Coronary stenting does not improve the long-term cardiovascular outcome of patients with mild to moderate renal insufficiency / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several studies have shown that coronary stenting reduces the frequency of clinical and angiographic restenosis in patients with mild to moderate renal insufficiency. However, less is known about the long-term benefits of stent use in this population. This study was aimed to determine the impact of coronary stenting on extended (5 years) long-term outcomes of patients with chronic renal insufficiency.</p><p><b>METHODS</b>The study included 602 consecutive patients who underwent successful percutaneous coronary intervention with stenting. Renal insufficiency was defined as an estimated glomerular filtration rate < 60 ml x min(-1) x 1.73 m(-2). The major adverse cardiac events were compared for patients with (n = 160) and without (n = 442) renal insufficiency.</p><p><b>RESULTS</b>After the third year of follow-up, nonfatal myocardial infarction and revascularization rates were significantly increased in patients with renal insufficiency compared with those without renal dysfunction (16.9% vs 7.7%, P = 0.001; 29.4% vs 15.8%, P < 0.001). In patients who had recurrent cardiovascular events, a significantly higher rate of de novo stenosis revascularization was found in patients with renal insufficiency than without renal insufficiency (57.7% vs 22.7%, P < 0.001), while there was no significant difference in target lesion revascularization between the groups (51.9% vs 43.6%, P = 0.323). Multivariate analysis demonstrated an independent impact of the presence of renal insufficiency on the major adverse cardiac events (hazard ratio: 1.488, 95% confidence interval: 1.051 - 2.106, P = 0.025) and de novo stenosis (hazard ratio: 5.505, 95% confidence interval: 2.151 - 14.090, P < 0.001).</p><p><b>CONCLUSIONS</b>The late major adverse cardiac events, after successful coronary stenting, is increased in patients with an estimated glomerular filtration rate < 60 ml x min(-1) x 1.73 m(-2). This might be associated with increased risk of de novo stenosis in this population.</p>

Reinfection with Schistosoma japonicum after treatment with praziquantel in Poyang lake region, China.

The study on reinfection with Schistosoma japonicum after treatment was carried out in a cohort of subjects in a heavy endemic village of Poyang lake region, China. After mass treatment with praziquantel in non-transmission time, detailed observations of water contact were estimated using the mean area of skin exposed daily. One year after treatment, the prevalence of infection in study subjects was 54.48%, returning to 83% of initial prevalence. The peak prevalence occurred the 11-15 year age class, but intensity of exposure also varies with age and that age group supporting the higher prevalence of reinfection had high levels of exposure. Among groups of subjects with a similar exposure stratum, young subjects under the age of 21 years were more heavily reinfected, while no heavy reinfection was observed in adults (> or = 25 years). These observations suggest that subjects in this area slowly acquire an increasing degree of immunity to lighten the intensity of infection with S. japonicum.