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Objective: To explore influence of urokinase on expression of soluble CD40 ligand (sCD40L) in patients with acute coronary syndrome (ACS).Methods: A total of 94 ACS patients diagnosed and treated in our hospital from Aug 2013 to Aug 2015 were selected.According to random number table, they were randomly and equally divided into routine treatment group and urokinase group (received small dose urokinase intravenous drip based on routine treatment group).Levels of sCD40L and cardiac troponin T (cTnT) before and after treatment, therapeutic effect and incidence rate of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before treatment, there were significant reductions in levels of sCD40L and cTnT in both groups after treatment, P<0.01 all;compared with routine treatment group after treatment, there were significant reductions in levels of sCD40L [(2.92±0.36) ng/ml vs.(2.58±0.18) ng/ml] and cTnT [(0.10±0.02) μg/L vs.(0.04±0.01) μg/L] in urokinase group, P=0.013, 0.001 successively.Compared with routine treatment group, there was significant rise in total effective rate (76.6% vs.95.7%),and significant reduction in incidence rate of MACE (34.0% vs.4.3%) within six months in urokinase group (P<0.01 both).Conclusion: Urokinase can significantly inhibit expression of sCD40L and reduce release of cTnT, and improve therapeutic effect, and prevent major adverse cardiovascular events in patients with acute coronary syndrome.
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Objective To evaluate the effect of a vasoactive substance urotensin Ⅱ on the expression of type Ⅰ collagen and migration of human skin fibroblasts,and to explore the underlying mechanisms of signal transduction.Methods Fibroblasts were isolated from human foreskin tissues and subjected to primary culture.After a series of subculture,fibroblasts were classified into several groups to be treated with different concentrations (10-10 to 10-6 mol/L) of urotensin lⅡ for 24 hours,urotensin Ⅱ of 10-s mol/L for different durations (0,4,12,24 hours),or pretreated with PD98059 (a mitogen-activated protein kinase kinase inhibitor),nicardipine (a calcium channel blocker) and ciclosporin (a calcineurin inhibitor) of 10-5 mol/L respectively for 30 minutes followed by treatment with urotensin Ⅱ of 10-8 mol/L for 24 hours.The cells receiving no treatment served as the control.Subsequently,enzyme-linked immunosorbent assay was performed to determine the level of urotensin Ⅱ in the supernatant of fibroblasts,and Transwell assay to estimate the migration activity of fibroblasts.Statistical analysis was carried out by t test and analysis of variance.Results Urotensin Ⅱ promoted the expression of type Ⅰ collagen in a time-and concentrationdependent manner.The level of type Ⅰ collagen was increased by 21.2％ (P ＞ 0.05),52.2％ (P ＜ 0.05),84.4％ (P ＜0.05),83.6％ (P ＜ 0.05) and 77.1％ (P ＜ 0.05) in the supernatant of fibroblasts treated with 10-10,10-9,10-8,10-7 and 10-6 mol/L of urotensin Ⅱ for 24 hours respectively,by 23.2％ (P ＞ 0.05),69.5％ (P ＜ 0.05) and 84.1％ (P ＜0.05) in the supernatant of fibroblasts treated with urotensin Ⅱ of 10-8 mol/L for 4,12 and 24 hours respectively,compared with the untreated control fibroblasts.The migration activity was markedly enhanced in fibroblasts treated with urotensin Ⅱ of 10-8 mol/L for 24 hours compared with the control fibroblasts (P ＜ 0.05).PD98059,nicardipine and cyclosporin A inhibited the secretion of type Ⅰ collagen by 18.2％,15.9％ and 19.7％ respectively,and suppressed the migration of fibroblasts by 38.3％ (P ＜ 0.05),20.7％ (P ＜ 0.05) and 81.4％ (P ＜ 0.05) respectively in the groups receiving pretreatment compared with those treated with urotensin Ⅱ alone.Conclusions Urotensin Ⅱ can promote the secretion of type Ⅰ collagen by and migration of fibroblasts,which may be realized through the Ca2+,calmodulin kinase,and mitogen-activated protein kinase pathways.
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Objective To investigate the effects of intervention of information literacy education on the feeling of uncertainty of patients with percutaneous coronary intervention.Methods A total of 228 cases of patients with percutaneous coronary intervention who were hospitalized during July 2010 to June 2012 were selected.The patients were divided into two groups by means of random numbers table:the experimental group (including 119 cases) and the control group (including 109 cases).The patients of the control group received traditional nursing intervention,while the patients of the experimental group received additional information literacy education intervention besides the traditional nursing.The change of feeling of uncertainty and state anxiety level of patients under two kinds of nursing interventions was analyzed and compared.Results The patients of the experimental group had high uncertainty level on the day of admission,(99.17-4.46) points.It was obviously higher than the total score (80) by 50％.Compared with that on the day of admission,the uncertainty level on the night before surgery and on the day of patient discharge significantly declined.The state anxiety level of the patients of the experimental group was (52.97±5.91) points,higher than the normative level of Chinese normal people.Compared with that on the day of admission,the state anxiety level on the night before surgery and on the day of patient discharge significantly declined,and it was lower than the normative level.Compared with those of the control group,the MUIS and SAI assessment of the experimental group on the night before surgery and the day of patient discharge obviously declined.Conclusions The information literacy education intervention was able to reduce the uncertainty level and state anxiety level of patients with percutaneous coronary intervention.Therefore,the nursing quality of patients was enhanced.
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Percutaneous coronary intervention(PCI) can effectively restore reperfusion of ischemic myocardium in patients with coronary artery disease.But currently PCI treatment is just available for a small proportion of the patients with coronary artery disease,so there was an insufficiency of PCI in patients with coronary artery disease.From the perspective of ethics,the reasons for the phenomenon and some feasible strategies for the problem are also analyzed in this paper.