Coronary-artery bypass grafting(CABG)has been a standard treatment for unprotected left main coronary artery disease.Advancement in percutaneous coronary intervention(PCI)makes PCI as effective as CABG in selected patients.In this study,we assess the optimal revascularization strategy for patients with unprotected left main coronary artery disease.

Objective To observe the long-term safety of revascularization with sirolimus-eluting stent in patients with multivessel coronary disease compared with bare metal stents.The study was a single center retrospective study.Methods Five hundred and sixty two patients with two-or three-vessel disease,or left main coronary artery disease who underwent revascularization were included and divided into two groups:the SES(n=251)and the BMS(n=311)group,according to the type of the stents implanted.The clinical end points were death and myocardial infarction one year later after stents implantation.Results Clinical follow up was accomplished in 92.9% of the patients and the median time of follow-up was 19.4 months.One year after stents implantation,3 patients died of cardiac causes in the SES group and 1 patient died in the BMS group.Myocardial infarction occured in 2 patients in each group.There was no significant difference in cardiac event rate between the 2 groups(2.3% versus 1.1%,P=NS).No significant difference was found in cardiac death and nonfatal myocardial infarction event free survival rates estimated by Kaplan-Meier method between the two groups(97.3% versus 97.2%,P=0.951).Conclusion One-year cardiac mortality and the incidence of myocardial infarction after SES implantation in patients with multivessel disease were similar to those after BMS implantation which may suggest that late stent thrombosis does not increase with SES.

AIM: To compare the clinical effect of Tianshu Capsule(Rhizoma Chuanxiong,Rhizoma Gastrodiae,efc) on migraine with Flunarizine. METHODS: 82 cases of patients with migraine were divided randomly into the treatment group(40 cases),which were treated with oral Tianshu Capsule,4 capsules(1.36 g),3 times daily after meals,and the control group(42 cases),which were treated with Flunarizine(Sibelium) 5 mg quaque nocte,for 2 months.One year follow-up was carried out.The frquency and duration of migraine were analyged before and after treatment,and duration of positive results after withdraw of drugs were also recorded.The body weight,blood and urine routine,liver and kidney function as well as electrocardiograph were compared before and after treatment. RESULTS: In the treatment group the frequency and duration of migraine decreased more than that of control group.The positive results remained longer in the Tianshu Capsule group(P

BACKGROUND: Radiofrequency catheter ablation (RFCA) in dog triggers myocardial nerve sprouting and sympathetic hyperinnevation. It is possible that RFCA in humans has the same effect. Nerve growth factor (NGF) is a neurons nurture that supports the survival and differentiation of sympathetic neurons and enhances target innervation. Therefore, it is hypothetic that RFCA can increases plasma NGF concentration in humans.OBJECTIVE: To test the hypothesis that RFCA increases plasma NGF concentration in humans.DESIGN: Self-control experiment.SETTING: Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Forty-three patients were selected from the Cardiological Department of Tangdu Hospital, the Fourth Military Medical University of Chinese PLA from January to June 2005, including atrioventricular nodal reentrant tachycardia (AVNRT) (n=18), right-sided accessory pathways (RSAP) (n=13) and left-sided accessory pathways (LSAP) (n=12), 20 males and 23 females, ages 28-65 years, all agreed to participate in the study voluntarily.METHODS: Blood samples were obtained from the peripheral veins before ablation and at 6 hours, 1, 3, 5, 7 days after ablation. The plasma concentration of NGF was determined with enzyme-linked immunosorbent assay (ELISA).MAIN OUTCOME MEASURES: The plasma concentration of NGF was determined with ELISA before RFCA and at 6 hours, 1, 3, 5, 7 days after RFCA in each patient.RESULTS: Total 43 patients who were referred for ablation therapy for AVNRT, RSAP and LSAP were involved in the result analysis without loss. Plasma NGF increased at 6 hours after RFCA. Increased NGF continued to 7 days in the RFCA treated patients. The plasma NGF concentrations at 6 hours, 1, 3, 5, 7 days after RFCA in AVNRT, RSAP and LSAP ablations treated patients were (29.72±7.04), (30.94±5.68),(31.39 ±4.92), (31.06 ±4.56), (29.11 ±4.59), (31.77 ±6.25), (30.69 ±5.10),(31.46±4.96), (30.15±4.01), (30.43±3.14), (31.42±6.75), (31.00±5.20),(32.08±4.62), (30.67±3.71), (29.27±2.75) μg/L, respectively, and all more than that before RFCA [(14.89±2.84), (15.00±2.71), (15.51±2.75) μg/L, P ＜ 0.01]. However, there were no significant differences in the NGF levels at 6 hours, 1, 3, 5 and 7 days after RFCA (P ＞ 0.05). The plasma NGF concentration was not significant different among AVNRT, RSAP and LSAP ablation patients at any given time (P ＞ 0.05). The number of RFCA applications, the procedure time and the total energy have no correlation with NGF concentration at any given time instance.CONCLUSION: RFCA increases plasma NGF concentration in humans and lasts for at least 7 days. The number of RFCA applications, the procedure time and the total energy have no correlation with NGF concentration at any given time instance.

Objective To explore the relationship between interleukin 1 receptor accessory protein-like 2 (IL1RAPL2) gene and cognitive abilities of children in Qin-Ba mountainous region. Methods Four tagged SNPs (rs5962434,rs5916817, rs3764765 and rs5962298 ) in IL1RAPL2 were selected, and then genotyped by PCR-SSCP method in a 320 children sample aged from six to fourteen years old. Results The results showed the rs5962434, rs5916817 ,rs3764765 and rs5962298 had no deviations from Hardy-Weinberg equilibrium (P＞0.05),and there were no significant statistical differences in the average psychometric scores of general cognitive ability(P=0.81,0.53,0.79,0.90) ,verbal comprehension (P=0.58,0.47,0.69,0.87 ) ,memory and concentration (P=0.69,0.35,0.76,0.90) among the compared genotype groups at each of the markers. Furthermore,the results also indicated that the four SNPs were not associated with perceptual organization in males and females respectively (P = 0.70,0.85,0.76,0.90,0.65,0.22,0.98,0.90 ). Conclusion The present work suggests that the human general cognitive ability, the three cognitive factors of C-WISC scale are not influenced manifestly by the genetic variations in IL1RAPL2.

Acute myocardial infarction complicated by cardiogenic shock and left main coronary artery disease is called left main shock syndrome. It is reported that the morbility and mortality of the syndrome is approximately 0.46%and 55%-80%, respectively. However, the best treat-ment strategy in these cases is unknown. In this article, we present a patient with LMSS who successively underwent emergency percutane-ous coronary intervention and coronary artery bypass grafting with hemodynamic support within 5 days. The patient is now on his three month uneventful out-patient follow-up.

Objective:To validate five-year risk prediction models for atherosclerotic cardiovascular di-sease (ASCVD) in a contemporary rural Northern Chinese population.Methods: Totally 6 489 rural adults aged 40 to 79 years without clinical ASCVD were enrolled at baseline between June and August 2010, and followed up through January 2017.Expected prediction risk using the China-PAR (prediction for ASCVD risk in China) model was compared with the pooled cohort equations (PCE) reported in the American College of Cardiology / American Heart Association guideline.Kaplan-Meier analysis was used to obtain the observed ASCVD event (including nonfatal myocardial infarction, coronary heart disease death, nonfatal or fatal stroke) rate at 5 years, and the expected-observed ratios were calculated to eva-luate overestimation or underestimation in the cohort.The participants in the cohort were divided into 4 categories (<5.0%, 5.0%-7.4%, 7.5%-9.9%, and ≥10.0%) for comparisons based on ASCVD prediction risk.The models were assessed by discrimination C statistic, calibration χ2, and calibration charts and plots for illustration as well.Results: Over an average 5.82 years of follow-up in this validation cohort with 6 489 rural Chinese participants, 955 subjects developed a first ASCVD event.Recalibrated China-PAR model overestimated ASCVD events by 22.2% in men and 33.1% in women, while the overestimations were much higher for recalibrated PCE as 67.3% in men and 53.1% in women.Gender-specific China-PAR model had C statistics of 0.696 (95%CI, 0.669-0.723) for men and 0.709 (95%CI, 0.690-0.728) for women, which were similar to those of 0.702 (95%CI, 0.675-0.730) for men and 0.714 (95%CI, 0.695-0.733) for women in the PCE.Calibration χ2 values in China-PAR were 17.2 and 54.2 for men and women, respectively;however, the PCE showed poorer ca-libration (χ2=192.0 for men and χ2=181.2 for women).In addition, the calibration charts and plots illustrated good agreement between the observations and the predictions only in the China-PAR model, especially for men.Conclusion: In this validation cohort of rural Northern Chinese adults, the China-PAR model had better performance of five-year ASCVD risk prediction than the PCE, indicating that recalibrated China-PAR model might be an appropriate tool for risk assessment and primary prevention of ASCVD in China.

Objective To investigate the incidence of miocardial infarction and risk factors in patients with different levels TG.Methods From June 2006 to October 2007,Kailuan coal mine group conducted an on-the-job and retired workers were took physical examination in Kailuan area,and their results were used in our study(n=100 271).According to different levels of TG,all cases were divided into five groups(TG1-5):TG1 group(0.0125 kg/m2,FBG≥6.1 mmol/L,HDL-C<1.5 mmol/L were all the risk factors for myocardial infarction (P<0.05).Cox proportional hazards regression model showed that after adjustment for sex,age and other factors,with the increase in TG levels.Conclusion In study of Kailuan crowd,the increased fasting triglycerides increase the risk of myocardial infarction,and the risk factors for myocardial infarction are age,BMI,FBG and HDL-C.

Objective To elucidate the clinical characteristics and coronary angiographic findings of patients underwent PCI before and after drug-eluting stents(DES).Methods DESIRE(Drug-Eluting Stent Impact on revascularization) was a retrospective registry of patients who received revascularization therapy during July,2001 through June,2002(non-DES era) and July,2003 through February,2004(DES era).In this analysis,we used the DISIRE data to examine the clinical and angiographic features of patients who received PCI in the different era.Results Among 3763 patients in the registry,2180 patients were analyzed(763 were in the non-DES era and 1417 were in the DES era).In the DES era,more diseased vessels(1.31?0.54 vs 1.39?0.61,P

Objective To establish a quality standard of yinqiao xiaozhen mixture. Methods Preparation of Forsyth-ia,Arctium lappa L.,and Honeysuckle were identified by TLC method.The concentration of baicalin in yinqiao xiaozhen mixture was determined by HPLC method. Results The qualitative identification method can detect Forsythia,Arctium lappa L.,and Honeysuckle.TLC spots were clear.TLC method has strong specificity.The linear range of baicalin was 0.122 5-1.531 2 μg,r=0.999 9,the average sample recovery rate was 99.42%,RSD was 2.19%,respectively. Conclusion The method is simple,ac-curate and repeatable,which can be used for quality control of Qinqiao xiaozhen mixture.