Imaging techniques play a vital role in evaluating myocardial damage in patients with myocardial infarction. Accurate evaluations of postinfarction function and scar can help identify high-risk patients and provide prognosis information, which contributes much to clinical practice. The assessment of myocardial damage mainly includes overall evaluations of ventricular function and remodeling and targeted characterization of myocardial infarction including infarct size, myocardial viability and microvascular obstruction. Echocardiography, cardiac magnetic resonance, CT and nuclear examinations are most common imaging techniques currently. This review is to update evidence on applications of these modalities in evaluation of postinfarction myocardial damage and offer some helps to health workers.

Objective To compare the clinical results of micropuncture technique and traditional puncture technique in the treatment of lower extremity arteriosclerosis occlusion.Methods From January 2007 to February 2012,862 patients of lower extremity arteriosclerosis occlusion were treated by endovascular technology,385 patients ( 463 limbs ) by 21-G micropuncture technique and 477 patients ( 586 limbs ) by traditional 18-G puncture technique.Access sites were managed with manual pressure hemostasis or a vascular closure device.Primary endpoints included groin hematoma ( ≥ 2 cm),pseudoaneurysm,iatrogenic arteriovenous tistula,retroperitoneal hematoma,vascular perforation requiring repair and blood flow limited dissection.Results Patients assigning to undergo micropuncture technique were at higher risk,there was a significant shorter puncture time required for micropuncture technique vs.traditional puncture technique,(3.2 ± 2.3 vs.5.1 ± 3.2,P ＜ 0.05 ),the overall access site complications rate was lower in micropuncture group ( 6.2％ vs.6.7％,x2 =7.91,P ＜ 0.005 ).Conclusions In lower extremity arteriosclerosis occlusion treatment,arterial access can be completed by micropuncture which was safer and more effective than traditional puncture technique.

Objective To study the diagnostic and predictive values of amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients presenting acute dyspnea. Method A total of 533 patients with dyspnea were studied. According to the clinical characteristics and echocardiographic findings, the patients were divided into two groups, namely acute congestive heart failure group (ACHF) and non-ACHF group. NT-proBNP levels were assayed in all patients in order to evaluate the diagnostic value, and predictive value in patients of ACHF group by following up study to know the clinical destination of patients to be cardiac death or re-admission into hospital. Results There were 272 ACHF patients and 261 non-ACHF patients, and the levels of NT-proBNT were significantly different between two groups ( 2683.4±86.9) pg/mL vs. (238.6+8.7) pg/mL, P＜0.01) . A total of 220 patients were followed for 158 ±32. 8 days. The level of NT-proBNT in myocardium of patients in re-admission group was 2683 + 86. 9 pg/mL and in death group was 3283.4 + 105.7 pg/mL which both were higher than that in patients without cardiac events ( 1123. 5 + 72. 1 pg/mL) ( P ＜0. 01 ) . By using multivariate Cox analysis, log NT-proBNT was ( r = 0. 987, P = 0. 002), and atrial fibrillation (r = 0. 876, P = 0. 005 ) and ventriculat tachycardia ( r=0. 891, P =0. 005) were the valid predictors of cardiac events. Conclusions Routine determination of NT-proBNT in Emergency Department should be useful for quickly sorting patients with acute dyspnea. The NT-proBNT could be used as a good prognostic indicator of ACHF. In addition, log NT-proBNT and atrial fibrillation, ventricular tachycardia were the independent risk factors of cardiac events.

Objective To evaluate a 5HT receptor antagonist sarpogrelate hydrochloride after percutaneous transluminal angioplasty (PTA) in infrapopliteal arteriosclerotic occlusive disease.Methods From June 2010 to June 2012,105 (116 limbs) patients of infrapopliteal arteriosclerosis obliterans treated by PTA were divided randomly into two groups:treatment group (58 cases,64 limbs)and control group(47 cases,52 limbs).All patients were treated with aspirin and clopidogrel for 3 months.Patients in treatment group were treated with additional sarpogrelate hydrochloride.Intermittent claudication,rest pain,amputation rate,ABI,vascular prosthesis obstructing degree were assessed.Results 95 patients were followed up for 6 months,the intermittent claudication rate in treatment group and control group were 3.8％ and 16.3％ (P ＜ 0.05); while there was not different on 1,3 months,in the intermittent claudication rate and 1,3,6 months,in rest pain rate,amputation rate,target artery patency rate and ABI between the two groups (P ＞ 0.05).There was one bleeding event in treatment group (1.7％).Conclusions 5HT receptor antagonist (sarpogrelate hydrochloride) significantly improves intermittent claudication after PTA in infrapopliteal arteriosclerotic occlusive disease,and its use is safe with aspirin and clopidogrel.

Objective To analyze the mid and long term results of endovascular procedures for diabetic below-the-knee lesions.Methods We retrospectively analyzed data of 762 patients (797 limbs in Wagner Grade 1 to 4) who suffered ischemic symptoms of diabetic below-the-knee lesions,admitted for endovascular procedures from Aug 2005 to May 2012.Technical success rate and complications,anklebrachial index,wound healing,limb salvage and survival were evaluated.Results 762 patients (797 limbs) underwent 857 endovascular procedures with immediate technical success in 805 times (success rate 93.93％).30 day complications included 33 cases (4.33％) of hematoma or pseudoaneurysm related to access site,20 cases (2.62％) of vasovagal reflex,38 cases (4.99％) of belowthe-knee arteriorrhexis,75 cases (9.84％) of inflow-limited dissection,23 cases (3.02％) of arterial embolism,4 cases (0.52％) of blue-toe sign.Postoperative mean ABI was improved significantly,from 0.33 ± 0.20 to 0.68 ± 0.17,P ＜ 0.005.722 patients (751 limbs) were followed up for more than 12 months (35 ± 23 months),wound healing rate within 3 months was 72.28％,limb salvage rate after 12 months was 85.62％,survival rate was 95.01％.Conclusions Immediate technical success rate of endovascular procedures for diabetic below-the-knee lesions is high,complications rate is low,medium and long term efficacy is satisfactory.

Objective To observe the primary clinical results of Gore （R） Viabahn endoprosthesis for atherosclerotic stenosis or occlusion in superficial femoral artery (SFA).Methods From March 2013 to November 2013,45 consecutive patients (54 limbs) who had ischemic symptom due to stenosis or occlusion of superficial femoral artery were treated by endovascular deployment of Gore （R） Viabahn endoprosthesis.We observed patency rate,improvement of Rutherford classification and ankle-brachial index,limb salvage rate and survival rate after 1,3 and 6 months.Results 43 patients (52 limbs)were followed-up,among which 32 patients(38 limbs)belonged to TASC Ⅱ type C or type D lesion.The mean (± SD) length of treated segment in 52 limbs was(19 ±4)cm.The rate of postoperative patency on duplex ultrasonography:one month,3 months and 6 months were 96.15％ (50 limbs),92.31％ (48 limbs)and 90.38％ (47 limbs) ; Ankle-brachial index increased from(0.32 ±0.20)to(0.68 ±0.18) (t =3.180,P ＜ 0.005) after 6 months ; at 6 months limb salvage rate was 96.08 percent (49 limbs),and survival rate was 97.67％ (42 patients).Conclusions Implantation of Gore （R） Viabahn endoprosthesis in atherosclerotic stenotic or occluded superficial femoral artery safely achieves a definite primary clinical effectiveness.

Objective To compare the mid-term clinical results of primary implantation of a selfexpanding nitinol stent and primary percutaneous transluminal angioplasty (PTA) for long range arteriosclerosis obliterans of the superficial femoral artery. Methods From December 2005 to February 2007,109 patients who had moderate-severe claudication or chronic limb ischemia (CLI)due to stenosis or occlusion of the superficial femoral artery were treated by endovascular technology. 53 patients (73 limbs) were treated by primary stenting and 56 patients (76 limbs)by PTA. We compared the clinical data of stenting group and PTA group at 6,12 and 24 months. Results The mean length of the treated segment was (16± 8)cm in the stenting group and(15±7)cm in the PTA group. At 6 months, the rate of restenosis on duplex ultrasonography was 13.7% in stenting group and 30.2% in PTA group (X2=4.09, P<0.05);at 12 months the restenosis rates were 25.5% in stenting group and 46.9% in PTA group(X2=4.75, P<0.05);at 24 months the restenosis rates on duplex ultrasonography were 38.1% in stenting group and 65.9% in PTA group(X2=6.66, P<0.01). Rutherford stages in stenting group were significantly better than those in PTA group. Conclusion In the mid-term, primary implantation of a self-expanding nitinol stent yielded results that were superior to those with PTA for arteriosclerosis obliterans or long range stenosis of the superficial femoral artery.

ObjectiveTo evaluate the therapeutic effect ofZishen decoction combined with standard treatment of western medicine for for stage IV diabetic nephropathy with Qi and Yin deficiency.MethodsA total of 112 patients with stage IV diabetic nephropathy and Qi and Yin deficiency were randomized to thestandard treatment and the combined treatment groups, 56 in each. The standard treatment group received conventional treatment, including blood glucose controlling, antihypertensive, blood lipid regulating and diet controlling. The combined treatment group receivedZishen decoction on the basis of conventional treatment. All the patients were treated for 3 months. The blood urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TG), triacylglycerol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and glycated hemoglobin (HbA1c) were measured by an automatic chemistry analyzer. The urinary albumin excretion rate (UAER) was measured by the enzyme-linked immunosorbent assay.ResultsCompared with the standard treatment group, the SCr (53.51 ± 18.12μmol/Lvs. 62.66 ± 21.14μmol/L;t=2.459,P<0.05), UAER(100.73±84.24μg/minvs. 156.24 ± 96.38μg/min;t=3.245,P<0.05), TG(1.73±0.22 mmol/Lvs. 2.06 ± 0.21 mmol/L;t=8.112,P<0.01), TC(4.56 ± 0.62 mmol/Lvs. 5.10 ±0.31 mmol/L;t=5.830, P<0.01), LDL-C (2.42 ± 1.05 mmol/Lvs. 3.31 ± 0.81 mmol/L;t=5.022,P<0.01) in the combined treatment group decreased significantly, and the HDL-C (1.67 ± 0.33 mmol/Lvs. 1.36 ± 0.41 mmol/L;t=4.460,P<0.01) increased significantly. ConclusionZishen decoction on the basis of conventional treatment can improve the SCr and UAER, and regulate the blood lipid in the patients with stage IV diabetic nephropathy and Qi-Yin deficiency.

Objective To estimate the security and effectiveness of double access technique to treat chronic total occlusion in lower extremity artery. Method Fifty four patients,who had lower limb arteriosclerosis and accepted failed endovascular treatment because of unable to reenter true lumen through antegrade access,were treated immediately in double access style to recanalize occluded artery (including 27 patients of dorsalis pedis artery puncture,17 patients of posterior tibial artery punctrue,5 patients of proximal anterior tibial artery puncture and 5 patients of distal superficial femoral artery puncture). Evaluate the revascularization rate,complication rate and 6-month limb salvage rate of double access technique,t test was used to compare the ABI.Results Revascularization rate was 98.2％ (53/54),average puncture frequency of every case was 6 ( the first access was 2 in every patient,the second access was 4 in every patient ),average treatment time was 167 minutes,complication rate was 5.6％ (3/54),2 patients were occlusion in puncture segment of the second access,1 patient was hematoma in the second access point. 6-month ABI after intervention increased from 0.44 ±0.13 to 0.69 ±0.15,6-month limb salvage rate was 100％. Conclusion For chronic total occlusion,double access is a feasible technique to deal with unable to reenter true lumen throughantegrade access,the complication rate is low,the primary limb salvage rate is relatively high.

Objective To evaluate the effect of the self-made Zishen decoction combined with conventional western medicine therapy and health education on the patients with early diabetic nephropathy. Methods The 112 patients with DN were randomly assigned to 2 groups (each group 56 patients) at a ratio of 1:1. The control group was treated with control of glucose, blood pressure, lipid, and diet therapy, and the treatment group was with self-made prescription of invigorating the kidney and health education based on the control group treatment. All patients were treated for 6 months. The SF-36 scale was used to assess the quality of life, and the clinical effect was determined based on the blood biochemical indexes. Results Total clinical effect of the treatment group was 85.7%(48/56), and the control group was 67.9%(38/56) (χ2=4.057, P=0.044). Compared with the control group after treatment for 6 months, the physical condition (72.17 ± 13.41 vs. 64.59 ± 11.83, t=3.172), social function (64.58 ± 14.54 vs. 58.94 ± 14.62, t=2.047), physical role function (55.82 ± 10.11 vs. 47.46 ± 10.18, t=4.360), emotional role function (60.43 ± 10.20 vs. 56.04 ± 11.44, t=2.143), energy (69.86 ± 11.43 vs. 62.47 ± 11.12, t=3.468), general health status (68.57 ± 11.25 vs. 62.45 ± 11.78, t=2.812) of the treatment group were significantly improved (P<0.01 or P<0.05). Conclusion The self-made Zishen decoction and health education combined with conventional western medicine can improve the clinical effect and quality of life of patients with DN.