Objective To evaluate the application of ZEEK thrombus aspiration catheter in treatment of acute myocardial infarction (AMI) in elderly patients. Methods The 52 patients with ST-elevation myocardial infarction(STEMI)were treated with percutaneous coronary intervention (PCI) plus thrombus aspiration by using ZEEK thrombus aspiration catheter (ZEEK group), and 42 STEMI patients were treated only with PCI (control group). The regression rate of ST segment, left ventricular ejection fraction (LVEF), incidence of no-reflow and mortality were followed up after PCI during hospitalization. Results No-reflow occurred in 5 (11.9%) patients and 1 (1.9 %) patient in the control group and ZEEK group, respectively. And 2 deaths were encountered only in the control group. The differences between the two groups were statistically significant (P＜0.05).Conclusions AMI treatments with PCI and application of ZEEK aspiration thrombus catheter are safe and effective. The two methods could lower thrombosis burden, may improve distal myocardium perfusion and cardiac function after the procedure.

Objective To compare the effect of perioperative intravenous injection of Analgecine on the analgesic efficacy and complications of patient-controlled intravenous analgesia ( PCIA ) of different doses of fentsnyl in postoperative lumhotomy patients.Methods 200 patients underweat hmbotomy in general anesthesia were randomly divided into four groups with fifty cases each.Fentanyl 1.0mg in group A,fentanyl 0.5mg in group B,fentanyl 1.0mg in group C,fentanyl 0.5mg in group D.The drugs in each group were diluted to 100ml and infused by pumps.Besides,the patients in group C and D were injected with analgecine 3.6u and 7.2u at the night before the operation,preoperation and postoperation respectively.The visual analog scale(VAS),times of PCA and incidence of side effects were recorded during the period of postoperative 24 hours.Results The VAS of group B at 2h after operation was (5.2 ± 1.9 ) points,which was significandy higher than that of group A,C and D( P ＜ 0.05 ),VAS became similar 4h later( P ＞0.05).The demanding times for supplemental bolus in group B were also significantly higher than that of A,C and D( P ＜ 0.05 ).The incidence of nausea,vomiting,itching,somnolence in group B and D were significantly less than those in group A and C( P ＜0.05 ).No respiratory depression or abnormal bleeding occurred in the four groups.Conclusion Perioperative intravenous injection of analgecine had a better effect on PCIA of fentanyl and could reduce fentanyl requirement and its side effects in lumbotomy patients.

Objective To study the effect of cardiac resynchronization therapy (CRT) on the cardiac function and arrhythmias of patients with chronic heart failure and left ventricular systolic dyssynchrony. Methods Thirty-two cases of patients with chronic heart failure and left ventricular systolic dyssynchrony underwent CRT therapy. And LEVESV, LVEDV, LVEF, LVEDD, MRA, LAA, MRA/LAA were detected by echocardiography while the cardiac function was kept stable. Then the left ventricular systolic 12 segment peak time (Ts) was measurements by tissue doppler in all patients, the poor (Ts-maxD) and standard deviation (Ts-SD) were also calculated. The 24-hour ambulatory 12-lead ECG was took postoperation. All the patients were treated by anti-heart failure drugs after CRT pacemeker implantantion. All these indicators were assessed again at 12 weeks later. Results Compared with the previous CRT pacemaker implantation, LVEF, LV dp/dpsignificantly increased (P < 0.05). LEVESV, Ts-maxD, Ts-SD, MRA, MRA/LAA markedly declined (P < 0.05). But no statistical significance was found between the preoperative and postoperative CRT (P>0.05). Atrial premature beats and paroxysmal atrial tachycardia were significantly reduced in the preoperative CRT (P < 0.05). No significant differences were found in atrial fibrillation, ventricular premature beats and paroxysmal supraventricular tachycardia between the preoperative and postoperative CRT (P > 0.05). Conclusion CRT resynchronization therapy can improve left ventricular systolic function, and reduce the MRA and Ts. The mechanism may be associated with the improvement of left ventricular synchrony, reducing mitral regurgitation, and reducing the occurrence of atrial arrhythmias.

Objective To investigate the usefulness of different-b-value diffusion weighted imaging (DWI) in patients with early cerebral infarction and obtain the optimal b value of early cerebral infarction.Methods DWI at b-value of 1,000,2,000,and 3,000 s/mm2 was performed for 40 patients within 72 h after the onset of stroke using a GE Signa HDx 3.0T MRI scanner.Post-processing was done by the DWI specific software Function Tool to gain signal intensity and mean apparent diffusion coefficient in the lesions center and the contralateral normal brain tissue,respectively.The sensitivity of conventional MRI and different-b-value DWI was calculated in the diagnosis of early cerebral infarction.Results In 40 patients with early cerebral infarction,the sensitivity of b-values of 1,000,2,000,and 3,000 s/mm2 (DWIb=1 000,DWIb=2 000,DWIb=3 000) and conventional MRI in the diagnosis of early cerebral infarction were 100％,97.5％,97.5％,72.5％,respectively.With b value increased,signal intensity and ADC value declined.Under the condition of different b values,signal intensity and ADC value were statistically significant in region of interest (P＜0.05).Conclusion DWI is superior to conventional MRI scan in monitoring early cerebral infarction.With the increase of b value,the sensitivity is the higher to hyperacute cerebral infarction,the signal contrast is obvious,while signal to noise ratio of the image reduces.It is suggested that brain tissue contrast and the sensitivity to the new cerebral infarction is more predictable on b value =1,000 DWI than on the other DWIs.