Humans ; Hyperlipoproteinemia Type II

Objective: To propose the hypothesis of "endogenous collateral wind" based on the pathomechanism of thrombogenesis complicated by ruptured plaque on acute coronary syndrome(ACS) and the theory of traditional Chinese medicine.Methods: Patients of coronary artery disease with successful coronary angiography(CAG) and intravascular ultrasound(IVUS) was made the differential diagnosis such as blood stasis,blood stasis due to phlegm obstruction and endogenous collateral wind.The levels of plasma inflammatory marker were measured to study the charactristic of "endogenous collateral wind".The prescription principle of Luoheng dripping pills was promoting blood circulation to expel wind-evil and remove wetness under guidence of "endogenous collateral wind" hypothesis.Patients with unstable angina were randomly divided into 3 groups based on therapeutic methods:conventional therapy group,luoheng dripping pills group and Tongxinluo capsule group.Results: There were characteristic changes of severity of coronary artery stenosis,the types of ACC/AHA lesion and Levin lesion,remodeling index,positive or negative remodeling percentage measured by IVUS,the plasma levels of plasma inflammatory marker measured by ELLSA in patients with endogenous collateral wind syndrome.The total effective rate of improved angina in luoheng dripping pills group was significantly higher than those in other two groups.The levels of plasma inflammatory marker were significantly lower in luoheng dripping pills group.Conclusion: There were some pathological found of the hypothesis of "endogenous collateral wind" on acute coronary syndrome.It provides the evidences that patients with coronary artery disease were treated with expelling wind-evil and removing wetness.

Henan is a large agricultural population province of China.It has relative scarcity of the primary health personnel and the health technology,together with farmers lacking understanding of prevention and treatment of cardiovascular diseases.which result in the diseases becoming the major effect on local residents'health.In the new situation of social change,the feasible medical technique extension for the rural health prevention and treatment of cardiovascular diseases faces on the new opportunities and challenges.The technical strategy was taken as following:choosing representative demonstration counties,focusing on actual demand for cardiovascular disease prevention and treatment and on technical problems of diseases with heavier burden and lack of appropriate technology.From the baseline survey.selecting a number of safe,effective and economic the feasible cardiovascular technology for the extension application in large area.The models of appropriate technology applications and operating mechanisms were studied systematically on different economic conditions and different regions.Some existing problems were found in the extension application.Meanwhile,the measures of prevention and treatment of cardiovascular rural grags-roots promotion of appropriate technology mode was put forward.This study would improve cardiovascular health services in rural areas.decrease the disease burden of farmers and raise their overall health level.

Fourteen patients with Wolff-Parkinson-White syndrome (W-P-W) and 2 pa-tients with atrioventricular node dual pathway (AVNDP) underwent radiofrequency current abla-tion. There were 14 accessory pathways located on the left side of the heart (11 left-free wall. 1 left postseptal, 1 left postlateral and 1 left midseptal), 2 on the right side (1 right anteroseptal, 1 right free-wall). In patients with left side pathways, ablation was attempted via a catheter posi-tioned in the left ventricule directly below the mitral annulus. In patients with right side accessory pathways , the ablation catheter was positioned in the atrial aspect of tricuspid annulus. Accessory pathway conduction was permanently abolished in all the patients (100% ). 2 patients with AVNDP were also successfully ablated by blocking the slow pathways. Plasma CK-MB , SGOT and LDH in-creased moderately in 9 patients (52. 9%) and decreased to normal level after 3～4 days. No severe complications were noted. Conclusion: catheter radiofrequncy current ablation may be an effective and safe therapeutic modality for patients with refractory tachycardias mediated by these path-ways.

The pulse wave velocity(PWV)known as one of important monitoring methods in crowd more can precisely reveal the occurrence of cardiovascular events.The brachia-ankle PWV(baPWV)is referred to cosmically epidemiological study in crowd.PWV is known as a vicarious mark of arteriosclerotic burden and an independent risk factor.Moreover,used for decision the therapeutic effect.Our study initially showed that PWV was only a mark of cardiovascular events and was not a predict end point.

With water immersion, the water exerts a pressure on the body surface. Thus there is a blood volume shift from the periphery to the central circulation, resulting in marked volume loading of the thorax and heart. This article illustrated hemodynamic and hurohumoral responses of hydrotherapy, and dicussed whether patients with left ventricular dysfunction (LVD) or chronic heart failure (CHF) can immerse, take balneotherapy, exercise in the water and swimming. A positive effect of therapeutic warm-water tub bathing has been observed in patients with LVD and CHF, which was assumed to be from afterload reduction due to peripheral vasodilatation caused by the warm water. Optimal swimming as used for cardiovascular training programs may be allowed exclusively for NYHA class Ⅱ patients with myocardial infarction older than 6 weeks, myocarditis suffered more than 6 months ago, and cardiomyopathy. Patients with previous severe myocardial infarctions and/or CHF may bathe in a half sitting position, but immersed no deeper than the xiphoid process, because immersion up to the neck could produce abnormal increase in mean pulmonary pressure and pulmonary capillary wedge pressure temporarily. In coronary artery disease (CAD) patients with reduced LV function the heart is working more efficiently with mild cycling in water than cycling outside of water. Decompensated heart failure is the absolute contraindication to hydrotherapy.

Students generally felt difficult in studying during clinical practice and the orthopedics teaching quality was unsatisfactory due to the discrepancies existed among teaching of anatomy,imagie and orthopedics clinical practice concerning the time,content,requirement and method.Students' understandings of anatomy and image knowledge were improved through launching theoretical study by means of lectures and case discussion.Students' understandings of orthopedics diseases were promoted through preoperative diagnosis and intraoperative conformation using anatomy and image knowledge for the patients they were responsible for.In all,orthopedics clinical teaching quality was promoted through applying these measures.

Objective To quantitatively assess cardiac intervals with tissue Doppler imaging(TDI) and normal reference values. Methods Apical 4 chamber, 2 chamber and long axis views of two-dimensional TDI were acquired in 29 healthy individuals(using GE Vivid 7 commercially ultrasound machine). The basal and middle segments in left ventricle(anterior septal, anterior, lateral, posterior, inferior and septal wall) and in the free wall of right ventricle were analyzed with tissue velocity imaging(TVI) model.Cardiac intervals of each segment, which included the isovolumic contraction time, contraction to peak time, insovolumetric relaxation time, rapid filling time and artrial contraction time were measured using TVI in the left ventricle and free wall of the right ventricle. Results The successful rate of sample was 100% in basal segment of each wall. There were significant differences between the left and right ventricle in the isovolumetric contraction time, the systolic accelaration time, contraction to peak time, isovolumetric relaxation time, early diastolic time, diastasis and artrial contraction( P

termined by serum cotinine determination.Effects of tobacco exposure on arterial elasticity in residents of poor areas in north China were more than those in urban residents.

Objective To investigate the perception of anticoagulant treatment for atrial fibrillation (AF) in physicians from county-level hospitals.Methods Two hundred and ninety two physicians from 9 hospitals of Jiangsu,Henan,Zhejiang,Jiangxi provinces were enrolled in this cross-sectional survey from June to November 2013.A standard questionnaire was used in the survey,which consisted of questions on knowledge,awareness and concerns of physicians regarding the diagnosis of atrial fibrillation and administration of warfarin.Results Total 292 questionnaires were returned and 208 of them were finally analyzed.According to the reports of the physicians,the percentage of anticoagulant treatment was 30.0％ (10.0％-60.0％) in patients with rheumatic valvular AF,20.0％ (10.0％-50.0％) in patients with non-valvular AF and 80.0％ (40.0％-100.0％) in those with mechanical heart valve replacement.The most common concerns of prescribing warfarin were worries about the bleeding related to warfarin (74.0％,154),the necessary of monitoring INR (65.4％,136) and advanced age (44.7％,93).A half of physicians (51.0％,106) thought that ECG was the main means for diagnosis of AF and only 28.3％ (59) used both ECG and Holter as diagnosis procedure.Among the physicians who reported to use INR for monitoring warfarin administration,62.5％ (130) reported a target ranging 2-3 and one third reported a target INR ＜ 2.The proportion of the physicians who were aware of CHADS2 score and CHA2DS2-VASc score was 51.0％ (106) and 41.3％ (86),but only 15.4％ (32) and 6.3％ (13) of them knew the correct answer of the risk factors,respectively.Although 34.6％ (72) physicians were aware of HAS-BLED score,only 5.3％ (11) selected the 9 parameters correctly.68.3％ (142) physicians reported that vitamin K is the antidote for warfarin.Conclusion This study reveals the concerns and deficits in perception of anticoagulant treatment for AF patients in physicians of county-level hospitals,suggesting that education programs are needed to increase the prevalence of warfarin use in patients with AF.