OBJECTIVE:More attention is being paid to the relationship between kidney dysfunction and cardiovascular events Characteristic features include renal dysfunction, left ventricular (LV) and left atrial (LA) enlargement. The aim of this study is to evaluate the relationships between circulating levels of β2-microglobulin (β2-m) and cystatin C and left atrial size in patients with coronary artery disease.MATERIALS AND METHODS:We recruited 300 patients who presented with chest tightness or chest pain and subsequently underwent coronary angiography. Of these, 202 patients were diagnosed with coronary artery disease (CAD) and 98 patients without CAD (non-CAD). Laboratory measurements included liver, kidney function (urea nitrogen, creatinine, β2-m and cystatin C), fasting glucose, and lipid analysis. CrCl were calculated according to Cockroft-Gault formula. Echocardiology was used to evaluate the cardiac structure and function.RESULTS:Significant differences of β2-m and cystatin C exist and no difference of creatinine and CrCl existed between the two groups. LA diameters were positively related to circulating levels of β2-m in the CAD group (r = 0.452, p < 0.001) and non-CAD group (r = 0.360, p < 0.001), and the similar relationships between LAD and circulating levels of cystatin C in the CAD group (r = 0.302, p < 0.001) and non-CAD group (r = 0.243, p = 0.016). LA diameters were negatively related to CrCl in both groups. After multivariate logistic regression analysis, the data indicated that the independent cardiovascular risk factors of LA enlargement for the patients with CAD were age, BMI, systolic blood pressure, LV mass, LVEDD, E/A, Em/Am, CrCl, and circulating levels of β2-m (OR = 1.630, 95% CI: 1.115 - 2.384, p = 0.012), cystatin C (OR = 4.504, 95% CI: 1.478 - 13.726, p = 0.008).CONCLUSIONS:A linear correlation exists between circulating levels of β2-m or cystatin C and LA diameters. Higher circulating levels of β2-m or cystatin C are independent cardiovascular risk factors of LA enlargement in patients with CAD, and could be a link between the kidney and the heart.

目的探讨护理安全日历在护理不良事件管理工作中的作用。方法在每个病区建立护理安全日历,每天对相关记录进行点评,遇有不良事件发生,则及时采用根源分析方法进行原因分析、制订整改措施并实施。结果实施护理安全日历后护理不良事件较前明显减少,与实施前1年相比,护理不良事件例数由262例减少到225例,不良事件发生率由1.15%下降到0.93%（χ2=5.749,P=0.016）。结论通过护理安全日历的使用,护理部对不良事件管理的主动性得到明显增强,病区护理人员的不良事件管理意识得到显著提升,促进了护理质量的持续改进和住院患者安全性的不断提高。

盐霉素又名沙利霉素(Salinomycin),商品名为优素精,是由白色链霉菌(streptomyces albus)经发酵提取而得到的动物专用抗生素.盐霉素致人类中毒十分罕见,现将我院近期收治的1例因误食盐霉素中毒致死亡的病例报道如下.

Objective To observe the effects of Shengmai Injection on NF-κB activation of the neutrophile granulocyte,serum TNF-a level and the prognosis of resuscitation on patients who had recovered from cardiac arrest.Methods The enzyme labeled immunohistochemical method was used to determine the NF-κB activation degree.Radio-immunity(RI) was used to determine the blood serum level of TNF-a.Changes of vital signs and laboratory examination indexes were also observed.Results ①The time,degree of vital signs recovery of the test group were superior to those of the control group,and the differences were statistically significant(P0.05).② The degree that NF-κB moved into the nucleolus and the TNFa level of the control group were higher than those of the test group,and the differences were statistically significant(P0.01).③Shengmai Injection suppressed the activation of NF-κB and the blood serum level of TNF-a on dosage(P0.01).④ The NF-κB activation degree and the TNF-a level were negatively correlated with the recovery of vital signs.The better the vital signs recovered,the lower were the NF-KB activation and the TNF-a level.Conclusion Shengmai Injection plus routine therapeutics have obvious therapeutic efficiency in protecting heart function,supporting good circulation state,and increasing the success rate of CPR possibly by suppressing the NF-κB signaling pathway and reducing NF-κB controled inflammation factors in a dose-dependent manner.

肌肉注射是将少量药液注入肌肉组织从而达到治疗的目的,是临床常用的注射方法之一.人体肌肉中分布着丰富的毛细血管网,毛细血管壁是多孔的类脂质膜,药物透过的速度较透过其他生物膜为快,因此自肌肉注射的药物通过毛细血管壁到达血液内,吸收较完全且迅速.

5年来,我院供应室十分重视医院感染管理工作,采取了一系列有效措施,使科室管理逐步走向常规化、制度化和规范化,并取得初步成效.

Objective:To investigate the preventive and therapeutic effects of puerarin(葛根素) and panangin(脉安定) early used on cardiac arrhythmia induced by reperfusion injury in patients with acute myocardial infarction(AMI).Methods:One hundred and two cases with AMI were randomly divided into two groups.The treatment group (n=51) was treated with puerarin injection and panangin infused intravenously,but the control group treated with compound of glucose-insulinpotassium.The thrombolytic and additional therapies were given to both groups simultaneously,the conventional therapy was given also to both groups.Results:The reperfusion arrhythmia(RA) was significantly decreased in treatment group compared to that in control group (P<0.01).The total effective rate was 96.1％ in treatment group and 82.4％ in control group.There was significantly different between two groups(P<0.01).Conclusions:The study indicates that puerarin and panangin has obviously preventive and therapeutic efficacy on cardiac arrhythmia induced by reperfusion injury in patients with AMI.

To evaluate the curative effect of Puerarin and panangin on reperfusion arrhythmia（RA） of patients with acute myocardial infarction. 102 cases with AMI were randomly divided into two groups.Puerarin and panangin were used in the test group，and GIK was used in the control group.Thromboclasis drug and other routine treatment were used in two groups.Results showed that the RA was decreased in test group than that in control group（P＜0.01）.General curative rate reached 96.1％ in test group and 82.4％ in control group（P＜0.01）.It suggests that the puerarin and panangin have obviously preventive and curative effect on RA of patients with AMI.

目的:探讨中药针剂葛根素加脉安定早期静滴防治急性心肌梗死(AMI)再灌注损伤的效果.方法:对102例AMI患者随机分为试验组和对照组,每组51例;试验组采用葛根素加脉安定,对照组用极化液;溶栓和其他治疗两组均常规进行.结果:两组HR、mBP无明显差异,试验组02max、RA显著减少(P＜0.05和P＜0.01);CK、CK-MB和HBD峰值显著低于对照组,且降至正常值的时间明显缩短(P＜0.01);WBC平均总数和中性平均百分比在48h～5d试验组显著降低(P＜0.05);BUN、Cr治疗前后试验组差异有显著性(P＜0.05),对照组差异无显著性;MIER为7.8%,其中试验组为5.9%,对照组9.8%.综合疗效评价试验组达96.1%,对照组为82.4%(P＜0.01).结论:葛根素加脉安定对急性心梗再灌注损伤有明显的防治效果.