Objective To observe the characteristics of culprit lesions in AMI with previous PCI.Methods Retrospective analysis was carried out in 61 consecutive AMI patients with previous PCI treated with primary PCI from April, 2004 to April, 2006 in Fuwai hospital.Results Location of culprit lesions in the 61 patients (62.1?10.0 yrs; male 88.5%) were: LAD 47.5%, RCA 39.5%, LCX 13.0%. Comparing the medication of the patients during the first year after the former PCI, besides the continous use of aspirin (93.8% vs 100%,P=0.113), all patients had stopped using clopidogrel, and the use of ?-blockers, ACEIs and statins also dropped significantly after 1 year (46.9% vs 75.0%, P= 0.001; 34.4% vs 70.8%, P= 0.001; and 28.1% vs 77.1%, P= 0.000, respectively). The characteristics of the culprit lesions included: acute and sub-acute in-stent thrombosis in 12 cases (19.7%), late and very late in-stent thrombosis in 6 cases (9.8%), plaque rapture in 41 cases (70.5%), but no restenosis was involved. The time of the recurrant AMI after the former PCI were: 13 cases (21.3%) within 1 month including 12 cases of acute or subacute in-stent thrombosis and 1 case of plaque rupture in anther coronary artery 3 days after primary PCI; 16 cases (26.2%) after the first month to 1 year including 12 cases of plaque rupture and 4 cases of late in-stent thrombosis; 32 cases (52.5%) 1 year including 30 cases of plaque rupture and 2 cases of very late in-stent thrombosis. Conclusion The major mechanism of recurrant AMI after preoious PCI is plaque rapture.

Objective To summarize clinical characteristics of coronary artery perforation during percutaneous coronary interventions.Methods Retrospective analysis of consecutive 32 patients who had coronary artery perforation in Fu Wai Hospital from April,2004 to August,2006 was carried out.Results Thirty-two cases of coronary perforation occurred during 7102 PCI procedures performed within this period(incidence:0.5%).These cases are comparatively complicated lesions including 81.3% of type B2+C and 62.5% of chronic total occlusion(CTO)lesions.Ellis classification:typeⅠ:14(43.8%),type Ⅱ:10(31.2%),type Ⅲ:8(25.0%),type Ⅳ:0.Mechanism of coronary artery perforation:guiding wire:21(65.6%),predilatation:6(18.8%),postdilatation:3(9.4%),stent implantation:2(6.2%).Clinical consequence:death:3(9.4%),cardiac temponade:7(21.9%),acute myocardial infarction(AMI):9(28.1%).Treatment:reversal of heparin-induced anticoagulation by application of protamine:14(43.8%),prolonged balloon inflation:9(28.1%),percardiocentesis:7(21.9%),implantation of membrane covered stent:4(12.5%),bail-out surgical repair:2(6.2%).Conclusion Coronary perforation during PCI is a rare complication;type Ⅲ perforation is associated with significant morbidity and mortality,which needs urgent and intensive treatment.

In this study, a closed-loop controller for chest compression which adjusts chest compression depth according to the coronary perfusion pressure (CPP) was proposed. An effective and personalized chest compression method for automatic mechanical compression devices was provided, and the traditional and uniform chest compression standard neglecting individual difference was improved. This study rebuilds Charles F. Babbs human circulation model with CPP simulation module and proposes a closed-loop controller based on a fuzzy control algorithm. The performance of the fuzzy controller was evaluated and compared to that of a traditional PID controller in computer simulation studies. The simulation results demonstrated that the fuzzy closed-loop controller produced shorter regulation time, fewer oscillations and smaller overshoot than those of the traditional PID controller and outperforms the traditional PID controller in CPP regulation and maintenance.
Algorithms ; Arterial Pressure ; Cardiopulmonary Resuscitation ; instrumentation ; Computer Simulation ; Coronary Vessels ; physiopathology ; Humans ; Models, Theoretical ; Perfusion ; Thorax

Objective To explore the correlation of Connexion43(Cx43),E-cadherin(E-cad)in breast infiltrating ductal carcinoma tis-sue. Methods The expressions of Cx43 and E-cad proteins were detected in 89 cases breast infiltrating ductal carcinoma tissue,48 cases partition groups. by immunohistochemistry Elivision method. Results The expressions of Cx43 and E-cad has a better consistency in the tumor area,the border area and far cancer area of breast infiltrating ductal carcinoma. For both the negative expression in tumor area same time,the rate of lymph node metastasis was highest. Conclusion Cx43 and E-cad in breast invasive ductal carcinoma has a certain synergy in the process of the occurrence and development,which related to its metastasis occurred.

Objective To investigate the effects of triptolide on lipopolysaccharide (LPS)-induced acute lung injury in rats.Methods Sixty-five male SD rats weighing 200-250 g were randomly divided into 5 groups: control group (group C,n =5),LPS group (group L,n =15),different doses of triptolide groups (groups TP1-3,n =15).In group C normal saline was injected iv and 1％ DMSO injected intraperitoneally(ip).In group L LPS 5 mg/kg was injected iv and 1％ DMSO injected ip.In groups TP1-3 LPS 5 mg/kg was injected iv and triptolide 25,50 and 100 μg/kg was injected ip respectively.Blood samples were collected at 1 h before administration and 1,3,6 and 12 h after administration for blood gas analysis.The animals were sacrificed at 12 h after administration.TNF-α concentrations in serum and bronchoalveolar lavage fluid (BALF) were determined by ELISA.The lungs were removed for microscopic examination,evaluation of diffuse alveolar damage (DAD) score and determination of W/D lung weight ratio and the expression of Toll-like receptor4 (TLR4) protein and mRNA.Results Compared with group C,PaO2 was significantly decreased at 3,6 and 12 h after administration,DAD score and W/D lung weight ratio were increased in groups L and TP1-3,TNF-α concentrations in serum and BLAF were increased,expression of TLR4 mRNA and protein was up-regulated in groups L,TP1 and TP2,whlie TNF-α concentrations in serum and BLAF were significantly decreased,expression of TLR4 mRNA and protein was down-regulated in group TP3 ( P ＜ 0.05).Compared with groups L and TP1,PaO2 was significantly increased at 6 and 12 h after administration,DAD score,W/D lung weight ratio and TNF-α concentrations in serum and BLAF were decreased,expression of TLR4 mRNA and protein was down-regulated in groups TP2 and TP3 ( P ＜ 0.05).There was no siginificant difference in blood gas parameters,DAD score and W/D lung weight ratio between group L and group TP1 and between group TP2 and TP3 ( P ＞ 0.05).Compared with group TP2,TNF-α concentrations in serum and BLAF were significantly decreased,expression of TLR4 mRNA and protein was down-regulated in group TP3 (P ＜ 0.05).The lung pathologic injury was reduced in groups TP1-3 as compared with group L.Conclusion Triptolide can attenuate acute lung injury induced by LPS in a dose-dependent manner in rats,and the inhibition of up-regulation of TLR4 expression and release of TNF-α may be involved in the mechanism.

Objective To evaluate GGT in combination with B ultrasound for the diagnosis of biliary atresia (BA) infants suffering from obstructive jaundice.Methods A retrospective analysis was made on 69 sick infants including 55 BAs and 14 non-BAs as identified by intraoperative cholangiography.The preoperative laboratory GGT and ultrasound data were collected and analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were compared.Results BA patients had significantly higher GGT than Non-BA patients (t =-4.164,P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of GGT ＞ 306 U/L were 69.1％,92.9％,97.4％,43.3％,73.9％,respectively.In BA group,abnormal gallbladder was significantly associated with proadening portal vein,broadening hepatic artery compared with Non-BA patients (x2 =9.995,P ＜0.05).The accuracy of abnormal gallbladder on ultrasound was 78.3％.When two method combined for the diagnosis of BA,the sensitivity,specificity,positive predictive value,negative predictive value were 92.7％,92.9％,98.1％ and 76.5％ and accuracy can reach 92.8％.Conclusions For obstructive jaundice infants with GGT ＞ 306 U/L and abdominal gallbladder ultrasound finding intraoperative cholangiography should be carried out to make definite diagnosis of BA.

Objective To study the feasibility and invasiveness of hand-assisted laparoscopic hepatectomy(HALH) for liver cancer.Methods Forty patients undergoing hepatectomy for liver cancer were randomly divided into HALH group and open hepatectomy(OH) group.Data of patients of two groups,Which included operating time,intraoperative blood loss,length of incision,postoperative flatus time,hospital stay,complications and C-reactive protein(CRP) were compared.Results The mean intraoperative blood loss,length of incision,postoperative flatus time,hospital stay and CRP in HALH group were significantly less than that in OH group;but there was no significant difference in operating time,or complication and recurrence rate.Conclusions HALH for liver cancer is less traumatic,and achieves faster patient recovery.It is feasible and safe in selected patients.

The system structure, working principle and main function of Kinect somatosensory interaction technology are presented in this paper. The feasibility of Kinect sensor using software libraries provided by Kinect forWindows SDK to interact with the application program is discussed. The present situation and development trend of Kinect somatosensory interaction technology in medical rehabilitation are introduced.

Objective To observe the curative effect of 32 P-colloid on craniopharyngioma .Meth-ods Eighteen patients with craniopharyngioma ( from January 2001 to February 2006 ) were treated with in-jecting certain dose of 32 P-colloid, via the technique of three -dimensional orientation conducted by CT to indicate the location of the tumor , and draw out the cystic liquid by centesis .Results The cysts continual-ly shrank in 8 patients(about 44.4%) and vanished thoroughly in 7 patients(about 38.8%).The total ef-fective rate was 83.3% without surgical death or serious complication occurred .Conclusion The 32 P-colloid combining with the technique of three -dimensional orientation conducted by CT is a promising method to treat craniopharyngioma without obvious side -effects.

Objective To compare the long-term effect of three different drng-eluting stents (DES) for in-stent restenotic lesions. Methods From April 2004 to June 2006, 390 consecutive patients undergoing DES implantation including 187 Cypher (group C), 89 Taxus (group T) and 114 Firebird (group F) with resulting in-stent restenotic lesions were studied. A mean of 2 year clinical and 7-month angiographic follow-up was carried out. Results Baseline characteristics indicated that there were more unstable angina cases in T group and less left main disease and more triple vessel disease cases in F group. A mean of 2-year follow-up results showed no difference of major adverse cardiac events (MACE) rate among the three groups (23.0% vs 22.5% vs 13.2% , P = 0. 081) and no difference of cardiac death, non-fatal myocardial infarction (MI) and target vessel revascularization rate(1.1% vs 4. 5% vs 1.8% , P = 0. 210, 5.9% vs 2. 2% vs 2. 6% ,P =0. 226 and 2. 9% vs 2. 2% vs 0. 9% , P =0. 509). There was no difference of total stent thrombosis or its components among the three groups (total: 4. 8% vs 3.4% vs 2. 6%, P=0. 605, early: 0. 5% vs 0 vs 0. 9% ,P =0. 560, late: 1.6% vs 1.1% vs 0. 9% ,P =0. 849 and very late: 2. 9% vs 2. 2% vs 0. 9% , P =0. 509) according to Academic Research Consortium (ARC) standard definitions (definite + probable). 7-month angiographic follow-up indicated that there was a lower trend of both in-stent and in-segment trestenosis rate in C and F groups (17.9% vs 29. 4% vs 13.6% ,P = 0. 214 and 21.8% vs 35.3% vs 15.9%, P =0. 132) and in-stent and in-segment late loss was significantly smaller inCand F groups [(0.31±0.12) mm vs(0.75±0.24) mm vs(0.31±0.13) mm, P=0.000 and (0.33±0.18)mm vs (0.61±0.23)mm vs (0.31±0.14)mm, P=0.001]. Conclusions Results from this 2-year follow-up, single-center study showed comparable effectiveness and safety of Cypher, Taxus and Firebird DES for in-stent restnotic lesions, but Cypher and Firebird had better effect in reducing restenosis.