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简介：Inrecentyears,Percutaneouscoronaryintervention(PCI)asaneffectivetreatmentforcoronaryheartdiseasehasbeenwidelycarriedoutinChina.However,peopleisstillconfrontedwiththeproblemthattheincidenceofin-stentrestenosis(ISR)afterPCI.Someriskfactorsofcoronaryheartdiseasehavebeenobviouslyknown,butthein-dependentpredictorfactorsfortheISRhasnotbeenclear.ClarifyingriskfactorsforISRtoestablishinterferingmeas-uresmaybeanewdirectionforPCItreatmentinthefuture.Atpresent,ithasbeenreportedthataldosterone(ALD)maybeinvolvedinISR.InordertofurtherinvestigatetherelationshipbetweentheserumALDlevelsandISR,ourre-searchwastodeterminetheALDandotherserummarkerstoexploretheimpactfactorsofISR.MethodsWemeas-uredserumALD,highsensitivityC-reactiveprotein(hs-CRP),adiponectin(ADP)andotherindicatorsin258pa-tientswithcoronarystenting,andmaderoutinefollow-upfor6-9monthstoperformcoronaryangiography.Accordingtotheresultsofcoronaryangiography,allpatientsweredividedintorestenosisgroupandnon-restenosisgroup.Wean-alyzedtherelationshipbetweenALD,otherindicatorsandISRtoexplorewhetherserumALDwasanindependentriskfactorISR.ResultsSerumALDlevelsweresignificantlyhigherinrestenosisgroupthannon-restenosisgroup.Logis-ticregressionanalysisshowedthatdiabetes,ALD,hs-CRPandcomplexlesionswerealsoindependentriskfactorsforISR(P<0.05),whiletheADPwasasaprotectivefactorforISR(P<0.05).ConclusionsALDisoneofinde-pendentriskfactorsforISRafterundergoingcoronarystentimplantationinpatients.Ithasthepossibilityofbecomingonenewmethodinthismedicalfield.

简介：ObjectivesToevaluatetheeffectivenessoffirebirdstentforthetreatmentofcoronarydenovolesioncomparedwithcypherstent.MethodsNinety-oneconsecutivepatientswith156lesionswhounderwentcoronarycypher(n=68lesions)andfirebird(n=88lesions)implantation,quantitativecoronaryangiography(QCA)wasperformedatthetimeofstentimplantationandsubsequentlyat8monthspost-stenting.Smallvesseldiseasewasdefinedas≤2.5mmofreferencevesseldiametermeasuredbyQCA.Majoradversecardiacevents(MACE)includingdeath,thrombosis,nonfatalmyocardialinfarctionandtargetlesionrevascularization(TLR)werecomparedbetweenthetwogroups.ResultsBaselineclinicalcharacteristicsandangiographicparametersweresimilarbetweenthetwogroups.Seven-monthangiographicfollow-up,thelatelosswasnotdifferentbetweenthetwogroups(0.14±0.38mmvs0.13±0.17mm,P>0.05).Similarly,overallthrombosisrateweresimilarinbothgroups(1.5%vs1.1%,P>0.05).However,in-stentrestenosisaswellasin-segmentrestenosisrateweresignificantlyhigherincyphergroupthanthatinfirebirdgroup(4.4%vs0%and19.1%vs3.4%,P=0.047andP=0.001respectively).TLRwasalsohigherinthecyphergroup(10.3%vs2.3%,P=0.033)comparedwithfirebirdgroup.ConclusionsInthissmallsamplesize,non-randomizedstudy,thedataindicatedthatimplantationoffirebirdstentforthetreatmentofsmallcoronarylesionshowedmorefavorableresultsinrespectiveofrestenosiscomparedwithcypherstentimplantation.Amulti-center,large-samplesize,randomizedstudy,therefore,maybewarranted.

简介：‘Stent对stent’研究是被设计与以前同意的相比显示出新stent图案的优势的一种使随机化的试用。这些研究被规章的机构通常使用，例如美国食物药品管理局(食物及药品管理局)，到表示同意到新stent图案。有这些临床的试用的问题是他们的高费用和困难。在这份报纸，为‘stent对stent’的一种数字选择复杂临床的研究被介绍。一个有限元素模型被开发在冠的stent放置以后在结果上调查stent设计的影响。二商业地可得到的stents(NIR和多连接stents)被建模，他们的行为以压力分发在推广期间被比较，光线的获得，外部直径变化并且节略。而且，狭窄率上的stent设计的效果被在动脉以内比较压力分发调查。在stented动脉的动脉的墙压力的分析显示多连接stent设计原因与slotted试管NIR设计相比与局部性的stenotic损害降低应力到一个动脉粥样硬化患者容器。有观察临床的狭窄的调查结果相互关联与多连接stent设计相比在NIR评估狭窄率，它更高报导了。

简介：Stentsthatkeepweakenedarteriesfromcollapsinghavebeentruelife-savers,butarenolongerneededoncethearteriesarestrengthened.Now,aresearcherhasdevelopedabiodegradablestentforheartpatientswhichwillcarrydrugswherethey'reneededandwillthendissolve.

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简介：ObjectivesToinvestigatetheeffectofsimvastatinontheprobabilityofrestenosisafterstentimplantationandserumleveloflipidsaswellashigh-sensitivityC-reactiveprotein(hs-CRP)inpatientswithcoronaryheartdisease(CHD).Methods118patientswithCHDafterstentingtherapyweredividedintotreatmentgroup(n=62)andcontrolgroup(n=56)randomly.Allpatientsweretreatedwithaspirin(100mg/d)andclopidogrel(75mg/d)whiletreatmentgrouppatientstooksimvastatin(40mgqn)additionally.Allpatientsunderwentcoronaryangiography(CAG)tocomparethedifferenceofrestenosisandtheserumleveloftotalcholesterol(TC),low-densitylipoproteincholesterol(LDL-c),high-densitylipoproteincholesterol(HDL-c),triglyceride(TG)aswellashs-CRPafterthedrugtreatmentfor6months.ResultsTheprobabilityofrestenosiswassignificantlylowerinthetreatmentgroupthanthatofcontrolgroup(P<0.01)andtheresultsweresimilarbetweenthepatientswithbaremetalstent(P<0.01)andthosewithsirolimus-elutingstent(P<0.01).TheserumlevelsofTC(P<0.01),LDL-c(P<0.01),TG(P<0.05)andhs-CRP(P<0.01)wereobviouslylowerwhiletheHDL-c(P<0.05)levelwashigherinthetreatmentgroupthanthoseofcontrolgroup.Therewasnodeathcase.ConclusionsSimvastatincoulddecreasetheprobabilityofrestenosissignificantlyaftercoronarystentimplantationwithdoseof40mg/d.Italsohasgoodperformanceonlipidscontrolandlighteninginflammatoryreactionswithitsundoubtedlysafety.

简介：BackgroundTheregulationoft-PAgeneistheessenceandcoreofthrombosis.Therefore,thepresentstudyaimedtopreparenanot-PAgenecoatedstentandtoobserveitseffectoncoronarystentthrombosisindogs.MethodsHighlyexpressedt-PAgeneplasmidwasconstructedandalbuminnanot-PAgenecoatingstentwasprepared.Themajorbranchvesselsofdogcoronaryarterywerepre-expandedwitha3.0mm×20balloonwith8-10atmosphericpressure.10dogsofthecontrolgroupwereimplantedwithbaremetalstent;while12dogsoftheexperimentalgroupwereimplantedwithnanot-PAgenecoatingstent.Bothgroupswerenotgivenanti-coagulationtreatments.Bloodsamplesweretakenfort-PAandD-dimerbeforetheoperation,at1,2,4and8weeksafteroperation.Pathologicalanalysisfoundthrombosisinthecavityandthehyperplasiaoftheintima.t-PAexpressionwasdetectedbyimmunohistochemicalindirectly,andthethicknessoftheintimaofthesectioncrosswasdirectlymeasuredbymorphometry.Liver,heart,kidneysandlungweretakenforpathologicalobservation.ResultsAllexperimentalanimalssurvivedatpostoperative8weeks.Vascularstentthrombosiswasseenin10casesofthecontrolgroupwiththethrombosisrateof100%;whilewasseenin2casesamong12casesoftheexperimentalgroupwiththethrombosisratewas16.67%(P=0.00087).Immunohistochemicalstainingshowedthatthepositivet-PAgenetransfectionoftheexperimentalgroupwasmainlydistributedonthesurfaceofhyperplasiaintima,andvascularwallt-PAexpressionofthecontrolgroupwasnegative.Positivet-PAsignalwasnotfoundintheliver,heart,kidneysandlung.ConclusionNanot-PAgenevectorcoatingstentcaneffectivelyexpresst-PAinvascularwallandeffectivelypreventsstentthrombosis.

简介：Objective:Tostudythetechniquesofplacementofmemoryalloyplatinggoldbiliarystentandplasticstentforpalliationofmalignantandbenignbiliaryobstruction,andtoassessitsclinicaleffectiveness.Methods:Thepatientsinplasticstentgroupincludedpaplillaofduodenuminflamationalstrictures(n=24),commonbileductinflammationalinferiorsegmentstrictures(n=4),choledocholithiasis(n=5),bileleak(n=11),bileductsurgeryinjurey(n=7)andpancreaticcarcinoma(n=1).Thepatientsinplatinggoldstentgroupincludedcommonbileductcarcinoma(n=5)andpancreaticcarcinoma(n=6).Underfluoroscopicguidancethestentwasinsertedintobiliaryobstructionsitesfromoralcavityinallcases.Complications,liverfunctionandbloodserumamylasewereinvestigatedduringthestudyperiod.Results:Successfulstentplacementwasachievedinallcases.Afteroperationof7days,ingoldbiliarystentgroups,theratesofdecreaseofbloodserumtotalbilirubin,glutamic-pyruvictransaminase,r-glutamyltranspeptidaseandalkalinephosphatasewere67.16%,58.37%,40.63%and41.54%respectively.Inplasticstentgroup,theratesofdecreaseofSTB,ALT,r-GTandAKPwere53.24%,55.03%,37.15%,34.12%respectively.Earlycomplicationincludedpost-ERCPpancreatitisandcholangititis.Occlusionofstentwasthemajorlatecomplication.Conclusion:Memoryalloyplatinggoldbiliarystentandplasticstentweresafeandefficaciousmethodsformalignantandbenignbiliaryobstruction,andcouldimprovepatient'slivingquality.Plasticstentwasanefficientcomplementfortherapyofbileleakandbileductinjury.

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简介：Brain-machineinterfaceshaveinrecentyearsallowedparalyzedpatientstocontrolroboticarms,computercursors,andexoskeletonssimplybythinkingaboutit.Theseinterfacesrequireelectrodesthataresurgicallyimplantedintoorontopofthebraintoreadelectricalsignalsfromfiringneurons.Butanov-

简介：AbstractBackground:The mechanism and characteristics of early and late drug-eluting stent in-stent restenosis (DES-ISR) have not been fully clarified. Whether there are different outcomes among those patients being irrespective of their repeated treatments remain a knowledge gap.Methods:A total of 250 patients who underwent initial stent implantation in our hospital, and then were readmitted to receive treatment for the reason of recurrent significant DES-ISR in 2016 were involved. The patients were categorized as early ISR (<12 months; E-ISR; n = 32) and late ISR (≥12 months; L-ISR; n = 218). Associations between patient characteristics and clinical performance, as well as clinical outcomes after a repeated percutaneous coronary intervention (PCI) were evaluated. Primary composite endpoint of major adverse cardiac events (MACEs) included cardiac death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR).Results:Most baseline characteristics are similar in both groups, except for the period of ISR, initial pre-procedure thrombolysis in myocardial infarction, and some serum biochemical indicators. The incidence of MACE (37.5% vs. 5.5%; P < 0.001) and TLR (37.5% vs. 5.0%; P < 0.001) is higher in the E-ISR group. After multivariate analysis, E-ISR (odds ratio [OR], 13.267; [95% CI 4.984-35.311]; P < 0.001) and left ventricular systolic dysfunction (odds ratio [OR], 6.317; [95% CI 1.145-34.843]; P = 0.034) are the independent predictors for MACE among DES-ISR patients in the mid-term follow-up of 12 months.Conclusions:Early ISR and left ventricular systolic dysfunction are associated with MACE during the mid-term follow-up period for DES-ISR patients. The results may benefit the risk stratification and secondary prevention for DES-ISR patients in clinical practice.

简介：AbstractCommon or external iliac artery injury due to blunt trauma is unusual without an associated pelvic fracture. Here we report on a 62 years old man that sustained left external iliac artery thrombosis due to blunt trauma following fall from motorbike. There was no immediate circulatory compromise. Contrasted CT of abdomen revealed an associated left lower abdominal wall traumatic hernia. The iliac artery was intervened with an endovascular stent to restore luminal flow and the hernia was repaired electively. The entire clinical course and management dilemma are described in this article.

简介：AbstractPurpose:To explore the significance of traditional vascular reconstruction and covered stent for limb salvage after subclavian artery injury.Methods:Patients with subclavian artery injury admitted to Beijing Jishuitan Hospital from January 2010 to December 2018 were retrospectively analyzed. All the injuries have been confirmed by intraoperative exploration, computed tomography angiography or digital subtraction angiography. Complete or partial amputation injuries were excluded. Mild artery defect or partial intimal damage was treated by inter-ventional implantation, while other patients received open surgeries, including direct suture of small defect less than 2 cm and transplantation with autologous vein or artificial blood when the defect was more than 2 cm. Patients were divided into open surgery group and stent implantation group based on the treatment they received. Patients were followed up at 2 weeks (first stage) and 6 months (second stage) after operation to investigate limb salvage. Student's t-test was used to compare the general data between two groups and Chi-square test to analyze the rate of limb salvage.Results:Altogether 50 cases of subclavian artery injury were treated, including 36 cases of open surgery and 14 cases of stent implantation. Combination of nerve injury was observed in 27 cases (75.0%) in open surgery group and 12 cases (85.7%) in stent implantation group. Amputation developed in 3 cases with open surgery and 1 case with stent implantation. Consequently the rate of successful limb salvage was respectively 91.7% (33/36) and 92.9% (13/14), revealing no significant difference (p > 0.05).Conclusion:Rapid reconstruction of blood circulation is crucial following subclavian artery injury, no matter what kinds of treatment strategies have been adopted. Interventional stent implantation can achieve a good effect for limb salvage.

简介：ＡＰＲＥＬＩＭＩＮＡＲＹＳＴＵＤＹＯＦＴＩＴＡＮＩＵＭ－ＮＩＣＫＥＬＳＨＡＰＥＭＥＭＯＲＹＡＬＬＯＹＩＮＴＲＡＶＡＳＣＵＬＡＲＳＴＥＮＴＡＰＲＥＬＩＭＩＮＡＲＹＳＴＵＤＹＯＦＴＩＴＡＮＩＵＭ－ＮＩＣＫＥＬＳＨＡＰＥＭＥＭＯＲＹＡＬＬＯＹＩＮＴＲＡＶＡ...

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简介：ObjectivesToinvestthesuccessprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvessels.Methods290patientswithselectedoremergencystentimplantationinsmallvesselsfromApril,1997toMarch,2002.Total299vessels,304lesionsand316stentswerestatisted.Thesuccesssrateofprocedure,immediateoutcomeafterprocedure,therateofmainadversecardiaceventsafterprocedureandrestenosisafterstentplacementinsmallcoronaryvesselswereassessed.Thepatientswerefollowedup1monthto4years.Re-catheterangiographyweredonein122/290patients.ResultsThenarrowrateoflesiondroppedfrom89%±12%beforeprocedureto5%±5%afterprocedure(diameter).202patientswerefollowedup1month(69.7%).197/202casesweresurvival.5/202casesdiedin3hrsto7days.2/5casesdiedofpersistenthypotensionafterprocedure.1/5casediedofacuteleftheartfailure.2/5casesdiedofsuddendeath.180caseswerefollowedup5monthsto4years.Thenon-eventsurvival(NES)ratewas73.3%(132/180).There-angiographyweredonein122cases.Restenosishappenedin39cases(30.3%).37patientsrepeatedPCI.2patientswenttoCABG.2casesgotanginarecurrenceandwereprovedsecondtimerestenosisbyre-angiography.ThethirdtimePCIwasdonein1patient.TheotherpatientswenttoCABG.1casediedofchronicheartfailureafter2years.1casesufferedacutemyocardialinfarctiononarterystentimplanted.ConclusionsTherearehighsuccessrateofprocedureandperfectimmediateoutcomeinstentplacementinsmallvessels.Mainadversecardiaceventsdidnotincreased.Non-eventsurvialwassatisfiedinlongtermfollow-up.Restenosisratewasshowedslightlyhigherthantheoneofmainvessels.

简介：ObjectivesToevaluatetheimpactofstentimplantationonproliferationandapop-tosisininjuredmediavascularsmoothmusclecells(VSMC)andtoexplorethemechanismofrestenosisafterstentimplantation.MethodsFiftymaleNewZealandrabbitswererandomizedintotwogroups,includingballoongroupandstentgroup.Controlgroupwassetup.Thesampleswereharvestedon3,7,14,28,56daysafteroperationandthefollowinginvestigationwascarriedout:(1)Assessingtheexpressionofproliferatingcellnuclearantigen(PCNA)ofmediaVSMCbythemethodofimmunohistochemistry;(2)AnalyzingapoptosisofmediaVSMCbyDNAagarosegelelectrophoresisandTUNELtechnique.ResultsTheexpressionofPCNAandapoptosisinstentandballoongroupsweremarkedlyincreasedcomparedwithcontrolgroups.(1)StentgroupinducedsignificantincreasedexpressionofPCNAinthemediaVSMCcomparedwithballoongroupon3to28days.Onday7,thepositiveratesofPCNAwere24.36±0.55%vs18.74±1.09%

简介：为了描述创造登陆的一种新奇技术，在trabecular网状组织以内脱衣指导trabecular微绕过stent(iStent)在经历了phacoemulsification.METHODSThirty的病人的培植--从从2014年5月在phacoemulsification以后经历了iStent培植到2015年2月的30个病人的四只眼睛在我们的回顾的学习被包括。所有iStents经由登陆长带技术被植入。A25计量器microvitreoretinal片被用来切分trabecular网状组织到不到1钟小时，有效地创造登陆脱衣。iStent棉棍沿着登陆长带被压然后stent被释放进34与iStent培植看的trabecularmeshwork.RESULTSOf，(79.4%)27看有的主要开角度的绿内障，(17.6%)6看有的pseudoexfoliation绿内障，并且(2.9%)1看有的眼睛的高血压。在6月的后续(n=17)，低血压患者药的吝啬的数字从2.2减少了

简介：BackgroundAfterpercutaneouscoronaryintervention(PCI),somepatientsmaysufferfromrestenosisandstentthrombosis.Manystudiessuggestthatendothelialprogenitorcell(EPC)hasanimportantroleinpreventingrestenosisandstentthrombosis.AnovelstentwhichcanattractEPChasbeendesignedtoprovideabetteroutcomefortheseproblems.MethodThedataofthepresentreviewwasobtainedbysearchingPUBMEDandotherdatabases(1994-2011)usingthekeytermsof'endothelialprogenitorcell','reendothelialization','restenosis','stentthrombosis',and'percutaneouscoronaryintervention'.ResultRapidreendothelializationisessentialinpreventingrestenosisandstentthrombosis.EPCcandifferentiateintoendothelialcellandacceleratethereendothelialization.Afternumerouspreclinicalandclinicalresearches,thecorrelationbetweencirculatingEPCstorestenosisstillremainspoorlyunderstood.However,manystudieshaveshowntheimportantroleofEPCindiminishingtheriskofthrombosisfollowingstentimplantation.Somepharmacologicalagentshavebeenreportedcanincreasethenumberand/orfunctionsofEPC.Recently,CD34+antibodycoatedstenthasbeendevelopedtoattractEPCtothehealingendothelium,andhasshowedfavorableresults.ConclusionEPChasimportantroleinrapidreendothelializationaftervascularinjury.EPCcanpreventstentthrombosisafterPCI,howevertheeffectsofEPCinpreventingrestenosisneedfurtherinvestigations.ThecapturingCD34+stentissafeandsignificantlydecreasesstentthrombosis.