Objective To investigate the ability of myocardial fractional flow resever (FFRmyo) in predicting the incidence of major cardiac events (death, myocardial infarction, revascularization and recurrance of angina) 3 months after stent inplantation and also try to find out the cutoff point. Methods Coronary pressure was measured in 79 patients with stable angina immediately after stent implantation. The values of poststenting FFRmyo was calculated and found to be related to the presence of major adverse cardiac events during first 3 months. Results In 14 patients (18.4%), at least one adverse event occurred. Two out of 12 patients experienced recurrance of angina and underwent revascularization. By Logistic Regress analysis, FFRmyo immediately after stenting was the most significant independent variable for predicting major cardiac events. By receiver-operating characteristic (ROC) analysis, the cutoff point of FFRmyo was 0.92. Conclusion FFRmyo immediately after stenting is an independent predictor of clinical events at first 3 months.

Clostridium difficile( C. difficile)is a major nosocomial infection pathogen and the principal causative agent of antibiotic-associated diarrhea. The toxigenic C. difficile strains cause colonic injury and inflammation mainly by secreting enterotoxin A( TcdA)and cytotoxin B( TcdB). The severity of C. difficile associated disease( CDAD)is correlated to the toxin level during host infection. However,the toxigenic capacity of C. difficile varies widely among strains,which correlates with the gene regulation involved during toxin production. This article reviewed the regulatory mechanism of C. difficile toxin-associated pathogenic gene and anti-toxin treatment.

Objective To investigate the relationship between the infarction area and the changes of serum fibrotic indexes in acute myocardial infarction (AMI) patients.Medthods Serum procollagen type Ⅲ (PCⅢ),collagen IV(IV?C) and laminin (LN) were measured in 42 AMI patients with successful recanalization,22 AMI patients with unsuccessful recanalization and 37 healthy controls.Michelle's method was used to calculate infarction area and correlative analysis was made between indexes and infarction area.Results Serum PCⅢ,IV.C and LN were significantly increased in AMI patients with unsuccessful recanalization as compared with the other two groups,which were positively correlated with the infarction area.However,there was no statistical significance between the indexes in the other two groups and infarction area.Conclusion Serum PCⅢ,IV.C and LN can be serum fibrotic indexes in AMI patients,which can reflect the infarction area indirectly.

Objective To determine the effect and feasibility of kissing dilating with cutting balloon and conventional balloon for bifurcated lesions Methods We divided 34 patients with true bifurcated stenosis into cutting ballon group (13 patients) and stenting group (21 patients) Intravascular ultrasound (IVUS) was performed before and immediately after the interventional procedure Several indexes including minimal lumen diameter, external vessel crossectional area, lumen crossectional area, plaque crossectional area, vessel/lumen diameter and %diameter stenosis were calculated, respectively Results In cutting balloon group, more common lesions were found in left anterior descending artery and first diagonal (43 5% vs 28 9%, P

Objective To determine the lesion characteristics and effect of intervention on diseased grafts in older patients. Methods Thirty-eight patients with angina after coronary artery bypass grafts (CABG) were enrolled into Nanjing First Hospital. Interventions were performed after multiple-view angiogram and formal consent from relatives received. Angiographic follow-up was conducted within 6 months. Cardiac events were recorded during the 6-month clinical follow-up. Results Of the 38 patients (36 males and 2 females), the average age was 63.2 years. Angina occurred 11.5 months after CABG. Angipgrams were performed 4.8 years after CABG. Diabetes was complicated in 10 cases and old myocardial infarction in 8, respectively. Left ventricular ejection fraction was increased from 52%?10% to 58%?14% (P

Objective To investigate the efficacy and safety of glycoprotein Ⅱb/Ⅲa inhibitor (tirofiban) for elderly high-risk patients with acute coronary syndrome (ACS) undergoing percutaneous coronary interventional therapy (PCI). Methods Ninety four high-risk ACS patients admitted between Dec 2004 and Jul 2006 were randomly divided into the tirofiban group (n=46, mean age 68.5?11.4 years old) whom received tirofiban and half-dose of heparin, and the conventional interventional group (n=48, mean age 66.8?9.9 years old) whom were treated by full dose heparin before PCI. The coronary reperfusion flow (TIMI grades) of culprit vessel (CV) after PCI, cardiac enzyme changed 6 hrs and 12 hrs afterwards, major adverse cardiac events (MACE) rates within 30 days, bleeding and transfusion rates were analyzed and compared between the two groups. Results The average TIMI reperfusion grades (by frames) and CK-MB levels at 6 hrs and 12 hrs after PCI were better in the tirofiban group than in the conventional group (35.6?6.1, 16.2?3.9 mmol/L, 13.4?3.9 mmol/L vs 38.7?8.2, 18.4?4.8 mmol/L, 15.5?5.1 mmol/L, P

Objective To prepare arginine-glycine-aspartic acid (RGD)-and ribonuclease A (RNase A)-conjugated CdTe quantum dot (QD) nanoprobes,and to observe their capability to target human A375 malignant melanoma cells.Methods RNase A-modified CdTe quantum dots (CdTe RQDs) were obtained by using a microwave-based heating method,and then chemically conjugated to the RGD peptide to prepare RGD-CdTe RQD nanoprobes,which were then physically and chemically characterized by transmission electron microscopy,powder crystal diffraction,fluorescence spectrophotometry,and ultraviolet absorption spectrophotometry.A375 cells were cultured in vitro and incubated with various concentrations (20,40,80 nmol/L) of RGD-CdTe RQD nanoprobes for different durations (12,24,36,72 hours).Then,methyl thiazolyl tetrazolium (MTT) assay was conducted to estimate the proliferative activity of A375 cells.To observe the targeting capability of RGD-CdTe RQD nanoprobes,A375 cells were treated with RGD-CdTe RQD nanoprobes at the concentration determined by MTT assay for one hour followed by laser confocal microscopy.Results CdTe RQDs with good dispersion and biocompatibility were obtained by using a microwave-based heating method,and then successfully conjugated to the RGD peptide to form RGD-CdTe RQD nanoprobes.The treatment with RGD-CdTe RQDs of 20 nmol/L for 12 hours exhibited the weakest effect on the proliferative activity of A375 cells,and hence,20 nmol/L was selected for the fluorescence imaging assay.Laser confocal microscopy revealed that RGD-CdTe RQD nanoprobes were able to actively target A375 cells.Conclusion RGD-CdTe RQD nanoprobes with a favorable capability to actively target A375 cells are successfully prepared in this study.

Objective To compare the efficacy of and adverse reactions to a fractional micro-plasma radio-frequency technology versus fractional ultrapulsed CO2 laser in the treatment of atrophic acne scars.Methods Twenty-one patients with atrophic acne scars were enrolled in this study.Half of each subject's face was treated with micro-plasma,and the other half with fractional ultrapulsed CO2 laser,for one session.Treatments were randomly administered in a split-face manner.The efficacy and adverse effects were evaluated 6 months after the treatment by using the following outcome parameters:ECCA grading scale (échelle d' évaluation clinique des cicatrices d'acné),degrees of post-treatment pain and edema,time taken for crusting and durations of inflammatory erythema,patients' subjective rating of improvement in scar by using a quartile grading scale.A non-parametric rank test was conducted to compare the efficacy and adverse effects between the two treatments.A scar model was established on both ears of a New Zealand big ear rabbit,and treated with the CO2 laser and micro-plasma respectively,immediately followed by the resection of scar tissue for the observation of histological changes.Results A decrease of ECCAscore was observed in 90.5％ (19/21) of the patients after micro-plasma treatment,and in 86.7％ (18/21) after CO2 laser treatment; no significant difference was observed in the response rate (P ＞ 0.05).In detail,ECCA score decreased by 31.5％ (from 50.71 to 34.76 ) after micro-plasma treatment,compared to 29.9％ (from 53.57 to 38.10) after CO2 laser treatmet.Mild edema was observed after micro-plasma treatment,with the duration of erythema and crusting being 13.95 days and 6.95 days,respectively,compared to 45.81 days and 10.10 days respectively,after CO2 laser treatment.Pigmentation occurred in none of the patients after micro-plasma treatment,but in 19％ after CO2 laser treatment.Animal experiment showed that microscopic ablation zones were broad and shallow after micro-plasma treatment,but narrow and deep after CO2 laser treatment.Conclusions Fractional micro-plasma and CO2 laser are both effective for the treatment of atrophic acne scars,but the former seems to have less side effects with a lower incidence of pigmentation.

BACKGROUND: Insulin-like growth factor-1 (IGF-1) is a peptide hormone, it has been proved a promotion role on the proliferation of precursor cells. OBJECTIVE: To explore the intravenous injection of IGF-1 on the proliferation, migration and differentiation of neural stem cells in rats after cerebral ischemia. METHODS: Eight adult male SD rats were randomly divided into control group and experimental group, with 40 rats in each group. The rats in two groups were used to prepare models of focal cerebral ischemia using modified suture method, the rats in the experimental group were treated with tail vein injection of IGF-1, according to 100 μg/kg computation, the injection was given for 6 continuous days; in the control group, rats were given equal volume of saline. The rats were decapitated at 7, 14, 21, 28 days following intervention, respectively, and rats in each group were given intraperitoneal injection of the BrdU at 1 day before death. Immunohistochemistry and double staining were applied to detect the expressions of BrdU-positive cells, PSA-NCAM-positive cells, BrdU + PSA-NCAM double-positive cells, and BrdU + MAP2 double-positive cells. RESULTS AND CONCLUSION: The number of BrdU-positive cells and PSA-NCAM positive cells reached the peak at 7 days after ischemia; BrdU + PSA-NCAM double-labeled-positive cells could be detected in ischemic bilateral subependymal zone and dentate gyrus, the number was the most at 7 days, then followed by a gradual decrease; the BrdU + MAP2 double-positive cells began to increase from 14 days, and then gradually increased along with the decrease of BrdU + PSA-NCAM double-positive expression, showing a reverse trend. Intravenous injection of IGF-1 can induce the proliferation, differentiation and migration of neural stem cells in rats following ischemic brain injury.

Objective To analyze complications of carotid artery stenting (CAS) and preventions.Methods Clinical data and treatment outcomes of 72 consecutive patients ( 80 stents ) from July 2006 to January 2012 with carotid stenosis were analyzed.Asprin 100 mg and clopedigrel 75 mg were given orally 5 days before CAS.Distal embolic protection device were implanted in all patients,pre-dilatation was done for those with carotid stenosis ＞ 90％ and post-dilatation was done for those of residual stenesis ＞ 30％.Severe complications of CAS mean death,myocardial infarction (MI) and stroke.Other minom included transient ischemic attack ( TIA ),hyperperfusion and intracranial hemorrhage ( ICH ),bradycardia and/or hypotension,hypertension,access hematoma or bleeding.Results In 72 patients a total of 80 self-expandable bare stents were successfully implanted.Distal embolic protection devices were used in all cases.Combined procedure was taken in 5 cases including OPCABG in 2 cases,left subclavain artery stenting in 2 cases and renal artery stenting in 1 case.The overall in-hospital complications was 37.5％ (27 of 72).Of these events,1 case had minor strokes defined as a modified Rankin Scale score less than 3 at 1-year follow-up,2 patients (2.78％ ) experienced a hemispheric TIA (neurological symptoms that resolved within 24 hours),1 patient experienced hyperperfusion syndrome.The overall mortality rate was 0,21 cases (29.2％ ) experienced hemodynamic instability (hypotension in 15 cases,bradycardia in 5 cases and hypertension in 1 case) and 2 others had access hematoms.The 30-day death/stroke/myocardial infarction risk was 1.39％ (1 minor stroke).Conclusions Hemedynamic instability (hypotension and bredycardia) is main complications of carotid artery stenting in patients with carotid artery stenosis,severe complications are rare.