Percutaneous coronary intervention(PCI) has created an epoch-making treatment approach to coronary artery disease(CAD).Over the last four decades,following constant progress of the new PCI technology and instruments,following the wide application of coronary stents,especially with drug-eluting stents(DES),PCI indications significantly broaden to cover more complex lesions and more high-risk patients.Some of the contraindications have shifted to indications of percutaneuous coronary intervention and some of former absolute contraindications are turned to relative contraindications.The change in indications and contraindications of PCI to coronary artery disease reveals the rapid development of percutaneuous coronary intervention.

Objective To study the location of coronary chronic total occlusion and the correlatin between coronary chronic total occlusion and coronary collateral. Methods SPSS was used to analyze the general clinical and coronary angiographic data of 113 patients with coronary bypass surgery performed. Results There were 61 patients with coronary chronic total occlusion. 71 sites of coronary chronic total occlusions were observed by coronary angiography, of which, one was located in left main coronary artery (0 9%), 17 in proximal left anterior descending artery (15 0%) , 9 in middle left anterior descending artery (8 0%), 3 in distal left anterior descending artery (2 7%), 5 in proximal left circumflex artery (4 4%), 6 in middle left circumflex artery (5 3%), 3 in distal left circumflex artery (2 7%), 9 in proximal right coronary artery (8 0% ), 10 in middle right coronary artery (8 8% ) and 8 in distal right coronary artery (7 1% ). There were 72 patients with coronary collateral. The coefficient of correlation between collateral and coronary chronic total occlusion was 0 707 (P=0 000 ).Conclusions Coronary chronic total occlusion is frequently located in proximal, middle left anterior descending artery and right coronary artery. There is significantly positive correlation between collateral and coronary chronic total occlusion.

Objective To analyzed the use of oral hypoglycemic drugs in our hospital for reference of clinical rational use of this kind of drugs. Methods The sorting methods of defined daily dose (DDDs) and the frequency of oral hypoglycenic drugs were used for analysis. Results The list of leading DDDs was glucosidase inhibitor, which accounted for 31.13 % of the total, followed by biguanides which accounted for 21.49%. Conclusions The glueosidase inhibitor, a new type oral hypoglycemic drugs used for lowering postprandial blood sugar level showed remarkable efficacy and safety, so it is currently the first choice for patients with diabetes.

Objective To study the treatment of renal artery stenting for patients with coronary artery heart disease and renal artery stenosis who need coronary atery bypass graft (CABG) and its effect on preventing acute renal dysfunction after CABG. Methods From April 2001 to January 2005, renal artery stenting was carried out in 82 patients (a total of 104 renal arteries) with CHD and renal artery stenosis who needed CABG. Among the 82 patients, 77 of them accompanied with hypertension and 21 of them had abnormal renal function. Heparin was selected as anticoagulant other than anti-platelet drug and low molecular weight heparin before stenting. Results All of the stents were successfully implanted in 104 renal lesions without complication. Blood creatinine (Cr) reduced in 9 patients with renal dysfunction by the time of discharge. Three patients had blood Cr increased provisionally after stenting. Four patients with normal pre-operational renal function showed transient increase in blood Cr after stenting. All of the patients with transient blood Cr elevation had bilateral renal artery stenosis. Conclusion Renal artery stenosis may cause acute renal failure after CABG. Pre-CABG renal artery stenting may prevent the occurance of acute renal failure after operation.

Percutaneous transluminal coronary angioplasty (PTCA) was done successfully in 33 patients,6 of them were associated with 8 acute coronary events. Radioimmunoassay was used for the determination of plasmaET,AII and CGRP levels. The samples were drawn successively from femoral artery just before PTCA and 0min, 15min,1h,3h,24h after the final balloon inflation. The results showed that the levels of plasma AII were higher in the complication group than those of noncomplication group before PTCA and 0min, 24h after PTCA. The differences in plasma ET levels before and after PTCA between the complication group and the non-complication group were not significant. The level of plasma CGRP was decreased at 15min and returned to basal level at 1h after PTCA in the complication group.In the patients without complication,there were no significant differences in their plasma CGRP levels before and after PTCA. All + ET/CGRP in the complication group raised more rapidly,recovered later and the peak appeared earlier than that of non-complication group. For a better understanding pathophysiologic meaning of the above changes,further studies are needed.

There were no data concerning restenosis rate after percutaneous transluminal coronary angio-plasty available in China so far. Our study was focused on clinical and angiographic follow-up and tried to reveal the predictive value for angiographic restenosis using noninvasive tests among 592 patients whose 841 coronary arteries were dilated in our department from Dec. 1987 to Dec. 1994.This patient group consisted of 503 males and 89 females had average age of 58. 4 ? 9. 1. The overall success rate was 93. 3% and acute vessel complications was 4. 1%. After successful procedures of PTCA,the patients were followed up with recurrence of angina, Holler ECG, submaximal excercise ECG and 99mTc-MIBI exercise scintigraphy regularly. 62 of these patients underwent coronary angiographic follow-up from 4-24 months (average time: 10. 4 ? 7. 6 months) after PTCA. We found 35 patients with angiographic restenosis and 27 patients without. Thus, we divided the patients into restenosis group and non-restenosis group according to the angiographic results. Subsequently, we oberserved whether the symptom and noninvasive tests were valuable in prediction of restenosis. The result showed that recurrence of angina, Holter ECG, submaximal exercise ECG and 99mTc-MIBI scintigraphy were useful in detecting restenosis with their specificity and sensitivity 75.7% and 72.0%, 71. 4% and 86. 7%, 66. 7% and 73. 1% ,76. 5% and 83. 3 %, respectively. Moreover, If any two of above four ischemic indexes were combined together to detect restenosis,the specificity and sensitivity were significantly enhanced (85. 2% and 92. 9%). It is concluded that recurrence of angina and the noninvasive tests were valuable in predicting restenosis. The combination of these ischemic indexes would greatly improve their predictive value.

31 rat were divided randomly into control group (n=10),tripterygium wilfordii glycosides group (n = 10 9. 4 mg/kg per day),and poly saccharide sulphate group (n=11. 30 mg/per day). We made balloon endothelium denudation in thoracic aortae of the rats. The treatments with drugs began 6 days before balloon injury and continously until the animal were killed 14 day after balloon injury. The determinations for area of neointima, neointima /media, coverage of neointima and 3H-TdR incoperation of thoracic aortae suggested that tripterygium wilfordii glycosides can inhibit intimal proliferation of injuried aorta, whill poly saccharide sulphate shows no effect.

Objective:To evaluate the nutritional risk and its risk factors in patients with chronic pancreatitis (CP).Methods:Using nutritional risk screening 2012,a retrospective study was performed to analyze nutritional risk in 156 CP patients.Conditional logistic regression model was applied to identify the risk factors from fourteen clinical features that potentially influen cenutritional risk.Results:Proportion of patients with nutritional risk was significantly higher than malnutrition patients (44.9％ vs 25.6％,x2 =12.64,P =0.000 4).Univariate analysis indicated the following seven factors,gender,concomitant diabetes mellitus,intervention by endoscope or surgery,pancreatic enzyme replacement therapy,anxiety depression,insufficient eating and nutritional support for less than 3 months were associated with higher nutritional risk in CP patients (P ＜ 0.01).The result of multivariate analysis showed that anxiety depression,insufficient eating and nutritional support for less than 3 months werethe risk factors for malnutrition CP patients.Conclusion:There are higher nutritional risks in CP patients and early psychotherapy,sufficient eating and timely parenteral or enteral nutrition support should be undertaken for patients with chronic pancreatitis.