OBJECTIVE: To evaluate the long-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) treated with different reperfusion strategies in Chinese county-level hospitals. METHODS: A total of 2,514 patients with STEMI from 32 hospitals participated in the China Acute Myocardial Infarction registry between January 2013 and September 2014. The success of fibrinolysis was assessed according to indirect measures of vascular recanalization. The primary outcome was 2-year mortality. RESULTS: Reperfusion therapy was used in 1,080 patients (42.9%): fibrinolysis ( n= 664, 61.5%) and primary percutaneous coronary intervention (PCI) ( n= 416, 38.5%). The most common reason for missing reperfusion therapy was a prehospital delay > 12 h (43%). Fibrinolysis [14.5%, hazard ratio ( HR): 0.59, 95% confidence interval ( CI) 0.44-0.80] and primary PCI (6.8%, HR= 0.32, 95% CI: 0.22-0.48) were associated with lower 2-year mortality than those with no reperfusion (28.5%). Among fibrinolysis-treated patients, 510 (76.8%) achieved successful clinical reperfusion; only 17.0% of those with failed fibrinolysis underwent rescue PCI. There was no difference in 2-year mortality between successful fibrinolysis and primary PCI (8.8% vs. 6.8%, HR = 1.53, 95% CI: 0.85-2.73). Failed fibrinolysis predicted a similar mortality (33.1%) to no reperfusion (33.1% vs. 28.5%, HR= 1.30, 95% CI: 0.93-1.81). CONCLUSION In Chinese county-level hospitals, only approximately 2/5 of patients with STEMI underwent reperfusion therapy, largely due to prehospital delay. Approximately 30% of patients with failed fibrinolysis and no reperfusion therapy did not survive at 2 years. Quality improvement initiativesare warranted, especially in public health education and fast referral for mechanical revascularization in cases of failed fibrinolysis.
Humans ; ST Elevation Myocardial Infarction/therapy* ; Percutaneous Coronary Intervention ; East Asian People ; Treatment Outcome ; Myocardial Reperfusion ; Myocardial Infarction ; Registries ; Hospitals

Humans ; Mutation ; NAV1.5 Voltage-Gated Sodium Channel/genetics*

OBJECTIVE: To evaluate whether the efficacy of Getong Tongluo Capsule (, GTC, consisted of total flavone of Radix Puerariae) on improving patients' quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba (EGB) for patients with convalescent-phase ischemic stroke and primary hypertension. METHODS: This randomized, positive-drug- and placebo-controlled, double-blind trial was conducted from September 2015 to October 2017. Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions, twice a day for 12 weeks: (1) GTC 250 mg plus EGB-matching placebo 40 mg (237 cases, GTC group), (2) EGB 40 mg plus GTC-matching placebo 250 mg (120 cases, EGB group) or (3) GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg (120 cases, placebo group). Moreover, all patients were orally administered aspirin enteric-coated tablets 100 mg, once a day for 12 weeks. The primary outcome was the Barthel Index (BI). The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale (NIHSS) scores. The incidence and severity of adverse events (AEs) were calculated and assessed. RESULTS: The BI relative independence rates, the clinical recovery rates of NIHSS, and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment (P<0.05), and no statistical significance was found between the GTC and EGB groups (P>0.05). The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12, 18 and 24 weeks after treatment (P<0.01). There were no statistically significant differences in the incidences of AEs, adverse drug reactions, or serious AEs among the 3 groups (P>0.05). CONCLUSION GTC exhibited significant efficacy in improving patients' quality of life as well as neurological function and controlling hypertension. (Registration No. ChiCTR1800016667).

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

OBJECTIVE: To explore the value of interferon-inducible protein 10 (IP-10) in the auxiliary diagnosis of tuberculosis and the judgment of the severity of disease. METHODS: From February, 2013 to February, 2017, a total of 193 patients with TB admitted in our hospital and 84 healthy control subjects were recruited consecutively. The peripheral blood plasma levels of interferon-γ (IFN-γ) and IP-10 were detected using liquid phase chip (Luminex) technique. According to the number of lung fields affected by TB, the patients were divided into group A (with lesions in 1-2 lung fields), group B (3-4 lung fields) and group C (5-6 lung fields), The expressions of IFN-γ and IP-10 in 3 groups were compared. RESULTS: The plasma levels of IP-10 were significantly higher in TB patients than in the control subjects ( < 0.05), but IFN-γ levels were comparable between the two groups ( > 0.05). Among the TB patients, plasma IP-10 levels was the highest in group C ( < 0.05), and IFN-γ levels did not differ significantly among the 3 groups ( > 0.05). CONCLUSIONS Plasma IP-10 has a certain reference value in the auxiliary diagnosis of active tuberculosis and the judgment of the severity of the disease.
Antigens, Bacterial ; Biomarkers ; blood ; Chemokine CXCL10 ; blood ; Humans ; Tuberculosis, Pulmonary ; blood ; diagnosis

Because cryopreservation can effectively slow down the putrefaction and prolong the preservation time of corpses, it has become the main way of corpse preservation in China. However, it may cause a certain degree of non-specific effects on the corpses and thus interfere with forensic pathological identification. This paper summarizes relevant problems reported in domestic and foreign literature reports and practical identification, and analyzes the effects of cryopreservation on corpses from aspects of anatomical findings, histomorphology, postmortem biochemistry, and postmortem imaging, therefore to provide Chinese forensic workers assistance on problems in their practice of forensic pathology.
Autopsy ; Cadaver ; China ; Cryopreservation ; Forensic Pathology ; Humans ; Postmortem Changes

Objective To evaluate the clinical efficacy and safety of combined therapy of Chinese and West-ern medicine in the treatment of schizophrenia.Methods According to the digital table,130 patients with schizophre-nia were randomly divided into the observation group and control group,with 65 cases in each group.The control group was treated with perphenazine and other Western medicine treatment,the observation group was treated based on the control group with Jieyu Kaiqiao pill added,The clinical curative effect,PANSS score and adverse drug reaction of both groups were compared.Results In the observation group,the total effective rate was 96.92%,significantly high-er than that of the control group (72.31%);After treatment,PANSS score of observation group was (42.68 ±6.11), while it was (55.12 ±6.45)in control group.The PANSS scores of both groups were significantly lower than that before treatment,PANSS score of observation group was significantly lower than that of the control group,there was significant difference between groups(t=6.61,P<0.05);the incidence of adverse reaction of the observation group was 10.77%,significantly lower than the control group (58.46%);the difference was statistically significant (χ2 =32.66,P<0.05).Conclusion Jieyu Kaiqiao pill combined with Western medicine for the treatment of schizophre-nia can significantly improve the clinical efficacy,reduce the incidence of adverse drug reactions.

OBJECTIVETo investigate the distribution and drug-resistance of bacteria in the lower respiratory tract in patients with tuberculosis and severe pneumonia receiving invasive mechanical ventilation.

METHODSThe clinical data, lower respiratory tract infection pathogens and bacterial drug sensitivity were analyzed in 208 patients receiving invasive mechanical ventilation for tuberculosis and severe pneumonia.

RESULTSA total of 355 pathogenic microbial strains were obtained from the patients, among which 281 (79.2%) strains were Gram-negative bacteria, 62 (17.5%) were fungi, and 12 (3.4%) were Gram-positive bacteria. Mixed infections were found in 68 cases (19.2%). The sensitivity rates of meropenem, imipenem and amikacin were over 60% for Gram-negative bacteria, and those of teicoplanin, vancomycin, and fusidic acid were 100% for Gram-positive bacteria.

CONCLUSIONThe main pathogenic bacteria are Gram-negative bacteria, fungi and Gram-positive bacteria in the lower respiratory tract of patients with tuberculosis and severe pneumonia receiving mechanical ventilation. Meropenem, imipenem and amikacin are effective antibiotics for lower respiratory tract infections, and multi-drug resistance is frequent in these patients, which urges appropriate use of the antibiotics.

Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; isolation & purification ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Microbial Sensitivity Tests ; Pneumonia, Bacterial ; microbiology ; Respiration, Artificial ; Respiratory Tract Infections ; microbiology ; Tuberculosis ; microbiology

OBJECTIVETo investigate the effects of refining temperatures and amounts of sheep's oil used in processing Epimedii Folium on Kedney-yang deficiency rats.

METHODThe corticosterone was subcutaneous injected to establish the kidney yang deficiency rat model. With the temperatures and amounts of sheep's oil were 250 degrees C/30%, 120 degrees C/30% and 120 degrees C/20% respectively, the crude drug and three kinds of pressed Epimedii Folium were extracted by water and used as examined samples while total flavonoid of Epimedii Folium was used as positive control. After examined samples and control samples were intragastirc administrated, the pharmacologic action was analyzed.

RESULTAs compared to crude drug, all of the aqueous extracts of processed Epimedii Folium have stronger effect of warming kidney and enhancing yang, especially the Epimedii Folium processed by sheep's oil with refining temperatures 120 degrees C and amounts of sheep's oil 30%. Its mechanism might be related to improving the insufficiency of hypothalamic-pituitary-adrenal-thymus (HPAT) axis suppression.

CONCLUSIONThe refining temperature of sheep's oil can affect the quality of excipients and processed drugs. The results may be useful in explaining the mechanism of Epimedii Folium processing and establishment of pharmaceutical standard of sheep's oil used as processing excipients.

Animals ; Drugs, Chinese Herbal ; administration & dosage ; Hypothalamo-Hypophyseal System ; drug effects ; Kidney Diseases ; drug therapy ; physiopathology ; Male ; Oils ; administration & dosage ; Pituitary-Adrenal System ; drug effects ; Rats ; Rats, Sprague-Dawley ; Sheep ; Technology, Pharmaceutical ; Yang Deficiency ; drug therapy ; physiopathology

Such measures as improved internal management and process, and utilization of contemporary management theories and scientific means, efficiently streamlined resourcea of all kinds at the outpatient clinic. Service quality and level have been significantly raised for appointment practice at the outpatient clinic, as evidenced by a growing percentage of appointments scheduled. On this basis,problems found in the existing appointment system were analyzed along with improvement suggestions.