=0.040) and 0.46 (95%CI:0.24-0.87, P=0.016) respectively.After adjusting for age, sex, body mass index, hypertension , body mass index , smoking , diabetes mellitus , the odds ratio for AAS was 0.66 ( 95% CI:0.44-0.99 , P=0.048 ) .However , there was no significant difference on the frequencies of rs 2118181 genotype between the two subgroups of classical aortic dissection and intramural haematoma . Conclusions The rs2118181 polymorphism of FBN-1 gene is correlated to the sporadic AAS , especially to IMH, in Chinese Han population .The carriers of TT genotype are vulnerable to AAS , especially to IMH , compared with the non-carriers.

Association between body mass index and cardiovascular events in male elderly hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the long-term relationship between body mass index (BMI) and cardiovascular events in male elderly hypertensive patients.</p><p><b>METHODS</b>A total of 839 male elderly (>65 years old) hypertensive patients were included in this prospective study. Baseline data were obtained on January 2004 and participants were followed up yearly till January 2014. Patients were divided into 3 groups according to their BMI: normal weight group (18.5 kg/m² ≤ BMI<24.0 kg/²), overweight group (24.0 kg/m² ≤ BMI<28.0 kg/m²), obese group (BMI ≥ 28.0 kg/m²). All-cause death and cardiovascular events were compared.</p><p><b>RESULTS</b>The average age of all 839 hypertension men was (75.4 ± 4.8) years at baseline. Baseline systolic blood pressure was (133.7 ± 14.6) mmHg (1 mmHg=0.133 kPa), diastolic blood pressure was (74.3 ± 9.3)mmHg. Baseline systolic and diastolic blood pressure was similar among the three groups. All 839 patients completed follow-up. There were 178 all-cause deaths, 54 cardiovascular deaths, 51 new/recurrent myocardial infarctions and 105 new/recurrent strokes during follow up. Incidence of all-cause mortality in overweight group (16.74%,72/430) was significantly lower than in normal weight group (27.01% (74/274), P<0.05). Kaplan-Meier curves showed the all-cause mortality and cardiovascular mortality were higher in normal weight group than in the other two groups. According to the Cox proportional hazards regression model, the risk of all-cause mortality (RR=0.867, 95% CI: 0.792-0.949) and cardiovascular death (RR=0.179, 95% CI : 0.05-0.645) in patients with a BMI ≥ 24.0 kg/m² were lower than in the group with BMI<24.0 kg/m².</p><p><b>CONCLUSION</b>Obesity paradox phenomenon is observed in elderly male hypertensive patients in that higher BMI is associated with lower mortality risks in elderly male hypertensive patients during the 10 years follow-up.</p>

Study on the Impacts of remote real-time transmission 12-lead electrocardiogram system on door-to-balloon time in patients with ST-segment elevation myocardial infarction / 中华急诊医学杂志

Objective This study was aimed to evaluate the remote real-time transmission 12-lead electrocardiogram system on door-to-balloon time in patients with ST-segment elevation myocardial infarction.Methods We retrospectively analyzed the consecutive patients with STEM I who had accepted primary percutaneous coronary intervention (PCI) in the chest pain center of our hospital from February 2012 to July 2012.The study group consisted of patients with pre-hospital ECG,while the control group included patients without pre-hospital ECG,Their door-to-balloon time and door-to-catheter room time,mortality w ere compared.Results Totally 60 consecutive patients who had received primary PC I for STEMI were evaluated.Among them,35 patients were hospitalized with pre-hospital ECG while the other 25 patients without ECG.The Pre-hospital ECG was associated with a significautly shorter median door-to-balloon time (38 min vs.94min;P ＜0.01),The proportion of patients received balloon dilation within the guidelinerecommended 90 min timeframes Was significantly higher in pre-hospital ECG group than in non pre-hospital ECG group (94.6％ vs.60％;P =0.001).No difference was observed in mortality between the two groups (5.7％vs.4％;P ＞ 0.05),Significant difference was seen in the median hospital time in study group (5 compared with control group (7day) (5 day vs.7 day;P ＜ 0.01).Conclusions The remote real-time transmission 12-lead electrocardiogram system is associated with a significantly shorter door-to-balloon time in STEMI patients.The remote real-time transmission 12-lead electrocardiogram system is recommended in patients suspected STEMI.

Preventive and therapeutic strategies of doxorubicin cardiotoxicity:research advances / 国际药学研究杂志

The utilization of d oxorubicin (DOX) is compromised by potential lethal cardiotoxicity in clinical application. Improving DOX efficacy in cancer cells while minimizing DOX-associated cardiotoxicity is in the forefront of research. Available methods at present include cardioprotective agents, DOX derivates and dosage schedules. This paper proposes new ideas on potential drug targets aiming at enhancing cancer therapy and cardioprotection simultaneously.

The effect of puncture technique in thoracic endovascular aortic repair with abdominal aortic aneurysm / 中国医师进修杂志

Objective To evaluate puncture technique in thoracic endovascular aortic repair with abdominal aortic aneurysm and assess the feasibility and safety of using a pre-close technique for puncture and closure of femoral access sites. Methods From May 2010 to August 2013, the pre-close technique which involved two 6 F per-close ProGlide devices deployed in the femoral artery before upsizing to a 18-25 F sheath and one or two deployed before upsizing to a 14-16 F sheath were applied to 42 patients with abdominal aortic aneurysm (group A). Forty-seven patients using surgical femoral cutdown from December 2006 to April 2010 were enrolled into group B. The rate of technical success, time from procedure to the aortic delivery, operation time, low limb braking time, local complication, time from procedure to discharge, local vascular diameter after 3 months was evaluated and compared between two groups. Results There was no significant difference in endograft external diameter between two groups ( P>0.05). The rate of technical success was 97.62%(41/42) in group A and 95.74%(45/47) in group B, and there had no significant difference (P>0.05). Time from procedure to the aortic delivery, operation time and time from procedure to discharge in group A were significantly shorter than those in group B: (21.79 ± 5.79) min vs. (41.37 ± 11.79) min, (127.66±37.83) min vs. (157.84±42.71) min, (6.59±1.89) d vs. (9.14±2.57) d, P0.05. Conclusion The puncture technique with per-close ProGlide is safe and effective in percutaneous endovascular aortic repair which can be adopted as an alternative technique of surgical femoral cutdown approach in patients with abdominal aortic aneurysm.

The correlation between Fibulin-3 and Pulse Wave Velocity in patients with hypertension / 实用医学杂志

Objective To investigate the changes and significances of the level of serum Fibulin-3 and correlation between Fibulin-3 and branchial-ankle Pulse Wave Velocity (baPWV) in patients with hypertension. Methods A total of 50 patients with hypertension and 38 healthy people were enrolled finally, whose fasting blood were collected. The levels of Fibulin-3、MMP-9 were detected by enzyme-linked immunosorbent assay. The baPWV was detected by pulse wave velocity automatic analyzer. Results The level of serum Fibulin-3 in hypertension was lower than the control group significantly (P < 0.001). There was no significance of serum MMP-9 in the two groups. The baPWV in hypertension was higher than the control group.Correlations between the level of Fibulin-3 and baPWV were significant (r = -0.324,P = 0.006). While correlations between the level of MMP-9 and baPWV had no significance (r=0.003,P=0.968). Conclusion The level of serum Fibulin-3 and baPWV can be used as index of functional changes in the early stage of hypertensive vascular remodeling, and may be applied for forecasting the organ damage in hypertension.

Investigate on the correlations between the time of thoracic endovascular aortic repair and prognosis in patients with acute Stanford type B aortic dissection / 中国介入心脏病学杂志

Objective To investigate the correlations between the time of thoracic endovascular aortic repair (TEVAR) and prognosis in patients with type B acute aortic dissection (AADB). Methods The clinical data of 156 AADB patients with TEVAR was retrospectively analyzed and divided into 3 groups according to the time from onset of symptom to TEVAR:less than seven days was deifned as group 1 (G1, n=87), seven days to fourteen days group 2 (G2, n=48);more than fourteen days was group 3 (G3, n=21). The status of aortic reconstruction at three months TEVAR, in-hospital mortalities, mean hospital expense and length of stay were compared among three groups. Results Before TEVAR, there was no signiifcant differences in the ratio of smallest true lumen diameter and largest false lumen diameter amony the three groups (0.47±0.33, 0.42±0.18, 0.47±0.27, respectively, P>0.05). At three months after TEVAR, the ratio of largest true lumen diameter and largest false lumen diameter among the three groups was signiifcantly greater in group 1 (1.76±0.51) than group 2(1.42±0.30) and group 3(1.34±0.34, P < 0.05), when there was no signiifcant difference between the later two groups. Complete aortic reconstruction (8 from group 1 and 4 from group 2) was achieved in 12 patients at 3 months after TAVAR. Eight patients died during hospitalization, 5 from visceral ischemic, 2 from proximal aortic dissection, one patient from sudden death. Compared with G3, the hospital expense of group 1 and group 2 was cut down about ￥20000. Length of stay was signiifcant greater in group 3 than in group 1 and group 2 (P<0.05). Conclusions Early TEVAR for AADB was safe and beneifcial for aortic reconstruct and reducing the hospital expense and length of stay.

Impact of establishing regional collaborative network on reperfusion time and prognosis of patients with ST-segment elevated myocardial infarction admitting to community hospitals without percutaneous coronary intervention capacity / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the impact of establishing regional collaborative network on reperfusion time and prognosis of patients with ST-segment elevated myocardial infarction (STEMI) admitting to community hospitals without percutaneous coronary intervention (PCI) capacity (Non-PCI hospital).</p><p><b>METHODS</b>A regional collaborative network was developed, consisting of a PCI center and over 30 Non-PCI hospitals and connected by a tele-transmitted real-time 12-lead electrocardiogram system. This system enables the cardiologists on duty in PCI center to help the physicians in the Non-PCI hospitals (network hospital) to confirm the diagnosis and choose a reperfusion strategy for STEMI patients. All cardiologists in PCI center and physicians in Non-PCI hospitals were trained to follow the flowchart of reperfusion strategies for STEMI patients to shorten the reperfusion time. The mean time from door of Non-PCI hospital to needle of thrombolysis (D-to-N), the mean time from door of PCI center to balloon (D-to-B) and the mean time from the first medical contact to balloon (FMC-to-B) and the 1-year mortality were compared between the 20 months before and the 20 months after establishment of the regional collaborative network for patients with the first medical contact in three network hospitals.</p><p><b>RESULTS</b>After establishment of the regional collaborative network, the mean D-to-N time was significantly shortened from (71 ± 62) min to (28 ± 9) min (P < 0.05), the rate of D-to-N below 30 min was increased from 11% (2/18) to 74% (26/35); the mean FMC-to-B and the mean D-to-B time were remarkably reduced in both complementary percutaneous coronary intervention and transfer percutaneous coronary intervention patients (all P < 0.05), the 1-year mortality post reperfusion was reduced from 15.1% (8/53) to 7.0% (10/142) (P < 0.05).</p><p><b>CONCLUSION</b>The establishment of regional collaborative network could shorten the perfusion time and reduce the 1-year mortality for STEMI patients presenting to Non-PCI hospitals.</p>

Sodium-calcium exchanger promoter promotes differentiation of mouse induced pluripotent stem cells into cardiomyocytesin vitro / 中国组织工程研究

BACKGROUND:Inducing pluripotent stem cels has been considered as a promising treatment for ischemic heart disease. However, an ideal inducing method has not been found yet. OBJECTIVE:To investigate the role of sodium-calcium exchanger (NCX1) promoter in the differentiation of mouse induced pluriptent stem cels (miPS) into cardiomyocytes. METHODS: The pLVX-IRES-ZsGreen1 vectors which contain NCX1 promoter constructed by recombinant DNA technology were co-transfected to 293FT cels with ViraPowerTM Lentiviral Packaging Mix. The recombinant lentiviruses infected with miPS were selected and purified by puromycin. miPS were recovered and passaged to form embryoid bodies. The embryoid bodies were induced by differentiation medium containing various concentrations of the virus titer. The number of beating embryoid bodies were calculated. The expression profiles of the myocardial intra-markers were tested to determine the differentiation efficiency of iPSC by RT-PCR and immunofluorescence analysis. RESULTS AND CONCLUSION:pLVX-IRES-ZsGreen1 vectors which contain NCX1 promoter were constructed and confirmed by PCR. Virus could be packaged, purified and concentrated successfuly. The recombinant lentivirus to transduce miPS was sorted by flow cytometry. In contrast to NCX1-/GFP- cels, NCX1+/GFP+ cels were differentiated and developed prominent beating areas with sustained contractile activity for additional 4 days, and demonstrated positive expression of gap communication marker CX43 and cardiac troponin. The expressions of GATA4, MEF2c and Nkx2.5 in the NCX1+ cels were 4.2, 7.5, and 2.5 times those in NCX1- cels. Results showed the NCX1 promoter can promote the cardiac differentiation of miPS .

The impacts of the establishment of chest pain center on the door-to-balloon time in patients with ST-elevation myocardial infarction by different transfer ways to hospital / 中国介入心脏病学杂志

Objective This study intends to explore the impacts of the establishment of chest pain center(CPC) on the door-to-balloon(D-to-B) time in patients with ST-elevation myocardial infarction (STEMI) by different transfer ways to hospital. Methods A regular CPC and a regional cooperative network were established based on the pre-hospital transmitted real-time 12-lead electrocardiogram system. The STEMI patients were divided into the following three groups by the different transfer ways to hospital before and after the establishment of chest pain center:self-referral groups (group A1, n=52, and group A2, n=65), EMS (emergency medical service ) groups (group B1, n=31, and group B2, n=92) and transfer PCI groups (group C1, n=23, and group C2, n=552). The mean D-to-B time and the rate of D-to-B below 90 minutes were compared between before and after the establishment of CPC and the reasons of reperfusion delay were analyzed. Results There were no statistical differences of the average D-to-B time [(123±78) min vs.(140±123)min, P > 0.05] and the rate of D-to-B time below 90 min (44.2%vs. 46.2%) between group A1 and group A2. The average D-to-B time was significantly shortened in group B2 [(89±66)min] while compared with that in group B1 [(155±115)min, P<0.05] and the rate of D-to-B time below 90 min was remarkably elevated in group B2 compared with that of group B1 (69.6%vs. 32.3%, P<0.05). The average D-to-B time was significant shorter in group C2 than in group C1 [(77±43)min vs. (337±662)min, P<0.05] and the rate of D-to-B time below 90 min was remarkable higher in group C2 than in group C1 (75.7%vs. 21.7%, P<0.05). The longer D-to-B time in self-referral groups was mainly due to the delay of getting informed consent before PCI when occupied catheterization laboratory was the major cause of reperfusion delay in EMS groups and transfer PCI groups. Conclusions The establishment of CPC may significantly shorten the D-to-B time and increase the rate of D-to-B time below 90 min for these patients admitted by EMS and transferred from non-PCI hospitals. However, the pathway for the self-referral patients should be further modified.

The comparison of establishment of the acute myocardial infarction model between the beagle dogs and the mini-pigs by interventional technique / 重庆医学

Objective To explore the success rate and the risk of establishment of the acute myocardial infarction model between the beagle dogs and the mini-pigs by interventional technique ,further to provid theoretical basis for choose a more suitable animal model .Methods 6 dogs and 6 mini-pigs were anaesthetized ,then underwent the coronary arteriography via femoral artery .After is-chemic preconditioning the coronary balloon was inflated to occlude the middle left anterior descending coronary for 180 minutes . The electrocardiogram was examined throughout the operation and the pathological sections were examined until the animals were executed one week later .Results All beagle dogs survived ,while 1 case of mini-pigs dead(1/6) .There was 1 cases(1/6) of beagle dogs had acute myocardial infarction ,while 5(5/6)cases in mini-pigs .All mini-pigs had malignant arrhythmia(6/6) but never seen in beagle dogs .The time needed for building a model was similar between the two groups ,the difference had no statistical signifi-cance(P>0 .05) .Conclusion The risk of establish myocardial infarction model in mini-pigs is higher than beagle dogs ,but the suc-cess rate is still high ,it might be the better choice .

The detection of non-stationary T-wave alternans: a modified correlation method / 生物医学工程学杂志

T-wave alternans (TWA) refers to a phenomenon appearing in the surface electrocardiograph (ECG) as a consistent fluctuation in morphology and amplitude of the T wave on an "every-other-beat" basis. Correlation method (CM) has a certain ability to detect the non-stationary TWA, but it is very sensitive to noise. In this paper we propose a modified correlation method to ensure a stable and accurate detection of non-stationary TWA. Compared to the CM, the method modifies the judge condition and uses the linear fitting to limit the noise to gain the ability of detecting of non-stationary TWA. Our simulation and clinical data assessment study demonstrates the improved performance of the proposed algorithm.

Study of the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with acute ST-segment elevated myocardial infarction / 中华急诊医学杂志

Objective To evaluate the pre-hospital diagnostic reliability of real-time tele-transmission of 12-lead electrocardiogram of patients with ST-segment elevated acute myocardial infarction (STEMI).Methods The 12-lead electrocardiogram was simultaneously recorded with real-time tele-transmission system and a conventional electrocardiograph in 40 STEMI cases.The width and amplitude of each wave,the deviated amplitude of ST-segment in the same leads were compared by t-test and rank-sum test.Results There were no statistical differences in the width and amplitude of P wave,QRS wave and t wave as well as the deviated altitude of ST-segment between the two separate electrocardiographs (P ＞0.05).There was a significant positive correlation between the two ECG devices in respect of ST-segment elevated altitude (r =0.912,P =0.000).The differential ability of ST-segment elevation between two separate ECG devices kept highly consistent (Kappa value:0.976).Conclusions Real-time tele-transmission of 12-lead electrocardiogram is reliable for the pre-hospital diagnosis of STEMI.

Effects of ulinastatin on cardiac function and myocardial p38MAPK in rats with septic shock / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of different doses of ulinastatin (UTI) on the cardiac function and myocardial expression of p38 mitogen-activated protein kinase (p38MAPK) in septic rats.</p><p><b>METHODS</b>Forty male SD rats were randomized equally into 5 groups, namely the control group (group A), sham-operated group (group B), sepsis group (group C), low-dose UTI group (group D), and high-dose UTI group (group E). Rat models of sepsis were established by cecal ligation and puncture (CLP), At 24 h after successful modeling, the left ventricle ejection fraction (LVEF) and fractional shortening (LVFS) were evaluated, and the myocardium of the left ventricle was sampled to examine the expression of the expressions of p38MAPK and p-p38MAPK using Western blotting.</p><p><b>RESULTS</b>In groups A, B, C, D, and E, the LVEF was (77.13∓3.76)%, (76.88∓3.64)%, (56.13∓4.16)%, (55.00∓3.12)%, and (66.50∓3.46)%, and the LVFS was (43.50∓3.70)%, (44.00∓3.38)%, (28.13∓1.81)%, (26.13∓2.70)%, and (38.00∓2.07)%, respectively. Compared with group B at 24 h after CLP, LVEF and LVFS were markedly lowered in the groups C, D and E (P=0.000, 0.000 and 0.002), but showed no significant differences between groups C and D (P=0.541 and 0.166); LVEF and LVFS were significantly lower in group E than in groups C and D (P=0.000 and 0.000). The p-p38/p38 ratio was similar between groups C and D (0.79∓0.12 vs 0.75∓0.12, P=0.682), but both significantly higher than that in group B (0.28∓0.15, P=0.001); the ratio in group E was significantly lower than that in group C (P=0.001), but similar with that in group B (P=0.972).</p><p><b>CONCLUSION</b>High-dose UTI can inhibit p38 phosphorylation, which may be the mechanism for its effect of myocardial protection in septic rat.</p>

Effects of emergent percutaneous coronary intervention on the prognosis of patints with cardiac arrest and cardiopulmonary resuscitation after acute myocardial infarction / 中华急诊医学杂志

Objective To investigate effects of emergent percutaneous coronary intervention(EPCI)on the prognosis of patients with cardiac arrest(CA)and cardiopulmonary resuscitation after acute myocardial infarction(AMI).Methods Thirty-two patients with CA and carcliopulmonary resuscitation after AMI were retrospectively reviewed and divided into EPCI group(n=12)and eonservative treatment group(n=20).EPCI was used during or after primary eardiopulmonary resuscitation in EPCI group but not in conservative treatment group.Mortality and occurrence rates of severe arrhythmia,of heart failure,of cardiac shock and of severe bleeding in hospital were compared between the two groups.Results The mortality in hospital was 17% in EPCI group and 70% in conservative treatment group,respectively(P＜0.001).Heart failure was developed in 3 patients from EPCI group and 16 patients from conservative treatment group,respectively(P＜0.01).There was no significant difference in severe arrhythmia,cardiac shock and severe bleeding between two groups(P＞0.05).Logistic regression showed that EPCI decreased mortality but the prolonged cardiopulmonary resuscitation(＞20 min)increased the mortality.Conclusion Early EPCI might improve the prognosis of patients with cardiac arrest and cardiopulmonary resuscitation after acute myocardial infarction.

Smoking and hyperlipidemia are important risk factors for coronary artery spasm / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the role of coronary artery spasm in the etiology of chest pain lacking significant coronary stenosis and to identify the clinical risk factors related to coronary artery spasm.</p><p><b>METHODS</b>Two hundred and seventy five patients with chest pain, but without significant coronary artery stenosis underwent the intracoronary acetylcholine test. Coronary artery spasm was diagnosed while coronary artery stenosis increased to 90% and was accompanied by the usual chest pain with or without ischemic changes on electrocardiogram. Logistic regression was employed to investigate the relationships between coronary artery spasm and sex, age, hypertension, diabetes mellitus, smoking, hyperlipidemia and results of electrocardiographic treadmill stress test. Left ventricular ejection fraction and end diastolic pressure were compared between spasm group and non-spasm group.</p><p><b>RESULTS</b>Coronary artery spasm was detected in 103 out of 271 patients, a rate of 38%. Logistic regression analysis showed that smoking and hyperlipidemia increased the relative risk of coronary artery spasm 4.2 times and 2.3 times, respectively. There was a significantly negative relationship between diabetes mellitus and coronary artery spasm. Furthermore, there was no significant difference of left ventricular ejection fraction and end diastolic pressure between spasm group and non-spasm group.</p><p><b>CONCLUSIONS</b>Coronary artery spasm was one of the important etiological factors for patients with chest pain but no coronary artery stenosis. Smoking and hyperlipidemia were the main clinical risk factors for coronary artery spasm.</p>

Research Status and Application of Piezoelectric Immunosensor / 医疗卫生装备

The basic principles of piezoelectric quartz crystal immunosensor are reviewed. Its characteristics and applications in biomedicine are summarized. The feasibility of its application in detecting cardiac troponin I (cTnI) is briefly analyzed. There's no need of any signs and segregation steps in the technique, so the instrument is simple and easily-operated. Besides, it has a bright application future for its merits of rapid detection and precise quantification.