INTRODUCTION:Percutaneous coronary intervention (PCI)-related myocardial infarction (type 4a MI) and major periprocedural myocardial injury have been demonstrated leading to poor prognosis of patients with coronary heart disease (CHD) undergoing elective PCI and still remain high occurrence even after the therapy of dual antiplatelet agents and statins. Proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab has been shown to be effectively in reducing the risk of acute MI (AMI). However, the effect of alirocumab on preventing PCI-related MI or major periprocedural myocardial injury in patients with CHD undergoing elective PCI remains uncertain.METHODS AND ANALYSIS:Alirocumab effect on Preventing Periprocedural ischaemic Events in coronary heart diseAse patients undergoing coronary StEnting trial is a multicentre, open-label, randomised controlled trial aiming to determine whether alirocumab could reduce the incidence of type 4a MI or major periprocedural myocardial injury in patients with CHD undergoing elective PCI. In total, 422 non-AMI CHD patients planned to undergo elective PCI will be randomly assigned to receive standard pharmacotherapy of CHD (control group) or additional use of subcutaneous alirocumab 75 mg 1 day before procedure (alirocumab group). The primary outcome is type 4a MI or major periprocedural myocardial injury defined as high-sensitivity cardiac troponin elevating above 5×99 th percentile upper reference limit in 48 hours after PCI. Patients will continue receiving standard pharmacotherapy or additional biweekly subcutaneous alirocumab 75 mg for 3 months according to the initial randomisation group. We will follow up for 3 months and record all the major adverse cardiovascular events (MACEs). Incidence of PCI-related MI or major periprocedural myocardial injury, and MACE in 3 months after PCI will be compared between control group and alirocumab group.ETHICS AND DISSEMINATION:Ethics approval has been obtained from the Medical Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University with approval number: (2022)02-140-01. The results of this study will be reported through peer-reviewed journals and conference presentations.TRIAL REGISTRATION NUMBER:ChiCTR2200063191.

目的：探讨沙库巴曲缬沙坦对急性前壁ST段抬高型心肌梗死经皮冠状动脉介入(PCI)术后心力衰竭患者心功能及N末端B型利钠肽前体(NT-proBNP)水平的影响。方法：将2019年1月-2020年12月在广州医科大学附属第二医院心内科治疗的112例急性前壁ST段抬高型心肌梗死PCI术后心力衰竭患者，随机数表法分为两组，剔除各种原因无法规范服药患者后，观察组50例，对照组48例。对照组使用常规治疗+培哚普利，在此基础上，观察组使用沙库巴曲缬沙坦替代培哚普利，对比两组的临床疗效、心功能[左心室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左心室心肌质量指数(LVMI)]、心肌损伤标志物[心肌肌钙蛋白Ⅰ(cTnI)、肌酸激酶同工酶(CK-MB)、NT-proBNP水平]。结果：观察组治疗有效率为94.00%，明显高于对照组的72.92%，差异有统计学意义(P＜0.05)；观察组治疗后LVEF明显高于对照组，LVEDV、LVMI明显低于对照组，差异有统计学意义(P＜0.05)；观察组治疗后NT-proBNP、cTnI、CK-MB水平明显低于对照组，差异有统计学意义(P＜0.05)。结论：沙库巴曲缬沙坦对急性前壁ST段抬高型心肌梗死PCI术后心力衰竭效果显著，能有效提高LVEF，降低LVEDV、LVMI，改善心功能，并可降低NT-proBNP等心肌损伤标志物水平，促进受损心肌的修复，具有积极的临床意义。

目的 观察番茄红素(Lyc)对人内皮祖细胞(EPCs)增殖、迁移、成管能力的影响,并探讨其作用机制.方法 取EPCs,培养24 h后分为4组;A组加入含10％胎牛血清的培养基和ox-LDL(10 mg/L)的培养基培养24 h后弃去上清,再加入含10％胎牛血清和Lyc(10 mg/L)的培养基培养24 h;B组加入含10％胎牛血清和ox-LDL(100 mg/L)的培养基培养48 h;C组加入含10％胎牛血清和Lyc(10 mg/L)的培养基培养48 h;D组加入含10％胎牛血清的培养基培养48 h;比较各组细胞增殖活力、细胞划痕愈合率、形成小管直径及p62、LC3-Ⅱ、Beclin-1、p-AMPK/AMPK、p-mTOR/mTOR蛋白相对表达量.另取EPCs,培养24 h后分为4组;E组首先加入含10％胎牛血清和AMPK抑制剂小分子化合物C(CC)的培养基温箱孵育30 min,然后加入含10％胎牛血清和ox-LDL(10 mg/L)的培养基培养24 h后弃去上清,最后再加入含10％胎牛血清和Lyc(10 mg/L)的培养基培养24 h;F组加入含10％胎牛血清的培养基和ox-LDL(10 mg/L)的培养基培养24 h后弃去上清,再加入含10％胎牛血清和Lyc(10 mg/L)的培养基培养24 h;G组加入含10％胎牛血清和ox-LDL(100 mg/L)的培养基培养48 h;H组加入含10％胎牛血清的培养基培养48 h;比较各组细胞增殖活力、细胞划痕愈合率、形成小管直径及p62、LC3-Ⅱ、Beclin-1蛋白相对表达量.结果 与B组比较,A组细胞增殖活力、细胞划痕愈合率、形成小管直径及LC3-Ⅱ、Beclin-1、p-AMPK/AMPK蛋白相对表达量增加,p62、p-mTOR/mTOR蛋白相对表达量减小(P均<0.05);与B组比较,D组细胞增殖活力、细胞划痕愈合率、形成小管直径及p-AMPK/AMPK蛋白相对表达量增加,p62、LC3-Ⅱ、Beclin-1、p-mTOR/mTOR蛋白相对表达量减小(P均<0.05).与F组比较,E组和G组细胞增殖活力、细胞划痕愈合率、形成小管直径减小(P均<0.05);与G组比较,E组p62蛋白相对表达量增加,E组LC3-Ⅱ、Beclin-1蛋白相对表达量和H组p62、LC3-Ⅱ、Beclin-1蛋白相对表达量减小(P均<0.05).结论 Lyc可以促进EPCs增殖、迁移和成管能力并增强自噬,其作用机制可能是上调AMPK磷酸化水平,下调mTOR的磷酸化水平,进而抑制mTOR信号通路.

目的:分析老年冠心病患者介入治疗中应用替罗非班的临床效果.方法:选取2018年1月—2020年6月在广州医科大学附属第二医院心内科治疗的120例老年冠心病介入治疗患者随机分为两组,每组各60例,对照组常规口服阿司匹林和氯吡格雷治疗,在对照组基础上,观察组在介入治疗中应用替罗非班治疗,对比两组的血流TIMI分级、各项血清因子变化、不良反应及心血管事件发生率.结果:观察组治疗后TIMI 3级血流获得率显著高于对照组(P<0.05);观察组治疗后24?h、72?h的h s-C R P、v W F、C K-M B、c T n I水平均显著低于对照组(P<0.05);观察组再次心绞痛、急性心力衰竭、非致死性心肌梗死等心血管事件发生率显著低于对照组(P<0.05),但两组在鼻腔黏膜出血、大便潜血阳性、肉眼血尿、呕吐咖啡样胃内容物等轻度出血不良反应发生率无明显差异,也无严重出血发生(P>0.05).结论:老年冠心病患者介入治疗中应用替罗非班的临床效果显著,能有效改善靶血管前向血流TIMI分级,减轻炎症反应及心肌损伤,降低心血管事件发生率,且出血反应发生率低,程度较轻,具有较高安全性.

目的:探讨冠心病患者血脂指标水平变化及其临床意义.方法:选取2015年1月～2018年12月某院冠心病患者193例并作为冠心病组,同期选取不符合冠心病标准者90例并作为非冠心病组,收集所有患者的一般资料并检测其血脂指标.结果:冠心病组男性占比明显高于非冠心病组,差异有统计学意义(P<0.05);冠心病组的TC、TG、LDL-C明显高于非冠心病组,冠心病组的HDL-C明显低于非冠心病组,差异有统计学意义(P<0.05);冠心病组的LCI、AIP、non-HDL明显高于非冠心病组,差异有统计学意义(P<0.05);Logistic回归性分析显示,性别、TC、TG、HDL-C、LDL-C、LCI、AIP、non-HDL是冠心病患者发生的危险因素(P<0.05).结论:冠心病的发生与多因素有关,尤其与血脂指标密切相关,提示应重点关注血脂变化,及时改善冠心病患者的预后.

目的:分析心脏康复对急性心肌梗死患者PCI术后血管内皮功能与不良事件的影响.方法:选取2018年1月—12月在本院接受治疗的A M I患者32例,随机数字表法将患者分为对照组、观察组,各16例,两组患者均采用PCI治疗,对照组术后采用常规饮食调整、健康教育等,观察组在对照组基础上采用心脏康复疗法.观察患者出院后血清炎性因子水平、血管内皮功能和不良事件发生情况.结果:观察组患者血清ET(5.42±0.51)ng/mL、vWF(134.50±6.81)％、TNF-α(8.49±2.29)mg/L、IL-6(9.10±1.87)ng/L、hs-CRP(3.28±1.21)mg/L、MPO(24.18±8.55)g/L水平均低于对照组,而NO含量(42.68±4.93)mol/L高于对照组,组间差异有统计学意义(P<0.05).结论:临床急性心肌梗死行PCI患者术后应用心脏康复可有效降低炎症反应程度,改善血管内皮功能,患者术后不良事件发生率不会增加.

目的 研究年轻Sca-1+骨髓干细胞对年老小鼠血管平滑肌细胞(OMVSMC)增殖能力的影响.方法 比较不同年龄组(年轻组和年老组)MVSMC增殖能力差别.缺氧条件下,将年轻Sca-1+/-细胞分别与OMVSMC共培养(分为Sca-1-细胞组与Sca-1+细胞组).通过BrdU染色、MTT、qRT-PCR、West-ern blot分别检测Sca-1+/-细胞对OMVSMC增殖相关基因和蛋白表达的影响,以及对细胞增殖能力的调控作用.通过qRT-PCR、ELISA检测年轻Sca-1+/-细胞旁分泌生长因子的差异.结果 与年轻组MVSMC相比,年老组MVSMC增殖细胞比例下降;cyclin B1、cyclin D1基因及蛋白表达下降(P<0.05).与Sca-1-细胞相比,Sca-1+骨髓干细胞可明显增加OMVSMC增殖细胞比例,促进OMVSMC中cyclin B1、cyclin D1基因及蛋白表达(P<0.05).与Sca-1-细胞相比,Sca-1+骨髓干细胞可旁分泌更多的PDGFBB(P<0.05).中和PDGFBB,使Sca-1+骨髓干细胞失去促进OMVSMC增殖的作用后,增殖细胞比例下降;cyclin B1、cyclin D1基因及蛋白表达下降(P<0.05).结论 年轻Sca-1+骨髓干细胞可通过旁分泌PDGFBB促进OMVSMC增殖能力.

Objective: The present observational study evaluated long-term management of hypertension in patients who received treatment with valsartan and amlodipine in a single-pill combination (Val/Aml SPC) in a real-world setting in China (Chinese Clinical Trial Registry number ChiCTR1900021324). Methods: This was a prospective, observational, multicenter, real-world registry study wherein patients with hypertension who had already received Val/Aml SPC (80/5 mg) for at least 4 weeks before study enrollment were observed for 1 year. Investigators recorded patient data every 3 months and essentially five times during the 1 year follow-up period. Effectiveness was assessed by the blood pressure (BP) control rate and average duration of treatment at the end of the study. Safety was monitored by the incidence of adverse events (AEs) and serious adverse events (SAEs). Results: Overall, 985 patients were enrolled (mean ± standard deviation [SD] age: 60.3 ± 11.5 years); of these, 894 were included in the full analysis set, 758 of whom completed the study. At baseline, BP was controlled (<140/90 mmHg) in 64.3% of patients on Val/Aml SPC for at least 4 weeks before enrollment. Office BP control rates significantly improved from baseline in 74.1% of patients at 1 year (p < .0001). Overall, 575 (87.0%) patients remained on Val/Aml SPC at 1 year (average exposure: 311.5 days). AEs were reported in 23.3% of patients. The majority of AEs were mild to moderate, and 0.6% of patients discontinued Val/Aml SPC because of SAEs. Conclusion: This study provides evidence that Val/Aml SPC effectively reduced BP over the long term among Chinese hypertensive patients, with a good adherence and tolerability profile, and that most hypertensive patients may benefit from this combination.

目的 探讨冠心病介入术后缬沙坦对冠脉再狭窄的影响.方法 选择2016年1月～2017年11月在广州医科大学第二附属医院行冠脉介入术+放支架的患者98例,按照随机抽取病例号原则随机分为实验组(n=49)和对照组(n=49).对照组给予常规治疗,实验组在常规基础上加入缬沙坦胶囊治疗,同时选择30例行冠脉造影但未放支架的作为阴性对照组.分析三组患者超声心动图心室射血分数(EF)值、不良心血管事件、冠脉再狭窄的发生情况和内皮素-1(ET-1)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、脂蛋白相关磷脂酶A2(LP-PLA2)的含量变化.结果 实验组有5例发生冠脉再狭窄,发生率为10.20％,对照组有13例发生冠脉再狭窄,发生率为26.53％,两组比较差异有统计学意义(P＜0.05).术后4周,三组患者的ET-1、hs-CRP、IL-6、LP-PLA2、EF值与同组术前比较,差异有统计学意义(P＜0.05).术后4周,实验组ET-1、hs-CRP、IL-6、LP-PLA2与对照组、阴性对照组比较,差异有统计学意义(P＜0.05),而对照组与阴性对照组比较,差异无统计学意义(P＞0.05).术后4周,实验组与对照组、阴性对照组EF值比较,差异均有统计学意义(P＜0.05).实验组的不良心血管事件发生情况较对照组少,差异有统计学意义(P＜0.05).结论 冠心病介入术后经缬沙坦治疗后可有效降低冠脉再狭窄的发生,降低内皮素及炎症因子的含量,明显减少不良心血管事件发生,改善超声心动图EF值.

Objective To study the plasma expression levels of miR-15b,miR-92a in the patients with acute coronary syndrome and the correlation between the severity of coronary artery lesions .Methods we collected 138 patients and divided them into three groups ,including 44 patients of normal coronary artery , 44 patients of unstable angina ( UA ) , 50 patients of acute ST-elevated myocardial infarction ( STEMI ) .The plasma levels of miR-15b and miR-92a were detected by RT-qPCR.Statistical software was used for statistical analysis to compare the difference between the three groups of basic information , biochemical indicators , the plasma levels of miRNAs ,also the correlation between the levels of miRNAs with SYNTAX score .Results 1.The plasma levels of miR-15b in STEMI group and UA group were significantly decreased (P<0.01) than normal coronary group , the differences were statistically significant .2 .The plasma levels of miR-92 a in STEMI group and UA group were significantly increased ( P <0.01 ) than normal coronary group , the differences were statistically significant; And the STEMI group of miR-92a levels was higher than the UA group (P<0.05), the differences were statistically significant .3.The plasma levels of miR-92a in STEMI group were positively correlated with the SYNTAX score , correlation coefficient r=0.779 (P<0.01), The plasma levels of miR-92a in UA group were positively correlated with the SYNTAX score , correlation coefficient r=0.828, (P<0.01).Conclusion The plasma levels of miR-15b decreased in patients with UA and STEMI, which could be used as a potential marker for the diagnosis of both .2.The plasma levels of miR-92a increased in patients with UA and STEMI , which could be used as a potential marker for the diagnosis of both .3.The plasma levels of miR-92a could be used as a potential marker for assessing theseverity of coronary artery disease in patients with ACS .

This study aimed to investigate the anti-oxidant and anti-hypertrophic effects of puerarin-7-O-glucuronide, a water-soluble puerarin metabolite. The anti-oxidant effects of puerarin-7-O-glucuronide were assessed by measurement of intracellular superoxide levels, total superoxide dismutase (SOD) activity, total anti-oxidant capacity, and glutathione (GSH)/glutathione disulfide (GSSG) ratio in cultured neonatal rat cardiomyocytes (NRCMs) stimulated with the xanthine oxidase (XO)/xanthine (X) system or angiotensin II. The activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and expression of NADPH oxidase subunits p22phox and p47phox were determined. The anti-hypertrophic effects of puerarin-7-O-glucuronide in angiotensin II-challenged NRCMs were characterized by changes in cell morphology and expression of hypertrophic genes. In the pharmacokinetic study, the plasma concentration of puerarin-7-O-glucuronide was determined by rapid resolution–liquid chromatography–tandem mass spectrometry (RR-LC-MS/MS). Puerarin-7-O-glucuronide prevented XO/X-induced increase in intracellular superoxide production and decreases in total SOD activity, GSH/GSSG ratio, and total anti-oxidant capacity. Puerarin-7-O-glucuronide also reversed angiotensin II-induced increases in intracellular superoxide production and NADPH oxidase activity and decreases in total SOD activity. These anti-oxidant effects of puerarin-7-O-glucuronide were accompanied by downregulation of p22phox and p47phox. Furthermore, puerarin-7-O-glucuronide prevented angiotensin II-induced increases in cell surface area and perimeter, as well as changes in Nppa, Myh7, and Myh6. In the pharmacokinetic study, puerarin-7-O-glucuronide was cleared with a half-life of 0.94 h after intravenous administration. Puerarin could be detected in rat plasma, albeit in low concentration, as early as 5 min after intravenous administration of puerarin-7-O-glucuronide. These anti-oxidant and anti-hypertrophic properties of puerarin-7-O-glucuronide were similar to those of its parent compound puerarin. These results support the development of puerarin-7-O-glucuronide as a novel pharmaceutical agent for therapeutic application.

目的 观察奥美沙坦酯对大鼠球囊损伤后血管ACE2/Ang(1-7)/Mas通路表达的影响,初步探讨奥美沙坦酯抑制球囊损伤后血管内膜增生的机制.方法 将32只雄性SD大鼠随机分为4组,每组8只:正常对照组(N组)、假手术组(S组)、单纯球囊损伤组(BI组)、奥美沙坦酯组(O组).4组均于术后第1天至术后28 d灌胃,术后28 d取材,ELISA法检测血清中Ang(1-7)的含量,Western blot检测血管中ACE2、Mas受体的表达.结果 与S组比较,BI组、O组血清中Ang(1-7)含量明显降低(P<0.05),BI组血管中ACE2、Mas表达明显降低.与BI组比较,O组血清中Ang(1-7)含量明显升高(P<0.05),其血管中ACE2、Mas表达也上调(P<0.05).结论 奥美沙坦酯可上调球囊损伤术后大鼠腹主动脉ACE2/Ang(1-7)/Mas通路表达,奥美沙坦酯防治再狭窄的机制可能与上调ACE2/Ang(1-7)/Mas通路的表达有关.

目的:研究利伐沙班对行急诊PCI治疗后的ST段抬高型心肌梗死(STEMI)患者高凝状态的效果.方法:选取60例STEMI患者为研究对象,采取回顾性分析法,分为研究组和对照组,各30例,研究组给予利伐沙班治疗,对照组给予氯呲格雷治疗.检测两组患者的D-D、PT、APTT以及FIB血浆凝血指标含量并进行比较;记录两组患者治疗后主要心血管事件和出血并发症并比较.结果:研究组患者治疗后D-D含量高于对照组,差异有统计学意义(P＜0.05),两组患者治疗后主要心血管事件和出血并发症差异无统计学意义(P＞0.05).结论:利伐沙班口服治疗STEMI患者,可一定程度上缓解高凝状态,简单、方便,可以作为治疗STEMI患者新型抗凝治疗策略,但由于本次研究存在样本量较小以及长期随访时间不充分等问题,需后期进一步采取大样本以及长期随访,再做进一步评价.

目的研究奥美沙坦酯对高糖环境大鼠胸主动脉血管平滑肌细胞（VSMCs）增殖、迁移的影响,并探讨ACE2/Ang（1-7）/Mas通路在该效应中的作用。方法离体培养大鼠原代胸主动脉VSMCs,分为正常糖组（NG组）、甘露醇对照组（Man组）、高糖组（HG组）、奥美沙坦酯组（Olm组）、A779组共5组处理细胞。NG组:5.5 mmol/L D-葡萄糖;Man组:5.5 mmol/L D-葡萄糖培养基中补充19.5 mmol/L甘露醇;HG组:5.5 mmol/L D-葡萄糖培养基补充19.5 mmol/L D-葡萄糖;Olm组:HG组培养基中加入1×10 -4 mmol/L奥美沙坦酯;A779组:1×10 -5 mmol/L A779预处理细胞30 min后,HG组培养基中加入1×10 -4 mmol/L奥美沙坦酯和1×10 -5 mmol/L A779。MTT法检测不同处理因素下细胞的增殖情况,流式细胞术检测细胞周期改变,划痕实验观察细胞迁移情况,Western blot法检测ACE2、Mas表达。结果与NG组相比,HG组表现出高增殖、高迁移,Man组与NG组差异无统计学意义。Olm组可改善高糖所致病理改变,A779预处理后奥美沙坦酯的治疗作用减弱。Western blot显示高糖环境下VSMCs中ACE2、Mas表达均下调,而Olm组可上调ACE2、Mas的表达。结论奥美沙坦酯可抑制高糖环境VSMCs的增殖、迁移,该效应可能通过调节ACE2/Ang（1-7）/Mas通路来实现。

Objective To discuss the short-term effects in elderly patients undergoing primary PCI for acute myocardial infarction of ST-segment elevation .Methods Retrospective analysis of 310 cases of elderly patients with STEMI who were treated by primary PCI in our hospital from June 2011 to May 2015.The patients were divided into the elderly group (102 cases) and the control group (208 cases) according to the age , and the clinical data , the characteristics of coronary angiography and the short term effect after 1 month were compared . Results The age, gender (female), cerebral apoplexy, old myocardial infarction and serum creatinine were higher in the elderly group than that of the control group , and the smoking , iohexol and ultravist solution was significantly lower than that of the control group , the difference is statistically significant ( P<0.05 ); the 3-vessel coronary artery disease , IABP in the elderly group was significantly higher than that of control group , and in the proportion of single vessel lesion was significantly lower than that of the control group , the difference has statistical significance (P<0.05);the hospitalization time, cardiac shock and mortality rates in 1 month in the elderly group were higher than the control group , the difference was statistically significant ( P <0.05 );Multivariate logistic analysis showed that age (≥80 years), gender (female), acute kidney injury were the risk factors for mortality rates in 1 month.Conclusions The recent prognosis of elderly patients with STEMI undergoing primary PCI has unfavorable prognosis , which has higher mortality than that of <80 years old patients .

OBJECTIVETo investegate the role of calcineurin (CaN) and its downstream nuclear factor of activated T-cells (NFATc3) in abdominal aorta restenosis following balloon dilatation in rats.METHODSSD rats were randomly divided into sham-operated group, balloon group and cyclosporine A (CsA) group. The rats in the latter two groups were subjected to abdominal aorta injury with balloon dilatation, and those in CsA group were treated with CsA at the daily dose of 12.5 mg/kg from 3 days before the surgery to the end of the experiment. Thirty days afer the injury, histological analysis of the arterial wall was carried out with HE staining and immunohistochemistry. The expressions of CaN and NFATc3 in the abdominal aortas were detected with rea1-time PCR, and serum concentration of MCP-1 was determined using enzyme-linked immunosorbent assay.RESULTSIntimal hyperplasia with irregular thickness of the neointima was observed in the aorta of rats with ballon injury. In rats with CsA treatment, the area of the intimal layers and the ratio of the intimal to the medial layers were obviously lower than those in the balloon injury group (P<0.05). Compared to those in the sham-operated group, the expressions of calcineurin protein and mRNA and NFATc3 mRNA in the arterial wall and serum level of MCP-1 increased significantly in the ballon injury group (P<0.05). CsA treatment significantly suppressed aorta restenosis and the alterations of CaN, NFATc3 and serum MCP-1 induced by ballon dilatation (P<0.05).CONCLUSIONSCaN-NFATc3 signal transduction pathway mediates restenosis of rat abdominal aorta following ballon dilatation, and CsA can attenuate the restenosis by suppressing this pathway.

Objective This work studies the epidemiological and clinical characteristics of ages,genders and education level for the patients of coronary heart disease associated with depressive symptoms.Method The volunteered patients coronary heart disease associated with depressive symptoms were categorized into two groups (265 cases for anti -depressive treatments with contrasts of 423 cases)to investigate effects of anti -depressive treatments by t -test and stratified analysis based on the Mantel -Haenszel model,where the results of epidemiological survey of 2 198 samples conducted in the same period were used as the baseline.Results ①the female patients had significantly high risks to occur the depressive symptoms,RR =1.70(P =0.05, CI =1.08 ~3.47);②the anti -depressive treatments can effectively reduce the MACE (P <0.05).Conclusion The patients, especially females at the age range of 55 to 64,with coronary heart disease have extreme high risks to be complicated by the de-pressive symptoms.

Objective:To determine the effects of Atorvastatin in elderly patients with heart failure of reduced ejection fraction (HFrEF),and its effects on left ventricular remodeling and inflammatory factors. Methods:Eighty elderly patients with HFrEF were randomly divided into the treatment group and the control group (n= 40 each). Both groups were given conventional anti-heart failure treatment. In addition,the treatment group was given Atorvastatin 20 mg every night,once/ d. The course of treatment was 6 months. The left ventricular ejection fraction (LVEF)and left ventricular end diastolic volume index (LVEDVI)were measured by echocardiography before and after treatment. The levels of serum lipids and tumor necrosis factor-α (TNF-α) were measured at the baseline,and 1 and 6 months after the treatment. Left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume index (LVEDVI)were measured by echocardiography. Results:After the treatment,the TNF-α level in the two groups were significantly decreased,and the decrease was the largest at 1 month after the treatment. It was further decreased at 6 months after the treatment,and the treatment group decreased more significantly (P<0.05). The LVEF was significant improved at 1 month after the treatment,which was lasted for 6 months in the two groups,and the treatment group was improved more significantly (P<0.05). In the treatment group,LVEDVI was decreased at 1 month after the treatment,and decreased more significantly at 6 months after the treatment. In the control group,LVEDVI was decreased significantly at 6 months after the treatment. Conclusion:For elderly patients with HFrEF,using Aatorvastatin on the basis of conventional anti-heart failure treatment can further decrease serum TNF-α concentration and improve cardiac function and ventricular remodeling.

Objective To determine the effect of phytosternols on lowing serum lipid levels for the hypercho-lesterolemic volunteers in South China. Methods With the randomized double-blind experimental design, 141 quali-fied volunteers were assigned to four groups where a placebo and daily doses of 1.04 g, 1.56 g and 2.08 g phytosternols were respectively ingested. The t-test and one-way ANOVA were used to analyze the influences of different dose and course of phytosternols treatment. Results (1) After the intake of phytosternols, the resulted indexes of BMI, ALT and CREA have shown statistically insignificant changing trends between phytosternol groups and the control group (P>0.05). (2) After 3 months, compared with the indexes of TC and TG that have shown statistically insignificant changing trends, the LDL values of placebo, low-, mid- and high-dose groups were (3.88 ± 0.82) mmol/L, (3.06 ± 0.65) mmol/L, (3.32 ± 0.86) mmol/L and (4.26 ± 0.75) mmol/L, respectively. There was a statistically significant treatment effect on the LDL values (P<0.05). (3) The ANOVA results further indicated that the higher dose of phytosternols can facilitate the de-crease of LDL value in a shorter period. The LDL value in the low-dose group had a 13.6%of decrease for 3 months, while the LDL values of mid- and high- dose groups reduced by 18.9% and 9% respectively for 1 month's treatment. Conclusion Phytosternols can effectively decrease the LDL value in hyperlipidemia population of South China with-out affecting the liver and kidney function and body mass index.

目的:探讨冠状动脉(冠脉)粥样硬化的危险因素对心肌桥和无心肌桥患者在冠脉粥样硬化形成过程中影响的差异.方法:回顾性分析心肌桥合并冠脉粥样硬化患者78例(A组),无心肌桥的冠脉粥样硬化者73例(B组),再进一步将A组根据心肌桥在收缩期的狭窄程度分为A1组和A2组,比较A组与B组、A1组与A2组的冠脉粥样硬化危险因素的差异.结果:A与B组、A1与A2组在年龄、胸痛、BMI等方面差异无统计学意义.A与B组在餐后2h血糖、低密度脂蛋白等方面差异有统计学意义(P＜0.05);A1与A2组在收缩压、低密度脂蛋白等方面差异有统计学意义(P＜0.05).结论:心肌桥者因其特殊结构而较无心肌桥者更易受危险因素的影响而形成冠脉粥样硬化,更早干预和更严格控制心肌桥者的危险因素可能有利于预防和延缓冠脉粥样硬化的形成和进展.收缩期狭窄率越重其所需形成粥样硬化的危险因素越少,心肌桥收缩期狭窄程度可能是粥样硬化过程中重要的影响因素.