Objective To investigate the interventional therapy effect of combination application of thrombus aspiration and intracoronary injection of tirofiban for treating heavy thrombosis burden of infarction related vessel in the patients with acute anterior myocardial infarction.Methods The patients with acute anterior myocardial infarction undergone direct primary percutaneous coronary intervention in the hospital were retrospectively analyzed.The group A received simple thrombus aspiration during transcutaneous PCI and the group B received the combination treatment of thrombus aspiration and intracoronary injection of tirofiban in direct PCI.Results The patients with myocardial perfusion grade less than 3 during thrombolysis during myocardial infarction(TIMI) in the group B were significantly less than those in the group A(P＜0.05).The cardiac magnetic resonance imaging(MRI) results indicated that the area of myocardial infarction in the group B was smaller than that in the group A(P＜0.05).The color echocardiography results showed that the left ventricular diastolic volume(LVDV) and left ventricular ejection fraction(LVEF) in the group B were significantly better than those in the group A(P＜0.05).Conclnsion The combination application of thrombus aspiration and intracoronary injection of tirofiban is safe and effective in direct PCI.

Angioplasty, Balloon, Coronary ; Heart Injuries ; drug therapy ; etiology ; Humans ; Thrombin ; administration & dosage

Objective To research the combined prognostic utility of NT-proBNP and hs-CTNI in NSTE-ACS risk stratification and early intervention therapy .Methods A total of 245 NSTE-ACS patients were divided to 4 groups(Aa ,Ab ,Ba ,Bb groups) ac-cording to immediate admission NT-proBNP and hs-CTNI .Patients were accepted percutaneous coronary intervention (PCI) ,coro-nary artery bypass grafting and conservative treatment were taken 6 months follow-up .Results The heart failure incidence of Aa group was significantly higher than Ba group(P<0 .05) .6 patients happened left main lesion or multivessel lesion in Aa group were obviously higher than other groups .The incidence of Bb group accepted PCI was obviously higher than Aa group (P<0 .05) .Bb group patients were accepted PCI earlier than other groups ,there was no significance(P>0 .05) .In 6 months follow-up ,5 patients died and 10 patients accepted revascularization again because of severe angina and AMI .Conclusion In NSTE-ACS patient ,NT-proBNP and hs-CTNI elevation was closely related with severe coronary lesions and worse prediction ,which could undergo early in-tervention therapy .

Objective To establish a standardized middle cerebral artery occlusion (MCAO) model with suture method in rabbits and to investigate the value of the assessment for cerebral ischemia with amplitudeintegrated electroencephalogram (aEEG).Methods A total of 34 male New Zealand white rabbits were randomly assigned to either an MCAO group (n =29) or a sham operation goup (n =5).A model of MCAO was induced with intraluminal suture method and the cerebral function monitor was performed.According to 2,3,5-triphenyltetrazolium chloride staining,the MCAO group was further divided into cortex + basal ganglia infarction,basal ganglia infarction,subarachnoid hemorrhage,and non-lesion subgroups.The differences among the physiological indicators,weight,thread end diameter,and insertion length were compared before and after modeling in all subgroups.Results The success rate of MCAO modeling with suture method in rabbits was 62.07％ (18/29),in which 37.93％ (11/29) involved in the cortex and basal ganglia,24.38％ (7/29) only involved in the basal ganglia,17.24％ (5/29) complicated by subarachnoid hemorrhage,and 20.69％ (6/29) had no infarction.There were no significant differences in the body temperature,heart rate,mean arterial pressure and arterial blood pH,oxygen partial pressure,and CO2 partial pressure among all the subgroups before and after modeling.The weight in the non-lesion subgroup was 2.36 ± 0.10 kg,it was significantly lower than 2.55 ± 0.09 kg in the cortex + basal ganglia infarction subgroup (P =0.001) and 2.50 ± 0.12 kg in the basal ganglia infarction subgroup (P =0.017).The length of suture placement in the cortex+basal ganglia infarction subgroup was 5.59 ± 0.24 cm,and it was significantly less than 6.00 ± 0.50 cm in the subarachnoid hemorrhage subgroup (P =0.036).However,it was significantly longer than 5.20 ± 0.50 cm in the non-lesion subgroup (P =0.033).After modeling there were significant differences in aEEG among all subgroups (F =14.059,P =0.000).Compared to before modeling,aEEG decreased 50.02％ (t =9.573,P ＜ 0.001) and 14.20％ respectively after modeling in the cortex + basal ganglia infarction subgroup and the ganglia infarction subgroup (t =2.908,P =0.027).Conclusions A standardized MCAO model in rabbits may be successfully established with suture method.The significantly decreased aEEG indicates that the MCAO model is successful and the lesions involve in the cortex.

ObjectiveTo explore the expression of hemopoietin(EPO) mRNA on cerebral ischemia-reperfusion injury in rats brain tissue and the effect of Tongxinluo on it.Methods The model of rat (MCAO) were perfused with Tongxinluo,the changes of neural stem cell proliferation and differentiation related cell factors of EPO mRNA were detected after ischemia-reperfusion injury 3、5、7、14 d by means of reverse transcriptase polymerase chain reaction(RT-PCR).ResultsEPO mRNA of ischemia-reperfusion models showed expression in different period,the expression enhanced in the third day,reached the highest in the fifth day; the ischemia side EPO mRNA expression enhanced in the third day after give Tongxinluo,in the 5,7 and 14 day,PCR expression gray values were higher than the model group.ConclusionEPO mRNA expression enhanced after cerebral ischemia,this expression can be strengthened by Tongxinluo,and may further induce neural stem cell proliferation and differentiation.

A series of surveillance and management actions was taken to minimize out-of-plan re-operations. These actions include: 1) Building and completing the surveillance and management mechanism against unplanned re-operations; 2) Building a real-time surveillance and reporting mechanism; 3) Enhancing quality control and continuous improvement at the operating departments; 4) Enhancing the supervision on regulations implementation by quality control departments of the hospital; 5) Enhancing quality control for medical records; 6) Building a feedback mechanism for surveillance results; 7) Building a penalty and reward mechanism. Efforts for one year and a half on such surveillance and management proved successful, as the incidence of out-of-plan re-operations fell from 1.7% before these actions to 1.0% afterwards.

Objective To investigate the diagnostic significance of the relative band power(RBP) of EEG in acute focal cerebral ischemia (AFCI). Methods EEG monitoring was performed in 20 patients with AFCI (51 lesions) in neurological intensive care unit (NICU) and 20 patients with normal EEG (control group) in NICU. The changes of bilateral RBP were observed and analyzed comparatively. RBP in the infarction group was compared with that in the control group. The diagnostic capabilities of all wave-band RBPs were assessed with the receiver operating characteristic (ROC) analysis. Results AFCI shoved asymmetry on all the wave-band RBPs. The RBP of of δwave on the lesion side was significantly higher than that on the normal side (P <0.01). RBPs of α, β and θ waves were decreased significantly (P <0.05). RBP of δ wave in the infarction group was increased significantly compared to the control group (P < 0.01 ). RBPs of α and β waves were decreased significantly (P <0.01). The diagnostic accuracy of the RBP of α was the highest, and both β and δ waves also had significance for the diagnosis of AFCI. Conclusions RBP had an important significance for the early diagnosis of AFCI. Conclusions RBP had an important significance for the early diagnosis of AFCI.

AIM: Tongxinluo had showed effects of inducing proliferation and differentiation on neural stem cells in previous observations on animal models. The experiment would investigate the time-effect and dose-effect relationship of Tongxinluo on neurocyte lineage development from rat embryonic neural stem cells (NSCs). METHODS: Experiments were performed at the Laboratory of Functional Science of Southern Medical University from June to October 2007. ①Pregnant rats of 12-14 days were provided by Experimental Animal Center of Southern Medical University. The experiment was performed in strict compliance with all standards for ethics. Tongxinluo contained ginseng, leech, scorpion, ground beetle, centipede, pellicula cicadae, red peony root, borneol and so on. Tongxinluo was produced by Shijiazhuang Yiling Pharmaceutical Co., Ltd., No. Z19980015. Preparation of serum containing Tongxinluo: 1 g/kg per day Tongxinluo suspension was given by lavage in rats of high-dose Tongxinluo group, and 0.5 g/kg per day in rats of low-dose Tongxinluo group. 7 days later, sera were extracted from all the rats and sterilized with filtrating, followed by separate-loading and cryopreservation at –70 ℃. ②NSCs cultured were separated from 12th-14th day SD rat embryo. The third passage of cells was treated with serum containing Tongxinluo in the high-dose and low-dose Tongxinluo group. Rats were treated with common serum as a control. ③Proportion of various kinds of nerve cells was observed by immunofluorescence staining at days 1, 3 and 7. RESULTS: ①At day 1, there was few cells labeled with 5-bromodeoxyuridine (BrdU) (+) and glial fibrillary acidic protein (GFAP) (+) in high-dose Tongxinluo group, with rest cells all labeled with BrdU (+) and Nestin (+). While in low-dose Tongxinluo group and control group, all cells were BrdU(+)Nestin(+). ②At day 3, the ratios of cells labeled with Nestin (+), ?tubulin (+) or GFAP (+) differentiated with each other (P 0.05). ③The ratios of NSCs labeled with nestin (+) decreased soon after administered Tongxinluo, and increased after that. The ratios of ?tubulin (+) cells increased in the high-dose Tongxinluo group while increased firstly then decreased in the low-dose Tongxinluo group and control group. The ratios of GFAP (+) cells increased in the low-dose Tongxinluo group and control group while increased firstly then decreased in the high-dose Tongxinluo group. The ratios of GalC (+) cells had no remarkable change in the high-dose and low-dose Tongxinluo group, but increased significantly at day 7 in the control group. CONCLUSION: Tongxinluo may induce proliferation and neuronal differentiation of rat embryonic NSCs with time-effect and dose-effect relationship. The more Tongxinluo is administered, the more significant and permanent effects will be achieved.

Objective To compare the characteristics of MRI, CT, single photon emission computed tomography(SPECT) and transcranial Doppler sonography(TCD) in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Methods Seventeen patients were investigated. MRI or CT was scanned in 17 patients, SPECT in 9 patients′ and TCD in 11 patients. Results MRI or CT: Brain MRI and CT revealed extensive symmetric white matter involvement of bilateral cerebral and cerebellar hemispheres and the brainstem.The lesions, which showed no contrast enhancement, were hypodense on CT and hypointense on T 1 weighted and hyperintense on T 2 weighted MRI. SPECT: The regional cerebral blood flows(rCBF) of white matter involvement on bilateral cerebral and cerebellar hemispheres was reduced obviously. The rCBF of temporal lobes, parietal lobes, occipital lobes, cerebellar hemispheres, and basal ganglion was reduced in varying degrees. TCD: The systolic peak became sharpened, and end diastolic flow velocity and mean flow velocity were reduced obviously and pulsatility index was increased markedly in patients with spongiform leukoencephalopathy after inhaling heroin vapor. Conclusion The characteristic manifestations of MRI and CT imaging may be regarded as the main foundation of diagnosing spongiform leukoencephalopathy after inhaling heroin vapor; SPECT and TCD can help comprehend the changes of hemodynamics of cerebral vessels and the degree of cerebral ischemia in patients with spongiform leukoencephalopathy after inhaling heroin vapor.

Objective To observe the therapeutic role on monoclonal antibody of alkaline phosphatase(AAP) to vasogenic cerebral edema in rats(VCE).Methods 60 Wistar rats were randomly divided into 3 groups:normal group,VCE group and AAP group.VCE animal model was made by injecting AAP.Brain water content of gray and white matter were measured by Moistrue Analyzer respectively.The permeability of the blood brain barrier (BBB) was determined by Evan's blue(EB) extravasation.Results The brain water content of gray and white matter in AAP group was reduced markedly,so the permeability of BBB was reduced(P0.05). Conclusion AAP can treat VCE well. Morbidity mechanism of VCE is related to the activity of alkaline phosphatase.