Objective To discuss the role and significance of serum fibroblast growth factor 23 (FGF23) in patients with atrial fibrillation (AF). Methods The patients (n=300) were chosen from Department of Cardiology of Renmin Hospital of Wuhan University from June 2017 to June 2018. All patients were divided, according to whether or not with AF and AF duration, into sinus rhythm group, paroxysmal AF group and persistent AF group (each n=100). The concentration of serum FGF23 was detected by using ELISA, and clinical data and hematological indexes were compared among 3 groups. The risk factors of AF occurrence and maintenance were analyzed by using multi-factor Logsitic regression analysis. Results The levels of FGF23 and NT-proBNP and left atrial diameter (LAD) were significantly higher in paroxysmal AF group and persistent AF group than those in sinus rhythm group (206.25±59.21 ng/ml vs. 238.16±60.40 ng/ml vs. 122.63±41.10 ng/ml, P<0.05), (519.58±93.47 pg/ml vs. 568.05±103.64 pg/ml vs. 409.17±79.54 pg/ml, P<0.05) and (39.59±4.18 mm vs. 41.24±4.49 mm vs. 36.97± 3.53 mm, P<0.05). The levels of FGF23 and NT-proBNP and LAD were significantly higher in persistent AF group than those in paroxysmal AF group (238.16±60.40 ng/ml vs. 206.25±59.21 ng/ml, P<0.05), (568.05±103.64 pg/ml vs. 519.58±93.47 pg/ml, P<0.05) and (41.24±4.49 mm vs. 39.59±4.18 mm, P<0.05). The results of Logsitic regression analysis showed that FGF23, NT-proBNP and LAD were risk factors of AF occurrence and development (P<0.05). Conclusion The level of FGF23 is up-regulated and significantly higher in AF patients than that in those with sinus rhythm, and FGF23 may be important to AF occurrence and maintenance.

缓慢的伤口愈合、感染以及增生性瘢痕是皮肤烧伤治疗领域的难点和热点,慢性伤口感染是烧伤患者的主要并发症,也是疼痛的主要原因之一.水凝胶作为一种3D网状交联高分子聚合物,具有良好的塑形性和水溶性,可以防止体液流失,保持伤口表面水化,促进愈合过程,还可作为防止细菌感染的屏障.目前水凝胶已被广泛用于促进伤口愈合,尤其是烧伤伤口.相较于普通水凝胶,新型智能型水凝胶因具有细胞黏附能力、高度生物相容性、无毒及环保等优点,且对各种生理或外部刺激具有特异的响应,而在烧伤治疗领域具有更广阔的应用前景.

目的 探讨血清簇集蛋白水平与冠心病的关系.方法 选取2017年2月—2018年4月在武汉大学人民医院行冠状动脉造影检查的患者139例,根据冠状动脉造影结果分为冠心病组81例和非冠心病组58例.比较两组患者一般资料和实验室检查指标,冠心病的影响因素分析采用二元Logistic回归分析.结果 冠心病组患者男性比例、吸烟史阳性率、糖尿病病史阳性率高于非冠心病组(P<0.05);两组患者年龄、饮酒史阳性率、高血压病史阳性率、高脂血症发生率比较,差异无统计学意义(P>0.05).冠心病组患者白细胞计数、血清簇集蛋白水平高于非冠心病组(P<0.05);两组患者血小板计数、尿酸及血清总胆固醇、三酰甘油、高密度脂蛋白、低密度脂蛋白、纤维蛋白原水平比较,差异无统计学意义(P>0.05).二元Logistic回归分析结果显示,男性〔OR=3.154,95％CI(1.285,7.736)〕、糖尿病病史〔OR=3.624,95％CI(1.296,10.136)〕是冠心病的危险因素,而血清簇集蛋白水平〔OR=0.924,95％CI(0.859,0.995)〕是冠心病的保护因素(P<0.05).结论 冠心病患者血清簇集蛋白水平明显升高,是冠心病的保护因素.

心房颤动(房颤)是临床上最常见的心律失常之一,而随着社会人口的老龄化,全球范围内心房颤动的发病率和患病率有逐渐增加的趋势[1],房颤导致心力衰竭、卒中的发生率及病死率明显增加,已经成为危害公众健康的重要心血管疾病之一,引起全社会的重视和关注.既往研究表明,房颤发生与遗传因素[2]、肾素-血管紧张素-醛固酮(renin-angiotensin-aldosterone system,RAAS)系统激活[引、氧化应激与炎症[4]、心房电重构[5]和代谢重构[6]等相关.

Objective To investigate the impact of CYP2C19 gene polymorphism on anti-platelet aggregation effect of clopidogrel in coronary heart disease patients treated by PCI. Methods From January to October 2017, a total of 116 patients with coronary heart disease were selected in the Department of Cardiovascular Medicine, the People′s Hospital of Wuhan University, and they were divided into fast metabolic group (n=47), moderate metabolic group (n=53) and slow metabolic group (n=16). Patients in the three groups received aspirin enteric-coated tablets (100 mg/d) and clopidogrel (150 mg/d) for maintenance therapy. General information, laboratory examination results, maximum platelet aggregation rate before treatment and 1 week after treatment were compared in the three groups. Results No statistically significant differences of male proportion, age, smoking history, drinking history, incidence of diabetes, hypertension, hyperlipidaemia or myocardial infarction was found in the three groups (P>0.05). No statistically significant differences of TC, TG, HDL, LDL, VLDL, FIB, PLT or cTnI was found in the three groups (P>0.05).No statistically significant differences of maximum platelet aggregation rate was found in the three groups before treatment (P>0.05); 1 week after treatment, maximum platelet aggregation rate in moderate metabolic group and slow metabolic group was statistically significantly higher than that in fast metabolic group (P<0.05), while no statistically significant differences of maximum platelet aggregation rate was found between moderate metabolic group and slow metabolic group (P>0.05).Conclusion Moderate and slow metabolic genetype of CYP2C19 can reduce the anti-platelet aggregation effect of clopidogrel in coronary heart disease patients treated by PCI, increase the risk of adverse cardiac events.

To study the effect of novel bioresorbable scaffold composed of poly-L-lactic acid (PLLA) and amorphous calcium phosphate (ACP) nanoparticles on inflammation and calcification of surrounding tissues after implantation. Ninety six PLLA/ACP scaffolds and 96 PLLA scaffolds were randomly implanted in the back muscle tissue of 48 SD rats. At the 1st, 2nd, 4th, and 12th weeks after implantation, the calcium, phosphorus, and alkaline phosphatase levels in the blood serum and the contents of calcium and alkaline phosphatase in the tissue surrounding the scaffolds were measured. Hematoxylin-eosin staining was performed to count the inflammatory cells. Von kossa staining was performed to observe calcification of the surrounding tissue around the scaffold. NF-κB staining was performed by immunohistochemistry to calculate the positive expression index of inflammatory cells. Western blot was used to detect the expression of IL-6 and BMP-2 in the tissues surrounding the scaffolds. At the 1st, 2nd, 4th, and 12th weeks after scaffold implantation, there were no significant difference in the serum concentration of calcium, phosphorus, alkaline phosphatase and in the tissue homogenate concentration of alkaline phosphatase between the two groups (P > 0.05). The level of calcium in tissue homogenates was lower in the PLLA/ACP group than in the PLLA group at 12-week (P < 0.05). The hematoxylin-eosin staining results showed that the inflammatory cell count in the PLLA/ACP group was lower than the PLLA group at 4-week and 12-week (P < 0.05). The results of NF-kB positive expression index showed that the PLLA group was significantly more than the PLLA/ACP group at 4-week and 12-week (P < 0.01). Western blot results showed that IL-6 expression levels in the PLLA/ACP group scaffolds were significantly lower than those in the control group at the 2-week, 4-week and 12-week (P < 0.05). The expression of BMP-2 in the PLLA group was significantly lower than that in the control group at 4-week and 12-week (P < 0.05). The PLLA/ACP composite material has good histocompatibility. The integration of nanoscale ACPs reduces the inflammatory response induced by acidic metabolites of PLLA material and may inhibit tissue calcification by reducing the amount of calcification factors in the body.

Objective To investigate the clinical characteristics of coronary heart disease risk fac tors,and explore the relationship of severity of coronary artery lesions in patients with coronary heart disease and coronary heart disease risk factors.Methods In our hospital for treatment of coronary artery disease patients during April 2013 to August 2014,230 cases of hospitalized patients were divided into two groups after coronary angiography diagnosis,including 170 cases of patients with coronary heart disease as the observation group,and 60 patients with coronary atherosclerosis as the control group with the degree of stenosis less than 50％.The clinical data of two groups were used to study the risk factors for coronary heart disease.The relationship was analyzed between severity of coronary artery pathological changes and coronary heart disease risk factors.Results For the observation group,type 2 diabetes,smoking,and men were associated with coronary heart disease (CHD),with the corresponding OR (95％ CI) of 17.489 (11.013-30.017),48.632 (20.379-117.178),and 18.976 (13.105-28.331),respectively.Smoking and type 2 diabetes were associated with coronary artery stenosis degree (P ＜ 0.05),with OR 95％ (CI) of 10.15 (2.012-2.584),and of 7.23 (1.613-2.176).The results found there was no relationship among hypertension,dyslipidemia,coronary heart disease (CHD),and age.There was a link between the body mass index (BMI) and the severity of the disease.For observation group,left ventricular ejection function,high-sensitivity C-reactive protein (hs-CRP),and Ccr were related to the severity of coronary lesions,and the patients existed lower Ccr,left ventricular ejection function abate,and increased hs-CRP levels increase,P＜0.05,and the OR (95％ CI) were 1.986 (5.204-17.627),1.103 (1.012-1.027),and 2.131 (1.901-2.369).Conclusions Type 2 diabetes,smoking,male patients with coronary heart disease risk factors had a close relationship,and the severity of coronary artery lesions included the reduced re nal function in patients and the increased hs-CRP level.

Objective To analyze the different continuous renal replacement therapy (CRRT) in coronary heart disease patients complicated with chronic renal failure undergoing pereutaneous coronary intervention (PCI).Methods We performed a prospective study on 56 patients in our hospital from January 2016 to August 2017.All patients were divided into 2 groups:Normal group(CRRT did in first 12 hours after PCI treatment);Reinforcement group:CRRT did in 24 hours before and 12 hours after PCI treatment.Chronic health conditions,acute physiology,incidence of contrast-induced nephropathy(CIN) and serum creatinine were compared between the two groups.Results There was no significant difference in general information between general group and reinforcement group.CIN incidence in reinforcement group was significantly lower than the that in normal group(7.14％ vs.39.28％,P＜0.01).In the common group,the serum creatinine level at 24 hours after PCI was higher than that before PCI [(308.14±45.08)μmol/L vs.(254.59±80.44)μmol/L,P=0.02],while the serum creatinine level at 48 h and 72 h after PCI had no significant difference with that before PCI[(232.49±20.12)μmol/L vs.(247.52±54.81)μmol/L vs (254.59±80.44)μmol/L,P＞0.05].In reinforcement group,the serum creatinine level at 24 hours after PCI had no significant difference with that before PCI[(274.04±71.06)μmol/L vs.(286.65±53.04)μmol/L,P＞0.05],but the serum creatinine level at 48 h and 72 h after PCI was significantly lower than that before PCI [(220.12±23.87)μmol/L vs.(286.65±53.04)μmol/L,P=0.01],[(250.17±44.20)μmol/L vs.(286.65±53.00)μmol/L,P=0.02].Conclusion The effect of CRRT achieved both before and after PCI is better than CRRT only did after PCI,which has a positive effect on reducing the contrast-induced nephropathy.

冠状动脉的介入治疗以其安全性、微创性、简单化的特点成为冠状动脉治疗发展的重点.从1977年第一次进行的冠心病球囊扩张治疗开始,冠状动脉介入治疗至今已过40年.40年间,冠状动脉的介入治疗方法日新月异,其中经历了4次主要的革命性发展.本文就40年来的冠心病介入治疗及支架发展过程进行综述,并对今后冠心病介入治疗的发展方向进行展望.

Coronary heart disease is the main cause of death,and harmful to the health of the elderly,affecting the quality of life of the elderly.Coronary stent treatment with its safety,minimally invasive,simplistic characteristics in the past 40 years has become the focus of coronary therapy development.At present,the bioresorbable scaffolds made of biodegradable materials have been developed,and magnesium alloy scaffolds have been developed rapidly as one of the representative materials.This article reviewed the progress of clinical research on bioresorbable magnesium alloy coronary stents in recent years,summarized stent development process,and thought about the future development of intervention and treatment of the future.

随着人们生活水平的提高,心血管疾病发病越来越多.心力衰竭是各种心血管疾病的终末期,因此我们应该重视心力衰竭的治疗.心力衰竭在全球的发病率和死亡率均较高,是全世界一个重要的公共卫生问题,影响全世界超过2300万患者[1].依据左心室射血分数(LVEF),心衰可分为LVEF降低的心衰(HFREF)和LVEF保留的心衰(HFPEF)[2].一般来说,HFREF就是指传统意义上的收缩性心衰,HFPEF是指舒张性心衰.虽然近年来对两型心力衰竭药物治疗的研究逐渐增多,对延缓患者心功能恶化取得了一定疗效,但是随着病程的发展,患者的远期生存质量差,预后不好.现就两型心力衰竭药物治疗的最新进展作一综述.

<正>2009年12月30日下午两点三十分,中央财经大学沙河校区大学生活动中心。窗外寒风凛冽,但位于大学生活动中心一层的创意咖啡吧却暖意融融。这里,正在进行第二期"校长茶座"——校长王广谦与来自各个学院不同专业、不同年级的三十余名同学相聚于咖啡吧,针对同学们所关