Objective To investigate the clinical effect of losartan combined with metoprolol tartrate in treat -ment of elderly patients with coronary heart failure and its effect on heart function ,plasma brain natriuretic peptide and hemorheology.Methods 88 elderly patients with coronary heart failure were randomly divided into two groups ,and 44 cases were in each group .All of the patients were given conventional treatment , and the control group was given losartan while the observation group was received metoprolol tartrate on the basis of the control group ,the clinical effi-cacy and effect on cardiac function ,plasma brain natriuretic peptide ,hemorheology indexes were compared between the two groups.Results The total effective rate of the observation group was 95.45% significantly higher than 77.27%of the control group (χ2 =7.728,P<0.05);cardiac function and plasma BNP were significant improvement compared with the control group(t=6.55,6.02,7.41 and 13.24,all P<0.05);after the treatment,except the plate-let adhesion rate ,the hemorheology of the observation group were significant improvement compared with the control group(t=7.84,7.32,6.55,7.02,5.89 and 5.70,all P<0.05).Conclusion Losartan combined with metoprolol tartrate in treatment of coronary heart failure is significant effect ,and it can effectively improve the patient′s cardiac function,plasma brain natriuretic peptide levels and blood rheology ,and it is worth to be applied in clinical .

Coronary-artery bypass grafting(CABG)has been a standard treatment for unprotected left main coronary artery disease.Advancement in percutaneous coronary intervention(PCI)makes PCI as effective as CABG in selected patients.In this study,we assess the optimal revascularization strategy for patients with unprotected left main coronary artery disease.

Objective To analyze death causes in patients with acute myocardial infarction complicated by cardiac rupture.Methods The patients who were admitted with cardiac rupture after acute myocardial infarction in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2012 to December 2014 were enrolled.These patients were divided into death group and survival group.Then statistical analysis was performed for the clinical data of these patients in two groups,Logistic regression analysis was used to analyze the risk factors with statistical significance.Results A total of 59 patients diagnosed cardiac rupture after acute myocardial infarction were enrolled in this study,including 50 patients died,and 9 patients survived.There were significant differences between the two groups of patients with clinical baseline data.Compared with the survival group,death group had higher age ((69.94 ± 9.24) years old vs.(61.56 ± 9.14) years old,t =2.511,P =0.015),the higher incidence of malignant arrhythmia (22.0％ vs.0,x2 =4.070,P =0.044),the lower proportion of alcohol abuse (12.0％ vs.44.4％,x2 =5.704,P =0.017),higher fasting blood glucose ((8.97 ±3.98) mmol/L vs.(6.06± 1.25) mmol/L,t =4.153,P＜0.01) and triglycerides ((1.78±0.50) mmol/L vs.(1.39±0.20) mmol/L,t =4.146,P＜0.01),higher proportion of pulmonary arterial hypertension(22.0％ vs.0,x2 =4.070,P =0.044) and brain natriuretic peptide (406.50 (110.00,570.28) ng/L vs.33.00 (20.00,176.00) ng/L,P=0.004),smaller the left ventricular end diastolic diameter((47.76±5.13) mm vs.(52.22 ±4.66) mm,t =-2.434,P =0.018).The use of fondaparinux sodium (26.0％ vs.0,x2 =4.920,P =0.027),heparin (48.0％ vs.88.9％,x2 =5.138,P =0.023) and nitrates (72.0％ vs.100.0％,x2 =5.361,P =0.021)were significantly differences.The occurrence of acute heart failure in patients in death group was significantly higher than the survival group (11.0％ vs.0,x2 =3.258,P =0.071),but the difference was not significant.Logistic regression analysis showed that old age (OR =1.151),fasting blood glucose (OR =1.974)and heart rupture were significandy correlated (P＜ 0.05).Conclusion Cardiac rupture patients have a high mortality rate after myocardial infarction.Advanced age and fasting blood glucose were risk factors,while the use of common heparin is protective factor.Patients should be evaluated in a timely manner to assess the prognosis and to take targeted measures.

Objective To study the value of HEART scores in predicting the risk of getting acute coronary syndrome in patients with chest pain and assessing the prognosis in order to elucidate the validity of the HEART scores.Methods A total of 1 200 patients with chest pain were continuously observed and followed up,and their HEART scores were calculated.The survival rates were calculated with Kaplan-Meier method and AUROC (area under ROC curve) was used to determine the accuracy of this methods.The HEART scores were compared with TIMI and GRACE scores.Results Low HEART scores (0-3) were found in 34.5％ of the patients and MACE (major adverse cardiac event) occurred in 1.4％ of them.The patients with intermediate HEART scores (4-6) accounted for 50.7％ patients,and MACE was diagnosed in 22.2％ of them.High HEART scores (7-10) were found in 14.85％ patients,and MACE occurred in 60.7％ of them.There was significant difference among these three groups (Log rank P ＜ 0.01).The AUROC of HEART score was 0.83 (95％ CI:0.80-0.85,P ＜0.01),being significantly higher than the GRACE scores (0.76) and TIMI scores (0.72).Conclusions The HEART score is applicable for predicting the risk of getting acute coronary syndrome of chest pain patients in emergency department and the prognosis.

Objective:To study the antioxidant activity and anticancer activity of tea polysaccharide.Methods:Tea polysaccharide was extracted and purified by gel permeation chromatography from coarse old green tea leaves obtained from Wuyuan county of Jiangxi province in China.The antioxidant activity of the tea polysaccharide was evaluated by determining the change in absorbancy after heat-induced oxidation in a linoleic acid system with ?-carotene,the decoloration of the 1,1-diphenyl-2-picrylhydrazyl and the elimination of superoxide generated from autoxidation of pyrogallol.On the other hand,the anticancer activities of tea polysaccharide at different concentrations were evaluated by MTT assay using two colon cancer cell lines(HCT-15,Caco-2).Results:Tea polysaccharide possessed distinctive antioxidative activity.The anti-proliferation capabilities of the tea polysaccharide against the tested human colon cancer cell lines were different under the designed experiment conditions.The tea polysaccharide with high purity exhibited good anti-proliferation activity against HCT-15 at concentration of 7.0?mol/L.Conclusion : Tea polysaccharide has remarkable antioxidative and anticancer bioactivities..

Objective To investigate the relations between cigarette smoking and the morbidity and prognosis of coronary artery disease(CAD).Methods A total of 3186 patients were divided into 3 groups: non-smoking group(n=1714),stop-smoking group(n=462) and the smoking(n=1010).All the patients came from the registry study of DESIRE-plus(Drug-Eluting Stent Impact on Revascularization plus).We intended to investigate the relations between cigarette smoking and CAD by analyzing the information of genernal clinical data,coronary angiography(CAG),Revascularization and major adverse cardiac cerebral vessels events(MACCE).Results The mean age of patients in the non-smoking group,the stop-smoking group and the smoking group was 62.5?9.8,60.5?9.9 and 55.3?10.3 years old,respectively(P

Objective To observe the long-term safety of revascularization with sirolimus-eluting stent in patients with multivessel coronary disease compared with bare metal stents.The study was a single center retrospective study.Methods Five hundred and sixty two patients with two-or three-vessel disease,or left main coronary artery disease who underwent revascularization were included and divided into two groups:the SES(n=251)and the BMS(n=311)group,according to the type of the stents implanted.The clinical end points were death and myocardial infarction one year later after stents implantation.Results Clinical follow up was accomplished in 92.9% of the patients and the median time of follow-up was 19.4 months.One year after stents implantation,3 patients died of cardiac causes in the SES group and 1 patient died in the BMS group.Myocardial infarction occured in 2 patients in each group.There was no significant difference in cardiac event rate between the 2 groups(2.3% versus 1.1%,P=NS).No significant difference was found in cardiac death and nonfatal myocardial infarction event free survival rates estimated by Kaplan-Meier method between the two groups(97.3% versus 97.2%,P=0.951).Conclusion One-year cardiac mortality and the incidence of myocardial infarction after SES implantation in patients with multivessel disease were similar to those after BMS implantation which may suggest that late stent thrombosis does not increase with SES.

Objective To compare the in-hospital and follow-up clinical results of percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG)in patients with coronary artery disease and diabetes mellitus.Methods The DESIRE(drug-eluting stent impact on revascularization)is a single-center registry comparing coronary revascularization in our institution before and after the introduction of drug-eluting stents.Between July 2001 and June 2002,July 2003 and June 2004,1040 patients were referred for revascularization(PCI or CABG)during hospitalization.Clinical,angiographic,revascularization data clinical condition in hospital and the follow-up results were collected for retrospective analysis.In the present study,patients with diabetes were selected and divided into PCI and CABG groups.The primary endpoint is in-hospital and follow-up major adverse cardiovascular and cerebral events(MACCE).Results Compared with the CABG group,the PCI group had lower in-hospital MACCE rates(P0.05),but the PCI group had higher rates of repeat revascularization than that of the CABG group(P0.05).Conclusion Although PCI has lower in-hospital MACCE rates in diabetic patients,the follow-up MACCE rates of PCI and CABG are comparable,and PCI has even higher rates of repeat revascularization than CABG.With the increasing use of drug eluting stents,PCI might have better performance.

Objective To evaluate the prevalence and the predictors of clopidogrel therapy after DES implantation,and to determine the impact of discontinuation of clopidogrel therapy on the occurrence of late stent thrombosis(ST)and very late stent thrombosis.Methods Between July 2003 and June 2005,2 930 consecutive patients treated with PCI and DES implantation in Anzhen hospital were involved in the study,and among them,13 patients died within 3 dys after PCI.A total of 2 704 patients out of the 2 917 patients were followed up successfully for at least 2 years,or mortality.All of the clinical,angiographic and intervention treatment character were recorded.ST was adjudicated by the definition of ARC Dublin.Patients were grouped by the duration of clopidogrel therapy to 4 groups(group 1,12 months).The duration of clopidogrel therapy and the predictors of the premature discontinuation of clopidogrel were evaluated,and the rate of late ST(1 month to 12 months)and very late ST(after 12 months)in the 4 groups were analysised.Results There were 82(3.0%)patients in group 1,333(12.3%)patients in group 2,1 590(58.8%)patients in group 3,and 699(25.9%)patients in group 4.In contrast with group 4,the mean level of total cholesterol were higher,mean LVEF value were lower,more patients were diabetes,less patients were STEMI,and the mean number of DES implantation was less in group 1-3.In group 1 and group 2,most of the discontinuation of clopidogrel therapy(95.1%,85.9% respectively)were directed by patients themselves;and in group 3,71.1% of the patients discortinued clopidogrel therapy on the doctor's order.There was no significant differences among the 3 groups on discontinuation of clopidogrel for bleeding or other operations.By Cox regression,diabetes(OR=1.542,95% CI=1.184-2.008,P=0.001)and number and DES implantation(OR=0.790,95% CI=0.709-0.880,P

Objective To non-invasive assess coronary blood flow velocity changes of patients with slow coronary flow phenomenon (SCFP) by coronary blood flow imaging (CFI).MethodsTwenty-one patients who had no significant coronary artery stenosis but had thrombolysis in myocardial infarction (TIMI) slow-flow phenomenon were the experimental group,nine patients who has no significant coronary stenosis and TIMI flow normal were the control group.Using corrected TIMI frame count(CTFC) assess velocity of coronary artery.The left ventricular end diastolic diameter,end systolic diameter,ejection fraction,E peak velocity,A peak velocity,E/A ratio were measured by conventional echocardiography.The distal anterior descending coronary artery diastolic peak flow velocity(Vmax),mean velocity(Vmean) and blood flow velocity time integral(VTI) were measured by CFI.Results The corrected TIMI frame count (CTFC) of left anterior descending artery blood flow in slow blood group was (45.37 ± 8.62)frame,that in control group was (15.94± 4.66)frame,the difference was statistically significant (t = -9.596,P =0.000).The conventional echocardiographic measurements of two groups were not significantly different.The left anterior descending artery Vmax was (22.86 ± 3.04)cm/s,Vmean was (17.62 ± 2.89)cm/s,VTIwas (8.49± 2.01)cm in the slow blood flow group,the left anterior descending artery Vmax was (31.78 ± 9.28) cm/s,Vmean was (23.67 ± 7.60) cm/s,VTI was (10.91 ± 4.47) cm in the control group.The difference was statistically significant.The left anterior descending artery CTFC with Vmax and Vmean was negative correlation in the control group and the slow blood flow group.The left anterior descending artery CTFC was negatively correlated with VTI in the control group,there was no correlation between left anterior descending artery CTFC and VTI in the slow blood flow group.Conclusions Coronary artery flow velocity in the left anterior descending artery was declined.CFI can reflect changes in coronary TIMI flow,but in the diagnosis of coronary slow flow phenomenon CFI has limitations.