Objective:To evaluate therapeutic effect and safety of Firebird stent combined tirofiban on acute myocar‐dial infarction (AMI) .Methods :A total of 86 AMI patients treated in our hospital from Aug 2011 to Aug 2013 were selected .According to random number table method ,patients were divided into combined treatment group (n=50 , received Firebird stenting combined tirofiban treatment ) and routine treatment group (n=36 ,received bare metal stenting) .Patients were followed up for 12~18 months ,therapeutic effects ,incidence rates of clinical events were compared between two groups .Results:After PCI ,compared with routine treatment group ,there were significant reductions in percentage of TIMI class 1~2 (13.9% vs .4.0% ) and corrected TIMI frame [ (29.2 ± 4.4) vs .(21.4 ± 5.1)] ,significant rise in percentage of TIMI class 3~4 (86.1% vs .96.0% ) in combined treatment group , P<0.05 all;on six months after PCI ,compared with routine treatment group ,there were significant reductions in inci‐dence rates of subacute thrombosis (2.8% vs .0% ) and myocardial infarction (2.8% vs . 0% ) in combined treat‐ment group (P<0.05 both);on 12 months after operation ,compared with routine treatment group ,there were sig‐nificant reductions in incidence rates of angina pectoris (16.7% vs .6.0% ) ,subacute thrombosis rate (11.1% vs . 0% ) ,myocardial infarction (8.3% vs .0% ) ,heart failure (2.8% vs .0% ) and rehospitalization rate (11.1% vs . 0% ) in combined treatment group , P<0.05 or <0.01 .Conclusion:Firebird stent combined tirofiban possesses sig‐nificant therapeutic effect on acute myocardial infarction ,and it's safe and reliable ,which is worth extending .

Objective To explore the hemodynamic changes in the brains of newborns with intracranial hemorrhage.Methods Totally,61 newborns,born in Anyang Maternal and Child Health Hospital of Henan Province,with intracranial hemorrhage diagnosed by ultrasound in early neonatal period,and 50 healthy newborns,also born in the same hospital from December 1,2010 to June30,2012,were selected.Intracranial hemorrhage newborns were graded according to the severity of hemorrhage and divided into mild (n=45) and severe groups (n =7).The peak systolic flow velocity (Vs),end diastolic velocity (Vd),mean flow velocity (Vm) and resistance index (RI) in the middle cerebral artery (MCA) and anterior cerebral artery (ACA) of brain were measured by Doppler ultrasound.Ttest was applied for statistical analysis.Results Among the 61 neonates with intracranialhemorrhage,12(19.7％) were grade Ⅰ,42(68.9％) were grade Ⅱ,6(9.8％) were grade Ⅲ,and one (1.6％) was grade Ⅳ.The Vs,Vm and Vd of MCA and ACA in the mild and severe intracranial hemorrhage group were significantly lower than those in the control group,the differences were statistically significant [MCA:(55.1±9.1) cm/s,(53.0±6.5) cm/s vs (60.1± 10.3) cm/s;(34.2±6.1) cm/s,(32.5±5.2) cm/s vs (38.2±6.9) cm/s; (17.1±4.8) cm/s,(15.3± 4.0) cm/svs (20.2±5.3) cm/s.ACA:(41.3±11.7) cm/s,(39.4±9.2) cm/s vs (45.3±9.8) cm/s;(25.2±5.8) cm/s,(23.3±4.9) cm/s vs (28.1±5.9) cm/s;(15.0±3.9) cm/s,(13.2±3.1) cm/s vs (15.9±3.8) cm/s,all P＜0.05].But the RI values were significantly higher in the control group,the differences were statistically significant (MCA:0.70 ± 0.10,0.77 ± 0.07 vs 0.62 ± 0.10 ; ACA:0.67±0.06,0.73±0.08 vs 0.61±0.05;all P＜0.05).TheVs,Vm and Vd of MCA and ACA in the severe intracranial hemorrhage group were significantly lower than in the mild hemorrhage group,while the RI values were significantly higher,and the differences were statistically significant (all P＜0.05).Conclusions Newborns with intracranial hemorrhage have significant hemodynamic changes in the brain and more prominent changes could be found in those with severe intracranial hemorrhage.

Objective To study the accuracy of improved resistance index (RI) in judging the prognosis in renal allograft with reversed diastolic flow. Methods According to the transplant nephrectomy, patients with reversed diastolic flow in renal allograft were classified into two groups:surgical group (n = 5) and nonsurgical group (n = 19). The differences in improved RI between two groups were compared by using Student's t test. Improved RI was defined as a ratio of peak systolic velocity plus peak diastolic velocity divided by peak systolic velocity. Receiver operating characteristic (ROC) curve was constructed for improved RI to evaluate diagnostic accuracy in judging the prognosis in renal allograft with reversed diastolic flow. Results Improved RI in surgical group ( 1.57 ± 0. 26)was higher than in nonsurgical group (1.22 ± 0. 08) (P＜＜0. 05). Areas under ROC curve for improved RI was 0. 979. An improved RI threshold of 1.31 had 100 % sensitivity, 90 % specificity, 71%positive predictive value, and 100 % negative predictive value for renal allograft with reversed diastolic flow loss as the maximum Youden index was 90 %. Applying this cutoff value to predict the function of renal allograft with reversed diastolic flow recovery, the accuracy was 92 % (maximum) or 83 %(minimum). Conclusion Improved RI can not only serve as a useful noninvasive index to predict renal allograft with reversed diastolic flow loss, but also to predict the function of renal allograft with reversed diastolic flow recovery.

Background and Objective To investigate the effects of simvastatin on lipid lowering therapy and platelet activation in elderly patients with hypercholesterolemia. Methods Fasting serum lipids, CD63, CD41a, serum glucose, hepatic and renal function, routine urine analysis (UA) were measured in 50 healthy subjects, and in 50 elderly patients with hypercholesterolemia before and after 4 weeks treatment with simvastatin (20mg daily for 4 weeks). Results 1. After simvastatin treatment for 4 weeks, the fasting serum level of lipids in elderly patients with hypercholesterolemia was significantly lower than before treatment (P＜0.01). 2. CD63 and CD41a were decreased after treatment compared with before, respectively (1.36 0.34) vs (4.26 1.06), (P＜0.01) and (123.54 19.73) vs (253.78 16.75), (P＜0.01).3. Changes in serum lipid level tended to be positively correlated with the declines in CD63 and CD41a, but there was no statistical significance (P＞0.05). Conclusions The results suggested that lipid lowering therapy with simvastatin inhibit platelet activity.

Objective To explore the effect of residual renal function(RRF)on the quality of life in uremia patients with peritoneal dialysis(PD).Methods 64 patients with uremia who underwent PD for 3 months or more were selected.According to the residual glomerular filtration rate(rGFR),the patients were divided into RRF group[35 cases with rGFR≥1mL· min-1·(1.73m2)-1] and non-RRF group[29 cases with rGFR≤1mL· min-1 ·(1.73m2)-1].The patients were followed up at 3-month intervals.The quality of life was assessed using the SF-36.Results The calcium,phosphorus,parathyroid hormone,serum creatinine,C-reactive protein,serum albumin,total urea removal,serum potassium,total urea clearance in the non-RRF group were(2.29±0.25)mmol/L,(1.68±0.42)mmol/L,275.68 ng/L,(1 121.58±215.36)μmol/L,(11.02±14.35)mg/L,(31.01±3.26)g/L,(100±50)mL/d,(3.48±0.78)mmol/L,(1.71±0.28),respectively,which in the RRF group were(2.21±0.19)mmol/L,(1.59±0.35)mmol/L,147.43ng/L,(872.56±264.68)μmol/L,(5.34±8.97)mg/L,(3.43±0.59)mmol/L,(33.21±4.62)g/L,(5.34±8.97)mg/L,(33.21±4.62)g/L,(800±200)mL/d,(3.79±0.59)mmol/L,(2.01±0.41),respectively,the differences between the two groups were significant(t=2.316,2.149,2.353,3.881,2.229,7.213,2.243,2.212,4745,all P<0.05).The total physical health measurement[(48.13±18.32)points and the physiological function[(46.61±21.79)points] in the non-RRF group were significantly lower than those in the RRF group[(56.02±18.12)points,(46.61±21.79)points,t=2.379,2.341,all P<0.05].There was no significant difference between the two groups in the total mental health and SF-36(P>0.05).Univariate linear regression analysis showed that rGFR was not associated with SF-36 overall score.Multivariate linear regression analysis found that SF-36 overall score and serum calcium,phosphorus,parathyroid hormone,serum creatinine,C-reactive protein,peritoneal ultrafiltration volume had relevance(t=4.102,2.412,2.174,4.259).Conclusion There was no significant difference in overall quality of life scores and mental health scores between the RRF group and the non-RRF group.RRF was not directly related to the quality of life of the patients.

OBJECTIVETo observe the therapeutic effect of acupuncture treatment on stroke according to the acupoint selection of "Najia method of Ziwua Liuzhu" and to investigate the mechanism.

METHODSOne hundred and ninety cases were randomly divided into a Ziwu Liuzhu group (n=95) and a routine acupuncture group (n=95). Five shu points on different meridians were selected according to the Tiangan (Heavenly Stems)-tables of "Najia method of Ziwu Liuzhu" in the Ziwu Liuzhu group, and the treatment was carried out within the period from Chen (7:00-9:00 AM) to Si (9:00-11:00 AM). In the routine acupuncture group, Fengchi (GB 20), Shuigou (GV 26), Waiguan (TE 5), etc. were selected to treat the patients immediately on first visit. The therapeutic effects of two groups were assessed by the scores of neural functial cinl deficiency, status of total living ability, blood rheological indexes and clinical comprehensive effectiveness.

RESULTSThe total effective rate of 95.8% in the Ziwu Liuzhu group was significantly better than 80.0% in the routine acupuncture group. The scores of neural functional deficiency, main items of blood rheology and total living ability in the Ziwu Liuzhu group were significantly lower than those in the routine acupuncture group (all P < 0.05).

CONCLUSIONAcupuncture treatment in the period from Chen to Si according to the acupoint selection of "Najia method of Ziwu Liuzhu" has a significant clinical effectiveness which is related with improvement of the indexes of blood rheology.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Hemorheology ; Humans ; Male ; Meridians ; Middle Aged ; Stroke ; blood ; physiopathology ; therapy

Objective To investigate the clinical effect of vagus nerve preserving pericardial devascularization plus subtotal splenectomy in treating portal hypertension with a history of variceal bleeding.Methods The clinical data of 33 cases of portal hypertension with variceal hemorrhage treated with vagus nerve preserving selective pericardial devascularization plus subtotal splenectomy from April 2004 to December 2013 (study group) were compared with that of 34 cases treated with pericardial devascularization plus splenectomy (control group).Results There was no mortality in two groups.The postoperative gastric drainage during the first 72 h were(1 525 ±30) ml in the study group and (2 130 ±40) ml in control group(P ＜0.05).Portal vein thrombosis developed in one case in the study group and 15 cases in the control group(P ＜ 0.05).Postoperative 3-year recurrent gastroesophageal varices hemorrhage was 15％ in the study group and 25％ in the control group (P ＜ 0.05).Postoperative 5-year variceal hemorrhage recurrence rate were 28％ in the study group and 30％ in the control group (P ＞ 0.05).Conclusions Maitaining vagus nerve selective pericardial devascularization plus subtotal splenectomy is of less postoperative complication and lower portal vein thrombosis rate and better patients' survival compared with pericardial devascularizatim plus total splenectomy.

Objective:To explore the validity of a function assessing tool based on the International Classification of Functioning, Disability and Health′s (ICF′s) rehabilitation set in assessing aging-related disability.Methods:A total of 1610 elderly people from 15 nursing homes across China were assessed using the tool based on the ICF′s rehabilitation set and with the 12-item short form health survey (SF-12). The structural validity of the responses was analyzed using factor analysis, and criterion-related validity was also evaluated.Results:The factor analysis yielded three factors with eigenvalues greater than 1. Their cumulative explanatory power was 74.4%. Item d550 eating had double loading in the factor analysis. The item scores and the total scores of the disability assessment tool were significantly negatively correlated with the physiological function domain scores and the psychological function domain scores.Conclusion:The function assessment tool based on the ICF′s rehabilitation set when combined with a numerical rating scale has good structural and criterion-related validity in the assessment of disability due to aging.

Objective To investigate the association between arterial compliance and fundus oculi arteriosclerosis in elderly people. Methods A total of 73 elderly subjects,including 61 elderly patients with fundus oculi arteriosclerosis and 12 healthy volunteers were recruited into the study.Capacitive arterial compliance(C1)and oscillatory arterial compliance(C2)were measured by DO2020 Cardiovascular Profiling Instrument.Moreover,fundus photographs were measured using Canon figure fundus camera. Results There were significant differences in systolic blood pressure(SBP),diastolic blood pressure(DBP),mean artery pressure,pulse pressure,capacitive arterial compliance (C1),and oscillatory arterial compliance(C2)between patients with fundus oculi arteriosclerosis and healthy volunteers(all P<0.05).In multiple regression analysis,the grade of fundus oculi arteriosclerosis was significantly correlated with SBP,DBP,mean artery pressure and pulse pressure (r=0.357,0.261,0.342,0.280,all P<0.05).Moreover,there were significant correlations between the grade of fundus oculi arteriosclerosis and Cl(r=-0.281,P<:0.05),and C2(r=-0.308,P<0.01). Conclusions These findings underscore the efficacy of C1 and C2 in identifying patients with fundus oculi arteriosclerosis.

Objective To observe the bleeding risk of bivalirudin combined with ticagrelor in patients with acute ST segment elevation myocardial infarction (STEMI) during emergency percutaneous coronary intervention (PCI) .Methods A retrospective a‐nalysis of 458 patients with STEMI who underwent emergency PCI in our hospital was performed .All patients were divided into the bivalirudin group (217 cases) and the standard heparin group(241 cases) according to the anticoagulation scheme during PCI opera‐tion .All patients administered the dual antiplatelet therapy of aspirin 100 mg and ticagrelor 180 mg before surgery .Then ,all pa‐tients were administered dual antiplatelet therapy of aspirin 100 mg once daily and ticagrelor 90 mg twice daily for a long time .The clinical data were analyzed and the bleeding situation within 72 h after PCI was compared between the two groups .Results There were no statistically significant differences in gender ,age ,body mass ,smoking proportion ,occurrence rates of accompanying and complicating diseases ,RBC count ,platelet count ,Hb and PT before PCI between the two groups(P>0 .05) .The bleeding incidence rate in the bivalirudin group was significantly lower than that in the standard heparin group ,and the difference was statistically sig‐nificant (χ2 =8 .455 ,P<0 .05) .Conclusion Compared with standard heparin ,on the basis of ticagrelor use ,giving bivalirudin dur‐ing PCI process can reduce the bleeding risk of patients .