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Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD) patients undergoing PCI via radial artery access with radial artery or (and) brachial artery spasm ( group A ) were retrospectively analyzed .Among all these patients , guiding catheters were delivered through the spasmodic vessels successfully by the aid of PCI guiding wires and balloons .The clinical data of other 38 CAD patients having PCI during the same period performed by other operators via radial artery or ( and ) brachial artery approach and experienced vessel spasm were anlysed as the control ( group B ) .All patients in group B received conventional anti-spasm management during PCI .All vessel spasm was identified by angiography.For patients in group A , a diameter of 0.014 inch guiding wire was chosen to pass through the spasmodic vessel segment carefully and gently .The diameter of balloon should be chosen according to the diameter of guiding catheter .A balloon diameter of 2.0 mm and 2.5 mm was corresponded to 6F and 7F guiding catheter respectively .The balloon was advanced to the tip of guiding catheter , keeping a half in catheter and a half in vessel followed by inflating the balloon with a pressure of 8 atm.The balloon was kept inflated the guiding catheter was pushed in vitro carefully and slowly until the catheter passed through the spasmodic vessel segment .Then the balloon was deflated and pulled out together with PCI guiding wire . Exchanged a diameter of 0.035 inch wire and completed the positioning of guiding catheter .After finishing the PCI, radial or ( and) brachial angiography was performed again to observe if spasm disappeared and to determine if there any contrast medium exudation .For patients in group B , routine approach was applied including administration of nitroglycerine , diltiazem or nitroprusside etc . to relieve vessel spasm. Results The location of vessel spasm was similar in group A and group B ( P=0.150 ) , and the incidence rate of spasm in brachial artery was higher than that in radial artery in both groups .The chance of guiding catheter crossing the spasmodic vessel segment was significantly higher in group A than in group B ( 100%vs.39.5%, P=0.00).In patients whose guiding catheter could pass through the spasmodic vessel segment successfully , time spent in group A was shorter than in group B ( P=0.000 ) .The patient number which time spent was less than five minutes , five to 15 minutes and more than 15 minutes was 30 and 2 ( 90.1%vs.13.3%) , 3 and 7 ( 9.9% vs.46.7%) and 0 and 6 ( 0% vs.40.0%) in group A and in group B respectively.The incidence of forearm hematoma was lower in group A than in group B without statistical difference [6.1%(2/33) vs.18.4%(7/38), P =0.113].Conclusions It is safe and feasible for passing guiding catheter through spasmodic vessels during PCI via radial artery access by the aid of PCI guiding wire and balloon .
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Objective To explore the accuracy of three dimensional speckle tracking imaging (3D-STI) in quantitative coronary evaluation of (CHD) patients' left ventricular global systolic function.Methods Sixty-eight CHD patients were divided into three groups according to the coronary artery angiography (CAG) results:32 cases in severe stenosis group,23 cases in moderate stenosis group,and 13 cases in mild stenosis group.Thirty gender-age-matched healthy subjects(control group) were enrolled in this study.All patients underwent 2D-echocardiography and real-time three-dimensional echocardiography (3DE).The global longitudinal strain(GLS),global radial strain(GRS),global circumferential strain(GCS),global area strain (GAS),global area strain rate (GASrate) and 3D global LV strain (3D-Strain) were analyzed using 3D-STI.Correlation between strain measurements and left ventricular ejection fraction (LVEF) by simpson method,3D-LVEF by 3DE were assessed using linear regression analysis.Results All 3D-STI parameters in the severe stenosis group were significant decreased compared with the other groups.GLS,GRS,GCS,GAS,3D-Strain of moderate stenosis group shown more significant decrease than both mild stenosis group and control group (P ＜ 0.05).Strong correlations were demonstrated in all 3D-STI parameters between 3D-LVEF and LVEF.The strongest correlation was observed between GAS with 3D-LVEF in severe stenosis group(r =-0.910,P ＜0.05).Intraobserver and interobserver reliability of GAS was better than other parameters.Conclusions Global strain of 3D-STI can quantitatively evaluate the global LV function in CHD patients,and GAS is more sensitive and reproducible than other parameters.
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Objective To compare the clinical efficacy of diciofenac sodium suppository and terazosin in treatment of prostatodynia. Methods 120 patients(age ranging from 19 to 48 years,mean age was 29. 8 years) suffering from prostatodynia, were randomly divided into 2 groups: diciofenac sudium suppositoy group of 60 patients (50mg,rectal medication, q12h for 2 weeks) and terazosin group of 60 patients (2mg, per os, q12h or qn for 2 weeks).The therapeutic effects and side-effects were compared after 2 weeks treatment. Results The total clinical effective rate in diciofenac sudium suppository group was 97% , higher than that (80%) of terazosin groups(P
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Objective To compare their antipyretic effect of diclofenac suppository (diclofenac) and injectio amidopyrini compositae (amidopyrin) in the treatment for surgical infection with high fever. Methods One hundred patients suffering from surgical infection with high fever were randomly divided into two groups: 50 cases in diclofenac group (50 mg with rectal administration) and 50 cases in amidopyrin group (2 ml, with intramuscular injection) , and their antipyretic effects were observed. Results The antipyretic effect of diclofenac (with an overall effective rate of 96% ) was better than that of amidopyrin (82% ), with a P-value less than 0.05, and their remarkably effective rates were 82% and 58% for the two groups, respectively, with a P-value less than P
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AIM: To observe the curative efficacy of Shenkang Bolt(SKB) in treating chronic renal failure(CRF) with blood silt and damp pathogen syndrome. METHODS: The randomized,parallel and controlled trial were used.38 cases in treatment group were treated with SKB,and 40 cases in control group were clystered with Chinese herbal medicine.The changes of the cumulative scores of traditional Chinese medicine(TCM) syndrome,the levels of serum creatinine(SCr) and creatinine clearance rate(CCr) before and after treatment in both groups were observed. RESULTS: The total effective rate was 81.5% in the treatment group,but 75% in the control group.The scores of TCM syndrome and the levels of SCr were both significantly decreased(P(0.05)). CONCLUSION: SKB can markedly improve the clinical manifestations of CRF with blood silt and damp pathogen syndrome,decrease the levels of SCr,but increase CCr.There was no difference between Chinese herbal clysis and Shenkang Bolt in curative effect,but it is convenent to take Shenkang Bolt.