简介:目的探讨酷似急性心肌梗死(AMI)的急性重症病毒性心肌炎(AFVM)的诊断和治疗。方法收集临床表现酷似心肌梗死(MI),经过冠状动脉造影(CAG)显示冠脉正常的AFVM14例,分析该病的发病机制、心电图特征、治疗及预后。结果经及时确诊并采取相应治疗后4例乏力、胸痛、心悸、气短等症状明显好转,心肌酶、心电图及心脏彩超恢复大致正常范围;2例发生阵发性心悸,发作时心电图示:非阵发性室性心动过速及室上性心动过速,室性期前收缩;4例发作性胸闷、胸痛,心电图示:ST-T改变(ST段下移0.1~0.2mV,T波低平伴切迹);1例心电图示三度房室传导阻滞;1例呈左束支传导阻滞;1例显示病理性Q波;l例因急性期而死亡。结论酷似MI的病毒性心肌炎其临床表现、心电图、心肌酶改变酷似AMI。着重把握临床资料,掌握客观诊断依据,积极合理诊治是值得临床医生重视的问题。
简介:BackgroundTheprognosticvalueofserumC-reactiveprotein(CRP)inpatientswithinfectiveendocarditis(IE)isnotwellelucidated.ThisstudyaimedtoevaluatetheusefulnessofCRPinpredictingtheoutcomeofIE.MethodsTwohundredninty-sixpatientsfrom2009to2012intheDepartmentofCardiologyatGuangdongGeneralHospitalwerescreenedanddividedintosurgicalandconventionaltreatmentgroups.CRP,whitebloodcell(WBC),erythrocytesedimentationrate(ESR)andotherclinicaldatawereobtainedwithfollow-upfor12months.ResultsTwohundredthirty-sixpatientswereassignedtoreceivesurgerytreatmentwhile60patientsreceivedconventionaltreatment.Inthesurgerygroup,thelevelofCRPinthedeathpatientswassignificantlyhigherthanthatinthesurvivalpatients(P<0.001).TheareaunderthecurveofROCwasabout0.749(SE0.064,P=0.005,95%CI,0.624-0.874)andthecut-offpointofCRPwas23.8mg/L.Inconventionalgroup,therewassignificantdifferencebetweendeathandsurvival(P<0.001).TheareaunderthecurveofROCwasabout0.701(SE0.095,P=0.032,95%CI,0.515-0.888)andthecut-offpointsofCRPwas65.6mg/L.TherewerenosignificantdifferencesinWBCandESRbetweensurgeryandconventionalgroups.ConclusionAmoreaggressivesurgicalinterventionresultsinabetteroutcomeoverconventionaltreatmentandCRPcouldbeservedasapredictivemarkerforadverseoutcomeinIEpatients.
简介:目的观察心肌梗死急诊经皮冠状动脉介入(PCI)治疗的疗效及安全性.方法对14例急性ST段抬高心肌梗死(STEMI)患者在发病12h内行急诊PCI.其中急性前壁、急性前间壁心梗10例,急性下壁心梗4例.结果14例患者中,冠脉造影显示梗死相关动脉(IRA)为前降支8例,回旋支3例,右冠脉4例,13例患者(92.9%)介入治疗获得成功,置入支架15枚,全部获得TIMI血流3级.1例因术中发生室颤,经除颤转为窦性心律后家属放弃手术未能成功.结论对急性STEMI患者行急诊PCI治疗是积极有效的,安全性高,能明显提高患者生活质量,降低住院死亡率.
简介:目的评估低密度脂蛋白胆固醇(LDL—C)/高密度脂蛋白胆固醇(HDL—C)比值对经皮冠脉介入(PcI)术后患者心血管事件的预测价值。方法选择急性冠脉综合征(ACS)并予前降支置入支架的患者119例,依据血浆LDL—C/HDL—C比值将患者分为3组,随访1年,评估三组患者心血管事件发生率,以及各危险因素与心血管事件发生率的关系。结果①与LDL—C/HDL—C比值较低的两组相比,比值较高组患者体重指数、女性患者百分率、吸烟人数及糖化血红蛋白、高敏C反应蛋(hs—CRP)、总胆固醇和LDL—C水平均明显升高,而HDL—C水平和他汀类药物使用率则较低(P〈0.05)。②第1组风险(HR)1.04,95%可信区间(c,)0.98-1.08,第2组HR1.16,95%C11.08-1.20,第3组HR1.27,95%C11.19~1.36(P〈0.05)。随着LDL—C/HDL—C比值的升高,PCI术后1年患者心血管事件发生率也逐渐升高(P〈0.05)。③Cox比例风险回归模型提示,LDL—C/HDL—C比值对PCI术后心血管事件风险的预测价值优于其他危险因素。结论LDL—C/HDL—C比值对PCI术后患者1年内心血管事件再发具有一定的预测价值。
简介:AbstractAnagedmalepatientwithcoronaryheartdiseasewhichhadbeentreatedwithcoronaryarterybypassgrafts(CABG)andadministrationofmetoprolol,presentedparoxysmalvertigointhepreviousthreeweeks.The24hourssynchronic12-leaddynamicelectrocardiography(DCG)revealedmanyepisodesofsinusarrestwhichmostlywerefollowedbyA-Vjunctionalorventricularescaperhythm,thelongestsinuspauselastingmorethan14.5secondswithnosymptom.Afterwithdrawalofmetoprolol,theDCGrevealedmuchlessepisodesofsinusarrestthanon-admission,butstillsomeA-Vjunctionalandventricularescapebeats.Sicksinussyndromeswasthendiagnosed,andasynchronousdual-chamberpacemaker(DDDR)wasimplantedtwoweeksafteradmission.
简介:ObjectivesTostudythedepressiveeffectoftheantisenseoligonuceotides(ASODN)ofc-mycandproliferatingcellnuclearantigen(PCNA)ontheproliferationofVSMC.MethodsTakingtheVSMCobtainedfromrataortathoracaliscultured4~8generationasresearchobject.Theobjectsweredividedintothreegroupstocarryoutcontrolstudy:controlgroup,PCNAASODNgroupandc-mycASODNgroup.TheASODNs'workingconcentrationallwere1:50.ThedepressiveeffectofASODNonVSMCproliferationwasinvestigatedbycellcounting,MTTand3H-TdRincorporationassay;PCNAandc-mycexpressionweredetectedbyimmunohistochemicalmethodaftertransferringPCNAandc-mycASODNintoVSMC.ResultsPCNAandc-mycASODNcouldinhibittheproliferationofVSMCsignificantly,comparedwithcontrolgroup(P<0.05).②TransferringPCNAandc-mycASODNintoVSMCobtainedsuccessfully;thecorrespondinggenewasinhibitedobviously;comparedwithcontrolgroup(P<0.05).ConclusionsPCNAandc-mycmightplayaconsiderableroleintheVSMCproliferationprocess.ThecorrespondinggenecouldbedepressedsuccessfullyaftertransferringPCNAandc-mycASODNintoVSMC,andthentheproliferationofVSMCwassloweddown.Thisstudypresentedabeneficialproposalandtheoreticalfundamentforatherosclerotictreatment.
简介:Bothendotheliallipasegene(LIPG)584C>T(rs2000813)polymorphismandalcoholconsumptionmodulateserumlipidlevels.Buttheirinteractionsonserumlipidprofilesarenotwellknown.ThepresentstudywasundertakentodetecttheinteractionsofLIPG584C>Tpolymorphismandalcoholconsumptiononserumlipidlevels.GenotypingoftheLIPG584C>Twasperformedin763nondrinkersand520drinkersaged15-85.Interactionsbetweenthegenotypesandalcoholconsumptionwereassessedbyusingacross-productterm.Thelevelsofserumtotalcholesterol(TC),triglyceride(TG),high-densitylipoproteincholesterol(HDL-C),apolipoprotein(Apo)AI,andtheratioofApoAItoApoBwerehigherindrinkersthaninnondrinkers(P<0.01forall).Therewasnosignificantdifferenceinthegenotypicandallelicfrequenciesbetweennondrinkersanddrinkers.ThelevelsofserumTC,HDL-CandApoAIinnondrinkersweredifferentamongthethreegenotypes(P<.05-.01).ThesubjectswithCTgenotypehadhigherserumTC,HDL-CandApoAIlevelsthanthesubjectswithCCgenotype.ThelevelsofserumHDL-CandApoAIindrinkersweredifferentamongthethreegenotypes(P<.001andP<.05;respectively).TheindividualswithTTgenotypehadhigherserumHDL-CandApoAIlevelsthantheindividualswithCCandCTgenotypes.ThelevelsofTCinnondrinkerswerecorrelatedwithLIPG584C>Tallele(P<.05),whereasthelevelsofTGandHDL-CwereassociatedwithLIPG584C>Talleles(P<.05)andgenotypes(P<.05);respectively.ThepresentstudysuggeststhatthesubjectswithTTgenotypebenefitedmorefromalcoholconsumptionthanthesubjectswithCTandTTgenotypesinincreasingserumHDL-CandApoAIlevels.
简介:backgroundBonemarrowmesenchymalstemcells(BMSCs)canbeisolatedandculturedtomanypassages.However,StemcellsincludingBMSCsquicklyundergosenescenceinculture.Thecellsenescenceandmulti-directionaldifferentiationhavehamperedproducingBMSCsinquantitywiththeirundifferentiatedstate.Inthisstudywereportanaturalcompound,vitaminC(Vc),maintainsBMSCsstemproperty.MethodsHumanBMSCswereisolatedfrombonemarrowandpurifiedby1.073g/mLdensitygradientcentrifugation.50ng/mLVcwereaddedtoBMSCsfordifferenttimepoint.FlowcytometrywasusedtodetectcellsurfacemarkersofBMSCswithorwithoutVctreatment.BMSCsproliferationwasanalyzedbyMTTassay.PCR(polymerasechainreaction)andreal-timePCRwereusedfordetectingc-kit,nanog,andOct-4genesexpressionlevels.DNAmethyltransferase(Dnmt)1andDnmt3blevelswerealsodetectedbyreal-timePCR.ResultsFlowcytometryshowedthatafterVctreatmentfor6h,thesurfacemarkersofBMSCswerealmostunchanged.VcincreasedtheproliferationactivityofBMSCsfrom6hto24h.PCRshowedtheexpressionofc-kit,nanog,andoct-4geneswereobviouslyincreasedinVctreatedgroupthancontrolgroupat12h.Real-timePCRshowedthatthelevelofc-kit,nanog,andoct-4geneswereunregulatedfrom6hto12hcomparedwithcontrolgroup.VcalsoincreasedDnmt3bbutnotDnmt1geneexpression.ConclusionsOurresultsshowedVcactsatleastacceleratesBMSCsproliferationandmaintainsstemcellproperty.Inourstudy,wehighlightedamethodofimprovingthespeedofBMSCsgenerationandprovidedadditionalinsightsintothemechanisticbasisofpreventingBMSCssenescence.
简介:BackgroundInthisstudy,weaimedtoevaluatetheimpactofabnormalglucose,lipidandCystatin-ConthevirtualPvectorcharacteristics,whichhaven’tbeenreportedinpreviousstudies.Methods204ofnon-diabetesmellitus(NDM),130ofDM(type2)and39ofimpairedglucosetolerance(IGT)patientswereconsecutivelyandretrospectivelyrecruited.Weselectedaone-minutelengthofelectrocardiogramat4AMforanalysis.Afteraseriesofcalculatingalgorisms,weobtainedthevirtualplanarPvectorparameters.ResultsTherewerenosignificantdifferencesinFPV,FPA,RSPV,RSPA,HPVandHPAgroups.Afteradjustingconfoundingfactors,theregressioncoefficients(RC)wereestimatedasfollow:forFPV,femalegender(RC-0.21,P=0.02),triglyceride(RC-0.09,P<0.01),RVOT(RC0.03,P=0.02);forRSPV,femalegender(RC-0.21,P<0.01),triglyceride(RC-0.10,P<0.01),averageheartrate(RC0.01,P=0.02);forHPV,triglyceride(RC-0.08,P<0.001),LDL(RC-0.19,P<0.01),ApoB(RC0.67,P<0.01);forRSPA,Btypeofblood(RC-22.06,P=0.02),Cystatin-C(RC-72.79,P=0.02),thicknessofinterventricularseptum(RC3.70,P=0.01).Cystatin-CwassuggestedasacurerelatedtoRSPA,andthecut-offpointwas1.6mg/L.TherewerenosignificantriskfactorsassociatedwithFPAandHPA.TherewasnodifferenceinvirtualPvectoramongDM,IGTandNDMgroups.ConclusionIncreasedlevelsoflipidandCystatin-CsignificantlyimpactthecharacteristicsofvirtualPvector,whereasglucosedoesnot.Thesechangesmaycomefromahigherlowvoltageatrialareaandabnormalorientationofatrialdepolarization.