[Long-term outcome comparison of ostial/shaft lesions in unprotected left main coronary artery treated by PCI or CABG].

Objective: To evaluate long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) and percutaneous coronary intervention(PCI) with drug-eluting stents(DES) for ostial/shaft lesions in unprotected left main coronary artery(ULMCA). Method: A total of 259 patients with isolated ostial/midshaft lesions in unprotected left main coronary artery were enrolled consecutively who received DES implantation or underwent CABG between January 2003 and July 2009 in Beijing Anzhen Hospital. The endpoints of the study were death, repeat revascularization, myocardial infarction (MI) and stroke. Time to the primary endpoint was evaluated according to the Kaplan-Meier method, and the log-rank test was applied to compare the incidence of the endpoint. Adjusted risks for adverse outcomes were compared by multivariate Cox proportional hazard regression analyses. Results: A total of 259 patients were included, including 149 in PCI group and 110 in CABG group. And 193(74.5%) cases were males.The age was (61.4±9.8) years old. The median follow-up was 10.1 years (interquartile range 8.3 to 11.2 years) in the overall patients. There were no significant difference for the incidence of death [37.0% vs. 43.1% ，P=0.143] , MI [34.0% vs. 19.4% ，P=0.866], stroke [6.4% vs. 11.7% ， P=0.732], repeart revascularization [33.6% vs. 39.9% ，P=0.522] between PCI group and CABG group before multivariate adjusting，according to the incidence calculated with Kaplan-Meier. After adjusting covariates such as age, left ventricular ejection fraction（LVEF） and serum creatine with multivariate Cox hazard regression model, there was still no significant difference between the two groups. Conclusions: PCI with DES is as effective and safe as CABG in patients with left main ostium/shaft lesion during a median follow-up of 10.1 years.

[A comparison of the outcome of therapy between fractional flow reserve guided- versus coronary angiography guided-strategy in acute coronary syndrome patients with moderate coronary lesions].

OBJECTIVE: To compare the outcomes between coronary angiography (CAG ) guided- and fractional flow reserve (FFR) guided-strategy in acute coronary syndrome (ACS) patients with moderate lesions. METHODS: Totally, 249 ACS subjects with moderate lesions examined by CAG in Beijing Anzhen Hospital from July 1, 2014 to July 30, 2015 were included in the present analysis. Among them, 98 patients were further examined by FFR and 151 were not. All the patients were treated with medication either guided by CAG or by FFR. Subjects were followed up for an average of 10 months. The end points included death, nonfatal myocardial infarction (MI), target vessel revascularization (TVR), and hospitalization costs. Major adverse cardiac events (MACE) were defined as death, nonfatal MI, and TVR. RESULTS: At the end of follow-up, 29 patients had MACE with 6 cases (6.5%) in the FFR-guided group, and 23 cases (16.2%) in the CAG-guided group (P=0.036). Patients treated with FFR-guided strategy had significantly lower rate of TVR than those treated with CAG-guided strategy (5.4% vs 14.8%, P=0.045). No statistical difference was observed in nonfatal MI (2.2% vs 3.5%, P=0.242) between the two groups, and no cardiac death occurred in the two groups. However, the rate of patients treated with stains (P=0.033) and the hospitalization costs (P=0.001) were significantly increased in the FFR-guided group. CONCLUSIONS: FFR-guided strategy for patients with ACS results in lower TVR and MACE, but higher cost when compared with CAG-guided strategy.

Intracranial aneurysm risk factor genes: relationship with intracranial aneurysm risk in a Chinese Han population.

Few studies have examined the genes related to risk fac-tors that may contribute to intracranial aneurysms (IAs). This study in Chinese patients aimed to explore the relationship between IA and 28 gene loci, proven to be associated with risk factors for IA. We recruited 119 patients with aneurysms and 257 controls. Single factor and logistic regression models were used to analyze the association of IA and IA rup-ture with risk factors. Twenty-eight single nucleotide polymorphisms (SNPs) in 22 genes were genotyped for the patient and control groups. SNP genotypes and allele frequencies were analyzed by the chi-square test. Logistic regression analysis identified hypertension as a factor that increased IA risk (P = 1.0 x 10(-4); OR, 2.500; 95%CI, 1.573-3.972); IA was associated with two SNPs in the TSLC2A9 gene: rs7660895 (P = 0.007; OR, 1.541; 95%CI, 1.126-2.110); and in the TOX gene: rs11777927 (P = 0.013; OR, 1.511; 95%CI, 1.088-2.098). Subsequent removal of the influence of family relationship identified between 12 of 119 patients enhanced the significant association of these SNPs with IA (P = 0.001; OR, 1.691; 95%CI, 1.226-2.332; and P = 0.006; OR, 1.587; 95%CI, 1.137-2.213 for rs7660895 and rs11777927, respectively). Fur-thermore, the minor allele of rs7660895 (A) was also associated with IA rupture (P = 0.007; OR, 2.196; 95%CI, 1.230-3.921). Therefore, hypertension is an independent risk factor for IA. Importantly, the TSL-C2A9 (rs7660895) and TOX (rs11777927) gene polymorphisms may be associated with formation of IAs, and rs7660895 may be associated with IA rupture.

[Anti-inflammatory effect of Caragana microphylla Lam].

Caragana microphylla can antagonize the inflammation induced by carrageenin, hot water and croton oil. It can also inhibit the proliferation of granuloma, blood capillary permeability, phagocytic function of mononuclear phagocyte system, and synthesis or release of PGE2 at the inflamed part.