简介：SignificanceofECGChangesinAcuteMyocardialInfarctionSTsegmentelevationisconsideredbymostasasignofanoccludedcoronaryarteryandmyocardialischemia.CoronaryarteryocclusionusuallyisthecauseoftheacuteinfarctioninthepatientwiththattypeofECG.PatientswithacutemyocardialinfarctionwhodonotshowSTsegmentelevationyetleaktroponin,stillhaveamyocardialinfarction.

简介：标题MINI研究:一个关于对比阿加曲班或肝素作为组织型纤溶酶原激活剂(tPA)的附加剂应用于急性心肌梗死患者的多中心、随机临床试验作者JangI-K,BrownDFM,GinglianoRP,etal

简介：IntroductionRecently,bonemarrowmesenchymalstemcells(MSCs)havebeenreportedtorepairchronicallyinfractedmyocardiumwithdirectinjection.However,itisverydifficulttolocalizetheinjectedcellsontotheischemicareatoregeneratesufficientcardiacmassinthethinnedscararea.Toovercometheproblem,wehaveutilizedourcellsheettechnologybasedontemperature-responsiveculturedishes.Whentheculturetemperatureisreducedfrom37℃to20℃,allcellsconnectedviacell-celljunctionproteinsareharvestedasasinglesheetwithoutusingproteolyticenzymes.Thistechnologyallowsustotransplantstemcellsinvivofortreatmentheartdiseasewithouttheproblemsmentionintheprevious.MethodsMaleClawnminipigswereusedinthisstudy.Bonemarrow(5-7mL)wascollectedundergeneralanesthesia.Histopaqe-1077(15mL),wereaddedtobonemarrowandcentrifuged.Thecellswerecollectedandculturedfor7days.Weseededthebonemarrow-derivedMSCsattheconcentrationof(6×10~5/ml)on60mmdiametertemperature-responsivedishesfor7days.Astheculturetemperaturedecreasedfrom37℃to20℃,MSCsheetdetacheditselfspon-taneouslyandfloatedupintotheculturemedium.Triplelayerswerestackedtogetherrepeatedlyformingspecialmultiplayer.Myocardialinfarctionwascreatedbytheligationoftheleftanteriordescendingbranchoftheleftcoronaryartery.Acellsheetswastransplantedontotheischemiaarea.Theechocardiographywasperformedtwoandfourweeksaftertransplantation.Thehearttissuewithcellsheetswereremovedandfixedwith10%formalinforhistologicalanalysisonemonthafterthetransplantationofcellsheets.ResultsMostMSCsarepositiveforCD29,CD90,CD146andCD73.ThesemeantheculturecellsheetswerecomposedofundifferentiatedMSCsandremainedmultipotent.Monolayers(20-30μm)andmultilayer(120μm)cellsheetswereproduced,whichretainedallcell-to-cellcontaction.Histologicalanalysesshowthecellsheetsbecomecloselycontactedwiththehearttiss

简介：Theriskofmyocardialinfarctionincreasesinpatientswithdiabetesmellitus.Theincidenceofmyocardialinfarctionissimilarinpatientswithtype2diabeteswithouthistoryofmyocardialinfarctionandinnon-diabeticpatientswithhistoryofmyocardialinfarction.DiabetesmellituswasconsideredasacoronarydiseaseequivalentbytheNationalCholesterolEducationProgram.Strictglycemiccontrolcanimprovethelong-termoutcomeofbothtype1andtype2diabetesmellitus.Whateverwithdiabeticornon-diabetic,strictglycemiccontrolwithintensiveinsulintherapycanreducethemortalityofcriticallyillpatientsinhospital.Aftermyocardialinfarction,therewouldbeaworseoutcomeforpatientswithpoorglycemiccontrol,whateverindiabeticornon-diabeticpatientswithstresshyperglycemia.Meanwhile,strictglycemiccontrolcanimprovetheoutcome.TheguidelineofAmericanCollegeofCardiology/AmericanHeartAssociationin2004onST-elevatedmyocardialinfarctionrecommendedinsulininfusionmaintainingtheeuglycemiaforpatientswithacutemyocardialinfarctionandcomplicatedconditions,whetherwithdiabetesmellitusornot,anditwasconsideredreasonabletoinfuseinsulinforallpatientswithhyperglycemiaduringtheperiodofacutemyocardialinfarction.Thispaperproposedaneffectiveandsafemethodforintravenousinsulininfusiontherapyfordiabeticpatientswithacutemyocardialinfarction.

简介：Managementofthrombusincoronarylesionsremainsachallengethatisfrequentlyencounteredduringprimarypercutaneouscoronaryintervention(PCI)forST-elevationmyocardialinfarction(STEMI)andisusuallyassociatedwithpoorclinicaloutcomes.Atthesametime,theoptimummanagementofsuchlesionsremainsadilemma.Multiplethrombusremovalprocedureshaveemergedwiththeshort-termaimofimprovingmyocardialperfusionandalonger-termaimofdecreasingtheincidenceofbothmajoradversecardiacevents(MACE)andall-causemortality.Inthisreview,wewillhighlightthemainproceduresutilizedforthrombusremovalduringprimaryPCIforSTEMI,withparticularemphasisonaspirationthrombectomy.Wewillalsoapproachpossibletheoriesthatmightexplaintheapparentlackofclinicalbenefitrecentlyshownwithsuchprocedures.

简介：Objectives:Toexploretheeffectofacupunctureoncerebralinfarctioninratsandtotryprovidingsomeexperimentalparametersforclinicalpractice.Methods:27healthyWistarratswererandomlydividedintopseudo-operation(n=10),model(n=8)andacupuncture(n=9)groups.Neuro-functionaldefectscoring,apoptosisofsinglebrainsliceandthenumberofbcl-2immuno-reaction(IR)-positiveneuronsinCA1areaofthehippocampuswereusedastheindexestoinvestigatethepossiblemechanismsofacupunctureof'NieSanZhen'(needlingthreeacupointsinthetemporalregion)and'SiShenZhen'(needlingfouracupointsintheocciputregion)intreatingratswithcerebralinfarction.Results:Thereexistedsignificantdifferencesbetweenacupuncturegroupandmodelgroupinimprovingneurologicfunctionalactivities,inhibitingapoptosisofthebraincellsandincreasingbcl-2IR-positiveneuronsinthehippocampalCA1area(P＜0.01).Conclusion:Acupuncturetherapycanimprovecerebralinfarctionintheratbysuppressingapoptosisandup-regulationofthebcl-2IR-positiveneuronexpression.

简介：目的将为服的梗塞续发症观察温暖挖出的刺破方法的临床的效果。有在有包括标准的一致的服的梗塞续发症的六十个病人随机被划分成一个治疗组和控制的方法组织，在每个组的30个盒子。控制组被给西方的药的基本治疗。治疗组被增加，针灸治疗在西方的药的治疗之上基于。在由健康的国家研究所的治疗摸规模(NIHSS)前后，病人的神经病学的缺点被估计。结果显著药品率是83.3%，全部的有效的率在治疗组是93.3%，对56.7%和70.0%处于在二个组之间的显著药品率和全部的有效的率与统计差别在控制组织(P<0.05)。在治疗以后，NIHSS分数在两个组减少了(P<0.01或P<0.05)，并且差别是统计的在二个组之间重要(P<0.01)。结论温暖挖出的刺破方法比在服的梗塞续发症的治疗的西方的药的单个治疗好。

简介：Objective:Toobservethetherapeuticeffectofoculo-acupuncturetherapyinthetreatmentofcerebralinfarctioninducedhemiplegia.Methods:58casesofstrokepatientswererandomlydividedintotreatmentgroup(n=30)andcontrolgroup(n=28).Intreatmentgroup,onthebasisofmedicationplusrehabilitationtreatment,patientsvoluntarilyacceptedoculo-acupuncturetherapy(acupunctureofUpper-JiaoAreaandLower-JiaoArea).Incontrolgroup,patientsonlyacceptedmedicationandrehabilitationtreatment.ThetherapeuticeffectwasevaluatedwithBrunstrom's6-stagesAssessingMethod.Results:After24sessionsoftreatment,theratiosofthediseasedlimbsreachingstageⅥandmoreinfunctionalactivityinthepatientsoftreatmentgroupincreasedfrom16.7%(upper-limb)and20.0%(lower-limb)beforetreatmentto70.0%and90.0%respectively;whileincontrolgroup,thoseratiosoftheupperandlowerlimbsincreasedfrom10.7%and28.6%beforetreatmentto39.2%and60.7%separately.Therewasasignificantdifferencebetweentwogroupsinthetherapeuticeffect(P＜0.05).Conclusion:Oculo-acupunctureplusmedicationissuperiortosimplemedicationtreatmentinimprovingfunctionalactivityofthehemiplegiclimbs.

简介：ObjectiveTofurtherimprovetherateofreperfusionofinfarctionrelatedarteryinAMI,removethestricture,rescueischemicmyocardium,protectcardiacfunctionandamelioratethelong-termprognosis.MethodAmong73patientswithA-MI,50underwentdirectPICA,15immediatePICA,8rescuePTCAand20braceswereimplanted.ResultTheproportionofrecanalizationis94.5%(69/73).Thegradeofbloodflow(TIMI)improvedtograde3in20patientswithbraceimplantation,while44tograde3and5tograde2among49patientswithsimplePTCA.Residualstenosisinvesselwas1.8±5.9(-10-10)%inpatientswithbraceimplantationversus15.4±11.(0-30)%withsimplePTCA.Theincidenceofreperfusivecardiacarrythmiawas18.1%(10/62).Therewasmainlyfrequentventricularprematurebeatandshortparoxysmalventriculartachycardia,ifleftanteriordecendingbranchwasreopened,whilebradycardiaandatrialventricularblockusuallyoccurredafterrightcoronaryreperfused.ConclusionEmergencyP

简介：ThetherapyofUBI(TheUltravioletirradiationoxygenateBloodItself-transfu-sion)isusedtotreat69casesofthepatientswithcerebralinfarctionwhichareallprovedtobecerebralinfarctionbythescanningofCT.TheeffectsofUBIonthenailfoldmicrocirculationofthepatientswerestudiedwith“WeightedMultipleScoreofthenailfoldmicrocirculation”workedoutbythemicrocirculationalspecialgroupP.L.A.Comparedwiththesameagedhealthyperson,theMultiplescoreofthenail

简介：Facialparalysiscanbeclassifiedascentralorperipheralfacialparalysisbasedonthelocationoftheunderlyinglesion,bothofwhichdemonstratefacialmotordysfunction.Inthecurrentlyreport,apatientadmittedtothedepartmentofotology,FirstPeople’sHospitalofQinhuangdao,presentedwithfacialasymmetryastheinitialsymptomofacerebralinfarctionandwasfirstmisdiagnosedasperipheralfacialparalysis.Thecaseisreportedasfollows.

简介：Thisstudysoughttoexamineneuroglobin(NGB)intheserumofacutecerebralinfarctionpatientswithdouble-antibodysandwichenzyme-linkedimmunosorbentassaytoidentifyallriskfactors,calculateinfarctsize,assessneurologicalimpairment,andanalyzetherelationbetweenNGBandeachofthesefactors.Thedouble-antibodysandwichassayindicatedthatlevelsofNGBinserumwereunalteredwithin6hoursfollowingacutecerebralinfarctioncomparedwithnormallevels.NGBlevelsthenunderwentadistinctchange,peakingat24hoursthenreturningtonormallevelsin72hours.TheresultssuggestthatthelevelofNGBmightberelatedtoinfarctsizeandlow-densitylipoproteinat24hoursafteracutecerebralinfarction.Therewerenosignificantdifferencesinneurologicalimpairmentscoresandinfarctsizeatdifferentperiodsfollowinginfarction.ThefindingsindicatedthatthelevelofNGBinserumofacutecerebralinfarctionpatientswascorrelatedwithinfarcttime.

简介：ObjectiveFortycasesofIAMIwereexaminedwithcoronaryangiographyinordertostudytherelationshipofthevesselswiththeECGofIAMI.MethodsForcoronaryangiographyJudkin’smethodwasused;IAMIwasdiagnosedbythe1979WHO’sstandardofISHDandECGwasseparatelymeasuredbytwodoctors.ResultsMostofIAMIwithpolybranchcoronaryoritscollateraldisease(32.5%and42.5%)andonly10cases(25%)withsinglebranchcoronarydisease,whoseECGswereuntypical.ConclusionIAMIwithsingle-branchcoronarydiseasemightexpressasmildsymptomsandhavenotypicalECGchange.WhiletypicalECGchangeemerges,thecoronaryarteryalwaysshowedpoly-branchdiseaseorcollateralbranchobstructionandthediseasewouldbeadvanced.ItisimportanttopaymoreattentiontothecasesofIAMIwithoutclassicECGchangesoastogivediagnosisandtreatmentthemintime.

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简介：Cholesterolcrystalshavelongbeenrecognizedaspartofatheroscleroticplaques.Theyhavebeenvisualizedbylightmicroscopyasemptyspacesorimprintswherecrystalswereoncepresentandthendissolvedbytissueprocessing.Thus,untilnow,theirroleinatherosclerosisandplaquerupturehadbeenconsideredtobeinert.However,bytheprocessingoftissuewithoutethanolitwaspossibletovisualizetheirextensivenessandpotentialroleintissueinjury.Also,itwasdemonstratedthatcholesterolexpandsinvolumewhencrystallizingfromtheliquidtothesolidstate,whichisthepresumedcauseofplaquerupturebysharp-tippedcrystalsgrowingoutoftheplaque'snecroticcore.Specifically,inpatientswhodiedofmyocardialinfarction,allculpritcoronarylesionshadextensivecholesterolcrystalsperforatingthefibrouscapandintima,whilethosepatientswhodiedofothercausesandhadplaquesdidnothavecrystalsperforatingthecapandintima.Additionally,cholesterolcrystalstravelingdownstreamfromtheplaquerupturesitecanscrapetheendotheliumandpromotevasospasm.Moreover,cholesterolcrystalslodgingintothemusclecantriggeraninflammationwithnecrosisindependentofcirculatorycompromiseorischemia.Thesefindingssuggestthatcholesterolcrystalscouldplayacriticalroleinplaquerupture,aswellasvascularandmyocardialinjury.

简介：CLINICALMATERIALSThepatientwas7year-oldboy,bodyweight20kg.HewasadmittedonMay10th,2002becauseoffever,rashes,enlargedlymphnodes,conjunctivaeinjection,strawberrytongue,edemaanderythemaofthehandsandfeet.Laboratorydataasfollow:1.Prominentincreaseinwhitebloodcell(WBC)14.3-22.7×109.2.Anemia,hemoglobin(Hb)121→103g/L.

简介：ObjectivesLittleisknownaboutthemechanismofexercise-indueedangiogenieresponseinisehemicmyoeardium.Thisstudywasdesignedtoinvestigatetheeffeetsofexercisetrainingonexpressionofvaseularendothelialgrowthfaetorandangiogenesisininfarctedheart.MethodsFiftymaleFVBmiceweredividedintothreesubgroupstotestvariousresponsestoexercise,includingtimedependentresponseofangiogenicfactorstoexercisetraininginintactheart(n=10)andinfarctedheart(n=10),aswellasexercise-inducedangiogenieresponseinheartwithmyocardialinfarction(MI)(n=30).Themiceintheexercise-traininggroupswereallowedtoexercisedailyat1hourperdayfor7days.ResultsVEGFproteinexpressionwasup-regulatedbyexercisetrainingintimedependentfashioninmicewithMI.AngiogenesiswasevidentbyincreasedmyocardialmicrovesselsobservedbyPECAM-1immunohistoc-hemicalstaininginpost-MIexercisegroup(16.5±3.4)/0.4mm^2versuspost-MIsedentarymice(10±2.1)/0.4mm^2(P<0.05).Cellproliferationassessmentshowedsignificantlyhigher(P<0.05)numberofBrdUpositivecellsinpostMImiceinexerciseerouoasopposedtosedentarypostMImice.2%TTCstainingdisclosedaprofounddifferenceinthesizeofMI(18.25±2.93)%inexercisegroupvssedentarygroup(29.26±7.64)%(P<0.05).ConclusionsActivationandup-regulationofVEGFininfarctedmiceheartmaycontributestheangiogenicresponsetoexercisetrainingattheearlystageofmyocardialinfarction.Thisunderscorestheimpactofexerciseonangiogenesisinpostmyocardialinfarctionsetting.

简介：ObjectivesToexaminepatientdelay(PD)inseekingtreatmentamongpatientswithST-elevationmyocardialinfarction(STEMI)andtoidentifyfactorsinfluencingPD.MethodspatientswithSTEMIweredividedintotwogroupsbasedonPD:ShortPDgroup(PD≤60minutesafteronsetofsymptoms)andlongPDgroup(>60minutesaftersymptomonset).Aquestionnairedevelopedtoassessdemographiccharacteristics,clinicalfactorsandpsychologicalfactors.Patientswereinterviewedwithin72hoursofadmissionto2hospitals.Results329consecutiveconfirmedSTEMIpatients(Meanage61years;72.5%men)withamedianPDof90minandapre-hospitaldelaytime170minwerestudied,PDwaslessthan1hoursin47.4%ofpatients,whilemorethan1hoursin52.6%,Inunivariateanalyses,patientswithshortPDwerewitnessonset,progresscourseofsymptom,severepain,deathanxiety,knowingAMIasadeadlydiseaseanditspresentation,takingthesymptomseriously.PatientswithlongerPDwereage≥65year,nocturnalonset,experiencedtheirsymptomsathome,gradualonset,’waitedtoseewhethersymptomsdisappeared’,’worriedabouttroublingothers’,’tookpainmedication’andpreinfarctionangina.Astepwisemultipleregressionanalysisfurthersuggestedthatthefollowinginde-pendentcontributorstoalatedecisiontoseekmedicalhelp(relativerisk,95%confidenceinterval):takingpainmedication(15.97;1.70～149.8),wantingtowaitandsee(6.46;1.92～21.74),notwantingtobotheranybody(6.42;2.87～14.34),preinfarctangina(2.73;1.20～6.19),age≥65years(2.51;1.15～5.48),gradualonset(2.40;1.05～5.44),severepain(0.38,0.17～0.85),witnessonset(0.27,0.10～0.70),takingsymptomsseriously(0.019;0.08～0.46).ConclusionsAge≥65years,gradualonset,witnessonset,severepain,preinfarctangina,emotionalresponsesandcopingstrategiesaretheindependentfactorsassociatedwithpatientdelayordecisiontimeinpatientswithAMI.Emotionalresponsesandcopin

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简介：ObjectivesTodetectwhetherpersistingortransientglucosemetabolismdisorderisresponsibleforadmissionhyperglycemiainpatientswithacutemyocardicinfarction(AMI).MethodsTwogroupsofpatientswereenrolled:AMIgroupandcontrolgroup.Fastingplasmaglucose,2hoursplasmaglucose,glycatedalbumin(GA)andglycatedhaemoglobin(HbA1c)weremeasuredatbaselineinbothgroupsand30daysafterAMIattackinAMIgroup.Results(1)Therewerenosignificantdifferencesinbaselinecharacteristicsbetweenbothgroups;(2)Comparedwiththecontrolgroup,thelevelsofGAandHbAlcinAMIgroupatbaselineweresignificantlyhigher.(3)At30dayfollow-upinAMIgroup,bothFBGand2hPGdecreasedtonormalvalues,HbAlcdidnotchange,butonlyGAkeptonincreasing.ConclusionsHyperglycemiaonadmissioninpatientswithAMIresultedfrombothpreexistingmetabolicdisorderandstressreactionaswell.GAistheonlyindicatorthatcouldrecalltheexaggerationofglucosemetabolicdisorderduringAMIattackat30dayfollow-up.