BACKGROUND Upper gastrointestinal bleeding(UGIB) after an acute myocardial infarction(AMI) is not an uncommon complication. Acute UGIB caused by Mallory-Weiss syndrome(MWS) is usually a dire situation with massive ble...BACKGROUND Upper gastrointestinal bleeding(UGIB) after an acute myocardial infarction(AMI) is not an uncommon complication. Acute UGIB caused by Mallory-Weiss syndrome(MWS) is usually a dire situation with massive bleeding and hemodynamic instability. Acute UGIB caused by MWS after an AMI has not been previously reported.CASE SUMMARY A 57-year-old man with acute inferior wall ST elevation myocardial infarction underwent a primary coronary intervention of the acutely occluded right coronary artery. Six hours after the intervention, the patient had a severe UGIB,followed by vomiting. His hemoglobin level dropped from 15.3 g/d L to 9.7 g/d L. In addition to blood transfusion and a gastric acid inhibition treatment,early endoscopy was employed and MWS was diagnosed. Bleeding was stopped by endoscopic placement of titanium clips.CONCLUSION Bleeding complications after stent implantation can pose a dilemma. MWS is a rare but severe cause of acute UGIB after an AMI that requires an early endoscopic diagnosis and a hemoclip intervention to stop bleeding.展开更多
Acute myocardial infarction is the main cause of human death.Traditional Chinese medicine,as an important part of the wisdom of the Chinese nation,plays an important role in the treatment of myocardial infarction.Comb...Acute myocardial infarction is the main cause of human death.Traditional Chinese medicine,as an important part of the wisdom of the Chinese nation,plays an important role in the treatment of myocardial infarction.Combining the latest research on the treatment of acute myocardial infarction with traditional Chinese medicine and related literature reports,it summarizes the theories and treatments of traditional Chinese medicine,aiming to provide clinicians with ideas and references in clinical diagnosis and treatment.展开更多
Objectives To examine effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI) in vitro, and the IL-6 concentration in superna...Objectives To examine effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI) in vitro, and the IL-6 concentration in supernatant was also examined. Methods Patients with AMI (n=40) and with stable coronary heart disease (CHD) (n=18) were registered. Peripheral blood monocytes from all participants were isolated and cultured for 24 hrs, but those from patients with AMI were randomly exposed to various concentration of atorvastatin (0, 0.1, 1, 10 μmol/L) during the cultivation. COX-2 mRNA expression in monocytes was analyzed by reverse transcription polymerase chain reaction (RT-PCR). Concentration of IL-6 in supernatant was measured by enzyme-linked immunosorbent assay (ELISA). Results COX-2 expression and IL-6 secretion by peripheral blood monocytes from patients with AMI (0.92±0.13, 205±46 pg/ml) were higher than that from controls (0.19±0.08, 41±8 pg/ml) (both P<0.05), and COX-2 expression was dramatically reduced up to 52% by atorvastatin (P<0.05), in a concentration-dependent manner respectively. The expression of COX-2 from patients with AMI was obviously correlated with the secretion of IL-6 (r=0.636, P<0.05). COX-2 expression in the monocytes after intervention of atorvastatin was also positively correlated with IL-6 secretion by these cells (r=0.783, P<0.05). Conclusions COX-2 involves inflammatory respond in early-stage of AMI. Atorvastatin may decrease COX-2 expression in peripheral blood monocytes from patients with AMI and cyclooxygenase-dependent pathway might be correlated with the anti-inflammation mechanism of statin.展开更多
Objective:To investigate the treatment and prevention of acute myocardial infarction after colon cancer surgery.Methods:A patient with acute anterior myocardial infarction who underwent stent implantation in the Seven...Objective:To investigate the treatment and prevention of acute myocardial infarction after colon cancer surgery.Methods:A patient with acute anterior myocardial infarction who underwent stent implantation in the Seventh Affiliated Hospital,Sun Yat-sen University in 2017 was selected as the subject.The patient was admitted to the emergency department for stent implantation and took antiplatelet and lipid regulating drugs orally on time after the operation.The patient also had a history of colon cancer.The lesion was resected,and the complication after operation was acute myocardial infarction.After active and effective treatment and intervention,the treatment effect of the patient was analyzed.Results:Urgent PTCA was performed,and 0.5 mg Tirofiban was injected into the coronary artery.The results of angiography showed that the blood flow of anterior descending branch recovered to grade 2.Conclusion:The condition of patients with myocardial infarction after colon cancer surgery changes rapidly.Surgery combined with drug treatment can achieve a good prognosis,reduce mortality,and improve patients’cardiac function.展开更多
目的探讨宿迁地区基层胸痛中心发病至送达胸痛中心大门(symptom onset to door,StoD)时间的影响因素及对策。方法选择2022年1月—2023年6月宿迁市中西医结合医院胸痛中心收治的81例急性心肌梗死患者为研究对象。根据患者StoD时间分为≤...目的探讨宿迁地区基层胸痛中心发病至送达胸痛中心大门(symptom onset to door,StoD)时间的影响因素及对策。方法选择2022年1月—2023年6月宿迁市中西医结合医院胸痛中心收治的81例急性心肌梗死患者为研究对象。根据患者StoD时间分为≤6 h组50例与>6 h组31例。统计人口学资料以及相关影响因子,利用单因素分析与多因素logistic回归分析胸痛中心StoD时间的影响因素。结果2组疼痛程度评分、通过120入院还是自行来院、社区医生是否通过网络将心电图结果传输至胸痛中心、发病症状是否典型、家属态度是否积极、有无心血管疾病危险因素、是否夜间发病、发病地点与就诊医院的距离等指标比较,差异有统计学意义(P<0.05)。单因素分析及多因素logistic回归分析显示,自行来院、发病症状不典型、有心血管疾病危险因素、夜间发病、发病地点与就诊医院距离远均是胸痛中心StoD时间的危险因素,家属态度积极为保护因素(P<0.05)。结论基层胸痛中心StoD时间受患者来院途径、症状表现以及发病时间等影响,而家属积极态度有利于缩短StoD时间,需提高家属对疾病的认识,发挥区域诊疗中心协同救治的作用,缩短StoD时间及提高救治效率。展开更多
基金Supported by National Natural Science Foundation of China,No.81570360Beijing Lisheng Cardiovascular Grant,No.LHJJ201612425
文摘BACKGROUND Upper gastrointestinal bleeding(UGIB) after an acute myocardial infarction(AMI) is not an uncommon complication. Acute UGIB caused by Mallory-Weiss syndrome(MWS) is usually a dire situation with massive bleeding and hemodynamic instability. Acute UGIB caused by MWS after an AMI has not been previously reported.CASE SUMMARY A 57-year-old man with acute inferior wall ST elevation myocardial infarction underwent a primary coronary intervention of the acutely occluded right coronary artery. Six hours after the intervention, the patient had a severe UGIB,followed by vomiting. His hemoglobin level dropped from 15.3 g/d L to 9.7 g/d L. In addition to blood transfusion and a gastric acid inhibition treatment,early endoscopy was employed and MWS was diagnosed. Bleeding was stopped by endoscopic placement of titanium clips.CONCLUSION Bleeding complications after stent implantation can pose a dilemma. MWS is a rare but severe cause of acute UGIB after an AMI that requires an early endoscopic diagnosis and a hemoclip intervention to stop bleeding.
文摘Acute myocardial infarction is the main cause of human death.Traditional Chinese medicine,as an important part of the wisdom of the Chinese nation,plays an important role in the treatment of myocardial infarction.Combining the latest research on the treatment of acute myocardial infarction with traditional Chinese medicine and related literature reports,it summarizes the theories and treatments of traditional Chinese medicine,aiming to provide clinicians with ideas and references in clinical diagnosis and treatment.
基金We acknowledge the help from Wei LI, Yang WANG and Yan-Yan ZHAO （Medical Research ＆ Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Disease, China） with the statistical analyses. This work was supported by the National Natural Science Foundation of China （No. 81470485）, Capital Clinical Featured Application Research Project （No. z151100004015175）, and CAMS Innovation Fund for Medical Sciences （CIFMS 2016-I2M- 1-009）. The authors have no potential conflict of interest to declare.
文摘Objectives To examine effect of atorvastatin on the expression of COX-2 in peripheral blood monocytes from patients with early stage of acute myocardial infarction (AMI) in vitro, and the IL-6 concentration in supernatant was also examined. Methods Patients with AMI (n=40) and with stable coronary heart disease (CHD) (n=18) were registered. Peripheral blood monocytes from all participants were isolated and cultured for 24 hrs, but those from patients with AMI were randomly exposed to various concentration of atorvastatin (0, 0.1, 1, 10 μmol/L) during the cultivation. COX-2 mRNA expression in monocytes was analyzed by reverse transcription polymerase chain reaction (RT-PCR). Concentration of IL-6 in supernatant was measured by enzyme-linked immunosorbent assay (ELISA). Results COX-2 expression and IL-6 secretion by peripheral blood monocytes from patients with AMI (0.92±0.13, 205±46 pg/ml) were higher than that from controls (0.19±0.08, 41±8 pg/ml) (both P<0.05), and COX-2 expression was dramatically reduced up to 52% by atorvastatin (P<0.05), in a concentration-dependent manner respectively. The expression of COX-2 from patients with AMI was obviously correlated with the secretion of IL-6 (r=0.636, P<0.05). COX-2 expression in the monocytes after intervention of atorvastatin was also positively correlated with IL-6 secretion by these cells (r=0.783, P<0.05). Conclusions COX-2 involves inflammatory respond in early-stage of AMI. Atorvastatin may decrease COX-2 expression in peripheral blood monocytes from patients with AMI and cyclooxygenase-dependent pathway might be correlated with the anti-inflammation mechanism of statin.
文摘Objective:To investigate the treatment and prevention of acute myocardial infarction after colon cancer surgery.Methods:A patient with acute anterior myocardial infarction who underwent stent implantation in the Seventh Affiliated Hospital,Sun Yat-sen University in 2017 was selected as the subject.The patient was admitted to the emergency department for stent implantation and took antiplatelet and lipid regulating drugs orally on time after the operation.The patient also had a history of colon cancer.The lesion was resected,and the complication after operation was acute myocardial infarction.After active and effective treatment and intervention,the treatment effect of the patient was analyzed.Results:Urgent PTCA was performed,and 0.5 mg Tirofiban was injected into the coronary artery.The results of angiography showed that the blood flow of anterior descending branch recovered to grade 2.Conclusion:The condition of patients with myocardial infarction after colon cancer surgery changes rapidly.Surgery combined with drug treatment can achieve a good prognosis,reduce mortality,and improve patients’cardiac function.
