Objective To observe prospectively the changes of left ventricular size and function, and to evaluate the impact of primary percutaneous transluminal coronary angioplasty (p-PTCA) and stent implantation and thrombolytic therapy on left ventricular remodeling and function. Methods The patients with a first acute myocardial infarct and without contraindications to thrombolytic therapy were randomly assingned to p-PTCA group or urokinase (1?500?000 IU) therapy group within 12 hrs from the onset of symptoms or within 12～24 hrs if the evidence of myocardial ischemia in infarc zones was available. Two-demensional echocardaography were applied in the 2 nd , 12 th , and 24 th week after infarction, and major cardiac events were recorded. Results Sixty-five patients were enrolled (male 55, female 10, age 58.95?8.94 y). The patency of infarct related artery of 32 patients assigned to p-PTCA was 100%, while that of thrombolytic therapy group (33 patients) was 75.76%. The differences of end-systolic volume index (ESVI), end-diastolic volume index (EDVI), left ventricular ejection fraction (LVEF), and regional wall motion score index (RWMI) were significant statistically between p-PTCA group and thrombolytic therapy group ( P

Objective To explore the relationship of the presence and severity of anxiety and depression with the increased inflammatory activity,as marked by the serum levels of high sensitivity C reactive protein(hs-CRP)after acute coronary syndrome(ACS).Methods Serum hs-CRP levels were measured in 647 ACS patients within 36 hours after onset of event.Depression and anxiety were evaluated by self-reporting standardized questionnaire,using a validated Chinese version of Hospital Anxiety and Depression Scale(HADS)(14 items)within 7 days.Results In ACS patients,serum levels of hs-CRP(mg/L)were lower in those with anxiety than those in control group[(10.43?3.55)mg/L vs(13.19?4.90)mg/L,P0.05].Conclusion Presence and severity of depression is associated with increased activity of inflammation in patients with ACS;however,anxiety does not have such an association with inflammation in patients with ACS.

Objective To evaluate the intestinal barrier function of the patients by two-sugar absorption test with high performance liquid chromatography (HPLC). Methods Nineteen children with confirmed food hypersensitivity (FH) and 19 normal children were included in this study. The average age was (8.1?1.7) months. After 8-hour fasting, subjects drank test solution (5 g lactulose and 2 g mannitol per 100 ml) at the dose of 2 ml/kg. Five-hour urinary excretion ratio of lactulose/mannitol (L/M) were measured using high performance liquid chromatography (HPLC). The condition of HPLC was as follows: Sugar-PakI column with refractive index detector; Mobile phase: pure deionized water; Flow rate: 0.5 ml/min; temperature of column: 85 ℃. Results HPLC chromatogram of urine sample was stable. The retention time of mannitol and lactulose was 13.86 min and 9.27 min respectively. A significant rise in 5 h urinary L/M excretion ratios was found in children with FH (0.18?0.06) as compared to that of controls (0.05?0.03) (P

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 observe and assess the effect of different dosages of aspirin on inflammatory biomarkers, hemorheology (platelet aggregation rate) and clinical prognosis in patients with acute coronary syndrome ( ACS). Methods ACS patients were randomly assigned to receive different dosages of aspirin treatment orally. Patients in group A,B and C took 100 mg, 500 mg and 1000 mg of aspirin per day respectively. They were treated and followed-up for 1 year. High-sensitivity C-reactive protein ( hsCRP) , IL-6, tumor necrosis TNFot and platelet aggregation rate were examined and major adverse cardiac events( MACE) were recorded. Results A total of 312 patients with ACS were enrolled in the study. The baseline characteristics of the three groups were not different with respect to age, gender, cardiovascular risk profile, level of inflammatory biomarkers and concomitant treatment before and after randomization. The levels of baseline serum hsCRP, IL-6 and TNFa were higher in subjects of the study as compared with normal reference value (P<0. 05, <0. 05, <0. 01) and they decreased significantly after therapy with 3 different doses of aspirin (detected at 30 days, 6 months and 12 months, P <0. 001 ) , but there were no significant differences among the three groups( P >0. 05) . Rehospitalization , MACE and the change of platelet aggregation ratio were not significantly different among the three groups. The incidence of gastrointestinal complaints was significantly higher in groups B and C than in group A ( P < 0. 05 ). Conclusions The levels of serum inflammatory biomarker increase in patients with ACS. Aspirin therapy may decrease the level of inflammatory markers significantly, but increasing the dosage of aspirin from 100 mg to 1000 mg daily does not decrease the level of inflammatory markers and the clinical MACEs further. However, the incidence of gastrointestinal complaints increase significantly with the increase of aspirin dosage.

Extracellular matrix (ECM)is not only one of current hot-points in medical cell biology,but also one tricky part for undergraduates to learn. This article compared chapters of ECM in medical cell biology courses and spotlighted that ECM chapter was often neglected in some domes-tic universities. Then it analyzed the possible causes,such as variable arrangement of ECM section in current textbooks. Lastly,the article recommended several suggestions,including giving a timely re-vision of the old ECM knowledge,designing an appropriate strategy for teaching,enumerating certain representative diseases to improve the ECM education. It appealed our teachers to pay more attention to how to make the module of ECM master well in near future.

Objective:To investigate the current situation of insomnia in patients with acute coronary syndrome (ACS), and analyze the influencing factors of insomnia in the ACS patients, so as to provide information on the development of new strategies for the treatment of insomnia in ACS patients.Methods:This is a multicenter and prospective observational study. A total of 771 ACS patients who met the criteria were selected from March 2013 to June 2015. The baseline social demographic information, sleep quality questionnaire, general anxiety disorder scale-7(GAD-7),patient health questionnaire-9(PHQ-9), short-form 12 health survey questionnaire(SF-12), and enhancing recovery in coronary heart disease patients social inventory(ESSI) were completed within 7 days after admission. Logistic regression analyses were used to analyze the influencing factors of insomnia in ACS patients.Results:A total of 741 subjects with valid questionnaires were collected, including 510 males (68.8%) and 231 females (31.2%). Among them, 487 (65.7%) subjects had at least one insomnia symptom: 308 (41.6%) subjects had difficulty in falling asleep, 369 (49.8%) subjects were easy to wake at night, 116 (15.7%) subjects woke up earlier than they expected, 74 (10.0%) subjects experienced both woke up earlier and difficulty in falling asleep, and 53 (7.2%) subjects woke up earlier, woke up at night and had difficulty in falling asleep at the same time. Logistic regression analyses showed that before admission physical activity ( OR =0.636, 95% CI 0.411-0.984), depression ( OR=1.908, 95% CI 1.101-3.305) and low social support ( OR=0.278, 95% CI 1.198-3.301) were independent factors of insomnia in ACS patients. Conclusions:Nearly 2/3 ACS patients have symptoms of insomnia. Difficulty in falling asleep and easy to wake up at night are the most common manifestations. Physical activity, depression and social support independently are associated with insomnia.

Objective To explore the relationship between self-management and self-efficacy of patients with coronary artery bypass grafting (CABG). Methods The questionnaires such as general data questionnaire, Coronary Heart Disease Self-management Scale and Chronic Disease Selfefficacy Scale were performed for 237 patients after CABG surgery. Results Total score of self-management for CABG patients was (86. 11 ± 9. 88) points, and self-efficacy scale was (6. 56 ± 0. 99) points, and total score of self-management was positively correlated with self-efficacy scores (P ＜0. 05). Conclusion Self-management of CABG patients was in the medium level and self-efficacy should be further improved. Self-efficacy of CABG patientsis closely related to the self-management in these patients. Nursing staff should strengthen their self-efficacy in order to improve the postoperative self-management ability.

Objective To explore the relationship between self-management and self-efficacy of patients with coronary artery bypass grafting (CABG). Methods The questionnaires such as general data questionnaire, Coronary Heart Disease Self-management Scale and Chronic Disease Selfefficacy Scale were performed for 237 patients after CABG surgery. Results Total score of self-management for CABG patients was (86. 11 ± 9. 88) points, and self-efficacy scale was (6. 56 ± 0. 99) points, and total score of self-management was positively correlated with self-efficacy scores (P ＜0. 05). Conclusion Self-management of CABG patients was in the medium level and self-efficacy should be further improved. Self-efficacy of CABG patientsis closely related to the self-management in these patients. Nursing staff should strengthen their self-efficacy in order to improve the postoperative self-management ability.

Objective To investigate the compliance status of secondary prevention in patients with coronary artery disease (CAD) following revascularization.MethodsA total of 512 patients with CAD who received procedures for coronary revascularization were enrolled in the study from January 2009 to October 2010,including 472 cases of percutaneous coronary intervention stenting,25 cases of coronary artery bypass grafting and 15 cases of stenting plus bypass.The demographic information,prophylactic drug therapies, lifestylechangesandmodifiableriskfactorsweresurveyedwithquestionnaires,anthroposomatologicalmeasurementsandlaboratorytestsinpatients3monthsaftercoronary revascularization.ResultsThe proportion of patients on statins,aspirin,β-blockers,angiotensin-converting enzymeinhibitors/angiotensinreceptorblockers(ACEIs/ARBs)andinfluenzavaccinationwere 81.4％ (417/512),93.9％ ( 481/512 ),82.0％ ( 420/512 ),76.2％ ( 390/512 ) and 3.7％ ( 19/512 ) respectively.Based on the criteria recommended by the American Heart Association/American College of Cardiology (AHA/ACC)Guidelines for Secondary Prevention for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2006 Update, the percentages of achieving therapeutic targets of modifiable risk factor management were as follows:glycosylated hemoglobin (90.2％,462/512 ),total cholesterol ( 68.6％,351/512 ),triglycerides ( 58.8％,301/512 ),high-density lipoprotein cholesterol ( 91.6％,469/512 ),low-density lipoprotein cholesterol ( 44.5 ％,228/512 ),systolic pressure ( 75.2 ％,385/512 ) and diastolic pressure (90.4％,463/512 ) respectively.And the proportions of improved lifestyle were as follows:smoking cessation/non-smoking 81.4％ (417/512),diet control 78.5％ ( 402/512 ),achieving weight targets 61.7％ (316/512)and regular exercise 58.2％ (298/512).ConclusionsThere is a relatively high percentage of standardized antiplatelet therapy and continuous statins medication in patients with coronary artery disease following revascularization. However,many significant modifiable risk factors have not been controlled optimally and lifestyle of patients needs further improvement. There is still a considerable scope for further improvement of secondary prevention in this group of patients.