Objective To compare the effects of intracoronary verapamil on coronary flow,myocardial perfusion and clinical outcome during primary percutaneous coronary intervention(PCI) for acute ST elevation myocardial infarction(STEMI).Methods A total of 99 consecutive STEMI patients undergoing primary PCI were randomly assigned to receive intracoronary verapamil or intracoronary heparinised saline immediately after stent deployment.Coronary flow was assessed by Thrombolysis in Myocardial Infarction(TIMI) flow grade(TFG) and corrected TIMI frame count(CTFC),and myocardial perfusion was assessed by TIMI myocardial perfusion grade(TMPG) and TIMI myocardial blush grades(MBG).Coronary and myocardial perfusion were assessed before and after PCI,as well as after drug administration by two doctors independently.Echocardiography were performed one week after PCI.Incidence of major adverse cardiac events in hospital and 3 months follow-up were compared between the two groups.Results Eight patients were excluded from the final analysis.Among the remaining 91 patients,47 patients were in the verapamil group and 44 patients were in control group.Baseline characteristics and angiographic characteristics were not significantly different between the two groups.CTFC,TFG,TMPG,and MBG before and after PCI were of no significant differences between the two groups.However,after drug administration,the verapamil group showed better outcome compared with the control group in CTFC(27.1?14.2 vs 39.0?23.8,P=0.011),TFG≥2(100% vs 90.9%,P=0.035),MBG≥2(91.5%% vs 75.5%,P=0.034),and TMPG≥2(89.4% vs 72.7%,P=0.042).LVEF measured by echocardiography was not significantly different between the two groups one week after PCI.The combined incidence of MACE in hospital(4.3% vs 9.1%,P=0.613) and at 3-month follow-up(23.9% vs 22.7%,P=0.894) was similar between the verapamil group and the control group.Conclusion Intracoronary administration of verapamil can improve coronary flow and myocardial perfusion in STEMI patients underwent primary PCI but show no obvious improvement in short-time clinical prognosis.

Objective To understand the current status of HIV infection in men who have sex with men (MSM) in Nanjing,explore the associated factors with HIV infection,and provide information for the intervention in MSM.Methods Data collected in the consecutive sentinel surveillances among MSM during 2011-2015 includes MSM's social-demographic information,sexual behavior histories,access to HIV prevention services and HIV testing in the past year.The infection trend was analyzed with x2 test and the factors associated with HIV infection were identified through multivariate logistic regression analysis.Results From 2011 to 2015,712,670,656,681 and 601 MSM were surveyed respectively.The HIV infection rates were 7.4％,13.7％,9.8％,12.0％ and 12.0％ respectively,with an increasing trend (P=0.044).Syphilis prevalence rates were 9.1％,11.5％,6.0％,10.6％ and 5.8％ respectively,with a decreasing trend (P=0.042).From 2011 to 2015,the percentage of MSM who failed to consistently use condoms for anal sex in the past 6 months increased significantly from 46.4％(260/560) to 55.7％(257/461) the percentage of those having commercial sex with males increased significantly from 1.2％(8/692) to 3.0％(18/593) in 2015,while the percentage of those receiving HIV test in the past year decreased significantly from 67.7％(482/712) to 57.6％(346/ 601).Those who were aged ＞25 years,lived in Nanjing for less than 2 years,had a high school or below educational level,failed to consistently use condoms at anal sex in the past 6 months,failed to have HIV test in the past year and were infected with syphilis had higher risk for HIV infection.Conclusion Given the increasing trend of HIV infection and high risk sexual behavior in MSM in Nanjing,it is necessary to strengthen the comprehensive HIV prevention and intervention through expanding HIV test coverage and promoting condom use to curb HIV epidemic in MSM.