Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital hea...Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital heart diseases who were administered in our hospital from June 2011 to July 2013 were recruited in our research.展开更多
Protecting Our Own:A Method for Reducing Breast Radiation Exposure in Healthcare Workers Lauren Zammerilla Westcott1, Gerald O. Ogola2, Chet R. Rees3(1. Department of Surgery, Baylor University Medical Center, Dallas,...Protecting Our Own:A Method for Reducing Breast Radiation Exposure in Healthcare Workers Lauren Zammerilla Westcott1, Gerald O. Ogola2, Chet R. Rees3(1. Department of Surgery, Baylor University Medical Center, Dallas, TX;2. Department of Biostatistics, Baylor University Medical Center, Dallas, TX;3. Department of Interventional Radiology, Baylor University Medical Center, Dallas, TX).展开更多
Objective:The efficacy of monotherapy in alleviating psychological disorders like anxiety and depression among breast cancer patients is suboptimal,necessitating effective psychosocial interventions.Mindfulness-based ...Objective:The efficacy of monotherapy in alleviating psychological disorders like anxiety and depression among breast cancer patients is suboptimal,necessitating effective psychosocial interventions.Mindfulness-based interventions have been shown to mitigate anxiety-depression symptoms and encourage beneficial behaviors.The online mindfulness based cancer recovery(MBCR)offers flexibility and guides practice across various settings,facilitating full patient engagement.This study amis to analyze the impact of a 4-week internet-delivered mindfulness-based cancer recovery program on anxiety,depression,and mindfulness among Chinese patients with breast cancer,and to evaluate the degree of satisfaction breast cancer patients experienced after participating in this program.Methods:This study utilized a two-armed,parallel,randomized controlled trial design.A total of 103 patients with breast cancer from June 2020 to January 2021 in the ward of Breast and Thyroid Surgery of a tertiary hospital in Changsha,Hunan Province were selected and randomly assigned to an intervention group(n=51)and a control group(n=52).The intervention group participated in an internet-delivered mindfulness-based cancer recovery program,which was delivered once a week for 4 weeks.Meanwhile,the control group received weekly group health education for 4 weeks.The outcomes of hospital anxiety and depression scale and mindfulness Attention Awareness Scale were evaluated at 3 distinct time points:Baseline(T1),postintervention(T2),and 1-month follow-up(T3).The satisfaction questionnaire of 4-week mindful cancer rehabilitation training program was used at T2 to evaluate patients’satisfaction with the intervention program.Generalized estimation equations were used to assess differences in anxiety,depression and mindfulness levels between groups before and after the intervention.Results:There were no statistically significant differences in demographic data and outcome index scores between the 2 groups at T1(all P>0.05),indicating that the 2 groups were comparable.The generalized estimating equation analyses showed that the intervention group had significantly better improvement in outcomes compared to the control group,particularly for anxiety(T2β=−1.30,95%CI−1.87 to−0.72;T3β=−2.78,95%CI−3.51 to−2.05)and depression(T2β=−1.92,95%CI−2.78 to−1.06;T3β=−2.96,95%CI−4.05 to−1.87;all P<0.001).Moreover,the mindfulness score in the intervention group was significantly higher than that in the control group at T2(β=3.23,95%CI 0.73 to 5.72)and T3(β=8.06,95%CI 4.37 to 11.75;both P<0.05).In addition,patients in the intervention group were satisfied with the 4-week mindfulness-based cancer recovery intervention and teaching/learning activities used to implement the program.Conclusion:In patients with breast cancer,the 4-week internet-delivered mindfulness based cancer recovery program,as a low-threshold,short-term mental health intervention,has a positive effect on reducing anxiety and depression and improving mindfulness levels.This program holds great promise as a tool for clinical nursing practice,given the high satisfaction and applicability.展开更多
DAI Jiong, WEN Jie-qing, LI Shan-quan. Department of Neurosurgery, Renji Hospital, Shanghai 200001, China The patient is a 79 years old male. He was admitted for recurrent dizziness accompanied tinnitus during the las...DAI Jiong, WEN Jie-qing, LI Shan-quan. Department of Neurosurgery, Renji Hospital, Shanghai 200001, China The patient is a 79 years old male. He was admitted for recurrent dizziness accompanied tinnitus during the last 2 weeks. These symptoms were aggravated during the last 4 days. He had a history of hypertension. Murmur was detected on the left subclavian artery. Left upper limb had IVth grade muscle force. The pulse of left radial artery was reduced. The systolic blood pressure of left upper limb was 30 mmHg lower than the right counter part. The Doppler sonography of vertebral artery revealed that there was inverse blood flow in the left vertebral artery. The angiography of left subclavian artery revealed that the left subclavian artery near the opening site(proximal to vertebral artery) was stenosed by approximatel 90%. Left vertebral artery was not detected. The angiography of right vertebral artery revealed that there was partial cerebral bolld flow steal to left subclavian artery via left vertebral artery. We treated this patient with percutaneous transluminal angiogrplasty(PTA)and stent implantation. Detailed description: Femoral artery was punctured, 8F artery theca was introduced. The 8F guiding catheter was introduced to the opening site of left subclavian artery. The 0.014 microwire was passed through the stenosis. The 3*30mm and 6*30mm balloon was introduced subsequently to widen the stenosis to guarantee the stent can pass the stenosis. Finally the 9*30mm Wallstent was introduced. Postoperative angioaphy revealed that there was approximately 5% stenosis remained and the left vertebral artery was patent. The patient’s symptoms and signs were all improved. From literatures, PTA and stent implantation is a safe and effective treatment and a first-line management in foreign countries for the subclavian artery stenosis. This is our first case. We feel that the most appropriate position of the guiding catheter is the key issue in successful treatment. We also think how to reduce the risk of stroke and upper limb ischemia more effectively.展开更多
Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients re...Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients referred for percutaneous coronary intervention (PCI).Methods Following aspirin and heparin, 166 patients were randomized to a 50 mg bolus of recombinant tissue type plasminogen activator(rt PA) or to a same volume sodium chloride injection followed by immediate primary PCI. The end points included patency rates on catheterization laboratory (cath lab) arrival, revascularization results when PCI was performed, complication rates, left ventricular function and restored patency rate following PCI. Results Patency on cath lab arrival was 64% with rt PA (34% TIMI 3,30% TIMI 2), while 31% of placebo (13% TIMI 3, 18% TIMI 2). There was no difference in the restored TIMI 3 rates of IRA between the two groups (85% vs 87%). No difference were observed in stroke or major bleeding. Left ventricular function was similar in both groups (52±9% vs 50±8%), but left ventricular ejection fraction fraction (LVEF) was higher with patent IRA (TIMI 3) on cath lab arrival than that of others (56±12% vs 48±10%).Conclusions Strategy thrombolytic regimens were compatible with subsequent PCI lead to more frequenc early recanalization (before cath lab arrival), which facilitates greater left ventricular function preservation with no augmentation of adverse events.展开更多
Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(...Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34~88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.展开更多
Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle(MAV/UAV) cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human f...Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle(MAV/UAV) cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human factors engineering(HFE).Firstly, based on the brief review of research status of HFE, it gives structural description to emergency in the process of cooperative engagement and analyzes intervention of commanders. After that,constraint conditions of intervention decision-making of commanders based on HFE(IDMCBHFE) are given, and the mathematical model, which takes the overall efficiency value of handling emergencies as the objective function, is established. Then, through combining K-best and variable neighborhood search(VNS) algorithm, a K-best optimization variable neighborhood search mixed algorithm(KBOVNSMA) is designed to solve the model. Finally,through three groups of simulation experiments, effectiveness and superiority of the proposed algorithm are verified.展开更多
Background and objective Airway stent placement is the effective regimen for central airway obstruction(CAO),while its application scenarios varied.This study aimed to make clinical comparison of airway stent placemen...Background and objective Airway stent placement is the effective regimen for central airway obstruction(CAO),while its application scenarios varied.This study aimed to make clinical comparison of airway stent placement in the intervention room and operating room.Methods Patients underwent airway stent placement between 2014 and 2018 were included in this retrospective case-control study.Clinical performance of airway stent placement in intervention room and operating room were compared.Results 82 patients were included in this study,including 39 in the intervention room and 43 in the operating room.Patients treated in the intervention room had lower Charlson comorbidity index(CCI)(P=0.018)and received less Y-shaped stents(P<0.001).Better clinical response(P=0.026),more stents placed(P<0.001)and longer length of stent(P<0.001)were observed in operating room,while there was no significantly statistical difference of stent-related complications and post-stent survival rate between the two groups.Extracorporeal membrane oxygenation(ECMO)supported airway stent placement procedures were performed in the operating room,which provided definitive safety support for high-risk intervention.Conclusion Patients with CAO could benefit from the operating room scenario,and airway stent placement in the operating room is more suitable for patients with higher CCI scores and receiving more complicated procedures.展开更多
Objective In 2006,Alzheimer's Association Victoria Australia funded the authors to conduct a systematic review of the community education literature in order to assist the development of their own community educat...Objective In 2006,Alzheimer's Association Victoria Australia funded the authors to conduct a systematic review of the community education literature in order to assist the development of their own community education strategy.Methods This paper draws upon this research project to convey the predominant messages arising consistently across the evidence base relating to key national health priority areas.Particular attention is given to exploring the needs of minority groups.Results The evidence reviewed indicates the need for multi-faceted intervention approaches that are carefully planned and assessed to ensure sufficient exposure of the target audience to the health messages.Conclusion Such approaches remain to be empirically tested within the context of dementia risk reduction.Nevertheless,there are consistent models in the evidence base that can be applied with confidence to community education in the current domain.展开更多
Objective We conducted the present study in order to compare safety and efficacy of transradial intervention(TRI)and transfemoral intervention(TFI)in women undergoing percutaneous coronary intervention(PCI)in a large ...Objective We conducted the present study in order to compare safety and efficacy of transradial intervention(TRI)and transfemoral intervention(TFI)in women undergoing percutaneous coronary intervention(PCI)in a large heart center in China.Methods The study population consisted of a consecutive cohort of 5,067 women undergoing PCI in Fuwai Hospital,Beijing,China between 2006 and 2011(TRI:n=4,105,TFI:n=962).展开更多
Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet re...Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet reactivity(HRPR)during DAPT therapy.Therefore,we performed a large prospective observational study to evaluate the platelet reactivity and related clinical outcomes in real-world patients with different renal insufficiency stage after PCI,and to examine whether HRPR is associated with higher incidence of adverse cardiovascular events in a 2-year follow up.展开更多
Objective The purpose is to investigate the safety and effectiveness of ticagrelor early postoperative mono-antiplatelet therapy in patients with percutaneous coronary intervention(PCI).Methods 832 patients who choose...Objective The purpose is to investigate the safety and effectiveness of ticagrelor early postoperative mono-antiplatelet therapy in patients with percutaneous coronary intervention(PCI).Methods 832 patients who choose ticagrelor for anti-platelet therapy from August 2015 to December 2016 and underwent PCI with the second generation drug-eluting stent(DES)was selected.展开更多
Objective To determine whether a workplace-based multicomponent intervention strategy could improve BP control among Chinese working population.Methods A cluster-controlled trail,with workplaces assigned to either the...Objective To determine whether a workplace-based multicomponent intervention strategy could improve BP control among Chinese working population.Methods A cluster-controlled trail,with workplaces assigned to either the intervention or control group.60 workplaces across 20 urban regions of China were selected.4,548 hypertensive employees aged 18-60 years were assigned intervention(n=3,470)or control(n=1,078),of whom 4,205(92.5%;intervention,n=3,209;control,n=996)were included in this analysis.展开更多
Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronar...Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronary intervention (PCI).展开更多
Steel slag, a by-product of the steel production industry reaches 10%–15% of crude steel output (Motz and Geiseler, 2001). Their main application lies in the field of building materials due to some containing cementi...Steel slag, a by-product of the steel production industry reaches 10%–15% of crude steel output (Motz and Geiseler, 2001). Their main application lies in the field of building materials due to some containing cementitious components, such as dicalcium silicate (C2S) and tricalcium silicate (C3S) (Waligora et al., 2010). However, blended cements with steelmaking slag show low early hydration activity, low compressive strength and bad durability because steel slag generates above 1600 ℃ with the tense and large grain size crystals, consisting of low content of C2S and C3S and high proportions of f-CaO and f-MgO compared with cement clinker.展开更多
Background and Objective The white blood cell count to mean platelet volume ratio(WMR)has recently been described as a predictor of cardiovascular events in patients who undergo percutaneous coronary intervention(PCI)...Background and Objective The white blood cell count to mean platelet volume ratio(WMR)has recently been described as a predictor of cardiovascular events in patients who undergo percutaneous coronary intervention(PCI).The aim of this study was to investigate the usefulness of admission WMR in predicting outcomes in patients with acute coronary syndrome(ACS).展开更多
Objective To evaluate the effect of a workplace-based comprehensive intervention strategy on the improvement of blood pressure (BP) control.Methods A cluster controlled trail, with workplaces (clusters)assigned to eit...Objective To evaluate the effect of a workplace-based comprehensive intervention strategy on the improvement of blood pressure (BP) control.Methods A cluster controlled trail, with workplaces (clusters)assigned to either the intervention or control group. Totally, 30 statedowned enterprises across China were included, among which 20were allocated to the intervention group and 10 to the control group.展开更多
Background and Objective In-stent restenosis(ISR)remains a major limitation of percutaneous coronary intervention despite improvements in stent design and pharmacological agents,whereas the mechanism of ISR has not be...Background and Objective In-stent restenosis(ISR)remains a major limitation of percutaneous coronary intervention despite improvements in stent design and pharmacological agents,whereas the mechanism of ISR has not been fully clarified.In the present study,we sought to investigate the potential association of serum soluble TREM-1(sTREM-1)levels with the incidence of ISR.The role of TREM-1 was evaluated in cultured vascular smooth muscle cells(VSMCs).展开更多
文摘Objective To explore the application of evidence-based nursing intervention in patients with congenital heart diseases treated by transcatheter interventional therapy.Methods A total of 64 patients with congenital heart diseases who were administered in our hospital from June 2011 to July 2013 were recruited in our research.
文摘Protecting Our Own:A Method for Reducing Breast Radiation Exposure in Healthcare Workers Lauren Zammerilla Westcott1, Gerald O. Ogola2, Chet R. Rees3(1. Department of Surgery, Baylor University Medical Center, Dallas, TX;2. Department of Biostatistics, Baylor University Medical Center, Dallas, TX;3. Department of Interventional Radiology, Baylor University Medical Center, Dallas, TX).
基金supported by the National Science Fund for Distinguished Young Scholars(81703084)the National Natural Science Foundation of General Program(82272924),and the Hunan Women’s Federation(19WTB03),China.
文摘Objective:The efficacy of monotherapy in alleviating psychological disorders like anxiety and depression among breast cancer patients is suboptimal,necessitating effective psychosocial interventions.Mindfulness-based interventions have been shown to mitigate anxiety-depression symptoms and encourage beneficial behaviors.The online mindfulness based cancer recovery(MBCR)offers flexibility and guides practice across various settings,facilitating full patient engagement.This study amis to analyze the impact of a 4-week internet-delivered mindfulness-based cancer recovery program on anxiety,depression,and mindfulness among Chinese patients with breast cancer,and to evaluate the degree of satisfaction breast cancer patients experienced after participating in this program.Methods:This study utilized a two-armed,parallel,randomized controlled trial design.A total of 103 patients with breast cancer from June 2020 to January 2021 in the ward of Breast and Thyroid Surgery of a tertiary hospital in Changsha,Hunan Province were selected and randomly assigned to an intervention group(n=51)and a control group(n=52).The intervention group participated in an internet-delivered mindfulness-based cancer recovery program,which was delivered once a week for 4 weeks.Meanwhile,the control group received weekly group health education for 4 weeks.The outcomes of hospital anxiety and depression scale and mindfulness Attention Awareness Scale were evaluated at 3 distinct time points:Baseline(T1),postintervention(T2),and 1-month follow-up(T3).The satisfaction questionnaire of 4-week mindful cancer rehabilitation training program was used at T2 to evaluate patients’satisfaction with the intervention program.Generalized estimation equations were used to assess differences in anxiety,depression and mindfulness levels between groups before and after the intervention.Results:There were no statistically significant differences in demographic data and outcome index scores between the 2 groups at T1(all P>0.05),indicating that the 2 groups were comparable.The generalized estimating equation analyses showed that the intervention group had significantly better improvement in outcomes compared to the control group,particularly for anxiety(T2β=−1.30,95%CI−1.87 to−0.72;T3β=−2.78,95%CI−3.51 to−2.05)and depression(T2β=−1.92,95%CI−2.78 to−1.06;T3β=−2.96,95%CI−4.05 to−1.87;all P<0.001).Moreover,the mindfulness score in the intervention group was significantly higher than that in the control group at T2(β=3.23,95%CI 0.73 to 5.72)and T3(β=8.06,95%CI 4.37 to 11.75;both P<0.05).In addition,patients in the intervention group were satisfied with the 4-week mindfulness-based cancer recovery intervention and teaching/learning activities used to implement the program.Conclusion:In patients with breast cancer,the 4-week internet-delivered mindfulness based cancer recovery program,as a low-threshold,short-term mental health intervention,has a positive effect on reducing anxiety and depression and improving mindfulness levels.This program holds great promise as a tool for clinical nursing practice,given the high satisfaction and applicability.
文摘DAI Jiong, WEN Jie-qing, LI Shan-quan. Department of Neurosurgery, Renji Hospital, Shanghai 200001, China The patient is a 79 years old male. He was admitted for recurrent dizziness accompanied tinnitus during the last 2 weeks. These symptoms were aggravated during the last 4 days. He had a history of hypertension. Murmur was detected on the left subclavian artery. Left upper limb had IVth grade muscle force. The pulse of left radial artery was reduced. The systolic blood pressure of left upper limb was 30 mmHg lower than the right counter part. The Doppler sonography of vertebral artery revealed that there was inverse blood flow in the left vertebral artery. The angiography of left subclavian artery revealed that the left subclavian artery near the opening site(proximal to vertebral artery) was stenosed by approximatel 90%. Left vertebral artery was not detected. The angiography of right vertebral artery revealed that there was partial cerebral bolld flow steal to left subclavian artery via left vertebral artery. We treated this patient with percutaneous transluminal angiogrplasty(PTA)and stent implantation. Detailed description: Femoral artery was punctured, 8F artery theca was introduced. The 8F guiding catheter was introduced to the opening site of left subclavian artery. The 0.014 microwire was passed through the stenosis. The 3*30mm and 6*30mm balloon was introduced subsequently to widen the stenosis to guarantee the stent can pass the stenosis. Finally the 9*30mm Wallstent was introduced. Postoperative angioaphy revealed that there was approximately 5% stenosis remained and the left vertebral artery was patent. The patient’s symptoms and signs were all improved. From literatures, PTA and stent implantation is a safe and effective treatment and a first-line management in foreign countries for the subclavian artery stenosis. This is our first case. We feel that the most appropriate position of the guiding catheter is the key issue in successful treatment. We also think how to reduce the risk of stroke and upper limb ischemia more effectively.
文摘Objective This study was to evaluate the efficacy and safety of a short acting reduced dose fibrinolytic regimen to promote early infarct related artery (IRA) patency for acyute myocardial infarction (AMI) patients referred for percutaneous coronary intervention (PCI).Methods Following aspirin and heparin, 166 patients were randomized to a 50 mg bolus of recombinant tissue type plasminogen activator(rt PA) or to a same volume sodium chloride injection followed by immediate primary PCI. The end points included patency rates on catheterization laboratory (cath lab) arrival, revascularization results when PCI was performed, complication rates, left ventricular function and restored patency rate following PCI. Results Patency on cath lab arrival was 64% with rt PA (34% TIMI 3,30% TIMI 2), while 31% of placebo (13% TIMI 3, 18% TIMI 2). There was no difference in the restored TIMI 3 rates of IRA between the two groups (85% vs 87%). No difference were observed in stroke or major bleeding. Left ventricular function was similar in both groups (52±9% vs 50±8%), but left ventricular ejection fraction fraction (LVEF) was higher with patent IRA (TIMI 3) on cath lab arrival than that of others (56±12% vs 48±10%).Conclusions Strategy thrombolytic regimens were compatible with subsequent PCI lead to more frequenc early recanalization (before cath lab arrival), which facilitates greater left ventricular function preservation with no augmentation of adverse events.
文摘Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34~88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.
基金supported by the National Natural Science Foundation of China(61573017)the Doctoral Foundation of Air Force Engineering University(KGD08101604)
文摘Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle(MAV/UAV) cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human factors engineering(HFE).Firstly, based on the brief review of research status of HFE, it gives structural description to emergency in the process of cooperative engagement and analyzes intervention of commanders. After that,constraint conditions of intervention decision-making of commanders based on HFE(IDMCBHFE) are given, and the mathematical model, which takes the overall efficiency value of handling emergencies as the objective function, is established. Then, through combining K-best and variable neighborhood search(VNS) algorithm, a K-best optimization variable neighborhood search mixed algorithm(KBOVNSMA) is designed to solve the model. Finally,through three groups of simulation experiments, effectiveness and superiority of the proposed algorithm are verified.
文摘Background and objective Airway stent placement is the effective regimen for central airway obstruction(CAO),while its application scenarios varied.This study aimed to make clinical comparison of airway stent placement in the intervention room and operating room.Methods Patients underwent airway stent placement between 2014 and 2018 were included in this retrospective case-control study.Clinical performance of airway stent placement in intervention room and operating room were compared.Results 82 patients were included in this study,including 39 in the intervention room and 43 in the operating room.Patients treated in the intervention room had lower Charlson comorbidity index(CCI)(P=0.018)and received less Y-shaped stents(P<0.001).Better clinical response(P=0.026),more stents placed(P<0.001)and longer length of stent(P<0.001)were observed in operating room,while there was no significantly statistical difference of stent-related complications and post-stent survival rate between the two groups.Extracorporeal membrane oxygenation(ECMO)supported airway stent placement procedures were performed in the operating room,which provided definitive safety support for high-risk intervention.Conclusion Patients with CAO could benefit from the operating room scenario,and airway stent placement in the operating room is more suitable for patients with higher CCI scores and receiving more complicated procedures.
文摘Objective In 2006,Alzheimer's Association Victoria Australia funded the authors to conduct a systematic review of the community education literature in order to assist the development of their own community education strategy.Methods This paper draws upon this research project to convey the predominant messages arising consistently across the evidence base relating to key national health priority areas.Particular attention is given to exploring the needs of minority groups.Results The evidence reviewed indicates the need for multi-faceted intervention approaches that are carefully planned and assessed to ensure sufficient exposure of the target audience to the health messages.Conclusion Such approaches remain to be empirically tested within the context of dementia risk reduction.Nevertheless,there are consistent models in the evidence base that can be applied with confidence to community education in the current domain.
文摘Objective We conducted the present study in order to compare safety and efficacy of transradial intervention(TRI)and transfemoral intervention(TFI)in women undergoing percutaneous coronary intervention(PCI)in a large heart center in China.Methods The study population consisted of a consecutive cohort of 5,067 women undergoing PCI in Fuwai Hospital,Beijing,China between 2006 and 2011(TRI:n=4,105,TFI:n=962).
文摘Background and Objective Renal insufficiency(RI)is reported to be associated with increased ischemic and bleeding events after percutaneous coronary intervention(PCI),which is possibly due to high residual platelet reactivity(HRPR)during DAPT therapy.Therefore,we performed a large prospective observational study to evaluate the platelet reactivity and related clinical outcomes in real-world patients with different renal insufficiency stage after PCI,and to examine whether HRPR is associated with higher incidence of adverse cardiovascular events in a 2-year follow up.
文摘Objective The purpose is to investigate the safety and effectiveness of ticagrelor early postoperative mono-antiplatelet therapy in patients with percutaneous coronary intervention(PCI).Methods 832 patients who choose ticagrelor for anti-platelet therapy from August 2015 to December 2016 and underwent PCI with the second generation drug-eluting stent(DES)was selected.
文摘Objective To determine whether a workplace-based multicomponent intervention strategy could improve BP control among Chinese working population.Methods A cluster-controlled trail,with workplaces assigned to either the intervention or control group.60 workplaces across 20 urban regions of China were selected.4,548 hypertensive employees aged 18-60 years were assigned intervention(n=3,470)or control(n=1,078),of whom 4,205(92.5%;intervention,n=3,209;control,n=996)were included in this analysis.
文摘Objective This study analyzed a large single-center sample in China to explain the impact of smoking state at baseline on long-term prognosis of coronary artery disease (CAD) patients who received percutaneous coronary intervention (PCI).
基金Supported by the National Key Technologies R&D Program of China (NO. 2011BAB03B05)
文摘Steel slag, a by-product of the steel production industry reaches 10%–15% of crude steel output (Motz and Geiseler, 2001). Their main application lies in the field of building materials due to some containing cementitious components, such as dicalcium silicate (C2S) and tricalcium silicate (C3S) (Waligora et al., 2010). However, blended cements with steelmaking slag show low early hydration activity, low compressive strength and bad durability because steel slag generates above 1600 ℃ with the tense and large grain size crystals, consisting of low content of C2S and C3S and high proportions of f-CaO and f-MgO compared with cement clinker.
文摘Background and Objective The white blood cell count to mean platelet volume ratio(WMR)has recently been described as a predictor of cardiovascular events in patients who undergo percutaneous coronary intervention(PCI).The aim of this study was to investigate the usefulness of admission WMR in predicting outcomes in patients with acute coronary syndrome(ACS).
文摘Objective To evaluate the effect of a workplace-based comprehensive intervention strategy on the improvement of blood pressure (BP) control.Methods A cluster controlled trail, with workplaces (clusters)assigned to either the intervention or control group. Totally, 30 statedowned enterprises across China were included, among which 20were allocated to the intervention group and 10 to the control group.
文摘Background and Objective In-stent restenosis(ISR)remains a major limitation of percutaneous coronary intervention despite improvements in stent design and pharmacological agents,whereas the mechanism of ISR has not been fully clarified.In the present study,we sought to investigate the potential association of serum soluble TREM-1(sTREM-1)levels with the incidence of ISR.The role of TREM-1 was evaluated in cultured vascular smooth muscle cells(VSMCs).