80mmHg in all patients at stimulating test. Selected septal branch angiography was taken. The methods of target septal branch selection included balloon occlusion test, angiography through the catheter lumen, and ultrasonic echocardiogram monitor. The 1st septal branch was ablated in 6 patients, and in 2nd branch in 2. The volume of alcohol injected was 1 75~7 0ml. The results showed that the successful rate of PTSMA operation was 100%, and the clinical symptoms for all patients improved significantly with mean LVOTPG decreased by 68 3%?13 0% at the end of the procedure. No severe ventricular arrhythmia occurred. One patient was followed-up clinically and angiographically half a year after the operation and his LVOTPG was 0 mmHg and the NYHA heart function was raised to Ⅱ grade from Ⅳ grades before operation. PTSMA is a promising interventional technique for HOCM therapy with satisfactory short-term clinical outcome.

Objective To compare the short-term efficiency and safety of high loading dose (600 mg) clopidogreal pretreatment with that of routine loading dose (300 mg) before coronary stenting in patients with acute coronary syndromes (ACS). Methods Prospective registry method was used in this study. Between February 2003 to July 2004, a total number of 316 hospitalized patients with ACS received 600 mg clopidogrel pretreatment, before coronary stenting. 309 patients with the same disease conditions who received 300 mg clopidogrel pretreatment between October 2001 to January 2003 were included as the control. The primary endpoints were the presence of subacute in-stent thrombosis. 30 days after the procedure. The composite endpoints were death of all causes, myocardial infraction and revascularization of the target ressel. The secondary endpoint was hemorrhagic events at 30 days after the stenting procedure. Results The baseline clinical and angiographic characteristics and the result of stenting between the two groups had no significants difference. Rate of subacute in-stent thrombosis was significantly lower in 600 mg group than that of 300 mg group (0.0% vs 2.6%, P=0.003). An interval of

Objectives\ To analyse the development of coronary intervention in our heart center of a general hospital in recent 13 years.Methods\ Coronary interventions were performed in 3945 target lesions of 2466 patients with coronary heart disease who were from 22 to 86 years old(averaged 58 8 yrs)with 80 5% of male,including 335 cases of acute myocardial infarction,64 cardiogenic shock,2106 acute coronary syndrome,1329 multivessel disease,and 21 left main disease.The proportion of complicated B2 and C type lesions were 77 1% and chronic total occlusion were 21 4%,PTCA and stenting were the main intervention operation(97 4%),and rotation,direct atherectomy,cutting,intravascular radiation and cover stenting were also perfromed for the remaining 2 6% patients.Results\ The mean annual case increase rate was 61 2% from 1995 to 2001 The toltal patient and lesion success rates were 98 1% and 97 1%,respectively.The mortality during intervention were 0 08% and for cardiogenic shock were 28 1% during hospitalization.Conclusions\ The data suggest that the success rate and incidence of complications for coronary intervention in the heart center with well-dereloped technigues are comparable with those reported in foreign literatures.

Objectives To evaluate the safety and effect of transradial approach for coronary intervention. Methods A total of 165 cases of coronary artery disease in this hospital accepted coronary intervention by transradial approach. Three of them had acute myocardial infarction, 112 had unstable angina, and 67 failed by transfemoral approach. Results The proportion of multivessel diseases were 60 6% and C type lesions were 20 7%. The interventons were performed in totally 294 target vessels and 299 target lesions and 246 stents were implanted. Coronary intravescular ultrasound were performed in 14 cases and cutting balloon technique in 16 cases. During intervention 1 case had right coronary spiral dissection and was successfully treated by stenting. One case had subacute thrombosis after intervention and was successfully treated by re-intervention. There were no other severe complications in this group. The mean hospital stay was (2 1?0 6) days. The total success rate was 98 2%(162/165) for transradial approach. The interventions in two cases who had chronic total occlusion in circumflex artery failed by transradial but succeeded by transfemoral thereafter .Conclusions Transradial approach for coronary intervention is a safe and effective approach so long as standardized manipulation is practised.

Objective To compare the clinical safty and short-term outcomes of multivessel percutaneous coronary intervention(PCI)by drug eluting stenting early after acute myocardial infarction(AMI).Methods A total of 343 patients who had multivessel disease and underwent PCI within 10 days after AMI were enrollded from January 2003 to November 2005 and were divided into three groups(134 patients in single-PCI group,112 patients in re-PCI-BMS group and 97 patients in re-PCI-DES group).The clinical safty and short-term outcomes of all patients were evaluated.Results The average ages of both re-PCI-BMS and re-PCI-DES groups were older than that of single-PCI group(68.4?12.8 yrs vs 63.9?11.4 yrs,P

Vasovagal reflex is one of complications from cardiac intervention.The major causes of vasovagal reflex postprocedure are commonly believed to be associated with mental stress,pain,low blood volume,visceral dilation,local hematoma and cardiac function.The incidence of vasovagal reflex may be effectively reduced with standard intervention training,strictly selected indications for PCI,adequate fluid replacement after procedure,anesthetic lidocaine to reduce pain,improved manual compression for vascular hemostasis and elimination of risk factors.

OBJECTIVE:To explore mechanism,prevention and treatment of thrombosis following implantation of coronary artery stent.METHODS:The first author used computer to retrieve Vip Database (http://www.cqvip.com/) for articles concerning thrombosis following implantation of coronary artery stent published from January 2000 to October 2009.The key words included "coronary artery,stent implantation,thrombus".The data were primarily screened,and references of each article were checked.Inclusion criteria:mechanism and risk factor of thrombosis in stent;prevention and treatment of thrombosis in stent.Exclusion criteria:articles addressing duplicated or old contents.Finally,28 articles were included.RESULTS:Thrombosis in stent was a severe complication in interventional therapy of coronary artery disease,could induce severe outcomes for the body.Compared with common mental stent,drug eluting stents can significantly reduce restenosis rate and revascularization rate of target lesions.Following stent implantation,thrombosis in stent can occur in early,late and extremely late phases.The mechanisms are different.Antiplatelet,anticoagulation and lipid-lowering therapy can diminish the occurrence rate of thrombosis in stent.Individual surgery and individual drug therapy not only can solve revascularization in the coronary artery,but also decrease restenosis rate and occurrence rate of thrombosis in stent.CONCLUSION:With the expectation of novel stents,various risk factors for thrombosis in stent should be assessed in detail to achieve individual surgery and individual drug therapy.During revascularization in the coronary artery,restenosis rate and occurrence rate of thrombosis in stent should be reduced.

Objective To evaluate the influence of complete or incomplete revascularization by percutaneous coronary intervention(PCI)on heart function of heart dysfunction patients with multivessel coronary artery disease.Methods The study retrospectively analysed the clinical data and the echocardiogram result in patients with multivessel coronary artery diease complicated with heart dysfunction,who underwent PCI procedure from October 1994 to October 2004 in our center.Results 6 months after revascularization by PCI,DE,SV,CO,LVEF,FS,MVCF and E/A elevated,MVEF velocity increased,and EPSS decreased in both complete and incomplete revascularization groups,but the above heart function indexes tested by echocardiogram in complete revascularization patients were better than those of incomplete revascularization patients.Conclusion PCI can significantly improve the heart function in both groups,but complete revascularization by PCI improves the heart function of patient with multivessel coronary artery disease more obviously in compare with incomplete revascularization.

Objective To analyze the trends and status of percutaneous coronary intervention(PCI)in Shenyang General Hospital of P.L.A.during a 18-year period.Methods Between August 1989 and April 2007,a total of 10 225 patients with 17762 target lesions had undergone PCI.Their clinical and angiographic baseline characteristics,PCI strategies and perioperative outcomes were retrospectively analyzed.All data were collected from PCI database of our hospital.Results Patients' age ranged from 22 to 92 years old(mean,59.9 years).A total of 2057 patients(20.2%)were with diabete,8647(84.6%)with acute coronary syndromes,1428(14.0%)with acute myocardial infarction(AMI)and underwent emergent PCI,477(4.7%)with cardiogenic shock;6701(65.5%)with multivessel disease,483(4.7%)with left main disease and 1795(17.2%)with chronic total occlusions(CTO).Overall patient success rate was 98.5% and lesion success rate was 98.3%.Procedural success was obtained in 99.6% of patients with left main disease and 90.5% of CTO lesions.About 89.8% of all patients underwent coronary stenting.Mean implanted stent number was 1.45 per patient.In-hospital mortality was 4.4%(63/1428)for AMI patients who underwent emergent PCI and 19.7%(42/213)for AMI patients with cardiogenic shock.Overall perioperative mortality was 1.1%(113/10 225),including 2 deaths during procedure(0.02%)and 80(0.8%)deaths after procedure.Two patients(0.02%)underwent emergent CABG.Acute or subacute stent thrombosis occurred in 58 patients(0.57%)and slow flow or no-reflow occurred in 127 patients,which accounted for 8.9% of AMI patients who underwent emergent PCI.Overall incidence of perioperative complications was 3.6% and the rate of procedure related complications was 0.48%.Conclusion In skilled cardiac center,PCI is associated with high procedural success rate,low incidence of complications and good short-term outcomes.PCI should be the first choice for treating patients with coronary artery disease,especially for high risk patients with AMI,cardiogenic shock or left main disease,etc.

To improve the quality of medical postgraduate students in our school and to meet the needs of basic medicine and the development of personalized medicine , we opened the course“molecular pathology” to medical graduates. To make the molecular pathology the true bridge course between basic medicine and clinical medicine, we optimized the content of molecular pathology, cre-ated diagnostic technical platform matched with molecular pathology, rationalized management system worked in the basic pathology and clinical pathology. Practice has proved that “molecular pathology”curriculum promotes medical postgraduate students' transformation of medical philosophy, cultivates their innovation ability in scientific research and clinical practice ability etc.