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Life sciences are the disciplines most closely related with human beings. As experimental disciplines, life sciences develop rapidly and highly intersect in many scientific fields. Under the "double first-class" initiative, the comprehensive development-oriented talent training system has put forward an urgent need for life sciences literacy and comprehensive ability training of college students. Taking the reform of liberal education curriculum system as an opportunity, we developed a series of eight life sciences practical liberal courses for students with non-biology majors. The courses cover all sub-disciplines or directions of life sciences, and aim to foster interdisciplinary talents with life sciences knowledge and literacy, as well as practical and innovative abilities. These courses could serve as references for experimental teaching centers in colleges and universities to set up practical liberal and experimental courses.
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Humans , Biological Science Disciplines , Curriculum , Students , UniversitiesABSTRACT
Objective:There are few domestic reports of liver transplantation from schistosomiasis donors. Two schistosomiasis donor livers were employed for liver transplantation. The relevant experiences were summarized along with a literature review.Methods:Two unexpectedly discovered donor livers infected by schistosomiasis were successfully transplanted. And long-term follow-ups were conducted for recipients.Results:The recipients were followed up for 77 and 14 months respectively without recurrence.Conclusions:Non-cirrhotic donor livers infected with schistosome may safely employed for transplantation. A positive donor should be treated with praziquantel. However, a recipient has no indication for preventive deworming.
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Objective@#To explore the value of index of microcirculatory resistance (IMR) for early prediction of periprocedural myocardial injury (PMI) in patients with stable angina pectoris (SAP) and acute coronary syndrome (ACS) after PCI.@*Methods@#It was a prospective study. One hundred and sixty-four patients who had single coronary lesion were consecutively enrolled from May 2014 to December 2017 at Nanjing Hospital affiliated to Nanjing Medical University. According to clinical manifestation, patients were divided into SAP group (n=81) and ACS group (n=83). IMR was determined by thermal dilution with pressure guide wire. Basic clinical characteristics, coronary angiographic results, PCI procedural details, IMR after PCI, ΔIMR (IMR=post-PCI-IMR pre-PCI), levels of myocardial biomarkers before and after PCI were compared between the two groups. Multivariate logistic regression was used to analyze the relation of PMI with IMR and ΔIMR, and the predictive ability was evaluated by receiver operating characteristic (ROC).@*Results@#The levels of total cholesterol and low density lipoprotein cholesterol were significantly higher in ACS group than in SAP group (P<0.05), other clinical data at baseline were similar between the two groups (P>0.05). Quantitative coronary angiography (QCA) results and PCI related data were also similar between the two groups before PCI (P>0.05). Values of mean transit time (Tmn) of intracoronary injection with room temperature saline, post-PCI IMR and ΔIMR were significantly higher in ACS group than in SAP group after PCI (P<0.05). Plasma creatine kinase isoenzyme-MB difference (ΔCK-MB) (ΔCK-MB=CK-MB post-PCI-CK-MB pre-PCI) and cardiac troponin-I (cTnI) difference (ΔcTnI=cTnI post-PCI-cTnI pre-PCI) were significantly larger in ACS group than in SAP group (P<0.05). Multivariate logistic regression analysis showed that coronary artery disease (CHD) type (SAP and ACS) (OR=1.301, 95%CI 1.083-1.562), age (OR=1.007, 95%CI 1.000-1.013), ΔIMR (OR=1.009, 95%CI 1.000-1.017) and post-PCI IMR (OR=1.008, 95%CI 1.001-1.014) were independent predictors of PMI (P<0.05). The area under the ROC curve (AUC) of ΔIMR was 0.763 to predict PMI (P<0.05), the optimum cut-off value of ΔIMR was 5.485 with 70.0% sensitivity and 77.4% specificity. ΔIMR was positively correlated with ΔcTnI (r=0.592, P<0.05).@*Conclusions@#ΔIMR serves as an early predictor of PMI in CHD patients after PCI. As compared with SAP patients, ACS patients are more likely to develop PMI.
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Objective@#The epidemiological investigation of donor infection and the investigation of donor-derived infection(DDI)events in kidney transplantation to provide a basis for the prevention and treatment of donor infection and donor-derived infection events.@*Methods@#We retrospectively reviewed 170 donors and corresponding 316 kidney recipients between January 2014 with December 2017, pre-harvest blood, sputum, urine positive and negative culture were systematically recorded. We also collected donors/recipients demographics, transplant characteristics and recipients infection data within one month and focused on patient data of DDI events. Outcomes were followed up 6 months after surgery.@*Results@#Infection rate in 170 donors was 67.6 %, the positive rate of Gram-negative bacteria, Gram-positive bacteria and fungal were 48.3 %, 41.2 % and 10.4 %. Nine of 170 donors were DDI(5.29 %). Positive blood culture, urine culture and donor age were independent risk factors for DDI.@*Conclusions@#The incidence of donor infection is high. Although a few DDI events occur, the survival rate decreased. The positive blood culture and urine culture were important risk factors for the occurrence of DDI events. Therefore, it is necessary to focus on the monitoring of some high-risk strains and donors infected by high-risk infection sites.
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Objective The epidemiological investigation of donor infection and the investigation of donor-derived infection(DDI)events in kidney transplantation to provide a basis for the prevention and treatment of donor infection and donor-derived infection events .Methods We retrospectively reviewed 170 donors and corresponding 316 kidney recipients between January 2014 with December 2017 ,pre-harvest blood ,sputum ,urine positive and negative culture were systematically recorded .We also collected donors/recipients demographics ,transplant characteristics and recipients infection data within one month and focused on patient data of DDI events .Outcomes were followed up 6 months after surgery .Results Infection rate in 170 donors was 67 .6 ％ ,the positive rate of Gram-negative bacteria ,Gram-positive bacteria and fungal were 48 .3 ％ ,41 .2 ％ and 10 .4 ％ .Nine of 170 donors were DDI(5 .29 ％ ) .Positive blood culture ,urine culture and donor age were independent risk factors for DDI .Conclusions The incidence of donor infection is high .Although a few DDI events occur ,the survival rate decreased .The positive blood culture and urine culture were important risk factors for the occurrence of DDI events . Therefore ,it is necessary to focus on the monitoring of some high-risk strains and donors infected by high-risk infection sites .
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Liver transplantation has become the most effective treatment for end-stage liver diseases.Due to the shortage of organ,more and more extended criteria donors (ECD) grafts had been used,which expand the liver pool.However,a series of complications post transplantation were caused by ischemia,hypoxia,steatosis and so on.The non-anastomotic biliary strictures after liver transplantation is one of the major complications when the ECD donors was be used in clinic.The study on the protective effect of machine perfusion on liver donors is too numerous to list,and existing studies have found that MP can reduce the incidence of NAS after liver transplantation.This review provides an overview of the pathogenesis of NAS and the reduction incidence of NAS by MP.
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Objective To investigate the correlation between plasma homocysteine(Hcy)level and lower extremity atherosclerotic disease(LEAD)in elderly patients of Chinese Han nationality with primary hypertension.Methods A total of 144 elderly Chinese Han outpatients with primary hypertension aged 60-90 years (92 cases in men,52 in women)were randomly recruited in our department from January 2015 to January 2017.The diagnosis of LEAD was confirmed in this study by ankle brachial index(ABI)≤0.90(ABI normal value=1.00-1.40).The patients were divided into three different plasma Hcy level groups:low-(＜ 10 μmol/L),middle-(10-29 μmol/L),and high-Hcy level group(≥30 μmol/L).The differences in Hcy,ABI,toe branchial index,high density lipoprotein,apolipoprotein-A1,and baPWV were compared between three different Hcy level groups.Pearson correlation was established between the influencing factors and serum level of Hcy.Moreover,binary logistic regression model was used to determine the independent risk factors for LEAD among elderly Chinese Han patients with primary hypertension.Results The values of apolipoprotein A-1,high density lipoprotein cholesterol,ankle brachial index,and toe brachial index were higher in the low Hcy group than in the middle-and high Hcy-group(P＜0.05).The ankle brachial index was higher in the middle Hcy group than in the high Hcy group(P＜0.05).The brachial-ankle pulse wave velocity was higher in the high Hcy group than in the middle and low Hcy group (P ＜ 0.05).No statistically significant difference was found in age,gender,body mass index,mean arterial pressure,triglyceride,low density lipoprotein cholesterol,blood urea nitrogen,serum creatinine,blood uric acid,and plasma hypersensitivity C-reactive protein among the three groups(all P＞0.05).Pearson correlation analysis showed that the level of serum Hcy was positively correlated with brachial-ankle pulse wave velocity (r=0.637,P =0.000),while it was negatively correlated with ankle brachial index,toe branchial index,high density lipoprotein cholesterol,and apolipoprotein A-1 (r =-0.743,-0.257,-0.240,-0.449,all P＜0.05).Binary Logistic regression model showed that gender,Hcy,and low density lipoprotein cholesterol level were independent risk factors for LEAD in elderly Chinese Han patients with primary hypertension.Conclusions Plasma Hcy level is an independent risk factor for LEAD in elderly Chinese Han patients with primary hypertension,and it is positively correlated with this disease.
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Objective@#To investigate whether Schisandrin B (Sch B) could improve cardiac structure and function in myocardial infarction (MI) mice and related mechanisms.@*Methods@#Male C57BL/6J mice were randomized into sham (n=8), MI+ Sch B (n=24, 80 mg·kg-1·d-1 per gavage) or MI+ vehicle (n=24, equal volume). After treatment for 3 weeks, cardiac function was detected by echocardiography measurement.Infarction size was measured by Evans blue and TTC staining.HE and Masson trichrome staining were used to observe the myocardial inflammation, structure and fibrosis.TNF-α, TGF-β, IL-1β were detected by ELISA. The apoptosis index of ischemic myocardial cells was detected by immunofluorescence. NF-κB, Bcl-2, Bax, Akt phosphorylated Akt(p-Akt), eNOS, phosphorylated eNOS (p-eNOS) were detected by Western blot.@*Results@#Three weeks after operation, survival rate (83.33% vs. 54.17%, P<0.05), LVEF((51.77±8.50)% vs.(40.23±8.30)%, P<0.05), LVFS((26.44±5.15)% vs. (19.53±4.56)%, P<0.05)were significantly higher; LVEDD ((4.13±0.40) mm vs.(4.44±0.46)mm, P<0.05), LVESD((3.07±0.39) mm vs. (3.46±0.52)mm, P<0.05), the heart weight/body weight ratio((0.59±0.06)% vs. (0.68±0.10)%, P<0.05)was significantly lower and infarct size ((23.4±2.36)% vs. (39.4±2.06)%, P<0.05) was significantly reduced in MI+ Sch B group than those in MI+ vehicle group. In MI+ vehicle group, HE staining showed a large number of inflammatory cells in the peri-infarctl region, and the permutation structure was very disorganized, while above changes were significantly reduced in the MI+ Sch B group. Masson staining results showed that the degree of myocardial fibrosis in MI+ Sch B group was significantly less than that of MI+ vehicle group.Moreover, Sch B could down-regulate some inflammatory cytokines, like NF-κB、TGF-β、TNF-α and IL-1β, activate Akt-eNOS pathway, upgrade Bcl-2 and downgrade Bax and reduce cell apoptosis as compared with MI+ vehicle group (all P<0.05).@*Conclusions@#Our results demonstrate that Sch B can reduce inflammation, inhibit apoptosis, and attenuate cardiac remodeling and improve cardiac function in this mice MI model.Sch B might serve as a potential novel therapeutic agent for ischemic heart disease.
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Background: Rice seed proteins are lacking essential amino acids [EAAs]. Genetic engineering offers a fast and sustainable method to solve this problem as it allows the specific expression of heterologous EAA-rich proteins. The use of selectable marker gene is essential for generation of transgenic crops, but might also lead to potential environmental and food safety problems. Therefore, the production of marker-free transgenic crops is becoming an extremely attractive alternative and could contribute to the public acceptance of transgenic crops
Objectives: The present study was conducted to examine whether AmA1 can be expressed specifically in rice seeds, and generate marker-free transgenic rice with improved nutritive value
Materials and Methods: AmA1 was transferred into rice using Agrobacterium-mediated co-transformation system with a twin T-DNA binary vector and its integration in rice genome was confirmed by southern blot. Transcription of AmA1 was analyzed by Real-Time PCR and its expression was verified by western analysis. Protein and amino acid content were measured by the Kjeldahl method and the high-speed amino acid analyzer, respectively
Results: Five selectable marker-free homozygous transgenic lines were obtained from the progeny. The expression of recombinant AmA1 was confirmed by the observation of a 35 kDa band in SDS-PAGE and western blot. Compared to the wild-type control, the total protein contents in the seeds of five homozygous lines were increased by 1.06 tilde 12.87%. In addition, the content of several EAAs, including lysine, threonine, and valine was increased significantly in the best expressing line
Conclusions: The results indicated that the amino acid composition of rice grain could be improved by seed-specific expression of AmA1
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Amaranthus , Agrobacterium , Amino Acids, Essential , Genes, PlantABSTRACT
Objective:To explore the influence of metabolic syndrome (MS) on coronary artery disease in patients with hypertension .Methods :A total of 220 patients with hypertension were enrolled .According to complicated with MS or not ,they were divided into MS group (n=90) and pure hypertension group (control group ,n=130) . Coronary angiography was used to measure distribution and number of diseased coronary vessels ,Gensini scoring was also performed to compare and analyze severity of coronary disease between two groups .Results:Detection rate of CHD in MS group was significantly higher than that of control group (84.44% vs .71.54% ) ,χ2 = 4.974 , P=0.026. Compared with control group ,there were significant rise in percentages of left circumflex coronary artery (29.23% vs .44.44% ) and right coronary artery lesions (23.08% vs .38.89% ) , P<0.05 both ;significant rise in Gensini score [(32.69 ± 20.64) scores vs .(40.71 ± 25.79) scores ,P=0.011] and percentage of three -vessel coro‐nary artery disease (26.15% vs .40.00% ,χ2 = 4.700 , P= 0.03) in MS group .Conclusion:Metabolic syndrome significantly elevates severity of coronary artery disease in patients with hypertension .
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<p><b>OBJECTIVE</b>To investigate the feasibility and safety of 3D laparoscopic and thoracoscopic esophagectomy.</p><p><b>METHODS</b>From October 2013 to March 2014, 154 patients with esophageal cancer of clinical stage T3N1M0 undergoing 3D or 2D minimally invasive esophagectomy in lateral prone position in our department were enrolled prospectively, and randomly divided into 3D group (78 cases) and 2D group (76 cases). The esophagus was dissociated by 3D or 2D laparoscope and thoracoscope to the entry of thorax. Stomach was dissociated by same telescopes and cut linearly. After tube stomach shaping was completed, esophagogastric anastomosis was performed in the left neck. The operative safety and short-term efficacy were compared between the two groups.</p><p><b>RESULTS</b>The entire procedure was technically successful in 154 patients. The average total operative time in 3D group was shorter than that in 2D group [(176.0±27.7) min vs. (203.0±31.5) min, P<0.05]. No significant differences were observed in blood loss [(124.0±35.8) ml vs. (127.0±25.7) ml], number of harvested lymph node (17.0±8.6 vs. 18.0±3.3), postoperative hospital stay [(11.8±9.3) d vs. (12.6±8.8) d] (all P>0.05), and morbidity of postoperative complication [12.8% (10/78) vs. 14.5% (11/76)]. The median follow-up time was 5.6 (3-8) months and 5.2 (5-7) months in 3D and 2D groups respectively, and no death or relapse cases were found during the follow-up.</p><p><b>CONCLUSION</b>3D laparoscopic and thoracoscopic esophagectomy under lateral prone position is technically feasible and safe for esophageal carcinoma, as compared to 2D procedure.</p>
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Humans , Carcinoma , General Surgery , Esophageal Neoplasms , General Surgery , Esophagectomy , Methods , Laparoscopy , Length of Stay , Lymph Nodes , Neoplasm Recurrence, Local , Operative Time , Postoperative Complications , Prone Position , Retrospective Studies , StomachABSTRACT
To develop a portable oxygen moisture bottle. The bottle adopted a double-tightened and separate structure, whose shell was made of transparent materials. The inner liner was made of PTFE hydrophobic mem-brane filter, which applied a 3-layer structure to inlet oxygen into the shell through the air membrane filter at all directions. The bottle had no requirements for site and high reliability, and the desired use for continuous oxygen inhalation was realized. The bottle has a simple structure, low cost, easy maintenance and high portability, and gains ad-vantages over the traditional one.
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Objective: To investigate the mechanism of vascular endothelial growth factor ( VEGF)165 and hepatocyte growth factor (HGF) improving cardiomyocyte proliferation in experimental porcine after myocardial infarction (MI). Methods: The MI model was established by left anterior descending artery ligation in 15 male pigs and the animals were divided into 3 groups, n=5 in each group. Control group, the pigs received normal saline injection at the infarct and peri-infarct zones. VEGF group, the pigs received (1×1010 ) pfu of viral titers of Ad-VEGF injection. HGF group, the pigs received (1×1010 ) pfu of viral titers of Ad-HGF injection. The myocardial perfusion and cardiac function were examined by SPECT, the protein expressions of VEGF165 and HGF were measured by Western blot analysis, cardiomyocyte proliferation was analyzed by immunolfuorescence and immunoprecipitation method. Results: ① Compared with Control group, the expressions of VEGF165 and HGF were higher at the infarct and peri-infarct zones in both treatment groups; ② Both treatment groups had better cardiac function and myocardial perfusion; ③ Both treatment groups had improved cardiomyocyte proliferation at the infarct and peri-infarct zones.④VEGF165 promoted cardiomyocyte proliferation via p27 pathway;⑤HGF promoted cardiomyocyte proliferation via p21 and p27 pathways. Conclusion: VEGF165 and HGF could improve myocardial perfusion and function in experimental porcine after MI, VEGF165 and HGF promote cardiomyocyte proliferation via different pathways.
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Objective To compare the therapeutic effects of early enteral nutrition and delayed enteral nutrition on severe acute pancreatitis. Methods Sixty-four patients of severe acute pancreatitis were enrolled into two groups: early enteral nutrition group was used as the treatment group and delayed enteral nutrition was used as the control group. Two weeks after the treatment, Variables of TP, ALB, CRP, APACHEⅡscore, hospital stay and recovery time of blood and urine amylase were compared between the two groups. Results The TP and ALB of the treatment group were significantly higher than those in the control group (P<0.05). The CRP and APACHEⅡscore of the treatment group were significantly lower than those in the control group (P<0.05). Compared with the control group, the recovery time of blood amylase, urine amylase and hospital stay were significantly shorter in the treatment group (P<0.05). Conclusion Using early enteral nutrition treatment in patients with severe acute pancreatitis is efficient, worthy of clinical use.
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<p><b>BACKGROUND</b>First generation drug-eluting stents (DES) were associated with a high incidence of late stent thrombosis (ST), mainly due to delayed healing and re-endothelization by the durable polymer coating. This study sought to assess the safety and efficacy of the Nano polymer-free sirolimus-eluting stent (SES) in the treatment of patients with de novo coronary artery lesions.</p><p><b>METHODS</b>The Nano trial is the first randomized trial designed to compare the safety and efficacy of the Nano polymer-free SES and Partner durable-polymer SES (Lepu Medical Technology, Beijing, China) in the treatment of patients with de novo native coronary lesions. The primary endpoint was in-stent late lumen loss (LLL) at 9-month follow-up. The secondary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction or target lesion revascularization.</p><p><b>RESULTS</b>A total of 291 patients (Nano group: n = 143, Partner group: n = 148) were enrolled in this trial from 19 Chinese centers. The Nano polymer-free SES was non-inferior to the Partner durable-polymer DES at the primary endpoint of 9 months (P < 0.001). The 9-month in-segment LLL of the polymer-free Nano SES was comparable to the Partner SES (0.34 ± 0.42) mm vs. (0.30 ± 0.48) mm, P = 0.21). The incidence of MACE in the Nano group were 7.6% compared to the Partner group of 5.9% (P = 0.75) at 2 years follow-up. The frequency of cardiac death and stent thrombosis was low for both Nano and Partner SES (0.8% vs. 0.7%, 0.8% vs. 1.5%, both P = 1.00).</p><p><b>CONCLUSIONS</b>In this multicenter randomized Nano trial, the Nano polymer-free SES showed similar safety and efficacy compared with the Partner SES in the treatment of patients with de novo coronary artery lesions. Trials in patients with complex lesions and longer term follow-up are necessary to confirm the clinical performance of this novel Nano polymer-free SES.</p>
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Aged , Female , Humans , Male , Middle Aged , Coronary Artery Disease , Drug Therapy , General Surgery , Drug-Eluting Stents , Immunosuppressive Agents , Therapeutic Uses , Prospective Studies , Sirolimus , Therapeutic UsesABSTRACT
Thirty-three patients with esophageal carcinoma (T3N1M0 or less) underwent thoracoscopic surgery in lateral prone position for esophagectomy from February 2010 to November 2012.Their postoperative outcomes and survivals were retrospectively analyzed.The results confirmed the feasibility and safety of this mini-invasive thoracoscopic procedure in lateral prone position for patients with esophageal carcinoma.A possible advantage of lateral prone technique is that in case of an emergency switch to open surgery,precious time may be saved in changing body position.
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ObjectiveTo evaluate the fourth-generation ultrasonic lithotripsy system for treating the urinary tract stones.Methods243 cases of urinary tract stones who received treatment of fourth-generation EMS ultrasonic lithotripsy system were analyzed retrospectively.ResultsImmediate phase I lithotrotrisy was performed successfully in 227 cases and the successful rate of phase I was 93.3％ (227/243).Delayed phase Ⅱ lithotripsy was performed for 16 patients.Complications happened in 2 cases,one case occurred hydropneumothorax during operation,required indwelling thoracic drainage tube processing,the other had severe bleeding which conservative treatment was ineffective,cured by the intervention of super-selective renal artery embolization.Conclusion Fourth generation of ultrasonic lithotripsy for treating stones on different anatomical locations of urinary system was safe,practical and efficient,worthy of clinical application.
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ObjectiveTo study the cardioprotective effects of ischemic post-conditioning on elderly patients with ST-elevation acute myocardial infarction (STEM1).MethodsConsecutive 215 patients with STEMI undergoing emergency percutaneous coronary intervention(PCI) were randomly assignedto receive ischemicpost-conditioningorconventional PCItreatment.The ischemic postconditioning (n=38) were conducted by 3 episodes of 30-second occlusion followed by 30-second reperfusion, while the control group (n= 46) was without any intervention after PCI.Reperfusion arrhythmias, corrected TIMI frame count (cTFC) and TIMI myocardial perfusion grade (TMPG)were compared between the two groups, respectively.Results The incidence of reperfusion arrythmias was less frequent in ischemic postconditioning group (21.1％ ,8/38) than in control group (45.7％ ,21/46) after PCI (x2 = 5.571, P＜0.05). The TIMI grade 3 flow was similar between two groups [(94.7％(36/38) vs. 82.6％( 38/46), x2= 2.919, P＞0.05], the cTFC levels (23.6±3.7vs. 26.1 ±5.9) and TMPG 3 perfusion [ 89.5％ (34/38) vs.69.6％ (32/46)] were significantly different (t= 5.434, P＜0.05; x2 = 4.899, P＜0.05, respectively) between two groups.ConclusionsIschemic postconditioning may reduce myocardial reperfusion injury in elderly patients with STEMI undergoing emergent PCI.
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Objective To investigate the value of contrast enhanced ultrasound(CEUS) with microbubbles targeted to vascular endothelial growth factor receptor type 2 (VEGFR2) for imaging tumor angiogenesis in murine tumor models.Methods Established human renal cell carcinomas(RCC) subcutaneous xenograft tumor model in nude mice,microbubbles targeted to VEGFR2(MBV) was prepared,control microbubbles(MBC) and MBV were injected respectively in each mouse,the intensity of each microbubble was compared,the expressions of VEGFR2 in tumors were tested by immunohistochemistry.Results CEUS imaging showed the intensity of MBV and MBC was (6.50±1.43)dB,(2.59±0.99)dB,respectively.There was significantly higher intensity when using MBV compared with MBC (P<0.01).The time to wash out was longer in MBV contrast group compared with MBC group.Immunohistochemistry showed VEGFR2 was highly expressed in novel vessel walls.Conclusions Contrast microbubbles targeted to VEGFR2 can specially enhance the images of RCC and has tremendous significance in the assessment of angiogenesis.
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Objective To explore the curative effect of tirofiban treatment on high-risk acute coronary syndromes (ACS) in elderly patients receiving an early percutaneous coronary intervention (PCI) treatment. Methods The 162 elderly cases including unstable angina pectoris and non-ST -segment elevation myocardial infarction (NSTEMI) undergoing early PCI were enrolled in this study.And they were assigned to early treatment group (n=82) and deferred selective group (n=80)according to the time of using tirofiban (Gp Ⅱ b/Ⅲ a inhibitor) treatment. The effectiveness of either strategic option on tissue-level perfusion was evaluated using the TIMI myocardial perfusion grade (TMPG) before and immediately after PCI. The corrected TIMI frame count (cTFC) was also used to assess coronary artery flow and myocardial perfusion. Bleeding complications and the composite end point events at 30 days were also evaluated. Results Of all the 162 patients, the TMPG 0-1 perfusion was observed in 65 patients (40.1%). The TMPG 0-1 perfusion was significantly less frequent in early treatment group (32.9%) than in deferred selective group (47.5%) before PCI (x2=3.58, P＜0.05); while the results of TIMI grade 0-1 flow (26.8% vs. 25.0%) and cTFC levels (34.2±11.8 vs. 34. 9±12. 7) before PCI were similar between the two groups (x2 =0. 07, P=0.47; t= 0.13, P=0.71, respectively). No differences were seen both in composite end point events at 30 days and bleeding complications (x2 = 0.31, P＞0.05; x2=0.004, P＞0. 05). Conclusions High -risk ACS patients treated with an early invasive strategy, routine upstream use of tirofiban are associated with improved tissue-level perfusion before PCI and does not increase bleeding complications when bleeding risks are carefully evaluated before enrollment.