75 yrs), presence of DM etc. (2) In our study, even though the door-to-ballon time was longer than the door-to-needle time, the therapentic outcome of primary PCI was better than that of thrombolysis. (3) There are improving room for guidelines application of reperfusions such as fibrinolytic and primary PCI, aspirin, ACEI, ?-blockers and cholesterol lowering agents in patients with acute ST segment elevation myocardial infarction in China.

Nowadays,laparoscopy has already been widely applied to the diagnosis and treatment of kinds of diseases,improving the outcome of the patients with its less invasive advantages.In the treatment of gastric cancer,doctors always choose different methods of laparoscopic gastrectomy(LG) according to the tumor's location and its invasion and metastasis.But LG hasn't got widely application in the treatment of gastric cancer,which is meanly attributed to the exist of some Technical problems,failing to control the complications very well and the lack of evidence of long-term oncological outcomes.But with the development of new technology and the accumulation of the surgeons' experience,these problems might be conquered to a certain extent.In this review,the author will summary the application status of LG in the treatment of gastric cancer.

Objective Current data on stent thrombosis(ST) in drug-eluting stent(DES) have come from randomized trials with strict entry criteria,which limits their generalizability to daily practice.The study sought to determine the real-world incidence of angiographically confirmed and possible stent thrombosis(ST) in an unrestricted population during the first 30 days after sirolimus-eluting stent(SES) implantation.Methods A cohort of consecutive complex patients treated with SES implantation was selected from Sep,2002 to May,2005.A total of 796 subjects entered the study.Results In the first 30 days after SES implantation,1 case had acute stent thrombosis and seven other cases had subacute stent thrombosis.Among these eight patients,ST presented as STEMI in three patients,NSTEMI in four patients and UAP only in one patient.Bifurcation stenting and long lesion stenting were the two significant risk factors(OR was 11.2 and 8.6 respectively,95% CI was 4.1 to 30.8 and 1.9 to 17.2 respectively,P

Objective: To find out whether or not low dose radiation could induce resistance to challenge dose-induced depression of immune functions.Methods:The following techniques were employed in this experiment:flow cytometry with immunofluorescence for the expression of TCR/CD3 receptor,3H-TdR incorporation technique for the spontaneous proliferation of thymocytes and the mitogen-induced proliferation of splencoytes as well as a bioassay with CTLL cells for IL-2 production.Results:The following optimal conditions for the induction of immunological adaptive response were determined:0.025 to 0.1 Gy for the conditioning doses (D1),1.0 to 1.5 Gy for the challenge doses (D2),and 6 to 12 h for the intervals between D1 and D2.Conclusion:Immunological adaptive response could be induced by low dose radiation.

Objective To investigate the evaluation of plasma osteoprotegerin (OPG) measurement for assessing the prognosis of intermediate coronary lesions in elderly patients.Methods We retrospectively analyzed patients met the inclusion criteria of suspicious chest pain or confirmed coronary artery disease (CHD),and intermediate stenosis lesions (20 ％ ～ 70 ％) in 3 main coronary arteries served as target vessels for qualitative comparative analysis (QCA).Plasma OPG level was detected by protein array method,and the concentration of hypersensitive C-reactive protein (hs-CRP)was determined by enzyme-linked immunosorbent assay(ELISA).Clinical endpoints were followed up.Results A total of 890 patients with intermediate coronary stenosis were enrolled in this study,and were divided into＜60 years of age group(n＝370)and ≥ 60 years of age group(n＝520).There were statistical differences in age,smoking history,hypertension history,triglycerides (TG),high-density lipoprotein cholesterol(HDL-C),white blood cell count,OPG,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI)between the two groups.The morphological indices in coronary lesions assessed by QCA had no differences between the two groups.During a median of 24 months of follow-up,58 patients(l1.2％)had clinical endpoints events.Age,smoking history,hypertension history,TC,TG,HDL-C,white blood cell count,levels of OPG above-median,hs-CRP,SBP,DBP,and BMI were used as the independent variables,and the clinical end events as the dependent variable.Forward stepwise logistic regression analysis showed that HDL-C,levels of OPG above-median,hs-CRP were the independent risk factors in elderly patients.The risk of cardiovascular events in patients with levels of OPG above-median was 2.510 fold higher than those with levels of OPG below-median.Conclusions The high levels of OPG and hs-CRP are the independent risk factors for the occurrence of coronary heart disease in the elderly with intermediate coronary lesions.

Aged ; Humans ; Male ; Stents ; adverse effects ; Thrombosis ; etiology

ObjectiveTo study the effect of platelet aggregation rate (PAR) level on the prognosis of percutaneous transluminal coronary angioplasty (PCI).MethodsFour hundred and one patients who performed PCI were divided into 4 groups:group 1 (PAR≤30％,103 cases),group 2 (PAR 31％ - 40％,102 cases),group 3 (PAR 41％ - 49％,103 cases ) and group 4 (PAR ＞ 49％,93 cases ).All the patients were followed up.The survival analysis was performed in 4 groups.ResultsThe data of survival table were tested by 3 methods among 4 groups:statistic was 0.612,degree of freedom was 3,P =0.894 in Log-rank (Mantel-Cox) test,statistic was 0.567,degree 9f freedom was 3,P =0.904 in Wilcoxon test and statistic was 0.586,P =0.900 in Tarone-Ware test.There was no significant difference among them.The mean follow-up duration was 2.2 years,and there was no significant difference in survival function among 4 groups (P ＞0.05).ConclusionPreoperative and postoperative measurement of PAR levels may not improve the prognosis.

ObjectiveTo investigate the clinical characteristics of patients with acute coronary syndrome suffering hemorrhage during hospitalization. MethodsThe clinical symptoms,diagnostic and therapeutic characteristics and in-hospital outcome of 3807 inpatients who were recruited into SINO-GRACE study in China due to acute coronary syndrome from March,2001 to December,2007 were collected.Statistical methods were adopted to compare the differences in clinical data between hemorrhage group and non-hemorrhage group.ResultsHemorrhage had happened in 57 out of 3807 inpatients with the incidence of 1.50％. Five patients, which accounted for 9.6％of the overall hemorrhage cases, were fatal hemorrhage.Nine patients were intracranial hemorrhage with the incidence of 0.24％. There were 155 deaths among the 3807 patients,with an overall mortality rate of 4.1％. The mortality of hemorrhage accounted for 3.2％in overall mortality. Patients with one of the following factors were more apt to hemorrhage:＞ 70 years old,previous hemorrhage history,renal failure history,heart failure history and clopidogrel and glycoprotein (GP)Ⅱ b/Ⅲ a receptor antagonist administration for coronary artery bypass grafting.Patients who developed hemorrhage might need prolonged hospitalization and were liable to develop heart-related adverse events,including re-infarction and sustained ventricular tachycardia/fibrillation after they were admitted in hospital over 24 hours. ConclusionPatients with acute coronary syndrome who underwent coronary artery bypass grafting,with advanced age,previous hemorrhage history,renal failure history,heart failure history or treated with clopidogrel and GPⅡ b/Ⅲ a receptor antagonist are more vulnerable to hemorrhage.

Objective To investigate the correlation between the levels of placenta growth factor (PLGF),soluble angiopoietin receptor-2 (sTie-2) and critical coronary artery plaque imaging morphology of coronary borderline lesions in patients with coronary heart disease (CHD).Methods In three consecutive years from April 2007 to September 2009,a cohort of 719 patients with borderline coronary lesions with stenosis in three main vessels with lumen diameter reduction varied all the way from more than 20％ to less than 70％ and with greater than 2.25 mm of the inner diameter were selected in this study from 4 teaching hospitals of tertiary class A in Beijing.These patients fell into three categories:unstable angina pectoris (UAP,n =292),stable angina pectoris (SAP,n =219) and coronary arteriosclerosis (AS,n =208).The vessels involved were analyzed using quantitative coronary angiography (QCA).Plasma levels of PLGF and sTie-2 were measured by using protein chip.The relationship between plasma levels of vascular factors,sTie-2,PLGF and coronary artery plaque imaging morphology among three groups were analyzed.Results (1) Plasma level of PLGF was 80.33 ng/L in the UAP group,which was significantly higher than 54.29 ng/L in the SAP group and 45.16 ng/L in AS group (both P ＜0.05).Plasma level of sTie-2 was 1353.06 ng/L in the UAP group,which was significantly higher than 1308.28 ng/L in the AS group (P =0.008).(2) There was significantly statistical differences in QCA between the SAP group and the UAP group as well as the AS group (both P ＜ 0.05) in terms of the minimal lumen diameter,diameter stenosis rate,minimal lumen cross-sectional area and cross-sectional area of stenosis.The plaque area in the UAP group was larger than that in the AS group (P =0.013).(3) The relationship between vascular factors and plaque imaging morphology was analyzed.There was significantly statistical difference in the involved lesions among the three groups (P ＜ 0.01).(4) There was a positive correlation between plasma level of PLGF and minimal lumen cross-sectional area (r =0.493,P =0.009).Conclusions The plasma levels of PLGF and sTie-2 reflect the level of neo-vascularization in the plaque,and could be taken as predictive factors for potential pathogenesis of coronary plaque.

Objective To evaluate the acute and long-term results of stenting for left main coronary artery (LMCA) bifurcation lesions. Methods Forty consecutive patients with LMCA bifurcation lesion and normal left ventricular function were included. Sirolimus-eluting stents were performed in all patients. Results (1)The average diameter of LMCA was (0.81?0.48)mm before stenting and increased to (3.53?0.22)mm after stenting.(2)The procedural success rate was 100.0%. In-hospital events including stent thrombosis,Q-wave myocardial infarction,and emergency bypass surgery did not occur in any patients,and non-Q-wave MI in one patient (2.5%).(3)Clinical follow-up was obtained in all patients at (8.43?3.24) months. There were no death and no myocardial infarction during follow-up. The major adverse cardis events rate was 20.0%.(4)The angiographic follow-up rate was 67.5% (27 of the 40 eligible patients),and the restenosis rate was 18.5% (parent vessel only 11.1%,side branch only 3.7%,and both 3.7%).(5)Different type of operation had no influence on restenosis rate during angiographic follow-up. Conclusion Sirolimus-eluting stent implantation for LMCA bifurcation stenosis appears safe and effective with regard to acute and midterm complications.