Objective To compare the diagnostic performance of prospective electrocardiogram (ECG)-triggered computed tomography coronary angiography (CTCA) versus retrospective ECG-gated CTCA.Methods Patients with suspected coronary artery disease divided into two groups which underwent 64-slice CTCA with prospective ECG-triggered or retrospective ECG-gated scanning (n=100 each,HR≤65 bpm).Multi-planar reconstruction (MPR),curved-planar reconstruction (CPR),maximum intensity projection (MIP) and volume rendering (VR) were made to demonstrate the coronary arteries.The image quality was defined as excellent,good and poor by motion and stair-step artifacts.Individual radiation exposure dose was estimated from the dose-length product.Results The mean effective radiation dose of prospective ECG-triggered CTCA[(2.81±0.48)mSv] was significantly lower than that of retrospective ECG-gated CTCA[(10.16±1.09)mSv,P＜0.01].Segments of diagnostic image quality (95.2%,1165/1224) and non-diagnostic coronary segments (4.8%,59/1224) in prospective ECG-triggered group were similar as those of retrospective ECG-gated group (94.1%,1186/1261 and 5.9%,75/1261,all P＞0.05).Conclusion Though the radiation exposure dose required is significantly lower,the diagnostic performance of prospective ECG-triggered 64 slice CTCA is comparable with that of retrospective ECG-gated 64 slice CTCA on patients with stable heart rates up to 65 bpm.

Objective To explore the continuing nursing care effect on anticoagulation therapy after heart valve replacement patients. Methods A total of 153 patients after heart valve replacement between September 2012 to August 2013 were randomly divided into the control group (77 cases) and intervention group (76 cases) by convenient drawing method. All patients in two groups during hospitalization received regular hospital health education and discharge education, and the patients of control group complete the telephone follow-up in 1 week after discharge, while the patients of intervention group received telephone follow-up ward visit, lectures for group and individual explanation at 1 week, 1 month, 3 months, 6 months, 1 year after discharge. 1 year later, the evaluation of patients′ medical compliance and anticoagulation effect were carried out between two groups. Results 1 year later, the recognition of anticoagulation therapy among intervention group patients obtained 89. 04%, part of recognition 9. 59%, far from recognition 1. 37%, better than 70. 27%, 20. 27%, 9. 46% of the control group (χ2 =8. 847, P =0. 012 ); the complete, part and none medication compliance of intervention group were 97. 26%, 1. 37% and 1. 37 better than 86. 49%, 10. 81%, 2. 70% of the control group;return visit on time was 97. 26% in the intervention group while 87. 84% in the control group (χ2 =6. 134, 4. 713;P<0. 05); 87. 67% patients achieved INR standard in the intervention group comparing with 70. 27% in the control group,the complication of anticoagulant therapy dramatically decreased to 6. 85%, lower than 18. 92% of the control group (χ2 =6. 686, 4. 757;P<0. 05). Conclusions Continuing nursing care can improve patient′s cognition and medication compliance of the anticoagulation therapy after heart valve replacement, improve the INR success rate, and reduce the anticoagulant therapy related complications.

Objective To summarize the surgical experience of surgical management for aortic dissection aneurysm. Methods A total of 265 patients with aortic dissection aneurysm were treated with surgical management and the surgi-cal approach were chosen according to the condition. Results There were 170 cases Stanford A ADAs and 95 Stanford B patients. After following-up for 6 to 12 months, of which 19 and 3 cases died, respectively, and in the survivals, whose CTA displayed artificial vessel were unobstructed,the endovascular stents were fixed well.The heart function re-covered to Ⅱ-Ⅰ stage. Conclusion Surgery is an important method to save the patients with aortic dissection a-neurysm,the choice of surgical procedures depend on the location of intimal tear of aortic dissection. Proper surgical indication,technique and brain protections are the key factors of aortic dissection surgery. EVGE is a minimally inva-sive,effective,safe surgery in treating Stanford type B aortic dissection aneurysm.

Objective To research the effect of specialized health education on patients after percutaneous coronary intervention (PCI).Methods A total of 406 patients after PCI were randomly divided into observation group (208 patients) and control group (198 patients).Patients in observation group accepted specialized health education , while patients were followed up by telephone for 4 times.The control group was given routine health education .The compliance and quality of life of patients at 12 after discharge in the two groups were compared .Results In the observation group , the 12-month recharge rate and complication rate were 7.21%and 8.17%, which were significantly lower than 31.82%and 28.79%in the control group (χ2 =11.078, 10.382, respectively;P<0.05).In the observation group, the scores of Seattle Angina Questionnaire of angina stability, angina frequency, treatment satisfaction and disease perception were (82.17 ±15.15), (89.05 ±2.25), (82.21 ±10.47) and (77.05 ±18.00), which were significantly higher than (70.00 ± 16.85), (75.50 ±9.10), (70.88 ±7.48) and (64.62 ±15.45) in the control group (t=5.045, 5.873, 9.312, 12.311, respectively;P <0.05 ).Conclusions Specialized health education is essential to the compliance and quality of life of patients after PCI .

Objective To explore effects of finger-press method and abdomen massage on bowel function of patients undergoing coronary artery bypass grafting (CABG). Methods A total of 93 cases with CABG were randomly divided into the control group of 46 cases and the intervention group of 47 cases. The control group was given routine measures of treatment and care while the intervention group in addition to routine treatment and care, on the first postoperative day performed the massage on five acupuncture points and abdomen with 3 times a day and continuous 3 days. Results Indicators including abdominal distention, bowel function recovery, anxiety, incidence of pulmonary infection of the intervention group was significantly better than of the control group. Conclusions The implementation of finger-press method and abdomen massage is helpful to prevent the abdominal distension and promote the recovery of bowel function in patients undergoing coronary artery bypass grafting. It can reduce the incidence of pulmonary infection as well.

Objective To investigate the effect of perioperative period D-dimer and tissue factor (TF)-1208 D/I gene polymorphism on the long-term prognosis of patients with off-pump coronary artery bypass grafting (OPCABG). Methods Retrospective analysis of the case data of the first OPCABG patients admitted to Tianjin Medical University General Hospital from May 2015 to May 2016 were enrolled. The general data, operation time, bypass number, left ventricular ejection fraction (LVEF), flow rate of 24-hour pleural effusion, intraoperative heparin dosage, combined anticoagulant and antiplatelet time, and the time of postoperative ventilator were measured. The blood biochemical indexes of 1, 4, 7, 14 days and 1, 2, 3 months after operation, perioperative complications, the level of D-dimer in the patients with different TF-1208 D/I gene polymorphism, and prognosis of 1-year follow-up were recorded. The risk factors of recurrent angina 1 year after operation was analyzed by Logistic regression analysis. Results The level of plasma D-dimer was increased continuously after OPCABG, and reached a peak at 1 month after operation [1.94 (1.07, 2.70) mg/L], then decreased, and decreased to preoperative level 3 months after operation [0.20 (0.10, 0.45) mg/L]. The level of D-dimer in TF-1208 I I genotype was significantly higher than that in TF-1208 DD genotype and TF-1208 D/I genotype group at 14 days and 1 month after operation [mg/L: 4.17 (1.54, 5.09) vs. 1.91 (1.07, 2.26), 1.02 (0.91, 1.88) at 14 days; 5.12 (2.41, 6.32) vs. 1.94 (1.18, 2.70), 1.62 (0.22,1.88) at 1 month, all P < 0.05]. The results of 1-year follow-up showed that 25 patients with recurrent angina pectoris without the occurrence of myocardial infarction. The proportion of recurrent angina pectoris in TF-1208 I I genotype was significantly higher than that in TF-1208 DD genotype and TF-1208 D/I genotype group (χ2= 0.197, P = 0.004). Logistic regression analysis showed that LVEF< 0.50 [odds ratio (OR) = 6.482, 95% confidence interval (95%CI) = 1.365-18.763, P = 0.015] and TF-1208 I I genotype (OR = 8.864, 95%CI = 1.613-46.743, P = 0.012) were independent risk factors for recurrent angina pectoris at 1 year after OPCABG. Conclusions After OPCABG, the body was in a hypercoagulable state and lasted for a long time, and almost recovered 3 months after operation. LVEF < 0.50 and TF-1208 I I genotype were independent risk factors of angina pectoris at 1 year after surgery.

Objective To evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions. Methods A total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm2 (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia- driven target vessel revascularization at 1 year after the index procedure. Results The baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182). Conclusions Both FFR-and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions. Methods A total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm2 (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia- driven target vessel revascularization at 1 year after the index procedure. Results The baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182). Conclusions Both FFR-and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.

Objective To research correlation factors and nursing measures for complication on perioperation in neonate-infants with congenital heart disease.Methods Strengthening the techniques on nursing preparation,to strict custodial care respiratory system function after operation,according nursing measures to liquid manage and tracheal intubation to the neonate-infants physiology characteristic.Results 49 cases had complication of lungs in 228 cases of group,that was 68.06%on the total 71(31.14%) complication cases,2.19%cases died in hospital,and the difference had statistical meaning(P<0.01) with Contrast group.Conclusions Those measures,such as strengthening respiratory system preparation technique for the characteristic of neonate-infants.nursing intervention to care respiratory system function and controlling infusion quantity,were effective action in prevention complication on postoperation of neonate-infants with congenital heart disease.