[Long-term outcomes of intravascular ultrasound-guided drug-eluting stents implantation in patients with acute coronary syndrome: ULTIMATE ACS subgroup].

Objective: To explore the long-term effects of intravascular ultrasound (IVUS) guidance on patients with acute coronary syndrome (ACS) undergoing drug-eluting stents (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. A total of 1 448 all-comer patients were enrolled between 2014 August and 2017 May. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target-vessel-related myocardial infarction, and clinically-driven target vessel revascularization. Results: ACS was present in 1 136 (78.5%) patients, and 3-year clinical follow-up was available in 1 423 patients (98.3%). TVF in the ACS group was 9.6% (109/1 136), which was significantly higher than 4.5% (14/312) in the non-ACS group (log-rank P=0.005). There were 109 TVFs in the ACS patients, with 7.6% (43/569) TVFs in the IVUS group and 11.6% (66/567) TVFs in the angiography group (log-rank P=0.019). Moreover, patients with optimal IVUS guidance were associated with a lower risk of 3-year TVF compared to those with suboptimal IVUS results (5.4% (16/296) vs. 9.9% (27/273),log-rank P=0.041). Conclusions: This ULTIMATE-ACS subgroup analysis showed that ACS patients undergoing DES implantation were associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in patients with ACS, especially in those who had an IVUS-defined optimal procedure.

Epidemiological studies on hemorrhagic fever with renal syndrome in China.

Hemorrhagic fever with renal syndrome (HFRS) has been reported from greater than 20 provinces in China. The number of reported cases has increased markedly in recent years and surpassed 80,000 human cases in 1983. All of the cases reported before 1981 were from rural areas and were attributed to Apodemus rats. In 1981, outbreaks of cases associated with house rats were first reported. Cases associated with Apodemus agrarius were more severe than those associated with the house rat Rattus norvegicus. The rate of inapparent infection in the rural population of areas endemic for Apodemus-associated disease was lower than that of Rattus-associated urban disease. After the onset of the disease, IgG antibody levels increase rapidly, peak after one week, and persist for as long as 25 years. Lung tissues from 16 species of rodent, from two species of sorex, and from cats and weasels in the epidemic areas have been found to carry antigen. A. agrarius, Apodemus peninsulae, and R. norvegicus serve as the main reservoirs of HFRS in rural areas, forest areas, and urban areas, respectively.