Efficacy of vitamin D adjuvant therapy for prevention of spontaneous bacterial peritonitis in patients with decompensated cirrhosis of hepatitis B / 中华临床感染病杂志

Objective:To evaluate the efficacy of vitamin D supplementation for prevention of spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis of hepatitis B.Methods:A total of 172 patients with decompensated cirrhosis of hepatitis B admitted in Jinhua Hospital affiliated to Zhejiang University School of Medicine from January to December 2021 were randomly divided into two groups with 86 cases in each group. Patients in both groups received conventional antiviral and symptomatic treatment; while patients in the intervention group received additinal oral vitamin D drops (800 IU/d) for 6 months. After 6 months of treatment, the incidence of SBP and the serum biochemical indexes were compared between two groups. SPSS 21.0 statistical software was used for data analysis.Results:After 6 months of treatment, the incidence of SBP in the intervention group(5.81%, 5/86) was significantly lower than that in control group(30.23%, 26/86)( χ2=19.210, P<0.01). The serum 25-(OH)D level in intervention group was significantly higher than that in the control group ( t=13.425, P=0.018), while the levels of CRP, PCT and IL-6 in intervention group were significantly lower than those in control group ( t=17.312, 10.353 and 12.218, P<0.01 or <0.05). Conclusion:Vitamin D adjuvant therapy can increase serum 25-(OH)D level, decrease serum CRP, PCT and IL-6 levels, and effectively reduce the incidence of SBP in patients with decompensated cirrhosis of hepatitis B.

Analysis of indicators related to visceral fat index based on the random forest model / 中华健康管理学杂志

Objective:To explore indicators related to visceral fat index by constructing a random forest model.Methods:In this cross-sectional study, the laboratory measures and body composition analysis records of 617 hospital employees (in-service and retired) who underwent physical examination in Heilongjiang Provincial Hospital Health Management Center from March to September 2021 were selected. The subjects were divided into a training set ( n=411) and a test set ( n=206) with the ratio of 2∶1. A total of 110 predictors were included in the model. The model was constructed with the training set and was evaluated with the test set. The optimal number of nodes and decision trees were selected to evaluate the prediction performance of the optimal model. And the top 10 relatively important factors were selected for further investigation. The 617 participants were further divided in to groups according to the visceral fat index: the normal or high visceral fat index group, and the differences of the top 10 relatively important factors were further compared between the two groups. Results:The optimal number of nodes of the final random forest model was 39 and the number of decision trees was 300. The accuracy, precision, sensitivity and specificity of the model was 83.3%, 73.9%, 89.4% and 78.7%, respectively. The area under the receiver operating characteristic curve and 95% confidence interval of the model was 0.881 (0.832-0.931). The top 10 relatively important factors in the model were body mass index, gender, age, serum uric acid, red blood cell count, monocyte cell count, C-peptide, carcinoembryonic antigen, glycosylated hemoglobin and glutamyl transpeptidase. There were significant differences in the up-mentioned 10 indicators between the subjects with normal and high visceral fat index (all P<0.05). Conclusions:The random forest model built in this study has good performance in predicting visceral fat index, and visceral fat is related with changes in liver function, pancreas function and immune function.

Recent progress in sono-photodynamic cancer therapy: From developed new sensitizers to nanotechnology-based efficacy-enhancing strategies

Many sensitizers have not only photodynamic effects, but also sonodynamic effects. Therefore, the combination of sonodynamic therapy (SDT) and photodynamic therapy (PDT) using sensitizers for sono-photodynamic therapy (SPDT) provides alternative opportunities for clinical cancer therapy. Although significant advances have been made in synthesizing new sensitizers for SPDT, few of them are successfully applied in clinical settings. The anti-tumor effects of the sensitizers are restricted by the lack of tumor-targeting specificity, incapability in deep intratumoral delivery, and the deteriorating tumor microenvironment. The application of nanotechnology-based drug delivery systems (NDDSs) can solve the above shortcomings, thereby improving the SPDT efficacy. This review summarizes various sensitizers as sono/photosensitizers that can be further used in SPDT, and describes different strategies for enhancing tumor treatment by NDDSs, such as overcoming biological barriers, improving tumor-targeted delivery and intratumoral delivery, providing stimuli-responsive controlled-release characteristics, stimulating anti-tumor immunity, increasing oxygen supply, employing different therapeutic modalities, and combining diagnosis and treatment. The challenges and prospects for further development of intelligent sensitizers and translational NDDSs for SPDT are also discussed.

Roles of multidisciplinary team (MDT) in diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19) / 浙江大学学报·医学版

OBJECTIVE@#To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19).@*METHODS@#The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.@*RESULTS@#Of the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times per case. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged; there was no cross-infection occurred in suspected patients during the hospitalization; there were no deaths and no medical staff infections.@*CONCLUSIONS@#The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved under MDT mode, particularly for complicated and refractory cases.

Roles of multidisciplinary team in diagnosis and treatment of suspected cases of COVID-19 / 浙江大学学报·医学版

OBJECTIVE@#To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19).@*METHODS@#The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.@*RESULTS@#In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections.@*CONCLUSIONS@#The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.

Clinical analysis of 18 cases of breast primitive neuroectodermal tumor / 中华内分泌外科杂志

Objective To investigate the clinical pathological characteristics and prognosis of primitive neuroectodermal tumor (PNET) of breast.Methods Patients with breast PNET were retrieved from CNKI,Pubmed,Europe PMC and other databases from Jan.1980 to Dec.2016.The clinical data of one patient with breast PNET in our hospital were analyzed retrospectively.Results 18 cases had painless,rapid growth mass as the main clinical features.The pathological morphology showed small round cell tumors,PAS staining positive.Immunohistochemistry CD99 and Fli-1 characteristic expression were the main indexes for the diagnosis of breast PNET.The positive expression of Vimentin,NSE,Syn and negative expression of CK,EMA,Desmin,CgA,LCA,S-100 also played an important role in the diagnosis of breast PNET.The positive expression of genetic marker EWSRI was the golden standard for diagnosis of breast PNET.The size of the tumor,surgical treatment,lymph node metastasis,distant metastasis and chemotherapy were the important factors that affect the prognosis of the PNET.The survival rates of 1 and 3 years were 71.4％ and 33.3％ respectively.Conclusions Breast PNET is a rare tumor with poor prognosis,and its diagnosis is highly dependent on pathology.Surgery can significantly improve the prognosis of the patients.Surgery should be the main treatment,combined with radiotherapy and chemotherapy.The current study does not show evidence of effectiveness in terms of endocrine or targeted drug therapy for breast PNET patients.

HER2 somatic mutations S310F and V777L are associated with poor survival in breast cancer patients / 中华普通外科杂志

Objective To assess the prognostic value of HER2 (human epidermal growth factor receptor-2) somatic mutations S310F and V777L in breast cancer patients.Methods HER2 somatic mutations S310F and V777L was screened in 338 consecutive patients with operable primary breast cancer using direct Sanger sequencing analysis.Results A total of 12 carriers of HER2 gene S310F and V777L mutations were found,10 were HER2-negative and 2 were HER2-positive.The median follow-up was 43 months (range from 1 to 61 months).4 were found with local or distant metastasis,and all were HER2-negative patients.Survival analysis found significantly lower survival rates in patients with S3 10F and V777L mutations than in non-carriers (RFS,unadjusted hazard ratio [HR]:5.89,95％ confidence interval [CI]:1.96-17.71,P ＜ 0.001;DRFS,unadjusted HR:5.53,95％ CI:1.56-19.55,P =0.003) and this difference was more manifest in the HER2-negative patients (RFS,unadjusted HR:8.93,95％ CI:2.79-28.62,P ＜ 0.001;DRFS,unadjusted HR:9.89,95％ CI:2.54-38.49,P ＜ 0.001).HER2 somatic mutations S310F and V777L are independent predictors of poor prognosis in breast cancer.Conclusion The prognosis of breast cancer patients carrying HER2 somatic mutations S310F and V777L is significantly worse than that of non-carriers,especially in HER2-negative patients.

Procalcitonin combined with coagulation factors in prognosis of cirrhotic patients complicated with spontaneous bacterial peritonitis / 中华临床感染病杂志

Objective To examine the short-term prognostic value of procalcitonin ( PCT ) combined with coagulation factors for cirrhotic patients complicated with spontaneous bacterial peritonitis (SBP).Methods Clinical data of 128 cirrhotic patients complicated with SBP admitted in Jinhua Central Hospital from June 2014 to October 2017 were retrospectively analyzed .In 3 months after admission , 83 patients survived ( survival group ) and 45 patients died ( fatal group ) .The factors related to prognosis were analyzed with Logistic regression and the prediction model was constructed with the weights derived from regression coefficients.The ROC curve and the area under the curve (AUC) of combination of PCT with coagulation factors were used to predict the survival of patients .Results Univariate analysis indicated that the level of PCT , total bilirubin ( TBil ) , serum creatinine ( Scr ) , prothrombin time ( PT ) , prothrombin activity ( PTA ) , blood coagulation factor Ⅱ, Ⅴ, Ⅶ, Ⅸ, Ⅹ, Ⅺ and Ⅻ were factors affecting the prognosis of cirrhotic patients complicated with SBP (P<0.01).Multivariate analysis showed that PCT , blood coagulation factors Ⅴ and Ⅸ were independent factors of short-term prognosis of cirrhotic patients complicated with SBP.The constructed predictive model was Logit (P) =1.200+0.099 ×PCT-0.026 × clotting factor Ⅴ-0.038 ×clotting factor Ⅸ.The sensitivity and specificity of the model were 0.822 and 0.675, respectively, and the AUC was 0.829.Compared with the classic MELD score , the difference was not statistically significant (P>0.05).Conclusions The predictive model based on PCT and coagulation factors Ⅴand Ⅸcan effectively predict the short-term survival of cirrhotic patients complicated with SBP . The overall prognostic ability is not different from MELD score , but the model is more simple and easier to apply.

A comparison analysis of the effects of standard decompressive craniectomy vs combined cisternostomy on severe traumatic brain injury / 中国神经精神疾病杂志

Objective To compare the effects of standard decompressive craniectomy (DC) vs.combined cisternostomy on severe traumatic brain injury (STBI).Methods Seventy-two patients with severe brain injury were divided into standard decompressive craniectomy group (control group,n=34) and DC combined cisternostomy group (treatment group,n=38).The clinical parameters from pre-and post-surgery were compared between the two groups.Results There was no statistical difference in clinical data including gander,age,injury causes,GSC score,Helsinki CT score and operative opportunity between two groups before surgery (P＞0.05).The treatment group was inferior in the duration of decompression (2.8±0.4 h vs.2.5±0.3 h,P＜0.05) relative to control treatment group.However,treatment group were superior to control group in the mean time of admission in neuro-intensive care unit (5.54±3.09 d vs.7.24±2.74 d,P＜0.01),the cumulative time of intracranial pressure (ICP) more than 20 nmHg within seven days after surgery(23.2±4.4 h vs.56.8±8.3 h,P＜0.01),Helsinki CT scores at postoperative day (3(2,5) vs.5(2,9),P＜ 0.01)and Glasgow Outcome Scores (GOS) at 3 month after surgery (P＜0.01).Conclusion DC combined with cisternostomy for STBI is significantly better than standard decompressive craniectomy,which is worth further study by multicenter clinical trials.

Screening of High-Affinity α-Glucosidase Inhibitors fromCichorium Glandulosum Boiss.et Hout Seed Based on UltrafiltrationLiquid Chromatography-Mass Spectrometry and Molecular Docking / 分析化学

High-affinity α-glucosidase inhibitors were screened from Cichorium glundulosum Boiss.et Hout seed (CGS) extract by ultra-filtration affinity-liquid chromatography-mass spectrometry (UF-LC-MS) and molecular docking.By taking 4-nitrobenzene-α-D-glucopyranoside (PNPG) as substrate and acarbose as positive control to evaluate the inhibitory activity of CGS extract, IC50 of acarbose and CGS extract were 0.003 mg/mL and 0.447 mg/mL, respectively.Meanwhile, 4 compounds from CGS extract by UF-LC-MS were screened and identified.Then by using autodock software, the compounds that combined with α-glucosidase were well screened out, including chlorogenic acid and isochlorogenic acid A.The inhibitory activity of chlorogenic acid and chlorogenic acid A against α-glucosidase was verified in vitro.The results showed that the inhibitory activity of the compounds toward α-glucosidase presented the sequence of acarbose>isochlorogenic acid A>chlorogenic acid.The inhibition rate of isochlorogenic acid A was close to acarbose.The experimental results illustrated that UF-LC-MS and molecular docking could be used to screen high affinity enzyme inhibitors from CGS.

Construction of Rehabilitation Management System Based on Treatment Task / 中国康复理论与实践

Objective To develop a set of information system for managing procedure in rehabilitation hospital, which can coordinate the services of rehabilitation teams characterized by the modern rehabilitation model. Methods Based on the working pattern of the rehabili-tation teams, and combined with the hospital information system and electronic medical records, the closed-loop management information system was developed, with the core of treatment-task schedules and feedbacks, and treatment-record communications. Results and Conclu-sion The Rehabilitation Treatment Management System was developed, which established the intelligent treatment process, realized the closed-loop management of resource sharing and treatment task.

Effects of 60Co irradiation and trace element zinc on fixation strengths of titanium implant / 中国组织工程研究

BACKGROUND: Irradiation therapy in the cancer patients after surgery may have negative effects on implant fixation. OBJECTIVE: To observe the effects of 60Co irradiation and trace element zinc on fixation strengths of titanium implant. METHODS: Thirty-six adult male rabbits were involved. One piece of titanium implant was separately placed into the bilateral proximal tibial heads in rabbits to set up animal models of titanium implants. The animals were randomly divided into control group, zinc supplement group, 60Co irradiation group and 60Co irradiation and zinc supplement group. Zinc sulfate of 10 g/L was administered intramuscularly to animals in the zinc supplement group at the dose of 4 mg/kg once per day, and those in the control group were treated with saline at the same dose. The animals in the 60Co irradiation group received 60Co irradiation at the dose of 45 Gy and saline by intramuscular injection. Those in the 60Co irradiation and zinc supplement group received 60Co irradiation and zinc sulfate. The animals were killed at 1, 4 and 12 weeks after treatment. The fixation strengths were measured and compared among groups. RESULTS AND CONCLUSION: (1) Zinc supplement made the titanium implants have higher fixation strengths, and reach a high level at 4 weeks after surgery. (2) 60Co irradiation significantly inhibited the fixation strengths of the implants. After 60Co radiation, zinc supplement stil could promote fixation strengths of titanium implants. (3) It is indicated that amount of zinc supplement after irradiation therapy can al eviate the negative effects of irradiation on implant fixation.

The experimental study on the expression of beta-catenin in the process of rats liver cancer formation ;chemically / 中国癌症杂志

Background and purpose:Hepatocellular carcinoma (HCC) is a common malignant tumor of the digestive system in our country, with high fatality, development of HCC and the machine system research and treatment is a primary issue in current study of HCC. To explore the expression ofβ-catenin at different stages in the process of hepatocellular carcinoma carcinogenisis for SD rats induced by chemicals. Methods: The experimental group included 48 male SD rats mice with primary liver cancer induced by diethylnirtosamine/carbon tetrachloride/Ethanol, while 48 normal male SD rats mice were used as the control group. The rats were killed every 3 weeks to collect the specimens and observe the pathological changes by HE staining. The changes ofβ-catenin protein expressions were detected by immunohistochemistry and Western blot respectively. Results:SD rats liver cancer was conifrmed by HE staining after 21 weeks DEN/CCl4/Ethanol induction. Immunohistochemistry showed thatβ-catenin expression level was obviously higher in the experimental group(0.27±0.01) than that of the control group(0.21±0.02) after 3 weeks induction(P<0.05). As time progresses, the expression levels ofβ-catenin kept on rising, and at the 18th(0.30±0.02) and 21th weeks(0.32±0.02), it was significantly higher than that of the earlier liver tissues of the experimental group(P<0.05), Western blot consistent with immunohistochemical results. Conclusion:β-catenin protein expression is different in the normal liver tissue, cirrhosis, liver cancer,β-catenin and the occurrence of liver carcinoma development had close relationship.β-catenin protein in the cell with further accumulation, may active a series of target gene, leading to the formation of liver cancer..

Study on effect of transforming growth factor-β1 vaccine on insulin-like growth factor binding protein in liver tissues of rats with liver fibrosis / 中华传染病杂志

Objective To observe the effect of transforming growth factor-β1 (TGF-β1) vaccine on the degree of hepatic fibrosis in rats ,and to explore the effect of TGF-β1 vaccine on the insulin-like growth factor binding protein (IGFBP)3 and IGFBP7 .Methods The hepatic fibrosis rat model was set up by injecting N-nitrosodimethylamine . Among them , 10 rats were injected with TGF-β1 vaccine , and additional 10 rats were set up as healthy control group .Changes in hepatic pathology were observe and the expressions of IGFBP3 and IGFBP7 were detected by the methods of immunohistochemistry , reverse transcription polymerase chain reaction (RT-PCR) and Western blot in rat fibrosis tissues after 6 weeks . Normality test and analysis of variance were conducted .LSD test was conducted if variances were tested homogeneity .Categorical data were analyzed using Fisher exact test . Results Changes in hepatic histology and serum levels of hyaluronic acid and laminin suggested that TGF-β1 vaccine interventions could reduce the extent of hepatic fibrosis in rats .The expressions of IGFBP3 mRNA in control group ,hepatic fibrosis model group and vaccine intervention group were 1 .735 ± 0 .097 ,1 .165 ± 0 .096 and 1 .491 ± 0 .046 ,respectively (t= 4 .575 ,6 .285 and 8 .489 ,respectively ,all P< 0 .05) .The expressions of IGFBP7 in the above three groups were 0 .497 ± 0 .021 ,1 .250 ± 0 .064 and 0 .885 ± 0 .149 ,respectively (t= 5 .161 ,30 .101 and 7 .250 , respectively ,all P < 0 .05 ) . Immunohistochemistry proved that the expressions of IGFBP7 in fibrosis model group and TGF-β1 vaccine group were all significantly higher than control group ;and the expressions of IGFBP3 in fibrosis model group and TGF-β1 vaccine group were all significantly lower than control group .The expressions of IGFBP3 protein in control group , hepatic fibrosis model group and vaccine intervention group were 7 .508 ± 0 .357 ,5 .200 ± 0 .210 and 5 .751 ± 0 .178 ,respectively (t = 7 .622 ,6 .180 and 29 .156 , respectively ,all P < 0 .05) . The expressions of IGFBP7 were 1 .176 ± 0 .051 ,1 .735 ± 0 .115 and 1 .428 ± 0 .056 ,respectively (t = 7 .188 ,4 .827 and 8 .649 ,respectively ,all P< 0 .05) .Conclusion TGF-β1 vaccine can affect the expressions of IGFBP3 and IGFBP7 ,which plays an important role in the formation and development of hepatic fibrosis .

Relationship between postoperative cognitive dysfunction and the expression of α1-antichymotrypsin in plasma / 临床麻醉学杂志

Objective To investigate the relationship between the expression ofα1-antichymot-rypsin (α1-ACT)in plasma and postoperative cognitive dysfunction(POCD).Methods The cognitive function of 64 patients undergoing operation under general anesthesia was evaluated by a battery of cognitive assessment instruments(BCAI)and the levels ofα1-ACT were measured at the time 1 d pre-operatively and 7 d and 3 months postoperatively.The patients were randomly divided into two groups:30 patients in ulinastatin group (group U)were injected with 10 000 U/kg ulinastatin,which was dissolved in 100 ml saline,within 20 min at the time of 30 minutes before induction;while control group (group C)were injected with the same volume saline.Results There was no significant differ-ence between the expression of α1-antichymotrypsin in patients with POCD and in control patients at the time before operation.Compared with control patients,the levels of α1-ACT in patients with POCD at the time of 7 d and 3 months postoperation were significantly higher (P <0.05).The levels of α1-ACT at 7 d postoperation were significantly higher than that preoperatively in both groups (P <0.05).The incidence of POCD in group U were significantly lower than that in group C,at the time of 7 d and 3 months after surgery (P <0.05).Conclusion POCD is associated with high expression of plasma α1-ACT.

The blood pressure control effect of captopril sustained-release-tablets based combination antihypertensive therapy on hospitalized high-risk patients with hypertension in high altitude region / 中国综合临床

Objective To investigate the blood pressure control effect of captopril sustained-releasetablets based combination, antihypertensive therapy on hospitalized high-risk patients with hypertension in high altitude region. Methods According to the blood pressure,risk factors and combined target organ damage,331 hospitalized patients with essential hypertension were divided into 2 groups and accepted different treatment:low-risk group had monotherapy (n=102) , and night-risk group had captopril sustained-release-tablets based combination antihypertensive therapy (n =229). The discharge blood pressure,extent of SBP/DBP decrease and the compliance rate of discharge blood pressure of two groups were compared. Results The extent of SBP/DBP decrease in hight-risk group was significantly greater than low-risk group (SBP [36. 83 ± 22. 23] mm Hg vs.[28. 74 ±18.71] mm Hg,t=-3. 207,P 0. 05;DBP[80. 67 ±9. 82]mm Hg vs. [78. 40 ±9. 97]mm Hg,t =-1.910,P > 0. 05). Furthermore we found no significant difference in the control rate of blood pressure between high-risk and low-risk group (72. 06% vs. 71. 57% , x2 = 0.928, P > 0. 05). Conclusion The captopril sustainedrelease-tablets based combination antihypertensive therapy is a reliable treatment in high-risk patients with hypertension from high altitude region,which shows satisfying blood pressure control rate.

A correlation study of Tei index and N-terminal pro-brain natriuretic peptide in patients with high altitude heart disease / 中华内科杂志

ObjectiveTo explore the diagnostic value of Tei index of right ventricle and serum level of NT-proBNP in patients with high-altitude heart disease (HAHD).MethodsRight ventricle Tei index and serum NT-proBN level were calculated and tested in 32 local healthy volunteers and 34 cases of HAHD patients hospitalized in our hospital in Golmud city (2808 meters above sea level) from 2008 to 2010,and a correlation study was conducted thereafter.ResultsThe pulmonary arterial systolic pressure and right ventricle Tei index,elevated significantly in HAHD patients compared with the control group [(86.61 vs 9.72)mm Hg(1 mm Hg=0.133 kPa) and(0.90 vs 0.33)respectively,P＜0.05].Patients diagnosed as mild pulmonary hypertension without alteration in cardiac structure showed higher pulmonary arterial systolic pressure and the Tei index compared with the control group [( 57.1 vs 9.72 )mm Hg and (0.78 vs 0.33 ) respectively,P ＜ 0.05 ].In addition,the level of serum NT-proBNP was significantly higher in HAHD group than that of control group [( 1246.8 ± 512.6) ng/L and (98.6 ± 21.7 ) ng/L respectively,P ＜ O.05 ].ConclusionRight ventricle Tei index and serum NT-proBNP level are sensitive indicators for right ventricular function and thus of favorable clinical significance for the diagnosis of HAHD.

Comparison of upstream versus downstream tirofiban on tissue-level perfusion and troponln release in non-st-segment elevation acute coronary syndrome patients treated with percutaneous coronary Intervention / 中国基层医药

Objective To compare the effects of upstream versus downstream tirofiban on tissure level perfu-sion and troponin Ⅰ release in high-risk non-ST-segment elevation acute coronary patients treated with percutaneous coronary intervention. Methods We randomized 138 non-ST-segment elevation acute coronary syndrome patients un-dergoing PCI to receive upstream(in the coronary care unit) and downstream(just prior to PCI) tirofiban. We com-pared the effects between the two drug regimens on tissue-level peffusion using Thrombolysis In Mycardial Infarction (TIMI) fram count,the TIMI myocardial perfusion grade(TMPG) and cardiac tropinin Ⅰ (cTn Ⅰ) release before and after PCI. Results There was no significant difference between two groups in TIMI 3 flow(P>0.05). High percent-age of TMPG 3 perfusion were observed in upstream tirofiban group than in downstream tirofiban group (P < 0.05). Post-procedual cTnI elevation was significantly less frequent among patients in the upstream group (P < 0.05). The cTnI level after PCI was significantly lower with upstream tirofiban compared with downstream tirofiban group (P<0.05). Conclusion Among high-risk non-ST-segment elevation ACS patients treated with an early invasive strategy, upstream tirofiban is associated with improved tissue-level perfusion and attenuated myocardial damage.