OBJECTIVETo study coronary artery stenosis, myocardial ischemia, and left ventricular dysfunction in dual source computed tomography (DSCT) coronary artery angiography.

METHODSTotally 32 patients underwent both DSCT and X-ray coronary angiography within one week to detect coronary artery stenosis separately. Meanwhile, the values of left ventricular myocardial mass (LVMM) , left ventricular ejection fraction (LVEF) , and left ventricular stroke volume (LVSV) were calculated using cardiac function software in DSCT. Electrocardiography was carried out to diagnose myocardial ischemia. The coronary artery stenosis, values of LVMM, LVEF, and LVSV, and myocardial ischemia were compared.

RESULTSThe results of DSCT and X-ray coronary angiography were not significantly different. LVMM, LVEF, LVSV, and myocardial ischemia were significantly different between two- or three-branch groups or between middle or severe groups (both P<0.05) . However, no such significant difference was observed between single and two branch groups and between mild and middle groups. There were no statistically different findings for LVEF and LVSV, but there was statistical deference between LVMM and myocardial ischemia (P<0.05) . For single branch and middle to severe stenosis in left anterior descending (LAD) coronary artery, right coronary artery, left circumflex coronary artery, only the values of LVMM,LVEF,and LVSV in LAD group showed significant difference (P<0.05) .

CONCLUSIONSMore stenotic branches and severer stenosis in coronary artery often are associated with higher incidence of myocardial ischemia and severer left ventricular dysfunction. The stenosis of LAD coronary artery has especially severe impact on cardiac functions. LVMM is a sensitive indicator for myocardial ischemia in coronary artery stenosis.

Aged ; Coronary Angiography ; methods ; Coronary Stenosis ; complications ; diagnostic imaging ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Myocardial Ischemia ; etiology ; Tomography, X-Ray Computed ; methods ; Ventricular Function, Left ; physiology

BACKGROUND: Proximal humeral fracture is a common disease of fall injury in the elderly, because of bone nonunion after treatment with a variety of factors such as senile osteoporosis. Currently, the use of reverse total shoulder arthroplasty has achieved good clinical effect, but has certain limitations. OBJECTIVE: To compare and observe the clinical effects of reverse total shoulder arthroplasty and open reduction and internal plate fixation in the treatment of nonunion of proximal humeral fractures. METHODS: Totally 120 cases of nonunion of proximal humeral fractures were randomly divided into observation group and control group, with 60 cases in each group. The observation group received reverse total shoulder arthroplasty (replacement of artificial shoulder joint). The control group received open reduction and internal plate fixation. RESULTS AND CONCLUSION: (1) Follow-up results: At 3 years after surgery, the pain score was lower in the observation group than that in the control group (P < 0.05). Constant daily activities, range of activities, strength test score, Constant total score, satisfaction and hospitalization expenses were higher in the observation group than in the control group. Functions of flexion, laterotorsion and intorsion were better in the observation group than those in the control group (P < 0.05). (2) Adverse reactions: At 3 years after surgery, 26 and 22 cases had adverse reaction in the observation group and the control group respectively. (3) The results show that the clinical effect of the elders' nonunion of proximal humeral fracture treated with reverse total shoulder arthroplasty is quite good, and the pain degree and shoulder function are obviously improved. The curative effect of reverse total shoulder arthroplasty is better than that of open reduction and internal plate fixation.

OBJECTIVETo explore the affecting factors on coronary heart disease among people over 40 years of age in Guangxi area, China.

METHODSBaseline data was gathered through the Third National Blood Pressure Survey in 1991 in China. A total number of 11 818 adults over 40 years old had been studied in Guangxi province. Data of morbidity and mortality of coronary heart disease was obtained.

RESULTSCardiovascular events were related to systolic blood pressure, diastolic blood pressure, pulse pressure, smoking, BMI regardless of their myocardial infarct (MI) history. Cox regression analysis showed that the relative risk for cardiovascular events increased by 21 [95% confidence interval (CI): 9.06-48.44] times for those people having MI history. When pulse pressure, systolic blood pressure, diastolic blood pressure increased by every 10 mm Hg, the relative risk for cardiovascular events increased by 1.29 (95% CI: 1.11-1.49), 1.18 (95% CI: 1.02-1.22), 1.13 (95% CI: 1.05-1.28) respectively. There was 1.23 (95% Cl: 1.05-1.45) times higher in smoker than non-smoker on relative risk for cardiovascular events. When BMI increasing 1, the relative risk for cardiovascular events would increase 1.03 (95% CI: 1.01-1 .05) times.

CONCLUSIONHypertension, smoking, increase of BMI were the risk factors of coronary heart disease among people who were over 40 years of age.

Adult ; Body Mass Index ; China ; epidemiology ; Cohort Studies ; Confidence Intervals ; Coronary Disease ; epidemiology ; etiology ; Health Surveys ; Humans ; Hypertension ; complications ; Myocardial Infarction ; Proportional Hazards Models ; Risk Factors ; Smoking ; adverse effects