Calcific coronary artery disease is an increasingly prevalent entity in the catheterization laboratory which has implications for stenting and expected outcomes. With new interventional techniques and equipment, strategies to favorably modify coronary calcium prior to stenting continue to evolve. This paper sought to review the latest advances in the management of severe coronary artery calcification in the catheterization laboratory and discuss contemporary percutaneous interventional approaches.

OBJECTIVETo study the effect of occupational exposure to traffic exhaust and smoking on DNA damage in traffic policemen.

METHODS812 traffic policemen (741 men and 71 women, 130 of office-work and 682 of outside work) from 8 districts in Guangzhou were investigated. Blood samples were taken by venipuncture and lymphocytes were collected by using lymphocyte separation medium and centrifugation. The comet assay was used to measure DNA damage.

RESULTSThe office-work policemen [(37.7 +/- 9.5) years] were older than the outside-work ones [(32.3 +/- 8.1) years, P < 0.001]. No significant difference was observed in sex (P = 0.08) and age (P = 0.45). Comet assay showed that occupational exposure to traffic exhaust significantly increased tail length [4.20 micro m, 95% CI: (3.98 - 4.42) micro m vs 3.23 micro m, 95% CI: (2.82 - 3.7) micro m, P < 0.001]. Smokers had longer tail length [4.66 micro m, 95% CI: (4.37 - 4.97) micro m] than ex-smokers [3.28 micro m, 95% CI: (2.57 - 4.17) micro m] and nonsmokers [3.47 micro m, 95% CI: (3.21 - 3.75) micro m, P < 0.001]. In nonsmokers, significant increase in tail length was observed by passive smoking at home (P = 0.004) but not at work (P = 0.22). When out-door nonsmokers were excluded, passive smoking at work also significantly increased tail length (P = 0.007). Analysis of covariance showed that occupational exposure to traffic exhaust, tobacco smoking, and female had independent effect on lymphocyte DNA damage (P < 0.001) after these factors were adjusted. Passive smoking and age had no effect on lymphocyte DNA damage.

CONCLUSIONSOccupational exposure to traffic exhaust and tobacco smoking respectively increase lymphocyte DNA damage. Female traffic policemen may have more severe DNA damage than male.

Adult ; DNA Damage ; Female ; Humans ; Lymphocytes ; metabolism ; Male ; Occupational Exposure ; Oxidation-Reduction ; Police ; Smoking ; adverse effects ; Vehicle Emissions ; adverse effects

OBJECTIVETo study the relative risk (RR) of mortalities of cerebro-cardiovascular diseases (CVD) in Guangzhou workers with hypertension.

METHODProspective cohort study was conducted in 78,379 workers, aged >or= 35, from 399 factories. Cox regression model were mainly used for data analysis.

RESULTS(1) There were 48,705 male and 29,674 female workers in the cohort. All workers were followed-up for 8 years. 363 CVD deaths (male 305, female 58) mainly died of stroke, coronary heart disease and hypertension. The crude mortalities were 78.58/100,000 person years in male and 24.55/100,000 person years in female. (2) Compared with the optimal or normal blood pressure (ONBP), the RR (95%) of CVD deaths with high blood pressure (HBP) were 6.19 (4.85 - 7.91) in male and 2.78 (1.59 - 4.85) in female. In male, compared with ONBP, the RR of CVD deaths without illness but with 1st-grade HBP at baseline, and of those suffered non-CVD but with 1st-grade HBP at baseline, and of those suffered CVD with 2nd-grade HBP at baseline were 3.98, 3.25 and 3.15 respectively (P < 0.01). (3) After stratifying of age, smoking, drinking, educational levels and occupational exposure, the RR of CVD deaths was higher in those who were younger, or ever-smoking, non-drinking, higher educational level, exposed to occupational hazards and with hypertension.

CONCLUSIONThere is relationship between BP levels and CVD mortality. High BP may affect CVD deaths at younger age. Comprehensive measures should be used to reduce the risk of CVD deaths.

Adult ; Aged ; Blood Pressure ; Cardiovascular Diseases ; mortality ; Cerebrovascular Disorders ; mortality ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies

OBJECTIVETo evaluate the effectiveness of Varenicline for smoking cessation in a community-based smoking-cessation-clinic (SCC) in Chinese smokers.

METHODSA prospective observational study was conducted in Beijing, China. 799 smokers (762 men and 37 women) were assessed on data gathered from structured questionnaires at baseline and follow up programs at 1, 3 and 6 months. Trained physician counselors provided free individual counseling and follow-up interviews with brief counseling for all the subjects. 272 subjects were additionally prescribed Varenicline according to their own choice and reported data were compared to those without Varenicline. Outcomes were self-reported, regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1, 3 and 6 month follow-up periods.

RESULTSAt 6-month and by intention-to-treat, the 7-day point prevalence on abstinence rate with Varenicline and counseling, was significantly higher than the group with counseling only (34.6% versus 23.1%; OR = 1.75, 95% CI: 1.27-2.42;P < 0.001). The 3-month continuous abstinence rate at 6 month was higher in the group with Varenicline(31.3% versus 18.2% ;OR = 2.04, 95% CI:1.46-2.86;P < 0.001). Varenicline also showed better outcomes at 1 and 3 month follow-up.

CONCLUSIONVarenicline prescription in the smoking cessation clinic appeared to be effective that doubled the rates of quitting among Chinese smokers in the practice at a community-based SCC.

Benzazepines ; therapeutic use ; China ; Counseling ; Female ; Humans ; Male ; Nicotinic Agonists ; therapeutic use ; Prospective Studies ; Quinoxalines ; therapeutic use ; Smoking Cessation ; Tobacco Use Disorder ; therapy ; Varenicline