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OBJECTIVE To investigate the effects of sacubitril/valsartan on renal function in patients with primary hypertension. METHODS A retrospective study was conducted among patients with primary hypertension who were admitted to PLA Strategic Support Force Characteristic Medical Center from January 2018 to June 2023. Based on their medication， they were divided into two groups： sacubitril/valsartan group and valsartan group. Propensity score matching was used to match baseline data between the two groups. Patients were treated with antihypertensive drugs based on improving their lifestyle. Sacubitril/valsartan group additionally received oral administration of 200 mg Sacubitril/valsartan tablets once daily， while valsartan group additionally received oral administration of 80 mg Valsartan capsules once daily. The increase amplitude of serum creatinine from baseline， the proportion of patients with elevated serum creatinine ＞30%-50% or ＞50%， and the proportion of patients with hyperkalemia （serum potassium ≥5.5 mmol/L） were compared between two groups at 2 months and 6 months after treatment. The trends of changes in serum creatinine， serum potassium and estimated glomerular filtration rate （eGFR） were compared between the two groups before treatment （at baseline）， 2 months and 6 months after treatment. RESULTS After propensity score matching， there were 62 patients in sacubitril/valsartan group and 61 patients in valsartan group； there were no significant differences in baseline characteristics between the two groups before treatment （P＞0.05）， indicating comparability. After 6 months of treatment， the increase of serum creatinine in the sacubitril/valsartan group was significantly lower than that in the valsartan group （P＝0.003）； the proportion of patients with elevated serum creatinine ＞30%-50% in the sacubitril/valsartan group was significantly lower than that in the valsartan group （P＝0.045）. None of the patients experienced hyperkalemia events after 2 months and 6 months of treatment. Repeated measures analysis of variance showed significantly statistical differences in serum creatinine and eGFR between the two groups within 6 months of treatment （P＜0.001）. Patients taking valsartan experienced a continuous increase in serum creatinine levels and a decrease in eGFR， while patients taking sacubitril/valsartan showed a first increase and then a decrease in serum creatinine levels， and a first decrease and then an increase in eGFR with a prolonged duration of medication. CONCLUSIONS Sacubitril/valsartan can delay or even reverse the decline in renal function levels， and limit the deterioration of renal function in patients with primary hypertension， without increasing the risk of hyperkalemia.
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Aim To investigate the differences in the role of different purinergic receptor subtypes at different sites in postoperative-hyperalgesic priming in mice. Methods A postoperative-hyperalgesic priming model was constructed by injecting PGE
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Objective:To review and summarize the main problems that have occurred in the history of manned spaceflight worldwide and the experience of the medical rescue support for astronauts at the main landing site since the first manned spaceflight mission of the Shenzhou-5 in China in 2003, focus on the technical status and return characteristics during the construction of the space station since the Shenzhou-12, and formulate a targeted injury treatment plan to ensure the safety of astronauts.Methods:This article summarized the lessons of accidental injuries of astronauts in foreign aerospace history, especially in the space station stage, combined with the experience of medical support of astronauts in manned spaceflight in China, and put forward a series of organizations, plans and treatments according to the mission characteristics of long-term orbits and adjustments of the main landing sites of space station mission spacecraft.Results:On the basis of the original pre-cabin emergency and helicopter ICU comprehensive rescue platform, the emergency procedures were further optimized, and the treatment plans under different complex terrains and the principles of rapid treatment and evacuation of astronauts were formulated.Conclusions:The effective treatment of astronauts returning from the space station in various situations could be ensured by the comprehensive rescue plan for the medical rescue of the space station mission and the construction and organization of the helicopter rescue platform.
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Objective:This study aims to analyze the characteristics and basic principles of emergency surgery risks and anesthesia care of medical support at the landing site for China’s taikonauts of the Shenzhou-12, and to summarize China’s experience in medical support at the landing site for manned spaceflight, and ensure supports in special environments such as an emergency return of manned spaceflight.Methods:This study was carried out through literature research on relevant reports on the emergency surgery risks and aids of domestic and foreign astronauts at the landing sites, and summaries of the experience in medical support for taikonauts of spacecrafts from Shenzhou-5 to Shenzhou-11 at the landing sites. At the same time, according to the characteristics of Shenzhou-12 such as the long on-orbit time, the adjustment in the landing area, the optimization of the mission mode, and new search and rescue power, a series of organization, pre-arranged planning, equipment allocation, and effective anesthesia treatment plan were proposed and inspected in practice.Results:Based on the original anesthesia care plan of medical support, the first-aid carrier was adjusted and modified, the first-aid procedure was optimized, a new generation of supraglottic airway opening tool, video laryngoscope, portable ultrasound, and other devices were added, and the anesthesia care plan at the landing site for manned spaceflight was formulated to provide strong support for the medical care of taikonauts that had stayed in the outer space for a long time.Conclusions:Upon the targeted improvement and process optimization, the anesthesia care plan of medical support for taikonauts of Shenzhen-12 in the landing area fully meets the anesthesia requirement of medical support in special environments such as the emergency return of the taikonauts that have stayed in the outer space for a long time under the new orbital altitude.
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Objective:To investigate the disease incidence of medical rescue teammates during medical security missions in the dry and hot areas of the Gobi Desert, and to explore its related influencing factors and solutions, so as to provide references for the establishment of a health maintenance system for medical rescue teammates in the Gobi Desert in summer.Methods:Fourteen medical rescue teammates during the medical support mission of the Shenzhou-12 spacecraft from May 2021 to June 2021 were selected as the research objects. A questionnaire survey was conducted and the data were analyzed.Results:During the mission, each teammate had suffered one or more kinds of diseases, mainly manifested in upper respiratory tract infection, dermatosis, systemic muscle soreness, diseases of ophthalmology and otorhinolaryngology, digestive system diseases and sleep disorders, with incidences of 20.3%, 20.3%, 18.5%, 18.5%, 12.9%, and 9.2%, respectively. Training or accidental injuries were mainly manifested as hand trauma, foot friction blisters, recurrence of joint synovitis, joint soft tissue injury, and accidental head injury, with incidences of 31.2%, 25%, 75%, 18.7%, and 6.2%, respectively. The recurrence rate was high in patients who previously suffered synovitis. There was a high possibility of secondary injury in patients who were suffered joint soft tissue trauma before.Conclusions:The incidence of certain diseases is high during the medical rescue support mission in the Gobi Desert. During the mission, the teammates should pay good attention to self-protection at all times, carry out targeted prevention and scientific training, and avoid non-combat attrition.
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Aim To investigate the protective effect of new structure compound 4-(5'-dimethylamino)-naphthalenesulfonyl-2 (3H)-benzoxazolone (W3D) on lipopolysaccharide (LPS) induced acute lung injury (ALI) and the underlying mechanism. Methods ICR mice were randomly divided into control group, LPS model group, chlorzoxazone (12.5 mg · kg
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Objective:Summarize the experience of the medical rescue team at the main landing site of China's manned space mission, analyze the new characteristics of the Shenzhou 12 space station mission, and take corresponding countermeasures and measures to ensure the strong medical rescue guarantee for astronauts.Methods:Search the publications about astronaut medical aid domestic and abroad, summarize the rescue and medical aid experiences from Shenzhou 5 to Shenzhou 11. In consideration of prolonged on-orbit time, Location adjustment of the landing site and the new characteristics of the complex terrain, new targeted strategies were presented.Results:The astronauts flew in orbit for 90 days, and the main landing site and launch site are in the same area. The medical security includes three parts: launch section, running section and return section. Desert rescue model were added. Ten injuries were simulated and each injury first-aid procedure was standardized.Conclusion:After targeted improvement and optimization, the Shenzhou 12 astronauts medical rescue support program ensures the safety of the whole process, all-weather and all-terrain emergency and rear delivery of the astronauts in the new mission environment and complex terrain.
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Objective:To investigate the feasibility of applying Fetal Intelligent Navigation Echocardiography (FINE) combined with Virtual Intelligent Sonographer Assistance (VIS-Assistance ?) in the prenatal screening of right aortic arch (RAA) with left-sided ductus arteriosus (LDA). Methods:A total of 32 fetuses with RAA and LDA during middle and late pregnancy in Zhejiang University Medical College Affiliated Sir Run Run Shaw Hospital from Jauary 2018 to Jauary 2020 were included in this retrospective study, and the datas about fetal cardiac three-dimensional volume were analyzed. The time-space correlation imaging (STIC) volume data were collected by using FINE by Senior doctor A. The two diagnostic elements of the transverse aortic arch on the right side of the trachea and the "U" -shaped vascular ring, as well as the three-vessel tracheal diagnostic section were obtained by low-aged doctor B and middle-aged doctor C by using VIS-Assistance ? technology. And then the detection rates of diagnostic sections and diagnostic elements for fetuses with RAA and LDA were calculated. The postpartum outcomes of fetuses with RAA and LDA were followed up. Results:Thirty-two fetuses were included in the study after excluding 2 cases due to the poor quality images, and the datas about fetal cardiac three-dimensional volume of the 32 fetuses were analyzed. The detection rate of one diagnostic element (the aortic arch on the right side of the trachea) were 84.4% vs 87.5% before VIS-Assistance ?, and 93.8% vs 93.8% after VIS-Assistance ? for each doctor B and doctor C , respectively. Another diagnostic element ( "U" -shaped vascular ring) were 78.1% vs 87.3% before VIS-Assistance ?, and 90.6% vs 90.6% after VIS-Assistance ? for doctor B and doctor C, respectively. But no significant difference was found before and after VIS-Assistance ? between the two each doctors(all P>0.05). The detection rate of three-vascular tracheal diagnosis view were 65.6% vs 71.9% before VIS-Assistance ? and 84.4% vs 87.5% after VIS-Assistance ? for doctor B and doctor C, respectively. There was significant difference before and after VIS-Assistance ? of doctor C( P<0.05). The scores of image quality after VIS-Assistance ? were significantly higher than that before VIS-Assistance ? for doctor B and doctor C, respectively [3(2.5, 3) vs 3.25(3.0, 3.5), and 3(2.5, 3.5) vs 3.5(3.0, 3.5)]. The agreement between two doctors performing VIS-Assistance ? was investigated using Bland-Altman analysis and the result showed that within 95% of the differences fall in the agreement interval. No obvious clinical symptoms of compression were found in 32 neonates after follow-up. Conclusions:The application of FINE combined with VIS-Assistance ? technology can easily and reliably obtain the key diagnostic view of RAA with LDA (three-vessel and tracheal view), and clearly display all diagnostic elements, having high repeatability and stability. VIS-Assistance ? technology can improve the detection rate and image quality even if the doctor was lack of experience. So it can be used as an effective supplementary means for prenatal screening of RAA and LDA.
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OBJECTIVE@#To investigate the complications and clinical outcome of children with acute myeloid leukemia (AML) undergoing mitoxantrone-cytarabine-etoposide (MAE) induction therapy.@*METHODS@#A total of 170 children with AML were given MAE induction therapy, and the complications and remission rate were analyzed after treatment.@*RESULTS@#The male/female ratio was 1.33:1 and the mean age was 7.4 years (range 1-15 years). Leukocyte count at diagnosis was 29.52×10/L [range (0.77-351)×10/L]. Of all children, 2 had M0-AML, 24 had M2-AML, 2 had M4-AML, 48 had M5-AML, 3 had M6-AML, 7 had M7-AML, 69 had AML with t(8;21)(q22;q22), and 15 had AML with inv(16)(p13.1q22) or t(16;16)(p13.1;q22). The most common complication was infection (158/170, 92.9%). Among these 158 patients, 22 (13.9%) had agranulocytosis with pyrexia (with no definite focus of infection), and 136 (86.1%) had definite focus of infection (including bloodstream infection). Other complications included non-infectious diarrhea, bleeding, and drug-induced hepatitis. Treatment-related mortality was observed in 10 children, among whom 8 had severe infection, 1 had multiple organ failure, and 1 had respiratory failure. Remission rate was evaluated for 156 children and the results showed a complete remission rate of 85.3%, a partial remission rate of 4.5%, and a non-remission rate of 10.3%.@*CONCLUSIONS@#Induction therapy with the MAE regimen helps to achieve a good remission rate in children with AML after one course of treatment. Infection is the main complication and a major cause of treatment-related mortality.
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Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cytarabine , Drug Administration Schedule , Etoposide , Leukemia, Myeloid, Acute , Drug Therapy , Mitoxantrone , Remission InductionABSTRACT
Objective To evaluate effects of early rehabilitation nursing program on the patients with first-attack ischemic stroke.Methods One hundred and thirty-one patients with first-attack ischemic stroke were selected and divided into control group(65) and intervention group(66).The control group was given conventional neurology nursing and the intervention group was given intervention of early rehabilitation nursing program.Before and after intervention,the patients were assessed with the National Institutes of Health Stroke Scale(NIHSS) and Barthel Index(BI).After 3 months of intervention,the patients were assessed with simplified modified Rankin Scale questionnaire(smRSq).Results At the end of 2 weeks after intervention,NIHSS scores of the intervention group was lower than that of in the control group[(3.41±2.36) scores vs.(4.49± 3.65) scores,P＜0.05],and the Barthel index scores was higher than that of control group[(72.65t±15.69) scores vs.(56.92±21.99)scores,P＜0.05].After 3 months of intervention,the difference of smRSq(71.21％ vs.49.23％,P＜0.05) scores between them were significant(P＜0.05).Conclusion Early rehabilitation nursing program can significantly improve the neurological function and daily life ability of patients with initial ischemic stroke,reducing the disability rate and improve the quality of life.
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Aim To investigate the effect of the novel benzoxazolone derivative 4-( 5′-dimethylamino )-naph-thalenesulfonyl-2 ( 3H )-benzoxazolone ( W3D ) on TLR4-MyD88-NF-κB signaling pathway in LPS-in-duced RAW264.7 cells. Methods The cell viability was detected by MTT assay, and the contents of TNF-α, IL-6, IL-1β and COX-2 in the cell supernatant were analyzed using ELISA methods. The protein ex-pression of IL-6, TLR4, MyD88, p-IRAK4 and NF-κB were investigated by western blot analysis, and the mRNA expressions of TLR4, MyD88 and IL-6 were an-alyzed by RT-PCR. Results W3D could obviously in-hibit the production of TNF-α, IL-6 and IL-1β in LPS- induced RAW264.7 cell supernatant, but it had no effect on the release of COX-2. Compared with the model group, the expressions of TLR4, MyD88 and IL-6 were decreased significantly in a dose dependent manner. Meanwhile, the expressions of p-IRAK4 and nucleus of NF-κB were decrease in W3D treated group compared with the model group. Conclusion The no-vel compound W3D could inhibit the release of the in-flammatory mediators through the regulation of TLR4-MyD88-NF-κB signaling pathway.
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Objective To investigate the relationship between ischemic time and thrombus types in patients with ST-segment elevation myocardial infarction (STEMI).Methods Eighty-two STEMI patients undergone emergency percutaneous coronary intervention (PCI) and coronary thrombus aspiration (CTA) from Sep.2012 to Apr.2016 were included and divided into 3 groups according to the ischemic time:≤4 hours (n=36),4-7 hours (n=30) and ＞7 hours (n=16).Visible aspirated thrombi were collected and separated into erythrocyte-rich type,platelet/fibrin-rich type and combined type thrombi by HE dying.The percentage difference of the 3 types thrombi was compared among the 3 groups.Results The percentage of platelet/fibrinrich type,erythrocyte-rich type and combined type thrombi in the 3 groups were as follows:in ≤4h group:61.1％(22/36),8.3％(3/36) and 30.6％(11/36),P=0.019;in 4-7h group:23.3％(7/30),10.0％(3/30) and 66.7％(20/30),P=0.012;and in ＞7h group:43.8％(7/16),12.5％(2/16) and 43.8％(7/16),P=0.913.For platelet/fibrin-rich type thrombi,the percentages in 3 periods were 61.1％(22/36),19.4％(7/36) and 19.4％(7/36),P=0.009;For combined type thrombi,the percentages in 3 periods were 28.9％(11/38),52.6％(20/38) and 18.4％(7/38),P=0.013;For erythrocyte-rich type thrombi,the percentages in 3 periods were 37.5％(3/8),37.5％(3/8) and 25.0％(2/8),P=0.895.Conclusions The types of intracoronary aspirated thrombi differ from various periods.Ischemia time may be an important predicted factor.
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Objective To examine the influence of gender difference on the reperfusion delay in patients with ST-elevation myocardial infarction (STEMI).Methods A total of consecutive 325 patients with STEMI were analyzed admitted in the 306 Hospital of PLA from Jan.2011 to Dec.2015.Patients were divided into two groups:male group (n=268) and female group (n=57).The clinical data and the time intervals including symptom onset to first medical contact (So-to-FMC),transfer delay (FMC-to-D),FMC to balloon dilatation (FMC-to-B),activation delay and door to balloon (D-to-B) time were compared between different gender groups,and the prognosis was observed.Results The overall median of pre-hospital delay was 125 minutes.The median of prehospital delay time (male 119.5min vs.female 160.0min) and So-to-FMC time (male 69.5min vs.female 100.0min) were longer in female than in male patients,but no statistical difference existed (P＞0.05) between the two groups in pre-hospital delay,So-to-FMC,FMC-to-B,D-to-B and total ischemia time.Compared with male patients,female patients were more likely to have additional comorbidities,such as hypertension and diabetes mellitus,and lower rate of smoking (P＜0.05).However,the incidence of major adverse cardiac and cerebrovascular events (MACCE) showed no significant difference between female and male patients at 30-day (male 5.22％ vs.female 5.26％) and I-year (male 10.82％ vs.female 8.77％) follow-up (P＞0.05).Conclusion The influence of gender on reperfusion delay is gradually weakening.
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Objective To investigate the effect of ambroxol atomization inhalation combined with erythromycin on neonatal pneumonia patients and its influence on high sensitivity C reactive protein( hs-CRP) ,myocardial enzyme level. Methods 100 cases of neonatal pneumonia were selected and they were randomly divided into observation group and control group according to the digital table,50 cases in each group. The control group was treated with erythromycin 30mg/kg, 1 time/d. The observation group was given ambroxol ultrasonic nebulizer inhalation, 15 minutes per time,3 times daily,on the basis of the treatment of the control group. The patients were treated for 4 consecutive weeks. The clinical symptoms disappeared time, hs -CRP level, CK -MB level and clinical efficacy were detected and compared. Results Compared with before treatment, the hs - CRP and CK - MB levels were decreased after treatment. Compared with the control group,the hs - CRP[(7. 25 ± 2. 11) mg/L vs. (12. 21 ± 3. 76)mg/L] and CK-MB[(21. 31 ± 4. 42) U/L vs. (27. 12 ± 3. 17) U/L] levels in the observation group were lower(t=8. 134,7. 553,all P<0. 05),the clinical symptoms disappeared in a relatively shorter time(t= 6. 520, 11. 824,19. 473,all P <0. 05),the clinical curative effect was better. Conclusion Ambroxol aerosol inhalation combined with erythromycin can reduce hs-CRP,CK-MB levels in neonatal pneumonia patients,and the clinical symptoms of the patients disappeared in a relatively short time, the clinical curative effect is better, has guiding significance in clinic.
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Objective To investigate the effect of ambroxol atomization inhalation combined with erythromycin on neonatal pneumonia patients and its influence on high sensitivity C reactive protein( hs-CRP) ,myocardial enzyme level. Methods 100 cases of neonatal pneumonia were selected and they were randomly divided into observation group and control group according to the digital table,50 cases in each group. The control group was treated with erythromycin 30mg/kg, 1 time/d. The observation group was given ambroxol ultrasonic nebulizer inhalation, 15 minutes per time,3 times daily,on the basis of the treatment of the control group. The patients were treated for 4 consecutive weeks. The clinical symptoms disappeared time, hs -CRP level, CK -MB level and clinical efficacy were detected and compared. Results Compared with before treatment, the hs - CRP and CK - MB levels were decreased after treatment. Compared with the control group,the hs - CRP[(7. 25 ± 2. 11) mg/L vs. (12. 21 ± 3. 76)mg/L] and CK-MB[(21. 31 ± 4. 42) U/L vs. (27. 12 ± 3. 17) U/L] levels in the observation group were lower(t=8. 134,7. 553,all P<0. 05),the clinical symptoms disappeared in a relatively shorter time(t= 6. 520, 11. 824,19. 473,all P <0. 05),the clinical curative effect was better. Conclusion Ambroxol aerosol inhalation combined with erythromycin can reduce hs-CRP,CK-MB levels in neonatal pneumonia patients,and the clinical symptoms of the patients disappeared in a relatively short time, the clinical curative effect is better, has guiding significance in clinic.
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Objective To investigate the prevalence of chronic kidney disease (CKD) in hospitalized patients with essential hypertension (EH) and analyze the related risk factors.Methods A retrospectivc analysis of chronic kidney disease and its influencing factors was taken from March 2014 to March 2015 in the Second Affiliated Hospital of Nanjing Medical University.People were diagnosed EH patients (1 020 cases).Results (1) The detection rates of proteinuria,estimated glomerular filtration rate (eGFR) and CKD in patients with EH were 22.3％,13.3％,and 26.1％,respectively.The ratio of CKD in male and female was 26.8％ vs 25.5％ (P＞0.05);(2) With the increase in systolic blood pressure levels (as the systolic blood pressure increased 20 mmHg),the constituent ratio of CKD increased with statistically significant difference (P ＜ 0.05);(3) The risk factors of essential hypertension complicated with chronic kidney disease were high uric acid,the history of diabetes,SBP ≥ 140 mmHg and the age (OR =2.682,2.224,1.932,1.065).Conclusions The detection rate of CKD in patients with hypertension in was high,and the blood pressure,blood glucose,and serum uric acid should be controlled to prevent and delay the occurrence and development of CKD.
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Objective To investigate the prevalence of chronic kidney disease (CKD) in hospitalized patients with essential hypertension (EH) and analyze the related risk factors.Methods A retrospectivc analysis of chronic kidney disease and its influencing factors was taken from March 2014 to March 2015 in the Second Affiliated Hospital of Nanjing Medical University.People were diagnosed EH patients (1 020 cases).Results (1) The detection rates of proteinuria,estimated glomerular filtration rate (eGFR) and CKD in patients with EH were 22.3％,13.3％,and 26.1％,respectively.The ratio of CKD in male and female was 26.8％ vs 25.5％ (P＞0.05);(2) With the increase in systolic blood pressure levels (as the systolic blood pressure increased 20 mmHg),the constituent ratio of CKD increased with statistically significant difference (P ＜ 0.05);(3) The risk factors of essential hypertension complicated with chronic kidney disease were high uric acid,the history of diabetes,SBP ≥ 140 mmHg and the age (OR =2.682,2.224,1.932,1.065).Conclusions The detection rate of CKD in patients with hypertension in was high,and the blood pressure,blood glucose,and serum uric acid should be controlled to prevent and delay the occurrence and development of CKD.
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Objective@#To investigate the impact of symptom onset to first medical contact (SO-to-FMC)time on the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI).@*Methods@#The clinical data of 341 consecutive STEMI patients, who were hospitalized to our hospital and received primary percutaneous coronary intervention(PCI) from August 2011 to April 2016, were retrospectively analyzed. The patients were divided into ≤90 min group (201 cases) and >90 min group (140 cases) according to the SO-to-FMC time. The treatment time, mortality and incidence of major adverse cardiac and cerebro-vascular events(MACCE) were analyzed. The risk factor of 1-year mortality after PCI and 1-year incidence of MACCE during the post-discharge follow-up period were analyzed by binary logistic regression analysis. The predictor of 4.5-year mortality after PCI was analyzed by multivariate Cox regression analysis. Methods The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023), first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001)were all significantly shorter in the ≤90 min group than in>90 min group. The 30-day mortality (2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89 (5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period(1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality(3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071).@*Results@#The door to balloon time (104(88, 125) min vs. 111(92, 144)min, P=0.023) , first medical contact to balloon time(146(119, 197) min vs. 177(125, 237)min, P=0.005), and symptom onset-to-balloon time(200(170, 257) min vs. 338(270, 474)min, P<0.001) were all significantly shorter in the ≤90 min group than in >90 min group. The 30-day mortality(2.99% (6/201) vs. 7.86%(11/140), P=0.042), 1-year mortality (2.89(5/173) vs. 9.57(11/115), P=0.015), 1-year incidence of MACCE during the post-discharge follow-up period (1.16%(2/173) vs. 6.96%(8/115), P=0.021), and 4.5-year cumulative mortality (3.00% vs. 11.20%, P=0.007) after PCI were significantly lower in the ≤90 min group than in the >90 min group. Moreover, the 4.5-year incidence with free of MACCE (97.20% vs. 88.80%, P=0.025) during the post-discharge follow-up period was significantly higher in the ≤90 min group than in the >90 min group. In-hospital mortality was similar between the two groups (2.49%(5/201) vs. 6.43%(9/140), P=0.071). Results of binary logistic regression analysis showed that the SO-to-FMC time >90 min was the risk factor of 1-year mortality(OR=2.90, 95%CI 1.22-6.92, P=0.016) and 1-year incidence of MACCE (OR=5.19, 95%CI 1.21-22.20, P=0.026) during the post-discharge follow-up period. Multivariate Cox regression analysis demonstrated that the SO-to-FMC time >90 min was the risk factor of 4.5-year mortality after PCI in patients with STEMI (HR=2.88, 95%CI 1.10-7.53, P=0.031).@*Conclusion@#Shorting the SO-to-FMC time can significantly reduce the treatment time of STEMI patients, short and long-term mortalities and the incidence of MACCE, and improve the prognosis of patients with STEMI.
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Objective To study the clinical effect of phentolamine combined with furosemide therapy in children with pneumonia complicated with heart failure.Methods The subjects were 92 cases of children with pneumonia complicated with heart failure in our hospital from October 2015 to December 2016,randomly divided into control group and observation group,46 cases in each group.The control group was treated with on the basis of routine treatment,the observation group,patients received phentolamine combined with furosemide treatment.Compared two groups of the total efficiency and the symptoms disappear time,and compare the cardiac function and electrocardiogram improvement effect.Results The total efficiency of observation group(93.48％)was significantly higher than the control group(71.74％)(χ2=7.57,P<0.05); observation group of the pulmonary rales disappeared time,breath,heart failure control time and hospitalization time were significantly lower than the control group(P<0.05); after treatment,the observation group of the ESV was significantly lower than the control group(P<0.05),EDV was significantly higher than that of control group(P<0.05),electrocardiogram indicators improved significantly better than the control group(P<0.01).Conclusion The clinical curative effect of phentolamine combined with furosemide in treatment of children with pneumonia complicated with heart failure significantly,can effectively improve the cardiac structureAnd function,reduce the occurrence of abnormal ECG,high safety,worthy of clinical promotion
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Objective To study the effect of low molecular weight heparin calcium combined with Bailing capsule in treatment of children with Henoch-Schonlein purpura nephritis and the efficacy of serum hs-CRP, MMP-9, APN and CysC.MethodsFrom January 2013 to December 2015, 84 children with Henoch-Schonlein purpura nephritis were enrolled in our hospital.According to the order of admission, the observation group and control group were divided into observation group and control group.The control group were given low molecular weight heparin calcium, the observation group were treated with low molecular weight heparin calcium combined with Bailing capsule for treatment.The levels of serum hs-CRP, MMP-9, APN, CysC, inflammatory factors and immune levels were observed in the two groups.ResultsAfter treatment, the clinical effective rate of the observation group was significantly higher than that of the control group[92.86% (39/42) vs 69.05% (29/42)] (P<0.05).There were no significant differences in hs-CRP, MMP-9, APN and CysC levels between the two groups.After treatment, the levels of hs-CRP, MMP-9 and CysC in the two groups were significantly higher than those before treatment (P<0.05).APN was significantly higher than that before treatment (P<0.05).Compared with the control group, the levels of hs-CRP, MMP-9 and CysC in the observation group were lower than those in the control group (P<0.05), and the APN level was lower than that in the control group (P<0.05).There were no significant differences in TNF-α, IL-6, IL-10 and IL-18 levels between the two groups before treatment.After treatment, The levels of TNF-α, IL-6 and IL-18 in the two groups were significantly lower than those before treatment (P<0.05).There were no significant differences in IgA, IgG and IgM levels between the two groups.After treatment, the levels of IgA, IgG and IgM in the two groups were significantly lower than those before treatment (P<0.05).The levels of IgA, IgG and IgM in the observation group were lower than those in the control group (P<0.05).There was no significant difference in adverse reaction rate between the two groups.ConclusionLow molecular weight heparin combined with Bailing capsule can effectively reduce hs-CRP, MMP-9, CysC level and APN level in children with Henoch-Schonlein purpura nephritis, improve clinical symptoms, good clinical efficacy and high safety.