1.Feasibility of a single catheter intervention using the transradial approach for ST-segment elevation myocardial infarction
Zhijian PENG ; Guijian CHEN ; Fenling HONG ; Hua HUANG ; Peixin ZHENG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(1):7-11
Objective:To evaluate the safety and effectiveness of primary percutaneous coronary intervention using the transradial approach in patients with acute ST-segment elevation myocardial infarction (STEMI) based on electrocardiography results.Methods:The clinical data of 298 patients with STEMI who had indications of emergency coronary angiography and percutaneous coronary intervention who received treatment in The Second People's Hospital of Shantou between January 2015 and June 2019 were retrospectively included in this study. These patients were assigned into traditional transfemoral intervention (TTFI, n = 56), traditional transradial intervention (TTRI, n = 167), and single transradial intervention (STRI, n = 75) groups. Door-to-balloon (D2B) time, needle-to-balloon (N2B) time, hospital days, and the incidence of major adverse cardiac events within 1 year after treatment were compared among the three groups. Results:The D2B time in the STRI, TTFI and TTRI groups was (67.6 ± 2.1) minutes, (73.3 ± 15.3) minutes, and (77.4 ± 16.7) minutes, respectively. There was a significant difference in D2B time among the three groups ( F = -2.24, P = 0.013). The D2B time was significantly shorter in the STRI group than in the TTFI and TTRI groups ( t = -1.84, -1.84, both P = 0.033). The N2B time in the STRI, TTFI and TTRI groups was (7.6 ± 2.1) minutes, (15.3 ± 6.5) minutes, and (14.1 ± 5.7) minutes, respectively. There was a significant difference in N2B time among the three groups ( F = -4.34, all P < 0.001). The N2B time was significantly shorter in the STRI group than in the TTFI and TTRI groups ( t = -2.06, P = 0.020; t = -3.12, P < 0.001). The proportion of patients with D2B time less than 90 minutes in the STRI group was 74.7% (56/75), which was significantly higher than that in the TTRI [46.1% (77/167)] and TTFI [51.8% (29/56)] groups ( χ2 = 4.07, P < 0.001). The incidence of major adverse cardiac events within 1 year after treatment in the TTFI, TTRI, and STRI groups was 16.1% (9/56), 13.2% (22/167), and 9.3% (7/75), respectively. The incidence of major adverse cardiac events within 1 year after treatment was significantly lower in the STRI group than in the TTFI and TTRI groups ( χ2 = 5.67, P < 0.05). Conclusion:STRI is safe and effective for STEMI and is expected to improve long-term prognosis.
2.Modified Stoppa approach for acetabular anterior fractures
Guijian LI ; Yazhou CHEN ; Peijuan LIU ; Jiawu LUO
Chinese Journal of Orthopaedic Trauma 2017;19(2):173-175
Objective To discuss clinical efficacy of the modified Stoppa approach in the treatment of acetabular anterior fractures.Methods From January 2011 to December 2014,22 patients with acetabular anterior fracture were treated at our department.They were 14 males and 8 females,with an average age of 36.6 years (range,from 18 to 49 years).By the LetourneI-Judet classification system,there were 9 anterior wall fractures,12 anterior column fractures,and one transverse fracture.The modified Stoppa approach was used for fracture reduction under direct visualization in this cohort.Fixation with reconstruction plate was conducted after satisfactory reduction was confirmed by the X-ray examination.The operative duration,incision length,bleeding volume,fracture reduction quality,function of the affected hip and complications were recorded.Results In this cohort,the incision length ranged from 6 to 15 cm,averaging 9.5 cm;the intraoperative bleeding volume ranged from 100 to 1,000 mL,averaging 550 mL;the operative duration ranged from 40 to 160 minutes,averaging 126.2 min.The 22 patients were followed up for an average of 15.5 months (from 12 to 18 months).According to the Matta imaging evaluation,the fracture reduction was rated as excellent in 18 cases,as good in 3 cases and as poor in one,yielding an excellent to good rate of 95.5%.According to the Harris scoring system,the function of the affected hip was assessed at the final follow-up as excellent in 12 cases,as good in 9 cases,and as poor in one case,giving an excellent to good rate of 95.5%.Traumatic arthritis occurred in one case;there were no such complications as reduction loss or implant failure.Conclusion The modified Stoppa approach is a satisfactory one for the treatment of unstable acetabular anterior fractures,owning to its advantages like minimal invasiveness,simple dissection,excellent visual control of reduction and fixation,and a low rate of complications.
3.Relationship Between Thyroid Hormone and Atrial Fibrillation Prevalence in Patients With Chronic Heart Failure
Chen LIU ; Xiaochen YUAN ; Zhengang ZHANG ; Qiuping LUO ; Junfeng YAN ; Kaizheng GONG ; Jianhua QIN ; Guijian ZHOU
Chinese Circulation Journal 2015;(8):749-752
Objective: To investigate the impact of thyroid hormone on atrial ifbrillation (AF) prevalence in patients with chronic heart failure (CHF).
Methods: A total of 322 non-valvular heart disease CHF patients treated in our hospital from 2011-0-01 to 2012-10-01 were retrospectively studied. Based on previous history and the ECG at admission, the patients were divided into 2 groups: AF group,n=187 and Sinus rhythm group,n=135. The proifle of serum levels of free thyroxine (FT4), free triiodothyronine (FT3), hyroid stimulating hormone (TSH) and LDL-C were examined within 24 hours of admission; 12 lead ECG and echocardiography were conducted to analyze the related factor for AF occurrence.
Results: Compared with Sinus rhythm group, AF group had increased FT4 level as 14.52 (12.74, 15.85) pmol/L vs 13.11 (11.68, 14.85) pmol/L,P<0.001, while FT3 level was similar between 2 groups as 4.06 (3.76, 4.44) pmol/L vs 4.1(3.80, 4.52) pmol/L,P=0.250. Spearman related analysis indicated that FT4 level was positively related to left atrial dimension (LAD) (r=0.134,P=0.016), FT3 level was positively related to LDL-C (r=0.235,P<0.001) and negatively related to age (r=-0.268, P<0.001). Taking FT4 as the continuous variable, Logistic regression analysis indicated that FT4 level [OR=1.227, 95% CI (1.112-1.354),P<0.001], LAD [OR=1.154, 95% CI (1.105-1.205),P<0.001], age [OR=1.038, 95% CI (1.012-1.064),P=0.003], CHF duration [OR=1.111, 95% CI (1.021-1.209),P=0.015], LDL-C level [OR=0.689, 95% CI (0.493-0.963),P=0.029] were related to AF prevalence in CHF patients.
Conclusion: High serum level of FT4 may increase the risk AF occurrence in CHF patients.
4.Study on the relationship between serum level of visfatin and coronary heart disease
Guijian ZHOU ; Ningru ZHANG ; Heng ZHANG ; Tao TIAN ; Bin CHEN ; Yang TANG ; Chengzhen RONG
Clinical Medicine of China 2011;27(4):384-386
Objective To study the relationship of serum visfatin level and coronary heart disease (CHD). Methods Eighty eight hospitalized patients were enrolled into the study and divided into CHD group(n = 62) and non-CHD control group(n = 26) according to the angiography results; the CHD group was further divided into single-, double-, multi-vessel affected groups. The serum level of visfatin was measured by ELISA,the lesion severity of coronary arteries was assessed by Gensini coronary scoring system, and the correlation between serum visfatin level and coronary lesion severity was evaluated statistically. Results The level of serum visfatin was significantly higher in CHD group than the control group([ 10. 77 ± 2. 63 ] μg/L vs. [ 7. 13 ± 2. 06 ]μg/L,P < 0. 05). The visfatin level increased along with the the number of stenosis vessels(P < 0. 05). The sermn visfatin levels of no stenosis, single-, double-, multi-vessel groups were(7. 13 ± 2. 06) μg/L,(9. 30±2. 19) μg/L,(10. 81 ± 2. 12) μg/L,(12. 79 ± 2. 20) μg/L respectively. A significant positive correlation was found between coronary lesion severity score and serum visfatin level(r = 0. 483, P < 0. 01). Conclusion The visfatin may be directly related to the initiation and development of coronary diseases. The higher level of serum visfatin was, the more severe coronary artery disease would be.

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