Objective To evaluate the clinical characteristics and long-term results of elective coronary stenting in octogenarians with coronary artery disease. Methods From Jan 2000 to Dec 2003, 84 octogenarians with coronary artery disease documented agiographically were divided into stent group (n=45) and medicine group (n=39). The clinical characteristics, in-hospital and long-term results were analyzed between the two groups. Results There were no difference between the two groups at the respect of basic clinical characteristics but the percentage of AMI was higher in the stent group (40.0% vs 17.9%, P

Objective To evaluate the clinicopathological characteristics and immunophenotype of solitary fibrous tumor (SFT),which is able to provide the basis for clinical diagnosis and prognosis,differential diagnosis and predictable prognosis.Methods Data from 11 cases of SFT were investigated by immunohistochemical.Results Histologically,SFT was composed of spindle cells,which arranged in fascicles pattern,as well as the collagen and branch vessels.Malignant SFT had higher and crowed cellularity with significant pleomorphism,numerous mitoses and putrescence.Positivity for bcl-2 and CD34 was observed in all SFT.Eight tissues showed CD99 positivity,one showed s-100 positivity,all 1 1 tissues showed Ckpan negativity.Conclusions SFT has originated from different sites,which should be distinguished with fibrosarcoma and other spindle cell neoplasms.More attentions should be paid to malignant SFT and focus on the follow-up visit.

Objetives To investigate the outcomes of sirolumus-eluting stent(CypherTM,Cordis/Johnson&Johnson,Warren,NJ,USA)and paclitaxel-eluting stent(TaxusTM,Boston Scientific,Natick,MA.USA)in the treatment of coronary heart disease after a four.year clinical follow-up.Methods 237 consecutive patients were enrolled in this study and treated with Cypher(136 patients)or Taxus(101 patients)from January to October 2003.111e rates of stenosis.stent thrombosis according to ARC definition and major adverse cardiac events(MACE a composite of cardiac death,myocardial infarction and target vessel revascularization)were analysed.Results There was no significant difference on secondary restenosis.target lesion revascularization(TLR)and MACE between Cypher and Taxus groups at six.month angiographic follow-up,but late luminal loss was higher in Taxus group[(0.15±0.43)mm vs(0.42±0.34)mm,P=0.022].At four-year follow-up,TVR-free survival rate was 88.97% in Cypher group versus 82.28% in Taxus group(P=0.158).MACE.free survival rate was 83.8% in Cypher group and 79.2% in Taxus group(P=0.056).The incidence of stent tllrombosis was no difference between the two groups(1.47% vs 1.98%).There was also no difference among early(0 vs 0.99%),late(0.73%vs0.99%)and very late stent thrombosis(0.73%vs 0)between the 2 groups.Conlusions There were nodifference between Cypher and Taxus in the treatment of coronary artery disease:Both Cypher and Taxus have good clinical outcomes except that Taxus had highcr late loss.

Objective: To make long-term comparison of drug-eluting stent (DES) implantation betweenleft internal mammary artery (LIMA) graft and native vessel in patients with previous coronary artery bypass grafting (CABG).
Methods: A total of 151 patients with anterior wall ischemia because of previous CABG induced LIMA graft lesion who received percutaneous coronary intervention (PCI) in our hospital from 2004-07 to 2012-12 were retrospectively studied. The clinical, coronaryangiography (CAG) and follow-up conditions for DES implantation were analyzed;according to the target vessel, the patients were divided into 2 groups:LIMA group, n=40 and Native vessel (NV) group, which meant all segments of left main to left anterior descending arteries, n=111. Primary end points included target lesion revascularization (TLR), target lesion failure (TLF) as cardiac death, target vessel related non-fatal MI with the composition of TLR and major adverse cardiovascular events (MACE).
Results:The median follow-up time was 30 (10-100) months. The rates of TLR and TLF were similar between 2 groups:(15.0%vs 11.7%, log-rank P=0.65) and (17.5%vs 13.5%, log-rank P=0.63). MACE occurrence in LIMA group was higher than NV group (35.0%vs 18.0%, log-rank P=0.043) which was mainly presented by new non-target vessel revascularization as right coronary artery, left circumlfex and saphenous vein graft(17.5%vs 4.5%, log-rank P=0.014). Cox multivariate analysis indicated that target lesion stent length was the only independent predictor for both TLR (HR=1.03, 95%CI1.00-1.06, P=0.01) and TLF (HR=1.03, 95%CI1.00-1.05, P=0.02);whereas, LIMA-PCI was the only independent predictor for MACE occurrence (HR=3.09, 95%CI1.28-7.60, P=0.012).
Conclusion: The chances of TLR and TLF were similar inpatients with previous CABG by either LIMA or NV, while MACE occurrence was higher in LIMA patients which should be further investigated.

In order to improve teachers' teaching ability and manage teachers effectively, we try to organize teachers to carry out a series of activities in the form of "teaching club". We set up six teaching clubs according to the key points of teaching work and teaching hot spots. We explore the formation of "teaching club" as a means of modern teacher management model, through the implementation of the teacher-centered concept, establish an efficient and flexible management system, and establish and improve the active development of behavior and other strategies. Through a period of practice and exploration, we have gained benefits and even made breakthroughs in many aspects, such as the construction of teaching team, curriculum construction and teaching competition. The management strategies mentioned above provide new ideas for the development of teacher management.

Pancreatic cancer has a poor prognosis, systemic comprehensive therapy including chemotherapeutic and molecular targeted therapy is the key to improve the postoperative prognosis of pancreatic cancer, as well as to prolong the survival time of advanced pancreatic cancer. However, due to the drug resistance and heterogeneity of pancreatic cancer cells, systemic comprehensive treatment still does not reach the ideal effect, and personalized therapy will be an important approach to solve this problem. The personalized therapy for pancreatic cancer will become possible with the application of patient-derived tumor xenograft (PDX) models. Here, this article will review the progress of the application of PDX models in comprehensive therapy of pancreatic cancer based on reviewing the methods of establishing pancreatic cancer PDX models, aiming to provide new ideas for personalized therapy of pancreatic cancer.

Objective To study the possible causes of ST-elevated acute myocardial infarction (STEAMI) occurring one month after percutaneous coronary intervention (PCI). Methods One hundred and ninety two patients aged from 40-79 years who had a successful previous PCI and also received primary PCI due to STEAMI in this hospitalization were included in this study. The AMI-related lesions and previous angiographic findings such as the number of lesions, the degree of the stenosis, the type of stents and the acute results of last PCI, etc. were recorded in detail. If the AMI-related lesion was localized in-stents or at the edge of stents (distance from the edge ≤5 mm), it was defined aslate thrombosis, otherwise it was regarded as an AMI induced by new-lesion. Results New lesions, as the cause of STEAMI, were found in 144 cases (Group A, 75%), and late thrombosis in 48 patients (Group B, 25%). There was a significant difference in the average time from previous PCI to AMI (30.1±12.4 vs. 20.3±11.9 months) between the two groups. Diabetes mellitus (DM) and drug-eluting stents (DES) utilization were associated with markedly higher morbidity of late thrombosis in adjusted logistic regressionanalysis [hazard ratio (HR) 3.387, 95% CI 1.053-10.898 and HR 5.311, 95% CI 1.066-26.464]. Conclusions STEAMI occurred 1 month after PCI are more likely to be developed from previous insignificant lesions than from late thrombosis in stents. Moreover, DM and DES are associated with a high incidence of late thrombosis, which may indicate that intensive antiplatelet therapy should be considered in diabetic patients receiving PCI.

OBJECTIVETo examine long-term efficacy of percutaneous transluminal coronary angioplasty (PTCA), coronary stenting and to assess the factors affecting its efficacy.

METHODSA total of 790 patients who underwent successful PTCA and PTCA + stent in this hospital were followed by direct interview or letter. The rate of follow-up was 84.2% and the period of follow-up was 0.9 - 12.7 (3.5 +/- 2.4) years.

RESULTSDuring follow-up, 4 (0.5%) patients died, 22 (2.8%) had nonfatal acute myocardial infarction, 10 (1.3%) had coronary artery bypass surgery, and 98 (12.4%) had repeat PTCA. The rate of recurrent angina pectoris was 31.1%. The cardiac event-free survival rate calculated by the Kaplan-Meier method was 88.2% at 1 year and 80.6% at 12.7 years. Cox regression analysis showed that there was a positive correlation between AMI history, stent implantation and the risk of cardiac events, and there was a negative correlation between the number of diseased arteries and the risk of cardiac events. Compared to the PTCA group, patients with PTCA + stent had significantly lower rates of total cardiac events.

CONCLUSIONThe long-term efficacy of PTCA, especially PTCA + stent in Chinese patients was very satisfactory, suggesting that PTCA + stent therapy should be the major treatment for revascularization in patients with coronary heart disease.

Adult ; Aged ; Angina Pectoris ; etiology ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Stenosis ; mortality ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; etiology ; Retrospective Studies ; Stents ; adverse effects ; Survival Rate ; Treatment Outcome

Objective: To evaluate the impact of primary percutaneous coronary intervention (PPCI) with pre-operative intra-aortic balloon pump (P-IABP) implantation on short and long term prognosis in octogenarian patients of ST-segment elevation myocardial infarction (STEMI). Methods: We performed aretrospectively study in octogenarian STEMI patients treated in our hospital from 2004-01 to 2014-08. The patients were divided into 2 groups: P-IABP group,n=24 and PPCI group,n=73 including 12 patients who received rescue IABP (R-IABP) because of intra- or post-procedural hemodynamic collapse as a subgroup.Major end point events included 1 month and 1-, 2-year post-operative death; major adverse cardiac and cerebral events (MACCE) included 1 month post-operative cardiac shock, new or worsening heart failure (HF), re-infarction and stroke. The predictors causing different endpoint events were identiifed by Cox proportional hazard model analysis. Results: 1 month and 1-, 2-year post-operative death were similar between 2 groups (8.3% vs 16.4%), (16.7% vs 24.7%), (25.0% vs 30.1%) respectively; MACCE incidence was also similar (20.8% vs 30.1%), allP>0.05. Death rates between P-IABP group and R-IABP subgroup were similar at different time points,P>0.05; while MACCE incidence in P-IABP group was lower than R-IABP subgroup (20.8% vs 66.7%),P=0.005 and it was mainly presented by reduced HF occurrence (8.3% vs 41.7%),P=0.003. Coxproportional hazard model analysis indicated that post-operative TIMI lfow<3 grade was the independent predictor for 1 month death (HR=4.79, 95% CI1.59-14.39,P=0.005), complicating diseases as chronic obstructive pulmonary disease, kidney impairment and anemiawere themain independent predictors for 2-year death (HR=3.0, 95% CI 1.37-6.56,P=0.006). Conclusion: PPCI and P-IABP had no signiifcant differencefor short and long term survivalin octogenarianSTEMIpatients. Compared with R-IABP, P-IABP patients had the lower MACC Eincidence at 1 month post-operation .

Objective: To evaluate the hybrid of drug eluting stent (DES) with bare metal stent (BMS) and exclusive DES implantation for treating the patients with multi-lesion coronary disease.
Methods: A total of 6495 patients with multi-lesion coronary disease received elective PCI in our hospital from 2004-04 to 2006-10 were retrospectively studied. The patients were divided into 2 groups, Hybrid group, n=848 and Exclusive DES group, n=5647. With 1:1 propensity score matching, there were 823 pair of patients were ifnally studied. The clinical outcomes included 1, 2 years post-operative all cause death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), major adverse cardiac events (MACE) and in-stent thrombosis. The relative risks of all outcomes were assessed by Cox’s proportional-hazard model after propensity match.
Results: With propensity match, Cox’s proportional-hazard model analysis indicated that compared with Exclusive DES group, Hybrid group had the higher risks of TLR (HR 2.38, 95%CI 1.50-3.70), TVR (HR 1.61, 95%CI 1.15-2.27), MACE (HR 1.37, 95%CI 1.02-1.85), all P<0.01. The all cause death, MI and the ratio of all cause death/MI were similar between 2 groups in 1, 2 years follow-up period, all P>0.05.
Conclusion:Compared with exclusive DES, the hybrid of DES with BMS implantation had the higher risk of TLR, TVR and MACE for treating the patients with multi-lesion coronary disease.