Objectives:To analyze the safety of coronary artery stent rotational atherectomy due to stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment. Methods:A total of 19 patients with coronary artery disease who underwent coronary artery stent rotational atherectomy for the above reasons in 7 large heart centers in China from 2016 to 2022 were collected.Their baseline data,procedure process data,procedural complications,the occurrence of procedure-related adverse events(type 4a myocardial infarction,emergency coronary artery bypass grafting,and all-cause death)during hospitalization and major adverse cardiovascular events(MACE,including target vessel revascularization,stroke,all-cause death,and recurrent myocardial infarction)during post-discharge follow-up were retrospectively collected. Results:The mean age of the 19 patients was 70(64,73)years,and 13 patients were males.The mean left ventricular ejection fraction was(56.89±8.76)%.Radial artery approach was used in 13 patients,11 patients used 1 burr during the intervention period,6 patients used 2 burrs,and 2 patients used 3 burrs.The average times of burr passing through the lesion was(7.00±4.23)times.The surgical success rate was 100%,and the immediate lumen acquired area was(1.23±0.78)mm2.Drug-eluting stents were successfully implanted in all patients after spinning.Coronary slow blood flow occurred in 1 case after rotational grinding,which was improved after drug treatment.The burr was entrapmented in 3 cases and successfully pulled out after operation.No coronary artery perforation,coronary artery dissection,coronary artery spasm,emergency thoracotomy,or death occurred during the operation,and no procedure-related adverse events occurred during hospitalization.During 3 to 24 months of follow-up,1 patient underwent target vessel revascularization,and there were no MACE in other patients. Conclusions:Coronary artery stent rotational atherectomy in patients with stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment,is a feasible option,with a high surgical success rate and satisfactory safety.None of the patients experienced MACE during long-term follow-up.

Objective:To investigate the relationship between bone mineral density (BMD) of lumbar spine and abdominal adipose tissue in adult males.Methods:A total of 1 374 healthy male examinees in the Affiliated Hospital of Guizhou Medical University from June 2018 to September 2018 were retrospectively analyzed. The age ranged from 30 to 75 (50.9±0.30) years. Height, weight and waist circumference was measured and body mass index (BMI) was calculated. Quantitative CT (QCT) was used to measure the mean BMD value of L1 and L2. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) at the level of L2 were measured as well. According to the BMD, the males were divided into three groups: normal group, osteopenic group and osteoporosis group. One-way ANOVA was applied to compare the age, BMI, VFA and SFA among three groups. LSD- t test was used for multiple comparisons, and Pearson correlation was used to analyze the correlation between age, BMI, VFA, SFA and lumbar BMD. Results:Totally 807 healthy males were in normal group, 451 in osteopenic group and 116 in osteoporosis group. There were significant differences in age, BMI and VFA among normal group, osteopenic group and osteoporosis group ( F=237.939, 5.788, 4.919, P<0.001, 0.003, 0.007). Age and VFA was higher in osteopenic group compared with normal group, and BMI was lower in osteopenic group compared with normal group. Age was higher in osteoporosis group compared with normal group, and the BMI was lower in osteoporosis group compared with normal group. The age was higher in osteoporosis group compared with osteopenic group. The above differences were statistically significant ( P<0.05). Although there was no statistical difference in VFA and SFA between osteopenic group and osteoporosis group, the VFA and SFA was higher in osteopenic group compared with osteoporosis group. BMD of male lumbar spine was negatively correlated with age ( r=-0.542, P<0.001), VFA( r=-0.104, P<0.001), and positively correlated with BMI ( r=0.109, P<0.001). After controlling for age and BMI, BMD was still negatively correlated with VFA ( r=-0.129, P<0.05). Conclusions:Males with abdominal obesity is more likely to manifest as low bone mass. The lumbar BMD is possibly negatively correlated with visceral adipose tissue in male.

Objective: To evaluate the efficacy and safety of catheter-directed interventional therapy in patients with acute pulmonary embolism(PE). Methods: PE was diagnosed by CT pulmonary angiography(CTPA). After risk stratification, a total of 79 PE patients (age (58.9±14.9) years old)were treated with catheter-directed interventional therapy via pulmonary vessels. The changes of pulmonary hemodynamics were compared before and after treatment. The risk of complications and side effects were observed. Results: The pulmonary artery pressure was changed followed by interventional therapy. The interventional therapy significantly decreased mean pulmonary arterial pressure (mPAP) from (35.3±11.2)mmHg (1 mmHg=0.133 kPa) to (30.0±10.6)mmHg (t=8.803,P<0.05) and the echocardiographic derived right ventricular dimension to left ventricular dimension (RV/LV) ratio from 0.93±0.16 to 0.83±0.15 (t=6.868,P<0.05). The arterial partial pressure of oxygen was increased from (69.0±8.6)mmHg to (75.1±9.9)mmHg (t=8.561,P<0.05) . The oxygen saturation was also increased from (93.9±2.9)% to (95.1±1.9)% at 24 h after the treatment (t=2.621,P<0.05) . Patients were further grouped as high-risk group (n=28) and intermediate risk group (n=51). mPAP and RV/LV ratio were significantly reduced in the two subgroups (all P<0.05) and the range of reduction was more significant in the high-risk group. Five patients experienced minor bleeding complication, 3 patients suffered worsened dispone post procedure and were treated with mechanical ventilation, 1 patient died, and 1 patient developed recurrent PE. Conclusion The catheter-directed interventional therapy improves pulmonary hemodynamics and reduces load of right ventricle both in high-risk or intermediate risk PE patients, this therapy strategy is safe and effective for patients with PE.

ObjectiveTo summarize the experience in laparoscopy combined with choledochoscopy and duodenoscopy in the treatment of gallstones complicated by intra- and extrahepatic bile duct stones, and to investigate its therapeutic effect. MethodsA total of 413 patients with gallstones complicated by intra- and extrahepatic bile duct stones who visited Meizhou People′s Hospital from March 2010 to March 2015 were enrolled, and according to the patients′ individual conditions, they were given laparoscopy combined with choledochoscopy and/or duodenoscopy. ResultsA total of 31 patients underwent laparoscopic cholecystectomy (LC)+laparoscopic transcystic common bile duct exploration (LTCBDE), and the success rate was 29.0% (9/31); 101 patients underwent LC+LTCBDE+T tube drainage, and the success rate was 93.1% (94/101); 96 patients underwent LC+laparoscopic common bile duct exploration (LCBDE)+choledochoscopic cholecystolithotomy+primary suture, and the success rate was 97.9% (94/96); 61 patients underwent LC+LCBDE+partial hepatectomy, and the success rate was 91.8% (56/61); 155 patients underwent endoscopic sphincterotomy (EST)+LC or LC+EST, and the success rate was 93.5% (145/155); 10 patients underwent laparoscopy+duodenoscopy+choledochoscopy (at the same time), and the success rate was 90%(9/10). Nineteen patients were converted to open surgery, and the overall success rate was 95.4％（394/413）. All the patients were cured, and there were no serious complications or deaths. ConclusionLaparoscopy combined with duodenoscopy and choledochoscopy is feasible, safe, and reliable in the treatment of gallstones complicated by intra- and extrahepatic bile duct stones.

Objective To investigate the damage mechanism of fluetuant high glucose on the INS-1 cells (pancreatic β-cell lines).Methods The cells were divided into five groups:the control groups (A group:5.5 mmol/L of glucose),the continuing high glucose group (B group:16.7 mmoL/L of glucose),the fluctuant glucose group ( C group:16.7 mmol/L of glucose for cultivation for 2 h,then the concentration changed to 5.5 mmol/L for cultivation for 3 h,which was repeated 3 times per day;the ceils were kept in the medium containing 5.5 mmol/L of glucose during night time for 9 h),the continuing high glucose plus NAC ( 1.0 mmo/L) group ( D group),the fluctuant glucose plus NAC group ( E group).The intracellular reactive oxygen species (ROS) was observed by the flow cytometry.The activity of glucose-6-phosphate dehydrogenase (G6PD) was estimated by the tetrazolium linked cytochemical method.Results 72 h after intervention,the levels of ROSwere 37.77±2.31,86.97±7.97,124.27±10.04,60.92±2.61 and 51.47±3.36,respectively,in A～E group;the activities of G6PD were 1.25±0.03,1.09±0.02,1.03±0.01,1.12±0.02 and 1.21±0.01,respectively;the levels of NADPH were (0.123±0.003) mmol/mg prot,(0.112±0.004) mmoL/mg prot,(0.099±0.002 ) mmol/mg prot,( 0.116±0.005 ) mmol/mg prot and ( 0.120±0.002) mmol/mg prot,respectively.The level of ROS in the cells of the fluctuant glucose group were significantly higher than that in the continuing high glucose group ( P ＜ 0.01 ).The G6PD activity and NADPH was significantly lower in fluctuant high glucose group than those in the continuing high glucose group (P ＜0.01 ).NAC co-cultivation decreased the extent of cell's change.Conclusions Exposure of INS-1 to high glucose lead to increased oxidative stress, possible mechanism included decreased G6PD activity and subsequent imbalance between oxidation and reduction.

Low frequency high power ultrasound is a recent addition to the list of methods for arterial angioplasty. This paper introduced the effects of the low frequency high power ultrasound and summarized the results of many experiments with its use for different kinds of arterial obstruction.
Angioplasty ; methods ; Arterial Occlusive Diseases ; surgery ; Arteriosclerosis ; surgery ; Constriction, Pathologic ; Endarterectomy ; methods ; Femoral Artery ; surgery ; Humans ; Ultrasonic Therapy ; methods

Objective To evaluate the clinical feasibility and safety of percutaneous transluminal coronary thrombolysis in acute myocardial infarction. Methods Consecutive patients( n =25) with evidence of AMI and thrombolysis in myocardial infarction(TIMI) grade 0 or 1 in the infarction related arteries(IRA) underwent coronary ultrasound thrombolysis. Degree of residual stenosis was measured and analyzed with SHIMADZU Digitex, a 2400 computerized analyzing system. Changes in imaging and blood flow in IRA, CK MB before and after the treatment, ST segment in ECG and clinical manifestations were observed to evaluate the feasibility of using angioplasty with ultrasound to treat AMI. Results It was found that IRA achieved grade Ⅲ of TIMI blood flow in 23 out of the 25 patients with AMI (potency recovering rate=92%) and the residual stenosis was 41.39?14.08%. Within 10 minutes after the treatment, disappearance of chest pain, depression of ST segment more than or equal to 50% and obvious migrating forward of CK MB peak value were found in the 23 patients. There were no adverse clinical events during the procedure and hospitalization. Conclusion Angioplasty with high intensity, low frequency ultrasound can be used as a new approach for treating acute myocardial infarction, opening IRA as early as possible and restoring TIMI blood flow grade Ⅲ.

Objective To evaluate the clinical feasibility of disruption of intracoronary plaques using catheter-delivered ultrasound. Methods Ultrasound was introduced via catheterization to treat patients (n=18) with serious stenosis of the coronary artery. Comparison of stenosis degree and ST segment in routine ECG before and after the treatment was conducted. Pre- and post-treatment exercise tests were performed to measure the time needed for induction of angina, the time needed for induction of decrease in ST segment for 0.1 mV and maximal range of decrease in ST segment. Results Ultrasound was found to have dissolved atherosclerotic plaques in 18 cases of coronary heart disease with stenosis in one blood vessel ≥75%. The residual stenosis was (40.11?15.33)% after the treatment, representing a decrease of 44.58% as compared with that before the treatment [(84.69?4.69)%], P

Objective To investigate the serum level of vascular endothelial growth factor (VEGF) in patients with coronary artery disease (CAD) and its clinical significance. Methods The study included 36 patients with CAD and 10 non-coronary heart disease patients as the control. The concentrations of serum VEGF in the coronary veins and the aorta were measured by an enzyme-linked immunsorbent assay (ELISA). Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and were cultured in M199 medium supplemented with 20% fetal bovine serum. After 7 days culture, attached cells were collected. The effect of VEGF on the migration of endothelial progenitor cells (EPCs) were assayed with modified Boyden chamber assay. Results The serum VEGF levels of stable angina pectoris (SAP) patients (208.46?44.74 ?g/L) and acute coronary syndrome (ACS) patients (267.29?93.99 ?g/L) were much higher than that of the controls group (120.77?26.25 ?g/L,P

Objective To investigate the effect of different types and dosages of contrast media on the function and cell injury of rat renal artery endothelium. Methods Renal artery rings were isolated from SD rats and incubated in IMDM medium with 30,60,90 ?l/ml Diatrizoate or Ioversol. The contents of NO and ET-1 were detected by Griess method and radioimmunoassay. The release of LDH was assessed by colotimetric method. Results After being incubated with Diatrizoate or Ioversol for 1 h,the renal artery endothelium did not show significant changes in the release of NO,but the release of ET-1 increased in a dose-dependent manner. When the renal artery endothelium was stimulated with Diatrizoate at dosage of 90 ?l/ml for 4 h,the release of LDH was increased markedly. A slight,but insignificant,increased release of LDH induced by Ioversol was observed. Conclusion Both Diatrizoate and Ioversol can affect the function of renal artery endothelium by interfering the secretion of ET-1,and the effects of Diatrizoate are more obvious than Ioversol. High-dose Diatrizoate can also induce renal artery endothelial cells injury.