OBJECTIVE To compare the characteristics of intravascular ultrasound in diverse TCM types of acute coronary syndrome(ACS).METHODS 66 patients diagnosed with ACS via IVUS were divided into group of toxic heat and blood stasis syndrome(NHST group with 36 cases) and the group pf non-toxic heat and blood stasis syndrome(Non-NHST group with 30 cases) based on syndrome differentiation.The indexes such as plaque area in criminal lesions, the area of extra-elasticity membrane(EEM), plaque burden, the incidence of high risk plaques, the positive or negative remodeling percentage and remodeling index(RI) were measured by IVUS.Analysis was performed by statistical package SPSS11.0, with the data being compared.RESULTS The plaque area in criminal lesions, the area of EEM and plaque burden in NHST group were significantly larger than those in Non-NHST group(P<0.01) respectively.The incidence of high risk plaques and RI in NHST group were markedly higher than those in Non-NHST group(P<0.05) respectively.More positive remodeling was observed in NHST group(P<0.01) while more negative remodeling was seen in Non-NHST group(P<0.01).CONCLUSION The coronary arterial atherosclerotic plaques in patients with NHST maybe more unstable.

OBJECTIVETo study the chemical constituents of the aerial parts of Liusticum chuanxiong.

METHODThe chemical components were isolated by silica gel and Sephadex LH-20 column chromatography. Structures were elucidated on the basis of physico-chemical properities and spectral data.

RESULTEight chemical constituents were isolated, and identified as protocatechuic acid (1), caffeic acid (2), scopoletin (3), apigenin (4), quercetin (5), cosmosiin (6), kaempferol-3-O-beta-D-glucopyranosid (7) and glucose (8).

CONCLUSIONCompounds 1-8 were obtained from the aerial parts of the plant for the first time, compounds 3-8 were obtained from the plant for the first time.

Apigenin ; chemistry ; isolation & purification ; Kaempferols ; chemistry ; isolation & purification ; Ligusticum ; chemistry ; Plant Components, Aerial ; chemistry ; Plants, Medicinal ; chemistry ; Scopoletin ; chemistry ; isolation & purification

15 scores were randomly divided into therapeutic group (30 cases)and control group(30 cases).The two groups were treated with the same conventional therapy. From the 1st day of admission,Xuebijing injection 80 ml was given by intravenous drip once for every 12 hours for 7 days to the therapeutic group.The level of tumor necrosis factor-?(TNF-?),interleukin-1?(IL-1?),IL-6,IL-10,and APACHEⅡscore were tested on 1,3,5 and 7 days after admission.The case fatality and incidences rates of sepsis and MODS in both groups were recorded.Results Compared with the control group,APACHEⅡscore,TNF-?,IL-1?,IL-6 and IL-10 of the therapeutic group were lower significantly on the 3rd day after admission,especially on the 5th day(all P

Circular RNA(circRNA)is a type of noncoding RNA with tissue specificity and high stabil-ity, which forms a closed continuous loop and is abundantly expressed in tissue cells. According to re-cent research, the regulatory function of circRNA elucidating in the occurrence and development of dis-ease shows a potential for diagnosing clinical disease and revealing disease mechanism. This paper re-views the biological characteristics, analysis methods of circRNA and its research progress in clinical ap-plication as biomarker, and outlooks its application in the field of forensic medicine.

Objective To investigate the clinical therapeutic effects of endovascular repair for patients with DeBakey Ⅲ aortic dissection.Methods From December 2002 to June 2007,endovascular TALENT stent-graft exclusion was performed in 75(65 males,mean age 54.4±12.6 years)patients with DeBakey Ⅲ aortic dissection(1 young woman due to Ehlers-Danlos syndrome,2 young men due to primary aldosteronism and trauma respectively).All patients were diagnosed by contrast enhanced computed tomography(CT)or MRI.Stent-grafts were deployed via femoral artery to exclude the tear of dissection.Aortic angiography was performed immediately after procedure.Results Eighty-one stent-grafts were installed in 75 patients successfully without operation related dissection.Endoleakage immediately after stent-graft deploying was evidenced in 25 patients and disappeared after stent placements(n=6)or balloon dilation (n=19).Two patients died from aortic rupture within 2 days after procedure.Iliac artery was torn in a female patient with Ehlers-Danlos syndrome,this patient developed hemorrhagic shock after stent-graft placement and recovered after anti-shock treatments and iliac artery replacement with synthetic artery.During the follow-up of 1-24 months,2 patients(including the woman with Ehlers-Danlos syndrome)suddenly died half a year after procedure.The remaining patients were alive and well.Repeat CT during follow up showed that reduced lumen size and thrombosis in the false lumen.There was no aortic rupture,endoleak and stent migration during the follow-up period except descending aortic dissection distal of the stent-graft in 1 patient 1 year after procedure and the patient were successfully treated surgically without complication.Conclusions Endovasular repair is a safe and effective treatment for patients with DeBakey Ⅲ aortic dissection,suitable for old patients with high risk of surgery.Ehlers-Danlos syndrome should be considered in young DeBakey Ⅲ aortic dissection patients without hypertension.Further studies are warranted on endovasular repair therapy for artery complication of Ehlers-Danlos syndrome.

Objective To explore the prevalence of coronary artery disease and risk factors in patients with abdominal aortic aneurysm(AAA).MethodsCoronary angiography was performed immediately after abdominal angiography in 70 elderly(＞50 years)consecutive patients with AAA. Medical history and imaging characteristics were evaluated. Results CAD was diagnosed in 63 patients(90. 0%)by coronary angiography: 20(28.6%)patients with single-vessel disease(SVD), 15(21.4%)with 2VD, 22(31.4%)with 3VD and 6(8. 6%)with left main disease + 3VD. Multi-variance logistic analysis showed that peripheral disease was the strongest predictor for CAD in AAA patients. Conclusion Coronary angiography should be performed in elderly AAA patients due to the high prevalence of CAD in this patient cohort.

Objective To propose an attention mechanism-based YOLOv5 algorithm to relieve the wrong or missed diagnosis due to the complexity and variability of trauma conditions.Methods A YOLOv5-attention algorithm was constructed with YOLOv5 algorithm as the basic framework,which introduced the convolutional attention mechanism module into the feature fusion network and embedded the self-attention module at the end of the feature extraction network and the feature fusion network,respectively.The YOLOv5-attention algorithm was trained and validated on the Kaggle platform and compared with Fast-RCNN and YOLOv5 algorithms for determining fracture sites.Results The YOLOv5-attention algorithm achieved an average presicion of 0.859 8 for fracture site determination,which behaved better than Fast-RCNN algorithm with an average presicion of 0.697 5 and YOLOv5 algorithm with an average presicion of 0.847 1.Conclusion The YOLOv5-attention algorithm with high accuracy and robustness can identify and locate trauma conditions effectively and accurately.[Chinese Medical Equipment Journal,2024,45(9):1-6]

BACKGROUNDDecreasing the intracranial pressure has been advocated as one of the major protective strategies to prevent spinal cord ischemia after endovascular aortic repair. However, the actual changes of cerebrospinal fluid (CSF) pressure and its relation with spinal cord ischemia have been poorly understood. We performed CSF pressure measurements and provisional CSF withdrawal after thoracic endovascular aortic repair, and compared the changes of CSF pressure in high risk patients and in patients with new onset paraplegia and paraparesis.

METHODSFour hundred and nineteen patients were evaluated for the risk of spinal cord ischemia after thoracic endovascular aortic repair. Patients with identified risk factors before the procedure constituted group H and received prophylactic sequential CSF pressure measurement and CSF withdrawal. Patients who actually developed spinal cord ischemia constituted group P and received rescue CSF pressure measurements and CSF withdrawal.

RESULTSAmong the 419 patients evaluated, 17 were graded as high risk. Four patients actually developed spinal cord ischemia after endovascular repair. The incidence of spinal cord ischemia in this investigation was 0.9%. The patients who actually developed spinal cord ischemia had no identified risk factors and had elevated CSF pressure, ranging from 15.4 to 30.0 mmHg. Six of the 17 patients graded as high risk had elevated CSF pressure: >20 mmHg in two patients and >15 mmHg in four patients. Sequential CSF pressure measurements and provisional withdrawal successfully decrease CSF pressure and prevented symptomatic spinal cord ischemia in high-risk patients. However, these measurements could only successfully reverse the neurologic deficit in two of the patients who actually developed spinal cord ischemia.

CONCLUSIONSCerebrospinal fluid pressure was elevated in patients with spinal cord ischemia after thoracic endovascular aortic repair. Sequential measurements of CSF pressure and provisional withdrawal of CSF decreased CSF pressure effectively in high risk patients and provided effective prevention of spinal cord ischemia. Risk factor identification and prophylactic measurements play the key role in prevention of spinal cord ischemia after thoracic endovascular aortic repair.

Aged ; Aorta, Thoracic ; surgery ; Cerebrospinal Fluid Pressure ; physiology ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Ischemia ; prevention & control

OBJECTIVETo study the benefit of prophylactic antibiotics (PA) in totally percutaneous aortic endovascular repair (PEVAR) in the catheterization laboratory for reducing stent-graft infection and postimplantation syndrome (PIS).

METHODSThe clinical data were analyzed of patients undergoing thoracic endovascular aortic repairs. The patients were divided into non-PA group and PA group according to the use of prophylactic antibiotics before PEVAR. The diagnosis of infection was made by two senior physicians with reference to Hospital Acquired Infection Diagnostic Criteria Assessment released by the Ministry of Health of China.

RESULTSThe 95 enrolled patients included 35 with PA and 60 without PA group, who were comparable for baseline characteristics. Infection-related deaths occurred in 1 case in non-PA group and retrograde Stanford type A dissection and death occurred in 1 case in PA group (1.67% vs 2.85%, P=1.00). The PA and non-PA groups showed no significant difference in the incidence of postoperative infection (5% vs 2.86%, P=1.000), hospital stay (9.30±7.21 vs 10.06±5.69, P=0.094), infection-related mortality (1.67% vs 0%, P=1.00), or postoperative fever (70.90% vs 91.43%, P=0.20). The body temperature showed significant variations at different time points after procedure (F=19.831, P<0.001) irrelevant to the use of prophylactic antibiotics (F=0.978, P=0.326).

CONCLUSIONThe current data do not support the benefit of PA in reducing postoperative infection and PIS in patients undergoing PEVAR, but the patients without PA may have worse clinical outcomes in the event of postoperative infections.

Anti-Bacterial Agents ; administration & dosage ; Antibiotic Prophylaxis ; Aorta, Thoracic ; surgery ; China ; Endovascular Procedures ; Humans ; Length of Stay ; Postoperative Complications ; prevention & control ; Stents ; Vascular Surgical Procedures

BACKGROUNDThe perioperative aortic dissection (AD) rupture is a severe event after endovascular stent graft placement for treatment of type B AD. However, this life-threatening complication has not undergone systematic investigation. The aim of the study is to discuss the reasons of AD rupture after the procedure.

METHODSThe medical record data of 563 Stanford type B AD patients who received thoracic endovascular repair from 2004 to December 2011 at our institution were collected and analyzed. Double entry and consistency checking were performed with Epidata software.

RESULTSTwelve patients died during the perioperation after thoracic endovascular repair, with an incidence of 2.1%, 66.6% were caused by aortic rupture and half of the aortic rupture deaths were caused by retrograde type A AD. In our study, 74% of the non-rupture surviving patients had the free-flow bare spring proximal stent implanted, compared with 100% of the aortic rupture patients (74% vs. 100%, P = 0.213). The aortic rupture patients are more likely to have ascending aortic diameters = 4 cm (62.5% vs. 9.0%, P = 0.032), involvement the aortic arch concavity (62% vs. 27%, P = 0.041) and have had multiple stents placed (P = 0.039).

CONCLUSIONSThoracic AD endovascular repair is a safe and effective treatment option for AD with relative low in-hospital mortality. AD rupture may be more common in arch stent-graft patients with an ascending aortic diameter = 4 cm and with severe dissection that needs multi-stent placement. Attention should be paid to a proximal bare spring stent that has a higher probability of inducing an AD rupture. Post balloon dilation should be performed with serious caution, particularly for the migration during dilation.

Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Aortic Rupture ; etiology ; Blood Vessel Prosthesis Implantation ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stents