PCI术前给予大剂量阿托伐他汀钙对急性心肌梗死患者血清降钙素原和高敏C反应蛋白水平的影响

目的观察经皮冠状动脉介入治疗（PCI）术前80 mg阿托伐他汀对急性心肌梗死（AMI）患者血清降钙素原（PCT）和血清高敏C反应蛋白（hs-CRP）水平的影响。方法选取预实行PCI术的100例AMI患者为AMI组,根据口服阿托伐他汀钙片剂量的不同将其分为A组（术后每天20 mg,n=34）、B组（术后每天40 mg,n=33）、C组（术前80 mg＋术后每天40 mg,n=33）,另入选冠状动脉造影正常的健康人40例为对照组;测定各组术前、术后1、3 d与对照组入院时血清PCT、hsCRP水平。结果与对照组比较,AMI组入院时PCT、hs-CRP水平明显升高（P〈0.05）;术后1、3 d C组患者PCT水平明显低于A、B组（P〈0.05）;AMI各组患者术后1 d hs-CRP水平差异无统计学意义（P〉0.05）,术后3 d C组hs-CRP水平明显低于A、B组（P〈0.05）;AMI患者血清PCT峰值与hs-CRP峰值呈正相关（r=0.368,P=0.026）。结论术前应用大剂量阿托伐他汀能更有效降低AMI患者血清PCT和hs-CRP的水平。     

阿托伐他汀对介入手术患者对比剂应用后肾功能的影响

 目的 观察阿托伐他汀对介入手术患者对比剂应用后肾功能的影响.方法 196例脑动脉弹簧圈介入手术患者随机分为2组,阿托伐他汀组98例,术前3 d给予阿托伐他汀80 mg/d;对照组98例,术前3 d给予安慰剂.观察血清肌酐(SCr)、尿N-乙酰β氨基葡萄糖苷酶(NAG)和尿渗透浓度水平.结果 术后第2天阿托伐他汀组血清SCr显著低于对照组,尿NAG水平显著低于对照组(P＜0.05).结论 阿托伐他汀能够预防脑动脉介入手术患者对比剂应用后肾功能恶化.     

他汀类药物对急性冠脉综合征患者介入治疗后炎性因子的影响

目的 探讨瑞舒伐他汀对急性冠脉综合征（ACS）患者冠状动脉介入（PCI）治疗术患者血清妊娠相关蛋白-A（PAPP-A）和超敏C-反应蛋白（hs-CRP）的影响.方法 选择2010年8月~2012年9月在我院行冠状动脉介入术的100例急性冠脉综合征患者为研究对象,随机分为2组：瑞舒伐他汀治疗组（瑞舒伐他汀10mg/d,n=51）和对照组（n=49）,分别于药物治疗前、药物治疗后1周及术后12h采集空腹静脉血,测定血清妊娠相关血浆蛋白A（PAPP-A）、超敏C-反应蛋白（hs-CRP）浓度.结果 药物治疗后1周,瑞舒伐他汀治疗组较对照组患者血清PAPP-A和hs-CRP浓度明显降低（P〈0.01）; ACS患者行PCI术后血清PAPP-A和hs-CRP浓度较术前升高;瑞舒伐他汀治疗组PCI术后患者血清PAPP-A和hs-CRP浓度明显低于同期对照组（P〈0.01）.结论 瑞舒伐他汀可降低急性冠脉综合征患者血清PAPP-A和hs-CRP浓度;冠状动脉介入术增加血清PAPP-A和hs-CRP浓度;瑞舒伐他汀可降低冠状动脉介入（PCI）治疗术后患者血清PAPP-A和hs-CRP浓度.     

PCI围术期强化他汀治疗心肌保护作用的研究

目的观察已服用阿托伐他汀的急性冠脉综合症（ACS）患者,择期经皮冠状动脉介入治疗术前12h强化阿托伐他汀治疗的心肌保护作用。方法选择我院住院的ACS择期PCI术患者90例,分术前12h未强化治疗（组1）、强化40mg（组2）和80mg（组3）,测定术前、术后肌酸激酶MB（CK-MB）,肌钙蛋白I（cTnI）等。结果术后组1、组2cTnI与CK-MB较术前增高,而组3无明显升高,且术后12h较组1、组2显著下降。结论服用阿托伐他汀3天以上的ACS患者择期PCI术前12h强化阿托伐他汀（80mg）有进一步的心肌保护作用。     

冠心病合并颈动脉斑块的危险因素及降脂方案分析

目的 探讨冠心病合并颈动脉斑块的相关危险因素,并比较不同降脂治疗方案对颈动脉斑块的影响。方法 收集2017年1月-2019年12月因冠心病在武汉市第一医院心内科住院并行冠脉造影及经皮冠状动脉介入治疗(PCI)的335例患者的临床资料进行回顾性分析。对比分析冠心病合并颈动脉斑块组(n=257)与冠心病无颈动脉斑块组(n=78)的生化指标,在冠心病合并颈动脉斑块组中筛查并分析影响血脂水平分布的因素。采用单因素及多因素二元logistic回归分析冠心病合并颈动脉斑块的危险因素。剔除冠心病合并颈动脉斑块组无法成组的9例患者,根据实际口服降脂药物方案分为4个亚组：阿托伐他汀20 mg组(n=90)、阿托伐他汀10 mg+依折麦布10 mg组(n=51)、瑞舒伐他汀10 mg组(n=71)、匹伐他汀2 mg组(n=36)。分析4组间PCI术前和术后1年颈动脉斑块数目及大小的变化情况。结果 冠心病合并颈动脉斑块组较无斑块组体重指数(BMI)、血压(包括收缩压和舒张压)、血肌酐、血尿酸、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、糖化血红蛋白(HbA_1c)、脂蛋白磷脂酶A...     

阿托伐他汀序贯治疗对接受急症PCI术急性心肌梗死患者缺血修饰白蛋白的影响

目的 探讨阿托伐他汀序贯治疗对接受急症经皮冠状动脉介入治疗(PCI)急性心肌梗死患者血清缺血修饰白蛋白(IMA)的影响.方法 收集2010年9月至2014年1月收治的符合纳入标准的83例急性ST段抬高型心肌梗死(STEMI)患者,随机分为阿托伐他汀常规治疗组(n=40,对照组)和序贯治疗组(n=43),对照组阿托伐他汀20 mg,/d,序贯治疗组术前80 mg/d,术后40 mg/d,3个月后20 mg/d.观察术前及术后2、4、6、8、10、12、14 h IMA,术中及术后6个月主要心血管不良事件(MACE).结果 序贯治疗组PCI术后血清IMA水平明显低于常规治疗组,差异有统计学意义(P＜0.05);序贯治疗组术后6个月MACE发生率明显明显低于常规治疗组,差异有统计学意义(P＜0.05).结论 阿托伐他汀序贯治疗可显著改善急症PCI患者心肌缺血,对心肌起主要保护作用,并降低术后MACE发生率,安全有效.     

阿托伐他汀对急性冠脉综合征患者hs-CRP浓度的影响

目的 观察小剂量阿托伐他汀(20 mg)对急性冠脉综合征(ACS)患者高敏C反应蛋白(hs-CRP)浓度的影响.方法 按照随机、双盲、对照的方法,将100例ACS患者随机分为治疗组和对照组.治疗组给予阿托伐他汀(20 mg,1次/d)治疗4w,另给予正规抗心绞痛治疗;对照组给予正规抗心绞痛治疗(不给予阿托伐他汀).结果 治疗组和对照组hs-CRP浓度均下降,治疗组下降更明显.亚组分析发现,在治疗组无吸烟史、高血压和心血管病病史的患者,hs-CRP浓度下降更明显.结论 在ACS患者的早期治疗阶段使用小剂量阿托伐他汀(20 mg)能获得良好效果.     

强化他汀治疗对冠脉慢血流患者血浆APN和HDL的影响

目的观察强化阿托伐他汀治疗对冠状动脉慢血流(CSF)患者血浆脂联素(APN)、高密度脂蛋白(HDL)的影响。方法将经冠脉造影检查诊断为CSF的98例患者,随机分为常规组及强化组,每组49例,常规组给予阿托伐他汀20 mg,1次/晚;强化组给予阿托伐他汀40 mg,1次/晚。观察治疗3个月后,两组患者血浆APN及HDL水平的变化。结果治疗3个月后,两组患者血浆APN及HDL水平均较治疗前明显升高,治疗前后比较,差异有统计学意义(P<0.05)。强化组与常规组比较,强化组APN及HDL水平较常规组明显升高,差异有统计学意义(P<0.05)。结论强化他汀治疗可明显提高CSF患者血浆HDL及APN水平。     

不同剂量阿托伐他汀治疗冠心病患者疗效观察

目的探讨不同剂量阿托伐他汀治疗冠心病患者的临床疗效。方法选取自2013年1月至2017年12月北部战区空军医院心内科收治的361例冠心病患者为研究对象。采用随机数字表法将其分为A组(n=181)与B组(n=180)。在常规治疗的基础上,A组患者行阿托伐他汀片20 mg/d治疗,B组患者行阿托伐他汀片40 mg/d治疗。比较两组患者治疗前后的血脂水平、肝功能指标水平、肾功能指标水平及治疗后的低密度脂蛋白胆固醇(LDL-C)达标率。结果治疗后,两组患者的血脂水平较治疗前均下降,但差异无统计学意义(P>0.05)。治疗后,两组患者肝功能、肾功能指标比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的LDL-C达标率较治疗前均升高,且B组升高更为显著;各组治疗前后LDL-C达标率比较,差异均有统计学意义(P<0.05)。结论高剂量与常规剂量的阿托伐他汀均对冠心病患者有降脂疗效,对于血脂不达标的患者,高剂量阿托伐他汀对LDL-C达标率提高得更为显著,对患者的肝肾功能无显著影响,且安全性良好。     

阿托伐他汀联合依折麦布对高血压合并糖尿病患者NT-proBNP和炎症指标的影响

目的探讨应用阿托伐他汀联合依折麦布与单用阿托伐他汀强化降脂对高血压合并糖尿病患者血脂,NT-proBNP、MMP-9和hs-CRP血浆浓度的影响。方法将在我院确诊的高血压合并糖尿病同时具有高脂血症患者100例随机分为A、B两组,各50例。A组采用饮食控制加阿托伐他汀20mg联合依折麦布10mg治疗6周,B组采用饮食控制加阿托伐他汀40mg,6周后比较两组之间血脂,NT-proBNP和MMP-9、hs-CRP血浆浓度的变化。结果 A组血脂降低明显（t=2.12,P=0.041）,且A组较B组降低hs-CRP、MMP-9的血浆浓度更明显（t=4.34,P=0.005）。但B组NT-proBNP较A组改善明显（t=-2.2,P=0.056;t=-3.12,P=0.03）,有统计学意义。结论虽然阿托伐他汀组联合依折麦布较阿托伐他汀组能降低高脂血症及炎症反应,但是阿托伐他汀组较阿托伐他汀联合依折麦布组对NT-proBNP影响更明显。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.