Objective To evaluate the long-term effect and safety of triple antiplatelet therapy(cilostazol,aspirin and clopidogrel)for the patients with diabetes and acute coronary syndromes(ACS)undergoing percutaneous coronary intervention(PCI).Methods Between December 2004 and February 2006,a randomized,single center trial was conducted in General Hospital of Shenyang Command for comparison of dual and triple antiplatelet therapy after PCI for the patients with ACS.Of 263 diabetic patients enrolled in present study,122 were randomly assigned to standard dual antiplatelet treatment with aspirin and clopidogrel,141 were assigned to triple antiplatelet therapy with aspirin,clopidogrel and cilostazol.Primary endpoint was a composite of cardiac death,non-fatal myocardial infarction(MI),stroke or target vessel revascularization(TVR)at 1 year.Results Baseline clinical and angiographic characteristics were comparable between the two groups.No definite stent thrombosis or MI occurred in either group during the period of follow-up,and no significant difference existed yet in the rates of 1-year cardiac death(4.1% vs 1.5%,P=0.255),stroke(3.3% vs 0.7%,P=0.186)and TVR(12.3% vs 7.8%,P=0.223)between the patients received dual or triple antiplatelet therapy.The rate of primary events was 9.9%(14/141)in triple group,which was significantly lower than that in dual group [18.9%(23/122),P=0.038].Patients receiving hypoglycemic medicine got more benefits from triple antiplatelet treatment.There was no significant difference between the two antiplatelet regimens regarding the risk of hemorrhagic events and premature discontinuation of aspirin or clopidogrel.Conclusion The regimen of cilostazol plus aspirin and clopidogrel for diabetic patients undergoing PCI is effective and safe in reducing long-term adverse cardiac and cerebral-vascular events,especially for the patients with high dangerous DM complicated with ACS.

Objective To evaluate the safety and feasibility of transradial approach for coronary angiography.Methods Five hundred and ten cases of suspected coronary artery disease received coronary angiography by transradial approach.Results The procedures were successfully performed in 503 cases. Seven failed, of them, three failed in acupuncture, 1 had deformed radial artery,2 were with severe tortuosity of nonname artery and one case was due to left subclavian artery occlusion. The radial artery was occluded in one case after operation.There was no other severe complication. Conclusions Transradial approach for coronary angiography is safe and feasible.Its advantage lies in higher success rate and less complication.

Objective To investigate the efficacy and safety of intravenous diltiazem in patients with perioperative angina pectoris in coronary artery revascularization.Methods Totally 128 patients with angina pectoris during perioperation of coronary artery revascularization received intravenous diltiazem.The efficacy was determined by angina symptom,changes of blood pressure (BP) and heart rate (HR),and acute heart events after 2 weeks.Results Ninety-one cases had no relapse and 37 were obviously improved of angina symptoms.BP and HR were safely lowered after intravenous diltiazem.Of the 128 cases,85 received successful PCI and were discharged 1-3 weeks postoperatively;41 of 43 cases successfully received CABG;2 died of ventricular fibrillation and heart failure.There was not side-effect in all patients.Conclusion Intravenous diltiazem is effective and safe for with angina pectoris during perioperation of coronary artery revascularization.

Objective To explore the post-implant complications of permanent cardiac pacemakers,their reason,treatment and preventive measures.Methods The records of 516 patients receiving a permanent pacemaker were reviewed and complications of the patients were analyzed.Results There were 69 cases of complications after the permanent cardiac pacemaker implantation,5 cases(7.2%) of infection,10 cases(14.5%) of haematoma,7 cases(10.1%) of pocket rankle,10 cases(14.5%) of hemothorax and pneumothorax,10cases(14.5%) of pacemaker syndrome,7 cases(10.1%) of undersensing,2 cases(2.9%) of pacemaker mediated tachycardia,3 cases(4.4%) of battery exhaust advance,3 cases(4.4%) of arrhythmia,10cases(14.5%)of electrode displacement and 2 cases (2.9%) of electrode fracture.Conclusion Good prognosis will be resulted from deep understanding of the usual complications,increased differentiating ability, emphasized pre-operation prevention,standardized operation,strengthened follow-up as well as the education of pacemaker knowledge,early discovery and treatment of the complications.

Objective To evaluate the safety and clinical effect of homemad Costant coronary stent implantation.Methods The immediate and two-year follow-up results of Costant coronary stent implantation in severe coronary heart disease(CHD)patients were retrospectively analyzedin the General Hospital of Shenyang Command of PLA and the Guanzhou People's Hospital from Mar.2001 to Aug.2003.Results Implantation of 86 homemad Costant coronary stents was successfully performed in 71 severe CHD patients although 3 main adverse cardiac events(MACE)occurred during hospitalization(2 patients died and 1 patient had sub-acute in-stent thrombosis).Follow-up was made in 63 patients for(21.5?4.4)months on an average and 4 patients died.Repeat coronary angiogram in 21 patients showed that in-stent restenosis for Costant stent existed in 4 patients and in-stent restenosis in other types of stent was found in 3 patients and in-stent restenosis in all stents was found in 1 patient who died of shock and neo-coronary lesions was found in 5 patients.Costant stent restenosis rate was 7.9%(5/63);MACE rate was only 12.7%(8/63)during follow-up.Conclusion Homemad Costant coronary stent can be safely implanted in severe CHD patients with ideal long-term outcomes.

55 mm and LVEF

60 mm and left ventricular ejection fraction (LVEF)

80%).Two patients had side lateral vein branches,and 5 patients had side branches of posterolateral veins.There was no significant relationship between the venous variation and sex.The rate of venous variation was higher in patients with noischemic cardiomyopathy than in patients with ischemic cardiomyopathy(91.25% vs 72.72%,P

BACKGROUND: Previous studies have shown that the complex of polyethylene glycol diacrylate and chitosan is biodegradable, has the anti-inflammation effect and can promote wound healing, with good biocompatibility.However, the composite material is brittle, and thus, it is necessary to develop a mechanical support material due to the anatomy of the nasal cavity.OBJECTIVE: To study the cytocompatibility of a novel degradable absorbable nasal packing material made of polyethylene glycol diacrylate composite hydrogel.METHODS: In our experiment, the composite hydrogel was formed by the combination of different ratios of polyethyleneglycol diacrylate, chitosan and polyvinyl alcohol using photo-crosslinking method. According to the international standard of medical devices, we used direct and indirect international standard experimental methods to evaluate the cytotoxicity of the materials. (1) Direct contact method: the polyethylene glycol acrylate composite hydrogel and mouse fibroblasts L929 were co-cultured for 24 hours to observe the morphological changes of cells. (2) Indirect extraction: mouse fibroblasts L929 were cultured in polyethylene glycol diacrylate composite hydrogel extracts (100, 50 μL) and RPMI1640 medium (100 μL), respectively, for 3 days to observe the proliferation and cytotoxicity by cell counting kit-8 assay.RESULTS AND CONCLUSION: (1) Direct contact method: the cells around the material formed a flat structure with fusiform or stellated protrudes. The material was confirmed to have good biocompatibility depending upon the presence of adherent cell growth, full and strong refraction, and the overall growth trend. (2) Indirect extraction method: with the increase of time, the number of cells in the hydrogel extract group increased, the relative proliferation rate of cells increased gradually, and the cytotoxicity was 0 to 1. To conclude, these experimental findings indicate that the polyethylene glycol acrylate composite hydrogel material has good cytocompatibility.

Objective To observe the effects of PTD-hepatitis B core antigen (HBcAg) induced murine bone marrow-derived dendritic cells (DCs) maturation on T lymphocyte proliferation in vitro.Methods Bone marrow derived DCs isolated from BALB/c mice were cultured with recombinant granu|ocyte-macrophage colony-stimulating factor (rGM-CSF) and recombinant interleutin-4 (rIL-4)for 5 days.Tumor necrosis factor (TNF)-a,HBcAg and PTD-HBcAg were added to induce DCs maturation.The distribution and localization of intracellular immunofluorescence were observed by confocal microscopy,and DCs phenotypes were analyzed by flow cytometry.The level of IL-12 p70 in the supernatant was detected by enzyme linked immunosorhent assay (ELISA).The proliferation of T lymphocytes was performed by using cell counting kit-8 (CCK-8).All data were analyzed using t test.Results DCs were cultured and identified successfully.Recombinant PTD-HBcAg could penetrate into DCs cytoplasm while recombinant HBcAg was detected on the surface of cells.DCs surface molecules,such as CD80,CD86 and major histocompability complex (MHC) II were upregulated by PTDHBcAg;IL-12 p70 levels induced by 50 mg/L and 100 mg/L recombinant PTD-HBcAg were (142.50±18.31) ng/L and (124.30±15.12) ng/L,respectively,which were significantly higher than those induced by recombinant HBcAg [(42.31±4.21 ) ng/L,t = 9.234 and 9.045,respectively,P＜0.05].The proliferation of T lymphocytes induced by PTD-HBcAg was much higher than that in HBcAg group or positive control TNF-a group.Conclusions PTD-HBcAg could penetrate membrane of DCs and promote the differentiation and maturation of DCs.PTD-HBcAg could up-regulate the expressions of costimulatory molecules on cell surface of DCs,and enhance the ability of DCs on stimulating T lymphocytes proliferation and IL-12 p70 production.