Chlorhexidine - a commonly used but often neglected culprit of dialysis associated anaphylactic reactions (case report).

BACKGROUND: Hemodialysis-associated anaphylactic reactions are rare and frequently complex in nature due to the sheer number of possible culprit agents. Unfortunately, dialysis is often unavoidable or strictly essential for life-saving solute clearance or fluid removal in patients with end stage kidney failure and those with severe acute kidney injury. It is of utmost importance that the culprit agent is identified and avoided to allow continuation of dialysis treatment as needed. CASE PRESENTATION: We present 2 cases of hemodialysis-associated anaphylactic reactions. These patients developed anaphylactic reactions peri-dialysis and were initially suspected to have dialyser reactions. They were investigated in a controlled healthcare setting and possible culprit agents were systemically identified and eliminated. They both underwent allergy testing and were diagnosed with chlorhexidine allergy. Of note, Case 1 was an incident dialysis patient at the time of presentation and Case 2 was a prevalent dialysis patient. This suggests that the time from initial sensitization to reaction may not always be helpful in determining if a particular agent is the culprit of an anaphylactic reaction. In both cases, the patients were dialysed through a tunnelled dialysis catheter. We postulate that the presence of an exit site, which represents a compromise to the integrity of the skin's epidermal barrier, may have a significant role in the development of these reactions. As chlorhexidine is a widely used disinfectant in hemodialysis, it is imperative that we consider it as a possible culprit agent when these reactions arise. To our knowledge, there are no other reported cases of anaphylaxis secondary to chlorhexidine use in dialysis patients other than a previous report in 2017. Our report also highlights the possibility of these reactions occurring more frequently in patients with damaged epidermal barriers and in patients exposed to higher environmental concentrations of chlorhexidine. These are novel concepts that can be explored with further research. CONCLUSION: Chlorhexidine associated anaphylactic reactions can occur in the peri-dialysis setting and a high index of suspicion is paramount to diagnosis.

Neural Network-Based Strong Motion Prediction for On-Site Earthquake Early Warning.

Developing on-site earthquake early warning systems has been a challenging problem because of time limitations and the amount of information that can be collected before the warning needs to be issued. A potential solution that could prevent severe disasters is to predict the potential strong motion using the initial P-wave signal and provide warnings before serious ground shaking starts. In practice, the accuracy of prediction is the most critical issue for earthquake early warning systems. Traditional methods use certain criteria, selected through intuition or experience, to make the prediction. However, the criteria thresholds are difficult to select and may significantly affect the prediction accuracy. This paper investigates methods based on artificial intelligence for predicting the greatest earthquake ground motion early, when the P-wave arrives at seismograph stations. A neural network model is built to make the predictions using a small window of the initial P-wave acceleration signal. The model is trained by seismic waves collected from 1991 to 2019 in Taiwan and is evaluated by events in 2020 and 2021. From these evaluations, the proposed scheme significantly outperforms the threshold-based method in terms of its accuracy and average leading time.

Di(2-ethylhexyl)phthalate induces reproductive toxicity via JAZF1/TR4 pathway and oxidative stress in pubertal male rats.

Di(2-ethylhexyl)phthalate (DEHP) is a typical endocrine-disrupting chemical and reproductive toxicant. Although previous studies have attempted to describe the mechanism by which DEHP exposure results in reproductive dysfunction, few studies focused on puberty, a critical period of reproductive development, and the increased susceptibility to injury in adolescents. To elucidate the mechanism underpinning the testicular effects of DEHP in puberty, we sought to investigate the JAZF1/TR4 pathway in the testes of pubertal rats. Specifically, we focused on the role of the JAZF1/TR4 pathway in male reproduction, including the genes JAZF1, TR4, Sperm 1, and Cyclin A1. In the present study, rats were exposed to increasing concentrations of DEHP (0, 250, 500, and 1000 mg/kg/day) by oral gavages for 30 days. Then we assayed testicular zinc and oxidative stress levels. Our results indicated that DEHP exposure could lead to oxidative stress and decrease the contents of testicular zinc. Additionally, significant morphological changes and cell apoptosis were observed in testes exposed to DEHP, as identified by hematoxylin and eosin staining and the terminal deoxynucleotidyl transferase-mediated nick and labeling assay. By measuring the expression levels of the above relevant genes by qPCR, we found the DEHP-induced increased expression of JAZF1 and decreased expression of TR4, Sperm 1, and Cyclin A1. Therefore, we have demonstrated that in vivo exposure to DEHP might induce reproductive toxicity in pubertal male rats through the JAZF1/TR4 pathway and oxidative stress.

Common Genotypes of Long QT Syndrome in China and the Role of ECG Prediction.

OBJECTIVES: Genetic testing, a gold standard for long QT syndrome (LQTS) diagnosis, is time-consuming and costly when all the 15 candidate genes are screened. Since genotype-specific ECG patterns are present in most LQT1-3 mutation carriers, we tested the utility of ECG-guided genotyping in a large cohort of Chinese LQTS patients. METHODS AND RESULTS: We enrolled 230 patients (26 ± 17 years, 66% female) with a clinical diagnosis of LQTS. Genotypes were predicted as LQT1-3 based on the presence of ECG patterns typical for each genotype in 200 patients (85 LQT1, 110 LQT2 and 5 LQT3). Family-based genotype prediction was also conducted if gene-specific ECG patterns were found in other affected family members. Mutational screening identified 104 mutations (44% novel), i.e. 46 KCNQ1, 54 KCNH2 and 4 SCN5A mutations. The overall predictive accuracy of ECG-guided genotyping was 79% (157/200) and 79% (67/85), 78% (86/110) and 80% (4/5) for LQT1, LQT2 and LQT3, respectively. The predictive accuracy was 98% (42/43) when family-based ECG assessment was performed. CONCLUSIONS: From this large-scale genotyping study, we found that LQT2 is the most common genotype among the Chinese. Family-based ECG-guided genotyping is highly accurate. ECG-guided genotyping is time- and cost-effective. We therefore recommend it as an optimal approach for the genetic diagnosis of LQTS.

In situ detection of salicylic acid binding sites in plant tissues.

The determination of hormone-binding sites in plants is essential in understanding the mechanisms behind hormone function. Salicylic acid (SA) is an important plant hormone that regulates responses to biotic and abiotic stresses. In order to label SA-binding sites in plant tissues, a quantum dots (QDs) probe functionalized with a SA moiety was successfully synthesized by coupling CdSe QDs capped with 3-mercaptopropionic acid (MPA) to 4-amino-2-hydroxybenzoic acid (PAS), using 1-ethyl-3-(3-dimethyllaminopropyl) carbodiimide (EDC) as the coupling agent. The probe was then characterized by dynamic light scattering and transmission electron microscopy, as well as UV/vis and fluorescence spectrophotometry. The results confirmed the successful conjugation of PAS to CdSe QDs and revealed that the conjugates maintained the properties of the original QDs, with small core diameters and adequate dispersal in solution. The PAS-CdSe QDs were used to detect SA-binding sites in mung bean and Arabidopsis thaliana seedlings in vitro and in vivo. The PAS-CdSe QDs were effectively transported into plant tissues and specifically bound to SA receptors in vivo. In addition, the effects of the PAS-CdSe QDs on cytosolic Ca(2+) levels in the tips of A. thaliana seedlings were investigated. Both SA and PAS-CdSe QDs had similar effects on the trend in cytosolic-free Ca(2+) concentrations, suggesting that the PAS-CdSe QDs maintained the bioactivity of SA. To summarize, PAS-CdSe QDs have high potential as a fluorescent probe for the in vitro/in vivo labeling and imaging of SA receptors in plants.

[The value of chest computerized tomography in evaluation of bone disease and clinical prognosis of multiple myeloma].

OBJECTIVE: To assess the status and severity of bone disease in patients with multiple myeloma (MM) by using chest computerized tomography (CT) and the relationship between clinical prognostic parameters and bone disease. METHODS: All 46 newly diagnosed MM in-patients received both imaging tests of chest CT and plain X ray. An experienced radiologist reviewed all the imaging data. Clinical laboratory parameters, stages of Durie-Salmon (DS) and International Staging System (ISS) were evaluated. Five cytogenetic abnormalities of bone marrow myeloma cells were tested by fluorescence in situ hybridization (FISH). RESULTS: The sensitivity of CT and X ray to determine pathological fractures was comparable, the positive rates of which were 41.3% (19/46) and 30.4% (14/46) respectively (P = 0.29). Nevertheless, the positive rate of osteolytic lesions ascertained by CT was significantly higher than that by X ray (P < 0.001), 60.9% (28/46) vs 13.0% (6/46) with diameter 5-10 mm and 50.0% (23/46) vs 10.9% (5/46) with diameter more than 10 mm. Osteolytic lesion numbers found by CT were more than those by X ray [5(0-21) vs 0(0-4) lesions with diameter 5-10 mm (P < 0.001), 2(0-14) vs 0(0-2) lesions with diameter more than 10 mm (P < 0.001), respectively]. Patients with positive osteolytic lesions had higher percentage of RB1 gene deletion [46.7% (14/30) vs 18.8% (3/16), P < 0.001], D13s319 deletion [43.3% (13/30) vs 18.8% (3/16), P < 0.001] and high risk cytogenetic abnormalities [50.0% (15/30) vs 25.0% (4/16), P < 0.001]. CONCLUSIONS: Chest CT is more sensitive than plain X ray in detecting osteolytic myeloma bone disease. Osteolysis determined by CT is relevant to clinical DS stages and risk stratification of cytogenetic abnormalities.

[Experimental Methods and Result Analysis of a Variety of Spectral Reflectance Properties of the Thin Oil Film].

In order to analysis the oil spill situation based on the obtained data in airborne aerial work, it's needed to get the spectral reflectance characteristics of the oil film of different oils and thickness as support and to select the appropriate operating band. An experiment is set up to measure the reflectance spectroscopy from ultraviolet to near-infrared for the film of five target samples, which means petrol, diesel, lubricating oil, kerosene and fossil, using spectral measurement device. The result is compared with the reflectance spectra of water in the same experimental environment, which shows that the spectral reflection characteristics of the oil film are related to the thickness and the type of the oil film. In case of the same thickness, the spectral reflectance curve of different types of film is far different, and for the same type of film, the spectral reflectance curve changes accordingly with the change of film thickness, therefore in terms of the single film, different film thickness can be distinguished by reflectance curves. It also shows that in terms of the same film thickness, the reflectance of diesel, kerosene, lubricants reaches peak around 380 nm wavelength, obviously different from the reflectance of water, and that the reflectance of crude oil is far less than that of water in more than 340 nm wavelength, and the obtained reflection spectrum can be used to distinguish between different types of oil film to some extent. The experiment covers main types of spilled oil, with data comprehensively covering commonly used detect spectral bands, and quantitative description of the spectral reflectance properties of film. It provides comprehensive theoretical and data support for the selection of airborne oil spill detection working band and the detection and analysis of water-surface oil spill.

[Study on in-orbit Vis/SWIR relative calibration monitoring system with high stability].

The present paper studied the in-orbit relative calibration monitoring system with high stability for onboard remote sensing calibration. The realizing principle and the critical technologies are described in detail. The calibration detector assembly with high stability was developed based on both visual (Vis) and shortwave infrared (SWIR) trap structure. Vis and SWIR photodetectors with high sensitivity were chosen to realize the photoelectric conversion. On the one hand, the detectors worked in the zero-bias photovoltaic mode with better linearity and lower dark current. On the other hand, the critical parameters of the analog operational amplifier circuit and data acquisition circuit were designed so that the trap-structure detector assembly could work properly. Thus the relative calibration monitoring system with high stability for measurement of spaceborne calibration radiance source was realized. The experiments were carried out using the laboratory integrating spheres and the standard lamps provided by the national measurement institution. The results showed that the relative standard deviation of the digital numbers that the system acquired reached to 0.030%-0.046% (Vis) and 0.040%-0.059% (SWIR). It was proved that the accuracy and the stability of the monitoring system could meet the in-orbit calibration system requirement and it could serve as a good solution for in-orbit relative calibration of remote sensor in the future.

Distinct characteristics of the DNA damage response in mammalian oocytes.

DNA damage is a critical threat that poses significant challenges to all cells. To address this issue, cells have evolved a sophisticated molecular and cellular process known as the DNA damage response (DDR). Among the various cell types, mammalian oocytes, which remain dormant in the ovary for extended periods, are particularly susceptible to DNA damage. The occurrence of DNA damage in oocytes can result in genetic abnormalities, potentially leading to infertility, birth defects, and even abortion. Therefore, understanding how oocytes detect and repair DNA damage is of paramount importance in maintaining oocyte quality and preserving fertility. Although the fundamental concept of the DDR is conserved across various cell types, an emerging body of evidence reveals striking distinctions in the DDR between mammalian oocytes and somatic cells. In this review, we highlight the distinctive characteristics of the DDR in oocytes and discuss the clinical implications of DNA damage in oocytes.

[Effect of Selinexor on Proliferation and Apoptosis of Acute Myeloid Leukemia Kasumi-1 Cells].

OBJECTIVE: To investigate the effects of selinexor, a inhibitor of nuclear export protein 1 (XPO1) on the proliferation inhibition and apoptosis of Kasumi-1 cells in acute myeloid leukemia (AML). METHODS: MTS method was used to detect the inhibitory effect of different concentrations of selinexor on the proliferation of Kasumi-1 cells at different time points. The apoptosis rate and cell cycle changes after treatment with different concentration of selinexor were detected by flow cytometry. RESULTS: Selinexor inhibited the growth of Kasumi-1 cells at different time points in a concentration-dependent manner (r 24 h=0.7592, r 48 h=0.9456, and r 72 h=0.9425). Selinexor inhibited Kasumi-1 cells growth in a time-dependent manner (r =0.9057 in 2.5 µmol/L group, r =0.9897 in 5 µmol/L group and r =0.9994 in 10 µmol/L group). Selinexor could induce apoptosis of Kasumi-1 cells in a dose-dependent manner (r =0.9732), and the apoptosis of Kasumi-1 cells was more obvious with the increase of drug concentration. The proportion of G0/G1 phase was significantly increased and the proportion of S phase was significantly decreased after the treatment of Kasumi-1 cells by selinexor. With the increase of drug concentration, the proportion of Kasumi-1 cells cycle arrest in G0/G1 phase was increased and the cell synthesis was decreased. CONCLUSION: Selinexor can promote the death of tumor cells by inhibiting Kasumi-1 cells proliferation, inducing apoptosis and blocking cell cycle.

Dahuang Zhechong Pill Improves Pulmonary Fibrosis through miR-29b-2-5p/HK2 Mediated Glycolysis Pathway.

OBJECTIVE: To explore the preventive and therapeutic effects of Dahuang Zhechong Pill (DZP) on pulmonary fibrosis and the underlying mechanisms. METHODS: The first key rate-limiting enzyme hexokinase 2 (HK2) of glycolysis was silenced and over-expressed through small interfering RNA and lentivirus using lung fibroblast MRC-5 cell line, respectively. The cell viability, migration, invasion and proliferation were detected by cell counting kit-8, wound healing assay, transwell assay, and flow cytometry. The mRNA and protein expression levels of HK2 were detected by RT-PCR and Western blotting, respectively. The contents of glucose, adenosine triphosphate (ATP) and lactate in MRC-5 cells were determined by enzyme-linked immunosorbnent assay (ELISA). Then, the relationship between miR-29b-2-5p and HK2 was explored by luciferase reporter gene assay. Pulmonary fibrosis cell model was induced by transforming growth factor-ß 1 (TGF-ß 1) in MRC-5 cells, and the medicated serum of DZP (DMS) was prepared in rats. MRC-5 cells were divided into control, TGF-ß 1, TGF-ß 1+10% DMS, TGF-ß 1+10% DMS+miR-29b-2-5p inhibitor, TGF-ß 1+10% DMS+inhibitor negative control, TGF-ß 1+10% DMS+miR-29b-2-5p mimic and TGF-ß 1+10% DMS+mimic negative control groups. After miR-29b-2-5p mimics and inhibitors were transfected into MRC-5 cells, all groups except control and model group were treated with DMS. The effect of DMS on MRC-5 cells were detected using aforementioned methods and immunofluorescence. Similarly, the contents of glucose, ATP and lactate in each group were measured by ELISA. RESULTS: The mRNA and protein expressions of HK2 in MRC-5 cells were successfully silenced and overexpressed through si-HK2-3 and lentiviral transfection, respectively. After silencing HK2, the mRNA and protein expressions of HK2 were significantly decreased (P<0.01), and the concentrations of glucose, ATP and lactate were also significantly decreased (P<0.05). The proliferation, migration and invasion of MRC-5 cells were significantly declined (P<0.05 or P<0.01), while the apoptosis of MRC-5 cells was significantly increased (P<0.01). After overexpressing HK2, the mRNA and protein expressions of HK2 were significantly increased (P<0.05), and the concentrations of glucose, ATP and lactate were also significantly increased (P<0.05 or P<0.01). The proliferation, migration and invasion of MRC-5 cells were significantly increased (P<0.05 or P<0.01), while the apoptosis of MRC-5 cells was significantly decreased (P<0.05). The relative luciferase activity of 3'UTR-WT+hsa-miR-29b-2-5p transfected with HK2 was significantly decreased (P<0.01). After miR-29b-2-5p mimic and inhibitor were transfected into the MRC-5 cells, DMS intervention could significantly reduce the concentration of glucose, ATP and lactate, and the mRNA and proteins expressions of HK2, phosphofructokinase and pyruvate kinase isoform M2 (P<0.05 or P<0.01). The proliferation, migration and invasion of MRC-5 cells were alleviated (P<0.05 or P<0.01), and the deposition of fibronectin, α-smooth muscle actin, and collagen I were significantly decreased (P<0.05 or P<0.01). CONCLUSIONS: Glycolysis is closely related to pulmonary fibrosis. DZP reduced glycolysis and inhibited fibroblasts' excessive differentiation and abnormal collagen deposition through the miR-29b-2-5p/HK2 pathway, which played a role in delaying the process of pulmonary fibrosis.

[The prevalence, awareness, and control of hypertension in Xianghe county of Hebei province].

OBJECTIVE: To investigate the prevalence, awareness, control status and associated risk factors of hypertension in a rural population in Xianghe county in North China. METHODS: A total of 830 adults (aged ≥ 35) from Xianghe county were examined during July to August, 2011. Blood pressure was obtained using a standardized sphygmomanometer after a 5-minute sitting rest. Information on gender, age, education level, marital status, smoking, drinking, income, family history of hypertension and use of antihypertensive medications was obtained. RESULTS: A total of 42.4% of all subjects had hypertension. Among those with hypertension, the awareness rate was 54.8% and 50.0% of the patients were taking antihypertensive medication with the control rate of 11.9% [BP < 140/90 mm Hg (1 mm Hg = 0.133 kPa)]. Lower age and education level, lower body mass index, negative family history of hypertension were associated with poor awareness of hypertension and worse compliance with the treatment. Older age, positive family history and alcohol consumption were associated with poor blood pressure control. CONCLUSIONS: Hypertension is highly prevalent in Xianghe rural area. The awareness, treatment and control rate are all low. There is an urgent need for comprehensive strategies to improve prevention, screening, and treatment of hypertension in rural China.

[The prevalence of congenital heart disease in students of Liangshan prefecture in Sichuan province].

OBJECTIVE: To investigate the congenital heart disease (CHD) prevalence of students in Liangshan prefecture in Sichuan province, and to explore the risk factors of CHD. METHODS: Stratified cluster sampling was conducted in collecting demographic data. Heart auscultation was used to screening the CHD, and colour Doppler flow imaging was used to diagnose the CHD. RESULTS: A total of 10,021 student were collected in this study. About 19.74% of total cases had cardiac murmur. Sixty-eight students were diagnosed as CHD through colour Doppler flow imaging, accounting for 0.68%. In addition, the top three ranks of CHD were atrial septal defect, patent ductus arteriosus, interventricular septal defect. Our study also found that per capita income of CHD families was lower than non-CHD families, meanwhile, the CHD prevalence of Yi nationality was higher than other nationalities. There was no statistical significance in age, gender, height, weight, body mass index, head circumference, waist circumference between different types of CHD. CONCLUSIONS: The CHD prevalence of students in Liangshan prefecture has been in a high level in China; therefore we need pay more attention on screening for the CHD.

[Prevalence of dyslipidemia and borderline dyslipidemia in aging residents from Beijing communities].

OBJECTIVE: To investigate the prevalence characters of dyslipidemia and borderline dyslipidemia in aging residents from Beijing communities and to evaluate the relative risk of cardiovascular risk factor (CRF) to dyslipidemia. METHODS: The samples were selected by random cluster multistage method. Serum lipid level and CRF were determined through questionnaire, physical examination and biochemical detection for 1974 subjects who was 65 and over 65 years old in Beijing communities. RESULTS: Age- and sex-adjusted standardized incidence of dyslipidemia and borderline dyslipidemia in ≥ 65 yrs was 35.11% (693/1974) and 28.57% (564/1974) respectively, optimal lipid was 36.32% (717/1974).Vs optimal status 3 borderline factors(BF) , 1 major CRF, 2 CRFs, and 3 CRFs to have dyslipidemia, the relative risks are OR = 1.537, 95%CI 0.597-3.959, OR = 1.898, 95%CI 0.993-3.628, OR = 2.441, 95%CI 1.268-4.698, and OR = 4.256, 95%CI 2.104-8.608 respectively. CONCLUSIONS: The prevalence of major CRFs of ≥ 65 yrs resident from Beijing communities are higher than the average level of China. The risk is higher while the number of borderline and major CRFs much more.

[Risk factors and prevalence of cardiovascular disease of rural residents in Xianghe of Hebei province].

OBJECTIVE: To observe the risk factors and prevalence of cardiovascular disease, and predict the 10-year risk of ischemic cardiovascular disease (ICVD) of a rural residents in Xianghe of Hebei province. METHODS: Two thousand five hundred and thirty two adults ( ≥ 35 years old) were surveyed at internal medicine outpatient department of Xianghe asthma hospital in Hebei province by face-to-face interview, physical examination and biochemical test. Subjects aged 35 to 59 were also evaluated using the National 10-year Risk Assessment for ICVD. RESULTS: The prevalence of stroke and coronary heart disease was 2.2% (56/2532) and 6.9% (176/2532) respectively, the age- and sex-standardized prevalence was 1.3% and 5.9% respectively. The prevalence of hypertension, diabetes, dyslipidemia, overweight, obese and central obesity was 59.9% (1516/2532), 26.9% (682/2532), 68.5% (1735/2532), 40.9% (1038/2532), 14.8% (374/2532) and 49.5% (1254/2532) respectively, the age- and sex-standardized prevalence was 43.8%, 19.9%, 56.5%, 35.1%, 15.6%, 41.9%, respectively. Ten-year ICVD risk was higher than 10% in 14.1% (188/1336) residents aged between 35 to 59 years. CONCLUSIONS: Risk factors and prevalence of cardiovascular disease as well as 10-year risk of ICVD are high in this rural population in Xianghe of Hebei province. Intensive prevention and therapy strategies are urgently needed to attenuate the ICVD risk factors and treat ICVD in rural area of China.

[The effectiveness and safety of L-amlodipine besylate for blood pressure control in patients with mild to moderate essential hypertension].

OBJECTIVE: To evaluate the effectiveness and safety of L-amlodipine besylate for blood pressure control in patients with mild to moderate essential hypertension. METHOD: A total of 1051 mild to moderate essential hypertensives were recruited from 22 centers and randomized into three groups and were given low-dose L-amlodipine besylate (2.5 mg/d), high-dose L-amlodipine besylate (5.0 mg/d), and amlodipine maleate (5.0 mg/d) on the principle of open-label and parallel control. The study drugs were administered for 8 weeks. RESULTS: After 8 weeks treatments, the response rate of the three groups were 72.4%, 85.6%, and 76.2%, respectively. The rate difference between high-dose L-amlodipine besylate group and the other two groups were statistically significant (P < 0.01), while the rate difference between low-dose L-amlodipine besylate group and amlodipine maleate group was similar (P = 0.28). The event rates of the three groups were similar (4.3%, 4.6%, and 5.1%, respectively, P = 0.84). CONCLUSION: High-dose L-amlodipine besylate is superior to the other 2 groups on blood pressure control. The efficacy profiles of amlodipine maleate and low-dose L-amlodipine besylate are equivalent. Safety profiles of these three groups are comparable.

Impact of therapy options on in-hospital and three-year outcome of patients with ST-elevation myocardial infarction in Beijing.

OBJECTIVES: To evaluate the clinical characteristics, in-hospital and three-year outcome in ST-elevation myocardial Infraction (STEMI) patients receiving conservative treatment (CT), thrombolytic treatment (TT) and primary percutaneous coronary intervention (PCI) in Beijing. METHODS: This 12-month prospective, multicenter registry study was conducted in 19 hospitals with 808 patients with STEMI in Beijing between Jan. 2006 and Dec. 2006, 518 (64%) received PCI, 106 (16.1%) received TT and 184 (22.8%) received CT therapy. Patients were followed up for 3 years. RESULTS: At baseline, the age of patients in CT group [(64.5 ± 13.5) years] was significantly higher than those in TT group p(57.9 ± 11.0) years] and in PCI group [ (60.4 ± 12.3) years, all P<0.01]; and the median time from symptom onset to hospital in CT group (207 min) was significantly longer than those in TT group (130 min) and PCI group (130 min, all P<0.01). Emergency Medical Service (EMS) use was significantly higher in PCI group (184/518, 35.5%) than in CT group (46/184, 27.3%) and TT group (29/107, 25.0%, all P<0.05). Health insurance holder was the highest in PCI group (P<0.01). PCI was performed less frequently than thrombolytic therapy [66.6% (345/518) vs. 80.2% (85/106)m P=0.02] during off-hours and more frequently performed in tertiary hospitals than in secondary hospitals[66.8%(437/651) vs. 52.6% (81/154, P<0.01)]. The in-hospital mortality and the cardiovascular mortality at 3 year after hospital discharge was significantly higher in CT group [9.2% (17/185) and 9.4% (15/159)] than in PCI group [3.5% (18/518), 4.5% (20/446)] and TT group [6.6% (7/106), 2.3% (2/86), all P<0.01]. Patients in PCI group had the highest adherence level of aspirin, ß-blocker, angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers or statins at 3-years follow-up (all P<0.05). Multivariable Cox proportional hazards regression analysis showed that only PCI was associated with lower risk of cardiovascular death (HR-0.40, 95% CI:0.21-0.73, P<0.01). CONCLUSIONS: Social and clinical setting may affect the physician's decision to provide reperfusion therapy in Beijing for STEMI patients. Better adherence of secondary preventive drugs and lower cardiovascular death are observed in STEMI patients receiving PCI during the 3-year follow-up