Objective To design an intravenous indwelling needle in battle field aid.Methods Several concavity were made on the hollow tube inner surface posterior puncture needle case,and some corresponding convexity uplifted peripheral needle handle pistons posterior puncture needle core.Revolution could be avoided because the needle handle pistons were just embedded in hollow tube concavity.It was convenient to operate and decreased the operator's orientation transformation by the needle's handhold vane adopting rectangle instead of butterfly shape.Results The improved puncture needle was stable and the rate of success of intravenous puncture was increased.Conclusion The improved venous retaining needle can be applied in battle field aid.

Objective To evaluate the efficacy and safety of permissive hypercapnia ventilation in mechanically ventilated newborns.Methods PubMed,Embase,the Cochrane Library,China National Knowledge Infrastructure (CKNI),Wanfang Data and Chinese BioMedical Literature Database (CBM) were searched up until March 31,2013.Randomized controlled trials (RCTs) comparing permissive hypercapnia (PHC) group with normocapnia (NC) group in mechanically ventilated newborns were included.The primary outcomes included the incidence of ventilator associated lung injury (VALI),bronchopulmonary dysplasia (BPD),intraventricular hemorrhage (IVH),periventricular leukomalacia (PVL),patent ductus arteriosus (PDA),neonatal necrotizing enterocolitis (NEC),neurodevelopmental injury and the mortality rate.Secondary outcomes included the duration of ventilatory support and the length of hospital stay.The Cochrane Handbook 5.1.0 was used to evaluate the methodological quality and RevMan 5.1 software from Cochrane Collaboration was used for meta-analysis.The fixed effects model or the random effects model was adopted according to the result of heterogeneity.Results (1) A total of 325 articles were searched,and eight RCTs involving 605 newborns (302 newborns in PHC group while 300 newborns in NC group) which met the inclusion criteria were selected.In seven studies,the partial pressure of carbon dioxide (PCO2) was controlled at ＜ 65 mmHg (1 mmHg=0.133 kPa) and pH at ≥ 7.2 in PHC group.In one study,PCO2 was ＞ 52 mmHg and pH＞7.2,without descripition of the upper limit of PCO2.(2) Four articles described the method of random allocation in detail; three described allocation concealment; all eight studies used blinding method for research subjects; two used blinding method for outcome assessment; all eight studies reported complete data; and three articles described the source of other bias.(3) All eight studies reported the incidence of VALI (I2=56％,P=0.03).The random effects model was used for the meta-analysis,and there was significant difference between PHC group and NC group (RR=0.52,95％CI:0.29-0.93,P=0.03).According to the gestational age,the eight studies were divided into two subgroups.One subgroup,including three studies with an average gestational age of 25 weeks (I2=0％,P=0.46),showed no significant difference in the incidence of VALI between PHC and NC group (RR=1.05,95％CI:0.72-1.54,P=0.78).The other subgroup,including five studies with gestational age of ＞27 weeks (I2=0％,P=0.68),showed significant difference in the incidence of VALI between the two groups (RR=0.27,95％CI:0.14-0.50,P＜0.01).The in-hospital mortality and duration of ventilation showed significant difference between the two groups (in-hospital mortality:RR=0.40,95％CI:0.22-0.74,P＜0.01; duration of ventilation:difference in means=-0.75,95％CI:-1.04--0.46,P＜0.01).There was no significant difference in the incidence of BPD,IVH,PVL,PDA,NEC and neurodevelopmental impairment between the two groups (all P＞0.05).Conclusions PHC ventilation in mechanically ventilated newborns can decrease the incidence of VALI,the in-hospital mortality and the duration of ventilation,while its protective efficacy against BPD is not remarkable.It does not increase the risk of IVH,PVL,PDA,NEC and neurodevelopmental injury,when the PCO2 is ＜ 65 mmHg and pH ≥ 7.2.

Objective To analyze the trends and status of percutaneous coronary intervention(PCI)in Shenyang General Hospital of P.L.A.during a 18-year period.Methods Between August 1989 and April 2007,a total of 10 225 patients with 17762 target lesions had undergone PCI.Their clinical and angiographic baseline characteristics,PCI strategies and perioperative outcomes were retrospectively analyzed.All data were collected from PCI database of our hospital.Results Patients' age ranged from 22 to 92 years old(mean,59.9 years).A total of 2057 patients(20.2%)were with diabete,8647(84.6%)with acute coronary syndromes,1428(14.0%)with acute myocardial infarction(AMI)and underwent emergent PCI,477(4.7%)with cardiogenic shock;6701(65.5%)with multivessel disease,483(4.7%)with left main disease and 1795(17.2%)with chronic total occlusions(CTO).Overall patient success rate was 98.5% and lesion success rate was 98.3%.Procedural success was obtained in 99.6% of patients with left main disease and 90.5% of CTO lesions.About 89.8% of all patients underwent coronary stenting.Mean implanted stent number was 1.45 per patient.In-hospital mortality was 4.4%(63/1428)for AMI patients who underwent emergent PCI and 19.7%(42/213)for AMI patients with cardiogenic shock.Overall perioperative mortality was 1.1%(113/10 225),including 2 deaths during procedure(0.02%)and 80(0.8%)deaths after procedure.Two patients(0.02%)underwent emergent CABG.Acute or subacute stent thrombosis occurred in 58 patients(0.57%)and slow flow or no-reflow occurred in 127 patients,which accounted for 8.9% of AMI patients who underwent emergent PCI.Overall incidence of perioperative complications was 3.6% and the rate of procedure related complications was 0.48%.Conclusion In skilled cardiac center,PCI is associated with high procedural success rate,low incidence of complications and good short-term outcomes.PCI should be the first choice for treating patients with coronary artery disease,especially for high risk patients with AMI,cardiogenic shock or left main disease,etc.

Objectives\ To analyse the development of coronary intervention in our heart center of a general hospital in recent 13 years.Methods\ Coronary interventions were performed in 3945 target lesions of 2466 patients with coronary heart disease who were from 22 to 86 years old(averaged 58 8 yrs)with 80 5% of male,including 335 cases of acute myocardial infarction,64 cardiogenic shock,2106 acute coronary syndrome,1329 multivessel disease,and 21 left main disease.The proportion of complicated B2 and C type lesions were 77 1% and chronic total occlusion were 21 4%,PTCA and stenting were the main intervention operation(97 4%),and rotation,direct atherectomy,cutting,intravascular radiation and cover stenting were also perfromed for the remaining 2 6% patients.Results\ The mean annual case increase rate was 61 2% from 1995 to 2001 The toltal patient and lesion success rates were 98 1% and 97 1%,respectively.The mortality during intervention were 0 08% and for cardiogenic shock were 28 1% during hospitalization.Conclusions\ The data suggest that the success rate and incidence of complications for coronary intervention in the heart center with well-dereloped technigues are comparable with those reported in foreign literatures.

Objective To investigate the surgical indication,complication management and therapeutic effect in treating Stanford B aortic dissection by using endovascular graft exclusion (EVGE).Methods Eight patients with Stanford B aortic dissection who underwent the procedure of mini-traumatic EVGE from April 2002 to April 2003 were analyzed.Tubular graft stents were introduced over the entry tear of aorta via the femoral or iliac artery.The lengths of the graft stents were 97-99mm and the diameters 34-42mm.Results The procedure was technically successful in all patients and no severe complications occurred during the perioperative period. All patients were alive with no delayed endoleak found during the follow-up of an average of (9.5?4.6) months.Conclusion EVGE is safe and efficient for Stanford B aortic dissection and it can be the first choice for treating these patients.

Objective To assess the outcome of renal artery stenosis approached by percutaneous transluminal renal angioplasty (PTRA) and stents.Methods Seventy-two patients (50 males and 22 female) were diagnosed as renal stenosis by renal angiography.Of them,68 cases were with atherosclerosis.The PTRA was done via femoral access site.Changes in blood vessel diameter and blood flow nd complications were recorded.Renal angiograph was performed to check the restenosis.Patient’s blood pressure and serum creatine level before and after the were observed.Results Angiograph showed unilateral artery lesion in 60 cases and bilateral stenosis in 12 cases.The ostium was involved in 72 sites and mid-part in 8.The lumen diameter of stenosis was 60%-95%.The stents were successfully implanted in 68 cases with 78 stents and 4 cases only by balloon.The lumen diameter of lesion increased from 2.0mm (0.8-2.6mm) to 6.5mm (4.0-8.0mm).TIMI flow decreased in 3 cases and renal function was impaired in 4 cases,but not severe.Blood pressure in 42 cases with hypertension decreased significantly.One case was complicated with perirenal hematoma.and there was no perioperative death.Conclusion PTRA and stenting treatment for renal artery disease are feasible and safe.

60 years old with coronary artery disease in hospital from Jan.2002 to Aug 2004 who accepted coronary intervention.They were divided into Tansradial group(TRA,n=382) and Transfemoral group(TRF,n=382).The success rate and time of puncture,x-ray exposure time,procedure duration,dose of dye,complication in puncture site and pulmonary embolism were observed in the two groups.Results 368 out of 382 cases success in TRA group and 372 cases in TRF group.The success rate was not different.The success rate of puncture,x-ray exposure time,procedure duration and dose of dye had no difference between the two groups.But the complication in puncture site and pulmonary embolism were more in TRF group than in TRA group.The coronary intravascular ultrasound and cutting balloon technique were successfully done in two groups.The mean in-hospital time was less in TRA group (2.1?0.6 days) than in TRF group (4.2?1.6days,P

Objective To explore the in-hospital clinical results of percutaneous coronary intervention (PCI) in patients with multi-vessel coronary disease during past 11 years. Methods Data related to rates of success, complications and clinical effects of 4 365 patients who were hospitalized in our center and underwent PCI for their target multi-coronary arteries from 1995 to 2005 were analyzed. Among them 3 833 patients had acute coronary syndrome (ACS, 87.8%), among whom 1 480 suffered form acute myocardial infarction within 30 days (38.6%), 2 353 unstable angina pectoris (61.4%), and the remaining 532 patients had stable angina pectoris (12.2%). Results Overall success rate of PCI procedure for all patients and target lesions were 96.9% ( 4 230/ 4 365) and 98.8% ( 11 185/ 11 320), respectively. The total in-hospital all-reason mortality was 1.3% (56/ 4 365) and the mortality during PCI procedure was 0.05 % (2/ 4 365).The complication rate related to PCI procedure was 7.2% (314/ 4 365). After PCI procedure the angina-free survival rate for all patients was 96.2% ( 4 147/ 4 309) at discharge and the average hospital stay was 13?9 days. Conclusion The success rate of PCI procedure in patients with multi-vessel coronary disease is high, and the rates of complications and in-hospital mortality are low, all indicating that with PCI therapy an ideal short-term effect in patients with multi-vessel coronary disease can be achieved.

Objective To compare the clinical safty and short-term outcomes of multivessel percutaneous coronary intervention(PCI)by drug eluting stenting early after acute myocardial infarction(AMI).Methods A total of 343 patients who had multivessel disease and underwent PCI within 10 days after AMI were enrollded from January 2003 to November 2005 and were divided into three groups(134 patients in single-PCI group,112 patients in re-PCI-BMS group and 97 patients in re-PCI-DES group).The clinical safty and short-term outcomes of all patients were evaluated.Results The average ages of both re-PCI-BMS and re-PCI-DES groups were older than that of single-PCI group(68.4?12.8 yrs vs 63.9?11.4 yrs,P