A novel peroxisome-related gene signature predicts clinical prognosis and is associated with immune microenvironment in low-grade glioma.

Low-grade glioma (LGG), a common primary tumor, mainly originates from astrocytes and oligodendrocytes. Increasing evidence has shown that peroxisomes function in the regulation of tumorigenesis and development of cancer. However, the prognostic value of peroxisome-related genes (PRGs) in LGG has not been reported. Therefore, it is necessary to construct a prognostic risk model for LGG patients based on the expression profiles of peroxisome-related genes. Our study mainly concentrated on developing a peroxisome-related gene signature for overall survival (OS) prediction in LGG patients. First, according to these peroxisome-related genes, all LGG patients from The Cancer Genome Atlas (TCGA) database could be divided into two subtypes. Univariate Cox regression analysis was used to find prognostic peroxisome-related genes in TCGA_LGG dataset, and least absolute shrinkage and selection operator Cox regression analysis was employed to establish a 14-gene signature. The risk score based on the signature was positively associated with unfavorable prognosis. Then, multivariate Cox regression incorporating additional clinical characteristics showed that the 14-gene signature was an independent predictor of LGG. Time-dependent ROC curves revealed good performance of this prognostic signature in LGG patients. The performance about predicting OS of LGG was validated using the GSE107850 dataset derived from the Gene Expression Omnibus (GEO) database. Furethermore, we constructed a nomogram model based on the gene signature and age, which showed a better prognostic power. Gene ontology (GO) and Kyoto Encylopedia of Genes and Genomes (KEGG) analyses showed that neuroactive ligand-receptor interaction and phagosome were enriched and that the immune status was decreased in the high-risk group. Finally, cell counting kit-8 (CCK8) were used to detect cell proliferation of U251 and A172 cells. Inhibition of ATAD1 (ATPase family AAA domain-containing 1) and ACBD5 (Acyl-CoA binding-domain-containing-5) expression led to significant inhibition of U251 and A172 cell proliferation. Flow cytometry detection showed that ATAD1 and ACBD5 could induce apoptosis of U251 and A172 cells. Therefore, through bioinformatics methods and cell experiments, our study developed a new peroxisome-related gene signature that migh t help improve personalized OS prediction in LGG patients.

Porous Cobalt Sulfide Selenium Nanorods for Electrochemical Hydrogen Evolution.

A key process in electrochemical energy technology is hydrogen evolution reaction (HER). However, its electrochemical properties mainly depend on the catalytic activity of the material itself. Therefore, it is important to find efficient electrocatalysts to realize clean hydrogen production. As a typical kind of catalytic materials, transition metal dichalcogenides (TMCs) play important roles in the field of energy catalysis. As a representative of TMCs, cobalt disulfide (CoS2), recently has raised much research interest owing to its abundant reserves, environmental friendliness, and excellent electrochemical stability. Meanwhile, given the fact that doping is one of the effective methods to improve the electrochemical catalytic property, various means of doping have been researched. Here, we report for the first time that porous-like Se-CoS2-x (or Se:CoS2-x ) nanorod can be facilely synthesized via a controllable two-step strategy. It is demonstrated that doping Se can greatly improve the catalytic performance of CoS2 electrode. The electrode can obtain a current density of 10 mA cm-2 at overpotential of only ∼260 mV. And the current changes with the applied bias voltage in an obvious stepped pattern, in the chronopotential (CP) curve of Se-CoS2-x , indicating its outstanding mass transfer property and mechanical stability.

MicroRNA-4491 enhances cell proliferation and inhibits cell apoptosis in non-small cell lung cancer via targeting TRIM7.

MicroRNAs (miRNAs) are involved in the development of non-small cell lung cancer (NSCLC). However, the biological roles of several aberrantly expressed miRNAs have not been explored yet. In the present study, miR-4491 was identified as a novel upregulated miRNA in NSCLC tissues and cell lines. Downregulation of miR-4491 by a miR-4491 inhibitor inhibited the proliferation and triggered the apoptosis of NSCLC cells. Tripartite motif containing 7 (TRIM7), a tumor suppressor gene expressed in NSCLC, was demonstrated in the present study to be directly targeted by miR-4491. This finding was verified by bioinformatics analysis, reverse transcription-quantitative PCR, western blotting and dual luciferase reporter assays. Furthermore, downregulation of miR-4491 inactivated nuclear factor-κB signaling via induction of TRIM7. In addition, TRIM7 silencing attenuated the effect of miR-4491 inhibitor in NSCLC cells. The decreased TRIM7 level in NSCLC tissues was negatively correlated with miR-4491 expression in NSCLC tissues. In conclusion, the findings from this study demonstrated that miR-4491 expression was upregulated in NSCLC tissues and cells and that miR-4491 may promote NSCLC progression via targeting TRIM7.

Analysis of risk factors for early stent thrombosis in the Chinese population: A multicenter restrospective study.

BACKGROUND: The predictive scoring systems for early stent thrombosis (EST) remains blank in China. The study aims to evaluate the risk factors and conduct a prediction model of EST in the Chinese population. METHODS: EST was defined as thrombosis that occurs within the first 30 days after primary percutaneous coronary intervention (PCI). Patients from ten Chinese hospitals diagnosed as stent thrombosis (ST) from January 2010 to December 2016 were retrospectively included as the study group. A control group (1 case:2 controls) was created by including patients without ST, major adverse cardiovascular events, or cerebrovascular events during follow-up. The present study evaluated 426 patients with single-vessel lesions and ultimately included 40 patients with EST and 80 control patients, who were included to identify factors that predicted EST and to develop a prediction scoring system. The other 171 patients without integrated 1:2 pair were used for external validation. RESULTS: EST was independently associated with a low hemoglobin concentration (adjusted odds ratio [OR] 0.946, 95% confidence interval [95% CI] 0.901-0.993, P=0.026), a high pre-PCI Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score (OR 1.166, 95% CI 1.049-1.297, P=0.004), and a DAPT (DAPT) duration of <30 days (OR 28.033, 95% CI 5.302-272.834, P<0.001). The simple EST prediction score provided an area under the curve (AUC) of 0.854 (95% CI 0.777-0.932, P<0.001) with 70.0% sensitivity and 90.0% specificity, and 0.742 (95% CI 0.649-0.835, P<0.001) with 54.5% sensitivity and 81.0% specificity for external validation dataset. CONCLUSIONS: EST may be independently associated with DAPT discontinuation within 30 days, a low hemoglobin concentration, and a high SYNTAX score. The scoring system also has a good ability to predict the risk of EST and may be useful in the clinical setting.

Interface engineering of cobalt-sulfide-selenium core-shell nanostructures as bifunctional electrocatalysts toward overall water splitting.

The number of active sites and stability of the structure of electrocatalysts are the key factors in the process of overall water splitting. In this paper, cobalt-sulfide-selenium (Se:CoS2-x) core-shell nanostructures are prepared by a simple two-step method, including hydrothermal reaction and chemical vapor deposition. The resulting product exhibits excellent electrochemical performance, owing to the synergistic effects between CoS2 and CoSe1-x, as well as the plentiful active sites in the electrode structure. The Se:CoS2-x material shows a more improved hydrogen evolution reaction activity compared to CoS2 and Co(OH)Cl precursor catalysts, with a low overpotential of only 240 mV achieved at 10 mA cm-2. Meanwhile, Se:CoS2-x as a bifunctional water splitting catalyst also shows remarkably improved oxygen evolution reaction activity, with a low overpotential of only 1.32 V at 10 mA cm-2. The above results show that selenide/sulfide materials provide a new research direction for discovering high-performance and cheap electrode materials.

Nonatrial Fibrillation Patients With Complete P Wave Disappearance: An Overlooked Population With High Stroke Risk.

BACKGROUND AND PURPOSE: Complete P wave disappearance (CPWD) in patients without atrial fibrillation is an uncommon clinical phenomenon. We aimed to study the relationship between CPWD and thromboembolism. METHODS: Between July 2007 and December 2018, consecutive patients with CPWD on surface ECG and 24-hour Holter recording were recruited into the study from 4 centers in China. All recruited patients underwent transesophageal echocardiography or cardiac computed tomography to screen for atrial thrombus. Atrial electrical activity and scar were assessed by electrophysiological study (EPS) and 3-dimensional electroanatomic mapping. Cardiac structure and function were assessed by multimodality cardiac imaging. RESULTS: Twenty-three consecutive patients (8 male; mean age 48.5±14.7 years) with CPWD were included. Only 3 patients demonstrated complete atrial electrical silence with atrial noncapture. Thirteen patients who had invasive atrial endocardial mapping demonstrated extensive scar. Pulse-wave mitral inflow Doppler demonstrated absent and dampened A waves in 18 and 5 patients, respectively. Pulse-wave tricuspid inflow Doppler showed absent and dampened A waves in 19 and 4 patients, respectively. Upon recruitment, 8 patients had previous stroke and 3 patients had atrial thrombus. Warfarin was prescribed to all patients. During median follow-up of 42.0 months, 2 patients developed massive ischemic stroke due to warfarin discontinuation. CONCLUSIONS: Our study suggested that CPWD reflects extensive atrial electrical silence and significantly impaired atrial mechanical function. It was strongly associated with thromboembolism and the clinical triad of CPWD-atrial paralysis-stroke was proposed. Anticoagulation should be recommended in such patients.

Graphene-based electrically controlled terahertz polarization switching between a quarter-wave plate and half-wave plate.

We theoretically present a high-efficiency switchable reflective terahertz polarization converter composed of a periodic array of rectangular-shaped metal-dielectric-graphene sandwich structure on a dielectric substrate supported by a thick metallic film. Graphene sheet together with the rectangular-shaped metal patch provides tunable anisotropic hybrid magnetic plasmon resonance to obtain tunable phase delay of 90° and 180°, corresponding to a quarter-wave plate (QWP) and half-wave plate (HWP), respectively. Results of numerical simulations indicate that the proposed structure can switch functions between a QWP and HWP at a certain frequency simply by adjusting the Fermi energy of graphene. Both the QWP and HWP have high energy conversion efficiency, respectively 83% and 90% at 15.96THz, and high polarization conversion ratio closed to 1.

Graphene-enabled electrically tunability of metalens in the terahertz range.

In general, the functions of most metalenses cannot be adjusted dynamically after being fabricated. Here, we theoretically propose an electrically tunable metalens composed of single-layered and non-structured doped graphene loaded with ribbon-shaped metallic strip arrays with varied widths and gaps. The combination of the different widths and gaps can provide full phase coverage from 0 to 2π, which is necessary for a plane wave to be focused. The metalens exhibits obvious tunability of focal length and focal intensity as we varied the Fermi levels of the doped graphene at 10 THz. The focus is able to be shifted within 90.4 µm (∼3λ), with maximum focusing efficiency up to 61.62%. The tunable metalens can also be expanded to other operation frequencies from mid-infrared to terahertz range by properly designing structural parameters. The metalens consisting of nanostructured metal and non-structured graphene utilizes mature metal nanostructure preparation process and avoids the graphene processing, which consequently facilitates the fabrication and promotes the application.

Initiating TrkB/Akt Signaling Cascade Preserves Blood-Brain Barrier after Subarachnoid Hemorrhage in Rats.

The integrity of the blood-brain barrier (BBB) plays a vital role in affecting the prognosis of subarachnoid hemorrhage (SAH). This study aimed to investigate activation of the Tropomyosin-related kinase receptor B (TrkB) and its downstream signaling pathway on preserving BBB breakdown after experimental SAH. An endovascular perforation SAH model was applied. N-[2-(5-hydroxy-1H-indol-3-yl) ethyl]-2- oxopiperidine-3-carboxamide (HIOC), the derivative of N-acetyl serotonin (NAS), was intracerebroventricularly administered 3 h after SAH induction. The neurologic scores and brain water content were evaluated in an outcome study. Western blot and immunofluorescence staining were used to investigate the mechanism. The results indicated that HIOC activated the TrkB/Akt pathway, increased the tight junction expression, improved neurologic deficits, and ameliorated brain edema after SAH. Thus, we conclude that initiating the TrkB/Akt signaling cascade preserves BBB breakdown after experimental SAH in rats.

25-Hydroxy vitamin D level is associated with total MRI burden of cerebral small vessel disease in ischemic stroke patients.

BACKGROUND: Decreased 25-hydroxyvitamin D [25(OH)D] has been reported to be related to increased risk of cerebrovascular disease. We aimed to investigate whether an association exists between 25(OH)D levels and cerebral small vessel disease (cSVD). METHOD: Patients with first-ever minor ischemic stroke or transient ischemic attack were recruited prospectively during Jan 2017 to December 2017. Serum 25(OH)D levels were measured at admission in all patients. Magnetic resonance imaging (MRI) was performed to determine the presence of cSVD, including silent lacunar infarcts (SLIs), white matter lesions (WMLs), cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVs). The severity of cSVD was evaluated by total MRI cSVD burden, an ordinal score from 0 to 4. The association between the baseline 25(OH)D level and cSVD was analyzed by multiple logistic regression models. RESULTS: Of 234 patients included, the median 25(OH)D level was 39.2 nmol/L. The proportions of patients with 0 to 4 cSVD features were 8.5%, 29.1%, 42.3%, 16.2%, and 3.8%, respectively. After adjusting for potential confounders, multiple logistic regression analysis demonstrated that patients with 25(OH)D level in its first quartile, compared with those in its fourth quartile, were more likely to have severe WMLs [odds ratio (OR), 3.31; 95% confidence interval (CI) 1.74-9.67; p = .004], severe EPVs (OR, 2.35; 95% CI 1.11-6.02, p = .046] and increasing total MRI cSVD burden (OR, 3.00; 95% CI 1.36-6.53, p = .006). CONCLUSIONS: Lower levels of 25(OH)D are associated with greater total MRI cSVD burden in ischemic stroke patients.

Multimodality Imaging for Navigation in Endoscopic Transsphenoidal Surgeries.

BACKGROUND AND STUDY AIMS: Computed tomography (CT) and magnetic resonance image (MRI) data have been widely used to for navigation in various neurosurgical operations. However, delicate intracranial structures cannot be displayed using only one imaging method. Navigation with multimodality imaging was developed to better visualize these structures in glioma removal, but whether it is useful in endoscopic transsphenoidal surgery is unknown. We describe our clinical experience using multimodality imaging for navigation in endoscopic transsphenoidal surgeries. MATERIAL AND METHODS: A total of 134 patients underwent endoscopic transsphenoidal surgery with navigation using multimodality imaging. CT and MR images were fused and processed to optimally visualize anatomical structures of the sphenoidal sinus and tumor. RESULTS: Navigation with multimodality imaging offers a precise display of anatomical structures in the sphenoid sinus as compared with navigation based on either CT or MRI. CONCLUSION: Navigation with multimodality imaging is capable of providing optimized guidance during endoscopic transsphenoidal surgeries. The fused images allow precise visualization of sphenoidal sinus structures, lesions and tumors. This is valuable for increasing safety in cases of anatomical variations and potentially decreasing the rate of tumor recurrence.

Comparison of everolimus-eluting bioresorbable vascular scaffolds and metallic stents: three-year clinical outcomes from the ABSORB China randomised trial.

AIMS: Absorb bioresorbable vascular scaffolds (BVS) and XIENCE cobalt-chromium everolimus-eluting stents (CoCr-EES) had comparable angiographic and clinical outcomes up to one year in patients enrolled in the ABSORB China randomised trial. Whether these favourable results with BVS continue beyond one year up to three years is unknown. In this study we sought to analyse the outcomes from the trial up to three-year follow-up. METHODS AND RESULTS: ABSORB China was a prospective, open-label, multicentre trial in which 480 patients with one or two native coronary artery lesions were randomised 1:1 to BVS (N=241) vs. CoCr-EES (N=239). Clinical endpoints included target lesion failure (TLF; cardiac death, target vessel-related myocardial infarction or ischaemia-driven target lesion revascularisation), its components, and definite/probable stent/scaffold thrombosis (ST). There were no significant differences in clinical outcomes in patients treated with BVS and CoCr-EES up to three years, including TLF (5.5% vs. 4.7%, p=0.68) and definite/probable ST (0.9% vs. 0.0%, p=0.50). STs in the BVS arm consisted of one probable subacute event at 15 days and one definite very late event at 622 days. Among 32 BVS patients with a reference vessel diameter between 2.25 and 3.75 mm by quantitative coronary angiography and in whom post-dilatation was performed at >16 atm with a balloon:scaffold diameter >1:1 and balloon ≤scaffold diameter 0.5 mm, no TLF or ST events occurred within three years. CONCLUSIONS: In the ABSORB China trial, BVS and CoCr-EES had similar results up to three-year follow-up, the time at which the scaffold has completely resorbed. BVS outcomes may be further optimised by appropriate lesion selection and implantation technique.

Transcription factor PU.1 is involved in the progression of glioma.

Glioma is a severe disease of the central nervous system. Although previous studies have identified the important role of the immune response in association with tumor intervention, it is still unknown whether PU.1, a transcription factor known for its role in myeloid differentiation and immune responses, is involved in the progression of glioma. In the present study, we found a significant increase in SPI1, the gene that encodes PU.1, in samples from patients with glioma. Through genotype-phenotype association analysis several candidate factors that may mediate the role of PU.1 in glioma were identified. To further validate the association between PU.1 and glioma we found that the expression of BTK, a potential target of PU.1, was also upregulated in patients with glioma. We also demonstrated that various biological pathways could be involved in PU.1-associated glioma by analyzing these potential targets in the Reactome database. These results provide evidence that PU.1 could serve a role in the progress of glioma through its transcriptional targets in multiple signaling pathways. Therefore, in addition to its role in hematopoietic linage development and leukemia, PU.1 appears to be involved in the regulation of glioma and potentially in other malignant cancers.

MicroRNA-24 inhibits the proliferation and migration of endothelial cells in patients with atherosclerosis by targeting importin-α3 and regulating inflammatory responses.

The aim of the present study was to measure the level of microRNA (miRNA or miR)-24 in the serum of patients with atherosclerosis and to investigate the effect of miR-24 on the expression of importin-α3 and tumor necrosis factor (TNF)-α, as well as the proliferation and migration of vascular endothelial cells. A total of 30 patients with atherosclerosis admitted to hospital between January and June 2016 were enrolled in the present study; 30 healthy subjects with a similar age range were enrolled as controls. Peripheral blood (10 ml) was collected from all participants. Human umbilical vein endothelial cells (HUVECs) were transfected with miR-24 mimic using Lipofectamine 2000. TargetScan was used to elucidate whether importin-α3 (KPNA4) was a target gene of miR-24. Expression levels of miR-24 and mRNAs were measured using reverse transcription-quantitative polymerase chain reaction, and protein expression was determined using western blotting. Cell Counting Kit 8 assay was used to assess the proliferation of HUVECs, and a Transwell assay was performed to detect the migration of HUVECs. Expression of miR-24 in peripheral blood from patients with atherosclerosis was significantly lower when compared with healthy subjects (P<0.05). Overexpression of miR-24 was demonstrated to significantly inhibit the transcription and translation of the importin-α3 gene (P<0.05) and negatively regulate the expression of endothelial inflammatory factor TNF-α (P<0.05). Furthermore, overexpression of miR-24 significantly inhibited the proliferation and migration of HUVECs (P<0.05), and miR-24 knockdown significantly promoted these processes (P<0.05). The results of the present study suggest that miR-24 exerts its effect in atherosclerosis by blocking the nuclear factor-κB signaling pathway, regulating inflammation in endothelial cells, and inhibiting the proliferation and migration of vascular endothelial cells.

Association Between PM2.5 Exposure and the Prognosis of Patients with Acute Myocardial Infraction.

BACKGROUND: Numerous case-crossover and time series studies of PM2.5 exposure and cardiovascular health effects have been conducted, fever studies have examined the effects of PM2.5 on the outcomes of CHD, especially on acute myocardial infarction (AMI). OBJECTIVE: The objective of this research is to investigate the association between PM2.5 exposure in Tianjin City and the outcome of AMI. METHODS: We conducted a retrospective analysis of a total of 598 patients with AMI in TEDA International Cardiovascular Hospital, from Oct 28th, 2013-Apr 30th 2014. All patients were divided into five groups according to the National Air Quality Classification Standard. Major adverse cardiovascular events (MACEs) including all-cause death, heart failure, myocardial infarction and target lesion revascularization (TLR) during one year follow-up were defined as endpoint. Furthermore, we divided the patients into two groups according to better and worse air quality, then examined the incidence of MACEs in the two groups. The prognostic was assessed by using multivariate Cox regression analysis. RESULTS: With the increase of the concentration of PM2.5, the incidence of MACEs were higher in patients after 1 year of AMI (In the five groups, Hazard Ratio [HR] 1.622, 95% CI 1.352-1.947; p = 0.000. In the two groups, HR 3.255, 95% CI 2.008-5.276; p = 0.000). CONCLUSION: PM2.5 exposure was associated with the outcome of patients with AMI, especially, the poorer air quality it is, the worse prognosis of patients will be.

Low Serum-Butyrylcholinesterase Activity as a Prognostic Marker of Mortality Associates with Poor Cardiac Function in Acute Myocardial Infarction.

BACKGROUND: Recently, butyrylcholinesterase (BChE) activity seems to have an independent prognostic role in acute coronary syndrome (ACS). However, the underlying mechanisms remain unclear. A previous study showed that serum BChE activity had a diagnostic value for chronic heart failure. This raises a question: whether BChE activity is associated with cardiac function in ACS, and if so, is this association related to the predictive value of BChE? The aim of this study was to determine the association between BChE activity with cardiac function assessed by Killip class and left ventricular ejection fraction (LVEF) in acute myocardial infarction (AMI) and to evaluate the independent prognostic role of BChE with consideration of these two indicators. METHODS: A total of 350 consecutive patients with AMI were retrospectively included. Serum BChE activity was measured upon admission. All patients were divided into two groups according to median value of BChE activity. All-cause death was defined as endpoint. The prognostic value of mortality was assessed by using Cox regression analysis. RESULTS: BChE activity was higher in patients with low Killip class (I or II) than that in those with high Killip class (III and IV) (7.0 +/- 1.3 or 7.0 +/- 1.5 vs. 6.2 +/- 1.6, p < 0.01). BChE activity was positively correlated with LVEF (r = 0.24, p < 0.001). During a mean follow-up period of 29 +/- 7 months, 25 patients died. BChE activity was significantly higher in surviving patients compared with non-surviving ones (7.0 +/- 1.4 vs. 5.7 +/- 1.3, p < 0.001). The survival rates were 89% and 97%, respectively, in the low and high groups of BChE activity. In a multivariate Cox proportional hazards regression analysis, after adjusting for potential confounders, BChE activity was an independent predictor of mortality after myocardial infarction [Hazard Ratio (HR) 0.65, 95% CI 0.46 - 0.91; p = 0.0131. However, when introducing Killip class and LVEF into the model, BChE activity was not in the equation. CONCLUSIONS: Low BChE activity as a predictor of mortality in AMI might be related to its association with poor cardiac function.

Therapeutic efficacy of a polysaccharide isolated from Cordyceps sinensis on hypertensive rats.

This study was aimed to investigate the antihypertensive effect of a polysaccharide fraction from Cordyceps sinensis on spontaneously hypertensive rats (SHR). The CSP1, one component of Cordyceps sinensis polysaccharides (CSP), was obtained after water extraction, deproteinization, de-colorization and purification with DEAE-cellulose 52. And a more homogeneous component CSP1-2 was obtained using Sepharose CL-6B chromatography. CSP1-2 mainly consisted of mannose, glucose and galactose in a molar ratio of about 2:2:1 and its average molecular weight was approximately 2.70×10(4)Da. Pharmacological tests showed that CSP1, in which the CSP1-2 was its main component, had antihypertensive effect by stimulating the secretion of vasodilator NO, decreasing the level of ET-1, epinephrine, noradrenaline and angiotensin II, inhibiting the increase of transforming growth factor ß1 (TGF-ß1) and lowering the level of inflammatory mediator of C-reactive protein (CRP). These results suggested that CSP1 may possess high potential in treating hypertension.

Comparison on the efficacy of everolimus-eluting stent and zotarolimus-eluting stents in coronary heart disease between diabetic and non-diabetic patients.

OBJECTIVE: The aim of this study is to examine and compare the efficacy of everolimus-eluting stents (EES) and zotarolimus-eluting stents (ZES) in coronary heart disease in diabetic or non-diabetic patients. METHODS: A total of 666 patients needed for percutaneous coronary intervention were randomly selected from June 2008 to June 2013 in our hospital and were divided into two groups: (i) coronary heart disease with diabetes group and (ii) non-diabetes group. Patients in each group were further assigned to receive treatment of either EES or ZES. Then we observed the major adverse cardiac events, including mortality, nonfatal myocardial infarction and non-fatal cerebrovascular events over the period of 15 months after initial stent implantation. RESULTS: Compared to the non-diabetic group, more patients in diabetic group had received anti-hypotensive treatment (72% vs. 49%, P < 0.0001) and hypolipemic treatment (80% vs. 67%, P < 0.0001) before the percutaneous coronary intervention. In both diabetic group and non-diabetic group, patients received ZES treatment had a much greater incidence rate of major adverse cardiac events compared to the patients received EES treatment (P < 0.05). Meanwhile, target lesion revascularization rate in the ZES group was also significantly higher than that in the EES group. The data showed big differences between ZES and EES groups with important statistical significance (P < 0.05). CONCLUSION: Patients with coronary heart disease and diabetes have a higher risk of major adverse cardiac events after stent implantation. EES treatment is safer with higher efficacy in our study, being a more effective stent for the patients merged with diabetes.