Objective To assess the value of SYNTAX score to predict major adverse cardiac and cerebrovascular events (MACCE) among patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention.Methods 190 patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention (PCI) with Cypher select drug-eluting stent were enrolled.SYNTAX score and clinical SYNTAX score were retrospectively calculated.Our clinical Endpoint focused on MACCE,a composite of death,nonfatal myocardial infarction (MI),stroke and repeat revascularization.The value of SYNTAX score and clinical SYNTAX score to predict MACCE were studied respectively.Results 29 patients were observed to suffer from MACCE,accouting 18.5％ of the overall 190 patients.MACCE rates of low ( ≤ 20.5 ),intermediate ( 21.0-31.0 ),and high ( ≥ 31.5 ) tertiles according to SYNTAX score were 9.1％,16.2％ and 30.9％ respectively.Both univariate and multivariate analysis showed that SYNTAX score was the independent predictor of MACCE.MACCE rates of low ( ≤ 19.5 ),intermediate( 19.6-29.1 ),and high( ≥29.2) tertiles according to clinical SYNTAX score were 14.9％,9.8％ and 30.6％ respectively.Both univariate and multivariate analysis showed that clinical SYNTAX score was the independent predictor of MACCE.ROC analysis showed both SYNTAX score ( AUC =0.667,P =0.004) and clinical SYNTAX score ( AUC =0.636,P =0.020) had predictive value of MACCE.Clinical SYNTAX score failed to show better predictive ability than the SYNTAX score.Conclusions Both SYNTAX score and clinical SYNTAX score could be independent risk predictors for MACCE among patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention.Clinical SYNTAX score failed to show better predictive ability than the SYNTAX score in this group of patients.

Objective To investigate the eye lens dose to the operators who tended to test the quality control of positron emission tomography (PET).Methods Before encapsulation and in preparation of point source,line source 1 and line source 2,the two operators were worn with lens thermoluminescence dosimeter each at the left of the left eye,the front of the left eye,between the right eye and the left eye,the left of the right eye,and the front of the right eye.Measurement and analysis were made of the radiation doses to eye lens received by the operators in order to calculate their maximum annual doses.Results The maximum lens dose was 2 439.80 μSv for the test of 5 PETs.There appears to be the same trend in the eye lens doses for the first and second operators.(x2 =15.629-16.155,P ＜ 0.05).The first operator have received higher eye lens dose higher than the second(Z =2.611,P ＜ 0.05).Conclusions The dose to the eye lens for a single PET test is relatively low.

Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study.The endpoints of the study were death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization). To reduce the bias between two compared groups , our study applid propensity score matching by logistic regression.Cumulative survival rate was calculated by Kaplan-Meier method.Multiple regression analyses, hazard ratio(HR) and 95%CI were tested by Cox proportional hazard models with the CABG group as the reference category. Results: The median follow-up was 7.2 years (interquartile range 5.1 to 8.3 years) in the overall patients.Unadjusted analysis showed that MACCE rate (PCI 44.5% vs. CABG 45.7%, P=0.036), the rate of repeat revascularization (PCI 33.7% vs. CABG 19.5%, P<0.001), the composite rate of serious outcomes (cardiac death, MI or stroke) (PCI 20.4% vs. CABG 34.3%, P=0.032), stroke rate (PCI 3.7% vs. CABG 23.5%, P<0.001) were significantly different for patients undergoing PCI or CABG. Death rate (PCI 13.0% vs. CABG 18.9%, P=0.12) and MI rate (PCI 11.3% vs. CABG 6.1%, P=0.108) were similar between PCI and CABG group.After adjusting covariates with multivariate Cox hazard regression model, there was no significant difference in rates of death (P=0.286), MI(P=0.165) and the composite rate of serious outcomes (cardiac death, MI or stroke) (P=0.305) between the two groups. Patients in PCI group suffered significant higher rates of MACCE(P=0.011), mainly driven by the significant higher rates of repeat revascularization(HR=2.46, 95%CI 1.662-3.642, P<0.001). However, stroke rate was still significantly higher in CABG group than in PCI group(P=0.001)after multivariate adjusting. After propensity score matching (PSM), there was no more significant difference for all covariates in the matched cohorts (202 pairs). Further PSM analysis showed that overall findings were consistent with multivariate Cox hazard regression model except for MI (PCI 12.7% vs. CABG 3.8%, P=0.039). Conclusions During a follow-up up to 8.3 years, the survival rate is similar between the PCI and the CABG group in patients with unprotected left main bifurcation disease.The rate of repeat revascularization is significantly higher whereas stroke rate is significantly lower in the PCI group compared to CABG group.After propensity score matching, PCI group not only had a significant higher rate of repeat revascularization, but also had significantly higher risk of MI in the matched cohorts; while they did not seem to translate into any disparity of mortality in ULMCA bifurcation disease patients.Accordingly, PCI for ULMCA disease can be used as a reasonable treatment option alternative to CABG.

Objective: To observe the predictive value of serial platelet function testing (PFT) on outcome in patients undergoing complex percutaneous coronary intervention (PCI). Methods: Six hundred and two consecutive patients undergoing complex PCI in Anzhen hospital were enrolled during October 2011 to June 2012.Adenosine diphosphate(ADP)-induced platelet aggregation was measured by light transmission aggregometry on the first, sixth and twelfth month after PCI and the mean value was calculated.The cut-off value of high on-treatment platelet reactivity (HTPR) was defined as 40%.The primary endpoint was major adverse cardiovascular and cerebral event (MACCE). Clinical outcomes were analyzed by the Kaplan-Meier method and differences were compared using the log-rank test.Multivariate analyses by Cox proportion hazards regression were applied to identify variables independently associated with the adverse outcomes. Results: Five hundred and eighty-five patients (HTPR, n=285; non-HTPR, n=280) finished the follow-up ((28.47±7.45) months). A total of 33 cases of MACCE were observed during the follow-up, among which 29 cases(8.42%) were in HTPR group and 9 cases (3.21%) in the non-HTPR group.Kaplan-Meier analysis suggested that HTPR was associated with an increased incidence of MACCE (log-rank test, P=0.01). The Cox multivariate analysis indicated that HTPR was an independent risk factor of MACCE (HR=2.69, 95%CI 1.23-5.85, P=0.01) in patients undergoing complex PCI.Incidence of MACCE was similar between HTRP patients receiving standard dual antiplatelet therapy (DAPT) or prolonged DAPT (>12 months). Conclusion Serial PFT could predict the long-term prognosis of patients underwent complex PCI.

Objective To study the methods to estimate absorbed dose to eye lens of infants from CT scanning using different protocols and try to find a practical quick way for estimating absorbed dose to eye lens.Methods By scanning one-year old anthropomorphic phantom using 7 kinds of different protocols,all TLDs were measured for final estimation of absorbed dose to eye lens using two different dose conversion methods.Meanwhile,linear regression equation was established between absorbed dose to eye lens and CTDI.Results Absorbed doses to eye lens of infants from children CT scanning using 7 kinds of different protocols were (9.96±0.69) mGy in head axis,(7.01±0.42) mGy in head helical,(12.60± 0.97) mGy in sinus,(12.97±0.42) mGy in inner ear,(0.63±0.03) mGy in neck soft tissue,(8.89± 0.44) mGy in cervical vertebra,and (0.34± 0.01) mGy in chest,respectively.There were statistically significant difference in doses among different groups (F =846.826,P ＜ 0.05).For different scanning locations,there was linear relation between absorbed dose to eye lens and CTDI(r=0.986-0.999,P＜ 0.05).Conclusions Absorbed dose to eye lens of infants from children CT scaning with single dose may not be above threshold dose.In addition,absorbed dose to eye lens can be estimated quickly by linear regression equation between absorbed dose to eye lens and CTDI.

Objective: To isolate and identify the undescribed compounds from the fruits of Cinnamomum migao and evaluate its nitric oxide inhibition potential. Methods: The chromatographic techniques of silica gel, Sephadex, and HPLC were used for isolation and purification of the compounds, while HR-ESI-MS, 1D NMR, 2D NMR, ECD, and X-ray diffraction techniques were used to characterize and confirm the isolated compounds. Moreover, the anti-inflammatory activity of the isolated compounds was carried out to check inhibitory potential against the production of nitric oxide with RAW264.7 cells stimulated by LPS. Results: Camganoid A (1), a novel sesquiterpene possessing an unprecedented skeleton, and camganoid B (2), containing a unique eight-membered sesquiterpene moiety with a new carbon skeleton, were isolated and identified from the fruits of C. migao. The absolute configurations of 1 and 2 were confirmed by single crystal X-ray diffraction and electronic circular dichroism (ECD) calculations. Among these compounds, compound 1 exhibited potent inhibitory activity against the production of nitric oxide with IC

OBJECTIVETo compare the long-term real-world outcomes of consecutive patients with unprotected left main coronary artery disease (ULMCA) underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) and coronary artery bypass grafting (CABG).

METHODSConsecutive patients with ULMCA (defined as stenosis ≥ 50%) undergoing DES implantation or CABG between January 2003 to July 2009 in Beijing Anzhen Hospital were enrolled. The follow-up period extended through August 2013. The end points of the study were death, cardiac death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization).

RESULTSFrom January 2003 to July 2009, 922 ULMCA patients were enrolled in this study (465 PCI patients, and 457 CABG patients). The median follow-up was 7.1 years (interquartile range 5.3 to 8.2 years). The crude relative risk was as follows: overall death rate (13.0% (41/465) vs. 22.1% (72/457), P = 0.009), stroke rate (5.8% (11/465) vs. CABG 18.9% (46/457), P < 0.001) were significantly lower whereas the rate of repeat revascularization (32.3% (110/465) vs. CABG 19.2% (58/457), P < 0.001) was significantly higher in PCI group than in CABG group. MI rate was similar between PCI and CABG group (13.9% (33/465) vs. 6.7% (26/457), P = 0.196). MACCE rate was also similar between the 2 groups (42.9% (145/465) vs. 42.5% (142/457), P = 0.122). After multivariate adjusting, there was no significant difference in rates of death, MI and a composite of serious outcomes (cardiac death, MI, or stroke) between the 2 groups. Rates of MACCE were significantly higher in the PCI group (P = 0.009) due to increased rate of repeat revascularization (P < 0.001). However, stroke rate was still significantly higher in CABG group (P = 0.001) after multivariate adjusting.

CONCLUSIONDuring a follow-up up to 8.2 years, the survival rate is similar between the PCI and the CABG group in patients with ULMCA disease. The rate of repeat revascularization is significantly higher and stroke rate is significantly lower in the PCI group compared to CABG group.

Coronary Artery Bypass ; Coronary Artery Disease ; epidemiology ; therapy ; Drug-Eluting Stents ; Humans ; Myocardial Infarction ; epidemiology ; Percutaneous Coronary Intervention ; Stroke ; epidemiology ; Survival Rate ; Treatment Outcome