The main functions of modern Clinical Engineer(CE) is discussed. By combining experience of clinical engineering in developed country with clinical practice in our country, the work character problem of clinical engineering was proposed. According to the reality of equipment management and operation, the function of CE is not only to ensure medical equipment to run normally but also estimate the value of equipment in before buying or abandoning, PSS and technology study. Through the efforts of CE, the main functions of equipment can be made the best, medical therapy and new method research is more efficient.

150?mol/L who underwent PTCA and/or coronary stenting were included (renal dysfunction group). Another 25 age and sex matched patients who had normal serum creatinine level and received coronary intervention at the same period were served as a control group. The status of coronary disease, procedural complications and long term prognosis were compared between the two groups. Results The number of patients with multi vessel disease (72% vs 48%, P

Objective To compare the effect of direct stenting (DS) and conventional post-dilation stenting (CS) on no-reflow phenomena in coronary artery disease (CAD) patients. Methods Demographic characters, final baloon dilation pressure instant angiographic results, and long term outcomes were compared between patients receiving DS (n=127) and patients receiving CS (n=127). Results Patients in DS group had less degree of stenosis (82%?6% vs 87%?11%,P

0.05). Angiographically identified stent thrombosis occurred in 2 patients (0.9%) in Firebird group, 2 patients (0.9%) in Cypher group and 3 patients (1.6%) in Taxus group. Conclusion Implantation of the Firebird stent in unselected patients with coronary artery disease is safe and has shown no inferiority in one-year clinical outcomes compared to the Cypher or Taxus stents.

Objective To evaluate the feasibility, safety and efficacy of ACS MULTI LINK PENTA (PENTA) stent in patients with coronary artery disease.Methods From March to June 2002, thirty PENTA stents were implanted in 28 patients with 30 de novo lesions. For each patient the demographic, interventional and mean 3 month follow up informations were recorded. Results Almost two thirds of patients suffered from hypertension(61%) and half experienced unstable angina (53%). Most target lesions(67%) had unfavorable morphological characteristics (type B2 or C). No stent deployment failure occurred as well as acute or subacute stent thromobis.The major branches compromised after stenting were only in 2 patients. During floow up,no MACE occurred, except reoccurrence of chest pain in 2 patients (7%). Conclusions The PENTA stent appears to be safe and effective in treating coronary artery disease.

Objective To evaluate coronary flow reserve (CFR) in patients with myocardial bridging.Methods Between September 2000 and January 2003, thirteen patients were detected myocardial bridging(MB) by coronary angiography(MB group). Another 32 patients with normal coronary arteries were served as a control group. Demographic information and CFR were compared between the two groups. Results All patients in MB group were presented with stable angina pectoris, and the systolic and diastolic coronary compressing stenosis were 78%?7% and 15%?5%, respectively. CFR in MB patients was significantly lower compared with the controls(2.0?0.3 vs 3.3?0.6, P

Objective To evaluate the long-term effect of coronary stenting in young coronary artery diseased patients (45) undergoing coronary stenting were chosen randomly as the control group. Comparison the general characteristics, coronary angiographies, interventional and follow-up informations between the two groups was undertaken. Results Comparing with the control group, the young group patients presented much more myocardial infarctions (68% vs 35%, P

Objective To evaluate the clinical outcomes of patients complicated with major bleeding after primary coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). Methods During the period of January 2004-January 2008, primary PC1 was performed in 412 consecutive patients with acute STEMI at Shanghai Ruijin Hospital. The clinical data were retrospectively analyzed. Major adverse cardiac events (MACE), including death, reoccurrence of myocardial infarction and target vessel revascularization, in patients with major bleeding were compared with that in patients without major bleeding. Results Compared to patients without bleeding, the patients with bleeding were older (70.0 ± 8.9 years vs 64.9 ± 12.7 years, P = 0.04), mainly the females (51.9% vs 23.1%, P = 0.001) and treated more often with glycoprotein (GP) Ⅱb/Ⅲa receptor inhibitor (88.9% vs 69.4%, P = 0.03) or intra-aortic balloon pump (7.4% vs 1.3%, P = 0.02). In-hospital and one-year MACE rate in the patients with bleeding was 18.5% and 37.0% respectively, which were significantly higher than that in the patients without bleeding (5.7% and 14.3%, with P = 0.008 and P = 0.002, respectively). Multivariate analysis indicated that patient aged over 70 years, feminine gender and use of GP Ⅱb/Ⅲa receptor inhibitor were independent predictors for the occurrence of major bleeding. The occurrence of major bleeding after primary PCI was significantly correlated with MACE occurred within one year after the procedure (OR 2.79, 95% CI: 2.21-5.90, P < 0.001). Conclusion In patients with acute STEMI, the occurrence of major bleeding after primary PCI is closely linked to the increased MACE rate within one year after the treatment. Feminine gender, aged patient and use of GP Ⅱb/Ⅲa receptor inhibitor are independent predictors to increase the danger of major bleeding.

Objective To evaluate the influence of the gene polymorphisms of matrix metalloproteinase(mmp)-1 ,-2,-3 and -9 on coronary atherosclerotic plaque progression. Methods During the period of January 2005-December 2008, 80 patients with coronary heart disease underwent two times coronary angiography at authors' hospital. Based on the angiographic findings, the patients were classified into plaque progression group (n = 31 ) and plaque non-progression group (n = 49). Coronary atheroselerotic plaque progression was arbitrarily defined as that the minimal lumen diameter (MLD) of coronary artery showed a decrease ≥ 0.4 mm on the second coronary angiography. The detailed history and clinical examination results were collected, including serum concentrations of lipid profiling, fasting glucose and hs-CRP. Genotypings for polymorphic variances of MMP-1 (-1607 G/GG), MMP-2 (-955 A/C), MMP-3 (-1612 5A/6A ) and MMP-9 (-1562 C/T) were performed by polymerase chain reaction (PCR) and sequencing analysis in two groups.Comparison of the clinical characteristics and polymorphisms between two groups was made to assess their effects on coronary atherosclerotic plaque progression. Results More female patients and patients with acute coronary syndrome (ACS) were noted in patients with plaque progression compare to those with no progression (41.9% vs. 18.4%, P < 0.05 and 77.4% vs. 46.3%, P < 0.01, respectively).The serum hs-CRP level also significantly increased in group with plaque progression (0.26 ± 0.44 mg/L vs.0.02 ± 0.14 mg/L, P < 0.01). Multivariable logistic regression analysis revealed that serum hs-CRP concentration and ACS were independent risk factors of coronary atherosclerotic plaque progression (OR:12.63,95% CI:1.45-110.29, P < 0.05 and OR:2.99,95% CI:1.04-8.63, P < 0.05, respectively). The frequencies of 6A/6A genotype and 6A allele of MMP-3 promoter at location -1612 were significantly higher in group with plaque progression than that in group with no progression (87.1% vs. 53.1%, P < 0.01 and 93.5% vs. 75.5%, P < 0.01, respectively). However, no significant differences in the distribution of MMP-1,-2 and -9 polymorphisms existed between two groups. Conclusion ACS, feminine gender, high serum hs-CRP concentration and 5A/6A polymorphism in the MMP-3 gene promoter are closely associated with coronary atherosclerotic plaque progression. In addition, 5A/6A polymorphism of MMP-3 can be used as a marker for plaque progression.