The three links theory" refers to the three key links in an emergency medical services system, viz. pre-hospital first-aid system, hospital emergency care system, and the ICU system. The construction of an emergency medical services system in China ought to be guided by the three links theory so as to set up a practical and highly efficient emergency medical services system, an instantly operating monitoring system, a smooth and real-time information system, a rational and long-lasting system of laws and contingency plans, and a system for cultivating universalists. The goal is to build an emergency green passage in the hospital.

Objective　To compare the effects of early and long-term treatment with captopril on clinical outcome between elder patients (65-75 years old) and younger patients (＜ 64 years old) suffering from acute myocardial infarction (AMI). 　Methods　In a randomized trial, 822 patients with a first AMI were treated with captopril at initial dosage of 6.25 mg and adjusted to 25 mg t.i.d according to blood pressure (209 younger patients, 269 elder patients) and conventional treatment (131 younger patients, 213 elder patients). Survival rate of the four groups was calculated with Kaplan-Meier method. 　Results　The survival of treatment group was correlated significantly with age during hospitalization (P=0.0002). Eight patients in younger treatment group and 10 patients in younger control group (3.83% vs 7.63%, P＞0.05), 25 patients in elder treatment group and 52 patients in elder control group (9.29% vs 24.41%, relative risk = 0.37, 95% CI 0.29-0.48, P＜0.0001) were died. During follow-up period, the survival was however not related to the age (P＞0.05), and both the elder and younger patients had better survival (all P＜0.01 ) and lower cardiac events (all P＜0.01) during captopril treatment. 　Conclusions　 Captopril exerts less effect on the younger patients but more effect on the elder patients during hospitalization after AMI. Long-term captopril had no difference between the youngers and the elders in prognosis.

50% and was classified as in-stent if inside stent or in-segment if located within the stented segment plus the 5 mm segments distal or proximal to the stent margins. Results Among the 8 patients included in this analysis, 5 had in-segment restenosis and 3 had in-stent restenosis (2 were not real in-stent restenosis and were just due to underexpansion). IVUS showed all restenosis occurred as localized lesion. Conclusion Restenosis after drug-eluting stents implantation is frequently associated with local trauma outside the stented segment and incomplete lesion coverage by the drug-eluting stent. Restenosis usually occurs proximal to the stent and presents as a localized lesion.

Objective To assess the value of implanting remedial or prophylactic cardioverter defibrillator in patients with Brugada syndrome for protecting from malignant ventricular arrhythmias and to estimate the initial outcomes in one-month follow-up. Methods Implantable cardioverter defibrillators (ICDs) were implanted in 21 consecutive patients (9 symptomatic and 12 asymptomatic) with Brugada syndrome using standard procedure under general anesthesia. Patients presented the typical ECG changes of Brugada syndrome with or without sodium channel blockers but without structural heart disease in all the cases. Electrophysiological examinations were performed in all patients. Eight asymptomatic patients had spontaneous or induced malignant ventricular arrhythmias and 4 asymptomatic patients had single positive family history. Results Sixteen single chamber ICDs (VVI) and 5 double chamber ICDs (DDD or DDDR) were implanted. The DDD- or DDDR-ICDs were applied for patients with sinus node dysfunction and/or atrioventricular conduction disturbances. Battery/lead status measurements of ICDs were good and met with standards of implantation during the procedure. No complications occurred after ICD implantation and also no changes of various electrophysiological parameters during re-hospitalization in one-month follow-up. There were no events' record of anti-tachycardia pacing or cardiovertion or defibrillation for ventricular arrhythmias in the memory of treatment by ICDs. Conclusions ICDs were implanted successfully with safety in patients with Brugada syndrome showing good function for the initial outcomes in one-month follow-up.

Objective To evaluate the efficacy and safety of Firebird drug-eluting stent (DES) in the treatment of de novo native coronary artery lesions.Methods 60 patients underwent coronary artery stenting with Firebird DES (Firebird group), 52 patients with Cypher DES (Cypher group) and another 20 patents with Mustang bare stents (Mustang group). The instant and short term follow-up outcomes were compared among the three groups. Results The procedural successful rates (98.3%vs 100.0%vs 100.0%), nitrate cessation (32.1%vs 33.3%vs 29.4% ), re-admission(5.6%vs8.3%vs11.7%) and follow-up rates (88.3%vs 92.3%vs 85.0%) did not significantly differ among the three groups. As compared with Firebird group, patients in Mustang group had more MACE(17.6%vs 0), higher occurrence rates of restenosis(17.6%vs 0) and target vessel revascularization(17.6%vs 0)(P

Objective To investigate the Correlation between Plasma Total Homocysteine and Copper in Patients with coronary artery disease complicated with diabetes mellitus. Methods 31 pateints with coronary artery disease complicated with diabetes mellitus were studied. 36 age-matched and gender-matched patients with coronary artery disease not complicated with diabetes mellitus and 30 normal subjects were served as control groups. The concentrations of copper and total homocysteine was determined and compared. Results The concentration of copper and total homocysteine was significantly highter in the patients with coronary artery disease complicated with diabetes mellitus (18.8?3.5 ?mol/L、21.1?3.8 ?mol/L, respectively) than in the patients with coronary artery disease not complicated with diabetes mellitus (15.6?1.9、14.8?2.2 ?mol/L, respectively) (P

Objective To investigate the association of Lipoprotein(a) concentrations and patients with aortic dissection.Methods 27 pateints with aortic dissection were studied. Sixty age-matched and gender-matched patients with acute myocardial infarction and fifty normal subjects were served as control groups. The levels of Serum lipoprotein(a), plasm C-reactive protein, white blood cell count were compared between the three groups. Observed the changes of the levels of lipoprotein(a), C-reactive protein, white blood cell count 24 hours, 72 hours and 5 days after the initial of disease in eight of the patients with aortic dissection. Results 1. Median serum lipoprotein(a) levels of patients with aortic dissection, acute myocardial infarction and normal subjects were 327.35?89.23, 261.35?77.54, 79.69?21.63 mg/L respectively (P

Objective To assess

Objective To evaluate the clinical outcomes of sirolimus-eluting stenting in patients with coronary artery disease and type 2 diabetes.Methods Among 101 patients with coronary artery disease and type 2 diabetes who underwent percutaneous coronary intervention, 67 received sirolimus-eluting stents (SES group) and 34 were treated only with bare metal stents (BMS group). Baseline clinical characteristics, procedural success rate, occurrence of cardiac events during follow-up were recorded and compared between the two groups. Results The procedural success rate was 100% in both groups. During follow-up(average one year), the SES group patients had significantly lower occurrence of cardiac events than those in the BMS group ( 7.5% vs. 32.4%, P= 0.001).Conclusions Sirolimus-eluting stent implantation for patients with coronary artery disease and type 2 diabetes is safe and can reduce major adverse cardiac events in long-term follow-up.

Objective To evaluate the role of transeso phageal echocardiography(TEE) before chemical or electric cardioversion for non-vulvular atrial fibrillation. Methods Forty-three patients, confirmed non-vulvular atrial fibrillation, undertook anticoagulation or anti-platelet therapy and transthoracic echocardiography and TEE less than 24-48 hours prior to cardioversion. Results Two thrombi in the left atrial appendage and three spontaneous echo contrasts in the left atrium were evidenced. After anticoagulation or anti-platelet therapy, 39 patients undertook cardioversion therapy. Among them,31 patients received drug cardioversion,success in 19,and failure in 12;8 patients received electric cardioversion,success in 6,and failure in 2. There were no thromboembolic events during the hospitalization. Conclusions TEE performed before cardioversion for atrial fibrillation is necessary to reduce the risks of thromboembolic events and to guide for anticoagulation therapy.