OBJECTIVE: To probe into the status quo and future tendency of utilization of cardiovascular drugs in hospital of high altitude area. METHODS: Consumption sum and DDDs of cardiovascular drugs used in our hospital were analyzed statistically during 2006～2008. RESULTS: Consumption sum of cardiovascular drugs was increased year by year as well as its percentages in the total consumption sum. Top 10 cardiovascular drugs in terms of consumption sum mainly included antianginal drugs, antihypertensive drugs, blood fat harmimegathy drugs and antithrombotics drugs. Consumption sum of antianginal drugs which had occupied 44% in that of cardiovascular drugs took the dominate place in three years. Consumption sum of antihypertensive drugs was increased fast as well as its percentage in cardiovascular drugs about more than 20%. Consumption sum of antithrombotics drugs had occupied about 22%. CONCLUSION: Requirement of cardiovascular drugs was increased year by year. Cardiovascular drugs from foreign countries and joint stock take main place. It is necessary to explore domestic substitute drugs to decrease the cost of cardiovascular drugs.

Objective To evaluate the feasibility, safty and methology of transradial coronary angiography Methods Transradial coronary angiography was carried out in 304 patients Results Transradial coronary angiography and ventriculography were successful in 291 patients (95 7%) Conclusion Radial artery seems to be both feasible and safe for coronary angiography, with a very low risk of local complication and more comfort for patients

Objective To evaluate the clinical effects of the artificial humeral head prosthesis in the treatment of proximal humerus bone tumors. Methods Fifteen patients with proximal humerus bone tumor had excision of bone tumor and application of artificial humeral head prosthesis were analyzed retrospectively. Among them,8 patients had osteosarcoma,4 patients had giant cell tumor of bone,2 patients had chondrosarcoma, 1 patient had fibrosarcoma. Results All cases were followed up for average (39 ± 5 ) months after the surgery.The duration time of operation were( 110 ± 10) minutes in average. The bleeding volume during operation were (600 ± 41 ) ml in average. One patient with osteosarcoma died of recurrence and metastasis 20 months after the surgery. The functions of the other 14 patients were assessed by Enneking system and the average score was 23.3 ± 3.7. The overall rate of excellent or good results was 84.6% ( 11/15 ). Conclusion Limb salvage surgery with the artificial humeral head prosthesis is an efficacious treatment for proximal humerus bone tumors,which can improve short-term clinical outcome.

Objectives To compare the in-hospital outcomes of elderly patients with acute myocardial infarction (AMI)treated by interventional or conservative protocols. Patients and Methods One handred and seventy-six consecutive patients hospitalized for AMI were involved, including 95 patients underwent emergent percutaneous coronary intervention (PCI) within 24 h after the onset of AMI and 81 patients received conservative non-invasive therapies.Clinical characteristics and in-hospital cardiac events of these two divisions were analyzed. Results In the PCI group, success rate of procedure and lesions was 98.9% and 98.5%, respectively. Procedure related complication were occurred in 6 cases(6.3%) and no patient died during operative procedures. PCI group had a lower in-hospital mortality (11.6% vs 24.7%, P＜0.05) and overall cardiac events rate (2A.2%vs56.8%, P＜0.01) compared with conservative group. Patients complicated by pump failure at admission in PCI group had a lower mortality compared with their counterpart in conservative group(27.3% vs 60.9%, P＜0.05). The average hospital duration between the two groups was no significant differences. The coronary care unit (CCU) duration of the PCI group was less than that of conservative group (4±5d vs 8±5d, P＜0.05). Conclusions In elderly patients with AMI, interventional treatment can significantly decrease the in-hospital mortality and cardiac events rate compared with conservative treatment, thus gains a better short-term outcome.

Objective To evaluate endovascular repair combined with assistant techniques for the treatment of Stanford type B aortic dissection involving aortic arch.Method From July 2002 to June 2010,46 patients of aortic arch dissection with the primary entry tear next to the orifice of left subclavian artery,were treated with endovascular repair.Left subclavian arteries were covered with TEVAR in 43 cases.PDA occludes were used in 6 patients.Nine patients received extrathoracic supra-aortic branches bypass.Double-barrel technique was performed in 8 patients.Fenestrated stent graft was used in 1 patient.Result All patients survived and were followed up for 2 to 76 months.No severe neurological complications happened.All synthetic grafts and carotid artery stents were patent.Type Ⅱ endoleak occurred in 10 patients,among them 6 received PDA occlude implantation in the left subclavian artery,and 2 patients recovered by conservative treatment.Nine patients suffered from ischemia of the left upper extremity,and 8 of them were treated with conservative method,one received bilateral subclavian artery bypass because of severe ischemia after endovascular treatment.In follow-up,all of the stent-grafts and grafts were patent.In the descending aorta,the diameter of true lumen increased significantly and the diameter of false lumen shrank gradually.Conclusions Endovascular aortic repair combined with extrathoracic supra-aortic branches bypass,PDA occlude,double-barrel technique and fenestrated technique is a safe and effective method for Stanford Type B aortic dissection involving aortic arch.

Objective To explore the clinical therapeutic effects in arterial interventional therapy in early osteosarcoma patients.Methods Thirty-eight early osteosarcoma patients received arterial chemoembolization therapies and performed operations.94.7% patients received limb salvage surgeries.Levels of alkaline phosphatase were tested in preoperative and postoperative phases.Results Levels of postoperativealkaline phosphatase[average(191.7±107.0)U/L]were significantly decreased compared with that before interventional therapy[average(1129.1±572.3)U/J.The survival rate in follow-up at 1,3 and 5 years Was97%,79%,50% respectively.The rate of recurrence and metastasis WAg 24%.Conclusions Arterialchemoembolization therapies in patients with early osteosarcoma could improve clinical symptoms effectively,enhance survival rate,relieve recurrence and metastasis,remain affected extremity.The clinical thempeutic effects of iodinated oil were the best among the three embolism materials.

BACKGROUND:Simple spinal decompression for lumbar degeneration-induced lumbar scoliosis spinal stenosis is difficult to obtain long-term efficacy. Because simple decompression is considered an iatrogenic lumbar instability, and can aggravate lumbar deformity. Posterior lumbar pedicle screw fixation combined with decompression and fusion obtained good curative effects in patients.
OBJECTIVE:To investigate the clinical efficacy of posterior decompression, internal fixation, and bone graft fusion with posterior pedicle screw system in the treatment of degenerative lumbar scoliosis with stenosis.
METHODA retrospective analysis was performed in 18 patients with degenerative lumbar scoliosis with stenosis who received surgical treatment from February 2009 to November 2012. These patients consisted of 6 males and 12 females, with a mean age of 62.2 years (range, 48-80 years). They had lumbar scoliosis with a mean Cobb angle of 28.6° and underwent posterior decompression, internal fixation, and bone graft fusion.
RESULTS AND CONCLUSION:Al the 18 patients achieved satisfactory fol ow-up. The mean fol ow-up was 22 months. Al patients were satisfied with treatment outcomes and had improved quality of life. The mean correction angle was 13.7° (range, 6.0°-28.4°) after operation. There was no failure of internal fixation, and no infected cases were found. These data inducated that posterior decompression, internal fixation, and bone graft fusion is one of the effective methods for treating degenerative lumbar scoliosis with stenosis.

Objective To investigate immunoprophylactic potential of genetic engineering vaccines of enterohaemorrhagie Escherichia coli O157:H7 in BALB/c mice after immunization with these vaccines. Methods Sixty BALB/c mice (3 weeks old) were randomized averagely into 5 groups. Group 1-3 were im-munized respectively with IntiminC300, Stx2B and HIyAN436, group 4 with a combination of these three vaccines, and group 5 with PBS. Each mouse was immunized with vaccine(100 μg)and Al(OH)3 adjuvant (100 μg) for 3 times. After 7 d of the second and third immunization, serum of each mouse was collected and the different antibodies were detected. After 10 d of the last immunization, all mice were given drinking water containing streptomycin for 3 d before and following oral challenge with O157:H7 (109 CFU), and treated with clinical, microbiological and pathological examination. Results The three vaccines elicited high titer antiserum, and some mice were died after infection with O157. The livability of group 1-4 was re-spectively 73%, 64%, 36% and 91%. And these vaccines depressed fecal and colon shedding with O157. Condusion IntiminC300, Stx2B and HIyAN436 have certain protective efficacy for infection of O157, and combined immunization was more effective than single vaccine.

Objective To explore the method of endovascular therapy for complicated aortic dissections.(Methods) The clinical data of 25 patients with complicated aortic dissections were analysed retrospectively.Results The patients′ ages ranged from 31-72 years with a mean of 50.2 years.Among the 25 cases,6 cases had severe ischemia of mesenteric artery,5 cases had renal artery ischemia,4 cases had severe(ischemia) of both legs,3 cases had renal arteries ischemia combined with superior mesenteric artery ischemia,2 had complicated aortic dissection combined with AAA,and in 5 cases the true aortic lumen was totally(compressed) by the false aneurysmal lumen.All patients underwent endovascular therapy,and the instant(technique) was successfully performed in all patients.Endoleak occurred in 3 cases after the stent-graft(deployment),it stopped spontaneously in 2 of them 7 days later,and 1 case with endoleak waiting for(treatment).In the other 22 patients,angiography after the operation showed that all the diseased area were sealed completely,and the viscera arterial blood supply was restored mainly via the true lumen.All the(patients) were cured and discharged.Conclusions In the management of complicated aortic dissections,(endoluminal) technique is simple,less traumatic,safe and has less complications as compared to the traditional operation.Improvement of the endoluminal technique is essential for successful treatment of these complicated cases.

Objective To explore the surgical management for acute cases of aortic diseases. Methods The clinical data of 18 acute cases of thoracoabdominal aortic diseases were analysed retrospectively. Results This study included ruptured thoracoabdominal aortic dissection of 15 cases and open wound of the abdominal aorta of 3 cases. There were 15 males and 3 females, with mean age of 42.7 years. Eight patients were received open emergent operation, and the other 10 cases underwent endovascular procedure. The mortality was 11.1% (2/18). Follow-up from 2 months to 3 years revealed all patients in a good condition. Conclusions In cases of emergent aortic diseases, endoluminal technique is simple, mini-invasive and safe. However, open surgery is still mandatory and effective especially when endovascular procedure is not indicated or failed.