Objective To investigate microvascular injury-related factors post-percutaneous coronary intervention (PCI). Methods Seventy-two elderly patients with stable angina , who underwent PCI from February 2009 to February 2014, were enrolled in this study. The index of microvascular resistance (IMR) was assessed and the clinical data were collected. The correlation between general clinical data and the IMR value before and after PCI were analyzed, and regression analysis was conducted on the relevant factors with postoperative microcirculation after PCI. Results After PCI, FFR, CFR, CK-MB, troponin were higher than those before PCI, with significant differences (P < 0.05). Linear regression analysis result showed that glycated hemoglobin, the degree of stenosis after PCI were positively correlated with IMR, but ejection fraction and CFR before PCI were negatively correlated with IMR. Conclusion Clinically, diabetes, severe vascular stenosis, low ejection fraction, low CFR before PCI in patients with unstable angina may likely occur microcirculation after PCI.

Objective To explore the related risk factors for bypass graft occlusion in patients within 1 year after coronary artery bypass grafting,in order to provide the basis for the prevention of postoperative bypass graft occlusion.Methods Clinical data of 197 cases treated with coronary artery bypass grafting were collected,and the incidence rate of bypass graft occlusion and its related risk factors were analyzed.Results Graft occlusion occurred in 28 (14.2％) of 197 patients.The incidence rate of bypass graft occlusion were much higher in patients with BMI ≥24 kg/m2,smoking,hypertension,hyperlipemia,diabetes,peripheral vascular diseases and cerebrovascular disease than in patients with BMI ＜24 kg/m2,non-smoking,patients without hypertension,hyperlipemia,diabetes,peripheral vascular diseases or cerebrovascular disease (20.0％ vs.9.8％,22.4％ vs.10.8％,21.2％ vs.3.8％,31.1％ vs.9.2％,23.4％ vs.9.8％,25.5％ vs.10.7％,26.3％ vs.11.3％,x2 =4.106,4.534,11.735,13.658,6.615,6.486,5.656,respectively,P=0.043,0.033,0.001,＜0.001,0.010,0.011,0.017).Smoking,diabetes,hyperlipidemia,peripheral vascular diseases and cerebrovascular disease were the independent risk factors for bypass graft occlusion.Conclusions Many risk factors are related with short-term postoperative bypass graft occlusion in patients with coronary artery bypass grafting.The corresponding control measures should be conducted to decrease the risk of postoperative bypass graft occlusion,aiming directly at the risk factors,especially the independent risk factors.

Objective To observe the safety and efficacy of preoperative Ticagrelor loading in emergency percutaneous coronary intervention (PCI)for acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 213 patients with acute STEMI before undergoing emergency PCI were randomly divided into Ticagrelor group(n =105)receiving 180 mg Ticagrelor loading dose,then 90 mg twice daily and Clopidogrel group(n =108) receiving 600 mg of Clopidogrel,then 75 mg once daily.Emergency PCI postoperative coronary artery TIMI flow grade and the change of incidence of no reflow,platelet aggregation rate,incidence of bleeding events and the incidence of major adverse cardiovascular events(MACE) were compared between two groups.Results The rate of no-reflow was 7.6 ％ (8 cases)in Ticagrelor group,and 16.7 ％ (18 cases) in Clopidogrel group(x2 =3.26、P=0.030).Platelet aggregation rates at 1 h and 24 h after treatment were (55.6±4.3)％ and (48.6 ± 4.1) ％ respectively in Ticagrelor group,and (63.6 ± 3.8) ％ and (57.6 ± 3.6) ％ respectively in Clopidogrel group,which showed that platelet aggregation inhibition effect was better in Ticagrelor than in Clopidogrel (t =14.40、17.20,both P =0.001).Two groups had no major life-threatening bleeding events.Bleeding incidence had no statistically significant difference between two groups(x2 =0.14,P =0.710),and the incidence of cardiovascular adverse events showed no statistically significant difference(x2 0.04,P 0.840)between the 2 groups.Conclusions Preoperativeticagrelor loading treatment in emergency PCI therapy for acute ST segment elevation myocardial infarction shows stronger antiplatelet aggregation function,significantly improve postoperative TIMI flow,and does not increase the incidence of bleeding events.

The levels of total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, apolipoprotein (APO) A1 and APO B were lower in Bai Ku Yao than those in Han nationalities (all P<0.01). There was no significant difference in serum triglyceride levels and the ratio of Apo A1 to Apo B between two nationalities. Dyslipidemia was positively correlated with body mass index, waist circumference, total energy and total fat intakes, and inversely correlated with degree of physical activity and total dietary fiber intake in both ethnic groups. In addition, dyslipidemia was also positively correlated with age and alcohol consumption in Han, but not in Bai Ku Yao.

Objective To investigate the effects of rapid response system of chest pain on the short-term and long-term prognosis of patients with acute ST segment elevation myocardial infarction (STEMI).Methods Referring to the international association of chest pain centers,the chest pain center was established in this hospital,and the corresponding management system and treatment process were worked out.A total of 374 acute STEMI patients who were recruited as the observation group were admitted to this hospital after the establishment of the chest pain center (December 2014 to June 2016),and 250 STEMI patients admitted before the establishment of the chest pain center (January 2012 to December 2012) were recruited as control group.Patients in observation group were treated in the chest pain center,and those in control groupreceived conventional treatment.The general situation,basic diseases,the finishing time of the first electrocardiogram(ECG),the time of door-to balloon expansion(D2B),the time of hospital stay,the average hospitalization expenses,in-hospital cardiac events and in-6-month cardiac events were compared between the two groups.All patients were followed up for 1 years,left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),left ventricular aneurysm,B type natriuretic peptide (pro-BNP),serum creatinine (Scr),C-reactive protein (CRP) levels and adverse cardiac events (heart failure,death,readmission rate etc.)were compared between two groups.Results Compared with the control group,the average completion time of the first electrocardiogram in the observation group was shortened (P=0.001),the time of entry balloon dilatation,the time of hospital stay,the average hospitalization expenses were less than that of the control group (P＜0.05),the adverse cardiac events (hospital death and heart failure) were lower in the observation group than in the control group (P＜0.05).After 6 months of follow-up,LVEF was significantly higher in the observation group than in the control group (P＜0.05).the levels of LVEDD,pro-BNP,CRP and adverse cardiac events in the observation group were significantly lower than those in the control group (P＜0.05),there was no significant difference in the formation rate of ventricular aneurysm and Scr between the observation group and the control group (P＞0.05).After 1 year of follow-up,LVEF was still higher in the observation group than in the control group (P＜0.05).The incidence of LVEDD,pro-BNP,CREA,CRP,left ventricular aneurysm formation rate,the incidence of adverse cardiac events were lower in the observation group than in the control group (P＜0.05).Conclusion The establishment of rapid response system of chest pain treatment not only effectively shortenthe treatment time of STEMI patients,improve the treatment efficiency,shorten the hospital stay,reduce the cost of hospitalization,but also improve the quality of life and disease prognosis.

Objective To screen the anti-Helicobacter pylori gastritis active components of the ethyl acetate extract of Alpinia officinarum Hance.Methods The"knock-out"strategy combined with high-performance liquid chromatography(HPLC)detection was developed to separate the components of the ethyl acetate extract of A.officinarum while obtaining the negative samples without the components.A human gastric epithelial cell(GES-1)model of H.pylori gastritis was established,and the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and interleukin-1β(IL-1β)in the supernatant of the cells were determined by enzyme-linked immunosorbent assay(ELISA).Results The total flavonoid fraction,the negative fraction without total diphenylheptanoids,the negative fraction without 5-hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenyl-3-heptanone(DHPA),and galangin significantly reduced IL-6 levels in the supernatant of H.pylori infected GES-1 cells at a concentration of 8 μg·mL-1 with 24 h incubation.The total flavonoid fraction strongly inhibited the release of IL-6,TNF-α,IL-8,and IL-1β from H.pylori gastritis GES-1 cells at a concentration of 16 μg·mL-1.Conclusions The total flavonoid fraction is the major anti-H.pylori gastritis active component of the ethyl acetate extract of A.officinarum.The results lay the foundation for further elucidation of the material basis of A.officnarum against H.pylori gastritis.

ObjectiveTo investigate the protective effect and mechanism of action of flavonoid combination of Alpiniae Officinarum Rhizoma （A. officinarum） against Helicobacter pylori （H. pylori） gastritis in mice. MethodsAfter acclimatization for one week， 56 SPF-grade healthy C57BL/6J mice were gavaged with mixed antibiotics for three consecutive days. They were randomly divided into a normal group， model group， positive drug group （triple therapy group）， and low- and high-dose groups （100， 200 mg·kg^-1） of flavonoid combination of A. officinarum. The H. pylori gastritis mice model was established by gavage with H. pylori bacterial suspension in each group except for the normal group. After successful modeling， mice were administrated with corresponding drugs once a day for two weeks. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in gastric tissue. Rapid urease test paper was used to detect the positive rate of H. pylori. Silver staining was used to observe the H. pylori adherence on the surface of gastric tissue. Immunohistochemistry was used to detect the protein expression of interleukin-8 （IL）-8 and myeloid differentiation factor （MyD88） in gastric tissue. The serum levels of IL-6， tumor necrosis factor-α （TNF-α）， IL-8， and IL-1β were detected by enzyme-linked immunosorbent assay （ELISA）. The expressions of phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） protein were detected by Western blot. ResultsCompared with those in the normal group， mice in the model group had lower gastric weight coefficients， higher pH of gastric juice， 100% H. pylori infection rate， and significantly changed gastric histopathology. The expressions of IL-8 and MyD88 proteins in the gastric tissue of mice in the model group were significantly elevated， and the serum levels of inflammatory factors IL-6， TNF-α， IL-8， and IL-1β were significantly up-regulated in mice. Compared with that in the model group， the gastric weight coefficient of mice in each treatment group of the flavonoid combinations of A. officinarum was elevated （P<0.01）， and the pH of gastric juice was reduced （P<0.01）. The infection rate of H. pylori was reduced. The expressions of IL-8 and MyD88 proteins in the gastric tissue of mice in the treatment groups were significantly reduced （P<0.01）， and the serum levels of inflammatory factors IL-6， TNF-α， IL-8， and IL-1β were significantly reduced in a dose-dependent manner （P<0.01）. The flavonoid combinations of A. officinarum down-regulated the expression of PI3K and Akt proteins in H. pylori gastritis-infected cells （P<0.01）. ConclusionThe protective effect of flavonoid combinations of A. officinarum against H. pylori gastritis is associated with the inhibition of H. pylori infection rate and regulation of PI3K/Akt signaling pathway， resulting in inhibiting the release of inflammatory factors.