Coronary heart disease is a common disease threatening human health. In recent years, the incidence of coronary heart disease in China has only increased. It is the most common type of organ disease caused by coronary atherosclerosis, which is observed in the aorta, carotid artery, and femoral artery. The main clinical treatments for coronary heart disease include coronary artery bypass grafting and drug treatment. To investigate the relationship of serum adipocytokine C1q/tumor necrosis factor-related protein 9 (CTRP9), amyloid A (SAA), and plasma homocysteine (Hcy) with coronary artery plaque characteristics in patients with coronary heart disease. Overall, 143 patients with coronary heart disease admitted to our hospital are selected as research participants. The proportion of plaque necrosis core volume is higher in group A than in group B, and the differences are statistically significant (P < 0.05). In group A, necrotic core volume percentage is negatively correlated with CTRP9 levels and positively correlated with SAA and Hcy levels (P < 0.05). Logistic regression analysis revealed that increased systolic blood pressure, increased number of coronary artery lesions, decreased CTRP9 levels, and increased Hcy levels are independent risk factors for thin fibrous cap atherosclerosis in patients with coronary heart disease (P < 0.05). Decreased CTRP9 levels and increased Hcy levels are independent risk factors for coronary heart disease patients with thin fibrous cap atherosclerosis.

Objective To find how to avoid stent malappsition in coronary artery stent implantation through study many factors that maybe have something to do with stent malappsition.Methods The number of patients of experimental groub is 503 and the number of stents of this group is 708.To control group the two numbers are 579 and 753.Stents of experimental groub are released at 120％ of its named pressure.Stents are released at its named pressure in control group.Three experienced doctors take part in this study.The role of SB Subtract, OCT and post expansion are studied at the same time.Results There is no significant difference of lesion vessel, stent diameter, rear diffuser and pressure of post expansion between the experimental groub and the control group.There is significant difference of the number of stents that need post expansion between the two groups by evaluation of the three doctors, SB Subtract and OCT.Conclusion Stents released by high pressure and post expansion may be beneficial to avoid stent malappsition in coronary artery stent implantation.OCT is the best method for the evaluation of stent adherence of the three methods in our study.To evaluation the stent adherence SB Subtract is a better methods than the three doctors.

Objective: To compare therapeutic effect and safety of dabigatran and warfarin anticoagulant therapy during catheter ablation in patients with atrial fibrillation (AF). Methods: Clinical data of 325 AF patients, who received catheter ablation in our hospital from Jan 2011 to Aug 2014, were retrospectively analyzed. According to perioperative anticoagulant therapy plan, patients were divided into dabigatran group (n=187) and warfarin group (n=138). General data, international normalized ratio (INR), activated coagulation time (ACT), success rate of pulmonary vein isolation (PVI), operation time and incidence rate of complications were compared between two groups. Results: Compared with warfarin group, there were significant reductions in percentages of diabetes mellitus (20. 3％ vs. 11. 8％), chronic heart failure (19. 6％ vs. 10. 2％) and left atrial diameter [(47±10) mm vs. (44± 9) mm]in dabigatran group, P＜0. 05 or＜0. 01. INR of dabigatran group was significantly lower than that of warfarin group [(1. 3±0. 3) vs. (2. 4±0. 4), P=0. 001], and there were no significant difference in ACT, success rate of PVI and operation time between two groups (P＞0. 05 all). Incidence rate of main complications in dabigatran group was significantly lower than that of warfarin group (0. 5％ vs. 5. 1％, P=0. 025). Conclusion: Compared with warfarin, there is significant reduction in INR and incidence rate of main complications during catheter ablation in dabigatran group, which is worth extending.

目的：探讨慢性心力衰竭(心衰)患者血清生长分化因子-15(GDF-15)与纽约心脏病协会(NYHA)心功能分级及B型利钠肽(BNP)的相关性。方法90例慢性心衰患者按NYHA心功能分级分为NYHAⅡ级组、NYHAⅢ级组、NYHAⅣ级组,每组30例,另选排除心、肺、肝、肾等系统的疾病者30例作为对照组,入选时常规采集研究对象血糖、血尿酸、尿素氮、血肌酐及心脏彩超等临床资料,同时抽血检测GDF-15及BNP水平,重点评估GDF-15在慢性心衰患者危险分层和预后中的临床预测效果。结果心衰患者各组血清GDF-15水平高于对照组(P<0.05), GDF-15水平随NYHA心功能分级逐级升高而升高,各心衰患者组间比较差异有统计学意义(P<0.05)。相关性分析显示各级心衰患者的GDF-15与BNP均呈正相关(r=0.599、0.755、0.840, P<0.05)。结论 GDF-15水平可以指导心衰患者进行危险分层,其判断心衰的价值并不劣于生物心衰指标BNP；心衰发生前GDF-15表达水平较高的患者更加需要适合有效的强化治疗。

Objective To regard the patients with coronary heart disease who were treated with PCI as the objects of study,the research analyzes and compares&nbsp;patients'postoperative effects by using clopidogrel and ticagrelor as wel as the potential adverse events.Methods It selects 150 patient cases with coronary heart disease who were treated with PCI in the hospital from August 2014 to August 2015,and divides them randomly into folowing two groups: the group of clopidogrel and the group of ticagrelor with the same patient number. Then it respectively analyzes and compares the clinical effects of these two medicines as wel as MACE.ResultsThe total effective rate of the clopidogrel group is 76.0%,while that of the ticagrelor group is 93.3% ,Patients with a postoperative MACE of the clopidogrel group is a total 30 cases,while that of the other group is a total 10 cases. Compare the two groups of patients in curative effects and MACE,the differences have statistical significance. (P<0.05) . Conclusion The patients with coronary heart disease who were treated with PCI wil have better curative effects when using ticagrelor,and the patients with a postoperative MACE is less.

Objective To explore the early acute myocardial infarction patients with serum potassium concentrations associated with coronary angiography in vascular and ventricular arrhythmias in relation, for reference by clinical research.MethodsFrom November 2014 to December 2015, 74 patients with acute myocardial infarction, through early serum potassium concentrations in acute myocardial infarction patients were divided into 2 groups, namely early group of low blood potassium (potassium concentration is less than 3.5 mmol/L) and normal blood potassium (potassium concentration between 3.6~5.5 mmol/L), Observation of 74 cases of acute myocardial infarction patients with serum potassium concentration associated with coronary angiography in vascular and the relationship of ventricular arrhythmias.Results Through this research can be seen, when the anterior descending artery lesion, associated with hypokalemia, also were susceptible to ventricular arrhythmia cases, the number of cases was signiifcantly higher than normal potassium blood, signiifcant difference (P<0.05).Conclusion Early serum potassium concentration in patients with acute myocardial infarction and coronary angiography in vascular and has some relationship of ventricular arrhythmias, can be used to promote.

目的 研究左西孟旦对心肌细胞氧化应激损伤的保护作用.方法 ①MTT法检测不同浓度的左西孟旦及HO2对大鼠心肌细胞生存率的影响.②光镜观察左西孟旦及H2O2对大鼠心肌细胞形态学的影响.③流式细胞仪检测左西孟旦及H2O2对大鼠心肌细胞凋亡的影响.结果 MTT显示:①浓度为0.03～0.24 μmol/L的左西孟旦加入正常大鼠心肌细胞后,测得其吸光度值与空白对照组吸光度值接近,并没有促进增殖的作用;②当加入浓度＞0.3 μmol/L的左西孟旦后,测得细胞吸光度值明显低于空白对照组;③H2O2500 μmol/L和1000μmol/L处理大鼠心肌细胞,吸光度值明显低于空白对照组;④预先加入左西孟旦进行预处理的心肌细胞吸光度较单加入H2O2的吸光度值明显升高且与浓度呈正相关.光镜下观察:①单纯加入左西孟旦组的心机细胞呈现梭形,呈放射状或栅栏状排列,浓度增加,未见细胞伪足收缩及胞体变圆.②加入H2O2500μmol/L和1000μmol/L后,随H2O2浓度的增加,胞体变圆,伪足收缩的细胞增多.③有左西孟旦保护的心肌细胞,胞体变圆,伪足收缩的细胞数量与浓度在一定范围内呈正相关,左西孟旦浓度越高,胞体变圆,伪足收缩的细胞越少.流式细胞结果显示:①空白对照组早期凋亡为0.31％,晚期凋亡6.88％,坏死的心肌细胞4.65％,存活的心肌细胞88.16％.②H2O2 1000μmol/L组早期凋亡为1.52％,晚期凋亡8.03％,坏死的心肌细胞7.66％,存活的心肌细胞82.79％.③Levo 0.24 μmol/L+H2O2 1000μmol/L组早期凋亡为0.44％,晚期凋亡6.48％,坏死的心肌细胞4.95％,存活的心肌细胞88.13％.结论 左西孟旦对大鼠心肌细胞氧化损伤有保护作用,且0.24μmol/L组作用较0.03μmol/L组作用更明显.

冠状动脉粥样硬化性心脏病（coronary heart diease,CHD）,简称冠心病,是目前常见的严重影响人类健康的心血管疾病[1]。冠状动脉粥样硬化是CHD发病的病理基础,其中炎症反应与动脉粥样硬化密切相关,被认为是冠状动脉硬化的主要发病机制之一[2],而高敏C反应蛋白（hypersensitive C-reactive protein,hs-CRP）可作用炎症标记物来间接

目的 本试验检测自发性高血压大鼠(SHR)血液中miR-448 5p、miR-128、miR 146a和miR-24 2*四种小分子RNA(miRNA)的表达,探讨高血压疾病与miRNA表达水平相关性,为人类高血压诊断及治疗提供新的靶标.方法 应用荧光定量PCR方法对SHR大鼠和正常大鼠血液中miR 448-5p、miR-128、miR-146a和miR 24-2*表达量进行检测.结果 与正常对照组相比,SHR大鼠血液中miR 448-5p、miR-128、miR-146a和miR-24 2*的表达量均显著上调2倍以上.结论 miR-448 5p等四种miRNA表达量与高血压疾病呈相关性,为人类高血压患者血液诊断标记物及为高血压治疗的研究提供新的思路.

目的探讨国产Excel雷帕霉素药物洗脱支架在不稳定型心绞痛患者介入治疗中的有效性和安全性。方法入选冠状动脉造影后需植入支架治疗的不稳定型心绞痛患者332例,采取家属自愿的原则,分别植入国产Excel(147例)、进口Cypher(185例)雷帕霉素支架。随访至少2年。结果 2组冠脉病变情况、支架植入长度及直径比较,差异均无统计学意义(P均>0.05)。2组心绞痛、非致死性心肌梗死、支架内血栓形成、支架内再狭窄及心源性死亡等差异无统计学意义(P均>0.05)。结论国产Excel支架相对价格低,疗效及安全性与进口Cypher支架相当,性价比高,适合临床广泛应用。

Objective To analyze clinical features of ST-elevation myocardial infarction(STEMI)combined chronic total occlusion(CTO)of non-infarction-relative artery(non-IRA) and the prognosis of primary percutaneous trasluminal coronary intervention(PCI).Methods A total of 417 patients with STEMI within 12 hours of onset admitted from June 2007 to June 2010 were recruited.The patients were divided into two groups according to with or without CTO of non-IRA:A group(53 cases) with CTO of one branch of non-IRA at least and B group(364 cases) without CTO of non-IRA.The case history,the condition of PCI therapy and the outcome were compared.Results Compared with B group,the ratios of medical history including old myocardial infarction and diabetes type 2(9.4% vs 2.5%,26.4% vs 12.9%,all P<0.05),the ratio of using intra-aortic balloon counterpulsation(IABP)(17.0% vs 8.0%,P<0.05),the ratio of using temporary pacing(20.8% vs 7.4%,P<0.01),the ratio of using cardiac electrical conversion(26.4% vs 7.1%,P<0.01) were higher in group A.At follow-up period of 12 months at least,the rate of re-hospitalization due to hart failure in group A was higher than that in group B(28.3% vs 12.9%,P<0.05).There were no significant differences for in-hospital mortality of acute period and the mortality of follow-up period between A and B groups(3.8% vs 3.6%,5.7% vs 5.5%,all P>0.05).Conclusions In patients with STEMI combined CTO of non-IRA,the anamnesis of diabetes and myocardial infarction is common,and Patient′s condition is dangerous;Therapies with IABP,cardiac electrical conversion and temporary pacing are common,but primary PCI could still raise survival rate and improve short-term and long-term prognosis.

目的 探讨代谢综合征(MS)、血尿酸(UA)、高敏C反应蛋白(hs-CRP)、血总胆红素(TBIL)与不稳定性心绞痛(UAP)之间的关系.方法 将158例UAP患者分为UAP合并MS和UAP无MS组,设健康对照组60例,比较其体重指数(BMI)、甘油三酯(TG)、空腹血糖(FBG)、高密度脂蛋白胆固醇(HDL-C)、UA、hs-CRP、TBIL的变化.结果 UAP患者BMI、TG、FBG、UA、hs-CRP较对照组显著升高(P＜0.01).TBIL较对照组显著降低(P＜0.05),UAP合并MS较对照组改变更显著(P＜0.01).结论 MS患者存在血脂、血糖代谢紊乱、炎症标志物hs-CRP升高的病理变化,MS、高UA、低TBIL对MS患者冠心病的发生和发展起着促进作用.

Objective To investigate the correlation between the insulin resistance of patients with essential hypertension(EH) and endothelial function as well as the serum 1evels of anticardiolipin antibody(ACA-IgG,ACA-IgM),high sensitive C-reactive protein(hs-CRP). Methods 120 patients(test group)with EH and 45 healthy persons(control goup) were studied.Serum levels of ACA-IgG,ACA-IgM and endothelin(ET),hs-CRP,glucose,insulin were measured and blood pressure were examined and insulin sensitivity index were calculated in everybodys. Comparing the difference of serum 1evels of ACA-IgG,ACA-IgM as well as insulin sensitivity index,hs-CRP,ET in test and control goup. Results The average serum levels of ET(62.43±18.09)mg/dl,hs-CRP(3.68±1.35)mg/dl,ACA-IgG(1.47±0.63),ACA-IgM(1.64±1.49) and insulin sensitivity index -4.45±0.41(0.55) in test group were significantly different than that of ET(37.45±16.58)mg/dl,hs-CRP(1.19±0.76)mg/dl,ACA-IgG(0.87±0.29),ACA-IgM(1.01±0.56) and insulin sensitivity index -3.86±0.33(1.0) in control group(P0.01 and P0.05). The correlation analysis showed that serum levels of ACA-IgG,hs-CRP,ET were negative correlated with the insulin sensitivity index in test goup separately r=-0.34(P0.05),r=-0.53(P0.01), r=-0.44(P0.01). Conclusion The insulin resistance of patiens with EH were accompany with dysfunction of endothelial and condition of inflammation, and were significantly negative correlated with the ACA-IgG. It was shown that insulin resistance of patients with EH were disposition of thrombus.

目的探讨冠状动脉造影心肌桥的检出率及临床意义。方法465例接受冠状动脉造影的患者,根据造影显示收缩期狭窄,而舒张期正常诊为冠状动脉心肌桥。结果共检出冠状动脉心肌桥23例,检出率为4.9%,近端合并冠状动脉粥样硬化7例。结论冠状动脉造影为心肌桥的有效检出方法,心肌桥多位于前降支,其近端易形成粥样硬化斑块。

Objective To study the effect of direct percutaneous coronary intervention(PCI) on QT interval dispersion(QTd) and corrected QTd(QTcd) of patients with acute myocardial infarction(AMI).Methods QTd and QTcd in 82 cases of(AMI) before and after successful primary PCI were measured and compared with those of 64 normal controls.Results Compared with the controls QTd and QTcd in patients with(AMI) before direct PCI were significantly increased(P0.05)and sigificantly reduced after direct PCI(P0.05).Conclusions The QTd and QTcd of the patients with AMI are longer significantly than that of normal people,but they may become shorter as the direct PCI had been successfully made in these patients.

冠心病全称为冠状动脉粥样硬化性心脏病,随着冠心病(CHD)在我国发病率和死亡率的增加,人们对冠状动脉粥样硬化发生、发展的研究也越来越多,近期研究认为,炎症是冠心病的一种危险因子,参与了冠心病及其并发症的发生与发展.C-反应蛋白(C reactive protein,CRP)是反映炎症的一个敏感性指标,许多研究也证实CRP是冠心病的一种预测因子,冠心病患者CRP水平升高,可以预测心血管事件的发生[1],与冠心病严重程度相关[2].本文旨在探讨CRP、TC/HDL、TG、LDL与冠心病的关系及血脂、炎症反应等参与冠心病的发病机制及风险评估的临床意义.

Objective We investigated oxidative stress in the kidney of diabetic rat in order to testify it's effect on the mechanism of diabetic nephropathy. Methods The animals were devided into two groups. One is normal group, the other is diabetic group. STZ was used to induce the diabetic models of rats. After 8 weeks, we measured blood glucose, blood lipid, urinary protein and the ratio of kidney weight to body weight in the rats of two groups. We also evaluated the content of MDA and the renal intrinsic anti-oxidatant enzyme activities such as Cu,Zn SOD and GSH-Px. Results Comparing with normal group, the level of blood glucose blood lipid, urinary protein and the ratio of kidney weight to body weight in diabetic group were significantly increased. The content of MDA in renal cortex was increased, whereas the activities of anti-oxidatant enzyme were decreased. Conclusion Oxidative stress existed in the kidney of diabetic rats. The deficiency of intrinsic anti-oxidatant enzymes may contribute to the development of diabetic nephropathy.

P波离散度(Pd)是心房内存在部位依从性非均质电活动的标志,是引起房颤的重要的电生理学基础.最大P波时限延长是房内或房间传导延缓的标志,而P波离散度是近年发现和提出的预测房性心律紊乱、阵发性心房纤颤的体表心电图一个新指标[1].对预测心房纤颤的发生有较高的敏感性和特异性[3].本研究观察了阵发性心房纤颤患者的最大P波时限(Pmax)和Pd,并与非心房纤颤的患者比较,旨在探讨它们在预测阵发性心房纤颤方面的意义.