Complications of vascular access are main component of vascular complication in percutaneous cardiovascular intervention.The common complications of femoral access may include hemorrhage and hematoma at access site,vasovagal reflex,pseudoaneurysm,arteriovenous fistula,retroperitoneal hematoma and deep venous thrombosis.The common complications of radial access may include radial artery spasm,radial artery occlusion,vascular injuries or hematoma at forearm and other sites,and osteofascial compartment syndrome.The common complications of ulnar and brachial accesses may include hemorrhage and hematoma at access site,upper limb and hand ischemia,and nerve injuries.Effective prevention and treatment of vascular access complications are key steps to minimize the incidence and hazards of vascular complications in percutaneous cardiovascular intervention.

The article mainly makes an outline on five kinds of lipid-regulating drugs(except for statins)and their combined application.The fibrates is suitable for hypertriglyceridemia,mixed hyperlipemia(triglyceride increases more)and low high-density lipoprotein-cholesterinemia.Up to now,nicotinamide acid is known as the most effective drug for elevating HDL.Statins combined with cholic acid chelating agent or fish oil agent n-3 fatty acid has a good cooperative effect on lowering serum lipid.

Objective To investigate the efficacy and safety of slow release paclitaxel eluting stents. Methods The 148 lesions of 71 patients were treated and 171 stents were implanted, of which 132 were slow release paclitaxel eluting stents and were implanted in 102 lesions. Results All except 1 of the slow release paclitaxel eluting stents were successfully implanted. No complications occurred during hospitalization. There were no cardic events and ischemic ECG evidence in 48 patients of the 6 months′ follow-up. Conclusion The efficacy and safety of slow release paclitaxel eluting stents within 6 months have been approved.

By studying the physician-related factors in physicianpatient relationship,authors put forwards that excellent medical skill,good medical ethics,favorable communication ability,and adequate knowledge on relevant legal regulations are four key points to handle the physician-patient relationship harmoniously.This article will supply reference from the above aspects for the all-around quality-based education for medical students.

Objective To observe the short-term curative effect of biventricular cardiac resynchronization therapy in patients with chronic heart failure.Methods Twenty-six patients with chronic heart failure underwent biventricular cardiac resynchronization therapy,and a left ventricle lead was implanted from the coronary sinus to vein.During the 3-34(13.8?10.4)months of follow-up period,the following parameters were recorded:the cardiac function,patients' activity,heart rate at night,QRS wave width,left ventricular end-systolic dimension(LVESD),left ventricular end-diastolic dimension(LVEDD),end-systolic volume(ESV),end-diastolic volume(EDV),left ventricular ejection fraction(LVEF),left ventricular filling time,and standard deviation of time to regional peak systolic velocity(Ts-Sd-12).Results One out of the overall 26 patients died from sudden cardiac death.The cardiac function was improved in the 25 survivals in the 3-months follow-up,showing that the effective rate of CRT was 96.2%.For the 25 patients,the cardiac function was improved according to New York Heart Association(NYHA)functional class from Ⅲ-Ⅳ grade to Ⅱ-Ⅲ grade.The average total activity time was increased from 0.31?0.40 hours per day to 2.35?1.20 hours per day.Average heart rate during night-time was decreased from 84.8?15.7 beats per minute to 63.4?4.5 beats per minute,variability of cardiac rhythm was raised from 47.3?7.1ms to 96.4?15.1ms;QRS duration was shortened from 158.6?31.8ms to 129.5?30.2ms(P

Objective To evaluate the efficacy and safety of distal embolic protection device(DPD) on acute myocardial infarction(AMI) with ST-segment elevation.Methods Two hundred and sixty-seven patients with ST-segment elevation AMI treated in emergency with percutaneous coronary intervention(PCI) from Jan.1,2004 to Dec.31,2005 in the Department of Cardiology,Xijing Hospital were studied retrospectively.169 patients were included in control group and 98 in DPD group.Patients in control group were treated with emergency PCI,while those in DPD group were treated with DPD during emergency PCI.The incidence of "no-reflow" phenomenon,thrombolysis in myocardial infarction(TIMI) 3 flow,and ST segment resolution were observed,and mortality in-hospital and left ventricular ejection fraction(LVEF) at 1 week after PCI were compared between the two groups.Results The incidence of "no-reflow" was 3.06%(3/98) in DPD group and 13.61%(23/169) in control group(P

Objective To explore the effect of arginine vasopressin(AVP) on proliferation and nitric oxide(NO) synthesis in rat cardiac fibroblasts(CFs). Methods CFs were isolated by trypsin digestion method. The effect of AVP on proliferation and NO synthesis were measured by MTT technique and nitric acid reductase method respectively. Results The MTT OD values of CFs increased in a concentration-dependent manner with the rising of the concentration of AVP and in a time-dependent manner with the prolongation of the culture time. For example, the MTT OD values of 10 -6 mol/L AVP group were higher than those of the control, and the MTT OD values of CFs cultured for 36h were significantly higher than those cultured for 6h when intervened with 10 -7 mol/L AVP. The content of NO of CFs displayed the same change as the MTT OD values. The contents of NO in 10 -7 mol/L and 10 -6 mol/L AVP groups were statistically higher than those of the contral group, 10 -9 mol/L AVP group and 10 -8 mol/L AVP group. The NO contents of CFs cultured for 24h and 36h were significantly higher than those cultured for 6h and 12h. Conclusion AVP can stimulate the proliferation of CFs and the synthesis of NO in neonatal rat. The enhancement of NO contents would inhibit CFs proliferation and myocardial fibrosis induced by AVP.

Connective tissue growth factor (CTGF) has recently received much attention as a possible key determinant of progressive fibrosis. It promotes tissue fibrosis through different pathways, such as cell proliferation, extracellular matrix accumulation and cell transdifferentiation. A number of regulators of CTGF expression have been identified, including transforming growth factor ?, vascular endothelial growth factor, tumor necrosis factor ?, etc. The mechanism of profibrotic effect by CTGF was reviewed. [

AIM: To explore the effects of tumor necrosis factor-? (TNF-?) on inducible nitric oxide synthase (iNOS)-nitric oxide (NO) system activity in arginine vasopressin (AVP)-induced rat cardiac fibroblasts (CFs). METHODS: CFs were isolated by trypsin digestion method. Nitrate reductase method, spectrophotometry and reverse transcription-polymerase chain reaction (RT-PCR) were used to detect NO contents, NOS activity and iNOS mRNA expression, respectively. RESULTS: AVP significantly increased iNOS mRNA expression, NOS activity and NO contents in CFs. Combined with AVP, TNF-? enhanced the effects of AVP on iNOS-NO system activity in a concentration-dependent manner. However, if the concentration of TNF-? was too high, the iNOS-NO system activity did not increase accordingly, but slightly decreased instead. CONCLUSION: TNF-? stimulates iNOS-NO system activity in coordination with AVP in CFs. The enhancement of NO contents inhibits ventricular remodeling induced by AVP and TNF-?. [

Objective To investigate the functional features of resveratrol on vasodilatation of abdominal aorta in rat and its underlying mechanism. Methods Isolated aortic ring was perfused and the tension of the vessel was measured. Results Resveratrol showed a dose-dependent relaxant effect on rat aorta at 4?10 -9～4?10 -5mol/L. At the concentration of 4?10 -5mol/L, the effect was attenuated by (74.9?1.9)% in the endothelium removal group, and it was significantly different from the control group (P0.05). At the concentration of 7?10 -5mol/L, resveratrol showed an relaxant effect on de-endothelium vessels. Conclusion Resveratrol relaxes the aorta in both endothelium dependent and independent manner. In the endothelium-dependent manner, the mechanism of vasodilatation may be associated with NO system and KATP channel, while in the endothelium-independent manner effect of resveratrol might be a direct one.