Máscara n95: percepções dos trabalhadores do centro cirúrgico / Máscara n95: percepciones de los trabajadores del centro quirúrgico / N95 mask: perceptions of surgical center workers

Objetivo: identificar as percepções dos trabalhadores do centro cirúrgico quanto ao uso da máscara N95 como Equipamento de Proteção Individual em relação à fumaça cirúrgica. Método: pesquisa qualitativa mediante entrevistas áudio-gravadas, com nove trabalhadores do Centro Cirúrgico de um hospital no norte do Paraná, Brasil. Questionou-se: qual a percepção dos trabalhadores expostos à fumaça cirúrgica em relação ao uso das máscaras N95? Foi utilizada a técnica de análise de conteúdo. Resultados: o estudo revela a fragilidade do conhecimento dos profissionais sobre a utilização da máscara N95 e sobre os riscos que estão expostos durante sua jornada de trabalho, quando expostos à fumaça cirúrgica. Assim como o desconforto pelo uso da máscara. Conclusão: sugere-se capacitação aos profissionais da saúde expostos à fumaça cirúrgica, onde possa ser esclarecido sobre o uso de Equipamento de Proteção Individual de forma correta e sua importância na prevenção para o desenvolvimento de doenças ocupacionais.

Objetivo: identificar las percepciones de los trabajadores del centro quirúrgico en cuanto al uso de la máscara N95 como Equipo de Protección Individual en relación al humo quirúrgico. Método: investigación cualitativa mediante entrevistas audio-grabadas, con nueve trabajadores del Centro Quirúrgico de un hospital en el norte de Paraná, Brasil. Se preguntó: ¿cuál es la percepción de los trabajadores expuestos al humo quirúrgico con respecto al uso de las máscaras N95? Se utilizó la técnica de análisis de contenido. Resultados: el estudio revela la fragilidad del conocimiento de los profesionales sobre la utilización de la máscara N95 y sobre los riesgos que están expuestos durante su jornada de trabajo, cuando están expuestos al humo quirúrgico. Así como la incomodidad por el uso de la máscara. Conclusión: se sugiere capacitación a los profesionales de la salud expuestos a humo quirúrgico, donde pueda ser esclarecido sobre el uso de Equipo de Protección Individual de forma correcta y su importancia en la prevención para el desarrollo de enfermedades ocupacionales.

Objective: to identify the perceptions of surgical center workers regarding the use of the N95 mask as Personal Protection Equipment in relation to surgical smoke. Method: qualitative research through audio-recorded interviews with nine workers from the Surgical Center of a hospital in northern Paraná, Brazil. It was questioned: what is the perception of workers exposed to surgical smoke in relation to the use of N95 masks? The technique of content analysis was used. Results: the study reveals the fragility of professionals' knowledge about the use of the N95 mask and the risks they are exposed during their working day, when exposed to surgical smoke. As well as discomfort from wearing the mask. Conclusion: training for health professionals exposed to surgical smoke is suggested, where it can be clarified about the use of Personal Protective Equipment correctly and its importance in preventing the development of occupational diseases.

Design and application of a portable cardiopulmonary resuscitation protection device / 中华危重病急救医学

Standardized cardiopulmonary resuscitation (CPR) of patients prior to the arrival of emergency medical services can significantly improve survival rate after out-of-hospital cardiac arrest (OHCA). According to statistics, about 40% to 85% of CPR led to chest fractures, making bystanders alarm, and reducing the willingness of rescuing by CPR. Therefore, there is an urgent need to develop a CPR protection device that is convenient for placing in public places outside the hospital and conforms to the operation habit of freehand CPR. In view of the above problems, medical students majored in emergency and rescue medicine and anesthesiology in Xuzhou Medical University, together with students majored in product design in Southeast University, designed a portable CPR protection device under the guidance of doctors working in department of emergency medicine of the Affiliated Hospital of Xuzhou Medical University, and obtained the national invention patent authorization of China (patent number: ZL 2021 1 0309001.4) and the national utility model patent authorization of China (patent number: ZL 2021 2 0591084.6). The device is composed of a foldable frame, support components, guide slide rails and compression body, which provides guidance and guarantee for the implementation of CPR, thus users can accurately grasp the implementation process, compression amplitude, strength and frequency, and effectively prevent accidental injuries such as rib fractures caused by CPR compression. The device is small, easy to store and move, with low manufacturing cost, making it suitable for social popularization.

Review of Measurement Methods for Hearing Protector Attenuation

Abstract@#The attenuation degree labelled on hearing protectors is based on internationally set standards. The attenuation is measurement in laboratories using methodology of real-ear attenuation at threshold (REAT), microphone in-real ear (MIRE) and acoustics test feature (ATF). The measured attenuation gap from the actual workplace is a problematic predicament. The conceptual review of how far these methods affect the gap could embark future researches. Therefore, a conceptual review of the conducted methodologies according to standards for attenuation which include Noise Reduction Rating (NRR) and Single Number Rating (SNR) are discussed in this paper. 23 papers from ProQuest, EBSCOhost and Google Scholar databases are chronologically reviewed. Summarily, the improved attenuation measurement methods will help close the gap between laboratory data and field performance and subsequently will better prevent Noise-Induced Hearing Loss. Most of the latest findings after year 2010 were in agreement with the studies in 2000 to 2009.

Individual Fit Testing of Hearing Protection Devices Based on Microphone in Real Ear

BACKGROUND: Labeled noise reduction (NR) data presented by manufacturers are considered one of the main challenging issues for occupational experts in employing hearing protection devices (HPDs). This study aimed to determine the actual NR data of typical HPDs using the objective fit testing method with a microphone in real ear (MIRE) method. METHODS: Five available commercially earmuff protectors were investigated in 30 workers exposed to reference noise source according to the standard method, ISO 11904-1. Personal attenuation rating (PAR) of the earmuffs was measured based on the MIRE method using a noise dosimeter (SVANTEK, model SV 102). RESULTS: The results showed that means of PAR of the earmuffs are from 49% to 86% of the nominal NR rating. The PAR values of earmuffs when a typical eyewear was worn differed statistically (p 0.05). CONCLUSION: This study could provide local individual fit data. Ergonomic aspects of the earmuffs and different levels of users experience and awareness can be considered the main factors affecting individual fitting compared with the laboratory condition for acquiring the labeled NR data. Based on the obtained fit testing results, the field application of MIRE can be employed for complementary studies in real workstations while workers perform their regular work duties.

The development of one kind of safety protection device for lead cable used in equipment and its application in clinical practice / 中国医学装备

Objective:To develop a safety protection device for lead cable of equipment in order to reduce or avoid the skin burn of patient and the invalidation of monitoring data caused by the short circuited of lead cable, and enhance the comfortable level of patient, at the same time, and reduce the pain of patient and potential adverse events.Methods: The device was consisted of the fixed sleeve of cylinder-shape (protective shell) and fixed sleeve of packaged cable (fixed sleeve of wire and cable), and its component was carbon fiber reinforced polycarbonate and silicone rubber. The fragile, repaired part or the rupture rubber of shell in upside and bottom of device were clamped in fixed sleeve. And then, the upside and bottom were fixed in one device, and take them socket with lead cable of device.Results: After the safety protection device of leading cable were used, the cable were fixed in the interior of the device, and could be protected. Therefore, some risks of adverse event were reduced and avoided.Conclusion: The device is stable in performance, is simple and convenient in operation and installation. In the application, it avoids the risk which caused by short circuit of cable in therapy monitoring, and could enhance the comfortable feel. This device is appropriate to various installation and application of lead cable, and it can be repeated to apply. It has got national patent for utility models due to its favourable application value.

Carotid stent angioplasty for severe carotid artery stenosis: analysis of curative effect in 25 patients / 介入放射学杂志

Objective To discuss the surgical characteristics,safety and perioperative management of carotid stent angioplasty (CSA) for the treatment of severe carotid artery stenosis (＞85％).Methods From December 2011 to May 2016,a total of 25 patients with carotid artery stenosis (＞85％) were treated with CSA.According to the stenotic characteristics of the lesion,distal cerebral protection device was employed in performing CSA.During the operation,attention was paid to individualized and detailed surgical management and perioperative management program;the revascularization and the dropping-off of thrombus in cerebral protection device were under close observation,while effort was made to control the occurrence of complications.The patients were followed up for one year to observe the occurrence of ischemic cerebrovascular events.Results The cerebral protection device was successfully deployed after it passed over the severe carotid artery stenosis.After balloon pre-dilation the stent was deployed,and the stent showed satisfactory shape.North America Symptomatic Carotid Endarterectomy Testing (NASCET) showed that the average degree of carotid artery stenosis was decreased from preoperative (91.0±3.1)％ to postoperative (21.0±5.1)％.The protective umbrella was successfully retrieved in all patients,and deciduous tissue fragments were observed in 6 retrieved protective umbrellas.During the perioperative period no severe complications,such as cerebral hemorrhage,cerebral infarction,hyper-perfusion syndrome or death,were observed.All the 25 patients were followed up for one year,and no transient ischemic attack,stroke or death occurred.Conclusion In treating severe carotid artery stenosis with CSA,in order to ensure a successful surgery and patient's safety the following points are very important:in-operative individualized and detailed management,perioperative preventive measures,and use of appropriate cerebral protection device.

Clinical Analysis Comparing Efficacy between a Distal Filter Protection Device and Proximal Balloon Occlusion Device during Carotid Artery Stenting

OBJECTIVE: The main concern during transfemoral carotid artery stenting (CAS) is preventing cerebral embolus dislodgement. We compared clinical outcomes and intraprocedural embolization rates of CAS using a distal filter protection device or proximal balloon occlusion device. METHODS: From January 2011 to March 2015, a series of 58 patients with symptomatic or asymptomatic internal carotid artery stenosis > or =70% were treated with CAS with embolic protection device in single center. All patients underwent post-CAS diffusion-weighted magnetic resonance imaging (DW-MRI) to detect new ischemic lesions. We compared clinical outcomes and postprocedural embolization rates. RESULTS: CAS was performed in all 61 patients. Distal filter protection success rate was 96.6% (28/29), whose mean age was 70.9 years, and mean stenosis was 81%. Their preprocedural infarction rate was 39% (11/28). Subsequent DW-MRI revealed 96 new ischemic lesions in 71% (20/28) patients. In contrast, the proximal balloon occlusion device success rate was 93.8% (30/32), whose mean age was 68.8 years and mean stenosis was 86%. Preprocedure infarction rate was 47% (14/30). DW-MRI revealed 45 new ischemic lesions in 57% (17/30) patients. Compared with distal filter protection device, proximal balloon occlusion device resulted in fewer ischemic lesions per patient (p=0.028). In each group, type of stent during CAS had no significant effect on number of periprocedural embolisms. Only 2 neurologic events occurred in the successfully treated patients (one from each group). CONCLUSION: Transfemoral CAS with proximal balloon occlusion device achieves good results. Compared with distal filter protection, proximal balloon occlusion might be more effective in reducing cerebral embolism during CAS.

Risk Factors for Developing Large Emboli Following Carotid Artery Stenting

OBJECTIVE: The introduction and development of the embolic protecting device (EPD) has resulted in a decreased rate of stroke after carotid artery stenting (CAS). The authors performed a retrospective study to investigate the risk factors for developing large emboli after CAS which can lead to ischemic events. METHODS: A total of 35 consecutive patients who underwent CAS between January 2009 and March 2012 were included in this study. Patients were divided into two groups including those with small emboli (group A; grade 1, 2) and those with large emboli (group B; grade 3, 4). The size and number of emboli were assigned one of four grades (1=no clots, 2=1 or 2 small clots, 3=more than 3 small clots, 4=large clots) by microscopic observation of the EPD after CAS. We compared demographic characteristics, medical history, and angiographic findings of each group. RESULTS: Thirty-five patients underwent CAS, and technical success was achieved in all cases. Twenty-three patients were included in group A and 12 patients in group B. Our results demonstrated that advanced age [odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01-1.52; p=0.044] and smoking (OR 42.06; CI 2.828-625.65, p=0.006) were independent risk factors for developing large emboli after CAS. CONCLUSION: In patients with carotid artery stenosis treated with CAS, advanced age and smoking increased the number and size of emboli. Although use of an EPD is controversial, it may be useful in CAS in patients with risk factors for large emboli in order to reduce the risk of ischemic events.

Captured Macro-embolus of Fractured Atheromatous Plaque by the Embolic Protection Device during Carotid Stent Assisted Angioplasty / 신경중재치료의학

The authors present a case in which macro-embolus from the ruptured atheromatous plaque developed during carotid artery stenting (CAS). A 63-year-old man who had suffered a left middle cerebral artery territory infarction had significant proximal left internal carotid artery stenosis required CAS procedure. Immediate after stent deployment, the patient showed abrupt neurological deterioration with 12 x 3 mm sized macro-embolus which was caught by the embolus protection device (EPD). Retrieval of the macro-embolus was performed safely and the patient recovered to pre-procedure status. Macro-embolus can be resulted during the CAS. The EPD can capture the macro-embolus and safe removal is technically feasible.

Extracranial Carotid Disease: An Interpretation of Extracranial Carotid Artery Disease Guideline 2011 / 대한뇌졸중학회지

To date, there have been many clinical trials to examine carotid endarterectomy (CEA) for its clinical usefulness, and-in comparison with the results of CEA-carotid artery stenting (CAS) for its clinical impact. The paper summarizes the guideline for extracranial carotid arterial disease, providing the classification of recommendation and level of evidence. Extracranial carotid artery is unique in its geometry, hemodynamics, and hemorheologic characteristics. Invasive or non-invasive imaging methods for the extracranial carotid arterial disease should be used appropriately for decision making.

Preliminary application of the INVATEC Mo. Ma proximal cerebral protection device during carotid artery stenting / 中国脑血管病杂志

Objective: To investigate the safety and effectiveness of the Mo. Ma proximal cerebral protection device during carotid artery stenting. Methods: The clinical data of 6 patients with severe internal carotid artery stenosis diagnosed by the Department of Interventional Radiology, Xuanwu Hospital, Capital Medical University from December 2008 to May 2010 were analyzed retrospectively. They were underwent carotid artery stenting and used Mo. Ma cerebral protection device. Neurological and head MRI examinations were performed before and 3 months after the procedure. Results: The clinical symptoms of the 6 patients were improved. The captured small plaques were found in the filter protection device. No patients had dislodgement of emboli. The severe internal carotid artery stenosis were improved significantly after the procedure (residual stenosis rate of <30%). No new ischemic lesions were found in intraoperative and postoperative MRI reexamination. During the use of Mo. Ma cerebral protection device, one patient had the upstream of external carotid blood and the distal cerebral protection device was added. One patient had acute coronary syndrome after surgery and improved after active treatment. Conclusion: In patients with severe carotid artery stenosis who performed stenting, the using of INVATEC Mo. Ma proximal cerebral protection device is relatively safe and effective, but further studies with larger sample is necessary.

Long-term outcomes of saphenous vein graft stenting compared with native coronary artery stenting in patients with previous coronary artery bypass graft surgery / Stents en vasos coronarios nativos comparados con endoprótesis en injertos de vena safena en pacientes con cirugía de revascularización coronaria previa. Evolución a largo plazo

Propósito del estudio: el objetivo primario del estudio fue valorar la tasa de eventos cardiacos mayores después de cirugía de revascularización coronaria por angioplastia con stent en el injerto de vena safena, comparados con los de angioplastia con stent en la arteria coronaria nativa, tanto en el periodo de hospitalización como a largo plazo. Métodos: estudiamos a 127 pacientes, 49 con stent en injerto de vena safena (grupo 1) y a 78 con stent en arterias coronarias innatas (grupo 2). Resultados: no hubo diferencias significativas en la edad, ni en frecuencia de diabetes, tabaquismo, hipertensión arterial, dyslipidemia, fracción de expulsión del ventrículo izquierdo o clase funcional entre los grupos. La incidencia del fenómeno de no reflujo persistente fue mayor en el grupo 1 (10.2% contra 1.2%, p = 0.0001) y la suma de eventos cardiacos sólo fue distinta durante el primer mes (10.2% contra 2.5%, p = 0.041). La supervivencia sin eventos cardiacos a 36 meses fue menor en los pacientes del grupo 1 (65.0% contra 89.1%, p = 0.024). Conclusiones: La suma de eventos cardiacos mayores fue mayor en el grupo 1 y la supervivencia sin dichos eventos a 3 años fue superior en los pacientes con endoprótesis en arteria coronaria natural.

Objective: Our main objective was to compare the in-hospital and long-term outcomes of saphenous vein graft stenting and native coronary artery stenting in patients with previous coronary artery bypass grafting. Methods: We studied 127 patients who had prior coronary artery bypass; they were divided in two groups, according to the kind of percutaneous coronary intervention performed. The first group included 49 patients with saphenous vein graft stenting and the second group included 78 patients who underwent native coronary artery stenting. Results: There was no significant difference in age, incidence of diabetes, smoking, arterial hypertension, dyslipidemia, left ventricular ejection fraction or in the New York Heart Association functional class between both groups. The incidence of no reflow phenomenon was higher in group 1 (10.2% vs. 1.2%, p = 0.0001). The cumulative incidence of major adverse cardiac events was different between groups at 1 month (10.2% vs. 2.5%, p = 0.041). There was a lower MACE (major adverse cardiovascular events) free survival at 36 months in the saphenous vein graft stenting group (65.0% vs. 89.1%, p = 0.024). Conclusions: Major in-hospital complications occurred more frequently in the saphenous vein graft stented group. MACE-free survival at 3 years was higher in the native coronary artery stent patients.

Effects of using distal protection device on neuroendocrine in patients with acute myocardial infarction / 中华急诊医学杂志

Objective To study changes of neuroendocrine in patients with ST segment elevation acute myocardial infarction (STEMI) after using distal protection device (GuardWire PlusTM). Method Seventy patients with STEMI received percutaneous coronary intervention (PCI) in Municipal Hospital Qingdao, during September 2004 to December 2006. They were randomdy (random numbs) enrolled in this prospective and control study. All the patients were divided into 2 groups: the distal protection device group (GW) and the non-distal protection device group (NGW).The inclusion criteria were:onset within 6 hours, chest pain more than 30 minutes without response to nitroglycerin, two or more adjacent ST segnents elevated over 0.2 mv,the proximal or middle diameter of infarction artery over 3 mm, and the increased plasma creatine kinase. The exclusion criteria were fluctuation in hemodynamics, severe heart failure, arteriopathy of left main coronary artery, mechanical complications of acute myocardial infarction and multi-vessel disease scheduled for coronary artery bypass. The plasma levels of endothelin(ET) , plasma renin activity (PRA),aldosterone (ALD),angiotensin Ⅱ (Ang Ⅱ), norepinephrine (NE) and epinephrine (E) were measured on the day of operation and on the 1st,2nd,3rd and 5th day after operation, respectively. The t-test was used to compare those neuroendocrine elements between two groups. Results There were no differences in plasma levels of all the neuroendocrine elements between two groups before operation. Compared with the NGW group, the levels of neuroendocrine elements in the plasma rapidly decreased in the GW group at 1 d after the operation ( P ＜ 0.05). Conclusions In patients with ST segment elevation acute myocardial infarction, the distal protection device can decrease the changes in neuroendocrine.

Pseudo-no-Reflow Phenomenon in Carotid Artery Stenting using FilterWire EX: Successful Recovery by Aspiration Thrombectomy

Distal protection devices such as FilterWire EX have been widely used in carotid artery stenting, however, the large amount of atherothrombotic debris entrapped in the filter could reduce or stop antegrade flow. We present a case of pseudo-no-reflow phenomenon after postdilatation of the stent in a patient with asymptomatic carotid artery stenosis. After several passes using an Export Aspiration catheter, normal flow in the internal carotid artery was restored. Aspiration thrombectomy can successfully recover pseudo-no-reflow phenomenon.

Cerebral Ischemia Detected with Diffusion-Weighted MR Imaging after Protected Carotid Artery Stenting: Comparison of Distal Balloon and Filter Device

OBJECTIVE: The aim of this study was to examine the incidence of ischemia during protected carotid artery stenting (CAS) as well as to compare the protective efficacy of the balloon and filter devices on diffusion-weighted MR imaging (DWI). MATERIALS AND METHODS: Seventy-one consecutive protected CAS procedures in 70 patients with a severe (> 70%) or symptomatic moderate (> 50%) carotid artery stenosis were examined. A balloon device (PercuSurge GuardWire) and a filter device (FilterWire EX/EZ, Emboshield) was used in 33 cases (CAS-B group) and 38 cases (CAS-F group) to prevent distal embolization, respectively. All the patients underwent DWI within seven days before and after the procedures. The number of new cerebral ischemic lesions on the post-procedural DWI were counted and divided into ipsilateral and contralateral lesions according to the relationship with the stenting side. RESULTS: New cerebral ischemic lesions were detected in 13 (39.4%) out of the 33 CAS-Bs and in 15 (39.5%) out of the 38 CAS-Fs. The mean number of total, ipsilateral and contralateral new cerebral ischemic lesion was 2.39, 1.67 and 0.73 in the CAS-B group and 2.11, 1.32 and 0.79 in the CAS-F group, respectively. No statistical differences were found between the two groups (p = 0.96, 0.74 and 0.65, respectively). The embolic complications encountered included two retinal infarctions and one hemiparesis in the CAS-B group (9.09%), and one retinal infarction, one hemiparesis and one ataxia in the CAS-F group (7.89%). There was a similar incidence of embolic complications in the two groups (p = 1.00). CONCLUSION: The type of distal protection device used such as a balloon and filter does not affect the incidence of cerebral embolization after protected CAS.

Effect of a distal protection device on epicardial blood flow and myocardial blush in primary percutaneous coronary intervention / 中华急诊医学杂志

Objective To study the effect of a distal protection device (Pereusurge GuardWire: GW) on epicardial blood flow and myocardial perfusion in primary percutaneous coronary intervention. Method Acute STEMI patients treated with primary PCI were eligible to be studied. Inclusion criteria were: (1) within 12 hours from the onset of chest pain;(2) culprit leision with diameter stenosis≥70% and TIMI flow grade≤2. Exclusion criteria were:(1) patients undergoing thrombolytic therapy before PCI; (2) a culprit lesion in the left main coronary artery;(3)reference vessel diameter

The Role of Distal Protection Devices for Cardiovascular Intervention

Distal embolization, such as plaque debris and thrombus during percutaneous coronary and carotid interventions, often lead to virtually untreatable small vessel occlusions and the no-reflow phenomenon, which may cause periprocedural end organ ischemia and infarction. This is clinically important as the one-year mortality is doubled in patients with a periprocedural myocardial infarction. To prevent a distal embolization a number of distal protection devices have been developed, with others still under development, such as a balloon occlusion device (PercuSurge GuardWire), numerous filter devices (FilterWire EX, AngioGuard, Mednova Neuroshield, AccuNet) and a catheter occlusion device (Parodi Anti-Emboli System). The usefulness and roles of distal protection devices, for cardiovascular intervention, are reviewed.

Application of embolic protection device in renal angioplasty and stenting / 中华放射学杂志

Objective To assess the effectiveness and safety of embolic protection device in renal angioplasty and stenting.Methods From March 2003 through Feb 2005,renal angioplasty and stenting (RAS)were performed in 73 patients with severe renal artery stenosis,14 of them were done with use of distal embolic protection device(EPD,in 17 arteries ).Technical success included not only the stent placement but also the successful use of EPD.Results The EPD and stents were delivered and deployed successfully in all target arteries.The average percentage of renal artery stenosis before and after stent placement were 80.1%?9.0%,and 6.0%?4.2% respectively.The cholesterol particles were found in the EPD grossly in 2 and microscopically in 9 cases.Conclusion The use of embolic protection device during renal angioplasty and stenting is technically feasible and appears to be effective in preventing procedure-related embolization complications.

Carotid Artery Stenosis:The Treatment by Carotid Stenting with Cerebral Protection Devices / 实用放射学杂志

Objective To explore the safety,efficacy and clinical significance of stenting with cerebral protection devices for carotid artery stenosis.Methods 14 patients with carotid artery stenosis were treated by intra-arterial stents implanted.All of them used cerebral protection of filter devices.Results 18 self-expandable stents were successfully implanted in 14 patients.Of them,stroke ictus caused by microemboli in 2 patients ,and they recovered after treatment for 1~3 d,6 patients had transient bradycardia and hypotension.No cerebral infarction could be seen in all cases during the follow-up period.Conclusion Carotid setenting with cerebral protection devices is an effective and safe method in treating carotid stenosis,and it is helpful to reduce the neurological complication.

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