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.

Preparation and property evaluation of a self-setting calcium phosphate cement / 中国组织工程研究

BACKGROUND: Preliminary studies have found that poly(lactic-co-glycolic acid) (PLGA) can improve the compressive strength and degradability of calcium phosphate cement. OBJECTIVE: To prepare a self-setting calcium phosphate cement which has better mechanical properties, biocompatibility and degradability on the basis of the previous findings. METHODS: Beta-tricalcium phosphate (β-TCP), pure calcium phosphate cement (CPC) and PLGA powder were mixed at different mixing ratios for preparation of PLGA/β-TCP/CPC. Setting time, compressive strength, elastic modulus and degradation properties of the composite bone cement were evaluated to screen the optimal level of β-TCP. MC3T3-E1 cells were cultured in CPC extract (control), PLGA/β-TCP/CPC extract (experimental), α-MEM containing 10% fetal bovine serum and 1% penicillin-streptomycin double antibody (negative control), and 6.4% phenol liquid (positive control). MTT method was used to detect cell proliferation at 1, 3, 5 days after culture, and lactate dehydrogenase activity in culture media was detected at 1 and 3 days after culture. MC3T3-E1 cells were seeded on the surface of PLGA/β-TCP/CPC and pure CPC respectively, and were then observed by scanning electron microscopy after 3 days. RESULTS AND CONCLUSION: Initial setting time and final setting time among of the composite bone cement were increased with the increasing of β-TCP content, but had no significant difference from those of the CPC (P ＞ 0.05). The compressive strength and elastic modulus of the composite bone cement were higher than those of the CPC, and moreover, the composite bone cement with 20% β-TCP exhibited the highest compressive strength and higher elastic modulus as compared with the other groups. Therefore, PLGA/20% β-TCP/CPC was selected in the cell test. Moreover, the degradation properties of the composite bone cement were also better than those of the CPC. (3) With the growth of culture time, cell absorbance value and lactate dehydrogenase activity were gradually increased in the experimental group, and no difference existed between the experimental group and the negative control group. The cells in the experimental group also grew well. (4) MC3T3-E1 cells grew well and fully extended on the surface of PLGA/β-TCP/CPC, and cell pseudopodia on the material surface were tightly adhered to the material. To conclude, PLGA/20% β-TCP/CPC has better compressive strength, elastic modulus, degradation properties and cytocompatibility relative to the CPC, and moreover, the composite bone cement has no obvious cytotoxicity.

A Treatment Effect Study of Arthroscope Combined Proximal Humerus Osteotomy in Knee Inversion Osteoarthritis / 昆明医科大学学报

Objective To discover the treatment effect of arthroscope combined with proximal humerus osteotomy in Knee inversion osteoarthritis.Methods From April 2012 to December 2016, 126 cases were diagnosed with knee inversion osteoarthritis in our deparment, then we divided them into two groups randomly, 63 in each group, the control group operated with arthroscope, and the observation group operated with arthroscope combined with proximal humerus osteotomy. The treatment effects of the two groups were compared. Results Two groups of patients'HSS score,VAS score,KSS score before surgery have no statistical significance (P＞0.05) . 6 months post-operation, the HSS score and KSS score have significant increase in both groups, while the VAS score has an obviously reduction. The differences between the two groups have statistical significance (P＜0.05), the treatment effects in two groups have statistical significance (P＜0.05), the observation group has better treatment effect than the control group, and in the case of adverse reactions in both groups, there were no statistical significance (P＞0.05) . Conclusion The treatment of middle-aged and elderly people knee inversion osteoarthritis by arthroscope combined with proximal humerus osteotomy could improve the treatment,soit is worth promoting in clinics.

Elevated Levels of Very Low-density Lipoprotein Cholesterol Independently Associated with In-stent Restenosis in Diabetic Patients after Drug-eluting Stent Implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>High rate of in-stent restenosis (ISR) remained an unsolved clinical problem in clinical practice, especially among patients with diabetes mellitus (DM). Diabetic patients often had hypertriglyceridemia with elevated levels of very low-density lipoprotein cholesterol (VLDL-C). Increasing evidence suggested that VLDL-C was known as a significant risk factor for atherosclerosis and had been recommended as a treatment target by current dyslipidemia guidelines. However, the role of VLDL-C in the occurrence and development of ISR in coronary artery disease (CAD) patients with DM had not been studied. The aim of this study was to evaluate the association between the elevated levels of VLDL-C and the risk of ISR in CAD patients with DM.</p><p><b>METHODS</b>A total of 1390 diabetic patients, who underwent coronary drug-eluting stent (DES) implantation at Beijing Anzhen Hospital and followed up by angiography within 6-24 months, were consecutively enrolled. Patients' demographic and clinical characteristics, including age, gender, CAD risk factors, family history, life style, medical history, and coronary angiographic information, were collected carefully at baseline percutaneous coronary intervention and follow-up angiography. Multivariate Cox's proportional hazards regression modeling using the step-wise method (entry, 0.05; removal, 0.05) was used to determine the independent risk associated with ISR in diabetic patients.</p><p><b>RESULTS</b>Finally, 1206 of patients were included in this study. ISR occurred in 132/1206 diabetic patients (10.9%) by follow-up angiography. Patients with ISR had elevated median serum VLDL-C levels compared with those without ISR (0.65 mmol/L vs. 0.52 mmol/L, P = 0.030). The multivariate regression analysis showed that VLDL-C was significantly associated with the risk of ISR in diabetic CAD patients (hazard ratio [HR] = 1.15, 95% confidence interval [CI]: 1.03-1.29, P = 0.017). The HR for the risk of ISR associated with VLDL-C level ≥0.52 mmol/L was 3.01 (95% CI: 1.24-7.34, P = 0.015).</p><p><b>CONCLUSION</b>The elevated level of serum VLDL-C was a significant and independent risk factor for ISR in diabetic CAD patients after coronary DES implantation.</p>

Evaluation of the Prostate Imaging Reporting and Data System for Magnetic Resonance Imaging Diagnosis of Prostate Cancer in Patients with Prostate-specific Antigen <20 ng/ml / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The European Society of Urogenital Radiology has built the Prostate Imaging Reporting and Data System (PI-RADS) for standardizing the diagnosis of prostate cancer (PCa). This study evaluated the PI-RADS diagnosis method in patients with prostate-specific antigen (PSA) <20 ng/ml.</p><p><b>METHODS</b>A total of 133 patients with PSA <20 ng/ml were prospectively recruited. T2-weighted (T2WI) and diffusion-weighted (DWI) magnetic resonance images of the prostate were acquired before a 12-core transrectal prostate biopsy. Each patient's peripheral zone was divided into six regions on the images; each region corresponded to two of the 12 biopsy cores. T2WI, DWI, and T2WI + DWI scores were computed according to PI-RADS. The diagnostic accuracy of the PI-RADS score was evaluated using histopathology of prostate biopsies as the reference standard.</p><p><b>RESULTS</b>PCa was histologically diagnosed in 169 (21.2%) regions. Increased PI-RADS score correlated positively with increased cancer detection rate. The cancer detection rate for scores 1 to 5 was 2.8%, 15.0%, 34.6%, 52.6%, and 88.9%, respectively, using T2WI and 12.0%, 20.2%, 48.0%, 85.7%, and 93.3%, respectively, using DWI. For T2WI + DWI, the cancer detection rate was 1.5% (score 2), 13.5% (scores 3-4), 41.3% (scores 5-6), 75.9% (scores 7-8), and 92.3% (scores 9-10). The area under the curve for cancer detection was 0.700 (T2WI), 0.735 (DWI) and 0.749 (T2WI + DWI). The sensitivity and specificity were 53.8% and 89.2%, respectively, when using scores 5-6 as the cutoff value for T2WI + DWI.</p><p><b>CONCLUSIONS</b>The PI-RADS score correlates with the PCa detection rate in patients with PSA <20 ng/ml. The summed score of T2WI + DWI has the highest accuracy in detection of PCa. However, the sensitivity should be further improved.</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>

Maxillary sinus augmentation with simultaneous implantation using guided bone regeneration / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of new bone formation in sinus augmentation with guided bone regeneration (GBR) using collagen membranes.</p><p><b>METHODS</b>The first maxillary molars of 18 adult female Beagle dogs were extracted and the sinus floors of both sides were lifted with simultaneous implantation. A combination of autografts and Bio-Oss in a 2:1 ratio was placed in the space under the membrane. On the experimental side in each dog, the collagen membrane was folded at the lateral osteotomy window, the apex of the implants and a certain part of palatal bone. On the contralateral control side, the collagen membrane only covered the osteotomy window. Six animals were sacrificed at 4, 12, and 24 weeks respectively after surgery. Gross observation, biomechanical testing and histological examinations were performed.</p><p><b>RESULTS</b>The translocation of grafted materials and bone absorption were found on the top of implants in the control side, and the grafted materials kept original shape at the experimental side at 4th week. The granule of Bio-oss absorbed obviously at 12th and 24th week. The pull-out force increased with time. At 24th week, the force of pull out was 558.1 ± 37.4 N at the study side, and 471.4 ± 31.5 N at the control side. There was a significant difference in the pull-out force was noted between the two groups (P < 0.01). Histological examination showed new bone formation on the sinus floor, and the grafted materials gradually reduced with time</p><p><b>CONCLUSIONS</b>GBR with the enfolded-coverage of the membrane can effectively decrease absorption of the grafted materialon the apical surface of implants and stimulate new bone formation in the sinus augmentation.</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>

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>

Effects of bandage compression and the specific radial hemostasis in patients undergoing transradial coronary intervention / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the effects of elastic bandage compression with the specific hemostasis devices in patients undergoing transradial coronary intervention.</p><p><b>METHODS</b>A total of 3000 consecutive patients were randomized to 3 groups and 2910 patients completed the study, 963 patients in elastic bandage group (ER), 976 in T band group (TB) and 971 in balloon group (TR). In-hospital vascular related complication was the primary study endpoint. The secondary endpoints included: risk factors of complications, compression time, fibroplasia conditions and the comfort feeling of patients.</p><p><b>RESULTS</b>The overall incidence of vascular related complication in 3 groups was similar (P = 0.262). Female, low body weight, prolongation of procedure and multi-punctures were identified as the independent risk factors for complications. Moreover, the compression time and the fibroplasia condition in TB and TR group were superior to those in the ER group. Comfortable feeling of the patients was better in TR and TB group than in ER group (P < 0.001).</p><p><b>CONCLUSIONS</b>Both conventional bandage device and specific radial device are feasible and associated with low incidence of vascular complication. However, the specific radial device has significant advantage over bandage strategy in compression time and quality of life.</p>

Clinical study of arterial anatomic variations for transradial coronary procedure in Chinese population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The radial artery is currently regarded as a useful approach for coronary intervention procedures. Adequate anatomical information of the radial artery should be helpful in performing transradial coronary procedures. Few data about the Chinese population have been obtained in this field. Therefore, we tried to evaluate the incidence and clinical significance of anomalous patterns, and their influence on the intervention procedure.</p><p><b>METHODS</b>In an estimated sample of 3000 cases, radial artery and subclavical artery angiography were performed after insertion of the sheath and coronary angiography (CA). The evaluable data including branch anomaly, tortuosity of the radial artery and procedural characteristics were analyzed. The procedure success was defined as CA or percutaneous coronary intervention (PCI) completed with the initial radial artery approach without changing to other routes.</p><p><b>RESULTS</b>In this study, 1897 cases of CA was undertaken and 1103 cases of CA combined with PCI were performed. The success rate of transradial intervention (TRI) was 96.6% (2899/3000). The approach in 44 cases was changed to the contralateral radial artery and 57 cases were changed to the brachial artery or femoral artery due to failure with the initial radial artery approach. The angiography of the upper limb artery was performed in all cases. Anatomic variations of upper limb arteries were noted in 610 patients (20.3%), which included tortuous configurations of the radial artery (5.0%), hypoplasias (2.2%), radioulnar loop (1.1%), abnormal origin of the radial artery (7.7%), stenosis of radial artery (1.4%), a tortuous configuration of the brachial artery (0.9%), a tortuous configurations of the subclavian artery (1.9%), lusoria subclavian artery (0.1%), and subclavian artery occlusion (0.03%). The procedural success rate in the normal population was higher than in the variation group (97.6% vs 93.0%, P < 0.001). In addition, other procedural outcomes and incidence of complications except radial artery occlusion were also significantly superior to variation group.</p><p><b>CONCLUSIONS</b>Anatomic variations of the radial artery were common, making up an important limitation in the trans-radial approach. Selection of appropriate instruments and understanding some tips and tricks were helpful to overcome the obstacles and effectively reduce the learning curve.</p>

Safety and feasibility of transradial coronary angiography at the outpatient clinic / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the safety and feasibility of transradial coronary angiography at the outpatient clinic.</p><p><b>METHODS</b>From February 2007 to June 2007, 100 outpatients who received transradial coronary angiography in Anzhen hospital were included in this analysis, 100 inpatients underwent coronary angiography were selected as control group. Primary endpoints included success rate, percent of angiographic catheter use with different diameters, adverse events during the procedure (such as death, malignant arrhythmia, acute myocardial infarction, coronary artery spasm, coronary artery dissection, perforation or occlusion, etc.) and after the procedure (such as death, acute myocardial infarction, upper limb haematoma, osteofascial compartment syndrome, radial artery pseudoaneurysm or occlusion, etc.).</p><p><b>RESULTS</b>The success rate (100% vs. 100%), procedure duration time [(12.5 +/- 3.4) min vs.(10.8 +/- 3.6) min, P = 0.517] and exposition time [(4.3 +/- 1.0) min vs. (4.1 +/- 1.0) min, P = 0.629] were similar between the outpatient and inpatient groups. Radial and coronary artery spasm were the main adverse events during the angiography, and haematoma was the main adverse event after the angiography. There were no significant differences of adverse events between the 2 groups. The total cost of the outpatient group was significantly lower than the inpatient control group [(4012 +/- 238) yuan vs. (5329 +/- 371) yuan, P < 0.001]. Expenditure including chemical tests, medicine, nursing care, room and board all decreased significantly.</p><p><b>CONCLUSION</b>Transradial coronary angiography application at the outpatient clinic was safe and feasible for stable patients, and this procedure could decrease the medical expenditure and shorten the admission time.</p>

An investigation of prostate cancer knowledge among Chinese city men / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the knowledge and the attitude toward prostate cancer (PCa) among Chinese city men and raise some suggestions for the improvement of the present state.</p><p><b>METHODS</b>In October 2007, a questionnaire investigation was conducted among males in 17 Chinese cities on the knowledge of PCa in the following 6 aspects: general state of PCa susceptible city men, basic knowledge, risk factors, symptoms, management and outcome, and attitude toward the treatment of PCa. The influences of education on their scores were analyzed and compared.</p><p><b>RESULTS</b>We distributed 1,700 copies of the questionnaire and collected 376 (22.1%) valid ones. The subjects averaged 67.1 +/- 10.1 years of age, 80.1% with junior high school education and above. As for the basic knowledge of PCa, 92.6% of them admitted hearing of it, but only 45.5% knew what it was, with statistically significant differences among men of different educations. The most common accesses to PCa knowledge were media (43.3%), hospital consultation (25.2%) and health booklets (10.1%). Of the total number of subjects, 32.7% regarded "Father has prostate cancer" as a risk factor, 82.2% knew that PCa could be treated by surgery, but only 8.9% knew that " hormonotherapy has an important role in PCa treatment". More positive attitudes toward PCa treatment and its consequence were found among those with higher education.</p><p><b>CONCLUSION</b>PCa susceptible men in Chinese cities have insufficient knowledge on the disease. Strengthened education in this aspect can improve the present state and promote early diagnosis and treatment of prostate cancer.</p>

Long-term outcome of patients of over 85 years old with acute coronary syndrome undergoing percutaneous coronary stenting: a comparison of bare metal stent and drug eluting stent / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patients aged over 85 years have been under-represented in percutaneous coronary intervention (PCI) trials despite an increase in referrals for PCI. The long-term safety and efficacy of percutaneous coronary stenting in patients aged over 85 years with acute coronary syndrome (ACS) remain unclear. Moreover it is unknown whether there are differences between bare metal stent (BMS) and drug eluting stent (DES) in this special population.</p><p><b>METHODS</b>A total of 80 patients with ACS aged over 85 years undergoing stenting (BMS group n = 21 vs DES group n = 59) were retrospectively studied. In-hospital, one year and overall clinical follow-up (12 - 36 months) of major adverse cardiac events (MACEs) including cardiac deaths, myocardial infarction, target lesion revascularization (TLR) and target vessel revascularization (TVR) as well as stroke and other major bleeding were compared between the two groups.</p><p><b>RESULTS</b>In the entire cohort, the procedure success rate was 93.8% with TIMI-3 coronary flow post-PCI in 93.8% of the vessels and the procedure related complication was 17.5%. The incidence of in-hospital MACEs in BMS group was higher (14.3% vs 6.8%, P = 0.30). The 1-year incidence of MACEs in DES group was 7.0% while there was no MACE in the BMS group. Clinical follow-up for 12 - 36 months showed that the overall survival free from MACE was 82.9% and the incidence of MACE in the BMS group was lower (5.3% vs 21.1%, P = 0.20). Multivariate regression analysis showed that the creatinine level (OR: 1.013; 95% CI: 1.006 - 1.020; P = 0.004) and hypertension (OR: 3.201; 95% CI: 1.000 - 10.663; P = 0.04) are two major factors affecting the long-term MACE.</p><p><b>CONCLUSIONS</b>Percutaneous coronary stenting in patients aged over 85 years is safe and provides good short and long-term efficacy. Patients with renal dysfunction and hypertension may have a relatively high incidence of MACE.</p>

Transradial approach for coronary angioplasty in Chinese elderly patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The radial artery is currently regarded as a useful vascular access site for coronary procedures. This study was conducted to investigate the feasibility and safety of the percutaneous radial artery approach for angioplasty in the elderly.</p><p><b>METHODS</b>Two thousand and fifty-eight consecutive patients (762 elderly, age = 65 years; and 1296 non-elderly, age < 65 years, respectively) who underwent transradial coronary angioplasty were recruited in this study. Study endpoints included procedure success rate, procedure time, vascular complications at access site, and major adverse cardiac and cerebrovascular events during hospitalization.</p><p><b>RESULTS</b>Elderly patients were more likely to present with unstable angina and renal dysfunction. The incidence of radial and brachiocephalic trunk anatomical tortuosity was higher in elderly patients than that in non-elderly patients (11.5% vs 3.7%; 8.9% vs 2.6%, P < 0.01, respectively). However, procedural success rate (94.7% vs 95.6%) and total mean procedure time ((67.9 +/- 27.3) minutes vs (58.6 +/- 38.5) minutes) for transradial coronary angioplasty were not significantly different between the two groups. Clinical course during the hospitalization was slightly worse in the elderly patients because of more adverse cardiac and cerebrovascular events after the procedure. However, the incidence of vascular complications was not significantly different between the elderly and non-elderly patients.</p><p><b>CONCLUSION</b>Although the incidence of radial and brachiocephalic trunk anatomical tortuosity is higher in elderly patients, transradial coronary intervention can be performed with similar safety and procedural success in these patients as compared with non-elderly patients.</p>

Biodegradation of tetrachlorothylene using methanol as co-metabolic substrate / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the biodegradation of tetrachloroethylene (PCE) using methanol as electron donor by acclimated anaerobic sludge.</p><p><b>METHODS</b>HP-6890 gas chromatograph (GC), together with HP-7694 autosampler, was used to analyze the concentration of PCE and intermediates.</p><p><b>RESULTS</b>PCE could be decholrinated reductively to DCE via TCE, and probably further to VC and ethylene. The degradation of PCE and TCE conformed to first-order reaction kinetics. The reaction rate constants were 0.8991 d(-1) and 0.068 d(-1), respectively, and the corresponding half-life were 0.77 d and 10.19 d, respectively. TCE production rate constant was 0.1333 d(-1), showing that PCE was degraded more rapidly than TCE.</p><p><b>CONCLUSION</b>Methanol is an electron donor suitable for PCE degradation and the cometabolic electron donors are not limiting factors for PCE degradation.</p>

A novel biosensor for the rapid determination of biochemical oxygen demand / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the function of a novel biosensor used for the rapid determination of biochemical oxygen demand (BOD) which is developed by our research group based on suspended immobilized microbial cell system in a completely mixed determining chamber as a substitute of the traditional membrane system.</p><p><b>METHODS</b>Activated sludge was immobilized by PVA gel and used as a bio-sensing element. The novel biosensor was used to measure the short time BOD value and the conventional cultivation method was used for BOD5 measurement.</p><p><b>RESULTS</b>A linear relationship was observed for the difference between the current and the concentration of glucose-glutamic acid (GGA) solution below 200 mg/L with a correlation coefficient of 0.995. The optimal response of the sensor was obtained at pH 7.0 and 30 degrees C. The sensor response was within 15 min and was reproducible within +/- 5% of the mean in a series of eight samples containing 75 mg/L BOD using standard GGA solution. The novel sensor response was found to be fairly constant over a period of 30 days, with +/- 5% fluctuations.</p><p><b>CONCLUSION</b>A relatively good agreement is found between BOD estimated by the novel BOD biosensor and that determined by the conventional 5-day BOD method. This novel BOD biosensor has good sensitivity, stability and reproducibility.</p>

Degradation of acenaphthene by ozone / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the oxidation of acenaphthene (Ace), a polycyclic aromatic hydrocarbon (PAH) with a saturated C-C bond by ozone and to characterize the intermediate products of ozonation.</p><p><b>METHODS</b>Ozone was generated from filtered dry oxygen by an ozone generator and continually bubbled into a reactor containing 1g/L Ace dissolved in an acetonitrile/water solvent mixture (90/10, v/v) at a rate of 0.5 mg/s. HPLC was used to analyze the Ace concentration. Total organic carbon (TOC) was used to measure the amount of water soluble organic compounds. GC-MS was used to identify the ozonized products. Oxygen uptake rate (OUR) of activated sludge was used to characterize the biodegradability of ozonized products.</p><p><b>RESULTS</b>During the ozonation process, Ace was degraded, new organic compounds were produced and these intermediate products were difficult mineralize by ozone, with increasing TOC of soluble organics. The ozonized products were degraded by activated sludge more easily than Ace.</p><p><b>CONCLUSION</b>Ozonation decomposes the Ace and improves its biodegradability. The ozonation combined with biological treatment is probably an efficient and economical way to mineralize acenaphthene in wastewater.</p>

Reductive dechlorination of p-chlorophenol by nanoscale iron / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate reductive dechlorination of 4-chlorophenol (4-CP) by nanoscale Fe0 under different conditions.</p><p><b>METHODS</b>Nanoscale Fe0 was synthesized by using reductive method. 4-CP and its intermediate products were analyzed by HPLC. Chlorine ion was quantified with DX-100 ion chromatograph. Nano-iron particles were observed under a FEI Quanta 200 FEG environmental scanning electron microscope (ESEM).</p><p><b>RESULTS</b>The size of the particles was in the range of 10-100 nm. The nano-iron particles could reduce 4-CP effectively. The initial concentration of 4-CP increased with the decrease of the relative degradation rate, whereas the reduced amount of 4-CP increased. Temperature could influence both the dechlorination rate and the reaction pathway. Moreover, the stability and durability of nanoscale Fe0 was evaluated through batch studies over extended periods of time.</p><p><b>CONCLUSION</b>The nanoscale Fe0 can be used for sustainable treatment of contaminants in groundwater.</p>

Characteristics of Zn2+ biosorption by Saccharomyces cerevisiae / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the characteristics of Zn2+ biosorption and the release of cations during the process of Zn2+ biosorption by intact cells of Saccharomyces cerevisiae.</p><p><b>METHODS</b>The batch adsorption test was used to study the biosorption equilibrium and isotherm. Zn2+ concentration was measured with atomic adsorption spectrophotometer (AAS) AAS 6 Vario.</p><p><b>RESULTS</b>When the initial concentration of Zn2+ ranged between 0.08 and 0.8 mmol/L, the initial pH was natural (about 5.65), the sorbent concentration was about 1 g/L and the capacity of Zn2+ biosorption was from 74.8 to 654.8 micromol/g. The pH value increased by 0.55-1.28 and the intracellular cations (K+, Mg2+, Na+, Ca2+) of the cells were released during the process of Zn2+ biosorption.</p><p><b>CONCLUSION</b>Ion exchange was one of the mechanisms for Zn2+ biosorption. The biomass of Saccharomyces cerevisiae is a potential biosorbent for the removal of Zn2+ from aqueous solution. More work needs to be done before putting it into practical application.</p>