0.05).The duration of procedure,fluoroscopy time and amount of contrast media consummed in the transradial angioplasty group were more than those in the transfemoral angioplasty group(54.9?15.2 min vs 40.1?10.6 min,P

Objective To observe the efficacy and safety of applying platelet glycoprotein Ⅱb/Ⅲa receptor antagonist(tirofiban) during the perioperation period of emergency percutaneous coronary intervention(PCI) in acute myocardial infarction(AMI).Methods Patients with coronary artery TIMI blood flow 0-1 grade and underwent emergency PCI were consecutively randomized into tirofiban group(n=45) and control group(n=45).Tirofiban was used in the former group before operation and continued for 36-48 hours after PCI.In the latter group,PCI was performed through routine process.The reflow rate,30 days reinfarction rate,mortality and platelet activation degree before and after PCI were recorded during the study.Results All patients in the tirofiban group were recovered with TIMI 3 grade flow and neither slow-reflow nor no-reflow phenomena were observed.In the control group 88.90% of patients restored TIMI 3 grade flow and 11.10% of patients were just recovered with TIMI 0-2 grade flow.The difference was found to be statistically significant(P

Objective To evaluate the short term and long term outcomes of primary percutaneous transluminal coronary angioplasty (PTCA) for acute anterior wall myocardial infarction (AMI) complicated with pump failure Methods 28 patients admitted within 12 hours after the onset of AMI and complicated with heart failure underwent primary PTCA and stent implantation The short term and long term therapeutic effects were observed Results The infarct related coronary arteries (IRCA) of the 28 patients were all LADs with occlusions at the proximal or beginning segment and TIMI flow was 0 Ⅰ Single vessel disease was showed in 15 patients,double vessel disease in 9 and triple vessel disease in 4 The immediate procedural success rate was 100% with TIMI flow Ⅲ in all IRCAs One patient without stent implantation had a recurrent chest pain 2 days after procedure and died of acute pulmonary edema During 1～36 month follow up of the 27 survivors, no death occured and the average LVEF was showed 59 8?6 5% by echocardiography Conclusion Primary PTCA for AMI complicated with pump failure was safe and effective to improve the short term and long term outcomes

Objective To evaluate the efficacy and safety of intravenous thrombolysis with urokinase combined with emergency interventional therapy for acute myocardial infarction(AMI). Methods Fifty two patients with first AMI (≤12 h from onset)were randomized to thrombolysis plus PCI group and primary PCI group,the patency rate of infarct related artery (IRA) before intervention,the procedural success rate,the incidence of bleeding complications and acute ischemic events during hospitalization and the left ventricular ejection fraction (LVEF) measured by echocardiography before discharge were compared.Results The IRA patency rate in the thrombolysis plus PCI group (61 5%) was significantly higher than that in the primary PCI group (19 2%) ( P 0 05),no major bleeding complication and acute ischemic event occurred during hospitalization in both groups,the LVEF in the thrombolysis plus PCI group (64 3?5 6)% was higher than that in the primary PCI group(54 8?4 9)% before discharge ( P

Objective To evaluate the clinical outcomes of emergency intracoronary stenting for senile patients with acute myocardial infarction (AMI). Methods Eighty-four senile patients with AMI underwent emergency intracoronary stenting were compared with eighty-eight non-senile patients with AMI. Results Eighty-six stents were implanted in eighty-four infarction related arteries (IRA), two patients died during hospitalization,the procedural success rate was 97.6% in senile group. Eighty-eight stents were implanted in eighty-eight IRA, one patient died during hospitalization, the success rate was 98.9% in non-senile group. There was no significant difference in characteristic of stents, bleeding complication and LVEF between the senile group and the non-senile group.Conclusion Emergercy intracoronary stenting was an effective and safe therapeutic maneuver for the senile patients with AMI.

Objective To investigate the association between chronic kidney dysfunction and the complexity of coronary artery disease in elderly patients.Methods A prospective study was conducted on 1380 consecutive patients underwent coronary angiography for the first time in our hospital and with angiographically diagnosed coronary artery disease from January 2011 to June 2012.The complexity of coronary artery disease were classified according to the American College of Cardiology/American Heart Association (ACC/AHA) grading system as types A,B1,B2,and C.Estimated glomerular filtration rate (eGFR) was calculated by the simplified Modification of Diet in Renal Disease(MDRD)equation.Patients were classified into 3 stages according to eGFR as follows:normal renalfunction(n=234,eGFR≥90 ml· min-1 · 1.73 m-2),mild renaldysfunction(n=881,60≤eGFR＜90 ml · min-1 · 1.73 m-2,and moderate or severe renaldysfunction(n=265,eGFR＜60ml · min-1 · 1.73 m-2).Ordinal logistic regression was used to analyze the association between chronic kidney dysfunction and the complexity of coronary artery disease.Results Patients with mild,moderate or severe renal dysfunction were older (F=56.82,P＜0.001),more predominantly female (x2 =66.29,P＜ 0.001) and more likely to have history of hypertension (x2 =17.57,P ＜ 0.001),diabetes (x2=20.97,P＜0.001) and hyperlipidemia (x2=10.48,P 0.005) than those with normal renal function.The percentage of lesions of types B2 or C in moderate or severe renal dysfunction group was higher than that in normal renal function group (x2=175.03,P＜0.001).The ordinal logistic regression showed that age,male,hypertension,diabetes,C-reactive protein and eGFR were independent risk factors for the ACC/AHA lesion classification.Conclusions Age,male,hypertension,diabetes,C-reactive protein and eGFR are independent risk factors for the complexity of coronary artery disease.

Objective To investigate the incidence and the risk factors for hospital-acquired pneumonia(HAP)in the elderly in Shanghai.Methods This was a muhicenter prospective clinical cohort study.A total of 5299 patients more than 65 years old.admitted into 31 secondary or tertiary hospitals in Shanghai,were enrolled.Measurements of the demographic and potential risk factors reflecting illness severity,nutrition,drug exposure,surgery and ventilation were performed.Pneumonia was classified by the definition of Chinese Medical Association.Risk factors were analyzed by univariate Pearson Chi-squared test and multivariable logistic regression analysis with backward(Likelihood ratio).Resuits Of the enrolled patients,2805 male and 2494 female,255(4.81%)developed hospital-acquired pneumonia.The incidence was 46.75/1000 hospitalizations.Among them 38 died:and the rough mortality was 14.90%.The incidence of HAP was higher in ICU(21.43%),hematology(12.17%),chest surgery(11.41%),and respiratory medicine(7.92%)departments.The mean of acute physiology and chronic health evaluation (APACHE Ⅱ)score was 8.3±3.4(5-31).Multivariable logistic regression analysis with backward (Wald)method found that admission into secondary hospitals.admission into ICU,history of chronic obstructive pulmonary disease≥10 years,immunosuppression,administration of antibiotics,insertion of nasogastric tube,mechanical ventilation,administration of H-2 antagonists or antacid and≤7 d,central nervous system diseases,depressed level of consciousness,supine position,albumin＜35g/L were independent risk factors of HAP in the elderly.Conclusion Hospital-acquired pneumonia in the elderly was the usual type of nosocomial infections.The risk factors identified from this study may prove useful to target future clinical interventions to prevent HAP in the elderly.

Objective To evaluate efficacy and safety of locally-produced pazufloxacin mesilate sodium chloride injection in the treatment of bacterial infections of respiratory and urinary tract.Methods A multi-center double-blind randomized controlled clinical trial was carried out to evaluate efficacy and safety of pazufloxacin mesilate sodium chloride in treatment for acute bacterial infection, as compared to those of levofloxacin hydrochloride and glucose injection as control treatment.A total of 244 patients with acute bacterial infection of respiratory and urinary tract were enrolled in the studies.120 in trial group and 120 in control group, with four withdrawals.Pazufloxacin mesilate and levofloxacin were administered intravenously by drip at a dose of 300 mg and 200 mg, every 12 hours for 7 to 14 days for trial and control groups, respectively.Resuits Overall efficacy of pazufloxacin mesilate was 77.0 percent and 93.5 percent in treatment for acute bacterial infections of respiratory and urinary tract.respectively, and that of levofloxacin was 80.6 percent and 89.6 percent, respectively.Overall bacterial clearance rate WaS 91.5 percent for pazufloxacin mesilate, 89.6 percent for respiratory tract infection and 94.1 percent for urinary tract infection, respectively.and 93.4 percent for levofloxacin, 97.3 percent for respiratory tract infection and 89.7 percent for urinary tract infection, respectively.No significant difference in adverse drug reactions between the two groups(P＞0.05)was found, with 4.88 percent and 7.44 percent for trial and control groups, respectively.Conclusions Pazufloxacin mesilate sodium chloride injection produced locally is a safe and effective antibiotic in treatment for acute infections of respiratory and urinary tract.

Objective To study of primary colorectal adenocarcinoma histone H2B single prime generalization (uH2B) and its relationship with clinicopathological parameters.Methods Colonic canceRtissue samples and para-carcinoma tissue of gastrointestinal surgery resection of 83 cases were selected from January 2013 to January 2016 in ouRhospital,and normal colon tissue of 20 cases was collected,and uH2B protein expression level in tissue samples was observed using immunohistochemical staining,and its relationship with clinical pathological parameters of patients with primary colonic carcinoma was analyzed.Results The positive expression rate of uH2B protein in colon canceRtissues was 46.99%,which was loweRthan 83.13% of adjacent tissues and 90.00% in normal colon mucosa,the differences were statistically significant (P<0.05);But there was no significant difference in the positive expression of uH2B protein in adjacent tissues and normal colonic mucosa (P>0.05);The positive expression rate of tumoRuH2B protein in colon canceRtissues in the TNM stage was correlation with degree of differentiation and lymph node metastasis (P<0.05),and it had no significant relationship with the patient′s age,gender,tumoRinvasion depth,tumoRsize (P>0.05).Conclusion The decreased expression rate of uH2B protein in colon carcinoma tissue is correlated with the TNM stage,differentiation degree and lymph node metastasis of the patients.

Objective To study of primary colorectal adenocarcinoma histone H2B single prime generalization (uH2B) and its relationship with clinicopathological parameters.Methods Colonic canceRtissue samples and para-carcinoma tissue of gastrointestinal surgery resection of 83 cases were selected from January 2013 to January 2016 in ouRhospital,and normal colon tissue of 20 cases was collected,and uH2B protein expression level in tissue samples was observed using immunohistochemical staining,and its relationship with clinical pathological parameters of patients with primary colonic carcinoma was analyzed.Results The positive expression rate of uH2B protein in colon canceRtissues was 46.99%,which was loweRthan 83.13% of adjacent tissues and 90.00% in normal colon mucosa,the differences were statistically significant (P<0.05);But there was no significant difference in the positive expression of uH2B protein in adjacent tissues and normal colonic mucosa (P>0.05);The positive expression rate of tumoRuH2B protein in colon canceRtissues in the TNM stage was correlation with degree of differentiation and lymph node metastasis (P<0.05),and it had no significant relationship with the patient′s age,gender,tumoRinvasion depth,tumoRsize (P>0.05).Conclusion The decreased expression rate of uH2B protein in colon carcinoma tissue is correlated with the TNM stage,differentiation degree and lymph node metastasis of the patients.