Objective To explore the clinical curative effect of percutaneous coronary intervention ( PCI) for acute myocardial infarc-tion ( AMI) . Methods Retrospectively analyzed the clinical data of 138 patients with acute myocardial infarction who were admitted into our hospital from September 2012 to September 2014. The 138 patients were divided into the intravenous thrombolysis group (65 cases) and the PCI group (73 cases) according to the different way of treatment. And the basic clinical data, surgical outcomes, complications, and postop-erative follow-up results of the two groups were compared and analyzed. Results Reperfusion rate of related blood vessels,rate of TIMI flow reached grade 3, and score of left ventricular ejection fraction ( LVEF) in the PCI group were significantly higher than that of intravenous thrombolysis group, and the difference is statistically significant (P<0. 05). Degree of residual stenosis in the PCI group were significantly lower than that of intravenous thrombolysis group, and the difference is statistically significant (P<0. 05). Cacoethic ST-segment resolution and average hospital stay of the two groups had no significant difference (P>0. 05). Compared with the intravenous thrombolysis group, the curative effect of the PCI group was obviously better than the intravenous thrombolysis group with a statistically significant difference (P<0. 05). During the follow-up period, arrhythmia, angina, recurrence of myocardial infarction, and mortality within 6 months in the PCI group were all lower than in the intravenous thrombolysis group, and the difference is statistically significant (P<0. 05). Conclusion Per-cutaneous coronary interention for patients with acute myocardial infarction can effectively open the lesion vessels and relieve myocardial nec-rosis in patients, and it is of good curative effect.

Objective To explore the influence of type 2 diabetes mellitus combined with subclinical hypothyroidism on diabetic vascular complications.Methods One hundred and two patients with type 2 diabetes mellitus were selected.The serum free triiodothyronine (FT3),free thyroxine (FT4),thyroid stimulating hormone (TSH),anti-thyroid peroxidase antibody (TPO-Ab),thyroglobulin antibody (TG-Ab) levels were measured by chemiluminescence method.The patients were divided into type 2 diabctes mellitus combined with subclinical hypothyroidism group (47 cases) and type 2 diabetes mellitus with normal thyroid function group (55 cases) according to the thyroid function.The glycated hemoglobin (HbA1c),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and albumin levels were measured.The estimated glomerular filtration rate (eGFR) was calculated according to the formula of modification of diet in renal disease (MDRD).The presence of diabetic retinopathy was examined by fundus examination,and the presence of lower limb artery lesions was measured by vascular ultrasound.All indicators were compared between 2 groups.Results There were no statistical differences in age,disease course,HbA1c,body mass index (BMI),TC,TG,HDL-C,LDL-C,incidence of lower limb artery lesions and incidence of diabetic retinopathy between 2 groups (P＞ 0.05).TheeGRF in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significantly lower than that in type 2 diabetes mellitus with normal thyroid function group:(83.74 ± 21.55) ml/(min· 1.73 m2) vs.(115.02 ± 12.29) ml/(min· 1.73 m2),and there was statistical difference (t =4.274,P ＜ 0.01).The incidence of diabetic nephropathy in type 2 diabetes mellitus combined with subclinical hypothyroidism group was significanlty higher than that in type 2 diabetes mellitus with normal thyroid function group:48.9％ (23/47) vs.23.6％(13/55),and there was statistical difference (x2 =7.103,P＜ 0.01).Logistic regression analysis showed that subclinical hypothyroidism was a risk factor for diabetic nephropathy (OR =0.524,95％ CI 0.12-0.93,P ＜ 0.05),but it was not the risk factor for diabetic retinopathy (OR =0.618,95％ CI0.19-2.16,P =0.475) and lower limb artery lesions (OR =0.485,95％ CI 0.32-2.13,P =0.689).Conclusion Subclinical hypothyroidism in patients with type 2 diabetes mellitus has no obvious effect on lower limb arterial complications and diabetic retinopathy,but may increase the risk of diabetic nephropathy.

Objective To explore the effect of transradial approach in percutaneous coronary intervention for elderly patient with coronary artery disease,and provide reference for clinic. Methods There were 198 patients older than 70 years with coronary artery disease in our hospital from March 2007 to March 2013,who were divided into the radial group(n=100) and the femoral group(n=98) according to differ-ent puncture pathways. The X-ray exposure time,operative time,amount of contrast medium,the success rate of puncture,achievement ratio of operation and venous complications were compared and analyzed. Results The X-ray exposure time,operative time,amount of contrast me-dium,the success rate of puncture,achievement ratio of operation of 2 groups has no significant differences(P>0. 05). The venous complica-tion of radial group was less than that of femoral group,the difference was statistical significance(P<0. 05). Conclusion The transradial approach in percutaneous coronary intervention for elderly patient with coronary artery disease was feasible and safe,with less complication.

Objective To explore the risk factors of hypotension of patient with acute myocardial infraction(AMI)after emergency per-cutaneous coronary intervention(PCI).Methods The data of 300 patients with AMI who received PCI in our hospital from January 2015 to August 2015 were collected.According to the symptom of hypotension,the patients were divided into hypotension group and normal group.The general information and relative clinical data were recorded and compared.The risk factors were analyzed by logistics regressive analysis. Results The incidence of previous angina of hypotension group was lower than that of normal group,the difference was significant(P <0.05), there was no difference in other general information between two groups(P >0.05).There was no difference in level of LDL-C between two groups(P >0.05).And the differences in peak value of CK-MB,inferior wall or right ventricular infarction were statistical significance (P <0.05).There was no significant difference in multi-vessel lesions(P >0.05),and the difference in others of coronary artery lesion be-tween two groups was statistical significance(P <0.05).Conclusion The peak value of CK-MB,inferior wall or right ventricular infarction and TIMI <2 after PCI can increase the possibility of hypotension after PCI,and angina pectoris before infarction can reduce the incidence of hypotension after PCI.

Objective:To explore the clinical significance of the level and dynamic changes of N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) in the diagnosis and prediction of long‐term prognosis for patients with chronic obstructive pulmonary disease (COPD) combined with pulmonary heart disease among Han Chinese in Yunnan district .Methods:A total of 234 patients with COPD who were treated in The Second People′s Hospital of Qujing in Yunnan province during Jan .2013 and Dec .2013 ,were selected .Among them ,there were 98 patients with COPD combined with pulmonary heart disease ,80 patients with acute exacerbation of COPD ,and 56 patients with stable COPD .The clinical data ,results of blood gas analysis and echocardiography were recorded on admission and the levels of NT‐proBNP were measured .Results:The distances of 6 minute walk test(6MWT) in acute exacerbation of COPD and COPD combined with pulmonary heart disease groups were significantly less than that in stable COPD group(P< 0 .01) .The level of NT‐proBNP in COPD combined with pulmonary heart disease group was significantly higher than those in stable COPD and acute exacerbation of COPD group(P< 0 .01) .Kaplan‐Meier survival analysis showed that there was no significant difference regarding the rate of readmission and death during 12 months between the NT‐proBNP<1 000 pg/mL group and the NT‐proBNP≥1 000 pg/mL group(P>0 .05) .The rate of readmission and death during 12 months in the group with NT‐proBNP level decreasing ratio after treatment ≥30% was significantly higher than that in the group with decreasing ratio < 30% (P< 0 .05) .Conclusions: The detection of NT‐proBNP is of great significance to the early diagnosis of COPD combined with pulmonary heart disease .The dynamic changes of NT‐proBNP levels before and after the treatment are superior to single detection of NT‐proBNP level in predicting readmission rate and mortality risk for patients with COPD combined with pulmonary heart disease .