[Research progress of congenital preauricular fistula]

Congenital preauricular fistula can be sporadic or genetic. When inherited, it exhibits incomplete autosomal dominant genetic patterns. It can occur alone or with other diseases such as branchio-oto-renal syndrome. According to the position of fistula opening, congenital ear fistula can be divided into four categories: congenital preauricular fistula, congenital posterior ear fistula, congenital auricular fistula and congenital external auditory canal fistula. Congenital auricle fistula can be subdivided into congenital auricular fistula, congenital teal fistula, congenital earlobe fistula and so on. The diagnosis of preauricular fistula should be based on its clinical manifestation, and the diagnosis and treatment of special type of preauricular fistula should be emphasized. The treatment methods of congenital preauricular fistula include medicine, incision and surgical excision. According to the clinical practice of us and other scholars, surgical treatment is recommended in the period of acute infection, and the recurrence rate is not increased. The operation method of preauricular fistula, the application of microscope, dye tracer, probe and general anesthesia, and the clear surgical visualization are all helpful to reduce the recurrence rate.

Long non-coding RNA ENST00000434223 inhibits the progression of renal cancer through Wnt/hygro-catenin signaling pathway

OBJECTIVE

The purpose of this study was to determine the function of long non-coding RNA (LncRNA) ENST00000434223 (Lnc ENST) in renal carcinoma, and to explore the potential molecular mechanism.

PATIENTS AND METHODS

Quantitative Real-Time-Polymerase Chain Reaction (qRT-PCR) was used to detect the expressions of lncRNA ENST00000434223 and Wnt/β-catenin pathway-related mRNAs in tissues and cells of renal cancer. Chi-square test was performed to figure out the relationship between lncRNA ENST00000434223 and clinic-pathologic features of renal cancer patients. Besides, si-NC, si-ENST00000434223, pcDNA-NC and pcDNA-ENST00000434223 were transfected into renal cancer cells. The proliferative ability, metastasis and invasiveness of cells were detected using Cell Counting Kit-8 (CCK-8) and transwell assay, respectively. Lastly, the activation of the Wnt/hygro-catenin signal transduction pathway was evaluated by TOP/FOP Wnt Luciferase reporter assay and Western blot.

RESULTS

The expressions of Wnt2b and β-catenin were significantly increased in renal carcinoma, while E-cadherin was markedly down-regulated. Lowly expressed ENST00000434223 was involved in the poor prognosis of patients with renal cancer. In addition, down-regulating ENST00000434223 could enhance the viability, metastasis and invasiveness of renal cancer cells. However, overexpressing ENST00000434223 remarkably weakened the above cell functions. At the same time, interference or overexpression of ENST00000434223 could affect the expression level of proteins related to the Wnt/β-catenin signal pathway.

CONCLUSIONS

LncRNA ENST00000434223 inhibits the progression of renal cancer through the Wnt/shell-catenin signal pathway.

[Analysis of occupational pneumoconiosis in Jiangsu province from 2006 to 2017]

Objective: To analyze the characteristics and patterns of occupational pneumoconiosis in Jiangsu Province, China, from 2006 to 2017, and to provide a scientific basis for government departments to develop effective interventions and preventive strategies against occupational pneumoconiosis. Methods: The data of 9327 patients with occupational pneumoconiosis were retrieved from the online report of occupational pneumoconiosis in Jiangsu Province from 2006 to 2017. Excel worksheet and SPSS 20.0 software were used to organize and analyze the data, respectively. An epidemiological statistical analysis was performed on age of onset, length of dust exposure, type of work, industry category, type of pneumoconiosis, annual incidence of pneumoconiosis, regional distribution, enterprise scale, and economic category in those patients. Results: A total of 9 327 patients with occupational pneumoconiosis were reported in Jiangsu Province from 2006 to 2017. In those patients, 8 559 were newly diagnosed and 768 had advanced disease. The male-female ratio was 16.34:1.Patients with stage I pneumoconiosis(6 994, 74.99%) were dominant in all the patients. The mean age of onset and length of dust exposure were 58.5±10.7 and 15.3±10.9 years, respectively. Most of the patients (6 012, 64.46%) had an age of onset between 50 and 69 years. For the length of dust exposure, the highest percentage was observed in patients exposed for no more than 5 years (2 231, 23.92%).The largest number of patients diagnosed with pneumoconiosis(1 200, 12.87%) was reported in 2010. Most of the patients(7 012, 75.18%) were from four cities, i.e, Wuxi (2 090, 22.41%), Yancheng (1 987, 21.30%), Suzhou (1 552, 16.64%), and Xuzhou (1 383, 14.83%). In all the patients, the incidence of silicosis (6791, 72.81%) was highest, followed by coal worker pneumoconiosis (1 364, 14.62%) and electric welder pneumoconiosis (563, 6.04%).Pneumoconiosis complicated by tuberculosis was found in 28 (0.3%) patients.A total of 1616 (17.33%) patients were reported in health, social security, and social welfare industries, while 1474 (15.80%) patients worked for coal mining and washing. Rock drillers (2 818, 30.21%) were dominant in those patients.State-owned economic enterprises reported the largest number of patients(5 441, 58.34%).Patients from small enterprises (4 323, 46.35%) had the highest percentage. Conclusion: Pneumoconiosis is an occupational disease with a high incidence in Jiangsu Province. Pneumoconiosis patients show an industry- and job-centered distribution. The length of dust exposure is decreasing.

Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus

PURPOSE

To explore the effects of mobile health (mHealth) intervention on pregnancy weight management, blood glucose control and pregnancy outcomes.

METHODS

A total of 124 patients with gestational diabetes mellitus (GDM) were selected. Patients were randomly divided into two groups. The 60 patients in the control group received standard outpatient treatment, while the remaining 64 patients received a nurse's online guidance both through a mobile medical App installed on their phone and through regular offline clinical treatment in the mHealth group. Patients were treated for an average of 13 weeks and general conditions, compliance, blood glucose, glycosylated hemoglobin, weight gain, pregnancy, and neonatal outcomes were monitored in both groups longitudinally.

RESULTS

The mHealth group demonstrated higher levels of compliance (83.3 ± 12.5% vs. 70.4 ± 10.1%, t = - 6.293, df = 122, p < 0.001), lower frequency of outpatient service (8.1 ± 1.3 vs. 11.2 ± 1.1, t = 14.285, df = 122, p < 0.001), lower hemoglobin A1C before delivery (4.7 ± 0.2 vs. 5.3 ± 0.3, t = 13.216, df = 122, p < 0.001) as well as the rates of off-target measurements both fasting (4.6 ± 0.4% vs. 8.3 ± 0.6%, t = 40.659, df = 122, p < 0.001) and 2 h post-prandial (7.9 ± 0.7% vs. 14.7 ± 0.8%, t = 50.746, df = 122, p < 0.001). Weight gain in the mHealth group was less than control group (3.2 ± 0.8 vs. 4.8 ± 0.7, t = 11.851, df = 122 p < 0.001).

CONCLUSION

Mobile health intervention management of gestational diabetes mellitus improves patients' compliance and blood glucose control, and reduces weight gain, thereby reducing the rates of complications in both pregnant women and fetuses during delivery during pregnancy.

Ultrafast electron diffraction from a Bi(111) surface: Impulsive lattice excitation and Debye-Waller analysis at large momentum transfer

The lattice response of a Bi(111) surface upon impulsive femtosecond laser excitation is studied with time-resolved reflection high-energy electron diffraction. We employ a Debye-Waller analysis at large momentum transfer of 9.3 Å^-1 ≤ Δ k ≤ 21.8 Å^-1 in order to study the lattice excitation dynamics of the Bi surface under conditions of weak optical excitation up to 2 mJ/cm² incident pump fluence. The observed time constants τ _int of decay of diffraction spot intensity depend on the momentum transfer Δk and range from 5 to 12 ps. This large variation of τ _int is caused by the nonlinearity of the exponential function in the Debye-Waller factor and has to be taken into account for an intensity drop ΔI > 0.2. An analysis of more than 20 diffraction spots with a large variation in Δk gave a consistent value for the time constant τ_T of vibrational excitation of the surface lattice of 12 ± 1 ps independent on the excitation density. We found no evidence for a deviation from an isotropic Debye-Waller effect and conclude that the primary laser excitation leads to thermal lattice excitation, i.e., heating of the Bi surface.

Erratum: Ultrafast Doublon Dynamics in Photoexcited 1T-TaS_{2} [Phys. Rev. Lett. 120, 166401 (2018)]

This corrects the article DOI: 10.1103/PhysRevLett.120.166401.

Effects of dietary crude protein levels and cysteamine supplementation on meat quality and related indices of finishing pigs

The aim of this study was to investigate the effects of dietary crude protein levels and cysteamine (CS) supplementation on meat quality and related indices in longissimus dorsi muscle of finishing pigs. One hundred and twenty barrows were randomly allocated to a 2 × 2 factorial arrangement with five replicates of six pigs each. The primary variations were crude protein levels (14% or 10%) and CS supplemental levels (0 or 140 mg kg−1). After 41 d, 10 pigs per treatment were slaughtered. The results showed that low-protein level diets (LPDs) decreased Warner–Bratzler shear force (P < 0.01) and increased the content of intramuscular fat (P < 0.01). The mRNA expressions of lipogenic genes were up-regulated (P < 0.01), and the mRNA expressions of lipolytic genes were down-regulated (P < 0.01) in pigs fed LPD. LPDs increased the mRNA expressions of μ-calpain, and decreased the mRNA expression of calpastatin (P < 0.01). In addition, CS supplementation increased the mRNA expression of μ-calpain (P < 0.01). In conclusion, LPD improved the meat quality probably through regulating the lipogenesis, lipolysis, and the proteolysis process in muscle. The CS supplementation did not affect the meat quality of finishing pigs. Moreover, no significant interaction between dietary protein levels and CS supplementation for the meat quality of finishing pigs was observed.

[Effects of PSMB5 on proliferation and bortezomib chemo-resistance in human myeloma cells and its related molecular mechanisms]

Objective: To investigate the effects of proteasome beta 5 subunit (PSMB5) on proliferation and bortezomib (BTZ) chemo-sensitivity of multiple myeloma (MM) and its related molecular mechanisms. Methods: We used two MM cell lines, RPMI 8226 and BTZ drug-resistant cell line RPMI 8226/BTZ100 (hereinafter referred to as BTZ100) , as the research object. PSMB5 was overexpressed or knocked down in two myeloma cell lines via lentivirus transfection. CCK8 assay was used to detect the impact of PSMB5 on cell viability and bortezomib sensitivity in human myeloma cells; Using flow cytometry to test the effects of PSMB5 on apoptosis rate of human myeloma cells under the treatment of bortezomib; Apoptosis-related gene expression of Bax, Bcl-2, p-Akt and cleaved caspase-3 were detected by Western blot. Results: ①PSMB5 overexpression and knockdown were successfully constructed in RPMI 8226 and BTZ100 cells. ②PSMB5 expression was positively correlated with cell proliferation of RPMI 8226 and BTZ100 cells (P<0.05) . ③The cell viability was lower after PSMB5 knockdown in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (7.01±0.47) and (9.64±0.55) nmol/L respectively, t=6.289, P=0.003]. The cell viability was higher after PSMB5 overexpression in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (10.99±0.58) and (9.51±0.37) nmol/L respectively, t=3.724, P=0.020) . PSMB5 expression was negatively correlated with the sensitivity of RPMI 8226 cells to BTZ. The results of BTZ100 cells were similar. ④The expression of PSMB5 was negatively correlated with the apoptosis of RPMI 8226 and BTZ100 under the treatment of BTZ. ⑤Meanwhile, PSMB5 knockdown could increase the expression of pro-apoptosis gene Bax and cleaved caspase-3 and decrease the expression of anti-apoptotic gene Bcl-2 and p-Akt. PSMB5 over-expression has the opposite results. Conclusion: PSMB5 knockdown could improve the bortezomib sensitivity of MM cells via activation of apoptosis signaling. PSMB5 may be a potential therapeutic target for MM.

Strong anisotropic nodal lines in the TiBe family

Using first-principles calculations and k·p model analysis, we find that Dirac nodal lines (DNLs) exist in low energy band structures of real materials of the body-centered cubic TiBe family.

Effect of Methylprednisolone on Liver Injury and Endotoxin Levels Following Brain Death in Rats

BACKGROUND AND AIM

Brain death impairs liver function in potential donors and is associated with inflammatory activation. Methylprednisolone treatment after brain death has been shown to reduce inflammatory activity. The aim of the present study was to evaluate the effects of methylprednisolone on liver injury and endotoxin levels in brain-dead rats.

METHODS

Thirty-two rats were randomly divided into 4 groups: a sham-operation group (Sham group), a brain death with methylprednisolone treatment group (Methy group), a brain death with saline treatment group (Saline group), and a brain death group (BD group). The rats were anesthetized and induced by gradually increasing the intra-cranial pressure using a Fogarty catheter balloon for brain death. All of the animals were observed and ventilated for 6 h prior to being euthanized. Hepatic pathologic histology (Knodell histology activity index), liver inflammatory cytokine levels, liver function and endotoxin levels were assessed.

RESULTS

After brain death, methylprednisolone markedly alleviated the Knodell histology activity index of liver injury (P < .05). Additionally, significant reductions in the levels of TNF-α, IL-1β, and IL-10 were observed in the Methy group compared to those in the Saline and BD groups (P < .01), whereas no significant differences were found between the Saline and BD groups (P > .05). Interestingly, although the rate of liver injury after brain death in the methylprednisolone treatment group improved, the endotoxin level did not decline in the Methy group compared to the levels in the Saline and BD groups (P > .05).

CONCLUSION

The present study verified that methylprednisolone was protective for liver injury in rats subjected to brain death. This protection appeared to be due to reduced inflammatory activity with no influence on the endotoxin level.

Two agroinfection-compatible fluorescent protein-tagged infectious cDNA clones of papaya leaf distortion mosaic virus facilitate the tracking of virus infection

Papaya leaf distortion mosaic virus (PLDMV, the genus Potyvirus) is an emerging threat to papaya production. Here, agroinfection-compatible fluorescent protein-tagged PLDMV infectious cDNA clones driven by the Cauliflower mosaic virus 35S promoter were successfully constructed using one-step Gibson assembly. The clones were directly transformed into Agrobacterium tumefaciens to prevent potential problems such as plasmid instability during propagation in Escherichia coli. Ninety-five percent of papaya seedlings infected with PLDMV-GFP or PLDMV-mCherry developed systemic symptoms typical of those caused by wild-type PLDMV. Green and mCherry red fluorescence was observed in leaves, stems, and roots of infected papaya plants. The fluorescent protein-tagged agroinfectious PLDMV cDNA clones were stable in papaya for more than 90 days and during six serial passages at 30-day intervals. The availability of these infectious clones will contribute to research on PLDMV-host interactions and can be applied in the papaya breeding program for PLDMV resistance.

[Application of da Vinci robot's bilateral axillo-breast approach in thyroid surgery of obese patients]

Objective:To discuss the effect of obesity on the operation of thyroid gland surgery and surgical results.Method:The clinical data of 446 patients who underwent robot thyroid surgery through bilateral axillo-breast approach (BABA) from the General Hospital of Jinan Military region from February 2014 to November 2017 were analyzed retrospectively, and the patients were divided into BMI<25 kg/m²; group, BMI 25-30 kg/m²; group and BMI>30 kg/m²; group according to body mass index (BMI). The operative complications were compared between the three groups of benign and malignant patients, such as operation time, postoperative lead flow, postoperative hospitalization time, tumor size (malignant), lymph node metastasis (malignant), cosmetic satisfaction score, laryngeal nerve injury and parathyroid function decrease. Statistical methods using Variance analysis and χ² test to compare the differences between the two groups of indicators, difference is statistically significant (P<0.05).Result:The difference of operation time, postoperative average hospitalization time and postoperative drainage fluid volume in 3 groups was not statistically significant（P>0.05）. ①Intraoperative and postoperative pathological results were benign: BMI<25 kg/m²; group 69 cases, BMI 25-30 kg/m²; group 48 cases, BMI>30 kg/m²; group 8 cases, temporary recurrent laryngeal nerve injury were 1 case, 0 case and 0 case respectively, temporary parathyroid function decrease 3 cases, 2 cases and 1 case. ②Intraoperative and postoperative pathological results were malignant:BMI<25 kg/m²; group 180 cases, BMI 25-30 kg/m²; group 119 cases,BMI>30 kg/m²; group 22 cases, temporary recurrent laryngeal nerve injury were 2 cases,1 case and 0 case respectively, temporary parathyroid dysfunction in 64 cases,29 cases and 5 cases respectively.③1 patient in BMI<25 kg/m²; group had lymphatic leakage after operation, 1 patient in BMI 25-30 kg/m²; group had subcutaneous tunnel hemorrhage, and 1 patient had lymphatic leakage during operation.Conclusion:For overweight or obese patients, the da Vinci robot thyroid operation is reliable, does not increase the risk of surgical complications, but also has a good cosmetic effect.

[Relationship between upper airway volume and polysomnography parameters of patients with obstructive sleep apnea hypopnea syndrome]

Objective:To study the relationship among upper airway volume of naso-pharyngeal, yelo-pharyngeal,glosso-pharyngeal, hypo-pharyngeal area which measured by spiral computed tomography three-dimensional reconstruction technique, apnea hypopnea indexes, and the lowest oxygen saturation in patients with OSAHS.Method:①fifty-one patients with OSAHS were received polysomnography, and then were divided into groups by the AHI,LSaO₂ values. ②To measure upper airway volume at normal breath and Müller maneuver state using spiral computed tomography three-dimensional reconstruction technique of CT measurement, and to calculate volume change rate and observe the upper airway compliance. ③To analyses the relationship between upper airway volume and AHI,LSaO₂ values.Result:The smallest upper airway volume of OSAHS was at the velo-pharyngeal level; the volume of velo-pharyngeal level were negatively correlated with AHI during normal respiration and Müller's maneuver state and were positively correlated with LSaO₂; the volume of hypo-pharyngeal were negatively correlated with AHI during normal respiration; the volume of glosso-pharyngeal were positively correlated with LSaO₂ during Müller's maneuver state.Conclusion:①The volume of velo-pharyngeal level with OSAHS patients can reflect the severity of AHI,LSaO₂. ②The measurement of upper airway volume using spiral computed tomography three-dimensional reconstruction technique is good method to evaluate the upper airway compliance of OSAHS patients.

[Comparison of percutaneous endoscopic lumbar discectomy versus transforaminal lumbar interbody fusion in treating upper lumbar disc herniation]

Objective: To compare the efficacy of percutaneous endoscopic transforaminal discectomy (PTED) and transforaminal lumbar interbody fusion (TLIF) in the treatment of high lumbar disc herniation. Methods: The clinical data of patients with high lumbar disc herniation from February 2010 to February 2015 were retrospective analyzed. According to the inclusion criteria, a total of 63 cases were enrolled, including PTED group 33 cases, TLIF group 30 cases. The improvement of the two groups before and after surgery was assessed by visual analogue scale (VAS) and Oswestry dysfunction index (ODI). The operative time, intraoperative blood loss, drainage volume at 48 h postoperatively, hospitalization time, number of fluoroscopy, complication, recurrence rate and postoperative recovery were compared between the two groups. The follow-up period was 12 to 33 months. Results: The operation time, intraoperative blood loss, drainage amount and hospitalization time in PTED group were significantly less than those in TLIF group[(71±19) vs (121±22) min, (30±21) vs (317±50) ml, 0 vs (93±29) ml, (3.5±1.9) vs (12.5±2.1) d]. The number of fluoroscopy in PTED group was significantly higher than TLIF group[(16.2±8.3) vs (6.7±4.2)](all P<0.05). There was no significant difference in VAS score and ODI improvement rate between the two groups after operation (both P>0.05). There was no significant difference between the two groups in the excellent rate of surgery and the recurrence rate (both P>0.05). Conclusions: PTED has the advantages of less trauma and bleeding, rapid postoperative recovery in the treatment of upper lumbar disc herniation compared with TLIF, and the curative effect and recurrence rate are similar with TLIF. Therefore, PTED is an effective method for the treatment of upper lumbar disc herniation.

[Trend of clinical features in patients with acute coronary syndrome undergoing emergent percutaneous coronary intervention]

Objective: To investigate the clinical features and change trend of patients with acute coronary syndrome(ACS) undergoing emergent percutaneous coronary intervention(PCI). Methods: In this retrospective study, we retrieved all medical records of 4 907 ACS patients who underwent emergent PCI in Fuwai hospital from January 1,2010 to December 31,2016. We analyzed the clinical features and change trend in these patients. According to clinical diagnosis, patients were grouped as ST-elevated myocardial infarction(STEMI) group (3 719 cases) and NSTE-ACS group (patients with non-STEMI and unstable angina, 1 188 cases). Results: The ACS patients were aged (59.5±11.8) years old. There were 3 772 males and 1 135 females. The annual number of ACS patients underwent emergent PCI increased from 412 patients in 2010 to 1 067 patients in 2016. The number of NSTE-ACS patients increased from 11.4% (47/412) in 2010 to 26.5% (283/1 067) in 2016. Compared with STEMI group, patients in NSTE-ACS group were significantly older ((61.2±10.9) years old vs. (58.9±12.1) years old,P<0.01).The percent of female patients (30.1% (358/1 188) vs. 20.9% (777/3 719), P < 0.01), history of hypertension (69.1% (821/1 188) vs. 60.4% (2 248/3 719,P <0.01), previous PCI (25.8% (307/1 188) vs. 12.4% (461/3 719), P <0.01), and previous coronary artery bypass grafting (3.0% (36/1 188) vs. 1.0% (37/3 719), P <0.01) were all significantly higher in NSTE-ACS group than in STEMI group. On the other hand, NSTE-ACS patients presented less chronic renal failure (2.9% (35/1 188) vs. 4.3% (173/3 719), P <0.05) and hepatic dysfunction (8.5% (101/1 188) vs. 13.3% (495/3 719), P<0.01) as compared to ACS patients. In coronary angiography, NSTE-ACS patients had a higher prevalence of left-main disease (14.0% (166/1 188) vs. 7.8% (291/3 719), P<0.012 5) and triple vessel disease (47.8% (568/1 188) vs. 43.5% (1 619/3 719), P<0.012 5). There were no differences in prevalence of diabetes mellitus (31.9% (1 187/3 719) vs. 34.8% (414/1 188),P>0.05) and acute renal failure (0.1% (38/3 719) vs. 0.6% (7/1 188),P>0.05) between STEMI group and NSTE-ACS group. Conclusions: This single center retrospective analysis reveals that there is an increasing trend of NSTE-ACS patients from 2010 to 2016. Furthermore, there are more high-risk clinical characteristics in NSTE-ACS patients than in STEMI patients.

Host MyD88 signaling protects against acute graft-versus-host disease after allogeneic bone marrow transplantation

Recent experimental strategies to reduce graft-versus-host disease (GVHD) have focused largely on modifying innate immunity. Toll-like receptor (TLR)-driven myeloid differentiation primary response 88 (MyD88)-dependent signalling pathways that initiate adaptive immune function are also critical for the pathogenesis of GVHD. This study aimed to delineate the role of host MyD88 in the development of acute GVHD following fully major histocompatibility complex-mismatched allogeneic bone marrow transplantation (BMT). When myeloablated BALB/c MyD88 knock-out recipients were transplanted with C57BL/6 (B6) donor cells, they developed significantly more severe GVHD than wild-type (WT) BALB/c hosts. The increased morbidity and mortality in MyD88^-/- mice correlated with increased serum levels of lipopolysaccharide and elevated inflammatory cytokines in GVHD target organs. Additionally, MyD88 deficiency in BMT recipients led to increased donor T cell expansion and more donor CD11c⁺ cell intestinal infiltration with apoptotic cells but reduced proliferation of intestinal epithelial cells compared with that in WT BMT recipients. Decreased expression of tight junction mRNA in epithelial cells of MyD88^-/- mice suggested that MyD88 contributes to intestinal integrity. Cox-2 expression in the GVHD-targeted organs of WT mice is increased upon GVHD induction, but this enhanced expression was obviously inhibited by MyD88 deficiency. The present findings demonstrate an unexpected role for host MyD88 in preventing GVHD after allogeneic BMT.

[Effect of 5F TigerⅠcatheter shaping technique in complex coronary angiography]

Objective: To observe the effect of 5 F Tiger Ⅰ catheter shaping technique in complex coronary angiography. Methods: This study was a single-center, single-blind, randomized, parallel controlled trial and subjects were consecutively enrolled if the first coronary angiography could not be completed by 5 F Tiger Ⅰ catheterization at our department from January 2016 to June 2017 (n=159). The subjects were divided into 2 groups using a random number table method: 79 patients in the control group, and 6 F Judkins and Amplatz catheters were used to perform coronary angiography through the radial artery; 80 patients in the experimental group, and 5 F Tiger Ⅰ shaping technique were used to perform coronary angiography through the radial artery. The reasons of complex coronary angiography were divided into 3 categories: class A referred the abnormal origin of left and right coronary arteries;class B referred left or right coronary artery opening higher or lower than conventional openings or opening downwards and upwards; class C referred the ascending aorta abnormalities (longer, wider, or shorter and thinner). Coronary angiography and operative complications were compared between the 2 groups. Results: X-ray exposure time of coronary angiography ((4.17±1.67) min vs. (4.78±1.51) min, P=0.017), X-ray dose (230 (175, 275) mGy vs. 267 (230, 321) mGy, P<0.001), contrast agent dose ((54.6±8.2) ml vs. (61.8±7.9) ml, P=0.001), operative time (21.6 (18.9, 25.4) min vs. 26.8 (23.4, 31.4) min, P<0.001), and number of catheters used (1.30±0.56 vs. 2.47±0.57, P=0.001) were all less in experimental group than in the control group. There was no significant difference in success rate of the coronary angiography between the experimental group and the control group(97.5% (78/80) vs. 98.7% (78/79), P=0.567). There was no significant difference in the incidence of radial artery spasm (2.5% (2/80) vs. 5.1% (4/79), P=0.396) and coronary artery spasm (1.3% (1/80) vs. 3.8% (3/79), P=0.639). In class A and C subjects, X-ray exposure time, X-ray dose, and operation time were similar between the experimental and control groups (all P>0.05), while the number of catheters used was less in the experimental group than in the control group (P<0.01). In the class C subjects, dose of contrast agent used was significantly lower in the experimental group than in the control group (P=0.001). In theclass B subjects, the X-ray dose, contrast agent dose, operation time, and number of catheters used were all less in the experimental group than in the control group (all P<0.01), and there was no significant difference in X-ray exposure time between the 2 groups (P=0.192). Conclusion: For complex coronary angiography, the imaging success rate and safety of the 5 F Tiger Ⅰshaping catheter is comparable to that of 6 F Judkins and Amplatz catheters.

[Contemporary use of ticagrelor in patients with acute coronary syndrome after discharge]

Objective: To investigate the degree and determinants of using ticagrelor among discharged patients with acute coronary syndrome (ACS). Methods: Patients with ACS in Fuwai hospital who were given ticagrelor after discharge between Jan. 2015 to Jun. 2015 were analyzed.The clinical characteristics and adherence to ticagrelor of these patients were collected by reviewing the electronic medical records and telephone interview.Date were statistically-analyzed. Results: Among all screened 404 patients, 158 (39.1%) patients prematurely stopped ticagrelor within 12 months, while 119(29.5%) patients switched from ticagrelor to clopidogrel.Unavailable locally (34.8%), economic reasons (17.7%) and hemorrhagic events (18.4%) were the main causes of the premature discontinuation of ticagrelor.Univariate analysis showed left main disease (P=0.04) and the frequency of outpatient follow-up (P<0.01) as relative factors for prematurely stopping ticagrelor outside hospital after discharge.Multivariate analysis revealed medical insurance payment (OR 1.79, 95%CI 1.03-3.11) and the frequency of outpatient follow-up (OR 0.61, 95%CI 0.43-0.86) as independent predictors of prematurely stopping ticagrelor outside hospital.Prematurely stopping ticagrelor has no significant effect on the ischemic events (myocardial infaction or stroke) (P=0.76). Conclusion: Social cinditions is the main factor for the persistence to ticagrelor among ACS patients after dischcrge.Medical insurance payment and low frequency of outpatient follow-up were independent predictors of prematurely stopping ticagrelor and it may not have impact on ischemic events.