Effect of complete percutaneous revascularization on improving long-term outcomes of patients with chronic total occlusion and multi-vessel disease / 中华医学杂志(英文版)

BACKGROUND@#Limited data are available on the comparison of clinical outcomes of complete vs. incomplete percutaneous coronary intervention (PCI) for patients with chronic total occlusion (CTO) and multi-vessel disease (MVD). The study aimed to compare their clinical outcomes.@*METHODS@#A total of 558 patients with CTO and MVD were divided into the optimal medical treatment (OMT) group ( n = 86), incomplete PCI group ( n = 327), and complete PCI group ( n = 145). Propensity score matching (PSM) was performed between the complete and incomplete PCI groups as sensitivity analysis. The primary outcome was defined as the occurrence of major adverse cardiovascular events (MACEs), and unstable angina was defined as the secondary outcome.@*RESULTS@#At a median follow-up of 21 months, there were statistical differences among the OMT, incomplete PCI, and complete PCI groups in the rates of MACEs (43.0% [37/86] vs. 30.6% [100/327] vs. 20.0% [29/145], respectively, P = 0.016) and unstable angina (24.4% [21/86] vs. 19.3% [63/327] vs. 10.3% [15/145], respectively, P = 0.010). Complete PCI was associated with lower MACE compared with OMT (adjusted hazard ratio [HR] = 2.00; 95% confidence interval [CI] = 1.23-3.27; P = 0.005) or incomplete PCI (adjusted HR = 1.58; 95% CI = 1.04-2.39; P = 0.031). Sensitivity analysis of PSM showed similar results to the above on the rates of MACEs between complete PCI and incomplete PCI groups (20.5% [25/122] vs. 32.6% [62/190], respectively; adjusted HR = 0.55; 95% CI = 0.32-0.96; P = 0.035) and unstable angina (10.7% [13/122] vs. 20.5% [39/190], respectively; adjusted HR = 0.48; 95% CI = 0.24-0.99; P = 0.046).@*CONCLUSIONS@#For treatment of CTO and MVD, complete PCI reduced the long-term risk of MACEs and unstable angina, as compared with incomplete PCI and OMT. Complete PCI in both CTO and non-CTO lesions can potentially improve the prognosis of patients with CTO and MVD.

Efficacy of alteplase combined with rosuvastatin calcium in the treatment of acute cerebral infarction / 中国基层医药

Objective:To investigate the clinical efficacy of alteplase combined with rosuvastatin calcium in the treatment of acute cerebral infarction.Methods:A total of 100 patients with acute cerebral infarction who received treatment in Zhejiang Xin'an International Hospital from October 2019 to October 2020 were included in this study. They were randomly assigned to undergo either rosuvastatin calcium (control group, n = 50) or alteplase combined with rosuvastatin calcium (study group, n = 50). The National Institute Health of Stroke Scale (NIHSS) score, serum viscosity, blood lipid change, and clinical efficacy were assessed before and after treatment. Results:Response rate was significantly higher in the study group than in the control group [90% (45/50) vs. 80% (40 /50), χ2 = 4.52, P < 0.05]. NIHSS score, soluble intercellular adhesion molecule-1 level, and soluble vascular cell adhesion molecule 1 level in the study group were (7.29 ± 1.46) points, (132.68 ± 15.20) μg/L, and (118.67 ± 112.60) μg/L, respectively, which were significantly lower than those in the control group [(11.47 ± 2.80) points, (189.22 ± 9.40) μg/L, (1 372.59±125.70) μg/L, t = 4.21, 3.21, 5.12, all P < 0.05]. Insulin-like growth factor 1 level was significantly higher in the study group than in the control group [(485.41 ± 51.30) μg/L vs. (364.23 ± 44.50) μg/L, t = 6.32, P < 0.05]. Total cholesterol and low density lipoprotein cholesterol levels in the study group were (3.29 ± 1.46) mmol/L and (3.04 ± 0.15) mmol/L, respectively, which were significantly lower than those in the control group [ (4.47 ± 2.80) mmol/L, (3.22 ± 0.41) mmol/L, t = 4.54, 3.87, both P < 0.05]. Conclusion:Alteplase combined with rosuvastatin calcium can greatly improve blood circulation, reduce blood viscosity, and restore neurological function in patients with acute cerebral infarction. This study is highly innovative and scientific.

The clinical features of patients with Parkinson's disease with chronic pain and its correlation with cognitive function / 中国基层医药

Objective To study clinical features of patients with Parkinson's disease (PD)with chronic pain and its correlation with cognitive function.Methods 100 PD patients with chronic pain were selected as the observa-tion group.100 PD patients without chronic pain were selected as disease control group.90 healthy subjects with pain were selected as control group.Statistical and clinical features of PD patients with pain,and the relationship between cognitive function were made.Results 100 patients with chronic pain with PD skeletal muscle pain in 42 cases (42.0%),motility pain in 23 cases (23.0%),23 cases of nerve root pain (23.0%),9 cases of central pain (9.0%),akathisia in 3 patients (3.0%);Control pain in patients with chronic pain with part mainly in the head and neck and the waist,PD patients with chronic pain with mainly in the limbs,pain in the two groups the incidence of head and neck pain,waist pain,limb pain had statistical differences (χ2 =10.017,4.990,21.770,all P 0.05).Conclusion PD associated with chronic pain is given priority to with skeletal muscle pain,PD associated with chronic pain pain is different from normal people,PD associated with chronic pain has influence on daily life, sleep quality and depression of patients bad feelings,PD associated with chronic pain are closely related to the depres-sion and cognitive dysfunction of patients.Cognitive and emotional disorders may be involved in the pathogenesis of chronic pain.