Imaging urodynamic characteristics of lower urinary tract dysfunction in young male / 现代泌尿外科杂志

【Objective】 To analyze the results, characteristics and clinical value of video urodynamic study (VUD) of lower urinary tract symptoms (LUTS) in young male. 【Methods】 A total of 106 young male LUTS patients (18-45 years old) who received VUD in our hospital during Jan.2016 and Sep.2021 were collected to analyze the clinical and imaging urodynamic characteristics. 【Results】 Of the 106 patients, 55 (52.44%) had neurogenic lower urinary tract dysfunction (NLUTD)with clear neurological etiology, and 51 (48%) had non-neurogenic lower urinary tract dysfunction (NNLUTD). In NLUTD patients, dysuria was the most common symptom (76.74%); lumbosacral lesions were the main cause (76.36%); imaging urodynamics indicated weakening of detrusor muscle in different degrees. In NNLUTD patients,the main symptoms were frequent urination (48.72%) and dysuria (48.72%); about 58.97% of patients had two or more LUTS, and the main diagnosis was detrusor underactivity (DU)(35.90%). 【Conclusion】 NLUTD in young male is characterized by varying degrees of detrusor muscle weakness, detrusor sphincter dyscoordination, and decreased bladder compliance. NNLUTD is mostly caused by detrusor overactivity (DO) and DU.

Technical requirements for prevention and control in kindergartens during COVID-19 outbreak / 中国学校卫生

Abstract@#Kindergartens are the key places for the prevention and control of COVID-19. This guidance puts forward the technical requirements for prevention and control of kindergartens from three aspects，which include organization guarantee and technical requirements, place and personnel requirements before opening; personnel management and control, cleaning and disinfection of the object surface of key areas, ventilation, food and drinking water sanitation, personal items disinfection, garbage cleaning after opening, and emergency disposal of suspected infection symptoms.

Related factors for the development of fulminant myocarditis in adults / 中华心血管病杂志

Objective@#To determine the early recognizable factors related to patients with fulminant myocarditis.@*Methods@#Medical records from 60 adult patients who were diagnosed with acute viral myocarditis from January 2003 to September 2016 in our hospital were retrospectively reviewed, and divided into the fulminant group (n=9) and the non-fulminant group (n=51). Clinical presentations, biochemical markers, electrocardiography and echocardiography features on admission were analyzed.@*Results@#Prevalence of syncope (33.3%(3/9) vs. 2.0% (1/51), P=0.009) and fatigue (77.8% (7/9) vs. 21.6% (11/51) , P=0.002) was significantly higher, while the duration from flu-like syndromes to chest discomfort was shorter ((2.0±1.8) days vs. (4.5±3.5) days, P=0.041) in the fulminant group than that in the non-fulminant group. Systolic blood pressare (SBP) ((94±14) mmHg(1 mmHg=0.133 kPa) vs. (117±12)mmHg, P=0.001) and left ventricular ejection fraction((49±12)% vs. (60±13)%, P=0.016) were significantly lower, while heart rate ((99±20)bpm vs. (84±19)bpm, P=0.040) and NT-proBNP concentration ((7 962 (1 470, 23 849) ng/L vs. 1 771 (45, 2 380) ng/L, P=0.000) were significantly higher in the fulminant group than those in the non-fulminant group. PR interval was longer (199 (140, 416) ms vs. 156 (112, 204) ms, P=0.021), QRS complex was wider ((127±14)ms vs. (95±13)ms, t=-6.647, P<0.001) in the fulminant group than those in the non-fulminant group. Prolonged QRS duration≥120 ms was more often in fulminant group (77.8%(7/9) vs. 5.9%(3/51), P=0.000). Multivariate analysis revealed that PR interval (adjusted odd ratio 1.044, 95%CI 1.005-1.084, P=0.025) and QRS complex width (adjusted odd ratio 1.252, 95%CI 1.045-1.501, P=0.015) were the independent risk factors significantly associated with fulminant myocarditis.@*Conclusions@#The risk of a fulminant course of acute myocarditis is higher in patients with elevated NT-proBNP, reduced left ventricular ejection fraction, and conduction disturbances at admission. Prolonged PR interval and widened QRS complex on admission are independent risk factors for developing fulminant myocarditis in adult patients with acute viral myocarditis.

Mid-term Outcomes of“2-staged”Hybrid Coronary Revascularization in Treating 73 Patients With Multi-vessel Coronary Artery Disease / 中国循环杂志

Objective: To observe the midterm outcomes of“2-staged”hybrid coronary revascularization (HCR) for treating the patients with multi-vessel coronary artery disease (CAD) and to evaluate the feasibility, safety and effcacy of“2-staged”HCR. Methods: A total of 73 relevant patients received elective “2-staged” HCR in our hospital from 2012-01 to 2014-06 were studied. There were 50 (68.5%) male and 23 (31.5%) female at the age of (61.1±10.7) years and all patients had multi coronary artery lesions including left anterior descending (LAD) artery. The key points of“2-staged”HCR were as follows:double-chamber intubation with general anesthesia, small incision between 4-5 ribs of left front thorax, take left internal mammary artery (LIMA) by direct view and make anastomosis of LIMA and LAD with heartbeat. At (3-5) days post-minimally invasive direct coronary artery bypass (MIDCAB), coronary angiography (CAG) was conducted to confirm that LIMA-LAD bypass vessel was unobstructed; then percutaneous coronary intervention (PCI) was performed in non-LAD coronary artery for stent implantation. Post-operative echocardiography, chest X-ray and ECG were examined in each year;coronary CTA or CAG would be taken if the patients with myocardial ischemia. Results: All patients finished“2-staged”HCR smoothly and no operative death occurred. The average surgical time was (152.9±43.8) min and (2.6±0.5) coronary branches were treated, total post-operative drainage volume was (558.6±441.3) ml, red blood cell transfusion was (0.8±1.9) U, mechanical ventilation time was (10.5±13.0) h. The interval between MIDCAB and PCI was (5.3±2) days and (1.6±0.7) stents was implanted. During post-operative follow-up period, there 1 (1.4%) patient died, 3 (4.1%) with recurrent myocardial ischemia, 1 (1.4%) with in-stent restenosis and received PCI again, 4 (5.5%) with MACCE. Conclusion: “2-staged”HCR is a safe and feasible operation with satisfactory peri-operative and mid-term outcomes;it is suitable for the patients with multi-vessel CAD including severe LAD lesions.

"Effect of ""brisk walking"" on male elderly with hypertension in community-based health centers" / 上海交通大学学报（医学版）

Objective · To explore the effects of brisk walking on blood pressure, body mass index (BMI), and autonomic nerve activity of male elderly with hypertension in community-based health centers in Shanghai. Methods · A total of 630 elderly men received brisk walking treatment (>10000 steps/d) voluntarily, who were selected from six community-based health centers in Pudong New Area of Shanghai. Among them, 210 people stick to training for 12 weeks. According to whether suffering from hypertension, the people were assigned to hypertension intervened group (intervention group, n=110) and normal intervened group (control group 1, n=100). Blood pressure, BMI, heart rate and autonomic nerve activity before and after the training were compared. Results · After 12 weeks of training, systolic blood pressure (SBP), diastolic blood pressure (DBP) and sympathetic nerve activity of intervention group were significantly lower than those before the training (P0.05). Conclusion · Brisk walking treatment lasting for 12 weeks can decrease blood pressure and sympathetic nerve activity in elderly men with hypertension. It is worthy to be popularized in the community.

Study of medical equipment configuration based on Markov-process / 医疗卫生装备

Objective To explore medical equipment allocation with considerations on randomly distributed and dynamic injury conditions by analyzing injury conditions transition and medical equipment stochastic service process.Methods A casualty array change model was established by injury conditions evolution analysis,Poisson process and Markov chain.Medical equipment stochastic service processes in medical facilities were probed,and the service rules were constructed.Expert investigation was carried out to acquire conditions transition indexes and to determine the vectors for conditions transition without manual intervention and their changes after treatment,then simulation tools were used to optimize medical equipment allocation.Results The emergency treatment table in some field medical station was considered as the subject,and the optimum allocation was proposed for emergency treatment table with practical data and simulation calculation.Conclusion The emergency treatment table allocation proposed was similar to the actual one in the medical station.Markov-process-based medical equipment allocation responses injury conditions changes and the fluctuation of treatment sequence,which has the result reliable and the method versatile and practical,and lays a foundation for medical equipment allocation and optimization.

Analysis of medical humanities connotation in view of value demand by patients / 中华医院管理杂志

Humanistic quality of medical workers directly affects the quality of medical service and patient satisfaction.In view of patient′s value demand,this paper identified main setbacks in humanistic service in China in the course of medical service.The authors found out the reasons for the lack of humanities quality,and interpreted medical humanistic spirit,medical professional spirit,medical ethics and morality,and connotation of medical law culture.On such basis,the paper unveiled the importance of medical humanities accomplishment in medical practice and medical students′training,proposing to promote the concept of humanistic spirit of medicine and the doctor-patient communication skills.

Advancement on the use of percutaneous mechanical circulatory support devices in severe cardiovascular diseases / 中华危重病急救医学

Percutaneous mechanical circulatory support (PMCS) devices are effective in the treatment of patients with cardiogenic shock and acute decompensated heart failure, as a bridge to the recovery of heart function or further treatment. The intra-aortic balloon pump (IABP) is now the most widely used PMCS. New PMCS devices including Transseptal device of Tandem-Heart, transaortic valve device of Impella and extracorporeal membrane oxygenation (ECMO) might provide more effective hemodynamic supports. Doctors should choose appropriate PMCS devices and their working modes, according to patient's clinical conditions, based on the working principles and hemodynamic effects of the devices, in order to achieve the best effects and help patients live through the crisis of diseases.

Equipment allocation analysis of the U.S.Army Medical Company / 军事医学

The modular,net-enabled,full-dimensional protective and highly mobile equipment of the U.S.Army medi-cal company is systematically analyzed.The roles and performance of essential equipment are outlined, and some sugges-tions are raised, providing reference for the PLA medical equipment construction.

Minimally Invasive Coronary Bypass by Using Bilateral Internal Mammary Arteries Combine with Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease:Case Report / 中国微创外科杂志

[Summary] A 60-year-old man was admitted with main complaint of chest pain on exertion.Coronary angiogram showed severe triple vessel disease.He underwent the hybrid technique of treatment through two left minithoracotomy incisions.Both internal thoracic arteries were harvested under direct vision.The left internal mammary artery (LIMA)and right internal mammary artery (RIMA) compositing Y grafts was constructed. The LIMA was anastomosed to the left anterior descending branch and the RIMA was anastomosed to the ramus intermedius.The operation time was 306 min.The amount of bleeding during operation was 50 ml.Five days later he underwent percutaneous coronary intervention at right coronary artery lesion successfully.He was discharged from hospital 8 days after operation,and didn’t complain of chest pain during fellow-up for one month.This technique demonstrates to be an effective and minimally invasive alternative to treat patients with multivessel coronary artery disease.

Study of α1 adrenoceptor-mediated vasoconstriction and protein expressions induced by mmLDL in mouse mesenteric artery / 中国药理学通报

Aim To investigate the effects of mmLDL on the up-regulation ofα1 receptors in moues mesenter- ic arteries. Methods Mice tail intravenous injection of mmLDL was used . Vitro sensitive myograph was empl- oyed to examine Noradrenaline ( NA) induced vascular contraction on mice mesenteric artery, and the mRNA and protein expressions ofα1 andα2 receptors were an-alyzed by real-time PCR and Western blot, respective-ly. Results mmLDL significantly increased NA in-duced concentration-contractile curve, and the data of Emax and pEC50 were from ( 122. 61 ± 9. 40 )% and (5. 65 ± 0. 05 ) in normal saline ( NS ) group to (161. 01 ± 6. 90 )% and ( 6. 20 ± 0. 08 ) in mmLDL group (P tion-contractile curve induced by NA towards right. Af-ter using mmLDL, the mRNA and protein levels of α1 adrenoceptor were significantly increased, but the mR-NA and protein levels of α2 adrenoceptor were not changed. Conclusion Tail intravenous injection of mmLDL enhances the vascular expressions of α1 adre-noceptors and the contractile effects mediated byα1 ad-renoceptors.

Development overview and suggestions of the US armed forces' medical electronic health record system / 医疗卫生装备

The development overview of the US armed forces' medical electronic health record system was described, including its emergence background, development process, block deployment, battlefield application, recent development and future trends, etc. Meantime, the related systems of the PLA were explained. Then, some suggestions on the development of the PLA health informatization were put forward, including emphasis on top-level design and overall planning, stepwise implementation and sequential advance, combined utilization during war and peacetime and integrated development, civil-military integration and technology outsourcing, etc.

An analysis of patients receiving emergency CAG without PCI and the value of GRACE score in predicting PCI possibilities in NSTE-ACS patients / 老年心脏病学杂志（英文版）

Background There are patients who underwent emergency coronary angiography (CAG) but did not receive percutaneous coronary intervention (PCI). The aim of this study was to analyze these reasons. Methods This is a single-center retrospective study. We recruited 201 consecutive patients who received emergency CAG but did not receive PCI. To investigate the value of the Global Registry of Acute Coronary Events (GRACE) score in predicting PCI possibilities in non-ST segment elevation acute coronary syndrome (NSTE-ACS) pa-tients, we recruited 80 consecutive patients who presented with NSTE-ACS and received emergency CAG as well as emergency PCI. Re-sults Among the 201 patients who received emergency CAG but did not receive PCI, 26%patients had final diagnosis other than coronary heart disease. In the patients with significant coronary artery stenosis, 23 patients (11.5%) were recommended to coronary artery bypass grafting (CABG), one patient (0.5%) refused PCI; 13 patients (6.5%) with significant thrombus burden were treated with glycoprotein IIb/IIIa receptor antagonist;74 patients (36.8%) were treated with drug therapy because no severe stenosis (>70%) was present in the crime vessel. Moreover, 80 of the 201 patients were presented with NSTE-ACS (excluding those patients with final diagnosis other than coronary heart disease, excluding those patients planned for CABG treatment), referred as non PCI NSTE-ACS. When comparing their GRACE scores with 80 consecutive patients presented with NSTE-ACS who received emergency CAG as well as emergency PCI (referred as PCI NSTE-ACS), we found that PCI NSTE-ACS patients had significantly higher GRACE scores compared with non PCI NSTE-ACS patients. We then used Receiver Operator Characteristic Curve (ROC) to test whether the GRACE score is good at evaluating the possibilities of PCI in NSTE-ACS patients. The area under the curve was 0.854 ± 0.030 (P<0.001), indicating good predictive value. Furthermore, we analyzed results derived from ROC statistics, and found that a GRACE score of 125.5, as a cut-off, has high sensitivity and specificity in evaluating PCI possibilities in NSTE-ACS patients. Conclusions Our findings indicate that the GRACE score has predictive value in determining whether NSTE-ACS patients would receive PCI.

Association between ambulatory blood pressure levels and blood pressure variability with myocardial performance index in untreated hypertensive patients / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the association between ambulatory blood pressure levels and blood pressure variability (BPV) with myocardial performance index (MPI) in untreated hypertensive patients.</p><p><b>METHODS</b>From January to September 2013, a total of 81 untreated hypertensive patients were included in this study. All patients received ambulatory blood pressure monitoring and echocardiography measurements. MPI was determined in all patients by the following formula: MPI = (isovolumic contraction time + isovolumic relaxation time)/ejection time. The patients were divided into two groups according to left ventricular MPI: patients with MPI < 0.47 (n = 39) and patients with MPI ≤ 0.47 (n = 42). The mean levels and standard deviation (SD) of 24 h, daytime and nighttime blood pressures were compared between the two groups. SD was used to express BPV. Determinants of MPI were identified by multivariate regression analysis.</p><p><b>RESULTS</b>24 h and daytime systolic blood pressure, 24 h, daytime and nighttime diastolic blood pressure, as well as SD of 24 h and daytime systolic blood pressure ((130.1±8.7), (134.0±8.2), (89.1±6.3), (90.9±6.4), (83.1±9.9), (13.7±3.3) and (14.2±3.5) mmHg (1 mmHg = 0.133 kPa), respectively) were significantly higher in patients with MPI > 0.47 than those ((124.8±8.7), (126.7±8.8), (84.5±7.1), (86.2±7.4), (76.4±7.5), (11.8±2.1) and (10.4±1.9) mmHg, respectively) in patients with MPI ≤ 0.47 (all P < 0.05). Multivariate regression analysis showed that 24 h diastolic blood pressure (β = 0.239, P = 0.007) and SD of 24 h systolic blood pressure (β = 0.333, P < 0.001), left ventricular mass index and early diastolic mitral annular velocity were independently associated with MPI.</p><p><b>CONCLUSION</b>The increase of diastolic blood pressure and systolic BPV are associated with the deterioration of left ventricular function.</p>

Association between serum uric acid level and the severity of coronary artery disease in patients with obstructive coronary artery disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies have shown that the serum uric acid (SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary artery disease (CAD) assessed by angiography and the Syntax score in patients with obstructive CAD.</p><p><b>METHODS</b>Participants who visited our hospital for a coronary angiography, from December 2007 to September 2012, were eligible for this analysis. SUA and other blood parameters after at least 12-hour fast were determined. First, the patients were divided into tertiles according to their Syntax scores (low Syntax score group: Syntax score ≤ 10.0; moderate Syntax score group: 10.0 <Syntax score ≤ 18.0; high Syntax score group: Syntax score >18.0). Second, to clarify the association between SUA levels and major adverse cardiovascular events (MACEs), all patients were divided into two subgroups on the basis of SUA levels. The cutoff value of SUA was defined by diagnostic criteria of hyperuricemia. Patients were separated into normal SUA group (n = 251, with SUA <416 µmol/L for men and SUA <357 µmol/L for women) and high SUA group (n = 96, with SUA ≥ 416 µmol/L for men and SUA ≥ 357 µmol/L for women). All participants were followed for a mean of 22.0 months (1-75 months, interquartile range: 28 months) for major adverse cardiovascular events (MACEs), including all-cause death, recurrent nonfatal myocardial infarction (re-MI) and recurrent percutaneous coronary intervention (re-PCI).</p><p><b>RESULTS</b>A total of 347 patients were registered for the study. The SUA levels in the high Syntax score group were significantly higher than that of the moderate Syntax score group and the low Syntax score group ((392.3 ± 81.6) µmol/L vs. (329.9 ± 71.0) µmol/L, P < 0.001; (392.3 ± 81.6) µmol/L vs. (311.4 ± 64.7) µmol/L, P < 0.001). The SUA level was positively correlated not only with the Syntax score (r = 0.421, P < 0.001; 95% CI: 0.333-0.512), but also with the number of diseased vessels (r = 0.298, P < 0.001; 95% CI: 0.194-0.396). After multiple linear regression analysis, SUA levels were identified to be independently correlated with a high Syntax score (B = 0.033, 95% CI 0.023-0.042, P < 0.001). Compared with the normal SUA subgroup, the high SUA subgroup tended to have a higher Syntax score (19.9 ± 8.7 vs. 13.6 ± 7.5, P < 0.001) and more multi-vessel disease (70.8% vs. 46.6%, P < 0.001). Follow-up data showed a higher incidence of MACE in the high SUA subgroup (20.8% vs. 6.0%, P < 0.001). Binary Logistic regression analysis indicated that the elevated SUA can predict the long-term prognosis of patients with obstructive CAD (OR = 2.968, 95% CI 1.256-7.011, P = 0.013). Kaplan-Meier analysis showed a significantly lower event-free survival rate in patients with high SUA levels than in the normal SUA subgroup (79.2% vs. 94.0%, Log rank = 17.645, P < 0.001).</p><p><b>CONCLUSIONS</b>SUA levels were independently associated with the severity of CAD in patients with obstructive CAD. An elevated SUA is associated with cardiovascular events and may be useful as a biomarker of the severity of CAD.</p>

Prognostic value of coronary artery calcium score in patients with stable an-gina pectoris after percutaneous coronary intervention / 老年心脏病学杂志（英文版）

Objectives To evaluate the prognostic value of the coronary artery calcium (CAC) score in patients with stable angina pectoris (SAP) who underwent percutaneous coronary intervention (PCI). Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography (MSCT) were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events (MACE) were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score>300 (n=145) had significantly higher PCI complexity (13.1%vs. 5.8%, P=0.017) and rate of procedure-related complications (17.2%vs. 7.4%, P=0.005) than patients with a CAC score≤300 (n=189). After a median follow-up of 22.5 months (4-72 months), patients with a CAC score≤300 differ greatly than those patients with CAC score>300 in cumulative non-events survival rates (88.9 vs. 79.0%, Log rank 4.577, P=0.032). After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio (HR):4.3, 95%confidence inter-val (95%CI):2.4-8.2, P=0.038] in patients with a CAC score>300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.

Relationship between fasting plasma glucose level and coronary lesions SYNTAX score / 中国介入心脏病学杂志

Objective To analyze the relationship between fasting plasma glucose (FPG) level and complexity of coronary artery lesions in patients with coronary stenosis by angiography. Methods The data of clinic and coronary angiogram (CAG) were retrospectively collected in 929 patients with established coronary stenosis by coronary angiography at Peking University Third Hospital from January 2009 to January 2011. The patients were grouped according to SYNTAX score, and the relationship between FPG level and SYNTAX score were analyzed using bivariate, Multivariate stepwise regression and logistic regression analysis. Results ①929 patients were devided into three groups:47 cases into low risk group (score<22), 189 into moderate risk group (score≥22 and<33) and 639 into high risk group (score≥33). Intergroup analysis showed that age (P=0.000), FPG level [5.20 (4.70,6.30) mmol/L, 5.70 (4.90,7.15) mmol/L, 5.80 (5.30,7.60) mmol/L, P=0.000], proportions of FPG abnormality [283 (40.8%), 100(52.9%), 28(59.6%), P=0.001] and patients with diabetes history (P=0.003) were increased along with SYNTAX score elevated.②Correlation analysis showed correlativity (r=0.167, P=0.000) between SYNTAX score and FPG. In non-diabetes history subgroup, correlation between SYNTAX score and FPG remained signiifcant (r=0.149, P=0.000). However, in diabetes history subgroup, the correlation was not significant. ③ Multivariate stepwise regression analysis showed an independent correlation between FPG and SYNTAX score (β=0.452, P=0.002). In non-diabetes history subgroup, the correlation remained significant (β=1.039, P=0.000).④ When moderate-high risk group serve as dependent variable, and age, gender, CAD risk factors and FPG serve as independent variables, logistic regression analysis screened out two variables:age (whole group:OR 1.033, 95%CI 1.017 ~ 1.049, P=0.000;non-diabetes history subgroup:OR 1.039, 95%CI 1.020 ~ 1.059, P=0.000) and FPG (whole group: OR 1.114, 95% CI 1.038 ~ 1.195, P=0.003; non-diabetes history subgroup:OR 1.299, 95%CI 1.088 ~ 1.387, P=0.001). Conclusions FPG is likely to relfect complexity of coronary artery lesions and predict SYNTAX score in patients with coronary stenosis, especially in patients without diabetes history.

Association of serum angiopoietin-1 and angiopoietin-2 with ST-segment resolution in acute ;myocardial infarction patients treated with primary percutaneous coronary intervention / 中国介入心脏病学杂志

Objective To investigate the association of serum angiopoietin-1 (Ang-1) and angiopoietin-2 (Ang-2) with myocardial reperfusion in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI). Methods A total of 103 consecutive STEMI patients who received primary PCI were enrolled in this study. The patients were divided into two groups according to ST-segment resolution (STR) at 2 h after PCI:STR ≥ 50%group (n=69) and STR0.05). In multivariable logistic regression analysis, Ang-2/Ang-1 before PCI was independently associated with STR < 50%;Other independent predictors were pain to balloon time, infarct related artery (LAD), and TIMI flow grade<Ⅲafter PCI. Conclusions Higher Ang-2/Ang-1 is an independent predictor of poor myocardial reperfusion in STEMI patients after PCI.

Diagnostic value of three-dimensional fluid-attenuated inversion recovery MR imaging after intratympanic administration of contrast media in Meniere's disease / 中华放射学杂志

ObjectiveAfter intratympanic gadolinium administration through the tympanic membrane,three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) was performed to evaluate endolymphatic visualization and its diagnostic value in Meniere's disease.MethodsTwenty-four hours after intratympanic gadolinium administration through the tympanic membrane,19 patients with unilateral Meniere's disease diagnosed clinically underwent 3D-FLAIR and 3D-Balance-FFE imaging at 3.0 T MR scanner.The enhanced imaging of perilymphatic space in bilateral cochlea,vestibular and (or) canal were observed.Scala tympani and scala vestibule of bilateral cochlear basal turn were scored respectively.The enhanced range of bilateral vestibule and the signal intensity ratio (SIR) between the vestibule and the brain stem were measured. Wilcoxon tests and paired t tests were used.ResultsThe gadolinium appeared in almost all parts of the perilymph in cochlea,vestibular and (or) canal,so the endolymphatic space was clearly visualized on 3D-FLAIR imaging.The score of scala vestibuli between the affected side (3 cases scored 2,9 cases scored 1,7 cascs scored 0) and the healthy side ( 15 cases scored 2,2 cases scored 1,2 cases scored 0 ) were significantly different ( U =3.090,P ＜ 0.05 ).The area of enhanced vestibular were (5.77 ± 2.33) mm2 and (8.11 ± 3.32) mm2 for the affected side and the healthy side,which were significantly different ( U =3.090,P ＜ 0.05 and t =2.638,P ＜ 0.05 ).Conclusions According to 3D-Balance-FFE MRI and the enhancement of perilymphatic space,3D-FLAIR MRI with intratympanic gadolinium injection through the tympanic membrance can be used to show the border between the perilymph and the endolymph and confirm endolymphatic hydrops,thus providing radiographic evidence for the diagnosis of Meniere's disease.

The door-to-balloon time in primary percutaneous coronary intervention for ST-elevation myocardial infarction:current clinical practice and influential factors / 中华内科杂志

To investigate whether current clinical practices are consistent with the guidelines of STEMI about door-to-balloon time and the factors associated with the delay of PCI.Methods A total of 219 patients,who were edmitted to our hospital during 2004 to 2005,were included in this study.Demographic data,clinical characteristics and the exact time of symptom presentation,registration at the emergency department and the first ballooning were retrospectively evaluated.Results The median door-to-balloon time was 135 minutes,and only 24.7% of the patients achieved a door-to-balloon time of less than 90 minutes.Patients who did not present in routine working hours were less likely to receive reperfusion therapy within current recommended time(P<0.001,OR=3.413,95% CI 1.805-6.452).Conclusions Many patients with STEMI were not treated within the recommended door-to-balloon time.Presentation of the patients out of working hours is one of the independent predictors of door-to-balloon time delay in primary angioplagty.