Tumour necrosis factor (TNF) levels are higher in patients who have experienced an acute ischemic stroke. Greater levels of TNF may not be linked to an increased risk of recurrent coronary events in the stable phase after myocardial ischemia (MI). Coronary atheroma is connected to endothelial and smooth muscle cells, as well as macrophages that emit the multifunctional cytokine tumour necrosis factor (TNF). Transplanted tumours become more vulnerable when TNF-α was first recognized to have a function in hemorrhagic necrosis. TNF-α has been demonstrated to induce heart failure, pulmonary edoema, and cardiomyopathy in people with advanced heart failure when it is elevated in the bloodstream. It has been postulated that prolonged overexpression of TNF-α after ischemia may contribute to poor cardiac outcomes by increasing TNF-α when the myocardium undergoes both temporary ischemia and reperfusion. A rise in TNF levels has been seen after a myocardial infarction, but it is unclear if these higher levels, found months after the initial event, are associated with an increased risk of subsequent heart attacks. We looked at TNF levels in the blood of 270 patients with coronary heart disease in the Chinese Hypertension League's Cholesterol and Recurrent Events (CARE) experiment to see if this notion held true. Recurrent coronary syndrome and coronary mortality were monitored prospectively in the participants. The min max imbalance normalization can be used to assess a patient's baseline characteristics, including hormone and cholesterol test results. Type 2 stimulant connection to aggregate the TNF-signaling qualities and fuzzy techniques was applied. There may now be enough preliminary evidence from the crucial bundle neural network analysis to identify the risk of coronary heart disease associated with TNF pregeneration studies. The tests were assessed using a variety of methods and performance metrics in a Matlab environment.

NOS–NO system activity is closely correlated with ischemia–reperfusion injury (IRI) and NOS subtypes were suggested to play different roles in IRI. In this work, the activity of serum NOS, NO levels, and ischemic necrosis after reperfusion in rabbit with AMI at different time was studied. We also explored the NOS–NO system activity changes and its correlation with myocardial ischemia and necrosis. It shows that after reperfusion in rabbits with AMI, NO–NOS system activities present different changes at each time point due to inactivation of NO and iNOS activation, and different experimental animals, ischemia–reperfusion degree, and length of time will also lead to different research results. Therefore, it is necessary to conduct dynamic observation on animals from different species at multi-temporal point under the state of NOS–NO system activities, and simultaneously detect inflammatory factor, MDA, and SOD indexes. Therefore, it is a must to conduct relevant drug research studies to make NOS–NO system activities maintain the level in favor of ideal myocardial ischemia reperfusion.

目的:探究用阿托伐他汀治疗肺源性心脏病的临床效果.方法:将2018年4月至2019年9月期间沧州市中心医院收治的64例肺源性心脏病患者按照随机数表法分为观察组(OBG组,n=32)与对照组(REG组,n=32).对两组患者均进行常规治疗,在此基础上加用阿托伐他汀对OBG组患者进行治疗,然后比较两组患者的临床疗效、血清一氧化氮、血浆内皮素、血清B型尿钠肽的水平、肺动脉压及其心肌做功指数.结果:OBG组患者治疗的总有效率高于REG组患者,差异有统计学意义,P<0.05.治疗后,OBG组患者血清一氧化氮的水平高于REG组患者,其血浆内皮素、血清B型尿钠肽的水平、肺动脉压及心肌做功指数均低于REG组患者,差异有统计学意义,P<0.05.结论:对肺源性心脏病患者进行常规治疗的同时,加用阿托伐他汀对其进行治疗能显著改善其血清一氧化氮、血浆内皮素、血清B型尿钠肽、肺动脉压及心肌做功指数等指标,提高其疗效,缓解其病情.

Depression is a common psychiatric disorder with a high recurrence rate leading to suicidal thoughts in some cases. Albiflorin is a monoterpene glycoside that is commonly used in the treatment of psychiatric disorders. However, the underlying mechanism of albiflorin on depression is unclear and remains to be investigated. To this end, a mouse model of depression was established via chronic unpredictable mild stress treatment. Next, the effects of albiflorin on depression in these mice were evaluated using the sucrose preference test, forced swim test, tail suspension test, and open field test. The results showed that chronic unpredictable mild stress decreased sucrose consumption, while albiflorin (10 mg/kg) treatment significantly increased sucrose consumption just as fluoxetine (10 mg/kg), a drug commonly used to treat depression. Moreover, both albiflorin and fluoxetine demonstrated significant decrease in immobility time in the forced swim test and tail suspension test with no change in spontaneous locomotor activities. Finally, the underlying mechanism of albiflorin was evaluated using western blot. Results showed an up-regulation of phospho-Akt without changing total-Akt, indicating that albiflorin improved the depression symptoms via inactivation of the Akt signaling pathway. Therefore, albiflorin might be a potential therapeutic treatment for depression.

目的:分析重组人脑利钠肽联合螺内酯治疗心力衰竭的临床疗效.方法:选取我院2017年1月至2019年3月收治的84例心力衰竭患者进行研究,采取随机抽签方式分组,分为单一组和联合组,各42例,在常规治疗基础上分别给予螺内酯和重组人脑利钠肽联合螺内酯治疗,比较两组疗效.结果:治疗后,联合组患者血清NT-proBNP、hsCRP水平低于单一组患者,治疗总有效率90.48％,LEVF、CI、SV,均高于单一组(P<0.05).结论:重组人脑利钠肽联合螺内酯治疗心力衰竭疗效显著,能有效改善心功能.

Increasing evidence shows that miRNAs play pivotal roles in cardiovascular diseases, including heart failure (HF). The aim of this study was to investigate the role of miR-129-5p in chronic heart failure and the underlying mechanisms. The levels of miR-129-5p and HMGB1 in chronic heart failure patients (CHF) and normal controls were examined by RT-qPCR and ELISA. Cardiac function, hemodynamics parameters, oxidative stress, and inflammation factors were analyzed in CHF rat model after transfection of miR-129-5p or HMGB1. Dual-luciferase activity reporter assay was conducted to validate the interaction between miR-129-5p and HMGB1. Downregulation of miR-129-5p and upregulation of HMGB1 were observed in the serum of CHF patients, respectively. Transfection of miR-129-5p improved heart function and hemodynamic parameters, as well as attenuated oxidative stress and inflammation factors in CHF rats. We further confirmed that HMGB1 is a direct target of miR-129-5p. Transfection of miR-129-5p also decreased the mRNA and protein levels of HMGB1 in myocardial tissues of CHF rats. Overexpression of HMGB1 diminished the effects of miR-129-5p on ameliorating oxidative stress and inflammatory response in rats with CHF. Our findings suggest that miR-129-5p protects the heart by targeting HMGB1.

The study was to evaluate the effect of recombinant compound hypertonic salt (C-HSS) combined with furosemide solution on patients with heart failure Ⅲ (NYHA) and to explore the effects of C-HSS combined with furosemide on diuretic resistance, hospitalization time, readmission rate, mortality rate

The aim of the present study was to evaluate the effects of hypertonic saline solution (C-HSS) with high dose furosemide on hospitalization time, readmission, and mortality in patients with New York Heart Association (NYHA) class III heart failure.Decompensated heart failure patients (NYHA III) with chronic ischemic or nonischemic cardiomyopathy and ejection fraction < 40% were divided into 2 groups in an open-label random manner: the first group received a 1-hour intravenous infusion of furosemide (100 mg) plus compound C-HSS (100 mL) twice daily and underwent serious water restriction (500 mL/day); the second group received furosemide intravenous bolus (100 mg) twice a day and water restriction (500 mL/day), without C-HSS. Both groups had normal sodium (120 mmol sodium) intake. After discharge, the two groups continued to receive 120 mmol Na/day and 500-1000 mL water/day.The first group (132 C-HSS patients) had an increase in urination, a reduction in hospitalization time (4 ± 2 versus 7 ± 2 days, P < 0.01), and a reduction in hospitalization costs (2210 RMB versus 3506 RMB, P < 0.01) compared with the second group (132 without C-HSS patients). During the follow-up period (36 ± 12 months), the first group had a significantly higher average readmission time (31.84 ± 7.58 months versus 15.60 ± 6.25 months, P < 0.01) and lower mortality rate (16.5% versus 31.9%, P < 0.01).The results suggest that periodical C-HSS administration, combined with serious water restriction and a normal sodium diet, significantly reduces the hospitalization time, readmission rate, and mortality in patients with NYHA class III HF.

Limited data are available with regard to the impact of daily lifestyle choices in patients with coronary heart disease (CHD) who have undergone stent placement. Thus, the aim of the present study was to investigate the impact of daily lifestyle factors in patients with CHD following stent implantation. Between March 2005 and March 2006, 129 consecutive patients with CHD were admitted to Cangzhou Central Hospital at Hebei Medical University (Cangzhou, China). The patients underwent coronary stenting and participated in a 7-year clinical follow-up that analyzed the impact of their daily lifestyle choices on CHD following the stent placement. Rates of dinner satiety [95% confidence interval (CI), 1.121-10.97, P=0.005], smoking (95% CI, 4.05-34.90, P=2.01×10-7) and heavy alcohol use (95% CI, 1.32-11.05, P=0.006) were significantly higher in the repeated (re)-revascularization group when compared with the non-revascularization group. In addition, the exercise rate was significantly lower in the re-revascularization group when compared with the non-revascularization group (95% CI, 0.02-0.65, P=0.005). However, no statistically significant differences were observed between the groups with regard to sleeping patterns (95% CI, 0.03-0.71, P=0.270) or anxiety rates (P=0.289). A coronary angiography performed during re-revascularization revealed in-stent restenosis in 26% of the patients, stenoses at the entrance to or exit from the stent in 29% of the patients and new lesions in 19% of the patients. Furthermore, original lesions exhibited deterioration in 26% of the patients. The clinical endpoint was reached in 55% of the patients between 3 and 5 years of the follow-up period. In conclusion, poor daily lifestyle habits can increase the in-stent restenosis rate, accelerate the progression of the original lesion and promote the emergence of new lesions in patients with CHD following stent placement.

Objective To assess the relationship of coronary atherosclerotic plaques detected by intravascular ultrasound(IVUS) and virtual histological imagining(IVUS-VH) with plasma lipoprotein(a) in patients with coronary disease. Methods Patients with acute coronary syndrome(ACS group), stable angina pectoris(SAP group) and control subjects(CTL) group were included in present study. Lipoprotein(a) were assayed by immunoturbidimetry. Coronary angiography(CAG) and IVUS/IVUS-VH were performed in all patients. The plaque compositions and features were assessed by IVUS-VH software. Results The levels of plasma lipoprotein(a) in ACS were remarkably higher than those in SAP group and CTL group;. More soft plaques were found in patients with ACS group than patients with SAP group(P<0.01). Compared with SAP group, lumen area significantly(P<0.01) decreased, remodeling index(RI) (P<0.05), eccentricity index(EI) (P<0.05) and plaque area (PA) (P<0.01)significantly increased. There were positive correlations between percentage of soft plaque and lipoprotein(a) (r=0.365, P=0.011), and between the plaque remodeling index and lipoprotein(a) (r=0.432, P<0.001), and between the EI and lipoprotein(a) (r=0.448, P=0.008). Conclusion Plasma lipoprotein(a) is correlated with the vulnerable features of the coronary plaque. The elevation of lipoprotein(a) may correlate with the plaque instability and rupture.

目的：探讨经皮冠状动脉介入（ PCI）术中应用Diver CE血栓抽吸导管在老年急性心肌梗死（ AMI）恢复期合并有高血栓负荷患者中的应用效果。方法选择2010年1月至2012年12月AMI恢复期并血栓负荷较重老年患者35例，随机分为应用Diver CE血栓抽吸导管的血栓抽吸组（18例）和常规PCI组（17例）。比较两组病人基础资料、PCI相关资料及临床预后等。结果两组患者基本临床资料差异无统计学意义（ P＞0.05）；术后心肌呈色分级（MBG）3级获得率较高，无复流及慢血流发生率较低（P＜0.05）；血栓抽吸组12个月左室射血分数（LVEF）较高（P＜0.05）；术后随访期间主要心血管事件（MACE）发生率两组比较有显著性差异（P＜0.05）。结论在对血栓负荷较重的 AMI恢复期患者行 PCI的过程中应用Diver CE血栓抽吸导管安全、有效，能改善心肌再灌注，减少无复流、慢血流等并发症的发生，能改善患者的长期心功能及预后。

目的 探讨逍遥丸联合黛力新在治疗"冠心病"型焦虑症中的安全性及有效性.方法 将经冠状动脉造影或冠状动脉CTA示冠状动脉正常并诊断为焦虑症的患者随机分为对照组(A组)、逍遥丸组(B组)、黛力新组(C组)和逍遥丸联合黛力新组(D组).观察各组患者出院时情绪症状缓解率、躯体症状缓解率、患者情绪症状缓解时间及躯体症状缓解时间.结果 D组患者情绪症状、躯体症状的缓解率明显高于A、B、C组(P均<0.05);B、C组情绪症状、躯体症状的缓解率高于A组(P均<0.05);C组情绪症状、躯体症状缓解率与B组比较无显著性差异(P均>0.05);B、D组7 d时躯体症状的缓解率高于A、C组(P均<0.05);C、D组15～21d时情绪症状缓解率高于A、B组(P均<0.05).结论 逍遥丸联合黛力新在"冠心病"型焦虑症患者的治疗中安全、有效,可以快速有效缓解患者的焦虑症状.

Objective:Study on the safety and efficacy of atorvastatin combined tirofiban in patients with acute myocardial infarction(AMI) did not undergo thrombolytic therapy or primary percutaneous coronary intervention(PCI).Methods:The patients with AMI did not undergo thrombolytic therapy or emergency PCI were randomly allocated into control group(A group),atorvastatin group(B group),tirofiban group(C group) and atorvastatin combined tirofiban group(D group).Observation the indicators when they discharged(1) Cardiovascular events incidence in hospital(recurrent angina,severe heart failure,death).(2) Recanalization rate of criminal showed by coronary angiography.(3) Acute or subacute stent thrombosis rate one month after PCI.(4) Left ventricular dysfunction rate measured by echocardiographic two weeks after hospitalization.(5) Bleeding rate.Results:Cardiovascular events during hospitalization of D group was significantly lower than the B group,C group and A group(P<0.005);Recanalization rate of criminals in D group was significantly higher than B group,C group and A group(P<0.005);Acute or subacute stent thrombosis rate after PCI of D group was significantly lower than the A group(P<0.05).Left ventricular dysfunction rate two weeks after hospitalization of B group,tirofiban and D group was lower than the A group,but no significant difference(P> 0.05).Bleeding rate was not significant difference among B group,C group,atorvastatin combined tirofiban and the A group(P>0.05).Conclusion:Atorvastatin combined tirofiban is safe and effective for the patients with acute myocardial infarction,the method have greater value in the patients with acute myocardial infarction did not undergo thrombolytic therapy or primary PCI.

目的探讨晚餐饱食对经皮冠状动脉介入治疗患者预后的影响。方法将接受经皮冠状动脉介入治疗者542例按其饮食习惯分为晚餐饱食组408例、晚餐无饱食组134例,对两组进行7年随访,观察晚餐饱食对患者预后的影响。结果晚餐饱食组的再次冠脉介入治疗、冠脉搭桥术、心力衰竭及猝死发生率明显高于晚餐无饱食组(P均<0.05)。结论晚餐饱食对经皮冠状动脉介入治疗患者有不良影响。

Objective:To explore and analyze the phenomenon of post-chronic heart failure diabetes mellitus(PCDM).Methods:Extensive survey was carried out to analyzed the effect of chronic heart failure(CHF) to diabetes mellitus(DM) from October 2000 to October 2010.Results:The chronic heart failure diabetes morbidity rate was 23.89% before heart failure,PCDM morbidity rate was 39.47%;The PCDM morbidity rate of survival time≤ 5 years was 30.54%;The PCDM morbidity rate of survival time 6～10 years was 47.72%;The PCDM morbidity rate of survival time 11～15 years was 48.61%;The PCDM morbidity rate of survival time 16～20 years was 66.10%;The PCDM morbidity rate of survival time≥ 20 years was 83.33%;The PCDM morbidity rate was significantly increased with the extension of the survival time of CHF,there are statistically significant differences(P<0.005).Conclusion:Long-term chronic heart failure can increase the incidence of diabetes mellitus.

随着我国社会的发展冠心病的发病率不断升高,目前已成为我国成年人死亡的主要原因之一.冠状动脉支架植入技术发展到今天已经相当的完善,然而在临床工作中发现一部分接受冠状动脉支架术的患者在接受充分药物治疗后仍会出现支架的再狭窄甚至出现新的冠状动脉病变等现象.如何使已经接受血管重建术的冠心病患者更健康的生活成为现阶段我国临床工作者面临的另一难点,应用Logistic回归模型,探讨再次血运重建与日常生活行为因素(晚餐饱食、吸烟、大量饮酒、规律睡眠、焦虑、健身)的相关性.

Purpose The role of electrocardiogram (ECG) in the diagnosis of acute myocardial infarction (AMI) is very important. As an emergency technique, electrocardiogram is easy to operate, although, to diagnose acute myocardial infarction (AMI) by electrocardiogram become difficult due to the irregular change of electrocardiogram in the patients with AMI. Diagnostic errors, missed diagnosis even delay therapy appeared. To assess the irregular change of electrocardiogram in the patients with AMI should be necessary in diagnosis and therapy. Methods The retrospective study enrolled 10 subjects with AMI who were hospitalisation in Cangzhou Central Hospital from May 2009 to May 2011. The changes of ECG were irregular in all of them. ECG, enzymes (due to myocardiolysis) and echocardiography were detected, percutaneous coronary intervention (PCI) was given also. Results 10 patients with AMI included four male, six female, aged 32–72 (57±4.16); 1±0.18 h were continuing from chest pain seizures to hospitalisation; No-dynamic change in ECGs in acute phase; Troponin was increased in two cases; serum creatine kinase and troponin I both increased in eight cases; completely morbid change of leftcircumflex in six cases and capital morbid change of leftcircumflex in four cases were detected by coronary angiography. Conclusions The atypical change of electrocardiogram in patients with acute myocardial infarction mostly predicts that infarct related artery is leftcircumflex.

Clinically effective cardioprotection under acute myocardial infarction (AMI) can only be achieved by establishing the mechanisms of reperfusion-induced cardiac cell death. In spite of the numerous earlier studies on the prevention of ischemia–reperfusion injury of myocardium, the problem of cardiac cell death upon reperfusion is not yet resolved. Even though animal models provide an immense opportunity in the understanding of the mechanisms of ischemia–reperfusion injury, clinically relevant animal models through which translation of this knowledge into clinic are lacking. In this work, we have established a reperfusion model in rabbits with induced AMI by obstructing and releasing the left anterior ventricular branch of left circumflex coronary artery, which is clinically more relevant. This was achieved by cutting the two left ribs of the rabbit followed by obstructing and releasing the artery unlike the traditional approach, which involves incision through sternum and blocking the anterior descending coronary artery. This animal model of ischemia–reperfusion more closely mimics the physiological condition and also the trauma the animal suffers is much smaller with higher survival rate and thus is a potentially better model for studying the pathology related to ischemia–reperfusion injury.

Objective To Explore the feasibility of establishing the reperfusion model on AMI rabbit by the method of obstructing and releasing the Left Anterior Ventricular Branch (LAVB) of left circumflex coronary artery (LCX). Methods A total of 24 healthy Japanese albino rabbits of both sex were used in this study. Rabbits were randomly divided into 3 groups: ischaemia-reperfusion group (IR group, 8), ischaemia-noperfusion group (AMI group, 8), sham group (sham, 8). After preconditioning the myocardium twice by obstructing the blood flow for 5 min, we obstructed the flow of LAVB in IR group for 60 min, and then released it to be reperfusion. In AMI group we obstructed the flow permanently by ligating LAVB. And in sham group we only threaded but did not obstruct the flow. Then we killed them 3 days later. Venous blood was gathered. The levels of cTNI, CK and CK-MB were assayed at pre-reperfusion (baseline) and post-reperfusion period (4-h, 8-h, 12-h, 24-h, 48-h and 72-h after being reperfusion). The summation changes of ST segment elevation were observed in leads П, Ш, avF by ECG. Histopathology of myocardia, Evan9s Blue and TTC dyeing were taken into notice. STATA8.0 software pack was used for data analysis. Results The results come out that the ST segment all elevated in each group after LAVB was obstructed. In IR group the ST segment lowered more than 50% within 120 min after releasing the artery. This phenomenon had not appeared in other two groups. Compared to baseline, the cTNI, CK and CK-MB were all raised in IR group, and the peak value antedisplaced to 8 h, 12 h and 10 h. These three factors were all raised but no antedisplacement of the enzyme peak in AMI group. In sham group the raising of the three factors was slight, and no antedisplacement of the enzyme peak either. The experiment of rabbits in IR and AMI groups were consistent with the AMI diagnostic criteria in AMI Guideline of diagnosis and therapy established by Cardiac Disease branch of Chinese Medical Association in 2004. The histopathology examination and TTC staining agree with the AMI diagnosis too. The experiment of rabbits in IR group was in accordance with the recanalisation criteria of IRCA recommended by the Chinese J Cardiol editorial committee in 1991. The injection of Evan9s Blue was in coincidence with the recanalisation of IRCA too. Conclusions AMI-reperfusion rabbit models can be successfully established by the application of this method. It has proved to be very effective.