他汀类药物对急诊PCI术后心室跨壁复极离散度及室性心律失常的影响

目的 探讨大剂量阿托伐他汀(80 mg)对ST段抬高性急性心肌梗死患者急诊PCI术后心室跨壁复极离散度及室性心律失常的影响.方法 将该院2009年9月～2011年6月住院行急诊PCI术治疗的ST段抬高性急性心肌梗死患者161例随机分为他汀组80例和非他汀组81例,另设对照组75例.他汀组在入院后即刻口服阿托伐他汀80 ng,急诊PCI术后3d内每日口服阿托伐他汀40 ng.然后分别测定并比较3组患者入院即刻、第2天、第3天校正的跨壁复极离散度值,并根据动态心电图检测结果比较3组恶性室性心律失常的发生率.结果 (1)急性心肌梗死患者较正常组心室跨壁复极离散度明显增加(P＜0.01)、恶性室性心律失常的发生率亦明显增加(P＜0.01).(2)他汀组较非他汀组心室跨壁复极离散度的明显减小(P＜0.05),但恶性室性心律失常的发生率尚无统计学差异(P=0.07).结论 ST段抬高性急性心肌梗死患者心室跨壁复极离散度值及恶性室性心律失常的发生率显著增加;大剂量阿托伐他汀能减小ST段抬高性急性心肌梗死患者急诊PCI术后心室跨壁复极离散度.     

匹伐他汀对急性冠状动脉综合征疗效及安全性研究

目的观察急性冠状动脉综合征（acute coronary syndrome,ACS）患者接受匹伐他汀应治疗的安全性及疗效。方法 60例ACS患者,含20例非ST段抬高心肌梗死（NSTEMI）服用1周匹伐他汀（力清之,4 mg/次,1次/d）,观察其调脂疗效。同时比较NSTEMI患者服用匹伐他汀与阿托代他汀后PCI手术即刻疗效。结果 60例患者服用1周匹伐他汀,胆固醇（total cholesterol,TC）及低密度脂蛋白（low density lipoprotein,LDL）明显降低,且无肝肾功能及肌肉的损害;NSTEMI患者服用匹伐他汀与阿托代他汀PCI术后近期效果无显著差异,且匹伐他汀临床副作用明显小于阿托代他汀。结论对于ACS患者,无论是否行PCI手术治疗,服用1周匹伐他汀（4 mg/次,1次/d）强化治疗是安全有效的。     

再次负荷量瑞舒伐他汀对NSTEACS患者经PCI术后心血管事件的影响

目的：观察非 ST 段抬高型急性冠状动脉综合征（NSTEACS）患者择期经皮冠状动脉介入（PCI）术前再次强化他汀治疗,能否降低围手术期心肌标志物水平及心肌梗死发生率。方法：120例患者随机分为两组,两组患者既往均长期（30 d以上）服用瑞舒伐他汀10 mg/d,入院后两组患者继续服用常规剂量瑞舒伐他汀,并接受NSTEACS其他常规治疗。强化他汀组术前24 h 服用瑞舒伐他汀40 mg,常规他汀组术前仍以瑞舒伐他汀10 mg/d 治疗。比较两组围手术期心肌梗死发生率及高敏 C 反应蛋白（hs-CRP）变化,观察随访1个月患者主要心血管不良事件（MACE）发生率。结果：强化他汀组围手术期心肌梗死发生率明显低于常规他汀组,两组比较差异有统计学意义（P 〈0.05）。PCI 术后24 h 强化他汀组hs-CRP低于常规他汀组,两组比较差异有统计学意义（P 〈0.05）。PCI 术后随访1个月,强化他汀组无MACE发生,常规他汀组发生心肌梗死5例;两组发生率差异有统计学意义（P〈0.01）。结论：既往长期服用他汀类药物治疗的NSTEACS患者,择期PCI术前再次负荷量他汀治疗能减少围手术期心肌梗死发生率,降低术后hs-CRP的升高,减少术后1月MACE发生率。     

强化他汀对急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗术后近期的预后效果分析

目的:探讨强化他汀对急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗(PCI术后近期的预后效果。方法:择取2016年1月-2018年1月本院心血管外科急性ST段抬高型心肌梗死实施急诊PCI术的患者80例,依随机数字表法分为常规组和强化组,各40例。常规组实施常规方案他汀药物治疗(术前使用20 mg阿托伐他汀),强化组实施强化方案他汀药物治疗(术前使用80 mg阿托伐他汀)。观察比较两组患者疗效、心功能、炎症指标、近期预后、用药安全性状况。结果:强化组治疗总有效率95.0%,显著高于常规组80.0%(P0.05)。术后1个月,强化组左室射血分数、室壁运动积分指数与常规组比较,差异均有统计学意义(P0.05)。术后12、24 h,强化组超敏C反应蛋白水平均低于常规组,差异均有统计学意义(P0.05)。术后6个月,强化组心血管事件发生率10.0%,显著低于常规组30.0%(P0.05)。强化组患者用药后不良反应发生率7.5%与常规组5.0%对比,差异无统计学意义(P0.05)。结论:对急性ST段抬高型心肌梗死患者实施强化他汀治疗可改善急诊PCI术治疗效果,减轻术后炎症反应,促进患者心功能恢复,且近期心血管事件发生率低,近期预后良好。     

阿托伐他汀预处理对非ST抬高急性冠脉综合征患者行冠脉支架置入术后炎性因子和预后的影响

目的：研究非sT抬高急性冠脉综合征（ACS）患者支架植入术前使用阿托伐他汀治疗对术后炎症因子及患者预后的影响。方法：选择我院住院的非ST抬高ACS患者76例,阿托伐他汀预处理组（38例）和对照组（38例）,阿托伐他汀预处理组于PCI前24h内服用80mg阿托伐他汀,对照组未服用阿托伐他汀,术后监测6h、12h及1周的血清c反应蛋白（CRP）、肿瘤坏死因子d（TNF-or）,白介素-1（IL-1）和白介素-6（IL-6）水平及两组的术后30d和60d的不良事件发生率并进行统计学分析。结果：阿托伐他汀预处理组的12h及1周的血清CRP、TNF-a、IL-1β和IL-6水平显著低于对照组,差异有统计学意义。术后6h两组的炎症因子水平比较无统计学差异。术后30d和60d,阿托伐他汀预处理组和对照组的心脏不良事件发生例数无统计学差异。结论：早期应用阿托伐他汀可促进非ST段抬高ACS患者行PCI术后的疗效,有效降低炎症因子水平,但心脏不良事件发生无明显降低,其原因尚需进一步的基础和临床研究。     

替罗非班在高危非ST段抬高急性冠状脉动综合征介入治疗中的应用

目的探讨替罗非班对高危非sT段抬高急性冠状动脉综合征患者经皮冠状动脉介入治疗（PCI）围术期应用血小板糖蛋白Ⅱb／Ⅲa受体拮抗剂的安全性和有效性。方法72例PCI的高危非ST段抬高急性冠状动脉综合征患者随机分为替罗非班组34例和对照组38例,观察住院期间和随访30d内不良心血管事件（再发心绞痛、心肌梗死、猝死）、心电图改变、心功能影响以及出血并发症情况。结果替罗非班组30d内主要不良心脏事件（MACE包括顽固性心绞痛、新发心肌梗死、死亡）发生率较对照组显著降低（P〈0．05）;心电图ST段下移程度和缺血导联数明显减少（P〈0．05）;PCI术后心功能改善。围术期皮肤、黏膜及穿刺部位并发症较对照组略增高。结论高危非ST段抬高急性冠状动脉综合征患者PCI围术期应用替罗非班有效、安全性好。     

替罗非班联合阿托伐他汀治疗急性ST段抬高型心肌梗死PCI手术中效果观察

目的:探讨替罗非班联合阿托伐他汀治疗急性ST段抬高型心肌梗死的实际临床效果.方法:选取2015年12月至2017年01月该院接诊的急性ST段抬高型心肌梗死患者84例,按照随机数字表法将入选患者分为单一组与联合组,每组各42例.单一组患者在常规治疗基础上加用替罗非班治疗,联合组患者在替罗非班治疗的基础上口服阿托伐他汀钙片治疗.治疗结束后比较两组患者的ST段抬高回落情况.结果:经治疗,联合组患者的ST段抬高回落总有效率为95.24％,明显的高于单一组患者的73.81％,两组患者的心电图改善差异有统计学意义(P＜0.05).结论:替罗非班联合阿托伐他汀治疗急性ST段抬高型心肌梗死PCI介入手术患者,可促进患者的ST段抬高回落,改善了患者的预后效果.     

急诊PCI围术期强化他汀类药物治疗对急性心肌梗死患者hs-CRP、sCD40L的影响

目的通过观察血清高敏C反应蛋白（hs-CRP）、可溶性CD40L（sCD40L）等指标变化,探讨在急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）围术期他汀类药物强化治疗的效果及意义。方法将112例行急诊PCI治疗的AMI患者随机分为治疗1组40例（术前服阿托伐他汀80mg,术后服阿托伐他汀40mgqd）、治疗2组40例（术前服阿托伐他汀40mg,术后服阿托伐他汀20mgqd）和对照组32例（常规治疗）,3组基线资料具有可比性。分别测定3组PCI术后血清hs-CRP、sCD40L及肌酸激酶同工酶（CK-MB）水平。结果与对照组比较,治疗1组和治疗2组PCI治疗后12h、24h、7d血清hs-CRP、sCD40L水平均明显下降（P均〈0.01）,治疗1组和治疗2组之间差异有统计学意义（P均〈0.01）。2个治疗组术后12、24h的CK-MB升高〉2倍正常值上限的患者发生率均较对照组明显降低（P均〈0.05）,2个治疗组比较差异亦有统计学意义（P均〈0.05）。结论 AMI患者急诊PCI围术期强化他汀类药物治疗,可能通过抗炎、抗血小板、稳定冠脉血管内皮及粥样斑块等作用,使患者获益     

大剂量阿托伐他汀对急性心肌梗死溶栓治疗后炎症反应的影响

目的探讨大剂量阿托伐他汀溶栓前治疗对急性ST段抬高心肌梗死（STEMI）溶栓后相关炎症反应及心肌标志物的影响。方法 58例接受急诊溶栓的急性ST段抬高心肌梗死（STEMI）患者随机分为治疗组（33例）和对照组（25例）,治疗组在艾通立（rt-PA,50mg）溶栓前给予阿托伐他汀80mg顿服,对照组溶栓前不使用他汀类药物。两组患者均接受其他常规治疗,且在溶栓后均接受他汀类药物治疗。于溶栓前及溶栓后24小时应用酶联免疫吸附法（ELISA）检测血清中的可溶性粘附分子sVCAM-1、sICAM-1、cTnI的水平。结果治疗组和对照组的溶栓后sVCAM-1、sICAM-1、cTnI与溶栓前比较均有显著升高（P〈0.01）。治疗组溶栓前和溶栓后的sVCAM-1、sICAM-1、cTnI均较对照组显著降低（P〈0.01或P〈0.05）。结论急性心肌梗死溶栓前给予阿托伐他汀80mg能够显著减少溶栓造成的炎症反应及心肌损伤,对心肌有保护作用,安全性好。     

术前阿托伐他汀对急性STEMI患者PCI术后冠脉血流和炎症介质水平的影响

目的探讨术前阿托伐他汀对急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)术后冠脉血流和炎症介质水平的影响。方法选取PCI术前及术后均使用阿托伐他汀的41例急性STEMI患者作为观察组,选取同期仅于术后使用阿托伐他汀的41例急性STEMI患者作为对照组,将两组患者PCI术后冠脉血流和炎症介质水平进行对比分析。结果 PCI术后,两组患者TIMI血流分级均得到显著改善,与术前比较,差异均有统计学意义(P0.05);但术后组间TIMI血流分级比较,差异无统计学意义(P0.05)。PCI术后,观察组梗死动脉无复流发生率为7.32%(3/41),显著低于对照组的21.95%(9/41),差异有统计学意义(P0.05)。观察组术后ST段完全回落率为95.12%(39/41),高于对照组的80.49%(33/41),差异有统计学意义(P0.05)。PCI术后,两组患者炎症介质水平均显著下降,与术前比较,差异有统计学意义(P0.05);观察组上述指标水平均显著低于对照组,差异有统计学意义(P0.05)。结论术前阿托伐他汀能减少急性STEMI患者血清炎症介质的释放,改善血流灌注,降低术后无复流现象发生风险。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.