0.05).Conclusion 64-slice CT provided a high diagnostic accuracy in assessing coronary artery stenosis.

Objective To evaluate the effects of intraaortic balloon pump (IABP) support in the emergency interventional procedures on pump failure or cardiogenic shock complicating acute myocardial infarction (AMI). Methods Group A included 21 patients with IABP support during the emergent interventional procedures, and group B included 66 patients without IABP. The two groups were compared for clinical criteria and in-hospital events or complications.Results No significant differences were noted between the two groups witch regard to baseline age, gender, onset of chest pain, timing of intervention, location of AMI, the number of coronary artery diseases, individual infarct-related artery, and TIMI grade before intervention. The degree of pump failure was significantly worse in group A than in group B. In a follow-up period of in-hospital, mortality and revascularization in-hospital were lower in the patients with IABP than in the patients without IABP. Conclusion The combination of early IABP and successful emergency coronary intervention is associated with improved survival in patients with pump failure or cardiogenic shock complicating AMI.

Objective To evaluate the clinical effects of free fibula and flap grafts on the repair of all the first metatarsal bone at one stage.Methods There were 9 cases with the first metatarsal bone defect from Janurary 2003 to December 2009 that treated with free vascularized fibular bone and free vascularized flap at one stage.In which 6 cases reconstructed at the primary stage and 3 cases reconstructed at the second stage.Seven cases reconstructed by free vascularized fibular combined with ALTPF,two cases reconstructed by free vascularized fibular combined with TAPF.The free vascularized fibular and flap restored the first metatarsal bone and the soft tissue defects respectively.Vascular anastomosis was the artery of flap anastomosis with anterior tibial artery and the vein of the flap anastomosis with great saphenous vein,the peroneal artery and accompany vein anastomosis with artery and vein of the flap.Results The grafted tissues survived smoothly in 8 cases,vein crisis happened in I case and the ALTPF necrosis after blood vessels expedition.So the TAPF was changed to cover the soft defect and survived smoothly.Followiy-up were done from 6 to 36 months in 9 cases.There were no ulcer on flaps and no fracture again,the fibulas had been bone healing.Evaluated by Maryland standards,six cases were excellent,two cases were fine,one case was good.Conclusion The fibula combined flap grafts provide a relatively better alternative to repair the first metatarsal bone compound tissue defects at one stage.In addition,the procedure decreased frequency of operations and short the course of treatment.Sensory function reconstruction of fibula flaps should be given full attention.As fine function of the reconstructed foot,it is a effective method for reconstruction the burdened area of the foot.

BACKGROUND: Anterior cervical discectomy and fusion has been considered the gold standard for treatment of symptomatic degenerative disc disease within the cervical spine.However,fusion may result in progressive degeneration of the adjacent segments.Artificial disc replacement seems to be promising,segmental motion and stability are preserved while the spinal canal has been enlarged,and the intervertebral disc biological mechanics has been preserved,but not leads to progressive degeneration of the adjacent segments.OBJECTIVE: To observe the functional outcome and kinematics after the Prodisc artificial neck intervertebral disc replacement.METHODS: A total of 55 cases (69 intervertebral discs),29 males and 26 females,aged 48 (31-76) years were selected,including14 with bi-segmental injury.There were 32 cases of cervical spondylotic myelopathy,9 of cervical spondylotic radiculopathy,and 14 of mixed type cervical spondylosis.Prodisc artificial neck intervertebral disc replacement was performed using anterior or oblique incision.Prospective data JOA score and kinematic measures were collected before surgery and at 3,6,12,and 24 months after surgery.Range of motion was determined by independent radiologic assessment of flexion-extension radiographs.RESULTS AND CONCLUSION: The 55 patients were followed-up,including 41 undergoing single segmental disc replacement and 14 undergoing bi-segmental disc replacement.They were followed up for 22(56-48)months postoperatively.JOA scores displayed improved cervical function by 56%.Range of motion of sagittal and coronal planes were similar to those prior to operation compared with preoperatively(P = 0.45,0.74),and the range of motion and stability were maintained as adjacent segments.Results showed that the artificial disc replacement maintained range of motion of original intervertebral disc,accelerated patient recovery,and slightly affected adjacent intervertebral disc.

Objective:To define impact of spontaneous TIMI-3 flow before angioplasty on outcomes of percutaneous coronary intervention strategy and the prognosis in patients with acute myocardial infarction (AMI ). Methods: The consecutive 301 patients enrolled in the ongoing register of emergent coronary angioplasty within 12 hours from symptoms who were diagnosed as having ST elevation AMI in our hospital from 2000 to 2006 were analyzed, they were followed up for one year and the clinical characteristics and survival rates were analysed. Results: Among the 301 patients enrolled in the ongoing register of emergent coronary angioplasty, spontaneous reperfusion (TIMI-3 flow) was present in 14.6% at initial angiography. Compared with patients without TIMI-3 flow, those with TIMI-3 flow before coronary intervention were less likely to present in new-onset heart failure(2.3% versus 16%, P=0.016), Patients with initial TIMI-3 flow had significantly lower 30-day mortality (0% versus 9.3%, P=0.035) , and cardiogenic shock (0%versus 8.6%, P=0.044) and had a shorter hospital stay (P=0.008). Cumulative 1-year mortality was 0% in patients with initial TIMI-3 flow, 11.3% with TIMI 0-2 flow (P=0.019). By COX regression analysis, postprocendural TIMI-3 flow was an independent determinant of survival (OR=0.285,P=0.004) , however,TIMI-3 flow before coronary intervention was not found as an independent determinant of survival significantly. The lenitive symptoms and current smoking were the independent determinants of TIMI-3 flow before coronary intervention (P=0.005, P=0.048, respectively).Conclusion: Patients undergoing primary percutaneous transluminal coronary intervention in whom TIMI-3 flow is present before angioplasty may present with greater clinical and angiographic evidence of myocardial salvage, be less likely to develop complications related to left ventricular failure, and improve early and late survival.

Human enterovirus 71 (HEV71) is a major causative agent of hand,foot and mouth disease.Children infection with HEV71 can lead to series of neurological complications including aseptic meningitis,cerebral ataxia and even fatal outcomes.During recent decades,epidemic of hand,foot and mouth disease have occurred in many countries and regions in the world,which has become a major public health problem for children's health.There are no specific antiviral drugs for HEV71 infection,so it is necessary to develop safe and effective vaccine.In recent years,the research on HEV71 vaccine has made a breakthrough,and this article reviews the research progress of the vaccine.

Objective To investigate the safety and short-term outcome of rotational atherectomy followed by drug-eluting stenting in heavily calcified coronary long lesions. Methods From Jan 1, 2011 to May 31, 2016, 109 cases with 114 heavily calcified coronary lesions which were treated with rotational atherectomy followed by drug-eluting stenting in Peking University People's Hospital were included. They were divided into diffuse lesion group ( lesion ≥25 mm, 68 cases, 72 lesions ) and focal lesion group (lesion ﹤25 mm,41 cases, 42 lesions). All patients were followed up in hospital. Procedure parameters, procedural complications ( dissection, perforation, slow flow/no flow and procedural related myocardial infarction),procedural success and major adverse cardiovascular events (cardiac death, non-fatal myocardial infarction and stent thrombosis) were analyzed. Results The procedural success rate was 98. 5%(67/68) in diffuse lesion group and 100% ( 41/41 ) in focal lesion group ( P=0. 453 ) . Complication rates did not differ between the two groups (41. 2% and 34. 1%, P=0. 673). Major adverse cardiovascular events rates were 41. 2% and 31. 7%, P =0. 484. Conclusions Treating coronary lesions ≥25 mm in length with rotational atherectomy followed by drug-eluting stenting does not impact the short-term outcome when treating carefully and correctly . Procedural success rate and in-hospital outcome is satisfactory.

Objective To explore the effectiveness and safety of branch protection technique with provisional stenting strategy in coronary bifurcation lesions by utilizing jailed balloon protection technique after pre-dilation in branch with cutting balloon. Methods 32 patients undergone jailed balloon protection technique after pre-dilation in branch with cutting balloon during January, 2015 to May, 2016 in Peking University of People's Hospital were enrolled consecutively in our study. 32 patients were involved including a total of 32 bifurcation lesions which were medina type 1,1,1 (n = 25, 78. 1% ), Medine type 0,1,1 (n =5,15. 6% ) and Medine type 1,0,1 (n = 2, 6. 3% ). For side branch diameter ≥2. 5 mm, the diameter ratio of cutting balloon to side branch was 1: 1. The angiography success rate after using branch protection during main branch stent implantation, perioperative complications and major adverse cardiac events were observed. Results ( 1 ) The angiography success rate of branch protection was 100% . ( 2 ) No perioperative complications and major adverse cardiac events were observed. Conclusions Side branches were effectively protected in provisional stenting strategy by applying jailed balloon protection technique after pre-dilation using branch cutting balloon.

Objective: To explore the application safety for off-label using of rotational atherectomy. Methods: A total of 112 patients received rotational atherectomy in our hospital from 2010-01 to 2015-12 were enrolled in this study. There were 9 off-label indications for using of rotational atherectomy which included vein grafts, massive thrombotic burden, unprotected left main coronary artery disease, culprit lesions of acute myocardial infarction, severe coronary dissection, signiifcant impaired left ventricular function (LVEF<30%), severe three-vessel coronary disease, diffuse long coronary lesions (≥25mm) and angulation lesions (≥45°). The patients were divided into 2 groups: Off-label group, the patients with ≥ 1 above mentioned indication(s),n=67 (59.8%) and On-label group, the patients without any indication,n=45 (40.2%). Rotational atherectomy related complication rates were compared between 2 groups including slow lfow/no lfow, stuck of rotablator, coronary artery perforation, guide wire fracture and in-hospital MACE as urgent CABG, acute in-stent thrombosis and cardiac death. Results:①The most common complication was slow lfow/no lfow and its occurrence rates were similar between 2 groups (4.5%vs 8.9%),P>0.05.②Off-label group had 1 patient with stuck of rotablator (1.5% vs 0%) and 1 cardiac death (1.5% vs 0%), both P>0.05; On-label group had 1 patient with acute in-stent thrombosis (2.2% vs 0%),P>0.05. Conclusion: Off-label using of rotational atherectomy did not increase the incidence of slow lfow/no lfow in relevant patients, other severe complications and in-hospital MACE occurrence were also rare.

Objective To investigate the characteristics of auditory brainstem response (ABR) in autistic children of 6 years or younger .Methods A total of 98 children with normal hearing and 22 autistic children were en‐rolled in this study .They were divided into 3 groups :1~2 years age group ,2< ~3 years age group ,and 3< ~6 years age group .The thresholds ,wave latencies and interpeak intervals of ABR were statistically analyzed .Results The ABR thresholds in normal hearing children (and autistic children) in 1~2 years age group ,2< ~3 years age group ,and 3< ~6 years age group were 15 .64 ± 5 .02 (17 .50 ± 5 .35) ,14 .73 ± 4 .85 (17 .81 ± 6 .58) ,and 15 .57 ± 5 .62 (17 .25 ± 6 .97) dB nHL ,respectively .There were no significantly statistical difference between the normal hearing children and autistic children (P>0 .05) .In 80 dB nHL click sound stimulus ,there was also no statistical difference in the values of peak latencies or interpeak intervals of ABR between normal hearing children and autistic children (P> 0 .05) ,whereas ,prolongation of peak latencies or interpeak intervals of ABR occurred in 36 .36%(25 .00% ears) autistic children .The ratio of prolongation of peak latencies of I ,III ,V waves and interpeak inter‐vals of I-III ,III-V ,I-V occurred in 4 .54% ,6 .82% ,13 .64% ,18 .18% ,6 .83% and 15 .91% ,respectively . Conclusion The ABR in some autistic children present abnormality and occur in various forms with the prolongation of interpeak intervals of I -III as the most common .