Spatio-temporal distribution of Oncomelania hupensis snails along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal / 中国血吸虫病防治杂志

Objective To explore the spatio-temporal characteristics of Oncomelania hupensis snails along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal, so as to provide scientific evidence for the dynamic assessment of the risk of snail spread in this region. Methods O. hupensis snail status was collected in the plain regions with waterway networks in the study area from 2012 to 2017. The spatio-temporal variations of snail distribution were investigated along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal using buffer zone analysis, spatial autocorrelation, hotspot analysis and standard deviational ellipse with the geographical information system (GIS) tools. Results The number of snail habitats showed a tendency towards a rise in the study area from 2012 to 2017, and snail habitats were predominantly distributed in the 1 000 m long buffer zone of the Danyang-Jintan-Liyang Canal, notably along the Jiuqu River at the junction between the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal. The distribution of snail habitats appeared spatial autocorrelations in 2014, 2016 and 2017, and the hotspot areas were mainly identified at the junction between the Danyang-Jintan-Liyang Canal and the Beijing-Hangzhou Grand Canal. In addition, the overall distribution of snail habitats was located in the northeastern-southwestern part of the study aera, and gradually shifted to the southern and northern parts with the time. Conclusions The spatial distribution of O. hupensis snails is complex along the Danyang section of the Beijing-Hangzhou Grand Canal and the Danyang-Jintan-Liyang Canal, and there is a risk of snail spread from the upper reaches to the lower reaches, where snail control needs to be intensified.

Clinical application of umbilical artery blood gas analysis / 中国实用妇科与产科杂志

Umbilical arterial blood gas is an important indicator for assessing fetal oxygenation and acid-base metabolism abnormalities. Furthermore, it is an important supplement for diagnosing neonatal asphyxia.We recommend routine umbilical arterial blood gas analysis in high-risk pregnant women with post-partum and intra-partum suspicion of fetal distress. The follow-up and treatment of high-risk infants based on blood gas results can reduce the incidence of neurological dysfunctions such as ischemic hypoxic encephalopathy and long-term cerebral palsy in the near future.

Association Between the Changes of Blood Lipids and the Progression of Non-target Lesions After Percutaneous Coronary Intervention / 中国循环杂志

Objectives:To investigate the relationship between the changes of blood lipids and the progression of non-target lesions after percutaneous coronary intervention (PCI). Methods:Consecutive patients hospitalized in Beijing Anzhen Hospital of Capital Medical University from January 2013 to December 2016 for acute coronary syndrome (ACS) with coronary angiography evidence of multivessel disease, in which single vessel disease (Target lesion) stenosis＞ 75%, and the single vessel was treated with PCI, and the remaining non-target lesions with stenosis ＜50%, and re-hospitalized due to chest pain within 6 to 24 months, were eligible for this study. A total of 3 071 patients met the inclusion criteria were enrolled in this study. According to the quantitative analysis of 3-dimensional reconstruction coronary angiography (QCA), patients were divided into A, B groups:group A (n=1 541) refers patients with progressive non-target lesions (stenosis from ＜50% to ＞75%), group B (n=1 530) refers progression-free non-target lesions (stenosis ＜75%). Blood lipid levels at two hospitalizations, blood lipid changes and the lipid control rate, LDL-C control rate = (＜1.8 mmol/L patients + LDL-C decline＞50%)/ total number of patients, were compared between the two groups. Results:The LDL-C level [group A:(2.68 ± 0.88) mmol/L vs group B:(2.72 ± 0.92) mmol/L, P=0.509] and the LDL-C control rate (group A:14% vs group B:13.1%, P=0.476) at the first hospitalization were similar between the two groups. At the second hospitalization, the level of LDL-C was significantly lower in group B than that in group A ([1.91 ± 0.64] mmol/L vs [2.17 ± 0.76] mmol/L, P＜0.001). The LDL-C control rate was significantly higher in group B than in the group A (43.66% vs 35.37%, P＜0.001). Moreover, the reduction of total cholesterol and triglyceride was more significant in group B ([0.85±0.81] mmol/L and [0.24±1.58] mmol/L) compared to group A ([0.58±1.01] mmol/L and [0.17±1.37] mmol/L, both P＜0.001) at the second hospitalization. Multivariate Logistic regression analysis showed that age, diabetes, hypertension, smoking, family history of coronary heart disease, hyperlipidemia and non-target lesions were not associated with progression of non-target lesions; LDL-C level at the second hospitalization (OR=1.686, 95%CI:1.508~1.885; P＜0.001) and regular statin use after PCI (OR=0.275, 95%CI:0.230~0.328; P＜0.001) were associated with progression of non-target lesions. Conclusions:Our results indicate that poor lipid control post PCI is one of the reasons leading to the progression of non-target lesions.

Effect of serum restriction on insulin like growth factor-1 expressions and invasiveness in human trophoblast HTR-8/SVneo cells in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the effect of serum restriction on the invasiveness and expressions of insulin-like growth factor-1 (IGF-1) and matrix metalloproteinase-2 (MMP-2) in human trophoblast HTR-8/SVneo cells in vitro.</p><p><b>METHODS</b>HTR-8/SVneo cells were cultured in the presence of 1%, 5%, or 10% fetal bovine serum (FBS) for 48 h. Fluorescence quantitative PCR and immunofluorescence staining were employed to examine the changes in IGF-1 and MMP-2 expressions at both the mRNA and protein levels in HTR-8/SVneo cells; MTT assay and Transwell invasion assay were used to assess the changes of the cell proliferation and the cell invasion ability, respectively. MMP-2 expression, cell proliferation and invasiveness were also assessed in the cells treated with recombinant human IGF-1.</p><p><b>RESULTS</b>HTR-8/SVneo cells exhibited significantly lowered cell proliferation in cultures containing low concentrations of FBS (P<0.05). The expressions of IGF-1 and MMP-2 at both mRNA and protein levels were significantly down-regulated and the invasiveness was significantly lowered in cells cultured in the medium containing 1% FBS as compared with those of cells cultured in the presence of 5% and 10% FBS (P<0.05). Treatment of the cells with recombinant human IGF-1 significantly up-regulated MMP-2 expression (P<0.05) and increased the cell invasiveness (P<0.05).</p><p><b>CONCLUSIONS</b>FBS restriction down-regulates IGF-1 expression in human trophoblast HTR-8/SVneo cells and suppress the cell invasiveness possibly by suppressing MMP-2 expression. Treatment with recombinant human IGF-1 can up-regulate MMP-2 expression and promote the invasiveness of HTR-8/SVneo cells.</p>

Clinical efficacy and safety of controlled-release dinoprostone insert: a multicenter retrospective study / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the effectiveness and safety of controlled-release dinoprostone insert for term labor induction in the Pearl River Delta of Guangdong province.</p><p><b>METHODS</b>Twenty hospitals using controlled-release dinoprostone insert for term labor induction in the Pearl River Delta of Guangdong province were stratified into provincial hospitals and municipal hospitals, and three hospitals of each level were selected as research units. According to the inclusion and exclusion criteria, 1390 pregnant women receiving term labor induction using controlled-release dinoprostone insert were retrospectively analyzed to evaluate the the effectiveness and safety with another 957 pregnant women with induced abortion using oxytocin as the control group.</p><p><b>RESULTS</b>Compared with the control group, the controlled-release dinoprostone insert group showed a significantly longer length of the latent phase of labor (4.06∓2.65 vs 3.20∓2.08 h, P=0.003, 95%CI [0.182, 0.920]) and shorter lengths of the active phase (1.73∓1.32 vs 2.22∓1.75 h, P=0.000, 95%CI [-0.795, -0.363]) and the second stage of labor (0.49∓0.37 vs 0.54∓0.43 h, P=0.003, 95%CI [-0.137, -0.028]). No significant differences were found in the length of the first stage of labor, the vaginal delivery rate, adverse reactions, or fetal outcomes between the two groups.</p><p><b>CONCLUSION</b>Controlled-release dinoprostone insert is effective and safe for labor induction at term.</p>

Renal artery injury caused by Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate renal artery injury caused by Kawasaki disease (KD).</p><p><b>METHODS</b>Forty-three children with KD were enrolled in the study. According to the blood pressure in the acute stage, these children were classified into normal blood pressure subgroup and increased blood pressure subgroup. Eighteen children with fever caused by acute upper respiratory tract infection were enrolled as the control group. The diameter of the origin of the main renal artery, hemodynamic parameters of the main renal artery and the renal interlobar artery, rennin activity, and levels of angiotensin II and aldosterone were compared between groups.</p><p><b>RESULTS</b>During the acute stage of KD, both subgroups had a significantly smaller diameter of the origin of the main renal artery, a significantly higher resistance index (RI) of the main renal artery, and a significantly lower end-diastolic velocity (EDV) than the control group (P<0.05).The increased blood pressure subgroup had a significantly lower EDV of the interlobar artery than the normal blood pressure subgroup, a significantly higher RI than the normal blood pressure subgroup and the control group, as well as a significantly higher rennin activity and significantly higher levels of angiotensin II and aldosterone than the normal blood pressure subgroup (P<0.05). A significantly increased EDV and a significantly reduced RI of the renal interlobar artery were observed in the increased blood pressure subgroup in the subacute stage compared with the acute stage (P<0.05).</p><p><b>CONCLUSIONS</b>KD may cause renal artery injury and early hemodynamic changes, resulting in a transient increase in blood pressure in some patients.</p>

Expression of CysLTR-1 and CysLTR-2 in adenoid tissues from children with adenoid hypertrophy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine the expression of cysteinyl leukotriene receptor-1 (CysLTR-1) and cysteinyl leukotriene receptor-2 (CysLTR-2) in the adenoid tissues from children with adenoid hypertrophy (AH) and to explore the role of leukotrienes in the pathogenesis of AH.</p><p><b>METHODS</b>Sixty children with AH who were treated by adenoidectomy and/or tonsillectomy were classified into two groups: simple AH and AH plus allergic rhinitis (n=30 each). Twenty children who underwent tonsillectomy due to recurrent purulent tonsillitis were selected as the control group. The expression of CysLTR-1 and CysLTR-2 in the excised tonsil and/or adenoid tissues was determined by immunofluorescence histochemical labeling and integrated optical density measurement.</p><p><b>RESULTS</b>The expression of CysLTR-1 and CysLTR-2 in the adenoid and tonsil tissues increased significantly in both the simple AH group and AH plus allergic rhinitis group compared with the control group (P<0.01). The expression of CysLTR-1 and CysLTR-2 in the AH plus allergic rhinitis group increased more significantly compared with the simple AH group (P<0.01).</p><p><b>CONCLUSIONS</b>CysLTR-1 and CysLTR-2 are highly expressed in the adenoid tissues from children with AH, suggesting that leukotrienes are involved in the pathogenesis of AH.</p>

Reconstruction of a digital three-dimensional model of fetal heart / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the methods for constructing the digital three-dimensional model of fetal heart.</p><p><b>METHODS</b>Original two-dimensional CT image data sets were collected from 4 abortion fetuses with fetal malformations but not heart malformation or chromosomal abnormalities. The three-dimensional fetal heart model was reconstructed using Mimics14.0 software.</p><p><b>RESULTS</b>In the reconstructed three-dimensional fetal heart, the left atrium, left ventricle, right atrium, right ventricle, the ascending aorta, the main pulmonary and their branches, the superior cava and inferior vena cava were marked with different colors, and these structures could be displayed individually or with other structures. This model also allowed three-dimensional arbitrary scaling, shifting or rotation at any angle, and the diameter of the each vessel could be measured with the software.</p><p><b>CONCLUSION</b>The fetal heart model can be successfully reconstructed from the CT datasets using three-dimensional reconstruction software to facilitate clinical and anatomical teaching.</p>

Treating coronary heart disease by acupuncture at neiguan (PC6) and xinahu (BL15): an efficacy assessment by SPECT / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of acupuncture combined single photon emission computed tomography (SPECT) in treating coronary heart disease (CHD) and its effect on the myocardial ischemia/perfusion and the recovery of heart functions.</p><p><b>METHODS</b>Totally fifty-nine patients with confirmed CHD were randomly assigned to two groups, the acupuncture group (32 cases) and the nitroglycerine group (27 cases). Patients in the acupuncture group were electro-acupunctured at bilateral Neiguan (PC6) and Xinshu (BL15) for 30 min with the frequency of 2/15 Hz and the current strength 9 - 18 mA after myocardial imaging induced by routine exercises or drug load. 99mTc-MIBI 370 MBq was injected 15 min after needling. The myocardial perfusion imaging was performed immediately after needling. 99mTc-MIBI740 MBq was injected to those in the nitroglycerine group during routine exercises or drug load. The myocardial perfusion imaging was performed 5 min after injection. Patients were asked to sublingual administration of nitroglycerine 1 mg after the myocardial perfusion imaging was completed. 99mTc-MIBI 370 MBq was intravenously injected 5 min later, and myocardial perfusion imaging was performed 5 min after injection.</p><p><b>RESULTS</b>There was statistical difference in changes of radioactive uptake between before and after treatment in the two groups (P < 0.05, P < 0.01). Both acupuncture and buccal administration of nitroglycerine could increase the blood perfusion of ischemic myocardium. But there was no statistical difference in the improvement of ischemic myocardial cells (t = 1.57, P > 0.05).</p><p><b>CONCLUSION</b>Using SPECT could clearly display therapeutic effects of acupuncture on CHD, thus providing a new visible research method for CHD studies.</p>

Clinical similarities and differences in Kawasaki disease during 1991-2001 and 2002-2011 periods / 中华实用儿科临床杂志

Objective To analyze the changes in clinical characteristics of Kawasaki disease (KD) between the first and the second decade and improve the diagnosis and treatment of incomplete KD.Methods Retrospective analysis of clinical data of children with KD was performed in the Second Affiliated Hospital of Guangzhou Medical Coliege during the recent 20 years (between Dec.1991 and Dec.2011).The changes in clinical manifestations of KD were compared between the first l0 years and the second l0 years.A total of 270 hospitalized patients diagnosed as KD were included in this study.The patients admitted after Dec.2001 were assigned as the observation group (192 cases) and those admitted before Dec.2001 were assigned as the control group (78 cases).The epidemiologic characteristics,clinical manifestations,impairment of organs,and laboratory findings were compared between the 2 groups and statistic analysis was performed on the available date.Results 1.The rate of KD patients ＜ 1-year-old and the incidence of incomplete KD in the observation group were significantly higher than those in the control group (all P ＜0.01) ; 2.The incidences of rash,changes in oral mucosa,congestion of conjunctiva,hardening edema of hands and feet,lymph node enlargement in the observation group were significantly lower than those in the control group (all P ＜ 0.01) ; 3.Incidence of coronary artery impairment in the observation group was significantly higher than that in the control group (P ＜ 0.05) ; 4.There were no significant differences for inflammation index between the 2 groups (all P ＞ 0.05).Conclusions The incidence of KD and the number of cases with incomplete KD increased in the last decade,especially in younger infants,and the incidence of coronary arteries impairment is increased.To incomplete KD,combining clinical manifestations with laboratory findings of inflammation index are needed for early diagnosis.

Heart rate distribution and predictors of resting heart rate after initiation of beta-blocker treatment in patients with coronary artery disease: REsults of Sympathetic Evaluation And Research of China (RESEARCH) study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The importance of heart rate as secondary prevention strategies for patients with coronary artery disease (CAD) is emphasized by multiple guidelines. However, limited information is available on the heart rate distribution and the change patterns of resting heart rate when initiating beta-blocker therapy among Chinese patients with CAD.</p><p><b>METHODS</b>The REsults of Sympathetic Evaluation And Research of China (RESEARCH) study is a multi-centre, prospective, observational study involving 147 centers in 23 cities across China. All eligible beta-blocker naive patients were prescribed with metroprolol succinate. Initial dosage and target heart rate were selected at the discretion of their physicians in charge according to their usual institutional practice. The heart rate distribution and the change patterns of resting heart rate after initiation of beta-blocker therapy were observed.</p><p><b>RESULTS</b>The majority of patients (63.6%) were prescribed with 47.5 mg metroprolol succinate. At baseline, there were only 17.4% of patients whose heart rate was less than 70 beats per minute, and the proportion reached 42.5% and 79.1%, one month and two months after initiation of beta-blockers, respectively. Multivariate linear regression analysis showed that baseline heart rate (B = 0.900, SE = 0.006, t = 141.787, P < 0.0001) and the dosage (B = -0.007, SE = 0.002, t = -3.242, P = 0.001) were independent predictors of resting heart rate 2 months after beta-blocker therapy.</p><p><b>CONCLUSIONS</b>Resting heart rate is not optimally controlled in a broadly representative cohort of Chinese outpatients with CAD even after initiation of β-blocker therapy, and baseline heart rate and the dosage of beta-blocker are both independent predictors of resting heart rate after β-blocker therapy.</p>

Plasma neutrophil-gelatinase-associated lipocalin and cystatin C could early diagnose contrast-induced acute kidney injury in patients with renal insufficiency undergoing an elective percutaneous coronary intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Contrast induced acute kidney injury (CIAKI) is an important complication in the use of iodinated contrast media (CM). Our study was to evaluate the neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C for early diagnosis of CIAKI.</p><p><b>METHODS</b>The patients with established or suspected coronary artery disease (CAD) with the estimated glomerular filtration rate (eGFR) was more than 30 ml × min(-1) × 1.73 m(-2) and nor more than 90 ml × min(-1)× 1.73 m(-2) were continuously enrolled. The blood samples of the first 50 patients were obtained before and at 2, 4, 8, 24 and 48 hours after procedure to identify the time points at which the biomarkers reached peaks and at which the blood samples of the rest of patients were obtained. The plasma NGAL and cystatin C measure used enzyme-linked immunosorbent assay (ELISA) kit. The diagnostic characteristics of absolute and relative increasing NGAL and cystatin C for CIAKI were evaluated.</p><p><b>RESULTS</b>Total 311 patients were enrolled, among whom 39 (12.5%) developed CIAKI. Plasma NGAL increased at 2 hours and reached peak at 4 hours after procedure, while plasma cystatin C increased at 2 hours and reached peak at 24 hours after procedure. Thus, we determine rational point of time at 4 hours for NGAL and at 24 hours after procedure for cystatin C, respectively. The plasma NGAL at 4 hours after CM exposure showed largest area under curve (AUC) of 0.662 (95% confidence interval (CI): 0.565 - 0.758, P = 0.002) with 51.5% sensitivity and 80.6% of specificity. The relative increasing 25% of NGAL showed the best sensitivity and specificity of 0.872 and 0.808, respectively, with maximum Youden index of 0.680, while cystatin C with relative increasing more than 25% had 76.9% of sensitivity and 81.2% of specificity. Combined two biomarkers might get more than 90% of specificity.</p><p><b>CONCLUSIONS</b>Single measurement of NGAL or cystatin C had poor sensitivity and specificity; however, the relative increasing 25% of NGAL at 4 hours after CM exposure demonstrated higher diagnostic values for CIAKI. Combining relative increasing plasma NGAL with relative increasing plasma cystatin C might perform better for early diagnosis of CIAKI.</p>

An epidemiologic study on functional constipation among adult communities in Shanghai / 中华流行病学杂志

Objective To determine the prevalence and risk factors of functional constipation (FC) by using Rome Ⅲ criteria in the local adult communities.Methods A stratified randomized and community-based study by multi-stage cluster sampling was employed.A household survey was conducted from April to May 2010.All of the participants were interviewed face-to-face by filling out the self-administered questionnaires which based on Rome Ⅲ criteria for the diagnosis of FC.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were carried out to evaluate the psychological characteristics and qualities of sleep.Results A total of 7648 subjects fulfilled the questionnaires,with the response rate as 90.0％.211 patients met the Rome Ⅲ criteria,including 90 males and 121 females.The adjusted prevalence rates of FC were 2.5％ in males,3.3％ in females and with an overall rate as 2.9％.The ratio of men to women was 1∶1.32,with significant difference between males and females (P=0.043).The most common group was in the 18-29 year-olds (x2=37.359,P=0.000).FC patients were more likely to be detected in the group with normal BMI (x2=16.087,P=0.002),having received high education (x2=27.604,P=0.000),being intelectuals ( x2=6.922,P=0.031 ) and divorced ( x2=22.000,P=0.000) than in other groups. Multivariate analysis showed that excessive intake of high-fat food was significantly associated with the presence of FC (odds ratio as 1.253,P=0.000),whereas foods with high-fiber (odds ratio as 0.854,P=0.029) might serve as protective factors.Significant differences between FC groups and control groups were found in the incidence of anxiety (with odds ratio as 2.583,P=0.000) and insomnia (odds ratio as 2.443,P=0.000).Conclusion The prevalence of FC in adult communities in Shanghai Songjiang district was not higher than that in other parts of the communities.Excessive intake of high-fat food,anxiety and insomnia might be risk factors for FC and foods with high-fiber contents might serve as protective factors.

Value of antiviral therapy for infectious monocytosis in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of antiviral therapy for infectious monocytosis (IM) in children by comparing the near-term therapeutic efficacies and long-term follow-up results in children with this disorder between receiving antiviral therapy or not.</p><p><b>METHODS</b>The medical data of IM children between 1999 and 2009 were retrospectively reviewed. A total of 172 cases with a follow-up visit period of 1 year and more were eligible. The children were classified into three groups according to the treatment protocol: ganciclovir treatment (n=49), acyclovir treatment (n=72) and symptomatic treatment (control; n=51). The children in the ganciclovir group received an intravenous drip of 10 mg/kg per day of ganciclovir, administered in twice-daily doses; Seven days later the drip volume was changed to 5 mg/kg, administered once each day; the total course lasting 10-14 days. The children in the acyclovir group received acyclovir orally at 20 mg/kg per day, administered in three times daily doses; the total course lasting 10-14 days. The children in the control group received symptomatic treatment only. In the three groups, indicators including fever course, improvement of isthmitis symptoms, lymph node retraction, hepatic and splenic lymph node retraction time, atypical lymphocyte fallback time and alteration of granulocyte amount after drug use were observed. The long-term follow-up visits covered such indicators as blood routine reexamination, hepatic function, liver and spleen B-ultrasonography, recovery rate, recurrence rate and mortality rate.</p><p><b>RESULTS</b>In the acute phase, there were no differences in terms of fever course, isthmitis improvement, hepatic and splenic lymph node retraction time and the time of atypical lymphocyte falling back to below 10% among the three groups (P>0.05). During the period of follow-up visits between 1 year and 8 years and 10 months, no significant differences were observed in the recovery rate, the recurrence rate and the mortality rate among the three groups (P>0.05).</p><p><b>CONCLUSIONS</b>The efficacies of antiviral therapy for IM children appear to be similar to non-antiviral therapy, suggesting that antiviral therapy fails to be beneficial for IM children.</p>

Assessment of early radial injury after transradial coronary intervention by high-resolution ultrasound biomicroscopy: innovative technology application / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transradial coronary intervention (TRI) introduces injury to the radial artery (RA) which will affect repeat transradial coronary procedure and the quality as a bypass conduit. We sought to compare the early radial injury after TRI between first-TRI and repeat-TRI by ultrasound biomicroscopy (UBM).</p><p><b>METHODS</b>A total of 1116 patients who underwent the transradial coronary procedures were enrolled. The patients depending on whether for the first time to accept transradial coronary procedure were divided into first-TRI group and repeat-TRI group. The RA was examined by UBM before and one day after the procedure.</p><p><b>RESULTS</b>Compared with first-TRI group, the mean RA diameter of repeat-TRI one day after the procedure decreased significantly (P < 0.05). In first-TRI group, the mean RA diameter was (2.32 ± 0.53) and (1.93 ± 0.57) mm before procedure and one day after the procedure respectively (P < 0.05). In repeat-TRI group, the mean RA diameter was (2.37 ± 0.51) and (1.79 ± 0.54) mm before procedure and one day after the procedure, respectively (P < 0.01). Compared with first-TRI group, the mean RA diameter was reduced significantly in repeat-TRI group one day after the procedure (P < 0.05). The early radial injuries and intimal thickening were compared between first-TRI and repeat-TRI. The mean intima-media thickness of RA was (0.24 ± 0.13) mm and (0.59 ± 0.28) mm before procedure and one day after the procedure in first-TRI group. The mean intima-media thickness of RA was (0.29 ± 0.16) mm and (0.68 ± 0.32) mm before procedure and one day after the procedure in repeat-TRI group. Compared with first-TRI group, the mean intimal thickening was increased significantly in repeat-TRI group one day after the procedure (P < 0.05). Intimal dissection, stenosis and occlusion were all significantly greater in repeat-TRI RAs (P < 0.05). Linear regression analysis revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.</p><p><b>CONCLUSIONS</b>RA early injuries were greater in repeat-TRI patients than in first-TRI patients. We first use high-resolution UBM imaging to demonstrate the rate of radial injury and revealed that diameter, repeated TRI procedure and PCI procedure were the independent predictors of intimal thickening.</p>

Safety and feasibility of repeated percutaneous transradial coronary intervention in the same route / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The radial approach has been increasingly used as an alternative to femoral access. And more procedures using repeated transradial coronary intervention (r-TRI) are performed. However, few data about r-TRI has been obtained. Therefore, we investigated the safety and feasibility of r-TRI using the same route.</p><p><b>METHODS</b>A total of 423 consecutive eligible patients undergoing r-TRI were enrolled in the r-TRI group, and 846 patients with initial TRI (i-TRI) were assigned to the i-TRI group in a 2:1 matching ratio compared to r-TRI group. The primary endpoint included the success rate of the procedure and the incidence of vascular related complications.</p><p><b>RESULTS</b>The baseline clinical characteristics in the two groups were comparable. The success rate of procedures in the r-TRI and i-TRI was similar (96.0% vs. 97.5%, P = 0.130). In subgroup analysis (coronary angiography only or angiography with pecutaneous coronary intervention), similar results were also observed. The puncture numbers and incidence of radial artery spasm in the r-TRI group were significantly higher than in the i-TRI group (P = 0.024 and P < 0.001, respectively). The other procedural outcomes in the two groups were identical. With respect to the incidence of overall vascular related complication and independent events, there were no significant differences in spite of a higher incidence of radial artery occlusion (RAO) in the r-TRI group (RAO: 1.2% vs. 0.7%, P = 0.521). The patients in the i-TRI group had more comfortable feeling than patients in the r-TRI group (P = 0.001).</p><p><b>CONCLUSIONS</b>R-TRI produces a comparable procedure success rate and incidence of vascular complication when compared to i-TRI. It should be considered as an acceptable and safe procedure.</p>

Risk factors of premature rupture of membranes with neonatal infection: a single-center study / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the high-risk factors of premature rupture of membranes (PROM) with neonatal infection and explore their clinical significance.</p><p><b>METHODS</b>Forty-two cases of PROM with neonatal infections were retrospectively analyzed for the risk factors with another 42 PROM cases matched for gestational age without neonatal infections as the control group. The relations of gestational age, time from membrane rupture to delivery, mode of delivery, placental pathology, maternal serum C-reactive protein concentration, leukocyte and neutrophil values to neonatal infections were analyzed.</p><p><b>RESULTS</b>The time from membrane rupture to delivery was significantly longer and the incidence of chorioamnionitis significantly higher in the study group (P<0.05). Meningitis and neonatal sepsis occurred at a significantly higher incidence in preterm PROM group (P<0.05).</p><p><b>CONCLUSION</b>An appropriate extension of the gestation weeks and timely termination of pregnancy after dynamic monitoring of the biochemical changes and identification of the signs of infection are important to reduce the incidence of neonatal infection.</p>

Randomized study on T stenting and small protrusion technique versus simple stenting for patients with coronary artery bifurcation lesions and with big size side branch / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the feasibility and safety of T stenting and small protrusion (TAP) technique and compare the efficacy with simple stenting in patients with coronary bifurcation lesions and with big size side branch.</p><p><b>METHODS</b>A total of 142 eligible patients were recruited and 127 patients completed the study (simple stenting group 58 and TAP technique group 69).</p><p><b>RESULTS</b>Major adverse cardiovascular event rate was similar at 12 months follow up between the groups (TAP technique group 13.0% versus simple stenting group 12.1%, P > 0.05). The rate of procedural-related myocardial infarction, procedure and fluoroscopy time, contrast volumes were also similar between 2 groups (all P > 0.05). At 8 months, coronary angiography revealed that the restenosis rate of the ostium of side branch in TAP group was significantly lower than that of simple stenting group (17.1% versus 3.8%, P < 0.05). Overall restenosis rate was similar between the groups (P > 0.05).</p><p><b>CONCLUSION</b>Both TAP technique and simple stenting are feasible and effective strategies for treating patients with bifurcation lesions.</p>

Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Radial artery spasm (RAS) is the most common complication in transradial coronary angiography and intervention. In this study, we designed to investigate the incidence of RAS during transradial procedures in Chinese, find out the independent predictors through multiple regression, and analyze the clinical effect of RAS during follow-up.</p><p><b>METHODS</b>Patients arranged to receive transradial coronary angiography and intervention were consecutively enrolled. The incidence of RAS was recorded. Univariate analysis was performed to find out the influence factors of RAS, and logistic regression analysis was performed to find out the independent predictors of RAS. The patients were asked to return 1 month later for the assessment of the radial access.</p><p><b>RESULTS</b>The incidence of RAS was 7.8% (112/1427) in all the patients received transradial procedure. Univariate analysis indicates that young (P = 0.038), female (P = 0.026), small diameter of radial artery (P < 0.001), diabetes (P = 0.026), smoking (P = 0.019), moderate or severe pain during radial artery cannulation (P < 0.001), unsuccessful access at first attempt (P = 0.002), big sheath (P = 0.004), number of catheters (> 3) (P = 0.048), rapid baseline heart rate (P = 0.032) and long operation time (P = 0.021) were associated with RAS. Logistic regression showed that female (OR = 1.745, 95%CI: 1.148 - 3.846, P = 0.024), small radial artery diameter (OR = 4.028, 95%CI: 1.264 - 12.196, P = 0.008), diabetes (OR = 2.148, 95%CI: 1.579 - 7.458, P = 0.019) and unsuccessful access at first attempt (OR = 1.468, 95%CI: 1.212 - 2.591, P = 0.032) were independent predictors of RAS. Follow-up at (28 +/- 7) days after the procedure showed that, compared with non-spasm patients, the RAS patients had higher portion of pain (11.8% vs. 6.2%, P = 0.043). The occurrences of hematoma (7.3% vs. 5.6%, P = 0.518) and radial artery occlusion (3.6% vs. 2.6%, P = 0.534) were similar.</p><p><b>CONCLUSIONS</b>The incidence of RAS during transradial coronary procedure was 7.8%. Logistic regression analysis showed that female, small radial artery diameter, diabetes and unsuccessful access at first attempt were the independent predictors of RAS.</p>

Safety and efficacy of transulnar approach for coronary angiography and intervention / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transradial approach, which is now widely used in coronary angiography and intervention, may be advantageous with respect to the femoral access due to the lower incidence of vascular complications. Transulnar approach has been proposed for elective procedures in patients not suitable for transradial approach. The objective of this study was to evaluate the safety and efficacy of the transulnar approach versus the transradial approach for coronary angiography and intervention.</p><p><b>METHODS</b>Two hundred and forty patients undergoing coronary angiography, followed or not by intervention, were randomized to transulnar (TUA) or transradial approach (TRA). Doppler ultrasound assessments of the forearm vessels were scheduled for all patients before procedures, 1 day and 30 days after procedures. The primary end point was access site vascular complications during hospitalization and 30 days follow-up. Major adverse cardiac events (MACE) as secondary end point was recorded till 30 days follow-up.</p><p><b>RESULTS</b>Successful puncture was achieved in 98.3% (118/120) of patients in the TUA group, and in 100% (120/120) of patients in the TRA group. Coronary angiographies were performed in 40 and 39 patients in TUA and TRA group. Intervention procedures were performed in 78 and 83 patients in TUA and TRA group, respectively. The incidence of artery stenosis 1 day and 30 days after procedures was 11.0% vs.12.3% and 5.1% vs. 6.6% in TUA and TRA group, respectively. Asymptomatic access site artery occlusion occurred in 5.1% vs.1.7% of patients 1 day and 30 days after transulnar angioplasty, and in 6.6% vs. 4.9% of patients 1 day and 30 days after transradial angioplasty. Minor bleeding was still observed at the moment of the ultrasound assessment in 5.9% and 5.7% of patients in TUA and TRA group, respectively (P = 0.949). No big forearm hematoma, and A-V fistula were observed in both groups. Freedom from MACE at 30 days follow-up was observed in all patients.</p><p><b>CONCLUSIONS</b>The transulnar approach is as safe and effective as the transradial approach for coronary angiography and intervention. It is an attractive opinion for experienced operators who are skilled in this technique, particularly in cases of anatomic variations of the radial artery, radial artery small-caliber or thin radial pulse.</p>