Background The clinical efficacy and safety of adjunctive thrombus aspiration （TA） in patients with ST-segment elevation myocardial infarction （STEMI） during percutaneous coronary intervention （PCI） remain contr...Background The clinical efficacy and safety of adjunctive thrombus aspiration （TA） in patients with ST-segment elevation myocardial infarction （STEMI） during percutaneous coronary intervention （PCI） remain controversial. Methods Twenty five eligible randomized controlled trials were included to compare the use of thrombus aspiration （TA） with PCI and PCI-only for STEMI. The primary endpoint was all-cause mortality and death. The secondary endpoints were major adverse cardiac events （MACE）, recurrent infarction （RI）, target vessel revascularization （TVR）, stent thrombosis （ST）, perfusion surrogate markers and stroke. Results TIMI flow grade 3 and MBG 2-3 were significantly increased in the TA plus PCI arm compared with the PCI-only arm [relative risk （RR）： 1.05, 95% confidence intervals （CI）： 1.02-1.09, P = 0.004] and （RR： 1.68, 95% CI： 1.40-2.00, P 〈 0.001）, respectively. There were no significant differences in all-cause mortal- ity, MACEs, TVR and ST rates between the two groups. The RI rate was lower in the TA plus PCI arm than that in the PCI-only arm with short-term follow-up duration （RR： 0.60, 95% CI： 0.38-0.96, P = 0.03）, but there was no significant difference in RI incidence over the me- diumor long-term follow-up periods （RR： 1.00, 95% CI： 0.77-1.29, P = 0.98）, and （RR： 0.96, 95% CI： 0.81-1.15, P = 0.69）, respectively. There were statistically significant differences in the rates of crude stroke and stroke over the medium- or long-term follow-up periods and the crude stroke rate in the TA plus PCI （RR： 1.60, 95% CI： 1.08-2.38, P = 0.02） and （RR： 1.43, 95% CI： 1.03-1.98, P = 0.03）, respectively; this was not observed between the two arms during the short-term follow-up period （RR： 1.47, 95% CI： 0.97-2.21, P = 0.07）. Conclusions Routine TA-assisted PCI in STEMI patients can improve myocardial reperfusion and get limited benefits related to the clinical endpoints, which may be associated with stroke risk.展开更多
Background Febuxostat,a novel nonpurine selective inhibitor of xanthine oxidase(XO),may be used in the prevention and management of atrial fibrillation(AF).The purpose of this study was to evaluate the effects of febu...Background Febuxostat,a novel nonpurine selective inhibitor of xanthine oxidase(XO),may be used in the prevention and management of atrial fibrillation(AF).The purpose of this study was to evaluate the effects of febuxostat on atrial remodeling in a rabbit model of AF induced by rapid atrial pacing(RAP)and the mechanisms by which it acts.Methods Twenty-four rabbits were randomly divided into four groups:sham-operated group(Group S),RAP group(Group P),RAP with 5 mg/kg per day febuxostat group(Group LFP),and RAP with 10 mg/kg per day febuxostat group(Group HFP).All rabbits except those in Group S were subjected to RAP at 600 beats/min for four weeks.The effects of febuxostat on atrial electrical and structural remodeling,markers of inflammation and oxidative stress,and signaling pathways involved in the left atrium were examined.Results Shortened atrial effective refractory period(AERP),increased AF inducibility,decreased mRNA levels of Cav1.2 and Kv4.3,and left atrial enlargement and dysfunction were observed in Group P,and these changes were suppressed in the groups treated with febuxostat.Prominent atrial fibrosis was observed in Group P,as were increased levels of TGF-β1,Collagen I,andα-SMA and decreased levels of Smad7 and eNOS.Treatment with febuxostat attenuated these differences.Changes in inflammatory and oxidative stress markers induced by RAP were consistent with the protective effects of febuxostat.Conclusions This study is the first to find that febuxostat can inhibit atrial electrical and structural remodeling of AF by suppressing XO and inhibiting the TGF-β1/Smad signaling pathway.展开更多
目的探讨生血宝合剂联合蔗糖铁注射液治疗小儿缺铁性贫血的临床疗效。方法选取2014年6月-2018年6月在驻马店市第一人民医院治疗的缺铁性贫血患儿80例,根据用药的不同分为对照组(40例)和治疗组(40例)。对照组静脉滴注蔗糖铁注射液,根据...目的探讨生血宝合剂联合蔗糖铁注射液治疗小儿缺铁性贫血的临床疗效。方法选取2014年6月-2018年6月在驻马店市第一人民医院治疗的缺铁性贫血患儿80例,根据用药的不同分为对照组(40例)和治疗组(40例)。对照组静脉滴注蔗糖铁注射液,根据体质量将适量药物用生理盐水稀释成1∶20,3次/周;治疗组在对照组基础上口服生血宝合剂,5 m L/次,3次/d。两组患者均治疗3月。观察两组患者临床疗效,同时比较治疗前后两组患者红细胞(RBC)、血红蛋白(Hb)、血清铁(S)、铁蛋白(SF)水平,血清γ干扰素(INF-γ)、白细胞介素-2(IL-2)、IL-6和IL-10水平以及QOL量表评分。结果治疗后,对照组临床有效率为80.0%,显著低于治疗组的97.5%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者RBC、Hb、SF、SI、INF-γ、IL-2水平均显著升高(P<0.05),而IL-6和IL-10水平明显降低(P<0.05),且治疗组这些指标变化明显好于对照组(P<0.05)。治疗后,两组患者QOL评分均显著降低(P<0.05),且治疗组患者QOL评分明显低于对照组(P<0.05)。结论生血宝合剂联合蔗糖铁注射液治疗小儿缺铁性贫血效果显著,可有效增加机体RBC、Hb、SF、SI水平,改善INF-γ、IL-2、IL-6、IL-10水平,促进患儿生活质量提高。展开更多
文摘Background The clinical efficacy and safety of adjunctive thrombus aspiration （TA） in patients with ST-segment elevation myocardial infarction （STEMI） during percutaneous coronary intervention （PCI） remain controversial. Methods Twenty five eligible randomized controlled trials were included to compare the use of thrombus aspiration （TA） with PCI and PCI-only for STEMI. The primary endpoint was all-cause mortality and death. The secondary endpoints were major adverse cardiac events （MACE）, recurrent infarction （RI）, target vessel revascularization （TVR）, stent thrombosis （ST）, perfusion surrogate markers and stroke. Results TIMI flow grade 3 and MBG 2-3 were significantly increased in the TA plus PCI arm compared with the PCI-only arm [relative risk （RR）： 1.05, 95% confidence intervals （CI）： 1.02-1.09, P = 0.004] and （RR： 1.68, 95% CI： 1.40-2.00, P 〈 0.001）, respectively. There were no significant differences in all-cause mortal- ity, MACEs, TVR and ST rates between the two groups. The RI rate was lower in the TA plus PCI arm than that in the PCI-only arm with short-term follow-up duration （RR： 0.60, 95% CI： 0.38-0.96, P = 0.03）, but there was no significant difference in RI incidence over the me- diumor long-term follow-up periods （RR： 1.00, 95% CI： 0.77-1.29, P = 0.98）, and （RR： 0.96, 95% CI： 0.81-1.15, P = 0.69）, respectively. There were statistically significant differences in the rates of crude stroke and stroke over the medium- or long-term follow-up periods and the crude stroke rate in the TA plus PCI （RR： 1.60, 95% CI： 1.08-2.38, P = 0.02） and （RR： 1.43, 95% CI： 1.03-1.98, P = 0.03）, respectively; this was not observed between the two arms during the short-term follow-up period （RR： 1.47, 95% CI： 0.97-2.21, P = 0.07）. Conclusions Routine TA-assisted PCI in STEMI patients can improve myocardial reperfusion and get limited benefits related to the clinical endpoints, which may be associated with stroke risk.
基金supported by the Beijing Natural Science Foundation(Z141100002114050)
文摘Background Febuxostat,a novel nonpurine selective inhibitor of xanthine oxidase(XO),may be used in the prevention and management of atrial fibrillation(AF).The purpose of this study was to evaluate the effects of febuxostat on atrial remodeling in a rabbit model of AF induced by rapid atrial pacing(RAP)and the mechanisms by which it acts.Methods Twenty-four rabbits were randomly divided into four groups:sham-operated group(Group S),RAP group(Group P),RAP with 5 mg/kg per day febuxostat group(Group LFP),and RAP with 10 mg/kg per day febuxostat group(Group HFP).All rabbits except those in Group S were subjected to RAP at 600 beats/min for four weeks.The effects of febuxostat on atrial electrical and structural remodeling,markers of inflammation and oxidative stress,and signaling pathways involved in the left atrium were examined.Results Shortened atrial effective refractory period(AERP),increased AF inducibility,decreased mRNA levels of Cav1.2 and Kv4.3,and left atrial enlargement and dysfunction were observed in Group P,and these changes were suppressed in the groups treated with febuxostat.Prominent atrial fibrosis was observed in Group P,as were increased levels of TGF-β1,Collagen I,andα-SMA and decreased levels of Smad7 and eNOS.Treatment with febuxostat attenuated these differences.Changes in inflammatory and oxidative stress markers induced by RAP were consistent with the protective effects of febuxostat.Conclusions This study is the first to find that febuxostat can inhibit atrial electrical and structural remodeling of AF by suppressing XO and inhibiting the TGF-β1/Smad signaling pathway.
文摘目的探讨生血宝合剂联合蔗糖铁注射液治疗小儿缺铁性贫血的临床疗效。方法选取2014年6月-2018年6月在驻马店市第一人民医院治疗的缺铁性贫血患儿80例,根据用药的不同分为对照组(40例)和治疗组(40例)。对照组静脉滴注蔗糖铁注射液,根据体质量将适量药物用生理盐水稀释成1∶20,3次/周;治疗组在对照组基础上口服生血宝合剂,5 m L/次,3次/d。两组患者均治疗3月。观察两组患者临床疗效,同时比较治疗前后两组患者红细胞(RBC)、血红蛋白(Hb)、血清铁(S)、铁蛋白(SF)水平,血清γ干扰素(INF-γ)、白细胞介素-2(IL-2)、IL-6和IL-10水平以及QOL量表评分。结果治疗后,对照组临床有效率为80.0%,显著低于治疗组的97.5%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者RBC、Hb、SF、SI、INF-γ、IL-2水平均显著升高(P<0.05),而IL-6和IL-10水平明显降低(P<0.05),且治疗组这些指标变化明显好于对照组(P<0.05)。治疗后,两组患者QOL评分均显著降低(P<0.05),且治疗组患者QOL评分明显低于对照组(P<0.05)。结论生血宝合剂联合蔗糖铁注射液治疗小儿缺铁性贫血效果显著,可有效增加机体RBC、Hb、SF、SI水平,改善INF-γ、IL-2、IL-6、IL-10水平,促进患儿生活质量提高。
