Objective To evaluate the efficacy of the drug-eluting stents in the treatment of coronary artery diseases in patients with diabetes. Methods This study included a retrospective database of 600 consecutive patients with coronary artery disease who underwent drug-eluting stems implantation in Zhong Shan Hospital,including 147 pa-tients with diabetes. The MACE in this study included death of any cause,nonfatal myocardial infarction,target lesion revascularization and target vessel revascularization. All the MACE were recorded. The efficacy of the drug-eluting stents was evaluated by the incidence of MACE and the rate of in-stent restenosis. Results No significant differences were found concerning the incidence of MACE (7. 9% vs 4. 9% ,P = 0. 344) as well as the rate of ISR(6. 0% vs 4.9% ,P =0. 540) between patients with diabetes and patients without diabetes. No significant differences were found concerning the incidence of MACE(7.9% vs 4. 9% ,P = 0. 344) as well as the rate of ISR( 1.4% vs 1.9% ,P = 1. 000) between Cypher stents and TAXUS stents. Conclusion Drug-eluting stents are effective in the treatment of coronary artery disease of patients with diabetes. There was no significant difference in the rate of MACE and in-stent restenosis between the two leading drug-eluting stents of sirolimus eluting Cypher stent and the paclitaxle eluting TAX-US stent.

ObjectiveTo investigate the role of Nav1.7 in dorsal root ganglia (DRG) in a rat model of diabetic neuropathic pain (DNP).MethodsThirty-two female Wistar rats aged 3 months weighing 180-220 g were randomly divided into 4 groups ( n ＝ 8 each):control group ( group C),sham operation group ( group S),DNP group and ProTx- Ⅱ (a selective Nav1.7 blocker) group (group E).Diabetes mellitus was induced by intraperitoneal streptozocin 65 mg/kg.Blood glucose level and mechanical paw withdrawal threshold (MWT)to von Froy filamentstimulation were measured 2 weeks later.DNP was confirmed by blood glucose level ≥ 16.0 mmol/L and MWT decreased by more than 50％ of the baseline value.Intrathecal catheter was implanted at L5,6 interspace on day 10 after successful induction of DNP.On day 4 after placement of the intrathecal catheter,ProTx- Ⅱ 10 μg/kg was injected intrathecally in group E,while the equal volume of normal saline was given in groups DNP and S.MWT and never conduction velocity (NCV) were measured 1 h after intrathecal injection.The rats were then sacrificed and DRGs of the lumbar segment (L4-6) were removed for determination of Nav1.7 protein expression (by immuno-histochemistry and Western blot) and Nav1.7 mRNA expression (by RT-PCR).ResultsThe MWT and NCV were significantly lower and the Nav1.7 mRNA and protein expression was significantly higher in groups DNP and E than in group C.ProTx- Ⅱ significantly attenuated the diabetes-induced changes in MWT,but had no effect on NCV and Nav1.7 mRNA and protein expression.ConclusionNav1.7 in DRG is involved in the maintenance of DNP in rats.

Seventy-one patients with variant angina (VA) admitted in the Cardiology Department from January 2003 to March 2011,were divided into non-stenosis group (stenosis ＜ 50％,n =43) and stenosis group (stenosis ≥50％,n =28) according to the degree of stenosis.The differences of the risk factors,clinical manifestations,electrocardiogram,echocardiogram and laboratory examinations between these two groups were compared.The average age of patients in stenosis group 58 ± 8 y was higher than that in non-stenosis group (52 ± 9 y,t =2.43,P =0.02).Other risk factors,including male gender,smoking,hypertension,diabetes mellitus and lipid disorder did not show any differences between the two groups.Percentage of patients with angina pectoris lasting less than 5 min was higher in stenosis group (x2 =5.98,P =0.02),while percentage of effort angina,seeking medical consultation ≤ 6 months of onset and hemodynamic disorders showed no difference.Laboratory examinations had no differences.It is difficult to determine whether the VA patient has fixed coronary stenosis by analyzing the risk factors,clinical manifestations and laboratory examinations; to determine the fixed coronary stenosis coronary angiography is necessary.

Objective: To observe the changes of circulating fractalkine and its receptor CX3CR1 level in patients with chronic congestive heart failure (CHF).
Methods: Our work included 2 group, CHF group, n=55 patients and Control group, n=25 healthy subjects. Plasma level of soluble fractalkine (sFKN) was measured by ELISA, CX3CR1 in peripheral blood mononuclear cell was examined by lfow cytometry method. The relationship between sFKN and NT-proBNP was studied.
Results: Compared with Control group, CHF group had increased sFKN level, P=0.004, and the patients with NYHY III, IV were more than NYHY II, and CHF group also had the higher CX3CR1 expression (14.7 ± 8.1), P<0.05. The CX3CR1 level increased accordingly with NYHY classiifcation, as the patients with NYHY II, CX3CR1 was at (25.1 ± 12.4), P=0.03 compare with Control group;with NYHY III, CX3CR1 was at (37.3 ± 11.0) , P=0.04 compared with NYHY II;with NYHY IV, CX3CR1 was at (41.7 ± 11.1), P=0.009 compared with NYHY II. The circulating sFKN level was positively related to pro-BNP level (r=0.364, P<0.01).
Conclusion: The circulating FKN l and its receptor CX3CR1 might be involved in pathogenesis of immune-inlfammatory pathogenesis in CHF patients.

Objective To investigate the feasibility of subtraction coronary computed tomography angiography (Sub-CCTA) for the diagnosis of coronary heart disease in the segment with severe calcification.Methods A retrospective analysis was performed on 27 patients who underwent clinically indicated digital subtraction angiography (DSA) and CCTA using a 320-detector row CT.Compared with the results of DSA,sensitivity,specificity,positive predictive value,negative predictive value and accuracy of Con-CCTA and Sub-CCTA were calculated.The clinical diagnostic accuracy of the two imaging methods was evaluated using the receiver operating characteristic (ROC) curve.The stenosis of coronary segments was divided into four grades (Ⅰ,Ⅱ,Ⅲ,Ⅳ).Kappa coefficient was used to measure agreement between two imaging methods.Image quality of 4-scale grade scoring method was used and t test was conducted.Results A total of 52 segments with severe calcification were evaluated.The scores of image quality in Con-CCTA and Sub-CCTA were 2.8 ± 0.5 and 3.4 ± 0.7,respectively.There was significant difference between them (t =5.9,P ＜ 0.05).Compared with the result of DSA as the golden standard,the Kappa coefficients were 0.55 and 0.81 respectively in Con-CCTA and Sub-CCTA for the quantitative evaluation of the severe calcified segments.The sensitivity,specificity,positive predictive value and negative predictive value and accuracy of Con-CCTA were 81.0％,63.1％,63.1％,81.1％ and 70.8 ％;and for Sub-CCTA they were 90.5 ％,85.2％,82.1 ％,92.0％ and 87.5 ％ respectively.Compared with Con-CCTA,the area under the ROC curve of Con-CCTA and Sub-CCTA were 0.84 (95％CI:0.70-0.93) and 0.96 (95％ CI:0.86-1.00),respectively,and the difference was statistically significant (P =0.03).Conclusions Sub-CCTA can improve the diagnostic accuracy of coronary artery stenosis in severe calcified segment.Application of subtraction technique in CCTA can reduce or even eliminate the artifacts caused by severe calcified plaque,and has a good clinical application prospect.

Objective To study the effect of hemilaminectomy, total laminectomyand recapping laminoplasty on stability of the cervical spine. Methods Fourteen fresh adult sheep cervical spine specimens were divided into two groups, with 7 cases in each group. Each specimen was applied with a pure moment load of 3.0 N·m under flexion/extension, left/right lateral bending, and left/right axial rotation. The range of motion (ROM) and neutral zone (NZ) of specimens were measured. In the first group, the ROMs and NZs of the specimens were measured and compared under the intact state, C5 hemilaminectomy state and C4-6 hemilaminectomy state respectively. In the second group, the ROMs and NZs of specimens under the intact state, C4-6 total laminectomy state and C4-6 recapping laminoplasty state were measured and compared. Results There were no significant differences in ROMs and NZs between C5 hemilaminectomy state and C4-6 hemilaminectomy state compared with the intact state (P<0.05). Compared with the intact state, ROMs of the specimens were significantly increased during flexion and extension under C4-6 laminectomy state and C4-6 recapping laminoplasty state (P<0.05). In addition, compared with the C4-6 laminectomy state, ROMs of the specimen were significantly decreased only during extension unde C4-6 recapping laminoplasty state (P<0.05), while no significant differences were found in ROMs between total laminectomy and laminoplasty under other loads. Conclusions With hemilaminectomy, ROMs and NZs of the cervical spine did not increase significantly, and stability of the cervical spine was not affected. With C4-6 total laminectomy, ROMs and NZs during flexion and extension increased significantly, and stability of the cervical spine was affected. Recapping laminoplasty did not significantly improve stability of the cervical spine with total laminectomy.

Objective:To explore the therapeutic effect of Jianpi Huoxue Jiedu recipe on upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical surgery for breast cancer.Methods:From January 2020 to May 2022, a total of 60 patients with upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin internal knot type after modified radical surgery for breast cancer were selected and treated in Longyan Hospital of Traditional Chinese Medicine Affiliated to Xiamen University. They were divided into control group and observation group according to random number table, with 30 cases in each group. The control group was treated with routine western medicine comprehensive swelling reduction surgery, while the observation group was treated with a combination of Jianpi Huoxue Jiedu recipe (1 dose/day, warmly-taken in the morning and evening) for one month on the basis of the control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, edema diameter, breast cancer quality of life scale (FACT), and joint range of motion were compared between the two groups after treatment.Results:After one month of treatment, the total clinical effective rate of the observation group (93.33%) was significantly higher than that of the control group (70.00%, P<0.05). After treatment, the TCM syndrome scores (upper limb swelling, pain, fullness, sense of restraint, skin keratinization, itching, heaviness, stuffiness, and fatigue) of both groups of patients decreased compared to those before treatment, and the observation group was lower than the control group (all P<0.05). After treatment, the diameter of edema in the affected limbs was significantly reduced in both groups of patients, and the diameter of 10 cm above the wrist and elbow stripes in the observation group was smaller than that in the control group (all P<0.05). After treatment, the FACT scores of the two groups of patients significantly decreased, and the FACT scores of the observation group were lower than those of the control group (all P<0.05). After treatment, the joint activity of the two groups of patients significantly increased, and the joint activity of the observation group was greater than that of the control group (all P<0.05). Conclusions:The clinical efficacy of Jianpi Huoxue Jiedu recipe combined with western medicine in treating upper limb edema of spleen deficiency and dampness stagnation, blood stasis and toxin accumulation type after modified radical operation of breast cancer is better than that of western medicine alone. It can significantly improve the clinical symptoms, signs, quality of life, and joint mobility of upper limbs of patients, and reduce upper limb edema.

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

OBJECTIVE:To analyze the results of national evaluation inspection for 83 batches of Compound jiegeng mahuangjian syrup(Ⅱ)from 4 manufacturers,and to evaluate their quality. METHODS:Legal inspection method and exploratory research were adopted to test,analyze and evaluate sample statistically. The contents of exploratory research included HPLC method was used to determine the contents of preservative benzoic acid and ephedrine hydrochloride;antibacterial efficacy examination of formulation was studied;pH value of solution was determined;the content of sucrose was determined by polarimetry photometry;the relationship of the content of ammonium chloride with microbial contamination was studied;headspace GC method was used to determine the contents of menthol and ethanol;Platycodon grandiflorum extractum was identified and studied by TLC. RESULTS:Results of legal inspection showed that among 83 batches of sample,80 batches were qualified and 3 batches were unqualified,with qualified rate of 96.4%. Unqualified items were loading capacity,microbial limit and content ofammonium chloride,content of ammonium chloride. The results of legal test combined with exploratory research showed thatantibacterial efficacy of formulation of one manufacturer was not in accordance with the regulations;Some raw materials were notfed according to formulation, and the quality of products was not even. It is recommended to revise the quality standard:identificatied the Campanulaceae by TLC; determination the pH, preservative content, menthol content; revision ephedrinehydrochloride assay method to HPLC. CONCLUSIONS:The overall quality of Compound jiegeng mahuangjian syrup(Ⅱ)is notsatisfactory;there is a big flaw in the production process and quality control of some manufacturers;quality standards needed to beimproved.

Objective: To evaluate the quality status of piroxicam tablets. Methods: The samples were examined by the statutory standard,and the exploratory studies were carried out. The results were statistically analyzed. Results: Totally 138 batches were exam-ined according to the statutory standard, and among them, 135 batches were qualified with the qualified rate of 97. 8% . The unquali-fied item of 3 unqualified batches was dissolution. The exploratory studies showed that there were two crystal forms of piroxicam used in the tablets, and the dissolution of the two crystal forms was different with form 1 less than form 2. An inspection method for the relative substance was established. Totally 14 impurities were detected out and the structures of 8 impurities were identified. The impurities were mainly derived from the raw materials, and many batches of samples were with single largest impurity content exceeding 0. 5% , and the total of impurity content above 1. 0% . A class I solvent 1,2-dichloroethane was detected out in 13 batches of tablets by GC and confirmed by GC-MS. Through the dissolution consistency test, it was found that there was a great difference in the dissolution behavior among the products from different manufacturers. Conclusion: The overall quality of piroxicam tablets is not ideal, and the production process of some manufacturers needs to be improved.