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简介：BackgroundTheremaybedysregulationofcirculatingmicroRNAsinacutemyocardialinfarction(AMI),whichisanaging-relatedprocess.However,thedifferencebetweenyoungandelderlypeopleinexpressionlevelofcirculatingmiR-21inAMIpatientshasnotbeeninvestigated.MethodsThestudyincluded72consecutivepatientswithAMI.ThegroupIconsistedof43patientsagedequaltoorabove65yearsandthegroupIIconsistedof29patientsagedequaltoorbelow45years.Real-timeRT-PCRwasappliedtodetectserummiR-21expressionlevelsatthetimeofmechanicalreperfusionand12h,D1,D3andD7afterPCI,respectively.ResultsTheexpressionlevelofmiR-21inAMIpatientsincreasedmarkedly12hafterPCIandreachedthepeakatD1afterPCIinbothgroups.TherewasnodifferenceofmiR-21expressionbetweenGroupⅠandⅡatthetimeofmechanicalreperfusion(5.12±0.73vs.4.98±0.87)andD7afterPCI(1.28±0.75vs.1.94±0.89),However,groupⅠpatientsexhibitedhighermiR-21expressionlevelthangroupⅡat12h(7.96±0.78vs.4.23±0.77,P<0.05),D1(9.32±0.89vs.6.12±0.92,P<0.05)andD3(4.78±0.91vs.2.97±0.77,P<0.05)afterPCI,respectively.ConclusionOurdatarevealanincreaseofmiR-21inpatientswithAMImaybeamechanismofmyocardialischemiareperfusioninjury.TheexpressionofmiR-21wasrelatedtothedevelopmentandprogressionofAMI,andthereisanage-relatedchangeintheexpressionofmiR-21inacutemyocardialinfarctionpatients.

简介：没有人会喜欢疼痛，但疼痛又是很重要的。疼痛是身体发出的一个信号，告诉我们可能身体的哪个部分出问题了．或许你对自己的身体情况有足够的了解，知道这些疼痛是因为昨天干了重活．或者是吃得太多。但如果疼痛比较严重而且引起疼痛的原因又不是那么清楚的时候．你内心的挣扎就开始了：

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简介：射频消融术作为一种成熟的治疗技术在临床应用已有近20年的历史，然而它毕竟是一种有创操作，与其有关的各种并发症时有发生，严重者甚至引起死亡。现将我科自开展该手术以来发生的3例猝死病例报告如下。

简介：支架植入术后晚期血栓是经皮冠状动脉支架植入术后的一种较为严重的并发症,可导致患者大面积心肌梗死,甚至猝死。有报道证明,药物洗脱支架（Drugelutingstents,DES）术后未服用或不规则服用双联抗血小板药物治疗,较易发生极晚期血栓。目前,我院有1例DES置入术后7年且规则服用双联抗血小板药物的患者发现血栓形成。据我们所知,这是DES植入后,规则服用双联抗血小板药物,支架内血栓形成的最晚期的报道[1]。

简介：BackgroundAcuterespiratorydistresssyndrome(ARDS)causedbyH7N9influenzainpregnantwomanisalife-threateningeventwithanincreasedriskformaternalandbaby'sdeath.Theaimofthisstudywastoevaluatetheimpactofpoint-of-careultrasonography(POCUS)onthemanagementandprognosisofthesepatients.MethodsAcaseof31-yr-oldpregnantwomaninourhospital,whowasunderwentPOCUSforevaluatingcardiopulmonaryfunctions,volumestate,fluidresponsivenessandultrasound-guidedprocedureswasadmittedtoIntensiveCareUnit(ICU).Weperformedultrasonographydailyformonitoringorganfunctions.Reviewofrelatedliteratureswasalsoconducted.ResultsWiththehelpofPOCUS,wemadequicklydiagnosisofseverepneumoniaandARDScausedbyH7N9influenza.ThetherapieshadalsobeenchangedafterPOCUSexaminations,suchasrestrictfluidadministrationrelyingontheassessmentsoftheinferiorvenacava(IVC)toestimatepreloadandlungultrasoundmonitoringtoidentifytheearlypresenceofextravascularlungwater(EVLW)andavoidfluidoverresuscitation,ultrasound-guidedrecruitmentmaneuvertoimprovedrespiratorydistresssyndrome,andsoon.ConclusionsPOCUShasasignificantimpactondecision-makingandtherapeuticmanagementandshouldbecomeaclinicalroutineinthemanagementofARDSpatientscausedbyH7N9influenzainpregnancy.

简介：目的总结起搏器介导性心动过速患者的临床特征和处理方法。方法回顾性分析7例冠状动脉粥样硬化性心脏病（冠心病）合并起搏器介导性心动过速患者的动态心电图资料及其临床处理方法。结果病例1动态心电图显示心房起搏心律，频发室性期前收缩，程控起搏器延长心室后心房不应期，降低高限频率，抗心律失常药物控制室性期前收缩，复查动态心电图无心动过速发生。病例2、3植入双腔起搏器（DDD）后出现心房颤动，将双腔起搏器程控为VVI工作模式，胺碘酮静脉注射及口服转复心房颤动。病例4、5、6、7动态心电图检查显示起搏器介导性心动过速，药物控制心律失常。结论起搏器介导性心动过速是双腔起搏器植入后临床上最重要、最常见的并发症，应及时发现，尽早处理。。

简介：窦性心律时心电图出现的一种新的旁道现象假性ICRBBB.

简介：ObjectivesToevaluatetheeffectsofn-3fattyacidsonthecoronaryheartdiseasepatients.MethodsFromSeptember2007toMarch2008,60patientswithcoronaryheartdiseasewererandomlyassignedton-3fattyacidsgroup(groupN)andcontrolgroup(groupC).BothgroupsreceivedstandardcoronaryarterydiseasesecondarypreventiontreatmentandgroupNalsoreceivedeicosapentaenoicacid(EPA)1.8gplusdocosahexaenoicacid(DHA)1.2gperdayfor12weeks.Plasmatriacylglycerols,totalcholesterol,low-densitylipoproteincholesterol(LDL-C),high-densitylipoproteincholesterol(HDL-C)andbloodpressureweremeasuredbeforeandafterthestudy.ResultsPlasmatriacylglycerols,bloodpressureandLDL-ClevelwereloweringroupNaftern-3fattyacidstreatmentwhilenochangewasfoundingroupC(P<0.05).HDL-Clevelslightlyincreasedandtotalcholesterollevelslightlydecreasedaftern-3fattyacidsbutbothchangewerenotsignificant(P>0.05).ConclusionsN-3fattyacidshavebeneficialeffectsonthecoronaryarterydiseasepatients.

简介：肌纤维发育不良（Fibromusculardysplasia,FMD）是一种非炎症性、非动脉硬化性、阶段性及多灶性的血管病。该病多见于中年女性,主要累及全身中、小动脉,以肾动脉、颈内动脉颅外段和椎动脉多见。主要表现为动脉狭窄和闭塞,也可引起动脉瘤和夹层。其临床表现与受累动脉相关,肾动脉受累可表现为肾性高血压,颈动脉、椎动脉受累可表现为头痛、耳鸣、短暂性脑缺血发作或脑梗死等症状。我院神经内科收治3例肌纤维发育不良伴颅内外血管病变患者,报告于下：

简介：INTRODUCTIONWiththedevelopmentofeconomyandimprovementoflifequality,theincidencesofhypertension,hyper-cholesterolemia,diabetes,obesityandsmokinghavebeenincreasedinChina,whichhasledtoasignificantincreaseinthemorbidityandmortalityofcoronaryarterydisease(CAD)~1.SinceitwasintroducedintoChinain1984,coronaryintervention(PCI)hasdevelopedrapidlyandhasbecomethemajortreatmentofCADbecauseofitsuniquecharacteristicsofminimalinvasiveand

简介：目的比较CT薄层增强扫描与3D-DSA数据源在颅内动静脉畸形（AVM）3D打印数据重组中的效果。方法前瞻性选取5例AVM患者,Spetzler-Martin分级Ⅱ级3例,Ⅲ级2例。对其中2例采用256层螺旋CT薄层增强扫描,3例采用3D-DSA旋转成像,提取检查结果的DICOM原始数据,通过Mimics14.0软件进行数字化处理,并按1∶1比例进行3D打印,获得实体模型并进行效果比较。结果基于256层螺旋CT薄层增强扫描数据源的3D打印可获取颅骨及血管的图像信息,能显示最细直径0.9mm的血管,但AVM内部细支结构难于分辨;基于3D-DSA数据的3D打印,数字减影无颅骨数据信息,但血管分支情况显示更丰富,可显示最细直径0.5mm的血管。结论应用CT薄层增强扫描或3D-DSA数据源均可获得AVM畸形团3D重组图像,而3D-DSA显示AVM畸形团空间构造效果更佳,有助于术前治疗方案的设计及相应辅助工具的开发。

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简介：为了推动我国急诊与危重症医学的全面发展，提升我国院前急救管理和服务水准，探索符合我国院前急救管理和运行的机制，“第3届首都急诊医学高峰论坛”（CFECCM）将于2010年8月27-30日在北京国际会议中心隆重召开。

简介：ObjectivesToinvestigatethechangesofβ3-adrenoceptor(β3-AR)mRNAexpressionintheratswithchronicheartfailure(CHF),andtoexploretheeffectofβblockers(βBs)onβ3mRNAexpression.MethodsThirty-fourratswererandomlydividedintoShamgroup(n=10)andheartfailuregroup(n=24).Ratmodelwasestablishedbyaorticconstriction.Thesurvivalratsinheartfailuregroupweredividedintoheartfailurecontrolgroup(HFgroup,n=6),metoprololgroup(METgroup,n=8)andcarvedilolgroup(CARgroup,n=8)threemonthsafteroperation.Metoprololtartartewasstartedorallywith12mg·kg-1·d-1,carvedilolwith6mg·kg-1·d-1,isometricsalinewasstartedinHFgroup.Afterthreemonthsofdrugtherapy,measurementofhemodynamics,indexofventricularmass,thelevelofβ3-ARmRNAexpressionwereperformed.ResultsComparedwithShamgroup,leftventricularendsystolicpressure(LVESP),andtheabsolutevaluesofmaximalrateofriseandfall(±dp/dtmax)ofleftventricularpressurewereallsignificantlydecreased(P<0.01),leftventricularenddiastolicpressure(LVEDP)wassignificantlyincreasedinHFgroup(P<0.01).ThehemodynamicparameterswereimprovedbyβBs,andcarvedilolwasmoreeffectivethanmetoprolol(P<0.01).TheindexofventricularmasswashigherinHFgroupthanMETgroup,CARgroupandShamgroup(P<0.01).βBssignificantlydecreasedtheindexofleftventricularmass(LVMI),andCarvedilolwasmoreeffectivethanmetoprolol(P<0.01).Theindexofrightventricularmass(RVMI)didnotchangeinMETgroup(P>0.05),butsignificantdecreasecouldbeseeninCARgroup(P<0.01).Thelevelofβ3-ARexpressioninleftventriclewasgreaterthanthatinrightventriclewhetherinthefailingheartorinthenon-failingheart.ComparedwithShamgroup,thelevelofβ3-ARmRNAexpressionwassignificantlyincreasedinHFgroup(P<0.01).Thelevelsofβ3-ARmRNAexpressionshowedaremarkabledecreaseinCARgroup(P<

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简介：心力衰竭是一种常见病,亦是老年人常见的住院原因,严重心脏衰竭的病人,经常反复地在医院内进进出出,生活质量非常低,心衰也是引起老年人死亡的主要原因之一。富含欧米加-3脂肪酸的鱼类有鲑鱼、金枪鱼、鲭鱼、鲱鱼、沙丁鱼等,而且已经有充足的研究表明:欧米加-3脂肪酸有助于保护心脏。防止心脏病及中风的发作。

简介：3D打印技术被制造业誉为第三次工业革命,在21世纪已经在许多领域都展现了巨大的价值和潜力,在医学领域如骨科、口腔科、整形外科、神经外科等都得到了广泛的应用.3D打印的开展应用也为血管疾病的诊治提供了新的方法,本文综述介绍3D打印技术在血管疾病诊治中的应用现状及未来发展趋势.