With improvement in stent designs, the practice of direct stenting (DS) without balloon predilation has become more widespread. DS may allow partial retention of endothelium within treated arteries, and associate with decreased utilization of contrast agent, number of catheter, exposure of X-ray,and expense. This paper evaluate the experiment base, principle, indication, contraindication, skills, complications as well as the result of acute and chronic follow up of DS.

Objective To investigate the correlation between abnormal lipid metabolism and coronary artery lesions. Methods Two hundred and sixty seven patients were devided into the control group ( n =101) and the coronary heart disease (CHD) group ( n =166), which included single vessel lesion ( n =54), double vessel lesions ( n =68) and triple vessel lesions ( n =44) according to coronary angiography. At the same time the lipid components were examined and the ralationship between serum lipid level and coronary artery lesions were analysed. Results Compared with the control, the total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) level were significantly elevated while but high density lipoprotein cholesterol (HDL-C) was lowered in the CHD group. The severity of coronary lesions was increased with the elevation of TC, LDL-C, apolipoproteinB (ApoB), TC/HDL-C, LDL-C/HDL-C, and the reduction of HDL-C. There were significant differences in terms of lipid level beteewn the CHD group and the control. The analysis showed that TC/HDL-C and LDL-C/HDL-C were most directly correlated with the coronary artery lesions in the CHD group. Conclusion The results suggest that the severity of coronary artery lesions correlated with abnormal lipid metabolism, and LDL-C/HDL-C, TC/HDL-C are better indicators than other lipid components.

Beta blocker can be categorized by non-selective agents,selective agents and agents with vasodilatory effect.Beta blocker therapy represents a major advance in the treatment of heart failure patients.The mechanisms include up-regulation of beta receptor,reversing remodeling,improving contractile and diastolic function,antiarrhythmia and anti-ischemia.Evidences from randomized controlled clinical trials have supported its use in the treatment of patients with heart failure to decrease mortality and improve life quality.Guidelines with various versions recommend that ?-blockers are indicated for patients with symptomatic or asymptomatic heart failure and a depressed ejection fraction of lower than 40%.There is something to be noticed for rational use of ?-blockers such as timing,dosage,duration and contraindications.

Objective To study the relationship between red cell distribution width (RDW ) and short-term outcomes in acute coronary syndrome (ACS) patients .Methods A totoal of 1654 ACS patients were divided into RDW ≤12 .1% group(n=419) ,RDW=12 .2% -12 .8% group(n=364) ,RDW=12 .9% -13 .2% group (n= 463) and RDW ≥13 .3% group (n= 408) .Their bio-chemical indicators and incidence of 1-month cardiac death ,heart failure ,recurrent myocardiac in-farction were compared .Relationship between RDW and 1-month adverse cardiac events was as-sessed .Results The incidence of cardiac death ,heart failure ,recurrent myocardiac infarction in-creased with the increasing RDW .Logistic regression analysis showed that RDW ,BNP>100 ng/L and LVEF< 40% were the independent risk factors for 1-month cardiac death in ACS patients (OR=2 .116 ,95% C I:1 .427-3 .137 ,P=0 .000;OR=3 .510 ,95% C I:1 .221 -10 .093 ,P=0 .020 ;OR= 4 .149 ,95% CI:2 .001 -8 .602 ,P= 0 .000 ) ,and that RDW ,age> 65 years ,diabetes and LVEF<40% were the independent risk factors for 1-month heart failure and recurrent myocardi-ac infarction in ACS patients (OR= 2 .134 ,95% CI:1 .602 -2 .844 ,P= 0 .000 ,OR= 2 .010 , 95% C I:1 .135 -3 .560 ,P=0 .017 ;OR=2 .279 ,95% C I:1 .345 -3 .862 ,P= 0 .002 ;OR=5 .009 , 95% CI:2.694-9 .316 ,P=0 .000) .Conclusion RDW is an independent risk factor for the short-term outcomes in ACS patients .

Hydrogen sulfide (H2S) was considered as the third gasotransmitter,along with nitric oxide and carbon monoxide,with extensively biological activities.Considerable evidence showed that H2S was involved in inflammatory processes such as in inflammatory cells,inflammatory mediates,vascular tension and signaling pathways.Previous studies suggested H2S played a bidirectional role in regulating inflammation including pro- and anti-inflammatory actions due to different animal models.Further study about the role and mechanism of H2S in inflammation will contribute to efficient prevention and treatment for inflammatory diseases.

Objective To evaluate the nutrition status and the prognosis of acute stroke patients with hy-pothyroidism during hospitalization. Methods The clinical data of 28 acute stroke patients with hypothyroidism (study group) and 28 stroke patients with normal thyroid function (control group) were retrospectively analyzed.Results After (10±4) days of hospitalization, hemoglobin and serum albumin levels in study group significantlydecreased ( P < 0. 05 ). The requirement of calories and protein, incidence of pulmonary infections, alimentarytract hemorrhage and diarrhea, and hospital stays were significantly higher in study group than in control group (P < 0. 05 ). Conclusion The nutrition status is poor in acute stroke patients with hypothyroidism, who were more easier to be suffered from clinical complications and worse prognosis.

Objective To investigate effects of mouse nerve growth factor on serum brain-derived neurotrophic factor, Fibulin-5 and intracranial blood flow in patients with acute cerebral infarction.Methods 98 patients with acute cerebral infarction in our hospital from September 2015 to September 2016 were selected as the research object, divided into observation group and control group, 49 cases in each group.The control group was treated with conventional treatment of acute cerebral infarction, patients in the observation group on the basis of conventional treatment combined with mouse nerve growth factor, Enzyme-linked immunosorbent assay was used to detect serum brain-derived neurotrophic factor, Fibulin-5, Intracranial ultrasonography was used to detect intracranial blood flow, the brain-derived neurotrophic factor, Fibulin-5, cerebral blood flow were compared between the two groups before and after treatment.Results Before treatment, two groups of patients with brain-derived neurotrophic factor (BDNF), Fibulin-5 and hemodynamics, the difference was not statistically significant.After treatment, the levels of BDNF and Fibulin-5 in the observation group were (5.63 ±1.34), (156.63 ±12.79), significantly higher than the control group (4.26 ±1.54), (115.52 ±15.66), the difference was statistically significant ( P<0.05 ) , the observation group of patients with cerebral hemodynamics index , average blood flow ( Qmean ) , the average blood flow velocity (Vmean), dynamic impedance (DR), cerebral vascular characteristic impedance (ZCV), cerebral vascular peripheral resistance (R) were significantly better than the control group, the difference was statistically significant (P<0.05), the prognosis of the observation group was better than that of the control group, the difference was statistically significant ( P<0.05 ) .Conclusion Clinical effect of mouse nerve growth factor on acute cerebral infarction is helpful to promote the growth of nerve function inhibition, improve cerebral blood flow, better prognosis.

Objective To observe the effect of Danshen injection combined with ulinastatin on the brain protection and inflammatory reaction in patients with Severe traumatic brain injury.Methods 83 cases of patient with Severe traumatic brain injury were randomly divided into the observation group(43 cases)and the control group(40 cases).The control group was given ulinastatin based on conventional treatment,and the observation group was given Danshen injection and ulinastatin based on the control group.For 10 days,the differences of hemodynamic parameters(Qmean、Zc、DR)and serum nerve function indexes(β-EP、DynAl-13、NSE),inflammatory factors(IL-1,IL-6,TNF-α,CRP)between the two groups were be compared.Results ①Comparison of hemodynamic parameters There was significantly difference of Qmean、Zc、DR in these two groups(Fgroup=6.126,5.024,5.621,P<0.05),Qmean was showed a rising trend over time and Zc、DR were showed a declining trend over time(Ftime=10.146,9.247,9.381,P<0.05),the changed amplitude in observation group was higher than the control group(Finteraction=5.357,4.257,4.813,P<0.05); Comparison of nerve function indexes There was significantly difference of β-EP、DynAl-13、NSE in these two groups(Fgroup=5.827,6.294,6.731,P<0.05),they was all showed a reducing trend over time(Ftime=12.613,11.746,9.842,P<0.05),the declined amplitude in observation group was higher than the control group(Finteraction=6.353,7.251,4.284,P<0.05);Comparison of inflammatory factors There was significantly difference of IL-1,IL-6,TNF-α,CRP in these two groups(Fgroup=4.284,5.162,6.174,4.291,P<0.05),they was all showed a rising then reducing trend over time(Ftime=9.163,10.357,13.457,12.434,P<0.05),the changed amplitude in observation group was higher than the control group(Finteraction=4.255,5.242,8.530,7.847,P<0.05).Conclusion Danshen injection combined with ulinastatin has more obviously function of protecting the cerebralfunction and suppressing inflammation in the treatment of Severe traumatic brain injury compared with ulinastatin alone.

Objective To assess whether urapidil (anα1 receptor blocker)is more effective than ni-troglycerin in treatment of non-valvular heart failure accompanying hypertension and diabetes mellitus (DM ) in elderly female patients .Methods Fourty-six elderly female patients with non-valvular heart failure accompanying hypertension and DM were randomly divided into urapidil treatment group (n= 24) and nitroglycerin treatment group (n= 22) .Patients in urapidil treat-ment group were treated with urapidil (50 -300 μg/min) and those in nitroglycerin treatment group were treated with nitroglycerin (5 -20 μg/min) for 48 -140 h according to their blood pressure (BP) and cardiac function .Their BP ,HR ,and metabolic activity were observed before and on days 1 ,2 ,3 and 7 after treatment .Results The effect of urapidil was significantly lower than that of nitroglycerin on SBP on day 7 after treatment (P<0 .05) .The serum NT-proBNP level was significantly lower in nitroglycerin treatment group than in control group (P<0 .01) . Conclusion The effect of urapidil is better than that of nitroglycerin on reducing and stabilizing SBP ,attenuating cardiac afterload ,and improving cardiac function in elderly female patients .Ura-pidil can thus be used as one of the first choiced drugs in treatment of elderly female patients with non-valvular heart failure accompanying hypertension and DM .

Objective To study hypoxia environment trophoblast cell autophagy and autophagy of the preeclampsia placental tis-sue .Methods Trophoblastic cell line HTR-8/SVneo were divided into three groups :low oxygen concentration group (group Ⅰand group Ⅱ) and normal oxygen concentration group ;48 h after the application the confocal laser scanning microscopy was used for detection of cytoplasmic autophagosome ,PCR technology analysis of autophagy-related gene expression change of LC3-Ⅱ .LC3-Ⅱ expression levels of 30 cases of preeclampsia placenta were detected by Immunohistochemistry .Results In low oxygen concen-tration group ,there were visible red autophagosome chromatin structure in cytoplasm ,which was extremely rare in the normal oxy-gen concentration group ,in low oxygen concentration group cell LC3-Ⅱ mRNA expression was significantly higher than that of normal concentration group .The preeclampsia placenta of patients with positive immunostaining of LC 3-Ⅱ was 67 .12% ,compared with 9 .14% in the normal control ,there was a significant difference between two groups .Conclusion Preeclampsia placenta auto-phagy activity increased ,hypoxia can induce autophagy trophoblast cell line phenomenon .