Influence of sodium creatine phosphate on PCI-related myocardial injury in UAP patients / 心血管康复医学杂志

Objective :To explore influence of sodium creatine phosphate (CP) on percutaneous coronary intervention (PCI)-related myocardial injury in patients with unstable angina pectoris (UAP).Methods : A total of 90 UAP pa-tients ,who were supposed to receive selective PCI ,were selected ,randomly and equally divided into routine treat-ment group and CP group (received CP treatment based on routine medication ).Plasma level of cardiac troponin I (cTnI) before and 18h after PCI ,plasma levels of C reactive protein (CRP) and brain natriuretic peptide (BNP) be- fore and 24h after PCI ,LVEDd ,LVESd and LVEF on two weeks after PCI ,and incidence of major adverse cardio-vascular events (MACE) within two weeks after PCI were measured and compared between two groups .Results :Compared with before PCI ,there was significant rise in plasma cTnI level on 18h after PCI ,and significant reduc-tions in plasma CRP and BNP levels on 24h after PCI in two groups ,P＝0-001 all ;compared with routine treatment group after PCI ,there were significant reductions in plasma levels of cTnI [ (1-58 ± 1-59) mg／L vs.(0-07 ± 0-04) mg／L] ,CRP [ (22-02 ± 2-14) ng／L vs .(11-40 ± 1-49) ng／L] and BNP [ (349-20 ± 28-57) ng／L vs .(175-20 ± 28-55) ng／L] in CP group , P＝0-001 all.Compared with routine treatment group ,there were significant reduc-tions in LVEDd [ (54-83 ± 1-23) mm vs.(50-74 ± 0-97) mm] and LVESd [ (45-65 ± 1-64) mm vs .(42-01 ± 1-84) mm] ,and significant rise in LVEF [ (52-41 ± 1-57)% vs.(65-21 ± 3-36)%] in CP group on two weeks af-ter PCI , P＝0-001 all.On two weeks after PCI ,incidence rate of MACE in CP group was significantly lower than that of routine treatment group (4-44% vs.28-89%) , P＝0-021- Conclusion : CP can significantly reduce plasma levels of cTnI ,CRP and BNP after PCI ,reduce PCI-related myocardial injury .

An investigation on the infection status and genotype of Hantavirus carried by rodents in Yuyao City of Zhejiang Province / 预防医学

Objective To learn the infection status and genotype of Hantavirus carried by rodents in Yuyao City.Methods From May,2014 to May,2015,a total of 248 rodents were captured from four kinds of characteristic topographies (plains, mountains,coastal and urban areas)with clip night method in Yuyao.The real time fluorescence quantitative PCR method was used to detect the Hantavirus from lung specimens of rodents.The RT-PCR method was used to sequence and analyze the M fragment gene.Results Hantavirus nucleic acid was detected positive in 12 samples from a total of 248 specimens, and the positive rate was 4.84%,and they were all detected in Rattus norvegicus and were all Seoul virus (SEOV).Eight samples were sequenced and analyzed,and phylogenetic tree was constructed.The result showed SEOV S3 subtype with high homology.Conclusion Hantavirus carried by rodents in Yuyao City is mainly SEOV S3 subtype,and the distribution of gene subtype is single.Rattus norvegicus is the main host of this virus.

The results of the epidemiological surveillance of severe fever with thrombocytopenia syndrome in Ningbo City / 预防医学

Objective To learn the epidemiological status of severe fever with thrombocytopenia syndrome (SFTS). Methods The surveillance sites were established in two county level hospitals and two township health centers in Ningbo city.Using the diagnostic criteria of the national ministry of health and questionnaire of epidemiological case survey,cases with SFTS were investigated.The SFTS virus was isolated with Vero cells from the positive serum and the gene sequence was analyzed.Results Eleven cases were reported during year 2012—2013,including one person died.A total of 156 ticks were detected negative.The positive rate of serum collected from healthy people in local area was 6.14% and increased with age(P <0.01).There were a close relationship between five isolates of Ningbo and isolates of Japan and Zhoushan,and the gene sequence similarity was more than 96%.Conclusion SFTS cases were reported in Ningbo City, and the surveillance system should be strengthened especially for the disease detection.

Azygous anterior cerebral artery and associated aneurysms: detection and identification using 3-dimensional time-of-flight magnetic resonance angiography.

AIM: The azygous anterior cerebral artery (Az) is a rarely observed anomaly of the anterior cerebral artery, and its associated aneurysm is even rarer. Our aim was to evaluate 3-dimensional time-of-flight magnetic resonance angiography (3-D-TOF MRA) in the diagnosis of Az and associated aneurysms. MATERIALS AND METHODS: Three thousand five hundred seventy-two consecutive patients underwent 3-D-TOF MRA at 3.0 T. Postprocessing techniques, including volume rendering (VR) and single artery highlighting, were performed by a 3-D specialist. All MRA data and clinical information were recorded and stored in a database for further analysis. RESULTS: Fourteen patients (.39%) were identified as having an Az. Among these cases, 3 males (21.43%) had an aneurysm located at the distal bifurcation of the Az, with a mean size of 9.43 ± 3.33 mm. In MRA, the common trunk of the Az was slightly larger in diameter than the A1 segment (2.62 ± .35 mm vs. 2.54 ± .35 mm; P = .008). CONCLUSIONS: With the VR technique, 3-D-TOF MRA is feasible and valuable in detecting an Az and associated aneurysm. Our MRA-based study has proved that the Az is a rare anomaly but has a relatively high incidence of associated aneurysms.

Genetic variation of the hemagglutinin and neuraminidase of influenza B viruses isolated in Ningbo during 2010-2012 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the epidemiological characteristics of influenza B viruses and explore the genetic evolution characteristics of the hemagglutinin(HA) and neuraminidase(NA) genes of local isolated strains in Ningbo, Southeast China, during 2010 to 2012.</p><p><b>METHODS</b>Respiratory specimens from 3440 cases of patients with influenza-like illness(ILI) during 2010 to 2012 were collected in for virus isolation. And the 628 sera samples were collected in 2010 from the healthy community population to detect the HI antibody level against the local isolated virus.For phylogenetic analysis, the fragments of HA and NA genes were amplified and sequenced from strains isolated in different years. The association between evolution of HA and epidemiological characteristics were analyzed.</p><p><b>RESULTS</b>A total of 109 strains of influenza B virus were isolated, including 102 (93.6%) Victoria-lineage strains and 7 (6.4%) Yamagata-lineage strains. Positive rates of HI antibody against Victoria-lineage strains and Yamagata-lineage strains were 51.1% (321) and 47.8% (300), respectively (χ(2) = 1.405, P > 0.05) among the 628 sera samples. The phylogenetic analysis showed that all HA fragments of isolated strains clustered the same branch with Malaysia/2506/2004 while the NA genes formed different branches. Compared with Brisbane/60/2008 strain, there were 1 to 5 Amino acid mutations in HA domain, and more mutations were detected in NA domain, ranged from 6 to 16 sites. The genetic evolution of NA in Victoria-lineage strains were faster compared with HA.</p><p><b>CONCLUSION</b>The genetic evolution rates of NA genes were faster than that of HA genes in the local circulated Victoria-lineage viruses during 2010 to 2012;The comprehensive analysis of HA and NA fragments were more reliable and sensitive on surveillance of genetic evolution of influenza B viruses.</p>

Placement of duodenal stents across the duodenal papilla may predispose to acute pancreatitis: a retrospective analysis.

PURPOSE: To evaluate retrospectively the incidence, predictive factors, and management of acute pancreatitis which develops following placement of duodenal stents in patients with malignant gastroduodenal obstruction. MATERIALS AND METHODS: Among 242 patients with symptomatic malignant gastroduodenal obstruction successfully treated with duodenal stent placement, acute pancreatitis occurred in 10 patients (4.1%) at 1-7 days after stent placement. Univariate and multivariate analyses were performed to evaluate factors predictive of acute pancreatitis. Management of acute pancreatitis was also evaluated. RESULTS: Ten patients with acute pancreatitis presented with abdominal pain and distention with vomiting at 1-7 days after stent placement, and seven patients developed acute jaundice. Pancreatitis resolved in four patients with a regime of fasting and intravenous nutrition. The remaining six cases were managed with percutaneous transhepatic cholangiography and drain (PTCD) placement. Univariate analysis showed that acute pancreatitis was associated with stent location in the descending duodenum (P = 0.001) and with stents bridging the duodenal papilla (P < 0.001). Multivariate analysis demonstrated that the presence of a stent bridging the duodenal papilla (odds ratio, 18.48; 95% confidence interval, 2.298- 148.48; P = 0.006) was an independent predictor of acute pancreatitis. CONCLUSION: Acute pancreatitis is an uncommon early complication of duodenal stent placement in patients with malignant gastroduodenal obstruction. In this group of patients, acute pancreatitis was associated with stent location in the descending duodenum and occurred in patients with stents bridging the duodenal papilla; the latter may be the most important predictor of acute pancreatitis. Jaundice can be managed conservatively or with PTCD.

Comparison of three different endovascular approaches for the treatment of intracranial giant or large type aneurysms / 介入放射学杂志

Objective To evaluate the clinical efficacy of detachable balloons,detachable coils and intracranial covered stents in management of intracranial giant aneurysms.Methods From April 1998 to March 2006,20 patients with a giant or very large aneurysm were treated by parent artery occlusion(PAO), coils embolization and covered stent,in which 9 aneurysms were treated by PAO,8 by coils embolization and 3 by covered stent at initial management.Two recurrent aneurysms treated by coils embolization were performed by covered stent.Follow-up 9-83 months,mean 41.1?25.3 months.Immediate postprocedural angiographic outcomes were categorized as complete occlusion(100%),subtotal occlusion(95%-99%),and incomplete occlusion(＜95%)of the aneurysms;and follow-up angiographic outcomes were categorized as stable, thrombosis,and recanalization.Clinical outcomes were graded according to a modified Glasgow Outcome Scale (GOS).Results Endovascular treatment was technically feasible in all aneurysms without procedural-related complications.Immediate postprocedural angiograms showed complete occlusion was achieved in 11 aneurysms, subtotal occlusion in 7 and incomplete occlusion in 2.One patient with incomplete occlusion died on the seventh day with a rebleeding.The final angiographic findings in nineteen survival patients confirmed a complete occlusion in 15 aneurysms,subtotal occlusion in 3 and incomplete occlusion in 1,in which 10 parent arteries were successfully preserved.No rebleeding occurred during the follow-up period.The clinical evaluation performed at final follow-up in 19 patients revealed that the symptoms disappeared in 11 patients and improved in 8 in the modified GOS.Conclusions Treatment of giant intracranial aneurysms with coiling was associated with a low complete occlusion rate and a high recanalization rate.Treatment with endovascular parent artery occlusion remains practical,but this technique may result in damage to the parent artery and cause cerebral ischemic events.The use of an intracranial covered stent proved to be a relatively simple and safe procedure and maintained the pateney of the parent artery.