Objective The aim of this study was to asses the success rate, lesion characteristics and complication in acute coronary syndromes treated by direct coronary stenting Methods 92 patients with acute myocardial infarction and unstable angina were divided into the direct stenting ( n =32) and stent implantation with balloon predilatation (conventional stenting, n =60) groups The clinical data, characteristics of target vessels ,success rate and complications were compared between two groups Results The age in direct stenting groups was much younger than that in conventional stenting group (53 14?9 18 vs, 64 28?12 36, P

Objective To evaluate the clinical feasibility of disruption of intracoronary plaques using catheter-delivered ultrasound. Methods Ultrasound was introduced via catheterization to treat patients (n=18) with serious stenosis of the coronary artery. Comparison of stenosis degree and ST segment in routine ECG before and after the treatment was conducted. Pre- and post-treatment exercise tests were performed to measure the time needed for induction of angina, the time needed for induction of decrease in ST segment for 0.1 mV and maximal range of decrease in ST segment. Results Ultrasound was found to have dissolved atherosclerotic plaques in 18 cases of coronary heart disease with stenosis in one blood vessel ≥75%. The residual stenosis was (40.11?15.33)% after the treatment, representing a decrease of 44.58% as compared with that before the treatment [(84.69?4.69)%], P

Objective To investigate the serum level of vascular endothelial growth factor (VEGF) in patients with coronary artery disease (CAD) and its clinical significance. Methods The study included 36 patients with CAD and 10 non-coronary heart disease patients as the control. The concentrations of serum VEGF in the coronary veins and the aorta were measured by an enzyme-linked immunsorbent assay (ELISA). Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and were cultured in M199 medium supplemented with 20% fetal bovine serum. After 7 days culture, attached cells were collected. The effect of VEGF on the migration of endothelial progenitor cells (EPCs) were assayed with modified Boyden chamber assay. Results The serum VEGF levels of stable angina pectoris (SAP) patients (208.46?44.74 ?g/L) and acute coronary syndrome (ACS) patients (267.29?93.99 ?g/L) were much higher than that of the controls group (120.77?26.25 ?g/L,P

Objective To explore the relationship of the plasma ox-LDL level and endothelium flow mediated vasodilation(FMD)in acute coronary syndrome patients(ACS).Methods From March to October 2004,in the Department of Cardiology,the Fourth PLA Hospital,51 patients with ACS were divided into 2 groups:AMI group(22patients)and UAP group(29 patients).20 subjects with normal coronary angiograms served as the control group.Nitrir oxide(NO)and plasma ox-LDL was measured by spectrophotometer and Sandwich ELISE method,respectively.The brachial arterial hyperemia-induced flow mediated vasodilation(FMD)and sublingual nitroglycerin(NTG)mediated vasodilation were measured by high resolution ultrasound.Results (1)The FMD in ACS group was significantly decreased compared with the control group[(7.2?1.42)、(7.6?1.12)vs(15.46?1.2),P0.05).(2)The No in ACS group was sigificantly lower than that in control group;the NO in AMI group was even lower[(48.46?12.44)、(60.42?10.30)vs(94.72?12.34)?mol/L,P1,which meant ox-LDL was a risk factor;the OR of FMD was

Objective To summarize our experience with combined cardiac pacing and beta-blocker therapy in patients with long-QT syndrome. Methods Nine patients with long-QT syndrome were treated with Propranolol. Its effectiveness was analyzed during matched periods before and after starting beta-blocker therapy. If sinus bradycardia, sinus arrest and atrioventricular occurred during the Propranolol treatment, DDD pacemaker were implanted. Results After initiation of beta-blockers, there was a significant reduction in the rate of cardiac events [(0.86?0.92) to (0.34?0.69) events per patient per year, P

Objective To evaluate the clinical feasibility and safety of percutaneous transluminal coronary thrombolysis in acute myocardial infarction. Methods Consecutive patients( n =25) with evidence of AMI and thrombolysis in myocardial infarction(TIMI) grade 0 or 1 in the infarction related arteries(IRA) underwent coronary ultrasound thrombolysis. Degree of residual stenosis was measured and analyzed with SHIMADZU Digitex, a 2400 computerized analyzing system. Changes in imaging and blood flow in IRA, CK MB before and after the treatment, ST segment in ECG and clinical manifestations were observed to evaluate the feasibility of using angioplasty with ultrasound to treat AMI. Results It was found that IRA achieved grade Ⅲ of TIMI blood flow in 23 out of the 25 patients with AMI (potency recovering rate=92%) and the residual stenosis was 41.39?14.08%. Within 10 minutes after the treatment, disappearance of chest pain, depression of ST segment more than or equal to 50% and obvious migrating forward of CK MB peak value were found in the 23 patients. There were no adverse clinical events during the procedure and hospitalization. Conclusion Angioplasty with high intensity, low frequency ultrasound can be used as a new approach for treating acute myocardial infarction, opening IRA as early as possible and restoring TIMI blood flow grade Ⅲ.

ObjectiveTo explore relationship between psychological resilience and life events of Tibetan nursing students receiving free vocational nursing education.Method The questionnaire of Symptom Checklist 90(SCL-90)and ASLEC were used in the survey among 120 nursing students to investigate the psychological resilience and life events and SPSS 17.0 was used to look into the correlations between them.Results The scores on psychological resilience of Tibetan nursing students was higher than the norm (P<0.05).There were negative correlations between life events and psychological resilience(P<0.05).Their psychological resilience was positively related to personal relations and health conditions(P<0.05)but negatively to learning pressure,punishment and losses (P<0.05).Conclusion The school and hospital should make teaching measures to psychologically support them in daily life to strengthen the abilities to handle failure and adjust to the society.

Objective To evaluate the clinical value of multislice spiral CT(MSCT) reconstruction in designing the pedicle screw trajectory before operation in atlantoaxial lesions.Methods 37 patients with upper cervical abnormality treated by surgery for atlantoaxial or occipitoaxial interfixation and/or fusion were undergone MSCT scan,and the 3D anatomical data(including the length,width and height of each pedicle,the angle between the pedicle and sagittal plane,and the thickness of internal occipital crest) were measured on volume reconstruction(VR) and multi-plane reconstruction(MPR) images and used for surgeon to select advisable pedicle screws(including the proper length and diameter) and to ensure the comfortable point,depth and direction for screw position at preoperation.The patients were followed up by atlantoaxial X-ray image and/or MSCT reconstruction to estimate the veracity of the screw position.Results All the patients were operated successfully,of them,5 patients were treated by simply atlantoaxial fixation,15 by atlantoaxial fixation and fusion,4 by simply occipitoaxial fixation,11 by occipitoaxial fixation and fusion,2 by atlantoaxial fixation and occipitoaxial fusion.X-ray images and/or MSCT reconstruction revealed that atlantoaxis were reposition entirely and all the screws were at predesigned trajectory.All the patients were followed up and no screw was broken or loosen and no atlantoaxial redislocation was found.Conclusion MSCT reconstruction for designing pedicle screw trajectory in atlantoaxial lesions before operation is satisfactory and valuable for clinical application.

OBJECTIVE:To systematically review the effectiveness and safety of methotrexate(MTX)in the treatment of rheuma-toid arthritis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline,EMBase,Cochrane Library,PubMed,CJFD,CBM,VIP and Wanfang Database,randomized controlled trials(RCT)about MTX in the treatment of rheu-matoid arthritis were collected,Meta-analysis was performed after data extraction and quality evaluation. RESULTS & CONCLU-SIONS:33 effectiveness evaluation were included,involving 8 253 patients,and 53 safety evaluation were included,involving 4 803 patients. Results of analysis show,the efficacy of MTX was not higher than leflunomide in the treatment of rheumatoid arthritis,superi-or to cyclosporine A,and similar to sulfasalazine. In addition,MTX shows similar efficacy with etanercept(7.5-20 mg per week),goli-mumab,adalimumab or rituximab,but less effective than trastuzumab. The incidence of adverse reactions of MTX is high,but mainly mild or moderate,and the most common adverse reactions are gastrointestinal symptoms. Oral administration of MTX is more secure than intramuscular injection and subcutaneous injection.

Objective To observe the effects of extracts of ginkgo leaves (EGL) on acute myocardial infarction, acute myocardial ischemia and blood hemorheology.Methods The effects of EGL on acute myocardial infarction were observed in dogs model induced by the ligation of anterior descending branch of left coronary artery; effects on acute myocardial ischemia were observed on rats model caused by intravenous injection of pituitrin and effects on blood hemorheology were observed in rabbits. Results EGL significantly reduced the myocardial infarction area, decreased the activities of lactate dehydrogenase and creatine phosphokinase in dogs, reduced the elevation of ST segment of electrocardiogram in rats with myocardial ischemia and decreased whole blood viscosity and plasma viscosity in rabbits. Conclusion EGL has protective effect against myocardial ischemic injury and can improve the parameters of blood hemorheology in rabbits. Its mechanism may be concerned with the reduction of the myocardial infarction area and infarction degree and the relief of acute myocardial ischemia.