急性心肌梗死自溶现象及其影响因素分析

目的分析急性心肌梗死（AMI）梗死相关血管（IRA）的自溶（SR）现象,探讨SR现象的影响因素。方法连续观察205例未予静脉溶栓治疗,直接行急诊冠状动脉造影的AMI患者,根据TIMI血流分为自溶组（前向血流TIMI 2-3级）和非自溶组（前向血流TIMI 0-1级）,分析其临床和造影特点,并寻求发生SR的影响因素。结果自溶组共49例（23.9%）。与非自溶组比较,一般临床情况差异无统计学意义（P〉0.05）,但自溶组发生梗死前心绞痛的比例较高（38.8%比22.4%,P〈0.05）。而非自溶组多支病变和存在侧支循环的比例高于自溶组（P〈0.05）。Logistic回归分析则提示多支病变和侧支循环是发生SR现象的独立影响因素。结论SR是AMI患者较常见的现象,其独立影响因素是多支病变和侧支循环。     

护理干预对冠心病患者生活质量的影响

目的观察护理干预对冠心病患者生活质量的影响。方法将100例老年冠心病患者随机分为干预组和对照组,每组各50例。两组均实施常规护理,干预组在此基础上给予健康教育、康复训练、心理护理等护理干预,并于护理干预8w末采用西雅图心绞痛调查量表进行评估分析。结果护理干预8w末,干预组西雅图心绞痛调查量表躯体活动受限程度评分显著高于对照组（P〈0．05）;治疗满意程度、疾病认识程度和总分评分显著高于对照组（P〈0．01）。结论对冠心病患者实施完善的护理干预体系可提高患者的生活质量。     

In-Hospital Patient Education Markedly Reduces Alcohol Consumption after Alcohol-Induced Acute Pancreatitis

Although excessive alcohol consumption is by far the most frequent cause of recurrent acute pancreatitis (AP) cases, specific therapy is still not well established to prevent recurrence. Generally, psychological therapy (e.g., brief intervention (BI)) is the cornerstone of cessation programs; however, it is not yet widely used in everyday practice. We conducted a post-hoc analysis of a prospectively collected database. Patients suffering from alcohol-induced AP between 2016 and 2021 received 30 min BI by a physician. Patient-reported alcohol consumption, serum gamma-glutamyl-transferase (GGT) level, and mean corpuscular volume (MCV) of red blood cells were collected on admission and at the 1-month follow-up visit to monitor patients’ drinking habits. Ninety-nine patients with alcohol-induced AP were enrolled in the study (mean age: 50 ± 11, 89% male). A significant decrease was detected both in mean GGT value (294 ± 251 U/L vs. 103 ± 113 U/L, p < 0.001) and in MCV level (93.7 ± 5.3 U/L vs. 92.1 ± 5.1 U/L, p < 0.001) in patients with elevated on-admission GGT levels. Notably, 79% of the patients (78/99) reported alcohol abstinence at the 1-month control visit. Brief intervention is an effective tool to reduce alcohol consumption and to prevent recurrent AP. Longitudinal randomized clinical studies are needed to identify the adequate structure and frequency of BIs in alcohol-induced AP.     

Comparing Digital Therapeutic Intervention with an Intensive Obesity Management Program: Randomized Controlled Trial

In this study, we evaluated whether the digital program Vitadio achieves comparable results to those of an intensive in-person lifestyle intervention in obesity management. This is a 12-month prospective, randomized controlled trial. Obese patients with insulin resistance, prediabetes or type 2 diabetes were included. The intervention group (IG) used Vitadio. The control group (CG) received a series of in-person consultations. Body weight and various metabolic parameters were observed and analyzed with ANOVA. The trial is ongoing and the presented findings are preliminary. Among 100 participants (29% men; mean age, 43 years; mean BMI, 40.1 kg/m²), 78 completed 3-month follow-up, and 51 have completed the 6-month follow-up so far. Participants significantly (p < 0.01) reduced body weight at 3 months (IG: −5.9 ± 5.0%; CG: −4.2 ± 5.0%) and 6 months (IG: −6.6±6.1%; CG: −7.1 ± 7.1%), and the difference between groups was not significant. The IG achieved favorable change in body composition; significant improvement in TAG (−0.6 ± 0.9 mmol/l, p < 0.01), HDL (0.1 ± 0.1%, p < 0.05), HbA1c (−0.2 ± 0.5%, p < 0.05) and FG (−0.5 ± 1.5 mmol/l, p < 0.05); and a superior (p = 0.02) HOMA-IR reduction (−2.5 ± 5.2, p < 0.01). The digital intervention achieved comparable results to those of the intensive obesity management program. The results suggest that Vitadio is an effective tool for supporting patients in obesity management and diabetes prevention.     

Effect of Clopidogrel on Platelet Membrane CD40 Ligand in Coronary Artery Disease Patients Undertaking Percutaneous Coronary Intervention

Objectives To investigate the change and clinical significance of clopidogrel on platelet membrane CD40L in coronary artery disease patients before and after percutaneous coronary intervention(PCI). Methods 30 cases who were diagnosis coronary artery diseases(CAD) by coronary angiography, mean age 56±9 years old. All the patients who had no antiplatelet aggregation contraindication, were treated with standard anti angina pectoris drugs. Before PCI, all the patients took clopidogrel 75 mg per day. Activated platelet membrane CD40L express rate was measured by flow cytometry before and after PCI 6 hours. Results Activated platelet membrane CD40L express rate were 3.73±2.15 and 2.46±0.90, respectively in 30 patients before and after PCI 6 hours. Activated platelet membrane CD40L express rate was significantly decrease after PCI 6 hours than that before PCI(P<0.01). Conclusions Clopidogrel has significance effect on platelet membrane CD40L in coronary artery disease patients undergoing PCI. Clopidogrel can suppression platelet activation and prevent thromboembolism event occurrence.     

抗炎-中药治疗动脉粥样硬化的有效途径

动脉粥样硬化发病机制的“炎症-损伤-反应”学说得到广泛支持和认可。炎性反应贯穿于动脉粥样硬化发生、发展的整个过程，并与急性心脑血管事件的发生密切相关；干预AS炎症反应可能是中药治疗动脉粥样硬化的有效途径。本文从动脉粥样硬化发生、发展过程的病理基础角度，总结了炎性反应在动脉粥样硬化形成早期、进展期、成熟期、破裂期的重要作用，并提出了从抗炎角度研究、筛选、治疗动脉粥样硬化中药的思路和方法。     

肝气郁结型亚健康的客观化四诊信息提取及社区干预研究

目的:对肝气郁结型亚健康状态干预效果的四诊客观化评价。方法:选择肝气郁结型亚健康状态人群为研究对象,分为实验组和对照组,使用四诊合参辅助诊疗系统采集四诊信息,并运用中医养生气功八段锦对其进行3个月的干预,干预后再次采集信息,并评价干预效果。结果:按照评分标准计算,干预前后症状改善明显(P<0.05),与对照组相比同样也有显著差异(P<0.05);脉诊指下感觉柔和,趋于平变,脉图也趋于平变。结论:四诊客观化评价可以应用于亚健康干预研究中,以此为基础,根据各型亚健康状态的特点,进一步制定和规范干预方法和检测手段,为大范围的推广奠定基础。