Objective To explore the incidence and risk factor of renal artery stenosis in patients with coronary artery disease and essentiality of renal arteriography while performing coronary artery angiography. Methods Renal arteriography was performed immediately after coronary artery angiography in 114 patients with suspected coronary artery disease. Results Incidence of renal artery stenosis was 18.4% (21/114) in 114 patients and 26% (20/77) in patients with coronary artery disease who were identified by coronary artery angiography. Only one case with renal artery stenosis was found in 37 cases whose coronary arteries were normal (2.7%, 1/37). Incidence of renal artery stenosis in patients with coronary artery disease was higher than that in patients with normal coronary artery (26% vs 2.7%, P

Objective In this angiographic trial,we compared the efficacy and safety of Pro-UK with urokinase in Chinese patients with acute myocardial infarction.Methods We recruited patients with acute ST-elevation myocardial infarction presented within 6 hours in Beijing Tongren Hospital offiliated to Capital Vnirersity of Medical Sciences from Feb.2003 to Mar.2004.After giving informed consent,patients were assigned a bolus and infusion of Pro-UK or a infusion of urokinase.The primary efficacy end points and safety end points were observed.Results Overall 26 patients were enrolled in the trial,of whom 16 patients were assigned to receive Pro-UK(6 patients to 40mg,6 patients to 50 mg,4 patients to 60 mg),and 10 patients to urokinase.The rates of TIMI grade 3 flow were 56.25%(9/16)with Pro-UK and 70%(7/10) with urokinase(P=0.683),of whom 66.7%(4/6) with 50 mg Pro-UK,75%(3/4)with 60 mg Pro-UK. The rates of TIMI grade 2 or 3 were similar for patients treated with Pro-UK versus urokinase(56.25% and 80%,respectively,P=0.399). All safety end points were similar between the two groups. The level of fibrinogen in blood plasma was significantly higher in Pro-UK group than that in urokinase group,indicating that Pro-UK had higher fibrin-specificity.Conclusion The bolus and 30 minutes infusion of Pro-UK 50 mg and 60 mg was clinically safe and effective thrombolytic regimen,but need further study.

Objective To investigate the association between glucose metabolism status and brachial-ankle pulse wave velocity(baPWV)in Chinese patients with coronary artery disease(CAD).Methods baPWV values were measured in 198 CAD patients.Plasma glncose,serum lipids,hsCRP and other baseline data were obtained in all the patients.According to the glucose level,the participants were divided into 3 groups:normal glucose tolerance(NGT)group,impaired glucose regulation(IGR)group and diabetes mellitus(DM)group.ResultsbaPWV values in the DM group(1807±381)cm/s were significantly higher than those in the NGT group[(1615±248)cm/s,P=0.000]and IGR group[(1674±277)cm/s.P=0.035].Multiple stepwise linear regression analyses indicated that higher baPWv values were associated with aging and hsCRP levels in 198 patients.In DM group,higher baPWV values were independently associated with aging and HbA1 C levels.Conclusions In patients with coronary artery disease.baPWV values increase with different glucose metabolism status from NGT to IGR then DM.baPWV values in the patients with DM were significantly higher than those in the other two groups.Glycemic control may ameliorate arterial stiffness.

Objective To investigate the relationship between brachial-ankle pulse wave velocity (baPWV)and different stage of cardiac dysfunction.Methods 253 consecutive patients with coronary atherosclerotic heart disease were enrolled from August 2006 to February 2007.Patients were grouped according to the functional classification of New York Heart Association(NYHA).The baPWV was measured non-invasively with a VP1000 automated PWV/ABI analyzer(PWV/ABI,Colin CO.Ltd.,Komaki.Japan).At the sanle time,BNP,EF,LAEDV and LVESV were measured in all the patients.Results Brachial-ankle PWV was significantly correlated with cardiac function classification of NYHA(r=0.444.P＜O.001),BNP(r=0.394,P＜0.001)and left ventriculat end diastolic volume(r=-0.130,P＜0.05),The under area of receiver operating charachateistic(ROC)curve was 73.9%.The ROC curve demonstrated that when the value of brachial-ankle PWV was equal to or larger than 1717 cm/s(≥1717 cm/s),the sensitivity of diagnosing mild cardiac dysfunction was 72.9%and specifity 61.8%.When its value was equal to or larger than 1900 cm/s(≥1900 cm/s),the sensitivity and specificity were 61.5%and 81.9% respectively.Conclusion Brachial-ankle PWV is significantly correlated to the NYHA classification of heart failure and it may be a prospective index to diagnose early stage of cardiac dysfunction.

Objective:To define impact of spontaneous TIMI-3 flow before angioplasty on outcomes of percutaneous coronary intervention strategy and the prognosis in patients with acute myocardial infarction (AMI ). Methods: The consecutive 301 patients enrolled in the ongoing register of emergent coronary angioplasty within 12 hours from symptoms who were diagnosed as having ST elevation AMI in our hospital from 2000 to 2006 were analyzed, they were followed up for one year and the clinical characteristics and survival rates were analysed. Results: Among the 301 patients enrolled in the ongoing register of emergent coronary angioplasty, spontaneous reperfusion (TIMI-3 flow) was present in 14.6% at initial angiography. Compared with patients without TIMI-3 flow, those with TIMI-3 flow before coronary intervention were less likely to present in new-onset heart failure(2.3% versus 16%, P=0.016), Patients with initial TIMI-3 flow had significantly lower 30-day mortality (0% versus 9.3%, P=0.035) , and cardiogenic shock (0%versus 8.6%, P=0.044) and had a shorter hospital stay (P=0.008). Cumulative 1-year mortality was 0% in patients with initial TIMI-3 flow, 11.3% with TIMI 0-2 flow (P=0.019). By COX regression analysis, postprocendural TIMI-3 flow was an independent determinant of survival (OR=0.285,P=0.004) , however,TIMI-3 flow before coronary intervention was not found as an independent determinant of survival significantly. The lenitive symptoms and current smoking were the independent determinants of TIMI-3 flow before coronary intervention (P=0.005, P=0.048, respectively).Conclusion: Patients undergoing primary percutaneous transluminal coronary intervention in whom TIMI-3 flow is present before angioplasty may present with greater clinical and angiographic evidence of myocardial salvage, be less likely to develop complications related to left ventricular failure, and improve early and late survival.

Objective: To investigate the value of computed tomography (CT) texture analysis in differential diagnosis of inflammatory and malignant pulmonary nodules. Methods: The image data of 54 patients with lung cancer and 36 patients with pulmonary inflammatory nodules were retrospectively collected in our hospital. All the patients received chest CT scan. CT texture analysis of entropy, correlation degree and contrast ratio were performed by the MaZda software. The receiver operating characteristic curve (ROC) was established and the area under the curve (AUC) was calculated to evaluate the value of CT texture analysis in differential diagnosis of inflammatory and malignant pulmonary nodules. Results: In the lung cancer group, the value of entropy, correlation degree and contrast ratio were 1.58±0.07, 0.02±0.17 and 8.79±2.59, respectively. In the inflammatory nodules group, the value of entropy, correlation degree and contrast ratio were 1.51±0.04, 0.22±0.16 and 12.53±2.24, respectively. The differences were all statistically significant (P values were 0.008, 0.027, and 0.006, respectively) between two groups. There was not statistically significant difference (P>0.05) in the CT values between the lung cancer group and the inflammatory nodule group based on the non-contrast enhanced CT scan. Meanwhile, there was no statistically significant difference (P>0.05) in the value of entropy, correlation degree or contrast ratio between two groups based on arterial phase or venous phase of contrast enhanced CT. The ROC analysis showed that the AUC in differentiating the lung cancer and inflammatory nodules was 0.821, 0.778 and 0.875, respectively. The AUC of combination of three phases was 0.931, which was higher than the AUC of entropy, correlation degree and contrast ratio respectively (P<0.01). The sensitivity was 88.9%, and the specificity was 87.5%. Conclusion CT texture analysis is a high-potential image analysis method, which can provide more information for the differential diagnosis of benign and malignant pulmonary nodules.

Objective To investigate the factors associated with delay in decision to seek treatment in patients with acute myocardial infarction(AMI) in Beijing. Methods This prospective,cross-sectional,multicenter survey was conducted from November 1,2005 and December 31 ,2006. The participants consisted of 799 patients with STEMI admitted within 24 h of symptom onset to 19 hospitals in Beijing. Data were collected by semi-structured interviews and medical records review. The patients were categorized into an early decision group and the a late decision group based on the 30 min cut-off. Results The median(25%,75%) decision delay in STEMI patients was 60(20, 180)min. Factors associated with late decision in an univariate analysis were age ≥65 years, retirement or unemployment, history of myocardial infarction,symptom onset at home and intermittent symptoms, whereas presence of bystanders such as friends,coworkers or even strangers,unbearable symptoms,dyspnea,sweating,syncope and attribution of symptoms to cardiac origin were related to early decision. Multivariate logistic analysis showed that history of myocardial infarction,absence of syncope, intermittent symptoms,bearable symptoms and attribution of symptoms to noncardiac origin were independent predictors of decision delay＞30 min. Patients in the early decision group had more chances to receive acute reperfusion therapies(P=0.001) and shorter time intervals from symptom onset to reperfusion therapies(P＜0.001). Conclusions To a great extent patients with AMI in Beijing delayed in decision to seek treatment. History of myocardial infarction, symptom characteristics and symptom attribution were associated with decision delay.

Objective This study was aimed to investigate the relationship between serum leptin,adiponectin,visfatin levels and obesity and essential hypertension in female subjects.Methods According to BMI and blood pressure,206 female participants enrolled were divided into four groups:group 1:obesity and hypertension (48 cases);group 2:non-obesity but hypertension (48 cases);group 3:obesity and normotension (56 cases) and group 4:normal BMI and blood pressure (54 cases).Serum leptin,adiponectin and visfatin levels were detected and their relationships to BMI,blood pressure and waist circumference were analysed.Results Serum leptin levels were significantly higher in non-obese groups [group 2:(4.47 ±1.26) ng/L,group 4:(3.73-±1.18)ng/L] than in obese groups [group 1:(2.97 ± 1.46) ng/L,group 3:(3.02 ± 1.18) ng/L],and higher in hypertension groups than in normotension groups.Serum adiponectin levels were obviously higher in group 4 [38.99 (19.75,103.71) μg/L] than in the other three groups.There were no significant differences in adiponectin levels among group 1,2 and 3.Serum levels of visfatin were lower in normotension groups [group 3:3.19 (0.96,9.45) ng/L;group 4:3.23 (1.92,4.64) ng/L] than in hypertension groups [group 1:3.84 (3.40,5.35) ng/L;group 2:3.75 (1.63,6.67) ng/L] irrespective of obesity.Logistics regression analysis showed that there was 1.6％,8.3％,or 5.45％ increased risk for hypertension for each 1 μg/L decrease in adiponectin,1 cm increase in waist circumference,or 1 μg/L increase in visfatin level in obesity,respectively.No relationship could be viewed between leptin and hypertension.Conclusions Adiponectin and visfatin levels were correlated with obesity and blood pressure in females.Both adipokines may play a crucial role in the development of hypertension in female obesity.

Objective To assess the predictive value of serum uric acid levels for cardiovascular and all-cause mortality in a large prospective population based study.Methods The study was based on 3648 participants in Shanghai and Beijing,who were inpatients with high cardiovascular(CV) risk at baseLine (2004.7 to 2005.1),and blood was taken.Follow-up for death from cardiovascular disease and any cause was complete until January 1,2006.Results The mean follow-up was 1 years.There were 303 deaths during follow-up,of which 121 were cardiovascular.Crude mortality rates were 8.3 % for all patients,6.8% for female patients (116/1715),and 9.7% (187/1933) for male patients.Among men,patients in the lower and higher uric acid groups had increased cardiac and overall mortality risks compared with patients in the normal uric acid groups.Similar relation was found in women but not statistically significant.After adjusting for other conventional risk factors (age,diabetes,hypertension,diuretic use and smoking),baseline uric acid level was still associated with increased risk for death from cardiovascular disease (P=0.005),or death from all causes (P=0.014) Conclusion Our data suggest that abnormal serum uric acid levels are independently and significantly associated with risk of cardiovascular and all-cause mortality.(J Geriatr Cardiol 2008;5:15-20)

OBJECTIVE： To provide reference for promoting the implementation of “two-invoice system” for drug purchase in medical institutions. METHODS： The function of confirmation， enquiry， statistics for “two-invoice system” of drug purchase order were added into relevant module of SPD （supply processing distribution） system to realize the management of “two-invoice system” data by means of information technology. By analyzing the data of the “two-invoice system” of Shanxi dayi hospital （our hospital） from Aug. 2017 to Jun. 2018， the effects of SPD system on “two-invoice system” of drug purchase in our hospital were introduced after the application of SPD system. The effects of SPD system were evaluated in respects of work efficiency， accuracy rate and resource saving， etc. RESULTS： SPD system was used for the management of “two-invoice system” to realize the information management of invoices. The time for checking “two-invoice system” information was shortened from 1.5 min/sheet to 0.1 min/sheet； the accuracy rate was increased from 95％ to 100％， and about 40 000 sheets of paper were saved each year. CONCLUSIONS： The application of SPD system in “two-invoice system” of drug purchase can improve the work efficiency， reduce the labor cost and reduce the waste of resources， it effectively improves the level of management in our hospital.