Objective:To observe the effect of chest pain center management model and emergency green channel on pre-hospital rescue rate of patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:Patients with STEMI admitted in Yunnan Provincial Emergency Center between January 2017 and June 2019 were selected as the study subjects. 522 patients with STEMI sent by emergency center were included in the observation group (chest pain center management model of first-aid), while 326 patients with STEMI who came to the hospital by themselves were included in the control group (emergency green channel for first-aid). The pre-hospital and nosocomial first-aid related indexes, cardiac function (assessed by Killip grade), rescue rate, hospital stay and incidence of complications were compared between the two groups.Results:The response time of visit, time of initial electrocardiogram (ECG) completion and total time of first-aid in observation group [(1.04±0.11)min, (1.56±0.25)min, (10.63±2.26)min] were significantly shorter than those in control group [(2.82±0.26)min, (5.99±1.06)min, (18.65±2.98)min, P<0.05]. The grade of cardiac function in observation group was significantly better than that in control group ( P<0.05). Compared with the control group, the observation group had higher successful rescue rate, shorter hospital stay , lower total incidence of complications [94.25% vs 42.02%, (6.09±1.02)d vs (8.92±1.65)d, 13.01% vs 32.12%, P<0.05]. Conclusions:Compared with emergency green channel, chest pain center management model can not only shorten first-aid related time of STEMI patients, but also improve their successful rescue rate, reduce incidence of complications and improve prognosis.

Objective To investigate the role of ORAI1 in the balloon injury-induced rat carotid artery neointimal formation and the relationship between ORAI1 and sodium and calcium exchanger(NCX) 1.Methods According to condition of carotid artery balloon injury and observation time,Sprague Dawley rats were divided into 3 groups including sham group,7 days injury group,and 14 day injury group (n =3 each).According to virus of transfection,Sprague Dawley rats were divided into 2 groups including negative control group (negative lentiviruses particles transfection after establishment of carotid artery balloon injury model,n =3) and siORAI1 group(siORAI1 transfection after operation,n =3).Carotid artery neointimal formation was analyzed after HE staining.The ORAI mRNA expression level was detected using real-time PCR.The proliferating cell nuclear antigen (PCNA),ORAI and NCX1 protein expression level were measured by Western blot.Results (1) Carotid artery intima was significantly thicker in 7 days and 14 days injury group than in sham group((0.54 ±0.11) μm2 and (0.89 ±0.12) μm2 vs.(0.11 ±0.08) μm2,both P ＜0.05).Relative expression level of PCNA protein was significantly higher in 7 days and 14 days injury group than in sham group(1.43 ±0.16 and 1.95 ±0.16 vs.1,both P ＜0.05).Relative mRNA expression level of ORAI1 (1.39 ± 0.14 and 1.78 ± 0.21 vs.0.56 ± 0.09,both P ＜ 0.05) and protein expression level (1.42 ± 0.19 and 1.78 ±0.22 vs.1,both P ＜0.05) were significantly higher in 7 days and 14 days injury group than in sham group.(2) After 14 days,relative expression level of ORAI1 protein was significantly lower in siORAI1 group than in negative control group (0.21 ±0.16 比 1,P ＜0.05).Carotid artery intima thickness was significantly reduced in siORAI1 group compared to negative control group((0.19 ± 0.14)μm2 vs.(0.91 ±0.23) μm2,P＜0.05).Relative expression level of NCX1 protein was also significantly lower in siORAI1 group than in negative control group(0.53 ±0.13 比 1,P ＜0.05).Conclusions ORAI1 may play a key role in the balloon injury-induced neointimal formation and vascular smooth muscle cells proliferation in rat carotid artery.ORAI1 knockdown could down regulate the NCX1 expression and attenuate the balloon injury-induced neointimal formation and vascular smooth muscle cells proliferation in rat carotid artery.

by lfow cytometry. According to CAG morphology, the plaques included 3 types as Type I, Type II and TypeⅢ. The patients also received coronary CT angiography (CTA), upon CTA value, the plaques were classiifed by soft plaque, ifbrous plaque and calciifed plaque. Expressions of platelet surface EMMPRIN and GPVI among different groups were compared.
Results:①Compared with Control group, ACS and SAP groups had increased expressions of EMMPRIN (5.82 ± 0.81 and 3.45 ± 0.48) vs (1.35 ± 0.15) and GPVI (16.22 ± 5.27 and 8.20 ± 2.87) vs (4.14 ±1.17); the expressions in ACS group were higher than those in SAP group, allP<0.05.②In ACS group, compared with Type I plaque, the patients with Type II and TypeⅢ plaques had elevated levels of EMMPRIN (6.35 ± 1.05 and 4.09 ± 0.67) vs (2.45 ± 0.27) and GPVI (19.50 ± 4.55 and 10.81 ± 2.33) vs (5.89 ± 1.28); the expressions in patients with Type II plaque was higher than those with Type III plaque, allP<0.05.③In ACS group, compared with calciifed plaque, the patients with soft and ifbrous plaques had the higher levels of EMMPRIN (6.18 ± 1.01 and 3.87 ± 0.56) vs (2.43 ± 0.25) and GPVI (19.14 ± 4.27 and 11.08 ± 1.94) vs (5.96 ± 0.99); the expressions in patients with soft plaque was higher than those with ifbrous plaque, allP<0.05.④In CAD patients, EMMPRIN expression was negatively related to plaque type (95% CI: -0.359 to -0.206, β: -0.211) and positively related to clinical type (95% CI: 0.893-1.034, β: 0.893); GPVI expression was negatively related to plaque type (95% CI: -1.222 to -0.586, β: -0.181) and positively related to clinical type (95% CI: 3.576-4.164, β: 0.960).
Conclusion: Expression levels of platelet surface EMMPRIN and GPVI were closely related to the stability of coronary plaque, both of them were the risk factors for severe coronary lesions. EMMPRIN and GPVI may have certain predictive value for early diagnosis of arteriosclerosis in ACS patients.

Objective A retrospective analysis were conducted to identify the effect of bypassing the emergency department on 30-days outcomes of patients with acute myocardial infarction undergone primary percutaneous coronary intervention ( PPCI) . Methods From June 2014 to April 2015, 187 patients underwent PPCI in Kunming General Hospital were included. 13 patients were excluded owing to their incomplete follow-up data. The total 174 patients were divided into two groups: the control group (n =59) who did not bypass the emergency department, and the bypass group ( n = 115) who bypassed the emergency department and directly received PPCI. The data of all patients were collected and analyzed. Results There were no significant differences in baseline characteristics and PPCI related data (including percentage of thrombus aspiration catheter used, length or diameter of stents applied between two groups (all P ﹥ 0. 05) . The bypass group had shorter door-to-ballon ( D2B) than the control group [ (67. 7 ± 21. 5) min vs. (89. 4 ± 23. 6) min, P ﹤ 0. 001] . There were no significant differences in 30-days all-cause mortality, re-myocardial infacrtion and target ressel revascularization (TVR) between the two groups (P ﹥ 0. 05) . Total MACEs rate in the bypass group was lower than in the control group (10. 2% vs. 1. 7% , P = 0. 012) . Logistic regression analysis showed that age, diabetes, pain-to-door (PTD) time and CK peak value were the main influencing factors for 30-day MACEs rate of patients receiving PPCI ( P ﹤0. 05) . Conclusions Bypassing the emergency department can shorten D2B time and reduce 30-days MACEs post-PPCI, but reducing the total ischemic time will be more beneficial to patients with acute myocardial infarction.

Objectives To investigate clinic outcome of ticagrelor in treatment of patients with acute ST-segment elevation my ocardial infarction receiving primary percutaneous coronary intervention.Methods Sixty-two consecutive patients with ST segment elevation myocardial infarction (STEMI) receiving primary percutaneous coronary intervention (PCI) were included in this study.The clinic characteristics,thrombolysis in myocardial infarction (TIMI) refuse after PCI,clinical outcomes after 30 d of patients were compared between patients who were treated with ticagrelor (group A 30 cases) and clopidogrel (group B 32 cases).Results There was no difference in the age,proportion of women,hypertension,and diabetics (P ＞ 0.05).TIMI 3 refuse after PCI were significantly higher in group A than group B (96.7％ vs 87.5％,P ＜ 0.05).The 30 d re-angina pectoris was lower in group A than group B (3.3％ vs 12.5％,P ＜0.05).However,tiny bleeding of group A was higher than group B (13.3％ vs 3.1％,P ＜0.05).Conclusions Ticagrelortreatment can improve the prognosis of STEMI receiving primary PCI,but increase the risk of bleeding.

Objective To explore the association between extracellular matrix metalloproteinase inducer(EMMPRIN) and urokinase-type plasminogen activator (uPA) and the severity of coronary artery lesions in coronary heart disease (CHD) patients.Methods This study enrolled 88 patients with acute coronary syndrome (ACS) and 46 patients with stable angina pectoris (SAP).The mean fluorescence intensity (MFI) of EMMPRIN on monocytes of peripheral blood (PBMCs) were examined by flow cytometry.uPA in serum was measured with ELISA.64-slice spiral computed tomography coronary artery imaging was performed in 108 CHD patients.Coronary artery plaques were divided into type Ⅰ (33 patients),type Ⅱ (59 patients) and type Ⅲ (44 patients) through plaque morphology characteristics according to coronary angiography.Coronary artery plaques were divided into soft (42 patients),fibrous (34 patients) and calcified plaque (32 patients) according to CT characteristics.Results (1)Type Ⅱ plaque(48 patients)and soft plaque (35 patients) were the major plaque types in the ACS patients,while type Ⅰ plaque (20 patients) and type Ⅲ plaque (17 patients) and fibrous plaque (16 patients) and calcified plaque (22 patients)were the major plaque types in the SAP patients.(2)The EMMPRIN expression and uPA levels were significantly higher in type Ⅱ plaque group (EMMPRIN MFI:1 1.61 ± 0.81,uPA:(0.89 ± 0.17) mg/L) than those in the type Ⅰ plaque group (EMMPRIN MFI:6.65 ± 1.32,uPA:(0.53 ±0.06) mg/L) and in the type Ⅲ plaque group (EMMPRIN MFI:9.47 ± 1.16,uPA:(0.56 ±0.04) mg/L,all P ＜ 0.05).The EMMPRIN expression was higher in the type Ⅲ plaque group (MFI:9.47± 1.16)than in the type Ⅰ plaque group (MFI:6.65 ± 1.32,P ＜ 0.05),but uPA levels were similar between the 2 groups ((0.56 ± 0.04) mg/L vs.(0.53 ± 0.06) mg/L).(3) The EMMPRIN expression and uPA levels in the soft plaque group (EMMPRIN MFI:11.37 ± 0.76,uPA:(0.97 ± 0.12) mg/L) were significantly higher than those in the fibrous plaque group (EMMPRIN MFI:8.93 ± 1.21),uPA:(0.52 ±0.09) mg/L) and calcified plaque group (EMMPRIN MFI:6.94 ± 1.19,uPA:(0.49 ± 0.12) mg/L,P ＜0.05).The EMMPRIN expression in the fibrous plaque group(MFI:8.93 ± 1.21) was higher than in the calcified plaque group (MFI:6.94 ± 1.19,P ＜ 0.05),but uPA levels were similar between the two groups.Conclusion Higher EMMPRIN expression and uPA levels were associated with plaque instability,which might be used to evaluate plaque stability in CHD patients.

Objective To obtain the data of injury among children aged 0~6 years in Haidian area and Pinggu area of Beijing.Methods A total of 2970 children aged 0~6 years in Haidian District(city area) and 2558 in Pinggu District (rural area)were investigated by cluster sampling method.Results A total of 5528 children were investigated,the incidence of injury was 8.64%.The incidence rate of aged 0~6 years child injury in Haidian District was10.54%,which was much higher than that in Pinggu District (6.45%).The top five causes of injury were falls,animal bites,burn/scalds,injury by sharp articles and struck/hit by falling object in Pinggu District.The top five causes of injury were falls,animal bites,injury by sharp articles,burn/scalds and blunt in Haidian District.the sequences of injury were similar between the two districts.The incidence rate of burns/scalds was higher in Pinggu District than that in Haidian District.The types of injury were little different between children who lived at home and children who lived in kindergarten.The types of injury were not too different between genders.Falls was the leading cause of injury for all children(in cities or in countries,boys and girls,in different age group).Conclusion The incidence rates of injury and types of injury are different in different areas,genders and age groups.So the intervention of injury should be different.

Objective To investigate the effects of B-type natriuretic peptides (BNP) on expression of monocyte chemoattractant protein-1(MCP-1) in rat peritoneal macrophages and to identify the inflammation-mediated effects of BNP in macrophages. Methods Peritoneal macrophages of primary culture were treated with BNP, BNP+HS-142-1, or BNP+TNF-?+HS-142-1. The protein expression of MCP-1 was measured by Western blot. Results BNP enhanced the MCP-1 protein expression in macrophages, and this effect could be abrogated by HS-142-1. In addition, BNP could inhibit TNF-? induced MCP-1 expression. Conclusion BNP can induce the MCP-1 protein expression in macrophages, suggesting BNP has a pro-inflammatory effect. However, BNP also can inhibit TNF-? induced MCP-1. These findings suggest that the effect of inflammation-mediated by BNP is biphasic though the mechanism is still unclear.

Objective To explore the mechanism by which urotensin Ⅱ induces hypertrophy of the cultured rat cardiomyocytes. Methods The cultured cardiomyocytes from neonatal SD rats were treated with urotensin Ⅱ, also with cyclosporine A for its blocking effect on urotensin Ⅱ induced cardiomyocytes hypertrophy. The mRNA and protein levels of ?-MHC and CaN were evaluated by real-time PCR and Western blotting, respectively. Results In the cells treated with 10-8 and 10-7 mol/L urotensin Ⅱ, the mRNA and protein levels of ?-MHC and CaN were significantly higher than that of control (P

Objective Angiotensin(AngⅡ)is an important proinflammatory mediator in the cardiovascular system.The present study is aimed at investigating the correlation between ceramide and p53 and apoptosis of human umbilical endothelial cells induced by AngⅡ.Methods Human umbilical endothelial cells were cultured in vitro and treated with AngⅡalone or in combination with Losartan(an in- hibitor of AT1),PD123319(an inhibitor of AT2),FB1(an inhibitor of ceramidase),PFT-?(an inhibitor of p53),respectively.The ap- optosis of cells was detected with TUNEL,and p53 expression at protein and mRNA was assessed with Western blotting and reverse tran- scription-polymerase chain reaction(RT-PCR).Results Compared to AngⅡgroup,PD123319 and FB1 could inhibit endothelial cells ap- optosis induced by AngⅡat 24h;hut Losartan and PFT-?could not.Compared to the control group,no statistical difference existed be- tween PD123319 and FB1,but it did exist between Losartan and PFT-?.FB1 and PFT-?down-regulated the p53 expression at the protein and mRNA levels.Conclusion In the process of apoptosis induced by AngⅡ,AngⅡcan induce the activation of ceramide by binding with AT2.AT2 and Ceramide play a key role in the endothelial cells apoptosis induced by AngⅡ.Ceramide may be situated in the upper stream of p53 and induce the apoptosis by p53 pathway.