1.Clinical application of cholesterol absorption inhibitor
Chinese Journal of Practical Internal Medicine 2003;0(01):-
The new cholesterol absorption inhibitor Ezetimibe(EZ)could markedly reduce the LDL-C level and increase the HDL-C level with little adverse effect.EZ combined with statins shows cooperative effect and avoids the latent adverse effect of large dose of statins.Thus this combined therapy is a reasonable choice for the patients whose cholesterol level could not reach the standard after using optimum dose of statins.
2.Research on mechanism of chaos during ventricular fibrillation induced by rapid pacing after acute myocardial infarction
He ZHANG ; Zhijun SUN ; Yingxian SUN
Chinese Journal of Practical Internal Medicine 2002;0(08):-
Objective To investigate the mechanism of chaos during ventricular fibrillation(VF)after acute myocardial infarction(AMI)and observe the property of nonlinear dynamics of VF in order to provide clinical doctors with theory evidences to prevent VF after AMI.Methods From Jun.2003 to Dec.2005,we made the acute myocardial infacrtion model and induced VF of canine in vivo by using rapid pacing,and recorded the cardiac electrophysiological parameters by using 64-trains multi-polar epicardial-mapping electrocardiogram system to observe the change of the cycle length(CL)of ventricular arrhythmia in the Second Affiliated Hospital of China Medical Univercity.Results The pacing interval of VF in acute ischemia myocardium had been significantly increased; the cycle length(CL)showed the spatiotemporal complexity,such as period doubling bifurcation and quasiperiodicity and its Poincar'e plots formed a ring-like structure meaning nonlinear dynamics property during VF.Conclusion The liminal value of VF has been significantly increased during acute myocardial infarction.VF is induced by system come-into period doubling bifurcation,quasiperiodicity and chaos.
4.Primary PCI for acute myocardial infarction caused by acute left main coronary artery occlusion
Wenyue PANG ; Yingxian SUN ; Xingli LIU
Chinese Journal of Practical Internal Medicine 2006;0(16):-
Objective To study mortality of acute myocardial infarction caused by acute left main coronary artery occlusion.The objectives of this analysis were to determine the effect of primary PCI and the impact of cardiogenic shock on acute myocardial infarction caused by acute left main coronary artery occlusion.Methods From 1999 to 2005,of 752 consecutive patients with acute myocardial infarction,16 patients had acute left main coronary artery occlusion with TIMI flow≤2.All patients were given primary PCI.Results Of these 16 patients,9(56.25%)died in hospital,and 7(43.75%)discharged.In the survival group reperfusion was successful in 100% of patients,as opposed to 44.44% in the mortality group(P=0.019).Cardiogenic shock was overt in 12(75.00%)patients,42.86% of the survival group and 100% of the mortality group(P=0.020).Shock patients had higher in-hospital mortality than stable patients(75 % vs 0%,odds=4.0,95%CI 1.50~10.66,P=0.019).Conclusion Patients presenting with AMI caused by acute left main coronary artery occlusion and cardiogenic shock have poor survival regardless of primary PCI.Nevertheless,primary PCI is a feasible and effective procedure,and it may save lives in this clinical setting.
5.The value of QT dispersion and heart rate variability in predicting early ventricular fibrillation after acute myocardial infarction
Wenyue PANG ; Yingxian SUN ; Dayi HU
Chinese Journal of Practical Internal Medicine 2001;0(09):-
Objective The aim of this study was to evaluate the value of QT dispersion and heart rate variability in predicting early ventricular fibrillation during hospitalization after acute myocardial infarction.Methods Seventy-two patients underwent 24-hour Holter monitoring within 6 hours after onset of acute myocardial infarction.They were divided into 2 groups,VF group (12 cases) and Non-VF group (60 cases),based on whether they had experienced an episode of ventricular fibrillation during their hospitalization.Index of QT dispersion and heart rate variability were calculated on the basis of 24 hours Holter recording.Results The HRV indexes showed significant difference (respectively,.P.
7.Clinical Value of ATP Stress 99mTc-MIBI Gated Myocardial Perfusion Imaging for Evaluating Myocardial Ischemia in Patients With Myocardial Bridge
Pengxiang ZHANG ; Song CHEN ; Lijuan WANG ; Yingxian SUN ; Yaming LI
Chinese Circulation Journal 2015;30(5):455-459
Objective: To explore the clinical value of adenosine triphosphate (ATP) stress99mTc-methoxyisobutylisonitrile (99mTc-MIBI) gated myocardial perfusion imaging (G-MPI) for evaluating the severity and region of myocardial ischemia and left ventricular function in patients with myocardial bridge. Methods: A total of 58 patients with CAG or CTA confirmed diagnosis of myocardial bridge received ATP stress99mTc-MIBI G-MPI examination in our hospital. The short and vertical long-axis image of left ventricular myocardium were divided into 13 segments and the radionuclide distribution was semi-quantitatively evaluated into 4 classes by 0-3 scores visually (0: normal, 1: mild reduction, 2: moderate reduction, 3: severe reduction). The summed stress score (SSS) of left ventricular myocardium was calculated, the severity and region of myocardial ischemia were judged and compared with the severity of myocardial bridge. The LVEF obtained by ATP stress 99mTc-MIBI G-MPI was compared with LVEF obtained by cardiac color ultrasound (UCG).Results: The detection rate of myocardial ischemia by ATP Stress 99mTc-MIBI G-MPI and by 24h dynamic ECGwere 82.76% vs 56.10%, P <0.05. ATP Stress 99mTc-MIBI G-MPI presented abnormal radionuclide distribution in258 segments (63.55%) of LAD supplied territory, 82 (47.13%) of LCX supplied territory and 74 (42.53%) of RCAsupplied territory; the ischemic segments in LAD supplied territory were more than those in LCX and RCA suppliedterritories, P <0.0125. The resting LVEF obtained by ATP Stress 99mTc-MIBI G-MPI and by UCG were (69.59 ± 4.13)% vs (63.22 ± 4.12) %, P >0.05 and they had positive correlation (r =0.555, P <0.05).Conclusion: ATP stress 99mTc-MIBI G-MPI could accurately and intuitively evaluate the severity and region ofmyocardial ischemia and left ventricular function in patients with myocardial bridge, it has certain guiding value inclinical practice.
8.Exploration of residents' choices for first contact care in Beijing communities and influencing factors
Xueying SUN ; Jun YIN ; Yingxian YE ; Yingchao YANG ; Danjie GUO
Chinese Journal of General Practitioners 2012;(12):928-929
A random sample survey was conducted in 17 community medical institutes in 4 districts in Beijing.Among an effective sample of 385 residents.47.5% (n =183)of community residents chose community medical institutes for first contact care while 52.5% (n =202) opted for class other hospitals.Residents with lower education levels tended to choose community medical institutes (P =0.01).And those with chronic diseases preferred to choose communities (P=0.00).
9.Clinical effects of tirofiban intra-coronary artary inject on patients with ST segment elevation myocardial infarction no-reflow and acute thrombosis after emergency intra-coronary artary stenting
Junhua SUN ; Yiqiang YUAN ; Huailin LIU ; Li YU ; Yingxian GUO ; Ruimin WANG ; Yun SUN
Chinese Journal of Primary Medicine and Pharmacy 2009;16(7):1241-1242
ObjectiveTo evaluate the efficacy and safety of tirofiban in treatment of ST segment elevation acute myocardial infarction(STEAMI) no-reflow and acute thrombosis after emergency percutaneous coronary intervention(PCI). MethodsForty patients which were made definite diagnosis of STEAMI were intra-coronary artary injection fortirofiban after emergency PCI stenting occured no-reflow and acute thrombosis. First,the dose of 0.4μg·kg-1·min-1 was given from intra--coronary artary injection of tirofiban within three minutes, after 30min the dose were given 0.1μg·kg-1·min-1 for 48 hours. ResultsThe no re-flow and acute thrombosis was completely disappeared within five minutes,at the time,side effect with in one week was not observed. ConclusionsTirofiban treatment by direct injection in coronary arteries combined with emergency PCI, can increase the repeffusion rate of infarction related vessel in AMI patients,and improve TIMI reflow. This reperfusion method was effective and safe.
10.The sensitivity and specificity of ankle brachial index in diagnosis of lower extremity arterial disease in the patients with high cardiovascular risk
Jue LI ; Yongxia QIAO ; Yingxian SUN ; Xiaoming GUO ; Wenyue PANG ; Yingyi LUO ; Dayi HU
Chinese Journal of Geriatrics 2008;27(9):641-644
Objective To prospectively evaluate the sensitivity and specificity of ankle brachial index (ABI) in the diagnosis of lower extremity arterial disease(LEAD)by using conventional digital subtraction angiography (DSA) as the reference standard, and to research the threshold value of ABI screening test for diagnosis. Methods A total of 383 consecutive patients (245 men and 138 women, mean age (64.1±11.7) years] underwent conventional DSA and ABI measurement. Receiver operator characteristics (ROC) analysis was performed to assess possible threshold values for predicting the LEAD in these patients. Results Conventional DSA was used as the gold standard in defining≥50% luminal stenosis for the diagnosis of LEAD. 0. 95 was the overall cutoff of ABI which was associatcd with 93.0% sensitivity, 85.0% specificity, 8.81 positive likelihood ratio(+LR) and 0. 23 negative likelihood ratio(-LR) for detection of hemodynamically significant stenosis (lesions>≥50%) in all 383 subjects (P<0.01). The area under the ROC curve was 0. 953(95%CI 0.920~0.985). Conclusions ABI measurement is an accurate and reliable non-invasive alternative to conventional DSA in the diagnosis of lower extremity arterial disease. And the cut-off 0.95 is the threshold ABI value for detecting LEAD in Chinese population.