Endoscopic submucosal dissection for symptomatic giant colonic lipomas / 中华消化内镜杂志

To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of symptomatic giant colonic lipomas (≥5 cm). Eight patients with giant colonic lipomas were treated with ESD at the Department of Digestive Endoscopy, Shanghai East Hospital from December 2018 to December 2021. The complete resection rate was 100% with the mean size of the resected lesion of 6.0 cm (ranging from 5.5 cm to 9.0 cm). The mean operation time of ESD was 41 minutes (ranging from 25 minutes to 80 minutes). Minimal bleeding were all successfully stopped with electrocoagulation and 2 small perforations were successfully sutured during the procedures. No abdominal pain, fever, delayed bleeding or perforation occurred after ESD. The mean hospital stay was 3 days (ranging from 3 days to 5 days). No residual or recurrence was found during the follow-up of 8-36 months. Thus, ESD is safe and effective for the treatment of giant colonic lipomas which can avoid surgical resection.

Comparison of effects of streptavidin and dimethylsilicone oil on the detection rate of microscopic lesions under gastroscopy / 中华消化内镜杂志

To investigate the effects of streptavidin and dimethylsilicone oil on the detection rate of microscopic lesions under gastroscopy, a total of 353 patients who underwent painless gastroscopy were categorized into the experimental group (given streptavidin combined with sodium bicarbonate, n=176) and the control group (given dimethylsilicone oil combined with sodium bicarbonate, n=177). Clinical indexes such as visual field clarity, examination duration, number of rinses, detection rate of micro lesions, early cancer detection rate and incidence of adverse reactions were recorded in the gastroscopy examination of the two groups. The experimental and control groups were compared in terms of visual field clarity (1.84±0.51 points VS 2.15±0.48 points, t=-5.900), fundus mucus properties (1.04±0.43 points VS 1.46±0.76 points, t=-6.347) and number of rinses (0.76±0.66 times VS 1.18±0.72 times, t=-5.628) with significant differences ( P<0.001). The examination time in the experimental group was slightly higher than that in the control group (10.01±4.40 min VS 8.98±4.22 min, t=2.239, P=0.026). The detection rate of microscopic lesions was significantly higher in the experimental group than that in the control group [97.73%(172/176) VS 91.53%(162/177), χ2=6.665, P=0.010]. There was no significant difference in the detection rate of inflammatory hyperplasia, polyps, precancerous lesions or cancer between the experimental group and the control group ( P>0.05). There was no preoperative drinking discomfort in either group, and 4 cases of intraoperative choking occurred in each of the experimental and the control group with no significant difference ( P>0.999). No postoperative adverse reaction occurred in either group. Taking streptavidin before operation could significantly improve visual field clarity and the detection rate of microscopic lesions, which helps to detect early lesions in stomach.

Retrospective investigation and analysis of pertussis in Ninghai County， Zhejiang Province from 2018 to 2019 / 上海预防医学

ObjectiveTo characterize the incidence of laboratory confirmed pertussis cases by immunization status in Ninghai County， and to provide evidence for improving pertussis prevention and control strategy in Ninghai County. MethodsData of reported pertussis cases in Ninghai County from 2018 to 2019 were collected through the National Notifiable Infectious Disease Reporting System. The immunization history of vaccines related to pertussis was collected through the Ningbo Immunization Planning Information Management System and field investigation. Descriptive epidemiological methods were used to analyze the collected data. ResultsThe respiratory secretions collected in the 64 cases tested positive for nucleic acid of Bordetella pertussis bacilli， of which 56.25% aged 0‒1 year. They were mainly pre-school children. No adolescent or adult case was reported. All cases had whooping cough. Of the cases， 78.13% had an increase in white blood cell count， 62.5% had an increase in lymphocyte percentage， 59.38% had completed three or more doses of pertussis vaccination， 69.39% had a time interval of >1 year between the onset and last dose of pertussis vaccination， and 31.25% reported close contact with pertussis patients before the onset. The misdiagnosis rate of pertussis was as high as 92.19%. In contrast， the prevalence of anti-pertussis IgG antibody in health population was 1.05%. ConclusionFurther improvement in the laboratory testing capacity can help clarify the diagnosis of pertussis. Generally， children aged 0-1 year are mainly affected， of which vast majority have received at least one dose of pertussis vaccination. Clinical symptoms are characterized by whooping cough. Additionally， elevated white blood cells and lymphocytes should be on the alert to pertussis infection.

Application of preoperative colonoscopic autologous blood labeling to localization for laparoscopic colorectal surgery / 中华消化内镜杂志

To evaluate the effect of preoperative colonoscopic autologous blood labeling to localization for laparoscopic colorectal surgery, data of 30 patients with colorectal neoplasms who underwent colonoscopic autologous blood localization followed by laparoscopic surgery in Shanghai East Hospital, Tongji University from January 2019 to January 2021 were retrospectively analyzed. The location of lesions was determined by local red marks on the serosal surface of the colon during laparoscopic surgery. The clarity of staining and whether there was leakage of injected autologous blood were observed. All patients successfully completed the localization of autologous blood under colonoscopy, without bleeding, perforation, fever or other complications. Laparoscopic exploration showed clear sites of autologous blood staining, without staining dispersion or leakage polluting the operation field. Postoperative pathology confirmed that the margin of the specimen was negative. The injection of autologous blood under colonoscopy is a safe and effective preoperative localization method for laparoscopic colorectal neoplasms surgery, which is worthy of clinical recommendation.

The clinical characteristics and influencing factors on postoperative emotion and cognitive functions for elderly versus non-elderly male patients with laryngeal cancer / 中华老年医学杂志

Objective:To analyze the clinical characteristics and influencing factors on postoperative emotional and cognitive function for elderly versus non-elderly male patients with laryngeal carcinoma.Methods:The patients with laryngeal cancer hospitalized in the Department of Otorhinolaryngology-Head and Neck Surgery were selected for a questionnaire survey in two Grade III-A Hospital in Shanxi Province from January 2018 to December 2019.There were 105 patients with laryngeal cancer, including 60 in the elderly and 45 in the non-elderly group.Negative emotion and cognitive function were investigated by using Self-rating Anxiety Scales(SAS), Self-rating Depression Scale(SDS), and Montreal Cognitive Assessment(MOCA)before surgery, 10 days after surgery, and 1 year after surgery, respectively.The clinical characteristics of the elderly versus non-elderly groups were analyzed and compared.Results:One year after surgery, there were 52 cases(86.7%)and 27 cases(45.0%)of depression and cancer-related cognitive impairment(CRCI)in the elderly group, which were higher than 30 cases(66.7%)and 4 cases(8.9%)in the non-elderly group, with statistically significant difference( χ2 = 6.013, χ2 =16.115 and P<0.05, P<0.01). The elderly group showed much more anxiety and CRCI 10 days after surgery(60.50±4.31 vs.55.84±3.81, 27.47±1.08 vs.28.31±1.08, P<0.01)and showed much more depression and CRCI(57.20±5.66 vs.62.60±5.37, 27.36±1.37 vs.26.08±1.42, P<0.01)than did the non-elderly group 1 year after surgery.The results of multiple linear regression analysis in the elderly group showed that the mode of operation and the pronunciation one year after surgery significantly affected their anxiety; the marriage and the educated level significantly affected their depression; the marriage, the educated level and operation mode significantly affected their cognitive function.Clinical stage of tumor significantly affected anxiety and depression, the educated level significantly affected cognitive function in the non-elderly group. Conclusions:Postoperative negative emotion and cognitive function in patients with laryngeal cancer continues to deteriorate after surgery, which were affected by many factors, especially in elderly patients.It is necessary to conduct active and effective interventions as soon as possible.

Efficacy and safety of different drugs by balloon catheter injection for no-reflow following percutaneous coronary intervention / 中华全科医师杂志

Objective To evaluate the efficacy and safety of different drugs injected via balloon catheter for no-reflow after percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI).Methods From January 2016 to December 2017,1 280 patients with STEMI were treated in Department of Cardiology,Beijing Luhe Hospital.All patients were underwent PCI and stent implantation in related infarct vessels (IRA).Among 1 280 patients no-reflow occurred in 164 cases (12.81％) during the procedure.No-reflow patients were divided into three study groups according to the order of consultation,who were given verapamil (verapamil group,55 cases),tirofiban (tirofiban group,55 cases) or nitroglycerin (nitroglycerin group,54 cases) by injection through balloon catheter.Coronary blood flow recovery (TIMI grading),myocardial perfusion level TMP grading (TMPG),average dose of drugs (mg) and adverse drug reactions (ADR) were compared among the three groups.Left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) were evaluated by echocardiography 7 and 30 d after operation.The incidence of major adverse cardiovascular events (MACE) was followed up.Results TIMI-3 ratio in verapamil,tirofiban and nitroglycerin groups was 89.90％ (49/55),91.82％ (45/55) and 61.11％ (33/54),respectively (Hc=13.920,P＜0.05).TMP-3 ratio was 72.73％(40/55) in verapamil group,65.45％ (36/55) in tirofiban group and 50.0％ (27/54) in nitroglycerin group,respectively (Hc=6.230,P＜0.05).During the procedure,one case (1.82％) had slow heart rate and one case (1.82％) had hypotension in verapamil group;three cases 5.56％) had transient hypotension in nitroglycerin group,and there was no significant difference in the incidence of ADR among the three groups (Hc=0.040,P＞0.05).There was no significant difference in LVEF and LVEDV among three groups on the d7 after operation (all P＞0.05).The improvement of LVEF and LVEDV was more significant in verapamil group on d30 after operation (all P＜0.05).One case (1.82％) of heart failure occurred in tirofiban group,three cases of heart failure and one case of recurrent myocardial infarction occurred in nitroglycerin group during six months of follow-up.There was no significant difference in the overall incidence of MACE among the three groups (Hc=0.070,P＞0.05).Conclusion Verapamil can be injected throμgh balloon catheter to restore coronary blood flow rapidly,effectively and safely,and improve left ventricular function in STEMI patients with no-reflux during PCI.

Effects of Long-term Oral Low-dose of Azithromycin on Pulmonary Function and Clinical Signs of Pa-tients with Stable COPD:A Systematic Review / 中国药房

OBJECTIVE:To systematically review the effects of long-term oral low-dose of azithromycin on pulmonary func-tion and clinical signs of patients with stable COPD. METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang da-tabase,randomized controlled trials(RCTs)about long-term oral low-doses of azithromycin for stable COPD were collected. After quality evaluation according to modified Jadad scale,Meta-analysis was conducted by Rev Man 5.2 statistical software. RESULTS:A total of 13 RCTs were included,involving 1207 patients. Meta-analysis showed that,long-term oral low-doses of azithromycin could significantly improve FEV1[SMD=0.78,95%CI(0.62,0.93),P<0.001],FEV1%[SMD=0.81,95%CI(0.61,1.00),P<0.001],FEV1/FVC [SMD=3.91,95%CI(2.58,5.24),P<0.001] and 6MWD[SMD=23.74,95%CI(21.20,26.18),P<0.001] in sta-ble COPD patients,meanwhile significantly reduce dyspnea score [SMD=-1.15,95%CI(-1.60,-0.71),P<0.001],quality of life score [SMD=-1.82,95%CI(-2.74,-0.90),P<0.001] and 24 h sputum volume[SMD=-18.68,95%CI(-24.79,-12.56), P<0.001],with statistical significance. CONCLUSIONS:Long-term oral low-doses of azithromycin can improve pulmonary func-tion,dyspnea,activity tolerance and quality of life in acute exacerbation of COPD patients.

Correlation Study Between Synchronic Heart Rate Variability, Blood Pressure Variability and Blood Vessel Damage in Patients With Essential Hypertension / 中国循环杂志

Objective: To investigate the relationship between heart rate variability (HRV), blood pressure variability (BPV) and autonomic nerve function, blood vessel damage in patients with essential hypertension (EH) via synchronous monitoring. Methods: A total of 275 EH patients admitted to our hospital from 2011-04 to 2014-01 were enrolled. The vascular function was assessed by carotid-femoral pulse wave velocity (PWV). Based on PWV, the patients were divided into 2 groups: Normal PWV group (PWV<9m/s),n=185 and High PWV group (PWV≥9m/s),n=90. Synchronic 24h dynamic electrocardiogram (Holter) and 24h ambulatory blood pressure monitoring (ABPM) were performed in all patients. t-test, chi-square test, person liner correlation study and multi stepwise regression analysis were conducted to explore the relationship between HRV, PBV and PWV. Results: HRV and BPV in High PWV group had been changed unusually. Compared with Normal PWV group, High PWV group showed decreased standard deviation of the average of all normal-to-normal intervals in all 5-minute intervals (SDANN) (159.66±66.50) ms vs (194.36±119.29) ms and increased 24 h systolic blood pressure standard deviation (24h SSD) (14.40±3.65) mmHg vs (12.98±3.46) mmHg, all P<0.01; increased new index of night/day HR ratio (0.90±0.08) vs (0.87±0.06), P<0.01 and it had liner correlation to PWV (r=0.169, P=0.005). Multi stepwise liner regression analysis indicated that 24hSSD and HRV at low frequency (LF) portion had obvious and independent correlation to PWV (standard β value=0.352 and 0.212 respectively). Conclusion: ① EP patients were with decreased HRV (SDANN), increased BPV (24h SSD) and the higher incidence of arteriosclerosis; 24h SSD and HRV at LF portion were the most 2 important risk factors affecting PWV. ②Autonomic nerve dysfunction, vagus nerve over-excitatory were the independent risk factors for promoting the occurrence and development of arteriosclerosis in EH patients. ③Night/day HR ratio as a sensitive index for examining autonomic nerve function was independently related to hypertensive vessel damage. Synchronic monitoring of HRV and BPV is helpful to identify blood vessel damage in EH patients.

Influence of drinking pattern and alcoholic fatty liver disease in coal miners / 中国综合临床

Objective To investigate the drinking pattern and the condition of alcoholic fatty liver disease in a certain coal mine workers in Shanxi Province.Methods A total of 1501 workers in a coal mine in Shanxi Province were surveyed by field investigation method.Contents include questionnaire, physical measurement, abdominal ultrasound liver and fasting blood glucose, blood lipid, liver function, cholesterol, blood biochemical indicator detection.ALD diagnostic criteria for fatty liver and alcoholic liver disease group were .recommended by the Chinese Medical Association in 2010.The t test,X2 test and multiariable logistic regression analysis were conducted by SPSS17.0 software.Results This study involved ALD patients with 265 people, accounting for 17.65％ of the total survey.The drinking pattern, such as drinking patterns in the initial drinking age,long duration of drinking, drinking frequency, drunkenness, fasting drinking, average daily alcohol intake as the risk factors of alcoholic liver disease.The Logistic regression analysis of alcoholic liver disease related factors showed that, drinking age, drinking way and daily average alcohol intake were closely related to the occurrence of ALD(OR=0.942,P=0.769;OR=2.811,P=0.000;OR=1.756,P=0.000;OR=542.844,P=0.001) .Conclusion In the coal mine workers, drinking pattern in the initial drinking age, drinking age, daily average alcohol intake are closely related to ALD illness.

Hepatitis C virus infection increases the incidence of intrahepatic cholangiocarcinoma: a Meta-analysis / 中华肝胆外科杂志

Objective A meta-analysis was conducted to evaluate the correlation between hepatitis C virus (HCV) infection and the incidence of intrahepatic cholangiocarcinoma (ICC).Methods EMBASE,MEDLINE,Web of Science,CNKI,Weipu and Wanfang databases were retrieved to identify eligible studies which were published between January 2000 and May 2015.Pooled odds ratios (OR) with 95％ confidence interval (95％ CI) were calculated using RevMAN 5.3.Results 14 case-control studies and 2 cohort studies were included in this study.As there was great heterogeneity among these 16 studies (Chi2 =53.18,df =15,I2 =72％,P ＜0.05),the random-effect model was employed.The combined risk estimates of all the studies showed a significant increase in ICC incidence with HCV infection (OR =3.96,95％ CI 2.63-5.95,P ＜ 0.05).The Begg funnel plot showed no evidence of publication bias.Conclusion HCV infection is related to an increased risk of ICC incidence.

First medical contact to balloon time in primary percutaneous coronary intervention for ST-elevation myocardial infarction and its influencing factors / 中国介入心脏病学杂志

Objective To investigate the first medical contact to balloon ( FMC2B) time in our center and to identify the influencing factors .Methods This is a retrospective study conducted in the heart center of Beijing Luhe Hospital . A total of 140 patients undergoing primary percutaneous coronary intervention ( PCI) were enrolled between July 2013 to September 2014.Demographic data , clinical risk factors and the emergency process were evaluated .All the patients were categorized into 2 groups including:the conformed group ( patients with FMC2B<120 min for non-PCI-capable hospital and <90 min for direct arrival at Luhe hospital, n=59) and the unconformed group (n=81).Multivariant regression aralysis was done to analyse factors influencing FMC 2B time.Results Among the enrolled 140 patients, 58 patients were initially seen in a non-PCI-capable hospital , 31 patients were directly sent to Luhe hospital by ambulance and 51 patients arrived by themselves.The median FMC2B time was 106.16 min (interquartile range [ IQR ]: 77.37 -165.52 min ) and 42.1% ( 59/140 ) of the patients achieved the current recommended FMC2B time.In a multivariate logistic analysis , FMC to electrocardiographic ( ECG) within 10 min ( OR=5.61 , 95% CI 1.91-16.88 ) , admission during normal working hours ( OR=5.11 , 95%CI 1.88-13.85 ) , patient′s education level of high school or above ( OR=4.16 , 95%CI 1.53-11.34 ) , awareness of heart diseases ( OR =2.58, 95% CI 1.13 -5.91 ) were predictors of improving FMC2B. Transfer for primary PCI (OR=0.37, 95% CI 0.15-0.92) increased FMC2B.Conclusions Less than half of the patients with primary PCI achieved the goal of guidelines′recommended FMC2B time.Initial ECG, admission during normal working hours , patient′s education level and awareness of heart diseases and transfer for primary PCI are the independent predictors of FMC 2B time.

Clinical analysis on 48 cases of kidney transplantation from brain and cardiac death donors / 中华肾脏病杂志

Objective To observe the short?term clinical outcomes of kidney transplantation from brain and cardiac death donors (DBCD) and assess its feasibility to expand organ donor pool. Methods A retrospective analysis was performed on 48 cases of kidney transplantation from DBCD. The transplant recipients had finished 12?month follow?up in the First People's Hospital of Foshan from September 2011 to February 2015, with their renal function, rejection reaction and complications at 1 week, 1 month, 3 months, 6 months and 12 months after renal transplantation being collected. Survival rates of transplant recipients and transplant kidneys, incidence of delayed graft function (DGF) and its influence for recipients and graft survival were analyzed by statistics. Results In the 48 cases, the survival rates of recipients at 1, 3, 6 and 12 months after transplantation were 100.0%, 100.0%, 97.9%, 95.8%, and the survival rates of transplanted kidneys were 95.8%, 95.8%, 93.8%, 91.7%, respectively. DGF occurred in 8 of 48 (17.0%), but the occurrence of DGF did not adversely influence patient's survival (P=0.524) or graft survival (P=0.362). Conclusions The short?term clinical outcomes of kidney transplantation from DBCD are ideal. As the legislation of donation after brain death (DBD) has not been ratified in China, the kidney transplantation from DBCD could be an important way to solve the shortage of organs, and increase the number of kidneys available for transplantation.

China’s participation of global environment and health governance:Opportunities, challenges and policy recommendation / 中国卫生政策研究

China faces opportunities and challenges as well when it participates in global environment and health governance. Major opportunities are as follows:(1) The convergence between global environment and health governance’s future trend and China’s environment and health strategies is a strongest incentive to push China to par-ticipate in global environment and health governance;(2) China can benefit from this participation in term of more access to international resources; ( 3 ) Global environmental and health issues are the areas that can best illustrate China’s international image as a responsible member; ( 4 ) Since global environmental and health governance is still young, early participation will give China a louder voice in its decision-making. The challenges that China faces are as follows:(1) Huge pressure from domestic environment and health challenges forces China to be primarily inward-looking and makes it very hard for the country to keep a high profile in global environment and health governance. China also faces the increasing international pressure. ( 2 ) The lack of global environment and health governance strategy prevents China from effectively participating in global environment and health governance. (3)“The Grand Health Outlook”hasn’t been fully established yet in China, leaving much room for improvement. (4) Intellectual sup-port is inadequate. (5) Some countries have too high expectations of China in terms of its contribution to global envi-ronmental and health governance. In order to effectively participate in this field, China should undertake coordinated planning on both the international and domestic scenes, and take some specific policies both at national and interna-tional level.

Understanding the linkage of environment and health:A case study of China / 中国卫生政策研究

Since 1949 , the linkage of environment and health in China has been mainly reflected in the is-sues, knowledge, policy and laws, organizations and the interactions between domestic and external factors, featuring the increasing expansion and complexity. The weak and inefficient environment and health governance institutions and the poor environment and health problems coping ability are the two major challenges that face the current environ-ment and health governance in China.

The linkage of global environment and health:Deepening of the scientific understanding / 中国卫生政策研究

This paper introduces and analyzes the changes of scientific understanding in the linkage of global envi-ronment and health from historical and environment perspective, emphasizing on the fact that:the environmental issue im-pacts on human health are attracting an increased attention and emphasis from the international community;the existing re-search has fully proved a clear causal relationship between environmental issues which constitute one of the major factors that lead to a variety of human diseases and human health risks;the environmental issues effects on health quantified at the global level are the highlights and difficulties in the related research, differences in the current research methods and con-clusions exist internationally, but quantitative research is popular; the integration perspective of the existing scientific knowledge and global policy is a huge challenge placed in front of the global environment and health governance.

The linkage of global environment and health:Policy response and institutional construction / 中国卫生政策研究

Based on the global governance prospective, this paper examines the linkage of global environment and health and the structural features in terms of the policy and institutions system level, the future challenges are al-so analyzed as well. From the institutional perspective, the linkage of global environmental and health is mainly re-flected in laws, norms, governance models, actors and institutions. The current global environment and health gov-ernance structure presents three characteristics: it experiences a rapid formation; it remains fragmented, loose and fragile, thus it has much room for future development;and it is held on dominating advantage in science, engineering and technology, funds, diplomatic skills and other aspects for the developed countries. There is also a potential con-flict between environment and health which may be from their different values or from different understanding of the relationship between them. Therefore, the future global environment and health governance faces challenges like po-liticization and national security considerations.

Toxicity and Anti-inflammatory Effect of Total Saponins from Panax japonicus by Different Extraction Technology / 中国中医药信息杂志

Objective To compare the toxicity and anti-inflammatory effect of total saponins from Panax japonicus by different extraction technology. Methods The total saponins of sample 1, sample 2, sample 3, sample 4, sample 5 and sample 6 was prepared respectively by different process, and RAW264.7 cells were treated with the samples of different concentration. Then cells morphology was observed under microscope, thiazolyl blue (MTT) method was used to detect cell activity, the nitric oxide (NO) release of RAW264.7 cells was detected with NO kit. Results The cell toxicity of different samples from low to high was as follows:sample 4sample 5>sample 2>sample 6>sample 1>sample 3. Conclusion Among these six different kinds of extraction process of total saponins from Panax japonicus, the total saponins extract by foam fractionation has not only the minimal toxicity, but also the best primary anti-inflammatory effect.

Evaluation effect of three scoring systems in the prediction of short-term outcomes following liver transplantation / 中华肝胆外科杂志

Objective To evaluate the predictive effect of preoperative CTP score,MELD score and MELD-Na score on short-term prognosis (≤ 3 months) after liver transplantation,to analyze factors which correlated with survival,and to seek indicators that accurately predicted short-term outcomes.Methods The clinical data of 73 consecutive patients with end-stage liver diseases who underwent liver transplantation in a single center were retrospectively analyzed.The area under the ROC curve (AUC) was used to determine the predictive power.Correlated factors were analyzed by multivariate logistic regression.The statistical processing package used was SAS 9.1.3 software.Results 11 (15.1％) of 73 patients died within 3 months after liver transplantation.The areas under the ROC curve of the preoperative CTP score,MELD score and MELD-Na score for predicting short-term survival were 0.817,0.839 and 0.860 respectively.There was no significant difference among these 3 scoring systems.On univariate analysis,indicators significantly correlated with early mortality were preoperative serum sodium,serum urea,PT-INR,CTP score,MELD score and MELD-Na score.On logistic multiple regression,only MELD-Na score remained as a significant indicator (P =0.001,β =-2.496,OR =0.085,95％ CI:0.019 ～ 0.370).Conclusions The MELD-Na scoring system showed superior predictability of early mortality in patients who underwent liver transplantation.The preoperative MELD-Na score was an independent risk factor of short-term survival.The higher the MELD-Na score,the higher was the early mortality.

Effect of intracoronary injection of tirofiban via aspiration catheter on myocardial no-reflow in elderly patients with acute ST-segment elevation myocardial infarction / 中华老年医学杂志

Objective To evaluate the effect of early intracoronary injection of tirofiban via aspiration catheter on myocardial no-reflow in elderly patients with acute ST-segment elevation myocardial infarction (STEMI).Methods 120 consecutive patients over 65 years old with AMI undergoing primary percutaneous coronary intervention (PCI) were randomized into two groups.In tirofiban group (n=60),thrombus aspiration and intracoronary tirofiban bolus (10 μg/kg prior to the first balloon inflation) via aspiration catheter were performed.In control group (n=60),thrombus aspiration was followed by primary PCI.The incidence of no-reflow and bleeding were assessed in the two groups.Results The moderate to severe bleeding (TIMI bleeding criteria) did not occur in the two groups,there's no significant difference between two groups in the incidence of minor bleeding [26.7％(16 cases) vs.21.7％ (13 cases),x2 =0.19,P=0.522].The incidence of myocardial noreflow was significantly lower in tirofiban group than in the control group [10.0％ (6/60) vs.25.0％ (15/60),x2 =4.68,P=0.031].Conclusions The intracoronary injection of tirofiban via aspiration catheter may significantly reduce the incidence of myocardial no-reflow in patients with STEMI without increasing bleeding complications.

Impact of domestic bivalirudin on platelet function during emergency percutaneous coronary interven-tion / 心血管康复医学杂志

Objective:To explore the impact of domestic bivalirudin on platelet function during emergency percutane-ous coronary intervention (PCI) .Methods :A total of 100 patients with acute ST segment elevation myocardial in-farction who recieved emergency PCI were randomly divided into unfractionated heparin group (UFH group ,n=53) and bivalirudin group (n=47) .Adenyl diphosphoric acid (ADP)-induced platelet aggregation rate was meas-ured and statistically compared between two groups before and after PCI .Results:Before emergency PCI ,there was no significant difference in ADP-induced platelet aggregation rate between two groups (P=0.99) .After emergency PCI ,ADP-induced platelet aggregation rate in bivalirudin group was significantly lower than that of UFH group [ (16.46 ± 10.23)% vs .(25.21 ± 15.91) % , P<0.01] .Conclusion:During percutaneous coronary intervention , compared with routine heparin anticoagulation , bivalirudin , as an anticoagulant , can more significantly inhibit platelet aggregation and possess antiplatelet effect .