Objective To discuss the application of multi-parameters of coronary CT angiography(CTA)in diagnosing coronary heart disease(CHD)and predicting major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI).Methods A total of 350 patients with CHD,who received PCI at the Affiliated Beijing Rehabilitation Hospital of Capital Medical University of China from January 2021 to January 2024,were enrolled in this study as observation group.Other 180 patients with suspected CHD,who underwent coronary CTA and coronary angiography(CAG)to exclude coronary artery lesion in the same period as in the observation group,were collected and used as control group.According to whether MACE occurred or not within 6 months after PCI,the patients of observation group were further divided into MACE group and non-MACE group.The CTA parameters,including total plaque volume(TPV),plaque burden(PB),remodeling index(RI),fat attenuation index(FAI)around coronary artery,spot calcification and napkin-ring sign,were compared between the observation group and the control group as well as between MACE group and non-MACE group.Logistic regression analysis was used to analyze the independent factors influencing the occurrence of MACE after PCI.Area under receiver operating characteristic curve(AUC)was adopted to assess the value of each parameter in predicting the occurrence of MACE within 6 months after PCI.Results The TPV,PB,RI,FAI,and the detection rate of spot calcification and napkin-ring sign in the observation group were significantly higher than those in the control group(P＜0.05).Of the 350 patients in the observation group,54(15.43％)developed MACE within 6 months after PCI,including cardiac death(n=5,1.43％),non-fatal myocardial infarction(n=22,6.29％),target vessel reconstruction due to in-stent restenosis(n=15,4.29％),and hospitalization due to heart failure(n=12,3.43％),all the 54 patients were classified in MACE group.The non-MACE group had 296 patients.The TPV,PB,RI,FAI,and the detection rate of napkin-ring sign in MACE group were higher than those in non-MACE group(P＜0.05).Logistic multivariate analysis showed that TPV,PB and FAI were the independent factors influencing the occurrence of MACE in CHD patients after PCI(P＜0.05).ROC curve analysis indicated that in predicting the occurrence of MACE within 6 months after PCI the sensitivity of TPV,PB and FAI were 65.40％,76.90％and 76.90％respectively,and the specificity of TPV,PB and FAI were 63.80％,72.50％and 73.80％respectively.The sensitivity and specificity of the combined detection were 96.20％and 71.80％respectively,with an AUC of 0.896.Conclusion Multi-parameters of coronary CT A have important application value in diagnosing CHD and in predicting the occurrence of MACE after PCI.The combined detection of TPV,PB and FAI can provide important reference for making clinical decision.

Femtosecond laser small incision lenticule extraction (SMILE) with different residual stromal thicknesses (RST) is set to investigate its effect on corneal biomechanical properties of rabbits in vivo. In this study, 24 healthy adult Japanese rabbits were randomly divided into group A and B. The RST of group A was set 30% of the corneal central thickness (CCT), and the RST of group B was 50% of the CCT. The thickness of the corneal cap in both groups was set one third of CCT. Corneal visualization Scheimpflug technology (Corvis ST) and Pentacam three-dimensional anterior segment analyzer were used to determine corneal biomechanical and morphological parameters before surgery, and 1 week, 1 month and 3 months after surgery. Pearson correlation analysis was used to analyze factors affecting corneal biomechanical parameters after SMILE. The results showed that the corneal stiffness of group A was significantly higher than that of group B at 1 week and 1 month after surgery, and most biomechanical parameters returned to preoperative levels at 3 months postoperatively. The results of correlation analysis showed that postoperative CCT and RST were the main factors affecting corneal biomechanical parameters after SMILE. There was no significant difference in corneal posterior surface height (PE) between 3 months after surgery and before surgery in both two groups. It indicates that although the ability to resist deformation of cornea decreases in SMILE with thicker corneal cap and less RST, there is no tendency to keratoconus, which may be related to the preservation of more anterior stromal layer.
Animals ; Biomechanical Phenomena ; Cornea/surgery* ; Postoperative Period ; Rabbits

Objective To compare the effectiveness and safety of two different protocol of chlopidogrel therapy on intra-stent thrombus prevention in patients undergone coronary interventions. Methods Sixty-three consecutive patients underwent elective coronary interventions in Beijing Mining General Hospital were enrolled in this retrospective study. The patients were divided into two groups according to the protocol of chlopidogrel therapy. For the testing group (n=29), 300 mg and 225 mg of chlopidogrel were given 48 hours and 24 hours prior to the intervention procedure respectively followed by 75 mg daily. And for the control group (n=34), 300 mg cholpidogrel were given 6 hours prior to the procedure followed by 75 mg daily. Acute, subacute and late in-stent thrombosis and bleeding were recorded during a 2-40 months follow-up. Results No in-stent thrombosis occurred in the testing group which, however, was recorded in 3 cases in the control group. The difference was statistically significant (P