Endotoxin of in-and out-flowing pulmonary blood (IPB ,OPB) was measured by limulus chromogenic test in rabbits; Clearance of ~(51)Cr-E. coli endotoxin by lung was measured by a double indicator dilution method in rabbits; 12 and 24 hour's mortality rates was observed after E. coli endotoxin (1?g/100g b. w.) was infused through vein (ⅳ)and aorta (av)into the lead-sensitized rats. The endotoxin level of IPB (44.45?31.73 pg/ml plasma, n=13) was significantly higher than that of OPB (19.23?17.85 pg/ml plasma, n=13)in normal rabbits, (P

Objective To elucidate the clinical implication of early ST segment changes after PCI for IRA for acute ST segments elevation myocardial infarction.Methods From Jan.2001 to Dec.2001,216 patients with AMI after successful angiographical primary PCI Who were admitted to Beijing Chaoyang Hospital were retrospectively analysed.Forty-one patients with index of ST segment elevation≥50%and 50 randomised patients from 175 patients with index of ST segment elevation

Objective To explore the hypothesis that postconditioning during percutaneous transluminal coronary angioplasty (PTCA) would improve cardiac function and reduce infarct size after prolonged reperfusion. Methods Forty-one patients undergoing primary PTCA with acute myocardial infarction were randomized into the control group (n=16) or the postconditioning (n=23) group within 90 minutes after admission. In the control group, no intervention was given at the onset of reperfusion, while in the postconditioning group, three cycles of repetitive angioplasty balloon inflation and deflation was performed within 1 minute after reperfusion. ST segment regression, TIMI flow and blush grade were analyzed for all patients after the procedure. Ejection fraction and infarct size assessed by nuclear imaging were quantified respectively at 7 days after restoration of reperfusion. Results ST segment resolution, TIMI flow and blush grade between the two groups were compatible. Area under the curve of serum CK release during the first 72 hours of reperfusion was significantly reduced in the postconditioning group than that in the control group (58?002 vs 79?787, P=0.04). There was a tendency towards amelioration in ejection fraction in the postconditioning compared with the control group (52.1%?12.9% vs 44.5%?16.7%, P=0.29). Conclusion Postconditioning during PTCA protects the heart against acute myocardial ischemic-reperfusion injury. More importantly, the study indicates that protection with postconditioning is still preserved after an extended reperfusion, suggesting a permanent protection.

Objective Previous studies have reported that the incidence of atrial fibrillation (AF)/atrial fluttler in patients with AMI who were treated with thrombolysis is 7%-10%. However, little is known concerning the incidence of AF/atrial fluttler and its effects on the prognosis of patients with AMI who are treated with PCI. Methods A total of 668 consecutive patients were studied in Beijing Chaoyang Hospital from Nov. 2000 to Jan. 2004. Patients were categorized into 2 groups according to the presence of AF/ atrial flutter. Results The results showed that the incidence of AF/atrial fluttler was 10% and that the patients with AF/atrial fluttler were older, were in higher Killip classes, had higher rates of previous myocardial infarction and previous cerebrovascular diseases, multivessel disease, and had poorer reperfusion of the infarc-related artery than those without AF/atrial fluttler. Patients with AF/atrial fluttler had higher in-hospital (11.9% vs 5.3%, P

Objective To investigate the feasibility,safety and efficacy of sirolimus-eluting stent implanting in diabetic patients with ST-segment elevation myocardial infarction(STEMI)treated by emergency percutaneous coronary intervention(PCI).Methods One hundred and six diabetic patients with STEMI treated by emergency PCI were included into this study.The incidence of major adverse cardiovascular event(MACE),stent thrombosis and restenosis was evaluated.Results Totally 105 patients were successfully treated by emergency PCI and there were no complication during the procedure.Totally 134 sirolimus-eluting stents were successfully implanted on 110 target lesions.There was one subacute stent thrombosis in 106 patients during one month.One-month follow-up result showed that the MACE was 4.72% and the death rate was 3.77%.The MACE was 10.38% and the death rate was 3.77% one year later.One-year angiography follow-up showed that restenosis rate was 11.54%.Conclusion Implanting sirolimus-eluting stent in STEMI patients during emergency PCI is safe and effective.Sirolimus-eluting stent can reduce restenosis rate and MACE in diabetic patients with STEMI treated by emergency PCI.

[Abstrct] In 2008, Beijing Chaoyang Hospital of Capital Medical University was certified as cardiovascular interventional therapy tralning base of National Health and Family Planning Commission (former Ministry of Health). In accordance with the requirements of the measures for the management of tralning base, and according to the characteristics of tralning students in combination with the clinical teaching experience, skills of teaching for tralning base were summed up as the following: in strict accordance with the syllabus requirements , systematic and standardized tralning were emphasized . Emphasis on theoretical study which combined closely with actual operation was also established. After the tralning, all students who received tralning can do coronary angiography and PCI for simple lesion in accordance with the requirements of the syllabus. All tralnees passed unified national exam organized by the Ministry of Health and got the qualification for interventional therapy.

Objectives To compare the safety and efficacy of radial artery access versus femoral artery access for percutaneous coronary intervention in acute myocardial infarction population. Methods From June 2004 to December 2006, 446 patients with acute myocardial infarction treated with percutaneous stenting were reviewed retrospectively. The radial artery approach was used in 242 patients, and the femoral artery approach in 204 patients. The success of the procedure, procedure duration, X-ray exposition, volume of contrast, incidence of major adverse cardiac events and complications were compared between the radial artery and femoral artery approach. Results Total procedure duration, X-ray exposition, the immediate success of the procedure and the proportion of patients with reperfusion time above 60min are higher in patients with radial artery acess than that with femoral artery access [(62. 1 ± 23. 4) min vs(56. 8 ± 16. 7)min,(2829. 4 ± 1365.2) mGY vs (2352. 3 ± 903.1) mGY, 4% vs 0.9% and 7.44% vs 2.94%respectively, all P ＜ 0. 05]. Conclusions In non-selected patients with acute myocardial infarction treated with primary stent implantation, the success rate of the radial artery approach is lower than the femoral artery approach and could prolong the reperfusion time. It is suitable to change artery access immediately if abnormality is found via radial artery access.

Objective To study the risk factor and prognosis of concurrent depression in elderly patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI). Methods Two hundred and ninety-five AMI patients who received PCI and whose clinical data were complete were selected. Depression was determined by a self-rating scale (SDS), and was confirmed when SDS standard score≥53 scores. The patients were divided into 2 groups according to the ages:senium (age ≥ 60 years, 144 cases) group and younger group (age<60 years, 151 cases). Multiple Logistic regression analysis was used to analyze the related factors of depression. The patients were followed up for 1 year, and the rehospitalization rate, incidence of major adverse cardiovascular events (MACE) and left ventricular ejection fraction (LVEF) at 12 months were compared. Results The incidence of depression in senium group was significantly higher than that in younger group: 41.7%(60/144) vs. 21.2%(32/151), and there was statistical difference (P<0.05). Female gender, hypertension and type 2 diabetes mellitus were the independent risk factor for depression in patients with AMI after PCI (P<0.05). In senium group, the rehospitalization rate and incidence of MACE in patients with depression were significantly higher than those in patients without depression: 18.3% (11/60) vs. 6.0% (5/84) and 15.0% (9/60) vs. 4.8%(4/84), the LVEF was significantly lower than that in patients without depression:(41.50 ± 2.25)%vs. (49.76 ± 2.93)%, and there were statistical differences (P<0.05). The LVEF in patients with depression of senium group was significantly lower than that in patients with depression of younger group:(41.50 ± 2.25)%vs. (51.50 ± 2.32)%, and there was statistical difference (P<0.05). Conclusions The elderly AMI patients treated with PCI have higher rates of depression. Female gender, hypertension and type 2 diabetes mellitus are the important risk factor for depression after PCI. Depression has a significant effect on the prognosis of AMI patients, especially on LVEF in elderly patients.

Objective To This paper is to probe the clinical implication of left ventricular function for angiographic no reflow phenomenon after primary percutaneous coronary intervention(PCI). Methods Cilnical and angiographic data of 497 patients after primary PCI were retrospectively analysed between January 1999 and October 2002. Angiographic no reflow phenomenon defined as substantial coronary antergrade flow ≤ TIMI 2 class without mechnical obstruction of embolism, thrombus, dissection and spasm in influence of normal flow after PCI, but, normal flow defined as TIMI 3 class. 58 patients were with angiographic no reflow phenomenon, 60 patients randomized from 439 with coronary antergrade flow TIMIⅢ after primary PCI were normal flow group, with random count table of excel. Results Enzyme value、Killip class、number of Q waves on electrocardiogam and WMS are significance in two groups with the angiographic no reflow phenomenon and with the normal flow( P

Objective To assess the association between admission plasma glucose (APG) and noreflow during primary percutaneous coronary intervention (PCI) in patients with ST-elevation acute myocardial infarction (STEMI). Methods A total of 1413 patients with STEMI successfully treated with PCI were divided into no-reflow group and normal reflow group. Results The no-reflow was found in 297 patients (21.0%) of 1413 patients; their APG level was significantly higher than that of the normal reflow group [( 13.80 ±7.47) vs (9.67 ±5.79) mmol/L, P＜0.0001]. Multivariate logistic regression analysis revealed that current smoking ( OR 1.146, 95% CI 1.026-1. 839,P = 0.031), hyperlipidemia ( OR 1. 082,95% CI 1. 007-1. 162, P = 0. 032), long reperfusion ( ＞ 6 h, OR 1. 271, 95% CI 1. 158-1. 403, P =0. 001 ) , admission creatinine clearance ( ＜ 90 ml/min, OR 1.046, 95% CI 1. 007-1.086, P = 0.020 ) ,IABP use before PCI (OR 9.346, 95%CI 1.314-67. 199, P=0.026), and APG ( ＞ 13.0 mmol/L, OR1.269, 95% CI 1.156-1.402, P = 0.027) were the independent no-reflow predictors. The no-reflow incidence was increased as APG increased ( 14. 6% in patients with APG ＜ 7. 8 mmol/L and 36. 7% in patients with APG ＞ 13.0 mmol/L, P = 0.009 ). Conclusion APG ＞ 13.0 mmol/L is an independent noreflow predictor in patients with STEMI and PPCI.