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Electrode array misplacement is a rare complication of cochlear implant. This article reports an 11-year-old boy who was mistakenly implanted the cochlear electrode array into the superior semicircular canal during the initial cochlear implant. After the diagnosis was confirmed, he underwent a second cochlear implant and the electrode array were successfully implanted into the cochlea. This article conducted a systematic review of the literature on electrode array misplacement, and the causes of electrode array misplacement were analyzed from different implantation position.
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Male , Humans , Child , Electrodes, Implanted , Reoperation , Cochlea , Cochlear Implantation , Cochlear Implants/adverse effects , Semicircular Canals/surgeryABSTRACT
Objective: To describe a technique of endoscopic transoral approach nasopharyngectomy for petroclival and jugular foramen nasopharyngeal carcinoma, based on anatomic studies and surgeries. Methods: Three dry human skulls and five fresh human cadaver heads were used for anatomic study of a endoscopic transoral approach to expose petroclival and jugular foramen. The anatomical landmarks and the extent of exposure were recorded. Six clinical cases who were treated in Eye & ENT Hospital, Fudan University from June 2020 to April 2022 were used to illustrate the technique and feasibility of this approach and to assess its indications and advantages, including 3 males and 3 females, aged 42 to 69 years old. Descriptive analysis was used in this research. Results: On the basis of the preservation of the internal pterygoid muscle and the external pterygoid muscle, this approach could fully expose the parapharyngeal, petrosal and paraclival segment internal carotid arteries, and safely deal with the lesions of jugular foramen and petroclival region. The 6 patients in our study tolerated the procedure well. Postoperative enhanced MRI showed complete resection of the tumor and no postoperative masticatory dysfunction. Conclusion: Endoscopic transoral approach is a safe, minimally invasive and effective surgical treatment for petroclival and jugular foramen recurrent nasopharyngeal carcinoma.
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Male , Female , Humans , Adult , Middle Aged , Aged , Nasopharyngeal Carcinoma , Jugular Foramina , Neoplasm Recurrence, Local , Endoscopy/methods , Nasopharyngeal Neoplasms/surgeryABSTRACT
Nasopharyngeal carcinoma (NPC) is a common malignant tumor in China. Radiotherapy is the first-line treatment. After appropriate radiotherapy, about 5%-15% patients experience recurrence. In view of the poor efficacy and high incidence of severe late toxicities associated with re-irradiation, salvage surgery by the transnasal endoscopic approach is recommended for recurrent NPC (rNPC). Compared with re-irradiation, endoscopic surgery can better prolong survival, improve the quality of life, and reduce complications and medical expenses of patients with rNPC. However, the complexity of the nasopharyngeal skull base enhances the difficulty and risk of surgery. Expanding the boundary of surgical resection remains a clinical challenge for otolaryngologists. In this regard, to help more advanced patients with rNPC, the surgical innovative system of NPC needs to be established by multi-disciplinary cooperation, involving skull base anatomy-based investigation, appropriate administration of the internal carotid artery (ICA), repair of skull base defect, and establishment of various types of endoscopic endonasal nasopharyngectomy.
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To evaluate the value of endoscopic retrograde cholangiopancreatography(ERCP)and SpyGlass in the diagnosis of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B). Data of patients who underwent ERCP and SpyGlass in Hangzhou First People′s Hospital from January 2016 to December 2019 were analyzed. ERCP and SpyGlass features, complications, clinicopathologic characteristics and prognosis were retrospectively analyzed.A total of 9 patients (5 benign lesions and 4 malignant lesions) were included.ERCP was successfully performed in 9 cases, while SpyGlass was technically successful in 8 cases. Endoscopy showed mucus outflow from the papilla in 5 cases, and the mucus was removed by the balloon of ERCP in 8 cases.ERCP showed bile duct diffuse dilatation and filling defects in all patients. SpyGlass found the mucus in the bile duct in all patients. SpyGlass showed lesion mucosa were fish-egg like without vascular images (Ⅱtype, 3 cases), fish-egg like with vascular images (Ⅲ type, 1 case), villous (Ⅳtype, 4 cases). SpyGlass defined extent of the lesion in 8 cases. SpyGlass found that the lesion involved the intra and extrahepatic bile ducts in one case. Therefore, liver transplantation was recommended to avoid surgical exploration. One type Ⅲ lesion underwent a direct biopsy. The pathology showed moderate dysplasia, which was consistent with the postoperative pathology. No complication occurred. ERCP combined with SpyGlass could clarify the scope of IPMN-B and provide basis for surgical options, which is safe and effective in IPMN-B diagnosis.
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Objective@#To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage.@*Methods@#Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate.@*Results@#32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively.@*Conclusion@#The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.
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To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.
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Objective:To investigate the correlation between concomitant diabetes mellitus and clinical features in patients with COVID-19.Methods:Fifty patients with COVID-19 admitted to the Sixth People′s Hospital of Shenyang were divided into 2 groups with and without diabetes mellitus. Indexes such as hospitalization days, duration of positive virus-PCR result, secondary infection, duration of fever, rate of liver dysfunction, and rate of cardiac injury were compared between 2 groups.Results:The average hospitalization durations of diabetes group and control group were(24.0±6.8) and(18.4±5.9) days, respectively, and the duration of positive virus-PCR testing results were(16.0±4.5) and(12.3±4.4) days respectively, suggesting longer hospital stay and longer time for virus clearance in the diabetes group than those in the control group(both P<0.05). The rates of secondary infection, severe subtype, liver dysfunction and cardiac injury in the diabetes group increased, though without significant difference( P>0.05). Conclusion:Prolonged duration of positive virus-PCR result and average days of hospitalization in patients with COVID-19 may be associated with diabetes mellitus.
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Objective To investigate the diagnosis and treatment of solid-pseudopapillary tumor of pancreas (SPTP). Methods The clinical manifestations, imaging findings, treatment and prognosis of 36 patients with SPTP from September 2005 to December 2015 were retrospectively analyzed. Results All patients were female, with the average age of 30.5 years. There were 11 cases of abdominal mass and 15 cases of abdominal tenderness. Thirty-three patients underwent ultrasonography, which showed pancreatic solid heterogeneous hypoechoic, echogenic light clusters or cystic mixed echogenic masses;the tumors boundary were clear, and some tumors were separated in the center; most tumors were not accompanied by pancreatic duct and bile duct dilatation. CT plain scan showed that most tumors were single circular mixed density shadow with clear capsule;CT enhanced scan showed that the arterial phase of the cyst wall and solid area was mild or moderately enhanced, and the portal phase and the delayed phase continued to strengthen, and the cystic part was not strengthened in each period. All patients underwent surgical treatment. Postoperative pancreatic fistula occurred in 8 cases, edematous pancreatitis in 6 cases, incision infection in 2 cases, all of which were cured after symptomatic treatment. The patients were followed up for 5 to 120 months with an average of 56 months. All patients were not treated with postoperative radiotherapy or chemotherapy. Thirty-four patients had a good prognosis and no signs oftumor recurrence and metastasis;1 patient died of acute leukemia 2 months after discharge, and 1 patient was lost in follow-up after 1 year of postoperative liver metastasis. Conclusions The main patient group of SPTP is young women. The clinical symptoms are mostly abdominal mass and tenderness. Preoperative diagnosis is difficult. Imaging examination is great significance for the preoperative diagnosis of SPTP. Surgical resection is the only effective treatment. The choice of surgery should be based on the location of the tumor, the invasion tendency of the tumor seen during surgery, and the rapid pathology of the operation. Most patients with SPTP have a good prognosis, and the recurrence rate and metastasis rate are low.
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Objective To explore the relationship between heart rate variability (HRV),heart rate turbulence (HRT) and blood pressure (BP) control in hypertensive patients.Methods Hypertensive patients with controlled BP group (n =50) and uncontrolled BP group (n =40) and control group non-hypertensive patients (n =52)were enrolled in this study in our hospital during June 2015 to June 2016.HRV and HRT as well as clinical characteristic of the three groups were analyzed.Results (1) Body mass index was significantly higher in the controlled BP group than in the control group.There was no statistical difference in proportions and categories of antihypertensive medication between the uncontrolled and controlled BP groups (P ＞ 0.05).(2) VLF,LF and TS were significantly lower in the uncontrolled BP group than the control group,and HF was significantly lower in the uncontrolled BP group than in the controlled BP group (P ＜ 0.05).(3) Results of muhiple logistic regression analysis showed that lower rMSSD,pNN50,VLF,LF,HF and TS were risk factors for BP control after adjusting for gender,age,EF value,creatinine,blood lipids,Beta-blockers and history of smoking,coronary heart disease and diabetes mellitus.(4) Spearman correlation analysis of the hypertensive patients showed that LF was negatively correlated with TO,and SDNN,SDANN,rMSSD,pNN50,VLF,LF,HF were positively correlated with TS.Conclusion The present results demonstrate that uncontrolled BP is associated with abnormal HRV and HRT,which suggested autonomous nervous imbalance was existed in uncontrolled hypertensive patients.
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Objective To investigate the effects of 72 h sleep deprivation(SD)on circadian clock gene expression in the rat liver.Methods Twelve rats were randomly divided into control group and SD group.An SD instrument was used to deprive the rats′sleep for 72 h.Then the abdominal cavity was exposed to obtain liver,and the expression of clock genes was detected by RT-PCR and Western blotting analysis, respectively.Results Compared with the control group, the mRNA levels of clock,npas2 and rev-erbαstrikingly decreased in the livers of the SD group rats.However,per1,per2 and rorαmRNA levels obviously increased.bmal1 and cry1 mRNA expression hardly changed in the control and SD groups. Meanwhile,the protein levels of liver BMAL1,CLOCK,NPAS2,CRY1 and REV-ERBαwere significantly down-regulated and PER1,PER2 and RORαprotein levels were up-regulated in SD group compared with control group.Conclusion 72 h SD can result in abnormal expressions of several circadian clock genes in the rat liver at both transcriptional and translational levels.
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Objective To evaluate the clinical outcomes of internal fixation with extra-articular distal humerus locking compression plate (LCP) for the treatment of mid-distal humerus diaphyseal fracture.Methods From December 2012 to December 2016,a cohort of 22 patients with mid-distal humerus shaft fracture were treated by open reduction and internal fixation using extra-articular distal humerus LCP.They were 14 males and 8 females with an average age of 42.7 years (range,from 18 to 86 years).According to AO classification,there were 13 cases of type 12-A,7 cases of type 12-B,and 2 cases of type 12-C.The surgical time,intra-operative blood loss and hospital stay were recorded.The clinical outcomes were evaluated by the Mayo elbow performance score (MEPS) at the last follow-ups.Results Surgical time ranged from 46 to 95 minutes with an average of 57 minutes.The average blood loss was 220 mL (range,from 150 to 400 mL).The average hospital stay was 10.5 days (range,from 9 to 13 days).The mean follow-up was 23.8 months (range,from 6 to 48 months).Bone union was achieved in 21 cases after an average of 4.6 months (range,from 3 to 9 months),and one patient experienced bone non-union which was uneventfully healed after secondary auto platelet rich plasma (PRP) graft management.The average MEPS elbow performance score was 88.2,resulting in 16 excellent,4 fine and 2 fair cases (excellent and fine rate:90.9％).Conclusions Since extra-articular distal humerus LCP can provide stable internal fixation,facilitating early postoperative rehabilitation,it may be considered an effective alternative osteosynthesis for mid-distal comminuted humeral diaphyseal fractures.
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The circadian rhythm generated by the endogenous circadian clock system depends on the feedback loop composed of a series of core clock genes (bmal1, clock, cry and per) and clock controlled genes (rev-erbα, rorα, dbp, tef and hlf) .The circadian rhythm is closely related to the body metabolism , which plays important roles in the metabolic process of the major nutrients , such as glucose and fat .Circadian rhythm disorders caused by exogenous factors will significantly increase the risk of metabolic syndrome .This paper focuses on the effect of circadian rhythms on metabolism and their roles in regulating metabolic syndrome .
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The circadian rhythm generated by the endogenous circadian clock system depends on the feedback loop composed of a series of core clock genes (bmal1, clock, cry and per) and clock controlled genes (rev-erbα, rorα, dbp, tef and hlf) .The circadian rhythm is closely related to the body metabolism , which plays important roles in the metabolic process of the major nutrients , such as glucose and fat .Circadian rhythm disorders caused by exogenous factors will significantly increase the risk of metabolic syndrome .This paper focuses on the effect of circadian rhythms on metabolism and their roles in regulating metabolic syndrome .
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Objective@#To establish the model of liver fibrosis based on noninvasive indices, and to investigate the diagnostic value of this model.@*Methods@#A total of 838 patients with chronic hepatitis B (CHB) who underwent liver biopsy in our hospital from March 2003 to October 2013 were selected, and the results of blood tests and B-ultrasound were collected. The correlation between these indices and liver fibrosis stage was analyzed. A logistic regression analysis was performed to establish a predictive model, and the value of this model was examined in validation group. The t-test, Mann-Whitney U non-parametric test, and chi-square test were used for data analysis. A Spearman rank correlation analysis was used for bivariate correlation analysis, and a dichotomous logistic stepwise regression analysis was used for multivariate analysis.@*Results@#In the model group, a model (FV) consisting of age, platelet count (PLT), γ-glutamyl transferase (GGT), albumin/globulin ratio (A/G), and splenic square area (SSA) was established. The areas under the receiver operating characteristic curve (AUROCs) of the model FV were 0.892, 0.910, and 0.915, respectively, in diagnosing significant liver fibrosis (S2-4), progressive liver fibrosis (S3-4), and early-stage liver cirrhosis (S4), with sensitivities of 77.6%, 83.7%, and 86.0%, respectively, specificities of 89.7%, 84.5%, and 83.7%, respectively, and accuracy of 82.1%, 84.2%, and 84.2%, respectively. There were no significant differences in AUROCs between the validation group and the model group (Z = 0.360, 0.885, and 0.046, all P > 0.05). In all patients, FV had significantly higher AUROCs in the diagnosis of liver fibrosis than FIB4 index and S index (Z = 4.569/3.423, 5.640/4.709, and 4.652/4.439, all P < 0.05). With < 0.374 and ≥ 0.577 as the cut-off values for the exclusion and diagnosis of significant liver fibrosis, 61.1% (512/838) of all patients could avoid liver biopsy, and the accuracy was 92.6% (474/512).@*Conclusion@#The noninvasive model based on age, PLT, GGT, A/G, and SSA can accurately predict liver fibrosis degree in patients with CHB with good reproducibility; therefore, it can be used for dynamic monitoring of liver fibrosis degree in clinical practice.
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Objective To investigate the effects of 72 h sleep deprivation (SD) on circadian clock gene expression in the rat spleen.Methods The rats were randomly divided into control group and SD group.An SD instrument was used to deprive the rats of sleep for 72 h.Then the lymphocytes from the spleen were obtained by Ficoll seperation medium before the expression of clock genes was detected by RT-PCR and Western blotting analysis respectively.Results Compared with the control group,the mRNA levels of bmal1,clock,per2 and rev-erbα strikingly decreased in the spleens of the SD group rats.However,npas2,per1,rorα and cry1 mRNA expression hardly changed in the control and SD group.Meanwhile,the protein levels of spleen BMAL1,NPAS2,CRY1 and RORα were significantly down-regulated and PER1 protein levels were up-regulated in SD group compared with control group.However REV-ERBα protein expression remained unchanged in the control and SD group.Conclusion 72 h SD can result in abnormal expressions of several circadian clock genes in lymphocytes of the spleen at both transcription and translation levels.
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Objective To investigate the effect of 36 h continuous sleep deprivation(SD) on circadian clock gene expression in the rat liver and kidney and the alteration of urine biomarker levels.Methods Twelve rats were randomly divided into control group and SD group.An SD device was used to deprive the rats of sleep.After 36 h continuous SD, the abdominal cavity was exposed to obtain livers and kidneys, and RT-PCR and Western blotting were used to detect expression of clock genes.Then,the pelvic cavity was exposed to obtain urine, and the changes in bio-marker total bile acids(TBA) were tested with ELISA.Results Compared with the control group, the mRNA level of liver clock and bmal1 was obviously reduced in the SD-treated rats (P<0.05).However, no obvious change was found in the samples from the kidney.Sharp down-regulation of CLOCK and BMAL1 protein expression was also observed in the rat liver after SD treatment.Urine TBA content in SD treated rats was raised obviously (P<0.001), compared with control.Conclusion Thirty-six hours of continuous SD could result in deregulation of circadian clock gene and cholesterol metabolism disorder in the rat liver.TBA might be used as a noninvasive biomarker of liver injury under SD stress conditions.
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Objective To explore the diagnostic value of combination detection of carcino‐embryonic antigen(CEA ) ,cytokeratin 19 fragment 21‐1(CYFR21‐1) ,neuron‐specific enolase(NSE) in bronchoalveolar lavage fluid (BALF) for early lung cancer and its correlation with clinical effects .Methods 69 cases of lung cancer were included into the lung cancer group and 50 cases of benign pulmonary disease were included into the lung benign disease group .All the patients were given bronchoalveolar lavage(BAL) .The chemiluminescence immunoassay was adopted to detect the levels of CEA ,CYFR21‐1 and NSE in BALF .The changes of tumor markers levels were compared between the two groups and among different clinical curative effects in the patients with lung cancer . Results The levels of CEA ,CYFR21‐1 and NSE in BALF of the lung cancer group were significantly higher than those of the be‐nign pulmonary disease group ,the difference was statistically significant (P < 0 .05) .The levels of tumor markers in the stage Ⅱ of lung cancer were higher than those in the stage Ⅰ of lung cancer ,the difference was statistically significant (P< 0 .05) ;the levels of CEA ,CYFR21‐1 and NSE in BALF were gradually increased with the decrease of clinical effect (P< 0 .05) ;the sensitivity and spe‐cificity of the combined detection of three tumor markers were 62 .3% and 82 .0% respectively ,which were significantly higher than those of any single tumor marker (P< 0 .05) .Conclusion The levels of CEA ,CYFR21‐1 and NSE in BALF of early lung cancer patients are obviously increased ,moreover which is closely correlated with the pathological stage of lung cancer ,the combined detec‐tion could contribute to improve the detection rate of early lung cancer and guide the evaluation of clinical effect .
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Objective To compare different noninvasive models in diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB).Methods A total of 838 CHB patients admitted in Shenyang Sixth People’ s Hospital during March 2003 and October 2013 were enrolled in the study.All the patients received liver biopsy, blood and ultrasound examinations; the AST-to-ALT ratio ( AAR), AST to platelet ratio index ( APRI) , age platelet index ( API) , cirrhosis discriminant score ( CDS) , spleen to platelet ratio index ( SPRI) and age-spleen to platelet ratio index ( ASPRI) were obtained.Area under receiver operating characteristic curve (AUROC) was used to assess the clinical value of noninvasive models in diagnosis of significant liver fibrosis (S2-4), advanced liver fibrosis (S3-4) and early liver cirrhosis (S4).Results Among six noninvasive models, APRI had the lowest value of AUROCs ( <0.7), while ASPRI had the highest AUROCs value in diagnosis of liver fibrosis.The AUROCs of ASPRI in diagnosing significant liver fibrosis, advanced liver fibrosis and early liver cirrhosis were 0.861, 0.873 and 0.881 with the sensitivities of 69.4%, 76.9%and 87.0%, the specificities of 87.9%, 81.5% and 75.8%, the positive predictive values of 90.9%, 74.9%and 46.1%and the negative predictive values of 62.2%, 83.1%and 96.1%, respectively.Taking<5.2 and≥9.7 as the cut-off values for exclude significant liver fibrosis and diagnosis of significant liver fibrosis, respectively, 49.4%(414/838) of the patients may avoid liver biopsy with an accuracy of 92.3%(382/414).Conclusion ASPRI is of value in diagnosing significant liver fibrosis and early liver cirrhosis in patient with chronic hepatitis B, and the number of liver biopsy can be reduced.
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Objective To analyze whether routine prophyrlactic antibiotic administration is necessary for the patients undergoing coronary stent implantation. Methods The clinical data of 156 patients from January 2010 to December 2010 (prophylactic antibiotic therapy),and 466 patients from January 2014 to December 2014(no-prophylactic antibiotic therapy), who underwent coronary stent implantation, were retrospectively analyzed. The prophylactic antibiotics and the infection rates in two groups were compared. Results The rate of infections related to coronary stent implantation in no-prophylactic antibiotic therapy group and prophylactic antibiotic therapy group, such as surgical site infection (0.2% vs 1.3%,P>0.05) and catheter-related infection(0.6% vs 1.9%,P>0.05), was not significant different(P>0.05). Similarly, the unrelated to coronary stent implantation was not significant different, too ( P > 0. 05). Conclusion Routine prophylactic antibiotic administration is unnecessary for the patients undergoing coronary stent implantation.
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Objective To explore the effect of different doses of tirofiban for PCI, myocardial injury and arterial flow conditions.Methods 70 patients undergoing PCI elevation acute myocardial infarction, were randomly and equally divided into the observation group and the control group.The control group of patients before PCI given haplotype character loading dose of tirofiban, the observation group were given a double load before PCI tirofiban.Recording and analyzing two groups of patients cTnI (cardiac troponin I), 90 minST section down percentage circumstances.Results The patients after 6h, 12h, 24hcTnI contents were (2.11 ±0.50,3.50 ±1.64,3.28 ±1.15) ng/mL was significantly lower than the control group (4.09 ± 1.13,9.48 ±2.61,5.79 ±1.26) ng/mL, and the difference was significant(P<0.05); the observation group were CTFC, 90 min fall within ST respectively was significantly better than the control group ( P<0.05 ) .Conclusion Preoperative use of double loading dose of tirofiban can effectively improve the blood flow after PCI,, and reduce the incidence of myocardial injury and postoperative cardiovascular events.