Objective To explore the risk factors of no reflow phenomenon on post-percutaneous coronary intervention(PCI) in patients with acute myocardial infarction (AMI).Methods The clinical data of 268 patients with AMI who performed emergency PCI were collected and divided into normal group(normal flow) and no-reflow group (no flow).The risk factors of predicting the occurrence of no reflow phenomenon were screened by univariate and multivariate analysis.Results Thirty-two cases (11.9％) of 268 patients had flow occurrence and 236 cases(88.1％) were with no flow occurrence.There were significantly statistical differences between the two groups in terms of angina pectoris history before infarction,white blood cell count (WBC),history of oral of stains,administration of 600 mg of plavix before the operation,creatinine kinase,MB isoenzyme (CK-MB),C-reactive protein (CRP),Low density lipoprotein(LDL),time of coronary artery perfusion,numbers of balloons used during PCI and Killip ≥ grade 2 (all P ＜ 0.05).The multivariate logistic regression model analysis displayed that Killip ≥ grade 2 (odds ratio (OR) =1.237,95％ confidence interval (95％ CI) 1.049 -2.264,P=0.021),history of oral of stains(OR=2.355,95％CI 1.547-3.438,P＜0.001),WBC ≥ 12× 109/L (OR =4.139,95％ CI 2.273-8.451,P＜0.001),no administration of 600 mg of plavix before the procedure (OR =2.645,95％CI 1.628-5.246,P＞0.005) and no angina pectoris history before infarction(OR=1.413,95％CI 1.150-2.426,P＜0.001) were independent risk factors regarding of causing no reflow phenomenon.Conclusion The factors including Killip ≥ grade 2,history of oral of stains,WBC ≥ 12× 109/L,no administration of 600 mg of plavix before theoperation and no angina pectoris history before infarction were independent risk factors in terms of causing no reflow phenomenon.

Objective To investigate the protective effects of the extract of ginkgo biloba(EGb)on the spiralganglion neuron(SGNs)in cochlea tissues on the hearing loss induced by noise in rats.Methods Thirty-six healthy animals were randomly divided into three groups:the normal control group(n=12).the noise exposured group(n =12)and the EGb treamment group(n=12).The control group received no noise and no medications.The other two groups were exposed to the noise of 110 dB SPL for consecutively 10 days,6 hours per day.The treatment group rats were injected with 10 ml/d EGb while the other two groups with 0.9%saline of the same amount.The experiment lasted for ten days.The rats were measured by auditory brainsterm response(ABR)before and after niose exposure.The ultrastructural changes of SGNs were detected by tranismision electron microscpoe(TEM) and the contents of malondiadehyde(MDA) and activities of superoxide dismutase(SOD)were also measured.Results Hearing were signifcantlly decreased in the experimental group.Nevertheless,EGb relatively reduced the contents of MDA while increased the activities of SOD.Conclusion EGb seems to be able to moderately pretect SGNs and to play a preventive and remedial role in noise-induced hearing loss.

OBJECTIVE To investigate the effect of ischemic postcondioning on cochlea following cochlear ischemia-reperfusion injury in rats. METHODSForty two healthy male SD rats were randomly divided into 3 groups, namely, the sham operation control group, the ischemia reperfusion group and ischemic postcondinging group. There were 14 rats in each group. The content of molondialdehyde(MDA) as well as the activity of catalase(CAT)in cochlea was measured by histochemistry. The ultrastructural changes of stria vascularis capillaries of the cochlea in experimental rats were examined by transmission electron microscopy(TEM). RESULTS In the ischemia reperfusion group, the CAT activities were decreased and MDA concentrations were increased significantly compared with those in the control group. However, in the ischemic postcondinging group, the activities of CAT were increased and MDA concentrations were decreased compared with those in the ischemia reperfusion group. Moreover, lesions were detected in the stria vascularis capillaries in all the three groups. The capillaries of stria vascularis were injured severely in ischemia reperfusion group. In the ischemic postcondinging group, the damage of capillary of stria vascularis were reduced significantly compared with that in ischemia reperfusion group, the structures were near normal, and no obvious destruction was observed. COCLUSION Ischemic postconditioning may markedly reduce the excessive generation of oxygen free radical during the process of ischemia-reperfusion injury and might be a potential strategy for its therapy.

Objective To investigate the effect of spirolactone on cardiac function and serum brain natriuretic peptide in patients with chronic heart failure( CHF). Methods Eighty-four patients with CHF were randomly divided into control group( n=42 )and observation group( n=42 ). The patients in the control group were given conventional therapy,while in the observation group were given spirolactone( 20 mg/times,2 times/day)based on treatment of the control group for six months. The clinical effects and left ventricular end diastolic diameter( LVEDd ),left ventricular ejection fraction( LVEF ) and serum brain natriuretic peptide( BNP ) of pretherapy and post-treatment between the two groups were recorded and compared. Results The total effective rate of observation group was 95. 2%(40/42),obviously higher than that of control group(80. 9%(34/42),χ2=6. 468,P=0. 028). The levels of LVEDd and BNP in two groups after treatment were(57. 8 ± 6. 2)mm and (62. 4 ± 7. 8)mm,(364. 4 ± 32. 8)ng/L and(457. 4 ± 43. 2)ng/L,significantly lower than those at before treatment((64. 6 ± 7. 4)mm and(64. 8 ± 7. 6)mm,(867. 8 ± 78. 5)ng/L and(864. 4 ± 74. 8)ng/L),while LVEF in two groups after treatment were( 49. 8 ± 5. 4 )% and( 42. 6 ± 4. 6 )%,significantly higher than those before treatment((35. 2 ± 3. 9)% and(35. 4 ± 3. 5)%),and the differences were significant(t = -3. 264, 4. 626,-5. 373,-3. 932,5. 438,-6. 548;P﹤0. 05). Moreover the changes in observation group were obvious than those in control group in terms of LVEDd,BNP and LVEF( t = -3. 425,3. 644,-2. 846;P ﹤0. 05 ) . Conclusion Spironolactone can effectively decrease the serum brain natriuretic peptide levels,improve the cardiac function in patients with chronic heart failure,and it is worthy of popularization and application.

Objective To discuss the impact of repeated contrast media exposure on renal function in patients who received coronary angiography ( CAG) or percutaneous coronary intervention ( PCI) within 1 week after CTA of coronary ateries. Methods A total of 258 patients who received CAG or PCI after coronary CTA were divided into the study group ( n=132, patients had CAG/PCI within 1 week after CTA) and the control group ( n=126, patients had CAG/PCI 1-2 weeks after CTA). Serum creatinine, cystatin C and estimated GFR were tested before and on day 1, 2 and 3 after procedures. The occurance of contrast-induced nephropathy ( CIN ) was recorded. Resu1ts The baseline clinical characteristics of the patients between the two groups had no significant difference. Preoperative and postoperative serum creatinine, cystatin C and eGFR values on day 1, 2 and 3 had no significant difference between the two groups (all P﹥0. 05). There was no significant difference in the incidence of CIN between two groups (5. 3% in the study group vs. 4. 8% in the control group, P﹥0. 05 ) . Conc1usions It is safe and feasible for patients with eGFR≥60 ml/( min?1. 73 m2 ) to undergo CAG or PCI within 1 week after coronary CTA.

Objective To investigate the association between arterial stiffness of the common carotid artery(CCA)and insulin resistance in hemodialysis patients. Methods Arterial stiffness index β of CCA was evaluated by an ultrasonic phase-lock Echo-tracking system in 80stable non-diabetic hemodialysis patients.Insulin resistance was detected by the homeostasis model assessment method(HOMA-IR).Plasma hemoglobin,serum albumin,total cholesterol,high density lipoprotein,low density lipoprotein,triglyceride,lipoprotein(a),ApoA1,ApoB,CRP,calcium,phosphorus and creatinine were determined by standard methods. Results The stiffness index β was 11.41±4.13 in patients with previous cardiovascular disease(CVD)and 9.75±3.63 in those without CVD(P＜0.05).The stiffness index β was positively correlated with HOMA-IR(r=0.321,P＜0.01),as well as with age(r=0.376,P＜0.01),pulse pressure(r=0.267,P＜0.05),and duration of hemodialysis(r=0.219,P＜0.05).In stepwise multiple regression analysis,HOMA-IR(β=0.228,P＜0.05)and age(β=0.308,P＜0.01)were identified as significant independent variables for stiffness index β of CCA. Conclusions Insulin resistance is associated with aaefial stiffness in nondiabetic hemodialysis patients.The increased arterial stiffness may be the link between insulin resistance and cardiovascular morbidity as well as mortality in hemodialysis patients.

Objective To comparative evaluation of root canal filling paste AH-plus and zinc oxide root canal of clove oil seal performance. Methods By computer, we retrieved PubMed, CNKI and controlled clinical trial databases to find out the standard randomised controlled trial, and literature retrieval time from building library until October 20, 2014. According to the Cochrane literature quality evaluation method of system for the evaluating methodlogical quality of the study, and then we extracted the relevant data and analyzed by Rev Man 5. 1 software for Meta analysis. Results Eventually the study included in 23 articles of randomized controlled trials, and a total of 4104 teeth. The results showed the pain occurred after plus treatment of AH paste group which was lower than that in the control group [OR=0. 32, 95%CI(0. 26,0. 26), P<0. 01);AH plus paste group cure rate was higher than that of the control group after intervened 1 -2 years [ OR=2. 61, 95%CI(2. 03, 2. 03), P<0. 01];the paste resin class root filling AH plus length of root tip leakage was better than that of the control group, and nail polish and wax experiment method of measuring the penetration length of the tooth had statistical significance [MD=1. 28,95%CI( -1. 48,-1. 08), P<0. 01]; India ink staining solution to measure the penetration length of the tooth had statistical significance [MD=0. 82, 95% CI(-0. 90,-0. 74),P<0. 01]. Conclusions AH plus paste in root canal therapy can significantly alleviate pain, and the long-term curative effect is good, and better than biological intermiscibility, which is an ideal root canal filling material. Due to large incorporated in the analysis of the research and the quality difference, it is necessary for large sample, multicenter, randomized, double-blind, placebo-controlled trails to further confirm the clinical curative effect.

Objective To explore the practice and significance of the new course of"Enhanced Recovery after Sur-gery(ERAS)and Perioperative Management"for graduate students under multidisciplinary cooperation.Methods The Department of Anesthesiology collaborated with the Department of Clinical Nutrition,Department of Geriatrics and six related surgical departments to develop a course of 30 credit hours on"ERAS and Perioperative Manage-ment"in Peking Union Medical College Hospital.Researchers analyzed the teaching effectiveness of the course by collecting survey questionnaires and evaluating scheme report of ERAS case.Results Researchers found that ten graduates joined this course and they believed that learning improved their understanding of ERAS related knowl-edge,such as preoperative nutrition and functional state optimization,intraoperative volume and temperature man-agement,prevention of postoperative nausea and vomiting,and perioperative pain management.Students had high satisfaction with the course and believed that it would help improve their clinical literacy.Conclusions The new course of"ERAS and Perioperative Management"for graduates may support capacity building in terms of clinical logic and thinking about ERAS and promotion of skills for perioperative management.Our experience of graduates′training with"Enhanced Recovery after Surgery and Perioperative Management"course can be shared by other trainers of health institution of China.

Objective:This study examines the application of echocardiography in the prenatal diagnosis of copy number variation (CNV) associated with fetal congenital heart disease (CHD).Methods:A retrospective analysis was conducted on 447 singleton pregnancies from Quanzhou Maternal and Child Care Hospital (Quanzhou Children's Hospital) from January 2019 to August 2022. These individuals underwent echocardiographic assessments suggestive of fetal CHD and subsequently received invasive prenatal diagnoses. Comprehensive karyotype analysis and chromosome microarray analysis (CMA) were performed for each case. The discrepancies in the chromosomal abnormality detection were analyzed between the results produced by CMA and karyotype analysis. Furthermore, differences in the detection of pathogenic copy number variation (pCNV) between the two methods in CHD cases with diverse cardiac phenotypes, including the presence or absence of extracardiac structural malformations, the type, and quantity of cardiac structural anomalies, were explored. Statistical analysis was conducted using the Chi-square test. Results:Compared with conventional karyotype analysis, CMA demonstrated a higher detection rate of fetal chromosomal abnormalities [10.5% (47/447) vs. 20.6% (92/447), χ 2=161.56, P<0.001]. In terms of distinct cardiac phenotypes, CHD cases with extracardiac structural anomalies displayed an escalated pCNV detection rate in comparison to isolated CHD cases [11.4% (45/394) vs. 32.1% (17/53), χ 2=16.68, P<0.001]. Within the cardiac structural anomaly subgroups, increased pCNV detection rates were observed in the septal defect subgroup, conotruncal malformation subgroup, and left ventricular malformation subgroup [18.4%(29/158), 25.9%(7/27), and 25.0%(7/28) vs. 7.6%(16/210); χ 2=9.15, 9.68, and 8.55, respectively, all P<0.05]. The CMA-identified pCNV correlated with CHD included 22q11.2 deletions/duplications in eight cases, 4p16.3 deletions in two cases, 11q23.3 microduplications in two cases, 1q21.1 microdeletions/microduplications in two cases, 4q28.3 microduplications in one case, and 10p15.3 microdeletions in one case. Conclusions:CMA technology exhibited an enhanced ability to detect pCNV in fetuses with CHD. Echocardiography can guide targeted CMA screening, thereby facilitating prenatal genetic assessment of CHD.

Objective:To investigate the clinical features of 17q12 microdeletion cases before and after delivery, and provide a reference for prenatal diagnosis and genetic counseling.Methods:A retrospective analysis was conducted on five fetuses diagnosed with 17q12 microdeletion by single nucleotide polymorphism array in Quanzhou Women's and Children's Hospital between April 2020 and June 2023. Clinical data including prenatal ultrasonography findings, genetic causes, parental clinical features, and postnatal outcomes were summarized and analyzed using descriptive statistical analysis.Results:The five fetuses had normal results of karyotype analysis of amniotic fluid, but carried a microdeletion of 1.4 to 1.8 Mb in the 17q12 region of the chromosome, involving 20 genes listed in the Online Mendelian Inheritance in Man database. Pedigree verification was performed on all five cases and the results indicated one maternally inherited case with the mother having polycystic kidneys complicated by left hydronephrosis, one de novo case, and three paternally inherited cases with one father having multiple cysts in both kidneys and two fathers showing no abnormalities. Multiple abnormalities were found in the five fetuses by prenatal ultrasonography, including enhanced renal parenchymal echogenicity in four cases and pyelectasis in one case. Two cases chose to terminate the pregnancies, while the other three continued the pregnancies to full term. Postnatal follow-ups showed that one case was normal in growth and development with no abnormalities by renal ultrasound; one case developed polycystic kidney; one case with normal renal ultrasound findings had a speech disorder and symptoms of suspected autism at the age of three. Conclusions:The main manifestation of 17q12 microdeletion is enhanced renal parenchymal echogenicity in the fetal stage and postnatal polycystic kidney. In prenatally diagnosed cases, pedigree verification is necessary as an objective and scientific genetic counseling is helpful in pregnancy decision-making.