Objective To evaluate the feasibility and safety of the treatment for ventricular septal rupture (VSR) by transcatheter interventional therapy coordinated with percutaneous coronary intervention (PCI) or percutaneous transluminal coronary angioplasty (PTCA).Methods Six patients who suffered from cardiogenic shock due to acute myocardial infarction (AMI) and VSR were given intra-aortic balloon pump (IABP) and mechanical ventilation support. After three weeks, they underwent transcatheter closure of ventricular septal rupture with Amplatzer ventricular septal occluder, and at the same time PCI and PTCA were performed. Results All the patients successfully underwent ventricular septal defect occlusion, including two cases of residual shunt. Segmental stenosis of the middle of anterior descending branch and circumflex artery were noted in three patients, and then stent implantation was used. The other three cases had multi-vessel lesion but were without stent implantation. All the patients with stent implantation survived and discharged. Conclusions It is safe and feasible to apply transcatheter closure of ventricular septal rupture with Amplatzer ventricular septal occluder, coordinated with PCI and PTCA for patients with acute myocardial infarction complicated with ventricular septal rupture.

Objective To evaluate the incidence of and risk factors for syphilis seroconversion amomg drug addicts during methadone maintenance treatment (MMT).Methods A retrospective study was performed on drug addicts receiving MMT at MMT clinics in Maanshan,who were seronegative for syphilis before the treatment and followed up by serological tests for syphilis for more than two years.The incidence of and risk factors for syphilis seroconversion during the two years of follow up were analyzed in all the subjects.Results A total of 161 drug addicts were included in this study,of whom,15 experienced seroconversion for syphilis with the average seroconversion rate being 4.66 per 100 person-years.The seroconversion tended to occurr in the early stage of MMT.Both Chi-square analysis and multivariate logistic regression analysis showed that syphilis seroconversion was independently associated with nonuse of condoms during the last sexual behavior before receiving MMT.Conclusions Interventions should be undertaken as early as possible to promote safe sexual behaviors among drug addicts at methadone clinics,and to promote condom use is especially important for blocking sexual transmission of diseases.

Objective To explore the effects of one time loading of different doses of simvastatin before percutaneous coronary intervention (PCI)on post-PCI inflammation,oxidation stress and the endothelium function in (ACS) patients. Methods Totally 124 cases with ACS were randomly divided into two groups:high dose simvastatin group(40 mg,62 cases),low dose simvastatin group (20 mg,62 cases). Each group was given the same basic treatment. Blood samples were obtained from all the patients before and 12 h after PCI,and endothelin-1 (ET-1),nitric oxide (NO),interleukin-10(IL-10),high sensitive - C reactive protein(hs-CRP),superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results The baseline information,distribution of sex,age,and implanted frames had no significant differences between the two groups (P＞0.05).Before PCI,the levels of ET-1,NO,IL-10,hs-CRP,SOD and MDA had no significant differences (P＞0.05) between the two groups.After PCI,ET-1,IL-10 and hs-CRP levels in simvastatin 40 mg group were significant lower while NO level was higher than in simvastatin 20 mg group[(4.4 ± 1.1)ng/L vs.(4.8±1.2)ng/L,t=2.03,P=0.044; (15.0±6.3) ng/L vs.(18.7±9.0)ng/L,t=2.68,P=0.008;(26.9±10.0)ng/L vs.(31.5± 11.7)ng/L,t=2.52,P =0.022;(51.9± 10.9)μmol/L vs.(47.1±11.8)μmol/L,t=2.37,P=0.020].There were no significant differences in MDA and SOD levels between the two groups.For safety,all the patients had no abnormality in liver and kidney function after treatment. Conclusions Compared with 20 mg simvastatin loading before PCI,the 40mg simvastatin loading may decrease the inflammatory cytokines and improve the endothelium function more effectively.