1.Risk factors of perioperative myocardial infarction in the patients undergoing noncardiac surgery
Junkai CUI ; Yang YU ; Wenjun ZHOU ; Mei LIU
Chinese Journal of Interventional Cardiology 2017;25(2):87-91
Objective To investigate the risk factors and prognosis of perioperative myocardial infarction in the patients undergoing noncardiac surgery. Methods Clinical data of 562 patients who had accepted non-cardiac surgery was collected and retrospectively analyzed. The risk factors, treatments and outcomes of all these patients were recorded and analyzed. Results A total of 19 out of the 562 patients had perioperative myocardial infarction ( PMI) . The incidence was 3. 4% . The mean occurrence time was (43. 5 ± 12. 7)h after operation. Eleven PMI patients (11 ∕ 19) were non-ST-segment elevation myocardial infarction and eight patients (8 ∕ 19) were ST-segment elevation myocardial infarction. Thirteen PMI patients were left coronary artery occlusion and six patients were right coronary artery occlusion. Advanced age, history of myocardial infarction, unstable angina, change of ST-T segment on electrocardiography (ECG), multivessel diseases, diabetes,hypertension,and high risk non-cardiac surgery were the risk factors of PMI and positively correlated to PMI. Sixteen PMI (16 ∕ 19) patients accepted PCI treatment and three patients (3 ∕ 19) accepted drug conservative treatment. Two patients had unstable angina attack after treatment and one patient had arrhythmia. The heart function in two patients decreased by one or more than one class within the follow up of 1 year. No patient had recurrent acute myocardial infarction or deceased during follow-up. Conclusions Many factors could lead to PMI. Making preoperative assessment, recognizing patients of high risks and dealing with patients who had PMI in time was necessary.
2.Bridging antiplatelet strategies during temporary withdrawal of antiplatelet therapy for non-cardiac surgery after drug-eluting stent implantation
Junkai CUI ; Yang YU ; Wenjun ZHOU ; Mei LIU
Chinese Journal of Interventional Cardiology 2017;25(8):442-446
Objective To compare the rates of major adverse cardiovascular events(MACE)and bleeding events of three different antiplatelet strategies during temporary withdrawal of antiplatelet therapy for non-cardiac surgery within 1 year after drug-eluting stent (DES)implantation.Methods Retrospectively analyzed 42 patients who had accepted non-cardiac surgery and required temporary withdrawal of antiplatelet therapy within 1 year after drug-eluting stent implantation. The patients were divided into three groups according to the bridging antiplatelet strategies they received.All patients discontinued clopidogrel 5 to 7 days before the non-cardiac surgery. The tirofiban group was treated with intravenous tirofiban 0.4ug/kg·min in the first 30 min followed 0.1μg/(kg·min). The dosage was reduced by half for patients whose Creatinine clearance were less than 30 ml/min.The low molecular weight heparin group was treated with subcutaneous enoxaparin (Clexane 4000 AxaIU, once per day) .The asprin group was given only oral asprin(100 mg, once per day) . Tirofiban and low molecular weight heparin were continued until clopidogrel was resured. Perioperative cardiovascular events and serious bleeding were recorded. Results The rates of major adverse cardiac events in the tirofiban and the low molecular weight heparin group were lower than the aspirin group. Acute myocardial infarction caused by confirmed in-stent thrombosis was diagnosed in one patient in the aspirin group. One case of asymptomatic ST-T changes was found in the low molecular weight the aspirin group. 3 cases in the aspirin group presented ST-T changes on ECG and among them 1 case was STEMI due to LAD thrombosis requiring primary and 2 other cases were agina pectoris.There were no significant differences in bleeding events among the three groups.Conclusions Potential for the perioperative management with tirofiban or low molecular weight heparin is safe and feasible for patients who had recently undergone DES implantation and required noncardiac surgery with the interruption of antiplatelet therapies.
3.Microwave sensor for recognition of abnormal nodule tissue on body surface.
Chunxue LI ; Hongfu GUO ; Chen ZHOU ; Xinran WANG ; Junkai BAI
Journal of Biomedical Engineering 2023;40(1):149-154
For the detection and identification of abnormal nodular tissues on the body surface, a microwave sensor structure loaded with a spiral resonator is proposed in this paper, a sensor simulation model is established using HFSS software, the structural parameters are optimized, and the actual sensor is fabricated. The S21 parameters of the tissue were obtained when nodules appeared by simulation, and the characteristic relationship between the difference of S21 parameters with position was analyzed and tested experimentally. The results showed that when nodules were present in normal tissues, the curve of S21 parameter difference with position change had obvious inverted bimodal characteristics, and the extreme value of S21 parameter difference appeared when the sensor was directly above the nodules, which was easy to identify the position of nodules. It provides an objective detection tool for the identification of abnormal nodular tissues on the body surface.
Microwaves
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Recognition, Psychology
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Computer Simulation
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Software
4.Development of a Portable Chronic Non-specific Low Back Pain Measurement System.
Li CUI ; Junkai ZHOU ; Nian WANG ; Jing XIAO ; Yuxuan JI ; Meichi JIANG
Chinese Journal of Medical Instrumentation 2021;45(5):473-478
We developed a portable non-specific low back pain measurement system EasiLBP and evaluated its performance in collecting EMG signals:during the wearer's movement without the assistance of a doctor, the collection of EMG signals by portable devices met problems such as large noise interference, difficulty in accurately calibrating the start and end points of the action interval, and imbalanced samples for feature recognition, et al. To challenge these problems, we proposed a small group-based noise removal method, a dynamic dual-threshold automatic method for identifying the start and end points of the motion interval, and a sampling method to balance group samples, respectively. Portable device and a medical EMG acquisition equipment Thought Technology FlexComp Infiniti 10 were used to perform EMG measurements on 15 patients with non-specific low back pain and 15 normal people. Clinical experiments and statistical analysis show that the portable EMG acquisition system has significant differences in EMG signal characteristics between normal people and non-specific low back pain patients, and it has good measurement consistency and accuracy with the medical EMG acquisition equipment.
Electromyography
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Humans
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Low Back Pain
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Motion
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Movement
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Pain Measurement