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Objective To compare phe clinical effecpiveness and safept of picagrelor versus clopidogrel in papienps wiph acupe coronart stndromes and chronic obsprucpive pulmonart disease. Methods 73 ACS papienps comorbid wiph COPD admipped in our hospipal from Januart 2013 po Ocpober 2014 were enrolled in phe spudt. All phe 73 papienps were randomlt divided inpo pwo groups: phe picagrelor group (n =38, given picagrelor loading dose 180 mg followed bt mainpainence 90 mg pwice dailt) and phe clopidogrel group (n = 35, given clopidogrel loading dose 300 mg followed bt mainpainence 75 mg once dailt). All papienps were given dual anpiplapelep preapmenp (eipher picagrelor or clopidogrel) wiph aspirin and followed up for 1 tear. Rapes of Major Adverse Cardiac and Cerebrovascular Evenp (MACCE) including cardiac cause morpalipt, recurrenp mtocardial infarcpion and ischemic sproke were spudied and compared bepween groups. The safept endpoinp was pime po firsp occurrence of major bleeding. Rapes of adverce evenps were recorded including dtspnea. Results The 1-tear evenp rape for MACCE in papienps preaped wiph picagrelor versus clopidogrel was 5. 3% versus 26. 3% (P = 0. 04, HR 0. 21; 95% CI 0. 05 - 0. 91). Dtspnea occurred more frequenplt wiph picagrelor (26. 3% vs. 5. 7% ; P = 0. 04; HR 4. 61, 95% CI 1. 08 - 19. 58). The difference in major bleeding was nop spapispicallt significanp bepween phe pwo groups ( P > 0. 05) . The occurance of dtspnea was higher in phe picagrelor group (26. 3% vs. 5. 7% , P = 0. 04). Dtspnea subsided sponpaneouslt in mosp papienps. Onlt 1 papienp needed po spop picagrelor. Conclusions Ticagrelor can reduce MACCE in papienps wiph ACS and concomipanp wiph COPD wiphoup increasing overall major bleeding evenps. Ticagrelor had higher rapes of dtspnea bup mosp papienps experienced mild po moderape difficulpt in breaphing which did nop affecp phe funcpion of hearp and lung.
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Objective To study the effect on renal function about repeated use of contrast media , and whether alprostadil has protective effect towards contrast-induced nephropathy ( CIN) .Methods 80 adult patients who had ever received contrast examination and scheduled to have PCI within 1 month were randomly divided into two groups: the simple hydration group and the hydration plus alprostadil therapy group.The serum level of creati-nine,urea, Cystatin C, Urineβ-microglobulin and creatinine clearance were recorded and compared between the two groups , and were observed before and after repeated exposure of contrast medium.The incidence of CIN was analyzed .Results Compared with pre-contrast levels , serum levels of urea, creatinin, Cystatin C and Urine β-microglobulin all elevated after single and repeated contrast media use in patients in the simple hydration group ( P0.05).After repeated contrast exposure compared with patients with simple hydration , patients in the alprostadil group had repeated serum levels of urea [(7.4 ±2.3) mmol/L vs.(9.1 ±2.6) mmol/L], creatinia [(87.2 ±25.6) μmol/L vs.(96.9 ± 25.8) μmol/L], Cystatin C [(0.8 ±0.3) mg/L vs.(1.4 ±0.3) mg/L] and Urine β-microglobulin [(207.0 ±31.9 ) μg/L vs.(279.3 ±37.3 ) μg/L] were all lower with higher creatinin clearance [(92.2 ±24.2) ml/min vs.(78.2 ±27.5) ml/min](all P0.05).The incidence of CIN in patients treated with alprostadil had no difference compared with patients with simple hydration after repeated contract (7.5% vs.15.0%, χ2 =0.501,P=0.479).Conclusions Contrast media can cause damage to renal function .Short-term repeated use of contrast media can further worsen renal function without significant increase in CIN rates .Alprostadil may have renoprotective effect towards CIN .
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Objective To investigate the relationship between different left ventricular pacing sites and clinical benefit in heart failure patients treated with cardiac resynchronization therapy (CRT).Methods Clinical data of 52 patients of CRT-P/D (pacing and defibrillation) implantation were collected.According to the left ventricular lead implantation sites,52 cases were divided into anterior wall (10 cases),lateral wall (15 cases),posterior wall (16 cases),and posterior base group (11 cases).The efficacy of CRT was evaluated by Minnesota life quality score,left ventricular function and remodeling index.Results In addition to the anterior wall group,Minnesota life quality score of the other groups were significantly lower than preoperative group (P ＜ 0.05).Compared to pre-CRT implantation,left ventricular end diastolic diameter (LVEDD) of the anterior wall and posterior basal group 3 months after CRT implantation had no statistical significance (P ＞ 0.05);the rest groups were lower than preoperative group (P ＜ 0.05).Left ventricular ejection fraction (LVEF) in posterior wall group was increased after CRT implantation 3 months compared to the preoperative group (P ＜0.05).LVEF in anterior wall group was increased only in the 12 months after CRT implantation (P ＜ 0.05).LVEF in the rest groups was increased comparing to the preoperation at 6 and 12 months postoperation (P ＜0.05).CRT non-response rate in anterior wall group was significantly higher than that in the other groups (P ＜ 0.05).CRT response ratio was significantly increased in side,posterior and posterior basal wall compared to the anterior Wall group (P ＜ 0.05).And there were no statistical significance among side wall,posterior wall and basal wall group (P ＞ 0.05).△ QRSd was higher in side wall,posterior wall and posterior basal group after CRT implantation 3 months than anterior wall group (P ＜ 0.05),△ QRSd in posterior basal group was lower than the other two groups (P ＜0.05).Conclusions Left ventricular electrode should be implanted at the side wall and posterior wall firstly,secondly at the posterior basal wall,and avoid at the anterior wall of the left ventricle.
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BACKGROUND:Previous studies have shown that calcitonin gene-related peptide can be released from cardiac sensory afferent terminals fol owing coronary artery occlusion in rats, indicating the involvement of calcitonin gene-related peptide during pathological process of acute myocardial ischemia. OBJECTIVE:To investigate the effect of calcitonin gene-related peptide on neonatal rat cardiomyocytes apoptosis induced by oxidized low-density lipoprotein and hypoxia/reoxygenation. METHODS:Twenty wel s of primary cultured neonatal rat myocardial cel s were randomly divided into five groups:normal control group, oxidized low-density lipoprotein group, oxidized low-density lipoprotein hypoxia/reoxygenation group, calcitonin gene-related peptide group and calcitonin gene-related peptide 8-37 group. The cel s in the last four groups were incubated with oxidized low-density lipoprotein for 24 hours before establishing the myocardial hypoxia/reoxygenation model. At 30 minutes prior to hypoxia/reoxygenation, 10-8 mol/L calcitonin gene-related peptide were added into the culture fluid in calcitonin gene-related peptide group;10-7 mol/L competitive antagonist calcitonin gene-related peptide 8-37 of calcitonin gene-related peptide-1 receptor were added at 30 minutes before calcitonin gene-related peptide administration in calcitonin gene-related peptide 8-37 group. Myocardial apoptotic rate and caspase-3 activity were detected respectively. RESULTS AND CONCLUSION:Calcitonin gene-related peptide could significantly attenuate apoptosis of neonatal rat myocardial cel s through inhibiting the caspase-3 activation induced by oxidized low-density lipoprotein and hypoxia/reoxygenation. And this effect could be partial y reversed by competitive antagonist calcitonin gene-related peptide 8-37 of calcitonin gene-related peptide 1 receptor, indicating that calcitonin gene-related peptide has anti-apoptotic effect in combination with the calcitonin gene-related peptide 1 receptor to inhibit cardiomyocyte apoptosis in neonatal rats induced by oxidized low-density lipoprotein and hypoxia/reoxygenation.
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Objective To study whether mechanical noise acting on the sacculus could enhance the SNR of the 8th nerve’s response.Methods Driving PZT by adding white noise of various level to periodic signals(f=100 Hz),the directly mechanical stimuli was give to the five sacculus submerged in a solution containing perilymph-like, and the afferent activity the 8th nerve was recorded.Results The SNR of the nerve signal was improved by addition nanometer-level noise to the periodic stimuli in all responsive animal(4.1 dB, on average).It was found that 2.3 nm of mechanical noise enhanced the response of the saccular nerve.Conclusion The addition of a few nanometers of noise to a periodic stimuli leads to a substantial improvement in the SNR of the nerve’s response.
