[Safety of carotid endarterectomy for the patiets with carotid artery stenosis and coronary artery disease under dual antiplatelet therapy].

Objective: To study the safety of dual antiplatelet therapy prior to carotid endarterectomy in the patients with carotid artery stenosis and Coronary Artery Accident. Methods: We review 86 patients with carotid artery stenosis and Coronary Artery Accidents who admitted in Peking University International Hospital between 2017 January and 2019 March. The 86 patients undergo carotid endarterectomy with dual antiplatelet therapy. We evaluate the safety of carotid endarterectomy dunring the dual antiplatelet thrapy by analyzing the incidence of acute coronary syndrome, ischemic cerebrovascular accident, intracranial hemorrhage, and regional hematoma. Results: From 2017 January to 2019 March, 86 patients with carotid artery stenosis and Coronary Artery Accident continued dual antiplatelet therapy prior to carotid endarterectomy. The incidence of main perioperative complications were as follows: acute coronary syndrome: 0; asymptomatic ischemia cerebrovascular accident: 8.1% (7/86); symptomatic ischemia cerebrovascular accident: 0; intracranial hemorrhage:0; neck hematoma:13.9%(13/86). All the patients were followed 30 days after the procedure. The modify Rakin Scale of the patients were all <3. The local hematoma were all recovered automatically without treatment and the perioperative mortality and morbidity was 0. Conclusion: For the patients with carotid artery stenosis and Coronary Artery Accidents, carotid endarterectomy under dual antiplatelet therapy was a safe choice.

[Simultaneous treatments in patients with severe carotid artery stenosis and coronary artery disease].

Objective: To implement simultaneous treatments in patients with severe carotid artery stenosis and coronary artery disease (CAD), we sought to investigate its efficacy of reducing perioperative major adverse cardiac and cerebrovascular event (MACCE). Methods: Brain-and-Heart treatment team in Peking University International Hospital performed hybrid Digital Substraction Angiography (DSA) of carotid artery and coronary artery for 37 patients meeting the group criterion from September 2017 to February 2019.Twelve patients were diagnosed and received simultaneous treatments of severe carotid artery stenosis and coronary artery disease after hybrid DSA. We conducted the retrospective study and made analysis of these patients. Results: The diagnosis rate by simultaneous treatmentsin patients with carotid artery stenosis and coronary artery disease is 59.5% (22/37), the rate of severe carotid artery stenosis or multi-vessel CAD is 77.3% (17/22).The rate of severe carotid artery stenosis with CAD is 54.5% (12/22), therate of simultaneous treatmentsis 83.3%(10/12). Nine patients post-operative symptoms release, one patient with ischemic stroke after CABG, and two patients of medical therapy with stable symptoms. Conclusion: Simultaneous treatments in patients with severe carotid artery stenosis and coronary artery disease not only reveal the positive correlation between carotid stenosis and CAD, but also accurately evaluate severity degree or rapidly formulate scheme and reduce MACCE.

[Application of combined angiography in diagnosis and treatment of carotid artery stenosis].

Objective: To evaluate the safety and clinical value of combined cardiac and cerebral angiography in the diagnosis and treatment of patients with carotid artery stenosis. Methods: Clinical data of patients from May 2016 to June 2019 were collected. The patient underwent combined angiography under local anesthesia. Clinical characteristics, prognosisand complications were retrospectively analyzed. Results: A total of 45 patients with carotid artery stenosis received combined angiography, among which 12 patients had no obvious carotid artery stenosis. There were 22 cases with unilateral carotid artery stenosis, including 12 cases with mild stenosis and 10 cases with moderate to severe stenosis. There were 11 cases of bilateral stenosis, including 3 cases with mild stenosis and 8 cases with moderate to severe stenosis. 12 patients had no obvious stenosis incoronary arteries, 11 patients had single-vessel disease, 7 patients had 2-vessel disease, and 15 patients had 3-vessel disease. In the whole group of patients, surgical indications are available of 18 patients with carotid artery stenosis, 4 of the mreceived combined therapy. 2 of them under went Carotid Endarterectomy (CEA)+Percutaneous Transluminal Coronary Intervention (PCI), 2 under went Carotid Artery Stenting (CAS)+PCI. CAS+coronary artery angiography was performed in 3 cases. CEA+coronary angiography was performed in 5 cases. 5 patients received conservative treatment after combined angiography. In one case, the condition of coronary artery was so complicated that PCI was performed firstly. No cardiac or cerebrovascular complications such as myocardial infarction or cerebral infarction occurred during perioperative period. Conclusion: Combined cardio-cerebrovascular angiography is a good method to evaluate the cardiovascular and cerebrovascular in the diagnosis and treatment of patients with carotid artery stenosis, which can provide a clear diagnosis for treatment with a low complications frequency.

Hydrostatic pressure effects on the static magnetism in Eu(Fe0.925Co0.075)2As2.

EuFe2As2-based iron pnictides are quite interesting compounds, due to the two magnetic sublattices in them and the tunability to superconductors by chemical doping or application of external pressure. The effects of hydrostatic pressure on the static magnetism in Eu(Fe0.925Co0.075)2As2 are investigated by complementary electrical resistivity, ac magnetic susceptibility and single-crystal neutron diffraction measurements. A specific pressure-temperature (P-T) phase diagram of Eu(Fe0.925Co0.075)2As2 is established. The structural phase transition, as well as the spin-density-wave order of Fe sublattice, is suppressed gradually with increasing pressure and disappears completely above 2.0 GPa. In contrast, the magnetic order of Eu sublattice persists over the whole investigated pressure range up to 14 GPa, yet displaying a non-monotonic variation with pressure. With the increase of the hydrostatic pressure, the magnetic state of Eu evolves from the canted antiferromagnetic structure in the ground state, via a pure ferromagnetic structure under the intermediate pressure, finally to an "unconfirmed" antiferromagnetic structure under the high pressure. The strong ferromagnetism of Eu coexists with the pressure-induced superconductivity around 2 GPa. Comparisons between the P-T phase diagrams of Eu(Fe0.925Co0.075)2As2 and the parent compound EuFe2As2 were also made.

[An analysis of spectrum of allergen sensitization among patients with tree pollen allergy in Beijing].

Objective:To explore the feature of allergic sensitization of tree pollen and the relationship between tree pollen and airborne pollen in Beijing. Method:Two thousand five hundred and twenty-one patients with allergic diseases were enrolled between January to July in 2017 in an allergy department. All patients received SPT of 8 kinds of tree pollen. Result:①The overall tree pollen positive rate of SPT was 49.3% (1 244/2 521). Male had a higher positive rate than female (56.4% vs 45.0%, P<0.01) while child group had a higher positive rate than adult group (55.9% vs 48.6%, P<0.05). The poly sensitization was observed with a rate of 26.3%, take the percentage of 53.3% of the overall positive subjects. ②The highest sensitization rate was found in March (62.2%), followed by May (52.1%), the lowest was January (27.9%). There was a positive correlation between tree pollen sensitization rate and pollen count of each month (r=0.929, P<0.01). ③Cypress had the highest positive rate (34.6%), followed by poplar (21.3%), the lowest was sophora (13.3%). The sensitization rate was positively correlated with pollen count among different tree pollen (r=0.714, P<0.05). Conclusion:The main allergic pollen in Beijing was cypress. The tree pollen sensitization showed a seasonality with the peak in March. The sensitization status was tightly associated with the amount of airborne pollen.

Non-contrast-enhanced MR angiography for detecting arteriovenous fistula dysfunction in haemodialysis patients.

AIM: To assess the diagnostic value of non-contrast-enhanced magnetic resonance angiography (NCE-MRA), using time-of-flight and black-blood MRA, in the evaluation of arteriovenous fistulas in haemodialysis patients in comparison to multidetector computed tomography angiography (MDCTA). MATERIAL AND METHODS: NCE-MRA and MDCTA were performed on the same day in 21 patients on maintenance haemodialysis with dysfunctional arteriovenous fistulas. The fistulas included three segments: arterial inflow, anastomosis, and venous outflow. Two experienced observers, who were blinded to the results of the NCE-MRA, recorded in consensus the significant stenoses (≥50%) seen on CTA. Two other experienced observers, unaware of the results of CTA, independently recorded significant stenoses (≥50%) in the NCE-MRA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NCE-MRA were calculated, with MDCTA as the standard reference. RESULTS: Sixty-three vascular segments in the 21 patients were clearly displayed. For the two observers of NCE-MRA, the accuracy was 98% and 95.4%; sensitivity 96.4% and 96.4%; specificity 97.1% and 94.3%; positive predictive value 96.4% and 93.1%; and, negative predictive value 97.1% and 97.1%. Inter-/intra-observer agreement for detecting stenosis was excellent for NCE-MRA, with a weighted kappa of 0.968 (95% confidence interval [CI], 0.874-1) and 0.936 (95% CI, 0.848-1). CONCLUSION: Non-contrast-enhanced MRA, using time-of-flight and black-blood MRA, is a reproducible and reliable imaging technique for detecting ≥50% stenosis in dysfunctional haemodialysis arteriovenous fistulas.

An x-ray scattering study of the structural phase transition in La(2-x)Sr(x)Cu0.99Fe0.01O4 (x = 0.20).

We report a comprehensive x-ray scattering study of the low-temperature orthorhombic (LTO)-high-temperature tetragonal (HTT) structural phase transition in 1% iron-doped La(2-x)Sr(x)CuO(4) (x = 0.2). The superlattice (032) peak intensity and the width are investigated in detail for a wide temperature range. We found that the structural phase transition is not sharp and the tilt ordering of the CuO(6) octahedra persists above the transition temperature T(S) (≈77 K). Even at room temperature, the superlattice peak is still observable. The structural phase transition is identified as an order-disorder type phase transition. We found that the tilt ordering in our iron-doped material is always short-ranged, and in the HTT phase the correlation between the tilts along the b axis is better preserved than that along the a axis. Moreover, we identify the role of the Fe as the nucleation centers of the LTO domains in the structural phase transition.

Determination of nalbuphine in drug abusers' urine.

Nalbuphine, chemically derived from the oxymorphone, is a potent analgesic with narcotic antagonist activity. Because of the limited availability of methamphetamine, the abuse of nalbuphine as an alternative for methamphetamine began in late 1991 in Korea. In this study, the analysis of nalbuphine by gas chromatography (GC) was investigated. Using solid-phase extraction, we analyzed drug abusers' urine samples in order to quantitate nalbuphine by GC after trimethylsilyl derivatization with N-methyl-N-trimethylsilyltrifluoroacetamide (MSTFA), trimethylsilylimidazole (TSIM), and 1% trimethylchlorosilane (TMCS) (100:2:5). Nalbuphine and its two metabolites, nornalbuphine and 6-ketonalbuphine, were identified by gas chromatography-mass spectrometry. The ratio of total (i.e., nonconjugated and glucuronide) nalbuphine to nonconjugated nalbuphine ranged from 1.8 to 3.0 in the five drug abusers' urine. The urinary excretion of nalbuphine showed that 93% of nalbuphine was excreted in 6 h after intraperitoneal administration of 10 mg/kg nalbuphine to five rats. No nalbuphine was detected in the urine specimens of rats from 24 to 48 h.