Stent fracture has been implicated as a cause of drug-eluting stent failure. The authors report here 2 cases with stent fractures which were diagnosed by coronary artery angiography and intravascular ultrasound (IVUS). Both of them received multiple-stent-implantation. Five stent fractures altogether were detected in two patients. All the involved stents were sirolimus-eluting ones. Angiographic study showed that three stent fractures were complete transverse linear fracture with stent displacement. IVUS demonstrated that three stent fractures were complete break and two were partial break. One fracture was located close to the overlapping site of two stents and another fracture was accompanied by the formation of a coronary aneurysm. Angiography and IVUS are helpful to identify stent fracture. In addition, IVUS is more likely to clarify the cause of stent failure as well as the mechanism of stent fracture.

Objective:To explore whether tumor-inducing agent 12-O-tetradecanoyl-phorbol-13-acetate (TPA) and bromodeoxyuridine (BrdU) affect CD133 expression in nasopharyngeal carcinoma (NPC) 5-8F cells. Methods:NPC cell line 5-8F was treated with single TPA, single BrdU, or TPA plus BrdU, respectively. CD133 mRNA and protein expression levels were detected by real-time fluorogentic quantitative PCR and Western blotting, respectively. Flow cytometry was used to separate CD133-positive cells and determine their levels. Boyden chamber test was used to measure the invasion capability of the cells. Results:Compared with untreated group, CD133 mRNA levels were increased in single BrdU group and BrdU plus TPA group (P=0.037 and 0.003, respectively), and decreased in single TPA group. Western blotting indicated that the expressions of CD133 protein was increased in all the three treated groups, and FCM showed that the quantity of CD133-positive cells also increased. The invasion capability was enhanced, especially in BrdU plus TPA group. Conclusion:Both TPA and BrdU increased CD133 expression in NPC.The effects of TPA and BrdU are synergestic.

Objective To identify the causes of coronary angiographic hazy lesions by intravascular ultrasound (IVUS) to avoid inappropriate stenting. Methods Twenty-five cases with hazy regions on coronary angiogram were consecutively identified from July 2009 to March 2010. Hazy regions were defined by coronary arteriongraphy as reduced contrast density without a clearly defined intimal tear, dissection,thrombus,or stenosis ( ＞ 50% ). This cohort of patients were subsequently underwent IVUS examinations and treated according to the results of IVUS. Results The lumen CSAs were settled as ＞ 4. 0 mm2 in all examinations. Among all 25 cases,hazy lesions were located in left anterior descending in 12 patients, right coronary artery in 6 patients, left circumflex in 5 patients, and left main artery in 2 patients. According to the IVUS findings, 2 cases showed absolutely normal or near-normal arterial wall structure image, 10 cases showed calcified plaque,5 cases showed plaque rupture,3 cases showed eccentric plaque ,2 cases showed thrombosis formation,2cases showed dissection,1 case showed subintimal hematoma. Seven patients received stent implantation, and the rest accepted medical therapy. There were no in-hospital MACEs reported among all patients. Conclusion Nearly half of the coronary arteriongraphic hazy lesions were caused by calcified plaque. IVUS can distinguish calcified plaques from intimal tears, thrombus and other underlying etiologies,and help to avoid unnecessary stenting.

One hundred and fifteen patients with rheumatic mi- tral stenosis were treated with Percutaneous Balloon Mi- tral Valvuloplasty (PBMV) from August,1988 to May, 1993.110 patient (94.5%) had successful operations. The observations showed that PBMV can enlarge the stenostic mitral orifice area over 1 time (from 1.04?0. 26cm to 2.08?0.32 cm,P

0.05).There were no statistical difference between the 50 mg IM group and the 75 mg NM group in secondary end-point.Conclusion Maintenance therapy with 50 mg domestic clopidogrel did not increase the 1-year incidence of major adverse cardiac events when compared with standard 75 mg of Plavix therapy.

Objective The objective of this study was to evaluate the clinical significance of coronary stenting in patient aged more than 70 years old.Methods The results of coronary stenting (14 with acute myocardiac infarction) were analyzed and compared them to 36 patients aged from 50 to 60 years old. Results The clinical success rate of coronary stenting for elderly group was 96.8%. The reanginal rate during 3 to 44 (21 ? 14) months' follow up of was 23% . No significant difference in the success and reanginal rate was observed between the two groups and no death case was found in the 14 elderly patients with acute myocardiac infarction.Conclusion Our data suggest that coronary stenting is a very safe and effective method of coronary revascularization in elderly patients.

Objective To explore the predictive factors of death in patients with AMI after emergency PTCA Methods PTCA were performed in 43 patients with AMI from June 1996 to March 2001, including 30 males and 13 females with aged 27-80 (mean 60 5?12 6) years old 7 Patients died inhospital Results The mortality of patients with killip 3-4, cardiogenic shock (58 3%, 44 4%) is higher than that of patients without such complications Compared with the patients without total occlusion, the patients with total occlusion have higher mortality (20 6% vs 0%) The mortality of patients with acute thrombolysis during PTCA is higher than that of patients without acute thrombolysis (40 0% vs 9 1%) Conclusion Killip 3～4, cardio genic shock, total occlusion, acute thrombolysis are the predictive factors of in hospital death in patients with AMI after PTCA

Objective To evaluate the relationship between pressure derived fractional collateral flow (Q C/Q N) and left ventricular remodeling after acute myocardial infarction(AMI) Methods The Q C/Q N was measured in 21 patients with first AMI treated with percutaneous transluminal coronary angioplasty (PTCA), being determined by simultaneous measurement of mean aorta pressure (P a), distal coronary pressure (P w) during the balloon occlusion 21 patients were divided into two groups according to the value of Q C/Q N (group A, Q C/Q N≥0 25, group B, Q C/Q N0 05) At one month follow up, the difference in EF ( P 0 05) Both ESVI and EDVI were considerably increased in two groups Conclusion Angiographic Rentrop′s classification has its limitation in assessing the collateral circulation Q C/Q N is a major determinant of left ventricular remodeling and prognosis in patients with AMI

Objective To investigate the incidence and risk factors of renal artery stenosis (RAS) in patients with coronary artery disease (CAD). Methods Retrospective analysis was made based on the clinical and angiographic data of patients with CAD and RAS proved by angiography during May 2003 and August 2004. Results Forty-eight (13.7%) out of 350 CAD patients were identified with significant RAS. Multi-variance logistic analysis showed that age over 70 years old, serum creatinine greater than 120 ?mol/L, history of hypertension and multi-vessel coronary disease were the independent predictive factors. Conclusion The incidence of RAS in CAD patients was 13.7%. Routine renal angiography was recommended for CAD patients.

Objective To assess the impact of patients's sex on outcome in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI). Design: Inception cohort of 232 patients (44 women and 188 men) who were admitted with a diagonosis of AMI to CCU between June 1996 and April 2002 in Heart Center of Dalian Medical University. Results Compared with men, women were older (66?9 vs 58?11, P