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Objective To explore the clinical feasibility and safety of early intervention for severe stenosis of non-infarct related artery(non-IRA)in patients with acute ST-segment elevation myocardial infarction(STEMI) and multi-vessel disease(MVD)after successful primary percutaneous coronary intervention(PCI)for infarct-asso-ciated artery(IRA). Methods From May 1st,2011 to December 30th,2016,165 patients with STEMI and MVD were enrolled in our study. After the completion of primary PCI in IRA ,75 patients still in the hospital agreed to undergo a second staged PCI in severe stenosis of non-infarct arteries. We analyzed the in-hospital adverse events ,the length of hospital stay and clinical outcomes during the follow-up in the study population. Results There was no significant difference in the incidence of adverse events between the two groups during hos-pitalization. However,compared to patients treated with the IRA-only PCI,those treated with early intervention for severe stenosis of non-IRA was associated with greater benefits for clinical outcomes(including rehospitalization for heart failure,rehospitalization for ACS,recurrent angina pectoris,necessity for reintervention)during the follow-up except for the all-cause mortality. Conclusion Early intervention for severe stenosis of non-IRA is a feasible and safe procedure in patients with acute STEMI and MVD after successful primary PCI.
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With the advantages of displaying visceral organs intuitively,showing the operative procedure vividly,making and spreading videos conveniently in clinical teaching,electrobronchoscopy image system was adopted in clinical teaching of respiratory medicine to assist the traditional teaching method,to make up for the deficiencies of tradition method and to improve the learning effectiveness of respiratory medicine for medical students at internship.
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Objective To evaluate the left ventricle geometry shape and left heart regional function in mitral insufficiency (MI) by quantitative tissue velocity imaging (QTVI) and the left ventricle systolic and diastolic geometry spbericity index. Methods Thirty normal subjects and 62 MI patients underwent QTVI and color Doppler imaging (CDFI) were enrolled in this study in order to measure the left ven-tricular geometry shape and left ventrieular regional function along LV apical long-axis view. Off-line LV regional velocity images along LV apical long-axis view were synchronously obtained. Peak tissue velocities of LV regional muscular tissue during systole(Vs),systolic acceler-ation(a), early diastole(Ve), LA contraction(Va)were synchronously measured as the index of left ventricular regional systolic and dias-tolic function. The left ventricle geometry shape index were reflected from the systolic and diastolic geometry sphericity index (SIs and Sid) and the left ventrieular ejection fraction (LVEF) and the peak D and peak a (PVd/PVa) of pulmonary veins flowing spectrum reflected the global left ventricular function index. The Vs, Ve, Va, a, PVd/PVd ratio, LVEF, SIs, SId were recorded and their correlation between normal subjects and patients with MI were compared. Result Vs, Ve,Va,a,PVd/ PVa ratio,SIs,SId in patients with MI were significantly re-duced. There was positive relation between Sis and a(r=0.602)and Ve/Va and SId(r=0.635). Conclusion There was negative rela-tion between regional cardiac function and LV spberieity, the higher cardiac function was accompanied with the lower SI.
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Objective To approach the correlation of the left ventricular function in elderly patients with acute myocardial infarction (AMI) at low-risk factor. Methods Forty-five elderly patients hospitalized for AMI were registered, including 20 patients who were underwent emergency percutaneous coronary intervention (PCI) after the onset of AMI and 25 patients who received conservative non-invasive therapies. These 45 cases all received echocardiography(ECHO) examination in the 4th and 24th week after acute myocardial infarction. Results In the PCI group, end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) had significant difference (P0.05) after therapy; WMSI was higher than PCI group (P
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Objective To assess the correlation between inflammation,specific immune response and coronary heart disease(CHD). Methods Thirty healthy cases passed the health examination were taken as the control group. Eighty cases who were diagnosised into CHD,affirmed by coronary angiography,were divided into three groups: acute myocardial infarction (AMI) group(26 cases),unstable angina pectoris (UP) group (24 cases),and stable angina pectoris (SP) group(30 cases). All the cases were tested on the concentrations of C-reactive protein(CRP),IgA,IgG,IgM in serum. Results The serum indices of CRP,IgG,IgA in AMI group and UP group were significantly difference than those in the control group (P0.05). Conclusion The correlation between inflammation and immune system activation are closely associated with CHD.
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Objective To explore the value of Doppler tissue imaging(DTI) in assessing the left ventricular diastolic function of patients with essential hypertension.Methods Twenty healthy person(group A),35 essential hypertension(EH) patients with normal left ventrecular mass index(LVMI,group B) and 30 EH patients with left ventricular hypertrophy(LVH,group C) were included.The mitral annular velocity in early diastole(Ea) and late diastole(Aa) were detected by DTI,meanwhile the mitral inflow velocity E and A were detected.Results The E,E/A,Ea,Ea/Aa of group B and group C were lower than those of group A(P0.05).The Ea,Ea/Aa of group C were lower than those of group B(P
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Objective To investigate the clinical significance of the alteration of left atrium diameter in hypertension patients.Methods Among 85 hypertension patients,65 cases were selected from the patients of our hospital.20 healthy subjects were also included in our study.Ultrasonography imager was used to measure the internal diameter of left atrium(LAD),septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF),left ventricular mass index(LVMI),E/A ratio and rest heart rate(RHR) for the analysis among them.Results LAD significantly enlarged in hypertension and normal LVMI patients compared with that of the control group(P
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Some measures about improving the teaching quality in respiratory department training are described in this report,including identifying the aim and importance of major training,raising students'enthusiasm,enhancing the basic major procedure training,performing various teaching,concentrating on the students'response and altering teaching methods continuously
