简介：ObjectivesTodetectionofchlamydiapneumoniae(Cpn)DNAinthecirculatingmononuclearcellfractionsofcoronaryheartdiseaseandtoinvestigatetheassociationbetweeninfectionwithchlamydiapneumoniaeandcoronaryheartdisease(CHD)andprospectivelywhetherblood-basednestedpolymerasechainreaction(nPCR)isusefulinidentifyingCpninfection.MethodsTheperipheralbloodmononuclearcell(PBMC)CpnDNAwasexaminedusingnPCRtechniqueandconfirmedbyelectrophoresisin150patientswithCHD.Select55patientswithclinicalsuspectedCHDbutangiographyresultarenormalascontrolgroup(CG).Thenweconductedaprospective,randomized,double-blind,placebo-controlledstudyof6monthsofazithromycinandplacebotreatmentinCHDgroup.PatientswithCpnDNApositivewerethenrandomizedtoreceiveazithromycinorplacebo.Aftertreatmentbloodsamplewerecollectedforrepeatedmeasurement.ResultsChlamydiapneumoniaeDNAwasdetectedin49(32.7%)of150personswithCHDandin1(1.8%)of55personswithcontrolgroup,oddsratio26.2,95%confidenceinterva13.52-194.98.ThepositivityratesofnPCRinCHDgroupswerehigherthanthoseincontrolgroup.16cases(29.1%)inlatentcoronaryheartdiseases(LCHD)group,19cases(39.6%)inunstableangina(UAP)group,and14cases(29.9%)inacutemyocardialinfarction(AMI)groupwereCpnpositivebynPCR.TherewerenosignificantdifferenceamonginAMIUAPandLCHDgroup.ThereweresignificiantdifferenceinCpnDNAnegativeratesaftertheazithromycinandtheplacebotreatment.ConclusionsChlamydiapneumoniaeispresentinPBMCofasignificantproportionofpersonswithCHD.Thepotentialroleofchlamydiapneumoniaeincoronaryatherosclerosismaythereforebemorerelatedtoaccelerationofdiseaseorsystemiceffectsbypersistentinfectionthantosuddeninitiationofprogressivecoronaryarterydiseasebyacuteinfection.ThedetectionofCpnDNAinPBMCwithnPCRmaybeofgreatvalueforidentifyingCpncarriersandfo

简介：Complicationsaremorefrequentinelderlypatientswithcoronaryheartdisease(CHD),suchasimpairedglucosetoleranceandconstipations.Itisalwaysdifficulttocurethesecomplicationsinclinicalpractice.Inthiscasewehadsuccessfullycuredaneighty-threeyearsoldmanwithCHDcomplicatingimpairedglucosetoleranceandconstipationbyintegratedChinese-Westernmedicine.

简介：

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：ObjectivesToassesstherelationshipbetweenpeakoxygenconsumption(PVO2)andtheambulationdistanceinsix-minutewalktest(6MWT)amongthehealthysubjects.MethodsThe51healthysubjectswererecruitedforthesix-minutewalktest.Dataofpulmonarygasexchangebreathbybreath,suchasVO2,VCO2werereal-timemeasuredwithwirelessremotesensingK4B2,sotostudytherelationshipbetweenpeakoxygenuptakeandtheambulationdistance.ResultsItwasnoticedthattherewasapositivelinearcorrelationbetweentheambulationdistanceandPVO2(r=0.619,P<0.001)insix-minutewalktest.Theregressionequationwassetup(VO2/kg=0.05D-6.331,P<0.001).PVO2>PVCO2,R<1werefound,whichsuggestedthat6MWTwasatestbelowanaerobicthreshold.ConclusionsTherewasacloselypositivelinearcorrelationbetweentheambulationdistanceandPVO2,whichissafety,convenientandvaluablefortheevaluationofcardiopulmonaryfunctionandthetreatmentofcardiopulmonaryrehabilitation.

简介：ObjectivesWereportacaseinwhichapatientwhosufferedfromanginasecondarytomediastinalirradiationandhavebeentreatedbyoff-pumpcoronaryarterybypass(OPCAB)inourhospitalsince3yearsago.A34-year-oldmanpresentedwithanginafor8yearsafterreceivingradiationtherapyforHodgkin'slymphoma.WeretrospectivelyreviewedallthecasesofOPCABinourhospitalandfollowed-updataforupto3yearspost-operatively.Mediastinalirradiationisprobablythecauseofsignificantostialstenosisofleftmaincoronaryandrightcoronaryartery.OPCABgraftingwasperformedonthispatient3yearsago.Hisanginadisappearedafteroperation,andherecoveredwellduringfollow-up.ConclusionsPatientswithmalignancieswhohavereceivedmediastinalirradiationshouldbecarefullyfollowedupandroutinelyscreenedfortheprematuredevelopmentofcoronaryarterydisease.OPCABmaybeanappropriatetreatmentforcoronaryarterydiseasecausedbymediastinalirradiation.

简介：Useagenesutureimmersedrecombinanttissue-typeplasminogenactivator(r-tPA)expressionplasmidtotransducemyocardiatopreventthethrombosisaftermechanicaltricuspidvalvereplacementinpigs.MethodsAr-tPAgeneplasmidwasconstructedandconjugatedtoanovelcationicphosphonolipidandar-tPAgenesuturewasmade.Eighteenpigswereselectedanddividedintotwogroupsatrandomization.Therewere9pigsintheexperimentalgroupand9inthecontrolgroup,allthe18pigs'tricuspidswerereplacedwithmechanicalvalves.Thegenethreadsweresuturedintotherightventricularwallsnearmechanicalvalvesandanultrasoundwasusedonthesurfacesoftherightventricularwallsforthegenetransferintheexperimentalgroup.Coagulativefunction,D-dimerlevelofthebloodandthethrombosisonthesurfacesofthevalveswereobserved.Resultsr-tPAgeneplasmidwassuccessfullyconstructedandr-tPAproteinwasexpressedintheventricularcellsaroundthegenesutures.D-dimerreacheditspeaklevel(1.67±0.79)μg·mL-1in1weekafteroperationintwogroups,butitdecreasedtopreoperationlevelthereafterincontrolgroupandkeptonthehighlevelandreincreasedtoanewhighlevel(1.89±0.79)μg·mL-1untiltheendoftheexperimentinexperimentalgroup.Thethrombosesaroundthevalveswerefoundinallthecontrolgroup(100%)butonly1(11.11%)caseinexperimentalgroup.Therewerenochangesinprothrombintimepreandpostoperationintwogroups.ConclusionsUsinggenesutureimmersedr-tPAexpressionplasmidtotransducemyocardiamightbeabestsubstitutionforlifelonganti-coagulationtherapyforthepatients,whounderwentoperation.

简介：ObjectivesThepurposeofthisstudywastodetermineiftheultrasonicintegratedbackscatterandechointensitycouldbeusedinclinicaldiagnosisofacutemyocardialinfarction.MethodsandResultsWithin2weeksafteracutemyocardialinfarction,35patientsunderwentultrasonictissuecharacterizationfromthepapillaryshort-axisview.Thecyclicvariationofintegratedbackscatterandechointensityofthreedifferentmyocardialregionsperfusedbyleftanteriordescendingcoronaryartery,leftcircumflexcoronaryandrightcoronaryweremeasured.Thevalueofcyclicvariationofintegratedbackscatterandintegratedbackscatterandechointensity≤halfofthehighestvalueofthreedifferentmyocardialregionsonasameviewweredefineasthecriteriafordiagnosingacutemyocardialinfarction,andtheresultswerecomparedwithcoronaryangiography.ThesensitivityofdiagnosingacutemyocardialinfarctionbybothUltrasonictissuecharacterizationwithintegratedbackscatterandechointens

简介：BackgroundThevideo-assistedthoracoscopicsurgicaltechniquesarewidelyusedinthetreatmentofpatientswithcongenitalheartdiseaseswithgoodoutcomes.However,thefeasibilityandsignificanceofnursebasedearlycardiacrehabilitationincardiacintensivecareunit(ICU)forpatientswithtotallythoracoscopiccardiacoperationhasbeenseldomstudied.MethodsThirty-sixpatientswithtotallythoracoscopiccardiacoperationundertheconditionofthecardiacICUinGuangdongGeneralHospitalwererandomallocatedtotheinterventiongroupandthecontrolgroupbetweenJanuary2012toDecember2014.Thecontrolgroupreceivedstandardnursingcare,andtheinterventiongroupreceivedearlycardiacrehabilitationnursingcareinadditiontostandardcare.Theoutcomemeasuresincludedtheoxygensaturation(SpO2%),vitalcapacity,forcedexpiratoryvolumein1second(FEV1),andpaininthethoracicwound(visualanaloguescale,VAS),whichweremeasuredatthebaselineandwithin2-dayafter4-weeknursingcare.Forsafetyreason,wealsomonitoredtherateofperceivedexertion(RPE),heartrate,systemicbloodpressure.ResultsTherewerenon-significantdifferencesbetweenthegroupsinage,sex,totalnumberofcomorbidconditions,totalnumberofmedications,surgicaltime,andanesthetictime(P>0.05).Following4weekstreatment,thecardiopulmonaryfunctionsandVASscorewereimproved(P<0.05)inallgroups.Inaddition,theimprovementsweremoreintheearlycardiacrehabilitationnursecaregroupthaninthecontrolgroup(P<0.05).ConclusionTheearlycardiacrehabilitationnursingcareincardiacICUissafe,feasibleandbeneficialforpatientswithtotallythoracoscopiccardiacoperation.

简介：BackgroundAnimalmodelsofhyperlipidemiawereestablishedbyfeedingrabbitswithhigh-cholesteroldiet,andthechangesinstructureandfunctionofcellmembraneinrabbitswerealsoreducedbyhyperlipidemia.Thus,thealternationsinerythrocytemembranelipidperoxidation(EMLP)andfluidityinrabbitsinducedbyhigh-cholesteroldietwereresearchedbyus.MethodsFourteenrabbitsweresubjectedtohigh-cholesteroldiet(cholesterol2g/d)andtheother14rabbitstocommondieteverydayforconsecutivetwomonths,plasmatotalcholesterol(TC),andbloodlipidsaswellasEMLPandfluidityweremeasuredbeforeandafterthefeeding.ResultsComparedwiththefeedingbefore,levelsofTCandlowdensitylipoproteincholesterol(LDL-C)weresignificantlyraised,thoseoferythrocytemembranelowdensitylipoproteincholesterol(MLDL-C),membraneconjugateddiene(MCD),erythrocytemalonaldehyde(RMDA)weresignificantlyincreased,whilethoseoferythrocytesuperoxidedismutase(R-SOD),membranefluidity(M-Flu)andmembranehighdensitylipoprotein-cholesterol(MHDL-C)weresignificantlydecreasedinexperimentalgroup,andtherewerenochangesincontrolgroup.ConclusionsHigh-cholesteroldietinduceslipidperoxidationandlowerfluidityoferythrocytemembrane.

简介：ObjectivesTostudythestatusoffibrinolyticinhibitioninpatientsofacutecoronarysyndrome(ACS)complicatedwithtypeⅡdiabetesmellitus(NIDDM)andtoevaluatetheeffectoffibrinolyticinhibitiontotheclinicalprognosis.MethodsTypeⅡdiabetesmellituswasdefinedbyADA1997/WH01998criteria.Thesubjectsweredividedintotreatmentgroupsthatincluded39patientsofACSwith20casesofacutemyocardiacinfarction(AMI),36patientsofACS+NIDOMwith20casesofAMI.Twentycasesofhealthypeoplewererandomizedtocontrolgroup.Theplasmaleveloftissuetypeplasminogenactivator(t-PA),plasminogenactivatorin-hibitortype-1(PAI-1)andplasmaD-dimerweredetectedbyusingelisatechnique.TheindexofstatueinfibrinolysiswasdetectedwiththeplasmalevelofD-dimerandtherateofPAI-1/D-dimerinpercentage.ThisindexwasusedtoevaluatethefibrinolyticinhibitionandtheclinicaloutcomeinallthepatientswithAMIintreatmentgroups.TheclinicaloutcomeinpatientswithAMIconsistedoftherateofreperfusion,theincidencesofreinfarction,severi-ousarrhythmia,pumpfailureanddeathintheearlyperiodofAMI.ResultsTheplasmalevelofPAI-1andD-dimerwashigherinthetwotreatmentgroupsthanthatinthecontrolgroup(P<0.01).TheplasmalevelofPAI-1significantlyhigherinACS+NIDDMpatientsthanthatinACS(P<0.05),buttheplasmalevelofD-dimerraisedfrombasiclevelwassignificanflylowerinACS+NIDDMthanthatinACS(P<0.05).TherateofPAI-1/D-dimerinpercentagewassignificantlyhigherinACS+NIDDMthanthatinACSorincontrolgroup(P<0.01).ForAMIpatientsintwotreatmentgroups,therateofreperfusionafterthethrorabolytictherapywassignifi-candylowerinACS+NIDDMthanthatinACS(P<0.01).TherateofincidencesinpumpfailurewassignificantlyhigherinACS+NIDDMthanthatinACStoo(P<0.05).Themorbidityofseveriousarrhythmia,re-infarctionandthemortalitywerealsohigherinACS+NI

简介：BackgroundAsforthepatientswithcoronaryarteriosclerosis,thepresenceofischemicmyocardialsurvivalissignificantforthetreatmentandprognosis.Gated13N-NH3and18F-FDGPET/CTimagingprovidesmyocardialperfusion,metabolismandcardiacfunctionwhichcanvaluatemyocardialviabilityaccuratelyandnoninvasively.MethodsFourpigsweresubjectedtobilateralinternalmammaryarteryY-bypassoperationinoperatingroom.ThepigsundertheanesthetizedstateweresenttoPETcenterwhentheoperationfinished.Then13N-NH3gated-PET/CTand18F-FDGgated-PET/CTwereperformed.ResultsThemyocardialperfusionandmyocardialmetabolismiswell-distributedofleftventricularwall.Themotionofthewallwasnormal.Theejectionfunctionwasgreaterthan50%.ConclusionGated-PET/CTcanbeusedfornoninvasiveevaluationofmyocardialperfusion,myocardialmetabolismandleftventriclefunction.

简介：

简介：BackgroundTheCHA2DS2-VAScschemahasrecentlybeenintroducedtocomplementtheCHADS2scoreandimprovetheidentificationofatrialfibrillation(AF)patientsat'trulylowrisk'forthromboembolism.WetestedthepredictiveabilityoftheCHA2DS2-VASc,CHADS2andvanWalravenriskstratificationschemesinacohortof'lone'AFpatientswitha12-yearfollow-up.MethodsandResultsWeconductedaregistry-based,observationalcohortstudyof345patientsinitiallydiagnosedwith'lone'AFbetween1992and2007.Atbaseline,allpatientshadtheCHADS2andvanWalravenscoresof0,and262(75.9%)hadaCHA2DS2VAScscore=0.Duringfollow-up(orwithinayearpriortostroke),228(66.1%),234(67.8%)and150patients(43.5%)retainedtheCHADS2,vanWalravenandCHA2DS2VAScscoresof0,respectively.Theoverallrateofischemicstrokewas0.19(95%CI:0.18-0.20)per100patient-years.Inthemultivariableanalysis,onlytheCHA2DS2-VAScscoreof0wassignificantlyrelatedtotheabsenceofstroke(OR5.1,95%CI:1.5-16.8,P=0.008).OnlytheCHA2DS2-VAScscorehadasignificantpredictionability(c-statistic0.72[0.61-0.84],P=0.031).ConclusionsTheCHA2DS2-VAScscorereliablyidentifiedthe'lone'AFpatientswhowereat'trulylowrisk'forthromboembolism,andwastheonlytestedriskstratificationschemewithasignificantpredictiveabilityforthromboembolismamongstloneAFpatients.

简介：ObjectiveTocomparetheacutehemodynamiceffectsoffivedifferentpacingmodesinpatientswithcardiacfunctionNYHAclassⅠtoⅡwithoutbundlebranchblock(BBB).MethodsThisstudyincluded12patients(SSS7,Ⅲ°AVB5)undergoingpacemakerimplantation.Rightventricularapex(RVA),rightventricularoutflowtract(RVOT),rightventricularbifocal(RV-Bi),leftventricularbase(LVB)andbi-ventricular(Bi-V)pacingat60-80ppmweredoneinVVImodepriortoimplantationofDDDpacemaker.Thecardiacindex(CI),meanpulmonaryarterypressure(mPAP)andpulmonarycapillarywedgepressure(PCWP)weremeasuredwithSwan-Ganzthermodilutioncatheterafter5minutesofeachpacingmode.Results(1)ComparingtopacingatRVA(CI:2.41±0.38L/minperm2,PCWP:16.7±3.3mmHg),theCIincreasedandthePCWPdecreasedsignificantlyinpacingatRVOT(CI:2.63±0.46,PCWP:13.8±2.3),LVB(CI:2.78±0.52,PCWP:14.4±3.1),RV-Bi(CI:2.83±0.57,PCWP:12.8±2.5)andBi-Vpacing(CI:2.