Objective To analyse change of neuroendocrine hormone and cardiac ultra ejection force in patients with heart failure before and after treatment with Huangqi Decoction.Methods 100 patients diagnosed with chronic heart failure were collected.According to the different treatment regimens divided into two groups ( control group: conventional western medicine; traditional Chinese medicine group: conventional western medicine treatment +Astragalus Decoction orally for 2 weeks) , before and after treatment,nerve endocrine hormone using echocardiography evaluation index and ejection force were detected in two groups, and compare the results of data.Results Compared with control group, Chinese medicine group with better anti heart failure treatment, performance: the plasma calcitonin gene related peptide (CGRP), atrial natriuretic peptide (ANP), C type natriuretic peptide ( CNP ) , neuropeptide Y ( NPY ) levels were significantly lower ( P<0.05 ) . Capacity index significantly improved cardiac function (P<0.05).Left atrial diameter, left atrial maximum, minimum volume decreased significantly (P<0.05).Ejection force of left atrium and left ventricular increased significantly ( P<0.05 ) .The results were statistically significant.Conclusion Huangqi decoction can inhibit the secretion of CGRP, ANP, CNP,NPY and other neuroendocrine hormones in patients with heart failure, reduce cardiac load, increase cardiac ejection force.

Objective To compare the efficacy and safety between Bivalirudin and Heparin during emergency percutaneous coronary intervention(PCI)in elderly patients with acute ST segment elevation myocardial infarction(STEMI).Methods Retrospective analysis of 80 patients diagnosed with ST-segment elevation myocardial infarction in elderly patients was conducted.The treatment group(n=40) received a bolus intravenous injection of Bivalirudin 0.75 mg/kg before emergency percutaneous coronary intervention,then 1.75 mg · kg 1 · h-1 continuous intravenous drip till the end of the operation from March 2011 to March 2015.Activated clotting time (ACT)was detected at 10 minutes after drug application.If ACT＜225 s,0.3 mg/kg were append.The control group received a bolus intravenous injection of Heparin 100 U/kg during emergency PCI,and after 10 minutes ACT was detected.If ACT＜ 225 s,300 U was appended.When operation extended,1 000 U was appended every 1 hour.Immediate postoperative blood flow,early stent thrombosis,target vessel reconstruction at 30 days after operation,recurrent myocardial infarction,non-fatal cerebrovascular accident,all causes mortality and bleeding conditions at 7 days after operation were compared between two groups.Results The immediate postoperative thrombolysis in myocardial infarction (TIMI)blood flow was significantly improved(P＜0.05) in the treatment group as compared with control group.There was no significant difference in target vessel reconstruction at 30 days after operation,recurrent myocardial infarction,non-fatal cerebrovascular accident,and all-cause mortality between two groups (all P＞ 0.05).The bleeding conditions at 7 days after operation were significant lower in the treatment group [2.5％(1 case)]than in the control group[22.5％ (9 cases)] (x2 =7.31,P＜0.01).Conclusions Bivalirudin treatment does not reduce the major cardiovascular events,but improves the TIMI blood flow after surgery and the incidence of bleeding as compared with control group,which suggests that Bivalirudin is safer in emergency PCI therapy in elderly patients with acute ST-segment elevation myocardial infarction

Objective To investigate the clinical characteristics and angiographic findings of cardiogenic shock(CS)following acute myocardial infarction(AMI) in elderly patients.Methods Between January 2015 and April 2016,we carried out a retrospective observational analysis of consecutive elderly patients in Tianjin Chest Hospital,who suffered CS-complicating AMI.Emergency angiography and percutaneous coronary intervention(PCI) were performed after admission.All selected patients were divided into CS and non-CS groups according to whether CS occurred.Electrocardiograph (ECG),cardiac enzyme testing,and ultrasound cardiography were performed after admission to monitor the occurrence of CS.Results The incidence of CS-complicating AMI was 8.33％ (34/408) in elderly patients.Among all CS patients enrolled,the aged patients accounted for 91.89 ％ (3 4/3 7).In-hospital mortality rate was 2 9.41 ％ (10/3 4).There were significant differences between two groups in WBC,H s-CRP,blood glucose,CR and ALT (t =2.403,4.596,6.778,6.109,each P＜0.05).The NT-Pro BNP level,the time of FMC,the frequency of left main and multivessel disease were higher in the CS group than in the non-CS group (each P ＜ 0.05).Conclusions Elderly patients are bearing high risk of CS following AMI.Prolonged FMC time and the presence of left main and/or multivessel lesion are independent risk factors for the development of CS.The optimal revascularisation strategy can improve the clinical outcome of patients with CS.