Objective To understand the correlation of caregiver′s burden, psychological state, quality of life, social support and health condition of patients with rheumatism, to provide the basis for improvements in health status and quality of life in patients with rheumatic diseases. Methods Totals of 153 patients and their caregivers were collected form rheumatism outpatient in our hospital, the patients′health condition was assessed by HAQ;Zarit burden scale was used to assess caregivers′burden;CES-D self-report depression scale was used for the assessment of psychological state;patients′health status, quality of life and supportive were assessed by using health assessment questionnaire, social support scale and World Health Organization quality of life assessment. Results Rheumatic patients and caregivers were vulnerable groups and their age gap was large. Caregivers were mainly young and middle aged men. Their relationship were mainly couples or parents and children. Their educational level was low and they usually lived in rural without fixed work. There was a linear relationship between burden and depression degree of caregivers and health status of patients (P<0. 01). There was a linear relationship between caregivers′quality of life and health status of patients (P <0. 05). There was no linear relationship between support of the caregivers and health status of patients (P>0. 05). Conclusions Caregivers have more depression and burden, patients obtain worse health condition. The higher caregivers quality of life, the better health status of patients. It seems no relationship between support of the caregivers and health status of patients.

ObjectiveTo investigate the feasibility of extended hepatectomy for huge hepatic carcinoma.MethodsA retrospective analysis was made on the clinical data of 28 patients with huge hepatic carcinoma who underwent extended hepatectomy from December 2006 to June 2011.Twenty-two cases were Child-Pugh grade A,6 cases were Child-Pugh grade B,19 cases were indocyanine green retention at 15 minutes (ICGR15)≤10％,5 cases were 10％ ＜ ICGR15 ≤15％,4 cases were 15％ ＜ ICGR15 ≤20％.ResultsThe operative death rate was 7.1％ (2/28) with Child-Pugh grade B,15％ ＜ ICGR15 ≤20％ and liver resection volume 60％-70％.Postoperative complications were found on 15 cases,but all recovered after treatment.ConclusionExtended hepatectomy for huge hepatic carcinoma can be feasible in the patients with enough reserve of the liver function provided.

ObjectiveTo evaluate the feasibility and the value of videodensitometric scale (VDS) in assessing myocardial microperfusion. Methods11 Beagles were embolized small coronary artery with polystyrene microbubble (100 μm). Coronary angiography was performed after the embolization and the VDS was calculated. Single photon emission computerized tomography (SPECT) was also performed after embolization and SPECT scores were also calculated. ResultsVDS after embolization was (15.2±3.8); and SPECT score was (17.6±6.4). VDS correlated negatively with SPECT scores (r=－0.85, P<0.05).ConclusionVDS keeps a closely correlation with SPECT. It can be used to assess myocardial microcirculation in clinical.

Objective To evaluate the feasibility and the value of videodensitometric scale(VDS)assessing myocardial microperfusion.Methods The small coronary arteries of 11 dogs were embolized by ejecting polystyrene microbubble(dm= 100 μm),six embolized at left anterior descending branch(LAD)and five embolized at left circumflex branch(LCX).Coronary angiography was performed before and after the embolization.The myocardial contrast echocardiography(MCE)was performed in 12th hour after embolization.VDS was calculated according to coronary angiography.MCE scales were calculated.Results Among the eleven experimental dogs,VDS before embolization was 24.4±4.9 and that after embolization was 15.2±3.8.VDS after embolization was obviously lower than before embolization(P<0.05).VDS between LAD and LCX at the same stage was no difference;MCE scores after embolization were 7.6±2.4.VDS was negatively dependent with MCES after embolization(γ=-0.78,P<0.05).Conclusion As a newly quantitative index and keeping a closely correction with MCE,VDS can be used as a quantitative index to assess myocardial microperfusion in clinic.

BACKGROUND:The safety and efficacy of paclitaxel-eluting stents (Taxus DES) has been proved by international researchers in clinic investigations.Based on further inclusion criteria,the incidence of in-stent restenosis is still lower than that of bare-metal stent.OBJECTIVE:TO observe restenosis of Taxus DES and the effect on local vessels through applying the follow up of coronary angiography and to investigate the biocompatibility of stent and host.DESIGN:Following-up observation.SETTING:Department of Cardiology,General Hospital of Chinese PLA.PARTICIPANTS:A total of 297 patients who had undergone coronary Taxus DES implantation for coronary artery disease were selected from Cardiovascular Department of General Hospital of Chinese PLA from May 2003 to May 2005.There were 265 males and 32 females and their ages ranged from 36 to 76 years.All patients provided informed consent,and the experiment had got confirmed consent from local ethic committee.METHODS:All patients were implanted Taxus DES and received the follow up within 6 and 12 months.In addition,at 6 months after operation,coronary angiography was used to measure the reference vessel diameter (RVD) and the minimal lumen diameter(MLD),calculate diameter restenosis rate and observe late loss.MAIN OUTCOME MEASURES:Coronary angiography at 6 months after Taxus DES implantation and biocompatibility of stent and host.RESULTS:①Quantitative angiographic analysis(QCA):Angiographic follow-up showed that the late loss of in-stent was significantly higher than that of pro-in-lesion and dis-in-lesion(P＜0.05).②Coronary angiography in-stent restenosis:In 134 angiographic follow-up patients,a total of 14 patients experienced restenosis,and the incidence was 10.4%(14/134).The patterns of restenosis were diffuse in-stent in 7 patients and the rate of revascularization was 6.7%.③Stent aneurysm:Angiographic evidence of aneurysm was observed in one patient among follow-up cases,and the rate of which was 0.75% (1/134).④Clinic follow-up major adverse cardiac events(MACE):Among 297 patients,one patient was attracted sudden death 5 months after intervention (0.34%; 1/297),and one patient was suffered subacute thrombosis 5 days after stent implant (0.34%;1/297),and late thrombosis occurred in 2 patients.The general rate of MACE was 1.35%.CONCLUSION:①The late loss of Taxus DES mainly takes place in in-stent.The patterns of restenosis of Taxus DES are in majority of diffuse in-stent,and the incidence of MACE is low.②Taxus DES possibly results aneurysm in local vessels.The follow up indicates that Taxus DES has a good biocompatibility to patients.

Objective To evaluate the feasibility and the value of video density scale (VDS) for assessing myocardial microperfusion.MethodsVDS and corrected TIMI frame counted (CTFC) were calculated and compared in 58 cases undergoing coronary catheter angiography.ResultsVDS of 58 cases was (22.5±5.8)and 95% confidence interval of normal myocardial microperfusion is(20.2,24.7).The CTFC was (21.1±4.5).It showed negative correlation between VDS and CTFC.ConclusionVDS is feasible to assess myocardial microperfusion quantificationally.The possibility of myocardial microperfusion dysfunction would be increased when VDS is lower than 20.

Objective To evaluate the immediate and long-term outcomes of left main bifurcation lesions using different stenting techniques.Methods 27 patients undergone unprotected left main coronary artery stenting had been analyzed.14 cases with simple stenting techniques and 13 cases with complex stenting techniques were involved.Results 40 coronary stents were deployed in 27 patients.The procedural success rate was 100%.No major adverse cardiac events(MACE)had developed in hospital.More true bifurcation lesions were involved in complex stenting group than in simple stenting group(84.6% vs 14.3%,P=0.0004),as well as multivessel lesions involved(100% vs 57.1%,P=0.0074).The residual ostial restenosis of left anterior descending artery(LAD)in complex stenting techniques group was more than that in simple stenting techniques group((4.29±4.25)vs(10.85±5.51),P=0.002).The residual ostial restenosis of left circumflex artery(LCX)in complex stenting group was less than that in simple stenting group((4.61±3.01)vs(13.63±11.21),P=0.009).The patients were followed up for 2～53 months.Angina pectoris recurred in 3 cases(11.1%)and target lesion revascularization(TLR)developed in 2 cases(7.41%).The total MACE happened in 2 cases(7.41%).There was no significant difference between complex stenting group and simple stenting group about symptom recurrence(7.1% vs 15.4%,P=0.59)and TLR(0 vs 15.4%,P=0.13).Conclusion Both simple and complex stenting techniques are feasible with better in-hospital and long-term outcomes.

Objective To investigate the effect of both thrombus aspiration device Diver CE and tirofiban therapy on patients of acute myocardial infarction (AMI) with coronary thrombotic burden lesion.Methods 32 patients of AMI with thrombotic burden lesion confirmed by coronary angiography were divided into the aspiration catheter and tirofiban group (n=24) and standard percutaneous coronary intervention (PCI) group (n=8). The rate of major adverse cardiovascular events (MACE) in hospital, changes before and after the therapy of two groups were compared.Results MACE incidence in hospital in the patients of the both thrombus aspiration and tirofiban group was obviously lower than that of the standard PCI group ( P<0.05). The thrombolysis in myocadial infarction (TIMI) after therapy in the thrombus aspiration group improved superior to the standard PCI group. All of two groups had no fatal hemorrhagic complications.Conclusion Combination of thrombus aspiration and tirofiban is a safe and effective method to manage the thrombotic burden lesion in AMI patients.

Objective To isolate mesenchymal stem cells(MSCs) from the mobilized peripheral blood and transdifferente them into cardiomyocytes for establishing an non-invasive cell source of stem cell transplantation for myocardial infarction therapy.Methods To granulocyte-colony stimulating factor((30 ?g/kg?day)) was injected into New Zealand White rabbits subcutaneously for 5 days,then MSCs were isolated from peripheral blood.After treatment with 5-azacytidine for 24 hours,the cultured cells were evaluated by immunohistochemical staining for actin,desmin and cardiac-specific troponin T(cTNT).Results After treatment with 5-azacytidine,the MSCs from the mobilized peripheral blood showed spindle-like and multinucleation,some cells aggregated and formed a ball-like appearance at 2 weeks.The ball-like cells and some spindle-like multinuclear cells were found with positively staining of actin,desmin and cTNT.Conclusion MSCs can be isolated from the mobilized peripheral blood and transdifferented into cardiomyocytes in vitro,suggesting that MSCs from the mobilized peripheral blood may be a new and non-invasive cell source of stem cell transplantation in myocardial infarction therapy.

Objective: To investigate the effects of bone marrow-derived mononuclear cells (BMC) transplantation for the therapy of myocardial infarction (MI) in rabbits. Methods: 20 rabbits were randomly divided into 2 groups. MI was induced by ligation of the left anterior descending artery.In transplantation group(T,n=10), BMC transplantation was performed on 5-7 days after MI . Bone marrow (3-5 ml) was obtained from iliac crest and labeled with bromodeoxyuridine (Brdu) for 24-48 hours, BMC were transplanted into infracted myocardium through intramyocardial injection. Control animals (C,n=10) didn′t receive any treatment after MI. Echocardiography was performed for evaluating the cardiac function in 1 week and 5 weeks after MI. Hemodynamic and histological studies were performed in the 5 th weeks after MI. Results: LV ejection fraction of group T had no change, but group C decreased in the 1st week and 5th weeks after MI. The results of Group T having higher LV max +dP/dt and max-dp/dt, lower LV end-diastolic pressure showed comparing with that of group C in the 5th weeks after MI. Histological studies revealed that there were Brdu positive cells in the infarcted area in group T, and the vascular density of group T in the infarcted area was significantly greater in comparision with group C. No regeneration of smooth muscle cell and cardiomyocyte were found in the infarcted area. Conclusion: Transplantation of BMC may avoid the deterioration of cardiac function through vasculogenesis in the infarcted area,but the efficacy in amelioration of cardiac function is limited.