Objective To investigate the angiographic coronary atheroslerosis findings with the plasma levels of von Willebrand factor (vWF) and ?-granule membrane protein (GMP-140). Methods 74 patients undergone selectrive coronary angiography (CAG) were divided into 3 groups based on plaque morphology, Group S(n=15), concentric or eccentric stenosis with smooth borders; Group C(n=37), eccentric stenosis with complex borders; Group N (n=22), CAG without coronary atheroslerosis. 37 patients in group C were divided into group Ⅰ (n=10, one-vessel involved CAD), group Ⅱ (n=12, two-vessel involved CAD) and group Ⅲ (n=15, three-vessel involved CAD) based on major epicardial coronary branches lesion. These 37 patients were divided into group x(n=21, ≤3 segments) and group y(n=16,≥4 segments) based on coronry stenotic segments. The plasma levels of vWF and GMP-140 were assayed by ELISA before angiography. Results (1)The plasma levels of vWF and GMP-140 in group C were significantly higher than those in group S(P

Objective To investigate the effect of unfractioned heparin and low molecular weight heparin on expression of plasma hepatocyte growth factor(HGF)during percutaneous coronary intervention(PCI).Methods Seventy four patients with unstable angina pectoris were classfied into unfractioned heparin(UFH)group(n=49)and low molecular weight heparin(LMWH)group(n=25)according to the type of heparin used during PCI.The plasma levels of HGF were measured before,during,and after PCI in the patients.Results The plasma levels of HGF before procedure were of no statistical difference between the two groups.The levels of HGF were significantly increased during and after PCI in the unfractioned heparin and the LMWH group.Comparing with the pre-procedure level,the post-procedure level of HGF in the UFH group was 13 565.60?3 768.99 ng/L(vs 1 736.09?603.95 ng/L,P

Objective To evaluate the effect and safety of ultrasound-guided percutaneous thrombin injection for the treatment of postcatheterization femoral arterial pseudoaneurysm.Methods Seventy-eight patients with femoral anterial pseudoaneurysm were included in this study.Pseudoaneurysms were treated by bedside compression in 50 of these 78 patients(group A),and by thrombin injection in 28 patients(group B).All patients were diagnosed by GE LOGIQ 9 Color Doppler Ultrasound.Ultrasound guided thrombin injection for femoral arterial pseudoaneurysme were carried out in patients in group B.Results Closure of the pseudoaneurysm was successfully in 82 percent(41/50) of the patients in group A.Six patients had vagus reflex,4 patients could not tolerate repeating compression and 5 patients were not effectively cured by compression and needed to receive remedial ultrasound-guided percutaneous thrombin injection.Closure of the pssudoareurysm by percutaneous thrombin injection was successful in all patients in group B.Successful immediate closure were noted in 25 patients and 2 patients needed second thrombin injection.One patient had vasovagal syncope and 12 patients had mild fever.No distal embolization,infection,hemorrhage or allergic reaction occurred.Conclusion Compared to compression therapy for treatment of femoral arterial pseudoaneurysme,ultrasound-guided percutaneous thrombin injection is a simple,safe and effective treatment alternative.

Objective To study the distance of MRI in the practice of correct diagnosed meningioma.Methods 152 cases which have been diagnosed meningioma from MRI scan compared to operation and pathology.16 cases which do not fit the diagnosis from them were analysed.Results There were 10 cases which were misdiagnosed other tumour(6.5%).Other tumour misdiagnosed meningioma were 6 cases(4%).The general misdiagnostic rate was 10.5%.Conclusion Because of complexity in histological structural,equipment function and scan technology,it is inevitable to misdiagnose.If we can pay more attention to the typical character and study the plain film and medical history taking carefully,we could increase correct diagnostic rate of meningioma.

Objective To evaluate the long-term safety and efficacy of domestic Firebird rapamycin-eluting stent in treatment of patients with coronary artery disease (CAD). Methods The 465 patients with CAD received percutaneous interventional therapy with domestic Firebird or imported Cypher rapamycin-eluting stent based on patients' will and they were followed up for more than 24 months. Results The 321 cases in Firebird group were followed up for (45.3 ±11.1)months, with 166 cases (51.7%) received reexamination by coronary angiography. The 144 patients in Cypher group were followed up for (46.1 ± 12. 1) months, with 82 patients (56.3%) received reexamination by coronary angiography. At the termination of follow-up, there were no significant differences in all-cause death (7.8% vs. 7.6 %, x2 = 1.32, P = 0. 250), cardiac death (5.9% vs.5.6%, x2 =0. 02, P=0. 877), acute myocardial infarction (2.8% vs. 3.4%, x2 =0. 15, P=0. 697),cardiovascular-cause rehospitalization (29.6% vs. 31.9 %, x2 =0.26, P=0. 610), acute and subacute thrombosis events (0.9% vs. 1.3%, x2 =0.19, P=0.661), late thrombotic events (1.2% vs.1.3%, x2 =0. 02, P=0. 900) and target lesion revascularization (3.4% vs. 4.2%, x2 =0. 15, P=0. 694) between two groups. Conclusions Domestic Firebird rapamycin-eluting stent has the same or similar long-term safety and efficacy with imported Cypher rapamycin-eluting stent.

Cardiopulmonary exercise test and electrocardiogram exercise test were performed in 68 patients with suspected coronary artery disease,the diagnostic value of two tests was compared with coronary angiography results as the gold standard.The results show that the sensitivity,specificity,positive predictive value and negative predictive value of electrocardiogram exercise test for coronary heart disease were 51.28％,68.97％,68.97％ and 51.28％ respectively; those for ratio of O2 pulse peak in cardiopulmonary exercise test were 51.28％,75.86％,74.07％ and 53.66％ respectively.It suggests that the results of cardiopulmonary exercise test may have the same value as electrocardiogram exercise test in diagnosis of coronary artery disease.

Objective To observe the immediate hemodynamic effects of the intercoronary ischemic preconditioning on the coronary perfusion pressure.Methods The observational study recruited 17 patients who were hospitalized for stable coronary disease and had severe stenosis lesions (70％ ～ 85％ ) in one or two vessels per coronary angiography.They were randomized into ICPC ( n =8 ) group ( receiving two cycles of 1-min balloon inflation and 5-min reperfusion) and control group (n =9).Before interventional treatment,the ICPC group was given 2 cycles of intercomary ischemic preconditioning.The occlusive and non-occlusive pressures proximal and distal to the stenosis were collected before and after ICPC.Fractional flow reserve (FFR) was calculated upon the following equation:FFR =Pd/Pa ( Pa:hyperemic mean aortic pressure,Pd:hyperemic coronary pressure distal to the stenosis).Results Before and after ischemic preconditioning,coronary wedge pressure and FFR of ICPC group were significantly increased ( coronary wedge pressure was from [ 22.08 ± 19.14 ]mm Hg to [25.46 ±19.04]mm Hg,P=0.011;FFR.was from [70.30±16.05]％ to [77.53 ±13.42]％,P=0.001).The collateral flow was increased significantly.Coronary wedge pressure and FFR of control group did not improved obviously.There were significant differences in FFRs and coronary wedge pressures between ICPC and control groups.Conclusion Coronary ischemic preconditioning can improve coronary perfusion pressure,and rapidly increase the coronary pressure distal to the severe stenosis lesions.

Objective To assess value of serum level of ischemia modified albumin (IMA) in diagnosis for myocardial ischemia of coronary artery disease (CAD). Methods Seventy-two patients with clinically suspected myocardial ischemia of CAD admitted to The First People's Hospital of Hangzhou during November 2009 to May 2010 ready for undergoing coronary angiography, the gold standard for diagnosis of CAD, were randomly selected for the study. The patients were divided into CAD and non-CAD groups based on their coronary angiography. Serum level of IMA was determined with cobalt-albumin binding ( ACB) assay before coronary angiography, which served as diagnostic standard for CAD. Logistic regression analysis method was used to evaluate varied levels of IMA with area under the receiver operating characteristic curve (AUCROC) in diagnosis for myocardial ischemia of CAD. Results Mean level of IMA was (97 ±24) U/ml and (81 ±15) U/ml for CAD group (n =51) and non-CAD group (n =21), respectively. Sensitivity and specificity of a cut-off value of IMA 83.69 U/ml in diagnosis for myocardial ischemia of CAD was 80 percent and 57 percent, respectively, with a predictive value of a positive test 82 percent and that of a negative test 55 percent, respectively, from AUCROC. Logistic regression analysis demonstrated that both hypertension (P=0. 022, 6 = 1.421, OR=4. 141) and level of IMA (P=0.003, b= 1.780, OR=5.928) were independent predictors for CAD. Conclusions Sensitivity, specificity and predictive value of a positive test of the level of IMA are relatively high in diagnosis for myocardial ischemia of CAD, which is an independent predictor of it.

Objective To review the clinical features of fulminant myocartitis,in order to provide assistance to the clinical management.Methods The clinic data of 183 patients with viral myocarditis,including 153 cases of acute myocarditis and 30 cases of fulminant myocarditis admitted in our hospital during January 2008 and Dec 2012 were retrospectively analyzed.The age of onset,interval after virus infect,initial symptoms,auxiliary examination,treatment,and turnover were compared in the study.Results The average onset age of fulminant myocartitis and acute myocarditis were similar [(22.3 ± 7.6) vs.(26.2 ± 12.6) years,P =0.105 5].There was a significant difference between the two gourps in the rate of patients with a explicit history of virus infection [30.0％ (9/30) vs.78.4％ (120/153),x2 =28.3,P ＜0.001],the average interval after virus infect [(3.1 ±2.2) vs.(7.0 ±3.80) d,P＜0.001] and the length of hospital stay [(12.1 ± 6.9) vs.(6.9 ± 4.50) d,P ＜ 0.001].Chest congestion (101/153,66.0％),feebleness (76/153,49.7％),fluster (74/153,48.4％) are the most onset symptoms of acute myocarditis,while chest congestion (24/30,80.0％),shortness of breath (14/30,46.7％),feebleness (13/30,43.3％) in flunimant myocarditis.Advanced A-V block (19/30,63.3％),cardiogenic shock (18/30,60.0％),ventricular arrhythmia(16/30,53.3％),Adams-Stokes syndrome(8/30,26.67％) and acute renal failure (8/30,26.7％) were the most complications of flunimant myocarditis.Temporary pacemaker (11 cases),extracorporeal memberane exygenator (7 cases) and intra-aortic balloon pump (7 cases) were applied in critical patients.In acute phase,21 cases were cured,9 cases was dead of cardiogenic shock and ventricular(27,30.0％).Two dead cases applied with ECMO because of delay.After leaving hospital,1 case was implanted permanent pacemaker,2 cases became chronic myocarditis and required hospitalization repeatedly.Conclusions The fulminant myocarditis has a rapid onset,most of which has no prodrome of virus infection or a shorter interval than acute myocarditis.Timely and effective mechanical circulatory support is critical for fulminant myocarditis.

The motor function of the trunk in 10 hemiplegic patlents was evaluated with Biodex Sys- tem Ⅱisokinetic testing aparatus. The result shows that the strength of flexors and extensors of the trunk,especially the flexors,becomes weaker(The ratio of flexors to extensors is less than 1).The patients weretreated with a series of the trunk retraining methods. The motor function of the trunk was improved aftertreatment(P<0.01 ).The total motor function(Fugl-Meyer Assessing Scale)also makes significant progress(P<0.01).The study proposes that the retraining and regaining of the trunk motor function in hemiplegiais quite important not only to the trunk but also to total motor function.