Objective To determine the influencing factors on informed consent associated with decline or delay of primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods This study was conducted in Peking University People′s Hospital from 1 August, 2014 to 31 March, 2016, with 229 consecutive cases of acute STEMI enrolled in the study.Data were collected by reviewing medical records and STEMI treatment time records.180 patients with ischemic symptoms ≤12 hours were included in the final analysis.Patients were divided into the consent group and the refusal group according to the final decision.For patients who received primary PCI, they were further categorized into two groups based on the 30min cut-off time.Results Among the 180 STEMI patients reviewed, 139 patients agreed to primary PCI and the remaining 41 patients refused primary PCI.Multivariate logistic analysis showed that symptom relief (OR 5.532, 95% CI 1.165-26.278, P=0.031) and history of chronic kidney disease (OR 4.786, 95% CI 1.346-17.011, P=0.016) were predictors of dissent of primary PCI.Self-rated symptoms severity (OR 0.094, 95% CI 0.034-0.260, P<0.001)was predictor of consent to primary PCI.106 patients had complete time point records of informed consent in the consent group (n=139).Among these patients, the median informed consent delay was 24 min.64 patients made a decision within 30 minutes, and the other 42 patients had their decision made beyond 30 minutes.Symptom-to-door time ≥4 hours (OR 4.563,95% CI 1.682-12.385, P=0.003) was independent predictor of informed consent delay.Conclusions Patients with resolved symptoms, self-rated mild symptoms or renal insufficiency were more inclined to refuse primary PCI.For patients who eventually received primary PCI, symptom-to-door time ≥4 hours was the independent predictor of informed consent delay.

Objective To study the therapeutic effects of Ag85A plasmid DNA vaccines in a mouse model of multi-drug resistant-(MDR-) Mycobacterium tuberculosis infection. Methods BALB/c mice were infected with Mycobacterium tuberculosis clinical strain HB361 with isoniazid and rifampin resist-ance by intratail-vein injection and were subsequently divided into 6 groups. At the third day after infection, the mice were treated with saline (group A), vector pVAX1 (greup B), rifampin (group C), vaccae (group D), Ag85A plasmid DNA vaccines (group E),rifampin and Ag85A plasmid DNA vaccines (group F) for 60 d. The lungs and spleens from the mice were taken and their pathological changes, weight and number of myeobacterial colony were examined at the third week after the end of treatment. Results At third week af-ter the end of treatment, the gross pathological observation and histopathological examination in lung showed that the lung lesions were limited, the profile of the alveoli was relatively clear, and normal structure could be seen in 2/3 areas of the lung sections in group D, E and F. The extent of lung lesion was 50% in group D,20% in group E and F. The pathological changes in group A, B, and C were more severer than those in group D, E and F. Compared with group A, the colony-forming units (CFU) in the lungs from mice in group D,E and F decreased 52%, 68%, 78%, respectively. The CFU in the spleens from mice in group D,E and F decreased 48%, 65%, 79%, respectively. Conclusion Ag85A plasmid DNA vaccines alone or Ag85A plasmid DNA vaccines along with chemotherapy have significant therapeutic effects on the mouse model of MDR-Mycobacterium tuberculosis infection.