Objective To study the mechanism of different forms of ST-segment elevation in acute myocardial infarction(AMI),and to investigate the distribution of its traditional Chinese medicine (TCM)syndrome types.Methods Two hundred and twelve hospitalized AMI patients with ST-segment elevation from March of 2015 to July of 2017 were divided into group A and group B.Group A had 102 cases with the elevation of concavity of STsegment,and group B had 110 cases with the elevation of arch of ST-segment.The correlation of ST-segment elevation in different forms with TCM syndrome types was analyzed.Results (1) Patients of group B were usually male,young and middle-aged,with or without short-term medical history of coronary heart disease,and coronary angiography results indicated the stenosis or occlusion of the vessels without collateral circulation.Patients in group A were usually female,aged,with medical history of coronary heart disease,and coronary angiography results indicated the existence of collateral circulation.(2) Group A was dominated by Qi-deficiency and blood-stasis syndrome,and the frequency of its syndrome types was in decreasing sequence:Qi-deficiency and blood-stasis syndrome,Qi-yin deficiency syndrome,heat-toxicity and blood-stasis syndrome,phlegm blended with bloodstasis syndrome,syndrome of cold stagnation in heart vessels.Group B was dominated by heat-toxicity and bloodstasis syndrome,and the frequency of its syndrome types was in decreasing sequence:heat-toxicity and bloodstasis syndrome,Qi-deficiency and blood-stasis syndrome,Qi-yin deficiency syndrome,syndrome of cold stagnation in heart vessels,phlegm blended with blood-stasis syndrome.The difference of the distribution of syndrome types was significant between the two groups (P ＜ 0.01).(3) In respect of the differentiation of deficiency and excess syndromes,group A was dominated by deficiency interweaved with excess syndrome,while group B was dominated by excess syndrome.The difference of the distribution of deficiency and excess syndrome was significant between the two groups (P ＜ 0.01).Conclusion AMI patients with different forms of ST-segment elevation have different TCM syndrome types.The investigation results will provide a new vision for the clinical trial of AMI treated with Chinese medicine integrated with western medicine,and will supply evidence for the syndrome differentiation and treatment of AMI patients with different forms of ST-segment elevation,which will contribute to enhancing clinical efficacy,saving life and improving prognosis.

ObjectiveTo study the mechanism of Huanglian Jiedutang （HLJDT） in treating mice with atherosclerosis （AS） by improving ferroptosis. MethodsA total of 10 SPF C57BL/6J mice were selected as a normal group， and 50 ApoE^-/- mice were randomly divided into five groups： model group， low-dose group of HLJDT， medium-dose group of HLJDT， high-dose group of HLJDT， and atorvastatin （ATV） group. ApoE^-/- mice were fed a high-fat diet for eight weeks to establish the AS model， and at the 9th week， they were given normal saline， low， medium， and high doses of HLJDT （3.9， 7.8， 15.6 g·kg^-1·d^-1）， and atorvastatin calcium tablets （0.01 g·kg^-1·d^-1）， respectively， for a total of eight weeks. The formation of aortic plaque in mice was observed by gross oil red O staining and Masson staining. The levels of total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， triglyceride （TG）， and high-density lipoprotein cholesterol （HDL-C） in blood fat were measured by the automatic biochemical analyzer， and the mitochondrial structure of the aorta was observed by transmission electron microscopy. The content of serum superoxide dismutase （SOD） in serum was detected by enzyme-linked immunosorbent assay （ELISA）. The content of reduced glutathione （GSH） in serum was detected by the microplate method， and that of malondialdehyde （MDA） in serum was detected by the TBA method. The protein expression of nuclear factor E₂-associated factor 2 （Nrf2）/glutathione peroxidase 4 （GPX4） signaling pathway was detected by Western blot. ResultsCompared with those of the normal group， the contents of TC， LDL-C， TG， HDL-C， and MDA in the serum and the aortic vascular plaque deposition of the model group were significantly increased （P<0.01）， while the expression levels of SOD and GSH in serum， as well as Nrf2， solute carrier family 7 member 11 （SLC7A11）， and GPX4 in aorta were significantly decreased （P<0.01）. Mice in the model group appeared mitochondrial fragmentation and vacuolation in the aorta， volume atrophy， mitochondrial crista reduction， or a loose and disorganized form. Compared with those in the model group， the aortic vascular plaque deposition was significantly decreased in the low-dose， medium-dose， and high-dose groups of HLJDT and ATV group， and the contents of serum TC， LDL-C， TG， and MDA in serum were significantly decreased （P<0.05， P<0.01）. The contents of serum SOD and GSH and the expression levels of Nrf2， SLC7A11， and GPX4 in the aorta were increased （P<0.05， P<0.01）， and the symptoms of aortic mitochondrial vacuolation were alleviated. The number of cristae was increased， and they were ordered neatly. ConclusionHLJDT can reduce aortic vascular plaque deposition， decrease blood lipid and MDA expression， increase SOD and GSH expression， and ameliorate the pathological changes of ferroptosis， the mechanism of which is related to the Nrf2/GPX4 signaling pathway.