BACKGROUND:Bare-metal stent for treatment of myocardial infarction may improve cardiac function to some extent, but it is prone to induce thrombus. OBJECTIVE:To explore the effect of heparin slow-release stent on angiogenesis and cardiac function of patients with acute myocardial infarction. METHODS:A total of 87 patients with acute myocardial infarction were enroled, including 47 males and 40 females, aged 55-81 years. These patients were divided into observation group (n=45) with percutaneous coronary intervention with heparin slow-release stent and control group (n=42) with percutaneous coronary intervention with bare metal stent. The folow-up period was 12 months, and angiogenesis, cardiac function improvement and adverse cardiac events in the two groups were observed and compared. RESULTS AND CONCLUSION:The new blood vessel density, myocardial survival area and left ventricular ejection fraction were al higher in the observation group than the control group (P < 0.05). At 3 months after intervention, there was one case of revascularization and one case of recurrent acute myocardial infarction in the observation group; in the control group, there was case of revascularization, one case of recurrent acute myocardial infarction and one case of sudden cardiac death, and there was no difference between the two groups. These findings indicate that that percutaneous coronary intervention with heparin slow-release stent has good biocompatibility and can effectively promote the regeneration of blood vessels and improve cardiac function of patients with acute myocardial infarction.

Objective To assess the effects of three way catalytic converter on the health risk of benzene series.Methods After collecting the benzene series(benzene,toluene,xylene) in the air inlet and air outlet of the three way catalytic converser in 100% working loads,their health risk was assessed with the methods of health risk assessment.Results After catalysis,the hazard index of toluene and xylene decreased in all loads,the hazard index and carcinogenesis risk of benzene increased in 100% loads,the chronic long-term hazard index of benzene deceased in 100% loads.Conclusion The three way catalytic converter can change the health risk of benzene series emission by gasoline engine,the carcinogenesis risk of benzene series emission will be increased when the gasoline is treated with the three way catalytic converter.

Objective To investigate the effect mechanism of sanguinarine on the proliferation,apoptosis,invasion and migration abilities of cervical cancer cells.Methods MTT,flow cytometer,cell scratch test and Transwell chamber assay were respectively used to detect the cellular proliferation,apoptosis,migration and invasion abilities after sanguinarine action.The expression levels of E-Cadherin,PTEN,β-catenin and MMP2 protein of cervical cancer cells after sanguinarine action were detected by Western blot.Results 0.6,0.8 μmol/L sanguinarine had the inhibitory effect on the proliferation of cervical cancer cells.After 0.8μmol/L sanguinarine action for 48 h,cervical cancer HeLa and Siha cells apoptosis rate were up to (45.68± 2.26)％ and(31.89 ± 3.80)％ respectively.0.8 μmol/L sanguinarine action for 3 h,cervical cancer cells HeLa and Siha adhesion rates were only (67.45 ± 2.13)％and(73.59± 2.61)％.0.8 mol/L sanguinarine action for 16 h,the invasion numbers of cervical cancer Hela and Siha cell were (39.64 ±1.98) and (43.87 ± 2.83) respectively.The expression amount of E-Cadherin and PTEN in cervical cancer cells after sanguinarine action was increased,while the expression amount of E-Cadherin and PTEN was weakened.Conclusion Sanguinarine has the proliferation inhibiting and apoptosis promoting effect on cervical cancer cells,its mechanism may be related to adhesion protein E-Cadherin,β-catenin and PTEN,MMP2.

Objective To study the effect of Pinus yunnanensis on acute alcoholic liver injury in rats and explore its mechanism. Methods A model of acute alcoholic liver injury in mice was prepared by alcohol. The mice were randomly divided into normal control group, model group, positive control group, Pinus yunnanensis low-, medium-and high-dose groups. Mice in the medicine group were given the corresponding medicine by gavage once a day for 7 days. After the last three hours of intragastric administration, the liver and spleen index, ALT, AST and GSH in serum, SOD, MDA and NO in liver homogenates were measured. Histopathological changes of liver were observed by HE staining. Results Compared with model group, Pinecone of Pinus unnanensis high-, medium- and low-dose groups could significantly reduce the liver index in mice (P<0.01), and high dose groups could significantly reduce the number of spleen (P<0.01); The contents of AST in the medium- and high-dose groups significantly decreased (P<0.01) and the GSH activity significantly increased (P<0.05, P<0.01). There was no significant difference in serum ALT level, SOD activity, GSH activity and NO content in the liver tissues of Pinus yunnanensis groups (P>0.05). HE staining results showed that, the damage of liver tissue in mice of Pinus yunnanensis was significantly improved compared with the model group. Conclusion Pinus yunnanensis has protective effects on acute alcoholic liver injury in mice.

Benzene ; poisoning ; Chronic Disease ; Humans ; Occupational Diseases ; chemically induced ; Occupational Exposure ; adverse effects

Objective To investigate the clinical value of [11C]CFT PET in the diagnosis and severity assessment of Parkinson disease (PD). Methods Thirty-eight patients with PD at various Hoehn & Yahr (H&Y) stages were included and underwent a [11C]CFT PET scan. The correlation between [11C]CFT uptake and unified Parkinson disease rating scale part III (UPDRS III) of PD patients was evaluated by calculating Pearson’s regression coefficient. Statistical parametric mapping (SPM) analysis was performed to compare the difference of dopamine transporter (DAT) distribution between ear-ly and advanced PD patients. Results There was a significant reduction of [11C]CFT uptake in the bilateral striatum of PD patients. There was a significant negative correlation between clinical scores of UPDRS III, rigidity, bradykinesia, pos-ture, gait and [11C]CFT uptake in the striatum. The SPM analysis revealed a significant and asymmetric decrease of [11C] CFT uptake in the striatum, predominantly on the putamen and caudate nucleus contralateral to the onset limb, in the posterior area of ipsilateral putamen in early PD (H&Y 1-2) patients compared with the normal controls. There was a sig-nificant symmetric decrease of [11C]CFT uptake in both putamen and caudate nucleus in advanced PD (H&Y 3-5) pa- tients, compared with normal controls. Compared with early PD patients, the reduction of DAT was more severe in bilater-al caudate nucleus and the ipsilateral putamen in the advanced PD patients. Conclusions [11C]CFT PET is a sensitive biomarker in the diagnosis and assessment of disease severity of PD patients.

Objective:To investigate the predictive value of platelet dynamics on the prognosis of 28-day in patients with extracorporeal membrane oxygenation (ECMO).Methods:From January 2017 to December 2020, 60 patients from the Emergency Medicine Center of the First Affiliated Hospital of Nanjing Medical University received ECMO for life support. The baseline data of the patients were collected, the minimum value of platelets on day 1-7 of the machine was calculated, and the platelet change value and change rate were calculated. The patients were divided into the survival group and death group according to the 28-day survival status after ECMO was installed, and the receiver operating curve (ROC) was drawn based on the platelet change value and change rate to evaluate its predictive value for prognosis.Results:Among patients receiving VV-ECMO, the platelet change value and change rate on day 7 had the best prediction effect on the patient's 28-day outcome ( AUCΔPLT7=0.772, P=0.016; AUCΔPLT7%=0.764, P=0.020), when the platelet change value was 4×10 9/L as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99% as the critical value, the sensitivity was 0.857, the specificity was 0.615, and when the platelet change rate was -28.99%. The sensitivity was 0.643 with a specificity of 0.846. In patients receiving VA-ECMO, the platelet change rate on day 6 predicted the best effect on the patient's 28-day outcome ( AUCΔPLT6%= 0.707, P = 0.045). When the platelet change rate was -26.19% as the critical value, the sensitivity was 0.842 and the specificity was 0.643. Conclusions:Platelet dynamic changes of platelets are correlated with the 28-day prognosis of patients receiving ECMO, and the combination of platelet change value and the critical value of change rate can better predict the poor prognosis of patients in both ECMO modes.

Objective:To summarize the experience and effect of extracorporeal cardiopulmonary resuscitation (ECPR) on the treatment of sudden cardiac death (SCD).Methods:The data of 120 adults with SCD-ECPR in emergency department of the first affiliated hospital of Nanjing Medical University from April 2015 to April 2023 were retrospectively analyzed. The patients were grouped by Survival/death at 90 days, OHCA/IHCA (out-of-hospital/in-hospital cardiac arrest), with/without acute myocardial infarction (AMI) and divided according to 60 min of the time from cardiac arrest to extracorporeal membrane oxygenation (ECMO) initiation (CA-Pump On time). Age, sex, Charlson comorbidity index, IHCA/OHCA, initial rhythm, no-flow time, CA-Pump On time, ECMO evacuation success rate, 90-day survival rate, ECMO treatment time were analyzed.Results:①Total of 114 adult patients with SCD-ECPR were enrolled, and 45 (39.5%) patients survived at 90 days, of whom 40 (88.9%) patients had good neurological outcomes.②Age and no-flow time were significantly lower in the 90-day survival group than that in death group, and the proportion of IHCA and shockable initial rhythm was higher. ③The no flow time in IHCA group was significantly lower than that in OHCA group, and the 90-day survival rate was higher. ④OHCA and regional interhospital transport prolonged CA-Pump On time and reduced the 90-day survival rate. ⑤The AMI group was older with a higher Charlson comorbidity index, and the 90-day survival rate was significantly lower than that in non-AMI group.Conclusions:ECPR improves the prognosis of patients with SCD, there are high benefits in patients with long healthy life expectancy, IHCA, shockable initial rhythm, and short no flow time. The smooth life-saving chain of SCD-ECPR improves survival rate, by screening high benefit candidates in patients with OHCA, delayed initiation of ECPR or requiring interhospital transport, despite CA-Pump On time > 60 min, there is still survival potential.

Objective:To investigate the major adverse kidney events (MAKE) in acute myocardial infarction (AMI) with extracorporeal cardiopulmonary resuscitation (ECPR).Methods:The data of 75 patients with AMI-ECPR in Emergency Medicine Department of the First Affiliated Hospital of Nanjing Medical University from April 2015 to April 2023 were retrospectively analyzed. The patients were grouped by survival/death at 90 days, with/without renal replacement therapy (RRT), and whether to initiate RRT because of acute kidney injury (AKI). age, sex, Charlson comorbidity index, OHCA/IHCA (out-of-hospital/in-hospital cardiac arrest), initial rhythm, Gensini score, ECPR initial blood gas pH and lactate value, no-flow time, time from cardiac arrest to extracorporeal membrane oxygenation (ECMO) initiation (CA-Pump On time), ECMO and RRT treatment time, 90-day survival rate were analyzed. Moreover, the renal function of the survivors was followed up.Results:① Total of 68 AMI-ECPR patients were enrolled, 22 (32.4%) patients survived at 90 days, 54 (79.4%) combined with RRT, and 48 (70.6%) MAKE within 90 days. ②Compared with the death group, the 90-day survival group had a higher proportion of initial shockable heart rhythm, a lower Gensini score, a higher ECPR initial blood gas pH and a lower lactic acid value. ③The severity of coronary artery disease, ECPR initial acidosis and hyperlactacemia in the RRT group was significantly higher than that in the non-RRT group, and all the non-RRT group patients survived. ④ There was no difference between the AKI-RRT group and the non-AKI-RRT group. Of 21 patients with stage 1 AKI initiating RRT, 5 survived, one of them still needs RRT for 90 days, and 7 patients with stage 2 to 3 AKI initiating RRT died.Conclusions:The 90-day MAKE rate in AMI-ECPR patients was as high as 70.6%, and the 90-day renal insufficiency rate in AMI-ECPR survivors with AKI was as high as 20.0%. Active initiation of RRT to avoid AKI or early initiation of RRT may improve the prognosis of AMI-ECPR patients.

Objective:To analyze the effectiveness and annual cost-effectiveness of extracorporeal cardiopulmonary resuscitation, ECPR) in adults.Methods:Totally 60 patients received ECPR from April 2015 to March 2020 in Emergency Medicine Department of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The patients were grouped by discharge survival/hospital death and shockable/unshockable initial rhythm. Age, gender, initial rhythm, survival rate, ECMO treatment time, time-to-death, length of stay and hospitalization costs were analyzed. All discharged survivors were followed up for 1 year, then cost-effectiveness analysis was performed using total cost of ECPR as the cost and 1-year survival rate as the effect.Results:Fifty-four adult patients with ECPR were enrolled, and 17 (31.5%) patients survived and discharged, of whom 15 (88.2%) patients had good neurological outcomes and survived at 1-year follow-up. The median ECMO time was 5 ( IQR 1-8) d, time-to-death was 4 ( IQR 1-9) d, length of stay was 10 ( IQR 3-18) d, total hospitalization cost was 209 122 ( IQR 121 431-303 822) RMB, and the daily cost was 23 587 ( IQR 13 439-38 217) RMB. The rate of shockable initial rhythm was significantly higher in the discharge survival group than the hospital death group. The survival rate of ECPR patients with shockable initial rhythm was significantly higher than that of patients with unshockable initial rhythm, and there was no difference in cost. Conclusions:ECPR is a resource-intensive treatment with a total cost of about 200 000 RMB. Moreover, the effectiveness and annual cost-effectiveness are superior for patients with shockable initial rhythm.