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ObjectiveTo explore the relationship of postoperative systemic inflammatory response syndrome(SIRS) and preoperative midway through the urine and perioperative renal pelvis urine of percutaneous nephrostolithotomy(PCNL).Methods Participants included 450 patients with urinary calculus who underwent PCNL,preoperative midway through the urine and perioperative renal pelvis urine of PCNL was collected.ResultsOf 450 cases,preoperative midway through the urine germiculture positive 100 cases (22.2％,100/450 ),perioperative renal pelvis urine germiculture positive 85 cases (18.9％,85/450),46 cases ( 10.2％,46/450) occurred SIRS after PCNL.Decompression of perioperative renal pelvis urine germiculture positive 20 cases(23.5％,20/85) preoperative midway through the urine germiculture positive,perioperative renal pelvis urine the bacteria cultures negative 80 cases (21.9％,80/365 ) preoperative midway through the urine germiculture positive(P ＞0.05),preoperative midway through the urine germiculture positive 15 cases ( 15.0％,15/100) in SIRS,preoperative midway through the urine the bacteria cultures negative 31 cases ( 8.9％,31 /350) in SIRS (P ＞ 0.05 ).Decompression of perioperative renal pelvis urine germiculture positive 18 cases (21.2％,18/85) in SIRS,perioperative renal pelvis urine the bacteria cultures negative 28 cases (7.7％,28/365) in SIRS (P ＜ 0.05 ).ConclusionPreoperative midway through the urine has no correlation with the occurrence of SIRS,perioperative renal pelvis urine germiculture positive can predict the occurrence of SIRS,giving corresponding antibiotic treatment can improve the security of PCNL.
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Objective:To define impact of spontaneous TIMI-3 flow before angioplasty on outcomes of percutaneous coronary intervention strategy and the prognosis in patients with acute myocardial infarction (AMI ). Methods: The consecutive 301 patients enrolled in the ongoing register of emergent coronary angioplasty within 12 hours from symptoms who were diagnosed as having ST elevation AMI in our hospital from 2000 to 2006 were analyzed, they were followed up for one year and the clinical characteristics and survival rates were analysed. Results: Among the 301 patients enrolled in the ongoing register of emergent coronary angioplasty, spontaneous reperfusion (TIMI-3 flow) was present in 14.6% at initial angiography. Compared with patients without TIMI-3 flow, those with TIMI-3 flow before coronary intervention were less likely to present in new-onset heart failure(2.3% versus 16%, P=0.016), Patients with initial TIMI-3 flow had significantly lower 30-day mortality (0% versus 9.3%, P=0.035) , and cardiogenic shock (0%versus 8.6%, P=0.044) and had a shorter hospital stay (P=0.008). Cumulative 1-year mortality was 0% in patients with initial TIMI-3 flow, 11.3% with TIMI 0-2 flow (P=0.019). By COX regression analysis, postprocendural TIMI-3 flow was an independent determinant of survival (OR=0.285,P=0.004) , however,TIMI-3 flow before coronary intervention was not found as an independent determinant of survival significantly. The lenitive symptoms and current smoking were the independent determinants of TIMI-3 flow before coronary intervention (P=0.005, P=0.048, respectively).Conclusion: Patients undergoing primary percutaneous transluminal coronary intervention in whom TIMI-3 flow is present before angioplasty may present with greater clinical and angiographic evidence of myocardial salvage, be less likely to develop complications related to left ventricular failure, and improve early and late survival.
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<p><b>OBJECTIVE</b>To compare the efficacy of low dose recombinant tissue-type plasminogen activator (rt-PA) thrombolysis with primary coronary stenting after acute myocardial infarction.</p><p><b>METHODS</b>Of 261 patients with first acute myocardial infarction, 131 were given low dose rt-PA intravenous thrombolysis, and 130 primary coronary stenting.</p><p><b>RESULTS</b>The age, time from onset of chest pain to hospital presentation and infarct location between these two groups were comparable. The patency rate of the infarct-related artery (IRA) in patients in the thrombolysis group was significantly lower than that of patients in the primary stenting group (P < 0.001). Recurrent myocardial infarction, and selective coronary stenting of patients with thrombolytic therapy were higher than that of patients in the primary stenting group (7.6% vs 1.5%, P < 0.05; 20.6% vs 0, P < 0.001, respectively). Left ventricular ejection fraction (LVEF) in patients in the thrombolysis group was lower than that of the stent group (55.6% +/- 13.4% vs 65.8% +/- 9.2%, P < 0.001). Total hospitalization time of the thrombolysis group was longer than that of the stent group (16 +/- 7 d vs 11 +/- 4 d, P < 0.001). Mortality in the thrombolysis group was higher than that of the stent group, but this difference was not significant (6.1% vs 3.1%, P > 0.05).</p><p><b>CONCLUSION</b>Comparing with low dose rt-PA thrombolytic therapy after acute myocardial infarction, primary coronary stenting has a higher patency rate of the IRA, better cardiac function and shorter hospitalization time.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Myocardial Infarction , Therapeutics , Recombinant Proteins , Therapeutic Uses , Stents , Thrombolytic Therapy , Tissue Plasminogen Activator , Therapeutic UsesABSTRACT
Objective In order to understand the mechanisms beyond lipid regulation of 3 hydroxy 3 methyl glutaryl coenzyme A(HMG CoA) reductase inhibitors in anti atherosclerosis, we observed the influence of pravastatin on the pathogenesis of atherosclerotic lesions and the expression of intercellular adhesion molecule (ICAM) 1 in aortic wall of the apoE deficient mice. Methods Pravastatin(10 mg?kg?d -1 ) was fed to 10 , 20 , and 30 week old male apoE deficient mice respectively for 4 weeks. The atherosclerotic plaque size and the ratio of plaque area to aortic luminal area (PA/LA) were determined by histochemical staining and analyzed quantitatively. The expression of ICAM 1 in aortic wall of apoE deficient mice was detected by immunohistochemistry and Western blotting. Results Compared with controls, pravastatin delayed the plaque formation in apoE deficient mice 〔(161 786 1?38 041 2) ?m 2 vs (99 127 9?13 600 3) ?m 2, P
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On the model of isoprenaline (ISO)-perinjured rat heart, the protctive effect of ischemic preconditioning (IPC) on ischemia reperfusion (I/R) damage was observed.It was found that compared with alone I/R group,IPC ameliorated I/R-induced reduced reduction of coronary blood flow (CBF) (8. 8 + 0. 6 vs 6. 6 + 0. 4mL/min,P