Objective To investigate the myocardial perfusion abnormalities in patients with isolated left ventricular noncompaction (ILVNC) and analyze the correlation between MPI and MRI.Methods Nineteen patients (14 males,5 females,age range:15-76 years) with ILVNC diagnosed by cardiac MRI were recruited.All patients underwent 99Tcm-MIBI MPI.Both MPI and cardiac MRI were analyzed using a 17-segment model.The thickness ratio of the non-compacted to compacted layers of myocardium (NC/C) was calculated,and segments with NC/C＞2.3 were considered as noncompaction.The incidences of delayed enhancement (DE) and myocardial perfusion abnormalities in non-compacted segments and compacted segments were calculated.x2 test was used for categorical data.The Pearson and Spearman correlation coefficient were used to assess the relationship between the numbers of myocardial segments with myocardial perfusion abnormalities/noncompaction/DE and lgLVEF.Results Of 19 patients,myocardial perfusion abnormality was found in 16 (84.2％) patients.The incidences of perfusion abnormality were 33.6％ (36/107) in non-compacted segments and 31.9％ (69/216) in compacted segments,respectively (x2=0.09,P＞0.05).There were 31 segments with DE.The incidences of DE were 5.6％ (6/107) in non-compacted segments and 11.6％ (25/216) in compacted segments,respectively (x2 =2.94,P＞0.05).The incidence of reduced perfusion was higher in segments with DE than those in segments without DE (54.8％ (17/31) vs 30.1％ (88/292) ; x2 =7.80,P＜0.01).The lgLVEF and the numbers of myocardial segments with noncompaction/DE/myocardial perfusion abnormalities were not correlated(r=-0.35,0.15,-0.34,all P＞0.05).Conclusion Most patients with ILVNC have myocardial perfusion abnormality,which can be observed both in non-compacted and compacted myocardium.Further research is required to elucidate the role of myocardial perfusion abnormality in ILVNC.

ObjectiveTo investigate the effects of autologous bone marrow-derived mesenchymal stem cells (MSCs)transplantation on acute myocardial infarction in swine models using MRI. MethodsFourteen Chinese mini-pigs(27±3 kg)were divided into control group(n=7)and transplantation group(n=7).Acute myocardial infarction(AMI)model was made by occlusion of the left anterior descending coronary artery for 90 minutes,and then 10 ml autologous MSCs(3 × 106 cell/ml)were injected into LAD by over-wire-balloon catheter after one week. MRl was performed to assess the cardiac function and myocardial perfusion 1 week after AMI and 6 weeks after transplantation.The implanted cells in vitro were analyzed by immunofluorescence.ResuitsThe left ventricular ejection fraction(LVEF)in transplantation group was increased from(42.7 ±7.5)%to(50.1±10.1)%,which was significantly different from that in control group(P＜0.01).In addition,the dyskinetic segments in infarcted region and the infareted area were decreased by 4 and 3.2 cm2 respectively(P＜0.01),and the left ventricular weight index was increased by 4.1 g/m2 in transplantation group(P＜0.05)compared with control group.The DAPI-labeled cells in infarcted and peri-infarcted region indicated the survived MSCs.Immunofluoreseence also confirmed that those cells expressed cardiomyocyte-specific troponin T,connexin 43 and vessel-specific smooth muscle actin.Capillary density in both infarcted and peri-infarcted region were higher in transplantation group than the control group(P＜0.01).Conclusion MRI is a reliable imaging method for assessing the effects of stem cell transplantation in acute myocardial infartion of swine models.

OBJECTIVETo make sure of the harmfulness degree of the dust in geological prospecting occupation.

METHODSThe determination of respirable dust, total dust and the free silica concentrations was carried out at different working spots exposed to dust. Personal sampling equipment was used to collect the respirable dust. The data of respirable dust concentration in the research was compared to the historical data.

RESULTSAs for respirable dust concentration level, 47.95% of 765 silica dust spots of geological prospecting occupation in 9 provinces(autonomous regions) were beyond the criteria. The profession and work type of the highest dust concentration was chiseling and sampling of geological prospecting [from 1996-2000, the dust concentration was (6.15 +/- 3.12) mg/m3]. The ratio of respirable dust to total dust was high in geological prospecting workers. The FSiO2 contentin dust to which geological prospecting workers exposed was high too.

CONCLUSIONSThe respirable dust concentration of some types of work in geological prospecting occupation was obviously higher than the national criteria, especially in chiseling, sampling and drilling workers.

Dust ; Humans ; Occupational Exposure ; Silicon Dioxide

Objective: To explore the correlation between antithrombotic strategy and its prognostic value in coronary artery disease (CAD) patients combining with atrial ifbrillation (AF) after percutaneous coronary intervention (PCI).
Methods: A total of 570 CAD patients with AF received PCI in our hospital from 2012-01 to 2013-12 were retrospectively analyzed by CHADS2 and HAS-BLED Score system. According to CHADS2 < 2 and CHADS2 ≥ 2 or with/without warfarin medication, the patients were divided into 2 groups:①CHADS2 < 2 (Low risk of stroke) group,n=339 including 309 patients without warfarin and 30 with warfarin medication;②CHADS2 ≥ 2 (High risk of stroke) group,n=231 including 200 patients without warfarin and 31 with warfarin medication. All patients were followed-up for 15 months to compare the different anti-platelet/ anti-coagulation strategies for the occurrence rate of MACCE, ischemic and bleeding events.
Results: Compared with Low risk of stroke group, the patients in High risk of stroke group had the worse prognosis and higher rate of MACCE occurrence,P<0.001, HR=2.677, 95% CI (1.535-4.635), more ischemic events,P=0.013, HR=2.080, 95% CI (1.167-3.709). Multi-factor Cox surving analysis indicated that compared with low risk patients without warfarin medication, the high risk patients without warfarin had the higher rate of MACCE occurrence,P=0.001, HR=2.985, 95% CI (1.532-5.816), more ischemic events,P=0.026, HR=2.068, 95% CI (1.090-3.925). Whereas, the occurrence rates of MACCE and ischemic events in high risk, low risk patients with warfarin and low risk patients without warfarin were similar, all P>0.05. The major bleeding events in patients with warfarin were a little higher than those without warfarin,P>0.05. The minor bleeding events were increased in both Low risk stroke group asP<0.001, OR=4.458, 95% CI (1.934-10.277) and High risk stroke group asP=0.002, OR=4.155, 95% CI (1.717-10.055).
Conclusion: Warfarin medication may obviously decrease the occurrence rates of MACCE and ischemic events in high risk of stroke patients, while in low risk patients, warfarin could not further decrease the occurrence of MACCE and ischemic events. Warfarin could increase the risk for minor bleeding in both low risk and high risk of stroke in CAD patients combining with AF after PCI.

OBJECTIVE: To analyze the indications of the therapies for rheumatoid arthritis (RA) with neural network model analysis. METHODS: Three hundred and ninety-seven patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine (WM) treated group, 194 cases; and traditional Chinese herbal medicine (CM) treated group, 203 cases. A complete physical examination and 18 common clinical manifestations were prepared before the randomization and after the treatment. The WM therapy included voltaren extended action tablet, methotrexate and sulfasalazine. The CM therapy included Glucosidorum Tripterygii Totorum Tablet and syndrome differentiation treatment. The American College of Rheumatology 20 (ACR20) was taken as efficacy evaluation. All data were analyzed on SAS 8.2 statistical package. The relationships between each variable and efficacy were analyzed, and the variables with P<0.2 were included for the data mining analysis with neural network model. All data were classified into training set (75%) and verification set (25%) for further verification on the data-mining model. RESULTS: Eighteen variables in CM and 24 variables in WM were included in the data-mining model. In CM, morning stiffness, swollen joint number, peripheral immunoglobulin M (IgM) level, tenderness joint number, tenderness, rheumatoid factor (RF), C-reactive protein (CRP) and joint pain were positively related to the efficacy, and disease duration and more urination at night negatively related to the efficacy. In WM, erythrocyte sedimentation rate (ESR), weak waist, white fur in tongue, joint pain, joint stiffness and swollen joint were positively related to the efficacy, and yellow fur in tongue, red tongue, white blood negatively related to the efficacy. In the analysis with the neural network model in the patients of verification set, the predictive response rates of 20% patients would be 100% and 90% in the treatment with CM and WM, respectively. CONCLUSION: Neural network model analysis, based on the full clinical trial data with collection of both traditional Chinese medicine and modern medicine diagnostic information, shows a good predictive role for the information in the efficacy in rheumatoid arthritis.

OBJECTIVE: To evaluate the correlations between clinical symptoms and treatment efficacy in patients with rheumatoid arthritis (RA). METHODS: Four hundred and thirteen patients were included in the clinical trial from 9 clinical centers. They were randomly divided into Western medicine-treated group with 204 cases and Chinese herbal drug-treated group with 209 cases. Eighteen clinical symptoms were evaluated before and after treatment. The Western medicine therapy included voltaren extended release tablets, methotrexate and sulfasalazine. The Chinese herbal drug therapy included glucosidorum Tripterygii totorum tablets and Yishen Juanbi Tablets combined with treatment based on syndrome differentiation. The American College of Rheumatology 20 (ACR20) was used as efficacy evaluation criteria. RESULTS: In the Chinese herbal drug-treated group, clinical symptoms such as arthralgia and tenderness of joints were positively correlated with the efficacy after 12-week treatment, while frequent urination at night was negatively correlated. In the same group, tenderness of joints and fever were positively correlated with the efficacy after 24-week treatment, while deep-colored and turbid urine was negatively correlated. In the Western medicine-treated group, tenderness of joints and thirst were positively correlated with the efficacy after 12-week treatment, while vertigo was negatively correlated. And in the same group, tenderness of joints was positively correlated with the efficacy after 24-week treatment, while heaviness of limbs was negatively correlated to the efficacy. The statistical results showed that the treatment efficacy was improved when the correlated symptoms were included in the indications. CONCLUSION: The treatment efficacy of RA is correlated with some symptoms, so further studies should proceed on these correlations in order to achieve better treatment outcome.

To explore the relationship between blood level of big endothelin and contrast-induced acute kidney injury (CI-AKI) in patients with emergent percutaneous coronary intervention (PCI). Methods: A total of 1061 consecutive patients received emergent PCI in our hospital from 2013-01 to 2015-06 were enrolled. According to blood levels of big endothelin, the patients were divided into 2 groups: Normal big endothelin group, n=236 and Elevated big endothelin group, n=825. The baseline condition, procedural features, occurrence rate of CI-AKI and composite endpoint events at 6 and 12 months post-operation were studied which including nonfatal myocardial infarction, revascularization, stroke and all-cause death. The risk factors for CI-AKI occurrence were identified by Logistic analysis. Results: The overall occurrence rate of CI-AKI was 22.7% (241/1061). Compared with Normal big endothelin group, Elevated big endothelin group had the higher incidence of CI-AKI, increased composite endpoint events at 6 and 12 months post-operation with P=0.041, P=0.040 and P=0.021, respectively. With adjusted covariates, elevated blood level of big endothelin, no matter as a continuous variable or categorical variable had the enhanced risk of CI-AKI incidence in patients after emergent PCI. Conclusion: Elevated blood level of big endothelin may significantly increase the risk of CI-AKI in patients with emergent PCI.

OBJECTIVETo study the relationship between glutathione S-transferase M1 (GSTM1) genotypes and lipid peroxidation of asbestos workers.

METHODS94 asbestos workers and 51 controls were selected as subjects. The general information, occupational history and individual habits were collected by questionnaires in all participants. The venous blood was sampled and the plasma was separated for the detection of malondialdehyde (MDA) level and lymphocytes for DNA isolation and GSTM1 genotyping.

RESULTSMDA level was significantly higher in asbestos workers [(0.283 +/- 0.054) nmol/L] than that in controls [(0.163 +/- 0.053) nmol/L, P < 0.01], however, neither duration of exposure nor accumulated asbestos exposure dose was related to MDA levels; MDA levels in control workers with GSTM1 +/- genotype [(0.190 +/- 0.034) nmol/L] were significantly higher than that in control workers with GSTM1 +/+ genotype [(0.138 +/- 0.055) nmol/L, P < 0.01]. Among asbestos workers, the same trend could be found, but the differences was not significant(P > 0.05). When the workers were stratified by duration of exposure or accumulated asbestos exposure dose, MDA levels in individuals with GSTM1 -/- genotype were also higher than those with GSTM1 +/+ genotype, but the differences were also not significant(P > 0.05).

CONCLUSIONBoth exposure to asbestos and deficiency of GSTM1 genotype were related to lipid peroxidation in workers, but the role of the former may be more important than that of the latter.

Asbestos ; adverse effects ; Genotype ; Glutathione Transferase ; genetics ; Humans ; Lipid Peroxidation ; Malondialdehyde ; analysis ; Occupational Exposure

Objective: To evaluate the impact of primary percutaneous coronary intervention (PPCI) with pre-operative intra-aortic balloon pump (P-IABP) implantation on short and long term prognosis in octogenarian patients of ST-segment elevation myocardial infarction (STEMI). Methods: We performed aretrospectively study in octogenarian STEMI patients treated in our hospital from 2004-01 to 2014-08. The patients were divided into 2 groups: P-IABP group,n=24 and PPCI group,n=73 including 12 patients who received rescue IABP (R-IABP) because of intra- or post-procedural hemodynamic collapse as a subgroup.Major end point events included 1 month and 1-, 2-year post-operative death; major adverse cardiac and cerebral events (MACCE) included 1 month post-operative cardiac shock, new or worsening heart failure (HF), re-infarction and stroke. The predictors causing different endpoint events were identiifed by Cox proportional hazard model analysis. Results: 1 month and 1-, 2-year post-operative death were similar between 2 groups (8.3% vs 16.4%), (16.7% vs 24.7%), (25.0% vs 30.1%) respectively; MACCE incidence was also similar (20.8% vs 30.1%), allP>0.05. Death rates between P-IABP group and R-IABP subgroup were similar at different time points,P>0.05; while MACCE incidence in P-IABP group was lower than R-IABP subgroup (20.8% vs 66.7%),P=0.005 and it was mainly presented by reduced HF occurrence (8.3% vs 41.7%),P=0.003. Coxproportional hazard model analysis indicated that post-operative TIMI lfow<3 grade was the independent predictor for 1 month death (HR=4.79, 95% CI1.59-14.39,P=0.005), complicating diseases as chronic obstructive pulmonary disease, kidney impairment and anemiawere themain independent predictors for 2-year death (HR=3.0, 95% CI 1.37-6.56,P=0.006). Conclusion: PPCI and P-IABP had no signiifcant differencefor short and long term survivalin octogenarianSTEMIpatients. Compared with R-IABP, P-IABP patients had the lower MACC Eincidence at 1 month post-operation .

Objective To discuss on the application of innovative quality control circle in optimizing pharmaceutical care,design pharmaceutical care model according to needs,and improve the quality of pharmaceutical care.Methods Using 10 steps of innovative quality control circle,the quality function development(QFD)was carried out by multidimensional quality tools,and the demand for pharmaceutical services was analyzed in the form of"House of Quality"Combined with PDCA cycle management tool,the situation of pharmaceutical services before and after improvement was analyzed and evaluated.Results After the implementation of the activities,many contents hd been improved,such as the dispensing time for outpatient pharmacy patients decreased from 16 min to 8 min,the finished product infusion configuration time in pharmacy intravenous admixture services decreased from 15 min to 7 min,the surgery pharmacy special management drug report automatically generated number increased from 2 copies to 6 copies,the daily order review time for each department of pharmacy decreased from 80 min to 20 min,the perfection rate of pharmaceutical care digital module increased from 65.23％to 80.34％,and the multidimensional quality tool adoption rate increased from 60.00％to 93.00％.In addition,a number of additional benefits and intangible results were obtained.Conclusion Adopting the management mode of QFD combined with PDCA cycle can effectively reconstruct the management mode of pharmaceutical care,and effectively promote the scientific and fine management of pharmaceutical care.