磺达肝癸钠在ST段抬高心肌梗死患者中的应用：药物、策略、环境或皆而有之？

抗栓治疗已成为应对动脉粥样硬化威胁的主要手段，而“动脉粥样硬化血栓形成”则成为心血管领域普遍接受的名称。可以理解，动脉粥样硬化血栓形成的生物学研究已导致多种阻断凝血途径药物的开发，从而预防动脉血栓形成。JAMA杂志中报道的OASIS（Organization to Assess Strategies for Ischemic Syndromes）-6研究代表了该领域又一个重要的里程碑。

Diagnostic value of HPV and P16 protein in patients with HSIL and prognosis

Objective: To investigate the diagnostic value and prognostic value of HPV and P16 protein in patients with HSIL and to provide a reference for the clinical diagnosis and assessment of the prognosis of patients with HSIL. Methods: The surgical treatment of HSIL patients from January 2013 to January 2015 in our hospital were selected. All patients were routinely tested for HPV and P16 protein, All patients were followed up for 1 year. Patients were divided into progressive group and quiescent group according to whether the disease progressed one year after surgery. Preoperative HPV and P16 protein levels were compared between the two groups. Using receiver operating curve (ROC curve) Analysis of HPV diagnostic value of HSIL. The levels of HPV and P16 protein in the two groups were analyzed and compared. Results: The quantitative level of high-risk HPV-DNA after LEEP was significantly lower than that before operation. The level of P16 protein in preoperative patients was higher than that before operation, and the difference was statistically significant. There were 21 patients in the postoperative progression group, and the average HPV-DNA content in the patients in the progression group was higher than that in the control group within one year after operation. The difference was statistically significant. The P16 protein level in patients in advanced group was significantly higher than that in resting group. Preoperative HPV-DNA levels and P16 protein levels in patients with progressive disease were significantly higher than those in still group. ROC curve analysis showed that the cut-off value of 2.441, HPV-DNA prediction of HSIL patients one year after the recurrence of the sensitivity was 95.12%, the specificity was 76.16%, under the curve area of 0.878;7.4 cut-off value, P16 The predictive value of HSIL patients recurrence after 1 year was 71.95%, specificity was 66.67%, and the area under the curve was 0.753. The recurrence group HPV-DNA content and P16 protein level showed a significant positive correlation, with statistical significance. Conclusions: LEEP can reduce the postoperative levels of HPV and P16 protein in patients with HSIL. The HPV and P16 protein levels are of high value for the early diagnosis of HSIL and the prediction of postoperative disease progression.

The main etiologies for patients presented to ER with chest pain or chest pain equivalent in Beijing,China

Objectives To identify the mian etilogoies for patients presented to the ER with chest pain or chest pain equivalent and further analyze the common presenting symptom of coronary heart disease patients in the ER.Methods We conducted a prospective,cross-sectinal survey of all patinets presented to the ER with chest pain and chest pain equivalent syndrome in 17 medical centre in Beijing,China from Ju ly to August 2009.Data was collected by structured interviews and medical record reviews.The mean follow up period was 30 days.Results A total of 5666 patients entered the study [age(58.09±18.39)years,2663 males and 3303 females]. Their final diagnoses are;Chest pain(4.65%) Coronary heart disease 1506(27.4%),Acute Heart failure 149(2.6%), Pericarditis 4(0.1%),Pulmonary embolism 11(0.2%),Aortic dissection8(0.1%),Acute cerebrovascular disease 431 (7.6%),Non-cardic chest pain 2538(44.9%).We further analyzed the cornary heart disease patients.Eight-eight percent patients with cornary heart disease have symptoms at their presentation.The other 12%? patients without symptom.71% with chest prseur sensation.38.8%with shorness of breath, 23.3%with dyspnea,irritable,1.6%syncope,1.0%Loss of Consciousness 33.2%Palpitation,22.0%dizziness,14.7% nausea and vomiting,19.1%sluggish.Conclusions A quarter of patients(27.4%) presented to the ER with chest pain or chest pain equivalent have defined etiology of coronary heart deisease.Howerer,nearly half(48.8%) of the coronary heart disease patients present with no chest pain and 18.7% CHD patients presents with chest pain equivalent syndrome. This study suggest chest pain is not a prerequisite for the diagnosis of CHD.Therefore,special vigilance and thorough coronary artery evaluation is needed for all patients with chest discomfort or respiratory distress in the ER,even for patients without chest pain complaints.