A novel biodegradable polymer-coated sirolimus-eluting stent: 1-year results of the HELIOS registry / 中华医学杂志(英文版)

BACKGROUND@#The HELIOS stent is a sirolimus-eluting stent with a biodegradable polymer and titanium oxide film as the tie-layer. The study aimed to evaluate the safety and efficacy of HELIOS stent in a real-world setting.@*METHODS@#The HELIOS registry is a prospective, multicenter, cohort study conducted at 38 centers across China between November 2018 and December 2019. A total of 3060 consecutive patients were enrolled after application of minimal inclusion and exclusion criteria. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, non-fatal target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR) at 1-year follow-up. Kaplan-Meier methods were used to estimate the cumulative incidence of clinical events and construct survival curves.@*RESULTS@#A total of 2998 (98.0%) patients completed the 1-year follow-up. The 1-year incidence of TLF was 3.10% (94/2998, 95% closed interval: 2.54-3.78%). The rates of cardiac death, non-fatal target vessel MI and clinically indicated TLR were 2.33% (70/2998), 0.20% (6/2998), and 0.70% (21/2998), respectively. The rate of stent thrombosis was 0.33% (10/2998). Age ≥60 years, diabetes mellitus, family history of coronary artery disease, acute myocardial infarction at admission, and device success were independent predictors of TLF at 1 year.@*CONCLUSION@#The 1-year incidence rates of TLF and stent thrombosis were 3.10% and 0.33%, respectively, in patients treated with HELIOS stents. Our results provide clinical evidence for interventional cardiologists and policymakers to evaluate HELIOS stent.@*CLINICAL TRIAL REGISTRATION@#ClinicalTrials.gov, NCT03916432.

Comparison of Zero-profile fusion and titanium plate combined with cage fusion in treating symptomatic adjacent segment disease after anterior cervical discectomy and fusion / 中华骨科杂志

Objective:To compare the clinical effects of Zero-profile (Zero-p) intervertebral fusion and titanium plate combined with cage fusion in treating symptomatic adjacent segment disease (ASD) after anterior cervical discectomy and fusion (ACDF).Methods:Retrospective analysis was performed on 26 patients who underwent ACDF and readmission due to concurrent symptomatic ASD from October 2014 to June 2019. There were 17 males and 9 females, aged 54.15±8.60 (range 41-68) years. The index level included C 2, 3 1 case, C 3, 4 3 cases, C 4,5 9 cases, C 5, 6 6 cases, C 6, 7 7 cases. Twelve cases underwent anterior cervical decompression with Zero-p intervertebral fusion and fixation (Zero-p group), while 14 cases underwent anterior cervical decompression with titanium plate combined with cage fusion and fixation (titanium plate group). The following parameters, including operative duration, intraoperative blood loss, Japanese Orthopaedic Association (JOA) score, visual analogue score (VAS), neck disability index (NDI), dysphagia Bazaz grade, bone graft fusion Eck grade, C 2-C 7 Cobb angle, and related complications, were compared between the two groups. Results:The operation was performed successfully in all the patients. The patients were followed up for averagely 33.38±21.26 (range 12-71) months. The operation duration was 95.83±5.47 (range 89-105) min in the Zero-p group, which was shorter than 121.28±8.24 (range 106-131) min in the titanium plate group. The Bazaz classification of dysphagia in the Zero-p group was superior to the titanium plate group at 1 month after operation ( W=126.00, P=0.022). Neither group had dysphagia 3 months after surgery. The JOA score increased from preoperative 9.50±1.31 to 14.33±0.78, and VAS decreased from 5.33±1.67 to 0.83±0.72 in the Zero-p group. The NDI decreased from 43.62%±9.31% to 14.99%±3.26%, and C 2-C 7 Cobb changed from 8.26°±2.92° to 14.80°±4.18° in the Zero-p group. The JOA score increased from preoperative 9.14±1.79 to 14.71±0.73, and VAS decreased from 5.43±1.55 to 1.43±0.76 in the titanium plate group. The NDI decreased from 43.76%±8.47% to 14.22%±4.59%, and C 2-C 7 Cobb changed from 5.53°±9.04° to 14.68°±6.89° in the titanium plate group. No complication, such as screw loosening or breakage or esophageal injury, occurred during the follow-up. Conclusion:Both methods can achieve good clinical effects in treating symptomatic ASD and can restore the physiological curvature of the cervical spine to a certain extent. Furthermore, the advantages of Zero-p intervertebral fusion include shorter operation duration, reducing soft tissue injury and less postoperative dysphagia.

Analysis of frequency-domain and window effect for cellular inner and outer membranes subjected to pulsatile electric field / 生物医学工程学杂志

Based on multi-layer dielectric model of spherical biological cell, a simulating method of frequency characteristics of inner and outer membranes is presented in this paper. Frequency-domain analysis showed that inner and outer membranes subjected to pulsed electric field exhibit band-pass and low-pass filter characteristics, respectively. A calculating method of the transmembrane potential of inner and outer membranes induced by time-varying electric field was introduced, and the window effect between electric field and transmembrane potential was also analyzed. When the duration is reduced from microsecond to sub-microsecond, and to nanosecond, the target induced was from the outer membrane to inner membrane gradually. At the same time, the field intensity should be increased to induce corresponding bioelectric effects. Window effect provides theoretical guidance to choosing reasonable parameters for application of pulsatile electric field in tumor treatment.

Focusing properties of picosecond electric pulses in non-invasive cancer treatment / 生物医学工程学杂志

In the light of optical theory, we advanc an ultra-wideband impulse radiating antenna (IRA) which is composed of an ellipsoidal reflector and a cone radiator. The high-intensity ultra-short electric pulses radiated by IRA can be transferred into the deep target in tissue non-invasively and be focused effectively. With the focused picosecond electric pulses, the organelles (mitochondria) transmembrane potential shall change to collapse under which the tumor cells will be targetly induced to apoptosis, so the method of non-invasive treatment of tumors would be achieved. Based on the time-domain electromagnetic field theory, the propagation characteristics of picosecond electric pulses were analyzed with and without the context of biological tissue, respectively. The results show that the impulse characteristics of input pulse were maintained and the picosecond electric pulses can keep high resolution in target areas. Meanwhile, because of the dispersive nature of medium, the pulse amplitude of the pulses will attenuate and the pulse width will be broadened.

Effect of autologous bone marrow cells transplantation on myocardial function in patients with acute myocardial infarction:A Doppler echocardiographic observation / 中国医学影像技术

Objective To evaluate left ventricular function of acute myocardial infarction (AMI) patients who underwent autologous bone marrow mononuclear cells (BMMNC) after percutaneous coronary intervention (PCI) transplantation with tissue Doppler imaging (TDI). Methods Forty-eight male patients with AMI were divided into experimental group and control group (each n=24). PCI was performed within 24 hours after attach. Patients in experimental group received autologous BMMNC transplantation 7-14 days after PCI. Conventional echocardiography and TDI were performed before and 1, 3 and 6 months after treatment. Left ventricular ejection fraction (LVEF), peak systolic (S_a, S_m), early diastolic (E_a, E_m) and late diastolic (A_a, A_m) mitral velocities and regional myocardial velocities were obtained with conventional echocardiography or TDI, and compared between the two groups. Results There was no significant difference of each index between two groups before operation. Compared with the control group, S_a, S_m, E_m, E_a/A_a and Em/Am improved significantly in experimental group at each follow-up time point; LVEF and E_a were significantly higher than those of control group 3 and 6 months after treatment. Conclusion Combination of PCI and autologous BMMNC transplantation is more helpful to improve regional and global cardiac systolic and diastolic function after myocardial infarction, which can be quantitatively evaluated with TDI.

Recent advances on physical ablation for tumor / 生物医学工程学杂志

Physical ablation is a new kind of tumor treatment which directly acts on local solid tumors to eradicate or destroy tumor tissues by use of various advanced physical techniques. Physical ablation can be classified by physical characteristics as thermal ablate therapy (TAT), cryoablation and electrical ablation. Recent studies and technical trend of these three physical ablation treatments are reviewed in this paper.

The study of apoptosis and mechanism of cells exposed to steep pulse / 生物医学工程学杂志

This experiment was designed to study the apoptosis and related mechanism of adherent liver tumor cells (SMMC-7721) and adherent normal liver cells (HL-7702) when they were exposed to the steep pulse generated by the steep pulse apparatus for tumor treatment. The results showed that the steep pulse of 200 V could induce tumor cells apoptosis. The tumor cells presented with their apoptosis when they were exposed to the steep pulse from 200 V to 250 V. Laser scanning confocal microscopy was used to make a real time study of calcium burst when the adherent tumor cells were exposed to the steep pulse. The results showed:On the condition of no extracellular Ca2+, the concentration of Ca2+ in tumor cells exposed to the steep pulse of 150 V did not change; the concentration of Ca2+ in tumor cells exposed to the steep pulse of 200 V decreased; the concentration of Ca2+ in tumor cells exposed to the steep pulse of 250 V decreased more evidently. On the condition of existing extracellular Ca2+, the concentration of Ca2+ in tumor cells exposed to the steep pulse of 150 V did not change; the concentration of Ca2+ in tumor cells exposed to the steep pulse of 200 V decreased little; the concentration of Ca2+ in tumor cells exposed to the steep pulse of 250 V reduced little, too. Maybe the change of calcium burst in the tumor cells is the mechanism of apoptosis when cells are exposed to the steep pulse.

Comparison of coronary stenting with or without predilation for infarct related lesions in patients with acute myocardial infarction / 中国介入心脏病学杂志

1?216 kPa(12 atm, 1 atm=101.325 kPa)] or low- (≤1?216 kPa) pressure inflation. Results In group A, all patients were successfully treated with PCI. In group B, 40 cases (95%) were successfully treated with DS, and DS in the remaining 2 patients failed due to an angle in IRL, which were successfully managed with pre-dilation. There were no procedure-related death, re-infarction, or emergency bypass surgery in both groups. The incidence of no-reflow after stenting was significantly higher in patients with high-pressure inflation than in those with low-pressure inflation (32% vs 7%, P

Stent supported coronary angioplasty in patients with severe ventricular dysfunction / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the immediate- and long-term outcomes of stent supported coronary angioplasty in patients with severe left ventricular dysfunction.</p><p><b>METHODS</b>Seventy-four consecutive patients with angiographic left ventricular ejection fractions < or = 40% underwent percutaneous coronary angioplasty, including 61 (81%) with stent back-up. Clinical follow-up (29.1 +/- 22.9 months) data were obtained in all clinically successful patients.</p><p><b>RESULTS</b>Angiographic success was achieved in 120 (89.5%) of 134 lesions. Clinical success was obtained in 66 (89.2%) patients with 1.4% procedure related mortality, 2.7% myocardial infarction and zero need of emergent bypass surgery. NYHA class reduction > or = 1 was seen in 29 (73%) of 40 successfully treated congestive heart failure patients at 6 months after the procedure. During long-term follow-up, 58 (87.9%) of 66 patients with clinical success were alive, including 44 (68.6%) free from cardiac events.</p><p><b>CONCLUSIONS</b>Patients with severe left ventricular dysfunction treated with stent supported PTCA experience a high rate of success, low procedure related mortality and satisfactory long-term survival.</p>

Application of distal embolic protection device in acute myocardial infarction with ST-segment elevation / 解放军医学杂志

Objective To evaluate the efficacy and safety of distal embolic protection device(DPD) on acute myocardial infarction(AMI) with ST-segment elevation.Methods Two hundred and sixty-seven patients with ST-segment elevation AMI treated in emergency with percutaneous coronary intervention(PCI) from Jan.1,2004 to Dec.31,2005 in the Department of Cardiology,Xijing Hospital were studied retrospectively.169 patients were included in control group and 98 in DPD group.Patients in control group were treated with emergency PCI,while those in DPD group were treated with DPD during emergency PCI.The incidence of "no-reflow" phenomenon,thrombolysis in myocardial infarction(TIMI) 3 flow,and ST segment resolution were observed,and mortality in-hospital and left ventricular ejection fraction(LVEF) at 1 week after PCI were compared between the two groups.Results The incidence of "no-reflow" was 3.06%(3/98) in DPD group and 13.61%(23/169) in control group(P

Time course of functional recovery after coronary intervention in patients with myocardial infarction / 中国介入心脏病学杂志

Objective To assess the time course of functional recovery after coronary intervention in patients with myocardial infarction. Methods 30 patients with myocardial infarction (left ventricular ejection fraction, LVEF

Effects and safety of PercuSurge distal protection device in coronary intervention in acute myocardial infarction / 中国介入心脏病学杂志

Objective To evaluate the effects and safety of PercuSurge distal protection device(DPD) in coronary intervention in patients with acute myocardial infarction. Methods From December 2003 to December 2005, 174 acute myocardial infarction patients who received primary coronary intervention were included into this study. Patients were divided into the DPD group (n=78) and the control group (n=96) according to whether Percusurge DPD was attempted during emergency PCI. The basic clinical characteristics, angiographic results, and follow up data before discharge were compared. TIMI flow grades and myocardial blush grades were performed in all cases after emergency PCI. Results Success application was achieved in 72 out of 78 patients with PercuSurge DPD with varies extent of material collected from the basket. There was no significant difference between the two groups in basic clinical characteristics and angiogram before PCI. Post-PCI TIMI flow grades (94.9% vs 79.2%) and myocardial blush grades (2.65?0.68 vs 2.22?0.94) were significantly higher in the DPD guoup than in the control group(P

Short-and long-term results of stenting supported balloon angioplasty in 10 patients with Takayasu arteritis / 中国介入心脏病学杂志

Objective To assess the short- and long-term results of patients with Takayasu arteritis underwent intervention therapy. Methods A total of 13 peripheral arteries in 10 consecutive patients with Takayasu disease were treated with percutaneous transluminal interventions. The target vessels included 2 subclavian arteries, 5 renal arteries, 1 abdominal artery, lcarotid artery, 1 lilac artery, and 3 pulmonary arteries. Nine stents were implanted in 8 patients for suboptimal results or dissection. Results Angioplasty and stenting were successful in all attempted lesions. Diameter stenosis was reduced from (90?11)% to (11?12)% ( P