放射CT血管造影在冠状动脉疾病诊断的应用

分析放射CT血管造影在冠状动脉疾病诊断的作用。方法 在2022年12月-2023年8月期间以我院接收的冠状动脉疾病患者360例,平均分为两组,各180例,对照组采用3mm造影重建检查,观察组采用1mm造影重建检查进行诊断,对比两组患者的诊断结果。结果 将两组患者的诊断结果进行对比,结果 显示观察组与对照组对比有差异(P<0.05),1mm造影重建的诊断优于3mm造影重建,有统计学意义。结论 使用1mm造影重建检查能够有效地有效地诊断冠状动脉疾病,值得临床重视和推广。

OPT-CAD评分对行直接PCI术后急性心肌梗死患者缺血事件风险的预测研究

目的评价中国冠状动脉疾病患者的最佳抗血小板治疗(OPT-CAD)评分对接受直接经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者出院后12个月缺血事件风险的预测价值。方法选取2016年3月—2019年3月由中国人民解放军北部战区总医院心血管内科收治的1953例AMI行直接PCI患者为研究对象。根据OPT-CAD评分进行分组,将患者分为低风险组(OPT-CAD评分<90分)541例和中高风险组(OPT-CAD评分≥90分)1412例。所观察的主要结局事件是出院后12个月内的缺血事件,包括心源性死亡、心肌梗死及卒中。次要结局事件为12个月内缺血事件的各独立组成成分及全因死亡。绘制受试者工作特征(ROC)曲线,评价OPT-CAD评分对患者院后12个月内(出院后3、6、9、12个月)缺血事件的预测价值。结果与低风险组患者比较,中高风险组患者12个月的缺血事件、心源性死亡及全因死亡发生率显著增加(P<0.05)。OPT-CAD评分预测患者出院后3、6、9、12个月缺血事件的曲线下面积(AUC)分别为0.767(95%CI:0.701,0.832)、0.769(95%CI:0.709,0.828)、0.756(95%CI:0.700,0.812)、0.764(95%CI:0.710,0.818),均>0.75。OPT-CAD评分预测患者出院后3个月缺血事件的临界值为125分,敏感性为71%(95%CI:0.596,0.827),特异性为73%(95%CI:0.707,0.747);6个月缺血事件的临界值为124分,敏感性为72%(95%CI:0.614,0.827),特异性为72%(95%CI:0.696,0.737);9个月缺血事件的临界值为123分,敏感性为71%(95%CI:0.609,0.806),特异性为70%(95%CI:0.680,0.721);12个月缺血事件的临界值为123分,敏感性为71%(95%CI:0.626,0.816),特异性70%(95%CI:0.681,0.723)。结论OPT-CAD评分可以准确且稳定地预测行直接PCI的AMI患者出院后12个月内缺血事件的风险。

NLR及OPT-CAD评分在急性STEMI介入术后发生心血管不良事件的预测价值

目的探讨中性粒细胞与淋巴细胞比值(NLR)、中国冠状动脉疾病患者的最佳抗血小板治疗(OPT-CAD)评分在预测急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后住院期间主要不良心血管事件(MACE)发生的价值。方法选取2019年1月至2021年5月就诊于界首市人民医院,接受急诊PCI治疗的200例STEMI患者,根据有无MACE的发生,分为有MACE组(34例)和无MACE组(166例)。比较两组性别、年龄、血检指标等基础资料,血小板淋巴细胞比值(PLR)、NLR、OPT-CAD评分等指标。应用多因素Logistic回归分析STEMI患者住院期间发生MACE的危险因素。通过受试者工作(ROC)曲线分析,评估在急性STEMI患者住院期间,独立和联合使用NLR、OPTCAD评分对MACE的预测价值。结果在200例STEMI患者中,有34例出现院内MACE,其中有MACE组的年龄、PLR、NLR、OPT-CAD评分均高于无MACE组,多因素Logistic分析提示OPT-CAD评分是发生院内MACE的独立因素(P<0.05)。ROC曲线提示,NLR及OPT-CAD评分对STEMI患者PCI术后发生院内MACE有预测能力(P<0.05),但两者联合曲线下面积较单独曲线相比,其曲线下面积更大,具有更好的预测价值。结论OPT-CAD评分是预测STEMI患者PCI治疗后发生院内MACE的独立危险因素。两者联合对急性心肌梗死患者PCI术后发生院内MACE具有更好的预测价值。

Prognostic performance of interleukin-10 in patients with chest pain and mild to moderate coronary artery lesions an 8-year follow-up study

Background Interleukin （IL）-10, IL-6 and their ratio （IL-6/IL-10） play an important role in the risk of developing coronary artery disease, and may correlate with its outcomes. Few clinical trials have investigated the prognostic impact of these factors on long-term car- diovascular events in patients presented with chest pain. Methods A prospective study was performed on 566 patients admitted with chest pain and identified mild to moderate coronary artery lesions. 1L-10, IL-6 and IL-6/IL-10 were measured. Results A total of 511 patients com- pleted the follow-up. The median follow-up time was 74 months. Kaplan-Meier analysis demonstrated a clear increase of the incidence of major adverse cardiac events during the follow-up period in patients with below-median levels of IL-10 （P = 0.006） and above-median levels of IL-6/IL-10 （P = 0.012）. Multivariate Cox proportional hazards analysis indicated the IL-10 levels to be strong independent predictors after adjustment for underlying confounders. Conclusions Elevated IL-10 levels are associated with a more favorable long-term prognosis in patients with chest pain and mild to moderate coronary artery lesions. IL-10 could be used for early risk assessment of long-term prognosis.

Predictors of new-onset atrial fibrillation in elderly patients with coronary artery disease after coronary artery bypass graft

Objective To identify the factors associated with the development of postoperative atrial fibrillation （POAF） after coronary artery bypass graft （CABG） in elderly patients with coronary artery disease （CAD）. Methods A total of 81 patients with CAD who underwent CABG were enrolled in the study. Patients were divided into two groups： Group 1, without postoperative atrial fibrillation （59 patients, 74.6% men, mean age 65.8 ~ 4.0 years）; Group 2, with early new-onset atrial fibrillation after CABG （22 patients, 90.9% men, mean age 67.7 ＋ 5.4 years）. Interleukin （IL）-6, IL-8, IL-10, C-reactive protein （CRP）, fibrinogen, superoxide dismutase （SOD）, N-terminal pro-B-type natriuretic peptide （NT-proBNP）, and troponin I were studied. Results During the observation period, atrial fibrillation occurred in 27.2% cases, an average of 4.9 ±3.8 days after surgery. In group 2, the left atrium （LA） dimension was larger than in group 1 （43.9 ± 3.4 mm vs. 37.6 ±3.9 rnm, P 〈 0.001）. Patients with POAF had significantly higher IL-6 （72.7 ±60.8 pg/mL vs. 38.0 ± 34.6 pg/mL, P = 0.04）, IL-8 （11.9 ± 6.0 pg/mL vs. 7.7± 5.4 pg/mL, P = 0.01） and SOD （2462.0 ± 2029.3 units/g vs. 1515.0 ± 1292.9 units/g, P = 0.04） compared with group without POAF. The multivariate analysis showed that the odds ratio （OR） for POAF development in patients with left atrium more than 39 mm was 2.1 [95% confidence interval （CI）： 1.2-3.8, P = 0.0004], IL-6 levels more than 65.18 pg/mL-1.4 （95% Ch 1.1-2.7, P = 0.009）, IL-8 levels more than 9.67 pg/mL-1.2 （95% CI： 1.1-3.7, P ： 0.009）, SOD more than 2948 units/g-1.1 （95% Ch 1.01-2.9, P = 0.04）. Conclusions In our study, the independent predictors of postoperative atrial fibrillation after CABG in elderly patients were left atrium dimension and the increased postoperative concentration of IL-6, IL-8 and superoxide dismutase.

Correlation between serum free fatty acids levels and Gensini score in elderly patients with coronary heart disease

Objectives To investigate the relationship between serum fxee fatty acids （FFAs） levels and the severity of coronary artery lesions in elderly patients with coronary heart disease （CAD）. Methods A total of 172 elderly patients who underwent coronary angiography were divided into CAD group （n = 128） and non-CAD group （n = 44） according to the results of coronary angiography. Serum FFAs and lipid levels were measured and the Gensini score were calculated. Results No matter the differences between age, gender and the usage of stat- ins or not, there was no statistical significance in FFAs levels （P 〉 0.05）. In terms of the Gensini score, it was higher in patients aged 70-79 years than in patients 60-69 years old [15.00 （5.00, 34.00） vs. 10.00 （2.00, 24.00）, P 〈 0.05], higher in men than women [14.00 （4.00, 34.00） vs. 7.00 （2.50, 19.75）, P 〈 0.05], and higher in patients on statins [13.50 （4.25, 33.50）vs. 6.50 （2.00, 18.00）, P 〈 0.05]. The serum FFAs lev- els [449.50 （299.00, 624.75） mEq/L vs. 388.00 （258.50, 495.25） mEq/L, P 〈 0.05J and Gensini score [17.50 （8.00, 41.75） vs. 1.00 （0, 5.00）, P 〈 0.05] were higher in the CAD group than in the non-CAD group. In the CAD group, there was no statistical significance in FFAs levels among patients with different numbers of diseased coronary vessels （P 〉 0.05）. Furthermore, the FFAs levels were positively correlated with the Gensini score （r = 0.394, P = 0.005）. Regression analysis showed that the FFAs levels were related to the Gensini score independently after adjusting for the other risk factors. Conclusions The serum FFAs levels were associated with the Gensini score in elderly patients with CAD. It might indicate FFAs as a biomarker predicting the severity of coronary artery lesions.

Endovascular management of patients with coronary artery disease and diabetic foot syndrome： A long-term follow-up

Background To investigate the long-term results of global coronary and peripheral interventional treatment of diabetic foot patients. Methods We retrospectively included 220 diabetic patients （78.5 ±15.8 years, 107 females, all with Fontaine Ⅲor Ⅳclass） who were referred to our centre for diabetic foot syndrome and severe limb ischemia from January 2006 to December 2010. Patients were evaluated by a team of interventional cardiologists and diabetologists in order to assess presence of concomitant coronary artery disease （CAD） and eventual need for coronary revascularization. Stress-echo was performed in all patients before diagnostic peripheral angiography. Patients with indications for coronary angiography were submitted to combined diagnostic angiography and then to eventual staged peripheral and coronary interventions. Doppler ultrasonography and foot transcutaneous oximetry of transcutaneous oxygen pressure （TcPO2） before and after the procedure were performed as well as stress-echocardiography and combined cardiologic and diabetic examination at 1 and 6 month and yearly. Results Stress-echocardiography was performed in 94/220 patients and resulted positive in 56 patients who underwent combined coronary and peripheral angiography. In the rest of 126 patients, combined coronary and peripheral angiography was performed directly for concomitant signs and symptoms of coronary heart disease in 35 patients. Coronary revascularization was judged necessary in 85/129 patients and was performed percutaneously after peripheral interventions in 72 patients and surgically in 13 patients. For Diabetic foot interventions the preferred approach was ipsilateral femoral antegrade in 170/220 patients （77.7%） and contralateral cross-over in 40/220 patients （18.8%） and popliteal retrograde ＋ femoral antegrade in 10/220 patients （4.5%）. Balloon angioplasty was performed in 252 legs （32 patients had bilateral disease）： the procedure was successful in 239/252 legs with an immediate success rate of 94.8% and a significant improvement in TcPO2 and ABI with ulcer healing in 233/252 legs （92.4%）. Freedom from major amputation was 82.8% at a mean follow-up of 3.1 ±1.8 years （range 1 to 5 years） whereas survival was 88%. Conclusions Global coronary and peripheral endovascular management of diabetic foot syndrome patients seems to lead to an high immediate success and limb salvage rates and increasing survival compared to historical series.

Coronary revascularization in the elderly with stable angina

A proportion of elderly with coronary artery disease is rapidly growing. They have more severe coronary artery disease, therefore, derive more benefit fi＇om revascularization and have a greater need for it. The elderly is a heterogeneous group, but compared to the younger cohort, the choice of the optimal revascularization method is much more complicated among them. In recent decades, results has improved dramatically both in surgery and percutaneous coronary intervention （PCI）, even in very old persons. Despite the lack of evidence in elderly, it is obvious, that coronary artery bypass surgery （CABG） has a more pronounced effect on long-term survival in price of more strokes, while PCI is certainly less invasive. Age itself is not a criterion for the selection of treatment strategy, but the elderly are often more interested in quality of life and personal independence instead of longevity. This article discusses the factors that influence the choice of the revascularization method in the elderly with stable angina and presents a complex algorithm for making an individual risk-benefit profile. As a consequence the features of CABG and PCI in elderly patients are exposed. Emphasis is centered on the frailty and non-medical factors, including psychosocial, as essential components in making the decision of what strategy to choose. Good communication with the patients and giving them unbiased information is encouraged.

Relationship between red blood cell distribution width and intermediate-term mortality in elderly patients after percutaneous coronary intervention

Background Large-scale clinical research on the relationship between red blood cell distribution width （RDW） and intermediate-term prognosis in elderly patients with coronary artery disease （CAD） is lacking. Thus, this study investigated the effects of RDW on the intermediate-term mortality of elderly patients who underwent elective percutaneous coronary intervention （PCI）. Methods Data from 1891 patients 〉 65 years old underwent elective PCI from July 2009 to September 2011 were collected. Based on preoperative median RDW （12.3%）, the patients were divided into two groups. The low RDW group （RDW 〈 12.3%） had 899 cases; the high RDW group （RDW 〉 12.3%） had 992 cases. The all-cause mortality rates of the two groups were compared. Results Patients in the high RDW group were more likely to be female and accompanied with diabetes, had lower hemoglobin level. The mean follow-up period was 527 days. During follow-up, 61 patients died （3.2%）. The postoperative mortality of the high RDW group was significantly higher than that of the low RDW group （4.3% vs. 2.0%, P = 0.004）. After adjusting other factors, multivariate Cox regression analysis revealed that preoperative high RDW was significantly associated with postoperative all-cause mortality （hazard ratio： 2.301, 95% confidence interval： 1.106-4.785, P = 0.026）. Conclusions Increased RDW was an independent predictor of the increased intermediate-term all-cause mortality in elderly CAD patients after elective PCI.

Positive correlation between plasma PCSK9 and tissue factors levels in patients with angiographically diagnosed coronary artery disease and diabetes mellitus

Background Pro-protein convertase subtilisin/kexin type 9 （PCSK9） is a secreted protein that influences plasma levels of low-density lipoprotein cholesterol （LDL-C）. Both oxidized LDL and tissue factor （TF） contributed to the development of prothrombofic state. The pre- sent study aims to explore the relationship between plasma level of PCSK9 and that of TF in patient with coronary artery disease （CAD）. Methods From July 2013 to March 2014, we enrolled 197 consecutive patients who underwent coronary angiography because of suspected CAD at Beijing Anzhen Hospital in this study. All patients had no history of using lipid-lowering medication. Of these 197 patients （1B 1 male and 66 female, mean age 56.9 ± 11.8 years）, 81 had angiographically diagnosed CAD. Clinical data were collected. Plasma PCSK9 and TF were measured using enzyme-linked immunosorbent assay （ELISA）. Levels of plasma PCSK9 and TF were compared and their correlation analyzed among different patient groups. Results Both plasma levels of PCSK9 （279.8 ± 60.4μg/L vs. 216.5 ± 45.3μg/L, P 〈 0.01） and TF （156.4 ± 26.6 μg/mL vs. 112.1 ± 38.3 μg/L, P 〈 0.01） were significantly higher in patients with CAD, as compared with those with- out CAD. Correlation analysis showed plasma level of PCSK9 was significantly correlated with that of TF in both patients with and without CAD. However, multivariate regression analysis after adjustment for age, gender, smoking, alcohol, hypertension and hyperlipidemia showed that only in CAD patients with type 2 diabetes mellitus, there was significant positive correlation between plasma levels of PCSK9 and TF （β = 0.353, P 〈 0.01）. Coneluslons The plasma level of PCSK9 is independently and positively associated with that of TF in CAD patients with diabetes mellitus, but not in those without diabetes mellitus. Further study is needed to investigate the underlying mechanism.

Patients ≥ 75 years with acute coronary syndrome but without critical epicardial coronary disease： prevalence, characteristics, and outcome

Objective Absence of significant epicardial coronary artery disease （CAD） in patients with acute onset of chest pain and elevation of myocardial necrosis markers is occasionally observed. The aim of this study was to analyse the clinical characteristics and outcome of such patients with advanced age. Methods We retrospectively analysed 4,311 patients with acute onset of chest pain plus necrosis marker elevation. Two hundred and seventy two patients without CAD on angiogram （6.3%） were identified. Out of them, 50 （1.2%） patients 〉 75 years （Group Ⅰ） were compared with （1） 222 acute coronary syndrome （ACS） patients without CAD on angiogram 〈 75 years （Group Ⅱ）, and （2） 610 consecutive patients ≥ 75 years with Non-ST-elevation Myocardial Infarction （NSTEMI） undergoing percutaneous coronary intervention （Group Ⅲ）. Results Group 1 compared to Group III patients made up for more females （64.0% vs. 49.2%; P 〈 0.0001）, and had more severe anginal symptoms on presentation [Canadian Cardiovascular Society （CCS） class Ⅰ/Ⅱ, 26.0% vs. 49.8%; P = 0.02]. Group I patients also had lower troponin levels （0.62 ± 0.8 ng/mL vs. 27 ± 74 ng/mL; P 〈 0.02）, lower leukocyte count （9.4 ± 3.13 × 10^9 vs. 12 ± 5.1 × 10^9; P = 0.001 ） and better preserved left ventricular function （56.7% ± 14.3 % vs. 45% ± 1 1%; P 〈 0.0001 ）. Event-free survival （cardiac death, myocardial infarction, recurrent angina, and re-hospitalisation） was more frequent in Group Ⅰ and Ⅱ patients compared to Group III patients （64.9%, 66.7%, and 41.6%, respectively; P 〈 0.0001）. Conclusions ACS in patients 〉 75 years without CAD is very infrequent, associated with a （1） similar outcome compared to ACS patients 〈 75 years without CAD, and （2） significant better outcome compared to NSTEMI patients 〉 75 years.

Minimally invasive surgical techniques in the era of hybrid coronary revascularization： additional benefits for the elderly patients？

Geriatric patients affected by stable multi-vessel coronary artery disease （CAD） are at the crossroad： they can live with the risks of acute coronary syndrome, malignant arrhythmias or heart failure, or they can undergo a rapid evaluation for myocardial revascularization.

Aortic arch calcification on chest X-ray combined with coronary calcium score show additional benefit for diagnosis and outcome in patients with angina

Background The coronary artery calcium （CAC） and aortic arch calcification （AoAC） are individually associated with cardiovascular disease and outcome. This study investigated the predictive value of AoAC combined with CAC for cardiovascular diagnosis and outcome in patients with angina. Methods A total of 2018 stable angina patients who underwent chest X-ray and cardiac multi-detector computed tomography were followed up for four years to assess adverse events, which were categorized as cardiac death, stroke, myocardial infarction, or repeated revascularization. The extent of AoAC on chest X-ray was graded on a scale from 0 to 3. Results During the four years of fol- low-up, 620 patients were treated by coronary stenting and 153 （7%） adverse events occurred. A higher grade of AoAC was associated with a higher CAC score. Cox regression showed that the CAC score, but not AoAC, were associated with adverse events. In patients with CAC score 〈 400, AoAC showed an additive predictive value in detecting significant coronary artery disease （CAD）. A gradual increases in the risk of adverse events were noted if AoAC was present in patients with similar CAC score. Conclusions As AoAC is strongly correlated with the CAC score regardless of age or gender, careful evaluation of CAD would be required in patients with AoAC on conventional chest X-rays.

Erectile dysfunction as a predictor of asymptomatic coronary artery disease in elderly men with type 2 diabetes

1 Introduction Erectile dysfunction （ED） and coronary artery disease （CAD） are closely linked, as both conditions share the same cardiovascular risk factors. Indeed, these risk factors can determine endothelial dysfunction that represents the common underlying mechanism of both ED and CAD. The prevalence of ED is about three-fold higher among diabetic patients than in the general population and a higher prevalence of CAD has been observed in people with diabetes when compared to non-diabetic subjects.Some studies showed that ED can be a powerful marker of silent CAD and a strong predictor of cardiovascular events in apparently uncomplicated type 2 diabetic patients Therefore ED is now considered as a sentinel symptom of silent CAD, as ED often precedes the onset of myocardial ischemia itself by many years.

Red blood cell level is increased in obese but not in non-obese patients with coronary heart disease

Objective To examine the changes of red blood cell levels in the obese and non-obese patients with coronary heart disease （CHD） and its clinical significance. Methods 230 cases of coronary heart disease were selected and divided into the obese group and the non- obese group. Obesity and non-obesity were defined based on the body mass index （BMI if 28.0kg/m2）, or waist-hip ratio （men〉 0.9, women〉 0.85）. In addition, 130 healthy subjects were recruited as controls. The pathological status of coronary lesions was quantita- tively analyzed according to the Coronary Vascular Image Segmentation Evaluation Criteria （American Heart Association 1984） and the Gensini scoring system. Results of the changes of both the hemoglobin levels and the red blood cell count in the obese group, the non- obese group with CHD and the control group were compared. Besides, Multivariant Logistic Regression Analysis was applied to assess the correlation between the red blood cells and the coronary artery disease. Results The red blood cell count and the level of hemoglobin in the obese group with CHD was higher than that in the non-obese group with CHD [（4.35 ± 0,55） and （4.13 ± 0.56） 10^9/L; （136.71± 15.87） and （129.96 ±16.23） g/L, P 〈 0.05 in both]; the proportion of acute coronary syndrome in the obese group with CHD was higher in the obese group with CI-/D than that in the non-obese group with CHD （P〈0.05）; Multivariant logistic regression analysis also showed that the red blood cell count was positively correlated with obesity with CHD.Conclusion The red blood cell count and the level of hemoglobin in the obese group were higher than those in the non-obese group; the increase of red blood cell count and hemoglobin level is one of the independent risk factors for the obese patients with CHD.

Effect of Liandouqingmai Recipe on life quality and vascular endothelial injury in patients with coronary heart disease

OBJECTIVE:To observe the effects of Liandouqingmai Recipe on life quality and vascular endothelial injury in patients with coronary heart disease.METHODS:Capitalized 101 patients with coronary heart disease were randomly divided into a treatment group(n=45) treated with Liandouqingmai Recipe and a standard treatment group(control group,n=56).A normal group of 16 healthy persons was additionally set up.Changes in ET-1 and NO levels were measured and Seatle Angina Questionnaire(SAQ) was adopted in studying life quality before and after treatment for two weeks.The data were analyzed with SPSS 16.0 statistic software.RESULTS:The average level of ET-1 in the normal group was lower and NO higher than that of patients with coronary heart disease.There was no significant difference in the average level of ET-1 and NO and in the scores of SAQ [physical limitation(PL),pngina stability(AS),apngina frequency(AF),treatment satisfaction(TS) and disease perception(DP)] between the two groups before treatment(P>0.05).But after treatment,the scores of SAQ(PL,AS,AF,TS,DP) and NO level were higher than those in the control group,and ET-1 average level in the treatment group was lower than that in the control group.The negative relations between PL and ET-1 and between AF and ET-1 were found in this study.CONCLUSION:Liandouqingmai Recipe can raise scores of SAQ and NO level and decline ET level in patients with coronary heart disease on the basis of convertional standard treatment,thus improving vascular endothelial function and life quality.Life quality is related to vascular endothelial function.

Therapeutic effect in patients with coronary heart disease based on information analysis from Traditional Chinese Medicine four diagnostic methods

OBJECTIVE:To study information gained by Traditional Chinese Medicine(TCM)four diagnostic methods and characteristics of syndrome development before and after treatment in patients with coronary heart disease,and to probe into assessment indexes of therapeutic effects with distinctive TCM features.METHODS:Information from the four diagnostic methods before and after treatment in 100 patients with coronary heart disease was collected using the TCM interrogation scale,a pulse condition instrument,a tongue-face diagnosis instrument,anda voice diagnosis information collection system.Changes in the four diagnostic method results from before and after treatment were analyzed with frequency analysis and t-test methods.RESULTS:Before treatment,deficiency syndrome complicated with hyperactivity of pathogenic factors was most common.After treatment,deficiency syndrome was most common.This change from complex syndromes to single syndromes indicates disease and syndrome alleviation.Frequencies of symptoms gained by interrogation after treatment for syndrome of deficiency of heart-Qi,syndrome of deficiency of heart-Yin,and turbid phlegm syndrome were all less severe than those before treatment.Parameters of face color,color on all sub-regions of tongue,color of tongue fur,septic and greasy fur,and lip color after treatment all had significant changes.After treatment,part of the voice diagnosis parameters in the deficiency of heart-Yin and turbid phlegm syndromes had significant changes,but no significant changes were found in the deficiency of heart-Qi syndrome.CONCLUSION:Use of the TCM four diagnostic methods can provide an effective basis forTCM syndrome diagnosis,observation of development of state of illness,and evaluation of clinical therapeutic effects.

Recurrence quantification analysis on pulse morphological changes in patients with coronary heart disease

OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （RQA） was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease （CHD） and 37 normal subjects （controls）. An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine （SVM） classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS： RQA measures can be divided into two groups. One group of measures [ecurrence rate（RR）, determinism （DEL）, average diagonal line length （L）, maximum length of diagonal structures （Lmax）, Shannon entropy of the frequency distribu- tion of diagonal line lengths （ENTR）, laminarity （LAM）, average length of vertical structures （TT）, maximum length of vertical structures （Vmax）] showed significantly higher values for patients with CHD than for normal subjects （P〈0.0S）. The other measures （RR_std, L_std, Lmaxstd, TT_std, Vmax_std） showed significantly lower values for the CHD group than for normal subjects （P〈0.05）. SVM classification accuracy was higher with RQA measures： With RQA （16 parameters） accuracy was at 88.21%, and with RQA（12 parameters） accuracy was at 84.11%. In contrast, with classic time-do- main （15 parameters） accuracy was 75.73%, and with time-domain （7 parameters） accuracy was 74.7O%. CONCLUSION： Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.

Effect of Liandouqingmai recipe on quality of life and inflammatory reactions of patients with coronary heart disease

OBJECTIVE: To observe the effect of Liandouqingmai recipe(Chinese herbal medicine compound preparation) on the quality of life(QOL) and inflammatory reaction of patients with coronary heart disease(CHD).METHODS: A total of 101 CHD patients were randomized into two groups: treatment group(n=45)receiving standard treatment for CHD plus Liandouqingmai recipe, and control group(n=56) receiving standard treatment only. The control group contained 16 normal healthy subjects. Changes in hs-C-reactive protein(CRP), peripheral blood leucocytes(PBL), and interleukin(IL)-6 and IL-10 levels were measured. The Seattle Angina Questionnaire(SAQ) was used to determine patient QOL before and after treatment for 2 weeks.RESULTS: Before treatment, SAQ scores [physical limitation(PL), angina stability(AS), angina frequen-cy(AF), treatment satisfaction(TS), and disease perception(DP)] were not statistically different between groups. After treatment, AS and DP levels of controls were significantly increased compared with the other groups, while PL, AS, AF, TS, and DP levels of the treatment group were significantly increased compared with controls. Treatment group SAQ scores(PL, AS, AF, TS, and DP) were significantly higher than for controls. CHD patient IL-6 and IL-10 levels were significantly higher than controls.Before treatment, mean levels of IL-6, hs-CRP and PBL of the two groups were not statistically different. After treatment, mean levels of IL-6, IL-10,hs-CRP and PBL of the two groups were significantly decreased compared with their before treatment values, and levels of IL-6, hs-CRP, and PBL of the treatment group were lower than controls. Although mean IL-10 levels of both groups decreased, there was no significant difference in between-group and in-group comparisons before and after treatment. Mean levels of IL-6 and IL-10 in the normal group were lower than in CHD patients.SAQ scores of QOL were negatively associated with the inflammatory index(IL-6/IL-10), and there was a significant negative association of IL-10 with AS(r=﹣0.15, P<0.05).CONCLUSION: Inflammatory reactions in CHD patients are related to angina status. Coadministration of CHD standard treatment and Liandouqingmai recipe increased patient SAQ scores by decreasing IL-6, IL-10, hs-CRP, and PBL levels in CHD patients, which might inhibit endothelial inflammation to improve patient QOL.