or =0.05 ng/ml (n=110) and cTnI-negative with serum cTnI

Objective To compare the incidence of MACE and predictors in patients with unprotected left main coronary artery disease (ULMCAD) after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). To establish a risk stratification to guide treatment and prognosis of patients with ULMCAD who underwent PCI. Methods The incidence of MACE in 201 patients with ULMCAD who underwent PCI or CABG was compared, retrospectively. The predictors of MACE of the two groups were obtained by logistic regression analyses. The predictors of MACE of the PCI group were assigned and stratified. The validity of the risk stratification on the prediction of MACE was verified in a new group of 126 patients with ULMCAD who underwent PCI. Results The incidence of MACE of PCI and CABG group was 16% and 11.9%, respectively. Logistic regression analyses showed that LVEF, diabetes mellitus and Syntax score were related to MACE in PCI group, while age, LVEF and renal function insufficiency were related to MACE in CABG group. The verification results showed a good predictive value of the risk stratification based on LVEF, diabetes mellitus and Syntax score on the incidence of MACE. Conclusions PCI treatment in patients with ULMCAD is feasible and has a good long-term outcome. The risk stratification in accordance with LVEF, diabetes mellitus and Syntax score has good predictive value on the incidence of MACE.

The problem of over-treatment of percutaneous coronary intervention is expounded in the paper.From the prospective of ethics,several factors such as doctor,patient and even society,all of which can affect the excessive implement of percutaneous coronary intervention,are analyzed in the article.Effective counter-measures to help the development of the technique are also discussed.

Presently there is co-existed of over-and deficient treatment in percutaneous coronary intervention in china and the conflict of interest between doctors and patients among which mainly appeared to be financial conflict.The conflict is resulted from deviation of direction in reformation of economy policy,mismatched conditions between medical ethics and medical technique,misunderstanding between doctors and patients.In this paper we discussed the resolving methods,including enhancing healthy economy reformation,establishing harmonious relationship between doctors and patients,optimizing the utilizing of interventional technique.We also must persist in justice and public good principle.Undoubtedly to say conflict of interests between doctors and patients always exists,the way to minimize it relay on co-exertion of society,governmental control agency,doctors and patients,and this will take a long time.

AIM: To study the effect of mobilization of stem cells by exogenous recombinant human granulocyte-colony stimulating factor (rhG-CSF) on the repairing process of reendothelialization and neointima hyperplasy on ballon injured rat carotid arteries. METHODS: Male Wistar rats were randomly divided into rhG-CSF group and NS+injury group. The animals were injected daily with 30 ?g/kg rhG-CSF or 0.9% NaCl for 7 days, then underwent balloon angioplasty of the common carotid arteries which were harvested and processed for scanning electron microscopy (SEM), Evans blue staining, morphometric analysis of endothelialization and neointimal formation at 1 h, 3 d, 5 d, 7 d, 14 d after injury. Immunohistochemistry for proliferation cell nuclear antigen (PCNA) and RT-PCR for eNOS mRNA were also conducted for evaluating the proliferation of cells of the vessel wall and the possible mechanism of the repairing. RESULTS: SEM and Evan’s blue staining showed increased reendothelialization of the denuded vessels in rhG-CSF-treated animals compared with that NS+injury animals [(60.6?7.3)% vs (41.6?3.3)%,P

0.05),however,after three days of pharmacological treatment,there was significantly reduced CRP content in group A [(5.44?1.57)mg/L vs(4.04?1.54)mg/L,P

OBJECTIVE: To evaluate the diagnostic accuracy of a dual-source computed tomography (DSCT) coronary angiography, with a particular focus on the effect of heart rate and calcifications. MATERIALS AND METHODS:One hundred and nine patients with suspected coronary disease were divided into 2 groups according to a mean heart rate (< 70 bpm and > or = 70 bpm) and into 3 groups according to the mean Agatston calcium scores (< or = 100, 101-400, and > 400). Next, the effect of heart rate and calcification on the accuracy of coronary artery stenosis detection was analyzed by using an invasive coronary angiography as a reference standard. Coronary segments of less than 1.5 mm in diameter in an American Heart Association (AHA) 15-segment model were independently assessed. RESULTS: The mean heart rate during the scan was 71.8 bpm, whereas the mean Agatston score was 226.5. Of the 1,588 segments examined, 1,533 (97%) were assessable. A total of 17 patients had calcium scores above 400 Agatston U, whereas 50 had heart rates > or = 70 bpm. Overall the sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for significant stenoses were: 95%, 91%, 65%, and 99% (by segment), respectively and 97%, 90%, 81%, and 91% (by artery), respectively (n = 475). Heart rate showed no significant impact on lesion detection; however, vessel calcification did show a significant impact on accuracy of assessment for coronary segments. The specificity, PPV and accuracy were 96%, 80%, and 96% (by segment), respectively for an Agatston score less than 100% and 99%, 96% and 98% (by artery). For an Agatston score of greater to or equal to 400 the specificity, PPV and accuracy were reduced to 79%, 55%, and 83% (by segment), respectively and to 79%, 69%, and 85% (by artery), respectively. CONCLUSION: The DSCT provides a high rate of accuracy for the detection of significant coronary artery disease, even in patients with high heart rates and evidence of coronary calcification. However, patients with severe coronary calcification (> 400 U) remain a challenge to diagnose.
Calcinosis/*radiography ; Coronary Angiography/methods/*standards ; Coronary Disease/*radiography ; Coronary Vessels/*pathology ; Female ; *Heart Rate ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods/*standards

Objective:To explore the mechanism of Gynostemma pentaphyllum in the treatment of atherosclerosis (AS) based on network pharmacology. Methods:TCMSP was used to analyze the chemical components and targeted effect of Gynostemma pentaphyllum, through the database like OMIM, TTD, drugbank and digsee to predict and screen the targeted effect of AS. The genes corresponding to the target were queried by UniProt database, and then the compound target (gene) network and protein-protein interaction network (PPI) were constructed by using Cytoscape 3.2.1 to screen out the core target. Finally, the function enrichment analysis of Gene Ontology (GO) and the pathway enrichment analysis based on Kyoto Encyclopedia of genes and genomes (KEGG) were carried out by David, and the mechanism of action was studied. Results:The compound-target network consisted of 13 compounds and 150 corresponding targets. The key targets were PGR, NR3C2, NCOA2, PPARG, PTGS1, PTGS2, etc. PPI network contains 131 proteins and 46 core proteins. There are 480 GO item in GO function enrichment analysis, including 403 entries in biological process (BP), 35 entries in cell composition (CC), and 42 entries in molecular function (MF). 25 signaling pathways related to AS were obtained by enrichment and screening of KEGG pathway, involving PI3K-AKT, TNF, HIF-1, MAPK, toll like receptor and other signaling pathways.Conclusions:This paper discussed the mechanism of Gynostemma pentaphyllum in the treatment of AS through network pharmacology, which provides new ideas and methods for further research and exploration of the mechanism of Gynostemma pentaphyllum in the treatment of AS.