Objective To investigate the clinical significance of irregular antibody screening positive patients in the blood transfusion.Methods From September 2003 to September 2012,5 260 samples of blood test were given pre-transfusion irregular antibody detection,and the patients with positive antibody screening were statistically analyzed.Results Of 5 260 samples,38 cases (6.8％) had irregular antibodies,the difference between males and females was statistically significant(x2 =2.646,P ＜ 0.05).The Rh blood group had the highest proportion in irregular antibodies;pregnancy history and history of blood transfusion group,pregnancy history group,history of blood transfusion group were significantly higher than those without history of pregnancy and transfusion history groups,the difference was statistically significant (x2 =28.827,P ＜ 0.05).Conclusion Screening of irregular antibodies plays an important role in the safety of clinical blood transfusion.

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.

Objective To investigate the disease medical management behavior patients who discharged from hospital after coronary artery bypass graft(CABG).Methods During June 2013 to March 2014,a total of 110 patients after CABG in Changhai Hospital Affiliated to Second Military Medical University were recruited to fill questionnaire,and the results were analysed.Results The average score of 110 patients of disease medical management behavior was 40.57±5.13,the total score index was 54.09％.In the four dimensions of disease medical management,treatment adherence was the worst which scored 8.19±1.28,and scoring index was 54.60％.Disease knowledge management was the best implementation which scored 13.83±2.05,and scoring index was 52.00％.Gender,education,medical treatment charge of payment and complication were the influence factors of disease medical management behavior.Conclusions Medical staff should adopt different self-management intervention strategy,according to different patients and self management content.

Objective To investigate the effect of trimetazidine postconditoning on myocardial cell apoptosis in acute ischemia-reperfusion injury in rats.Methods 40 healthy adult Wistar rats were randomly assigned to Sham-operated group,MIRI group(I/R group),trimetazidine group and ischemic postconditioning group(IPOC group).The left anterior descending coronary artery of rat was ligated and the acute myocardial ischemia-reperfusion injury model was established.After that,ultrastructural changes of apoptotic myocardial cells were observed under electron microscope,and apoptotic cells were detected under optical microscope.The expressions of the Bcl-2,caspase-3 apoptosis related proteins were determined.Results ① The degree of ultrastructural injury of apoptotic myocardial cells was mild and basically the same in trimetazidine group versus IPOC group,and had a significant improvement as compared with I/R group.② The degree of myocardial apoptosis was basically the same in trimetazidine versus IPOC group,and lighter than in I/R group.③ Bcl-2 protein expression levels were(61.9 ± 2.9) ％,(21.4 ± 3.2) ％,(46.8 ± 3.5) ％ and (49.7 ± 3.1) ％,and caspase-3 protein expression levels were(38.1±4.5) ％,(72.8±5.7) ％,(47.2±5.1) ％ and(39.8 ±4.6)％ in Sham-operated group,I/R group,trimetazidine group and IPOC group respectively.Compared with I/R group,the expression of Bcl-2 protein was increased obviously,while the expression of easpase-3 protein was decreased in trimetazidine group and IPOC group.But there were no significant differences in the protein levels of Bcl-2 and caspase-3 between trimetazidine group and IPOC group(both P＞0.05).Conclusions Trimetazidine postconditoning can inhibit the myocardial cell apoptosis in acute ischemia-reperfusion injury in rats,and has a protective effect on myocardial cells.

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objective To evaluate the vulnerability of coronary artery plaque with coronary angiography(CAG),intravascular ultrasound(IVUS)and the levels of plasma inflammatory markers.Methods 58 consecutive patients with lesion of a single blood vessel demonstrated successfully by CAG were randomly divided into 3 groups based on the angiographic morphology of the the lesions:type Ⅰ lesion group(n=16),type Ⅱ lesion group(n=25),type Ⅲ lesion group(n=17).Meantime,a control group of stable angina(n=17)was established.A subgroup of 28 patients(including 18 acute coonary sysdrome (ACS)patients and 10 stable angina control patients)who underwent IVUS study were analyzed.Then the plasma levels of high sensitivity CRP(hs-CRP),matrix metalloproteinase(MMP,including MMP-2 and MMP-9),CD40 ligand(CD40 L)and pregnancy associated plasma protein-A(PAPP-A)were measured with ELISA.Analyses were performed by statistical package SPSS 11.0.Results The plasma levels of MMP-2,MMP-9 and PAPP-A in typeⅡ lesion group were significantly higher than the other groups(P＜0.05,0.05,0.001,respectively).In type Ⅱ lesion group,linear correlation analysis manifested significantly positive correlation between levels of hs-CRP and MMP-2(r=0.508);MMP-2 and MMP-9,CD40 L,PAPP-A(r=0.647,0.704,0.751,respectively);MMP-9 and CD40L,PAPP-A(r=0.491,0.639,respectively);CD40L and PAPP-A(r=0.896).IVUS subgroup analysis showed that the area of plaques and plaques burden in culprit lesion,the incidence of high-risk plaques,remodeling index(RI)and positive remodeling percentage in ACS patients were significantly greater than those in the control group(P=0.000,0.037,0.028,0.015,0.040,respectively).Compared with the control group,the plasma levels of hs-CRP,MMP-2,MMP-9 and PAPP-A were markedly elevated(P=0.033,0.000,0.000,0.027,respectively).Conclusions CAG and IVUS combined with the study on plasma levels of inflammation mediators were helpful in judging the vulnerability of coronary artery plaques.

Objective To examine the use of reperfusion strategies in elderly patients with acute myocardial infarction (AMI) and investigate the factors affecting its use. Methods This survey population consisted of 338 consecutive elderly patients with AMI( t65 years) who were admitted to the department of cardiology of Beijing Military General Hospital between December 2003 and November 2007. The patients were divided into two groups based on the receiving of reperfusion strategies : a reperfusion group ( n = 252) and a non-reperfusion therapeutic group ( n = 86). Qualitative data were compared between the two groups using Chi-square tests and multiple binary logistic regression was used to determine the relationship between various patient-related factors with the probability of choosing reperfusion therapies or not. Results About 74. 6% of the elderly patients with AMI recevied reperfusion strategies [62. 2% pereutaneons coronary intervention (PCI) and 12.4% thrembelysis]. Stepwise logistic regression analysis revealed that age ≥ 75 years( OR = 0. 255, P = 0. 000), history of angina ( OR = 0. 570, P = 0. 016 ) and high Killip classification ( OR =0. 671 ,P =0. 012) were confirmed factors for receiving less reperfusion therapy. Meanwhile, inferior wall myocardial infarction (MI) with complicating right ventricular MI( OR =4. 585,P =0. 002) ,sweating ( OR = 1. 970, P = 0. 016), unbearable symptoms ( OR = 1. 836, P = 0. 038 ) and medical insurance ( OR =1. 968,P =0. 029) were independent predictors for receiving reperfusion therapy. Intracranial hemorrhage (2.8% vs 7. 1%,P =0.000), left ventricular ejection time <45% (12% vs 31%,P =0.016) and mortality rate within 1 year(2. 3% vs 4. 7%, P = 0. 039) were obviously decreased in the PCI group as compared with the thrembelysis group. Conclusions Aging, medical history of angina, high Killip classification, inferior MI with complicating fight ventricular MI, sweating, unbearable symptoms and medical insurance were independent predictors for receiving reperfusion strategies.

The atherosclerotic plaque vulnerability may be related to inflammation,immunity,metabolism and blood clotting.One of the key factors affecting plaque stability is inflammatory reaction.This study was to investigate the relationship between vulnerability of coronary artery plaque evaluated with coronary angiography (CAG),intravascular ultrasound (IVUS) and the levels of plasma inflammatory markers.Methods Fifty-eight consecutive patients with acute coronary syndrome who had coronary lesion of a single vessel were divided into 3 groups based on angiographic morphology of the lesions:type Ⅰ lesion group (n =16),type Ⅱ lesion group (n =25) and type Ⅲ lesion group (n =17).The control group consisted of 17 patients with stable angina.Plasma levels of high sensitivity C reaction protein (hs-CRP),matrix metalloproteinase (MMP,including MMP-2 and MMP-9),CD40 ligand (CD40L) and pregnancy associated plasma protein-A (PAPP-A) were measured by ELISA.A subgroup of 28 patients (including 18 ACS patients and 10 stable angina control patients) who underwent IVUS study,were analyzed.Results The plasma levels of MMP-2,MMP-9 and PAPP-A in type Ⅱ lesion group were significantly higher than those in other groups (all P＜0.05).In type Ⅱ lesion group,linear correlation analyses showed significant positive correlation between levels of hs-CRP and MMP-2 (r=0.508);MMP-2 and MMP-9,CD40L,PAPP-A (r=0.647,0.704 and 0.751,respectively);MMP-9 and CD40L,PAPP-A (r=0.491 and 0.639,respectively);CD40L and PAPP-A (r=0.896).IVUS subgroup analysis showed that the area of plaques and plaque burden in culprit lesion,the incidence of high-risk plaques,remodeling index (RI) and positive remodeling percentage in ACS patients were significantly greater than those in control subgroup (P=0.000,0.037,0.028,0.015 and 0.040,respectively).Compared with control subgroup,the plasma levels of hs-CRP,MMP-2,MMP-9 and PAPP-A were markedly elevated (P=0.033,0.000,0.000 and 0.027,respectively).Conclusions CAG and IVUS combined with study on plasma levels of inflammation mediators are helpful in judging the vulnerability of coronary artery plaques.(J Geriatr Cardiol 2008;5:207-211)

ObjectiveTo examine the relationship between ankle brachial index (ABI) and the extent of coronary stenosis and evaluate the usefulness of ABI to predict the extent of coronary stenosis in old patients.Methods118 patients with coronary angiography were examined by ABI and hemostatic factors evaluation in addition to history collection.ResultsABI was inversely and significantly associated with Gensini score. ABI reduced significantly (P<0.001) in the patients with 3-vessel or left main coronary artery disease (CAD). But there were no significant differences in ABI among the patients with no CAD, 1-vessel or 2-vessel CAD. The corresponding area under the ROC curve was 0.75±0.045, with 95% CI=0.67～0.84 (P<0.001) in ABI in 3-vessel or left main CAD. When ABI≤0.9, it had a relatively high specificity (89.1%) and sensitivity (55.6%) for predicting the presence of 3-vessel disease or left main CAD.ConclusionIn the old patients, ABI is inversely and significantly associated with the extent of coronary stenosis, and ABI≤0.9 has a relatively high specificity and sensitivity for predicting the presence of 3-vessel or left main CAD.

Pathological neural activity in subthalamic nucleus (STN) is closely related to the symptoms of Parkinson' s disease. Local field potentials (LFPs) recordings from subthalamic nucleus show that power spectral peaks exist at tremor, double tremor and tripble tremor frequencies, respectively. The interaction between these components in the multi-frequency tremor may be related to the generation of tremor. To study the linear and nonlinear relationship between those components, we analyzed STN LFPs from 9 Parkinson's disease patients using time frequency, cross correlation, Granger casuality and bi-spectral analysis. Results of the time-frequency analysis and cross-frequency correlation analysis demonstrated that the power density of those components significantly decreased as the alleviation of tremor and cross-correlation (0.18-0.50) exists during tremor period. Granger causality of the time-variant amplitude showed stronger contribution from tremor to double tremor components, and contributions from both tremor and double tremor components to triple tremor component. Quadratic phase couplings among these three components were detected by the bispectral approaches. The linear and nonlinear relationships existed among the multi-components and certainly confirmed that the dependence cross those frequencies and neurological mechanism of tremor involved complicate neural processes.
Action Potentials ; Electromyography ; Humans ; Parkinson Disease ; physiopathology ; Subthalamic Nucleus ; physiopathology ; Tremor ; physiopathology