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A new buddy stingray and stick technique for antegrade dissection and re-entry during chronic total occlusion recanalization: a case report

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Journal of Geriatric Cardiology 2019年第11期16卷 835-839页

作者： Bing TIAN quan-min jing Bin WANG Yan-Bin SU Central Hospital affiliated to Shengyang Medical College ShenyangChina General Hospital of Northern Theater Command ShenyangChina

Although the retrograde approach was a promising strategy for chronic total occlusions(CTO)-percutaneous coronary interventions(PCI),[1]with the development of coronary interventional therapy technology and interventional instruments,antegrade dissection and re-entry(ADR)are commonly employed in PCI to open CTO of coronary arteries.

关键词： Antegrade dissection Chronic total occlusions Percutaneous coronary interventions

Percutaneous recanalization of total saphenous vein graft occlusion with excimer laser treatment

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Journal of Geriatric Cardiology 2020年第4期17卷 234-240页

作者： Yuan HAN quan-min jing Qian-Cheng WANG Yan-Bin SU Guo-Jun CHEN Department of Cardiology State Key Laboratory of Organ Failure ResearchNan Fang HospitalSouthern Medical UniversityGuangzhouChina Department of Cardiology General Hospital of Northern Theater CommandShenyangChina

Patients presenting with recurrence of anginal symptoms after saphenous vein bypass surgery pose an increasingly frequent *** general,approximately 40%to 50%of saphenous vein graft(SVG)will become diseased or occluded within the first ten years after surgery.[1]Because adverse clinical outcomes,such as high restenosis rates and distal embolization,have been reported,percutaneous coronary intervention(PCI)for SVG is not recommended as a first-line strategy.[2]Distal embolization occurs in 2%–17%of patients despite advances in therapy,including the utilization of embolic protection device(EPD),which may lead to increased mortality at both short follow-up and midterm follow-up.[3]However,these patients often associated with inappropriate anatomic characteristics of native vessel intervention including calcification,tortuosity,abundant plaque burden,and complex chronic total occlusion(CTO)***,repeat coronary bypass surgery is an option but is technically more demanding and is associated with a higher ***,it can sometimes result in SVG stenosis being the only intervention *** is why the recanalization of SVG lesions,especially totally occluded lesions,remains one of the most challenging procedures in interventional cardiology.

关键词： Excimer laser Percutaneous coronary intervention Saphenous vein graft

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Chinese Medical Journal 2018年第12期131卷 1420-1429页

作者： Wen-Xia Fu Tie-Nan Zhou Xiao-Zeng Wang Lei Zhang quan-min jing Ya-Ling Han Department of Cardiology The General Hospital of Shenyang Military Region Shenyang Liaoning 110016 China

Background： Females with ST-segment elevation myocardial infarction （STEMI） have higher in-hospital and short-term mortality rates compared with males in China, suggesting that a sex disparity exists. The age of onset of STEM1 is ahead of time and tends to be younger. However, there are relatively little data on the significance of sex on prognosis for long-term outcomes for adult patients with STEMI alter percutaneous coronary intervention （PCI） in China. This study sought to analyze the sex differences in 30-day, l-year, and long-term net adverse clinical events （NACEs） in Chinese adult patients with STEMI after PCI. Methods： This study retrospectively analyzed 1920 consecutive STEMI patients （age 〈60 years） treated with PCI fYom January 01, 2006, to December 31,2012. A propensity score analysis between males and females was perfimned to adjust tbr differences in baseline characteristics and comorbidities. The primary endpoint was the incidence of 3-year NACE. Survival curves were constructed with Kaplan- Meier estimates and compared by log-rank tests between the two groups. Multivariate analysis was perforated using a Cox proportional hazards model for 3-year NACE. Results： Compared with males, females had higher risk profiles associated with old age, longer prehospital delay at the onset of STEMI, hypertension, diabetes mellitus, and chronic kidney disease, and a higher Killip class （≥3）, with more multivessel diseases （P 〈 0.05）. The female group had a higher levels of low-density lipoprotein （2.72 [2.27, 3.29] vs. 2.53 [2,12, 3.00], P 〈（1.001）, high-density lipoprotein （ 1.43 [1.23, 1.71] vs. 1.36 [1.11, 1.63], P - 0.003）, total cholesterol （4.98±1.10 vs. 4.70 ±1.15, t = -3.508, P 〈 0.001）, and estimated glomerular filtration rate （103.12 ± 22.22 vs. 87.55 ±18.03, t = 11.834, P〈 0.001 ） than the male group. In the propensity-matched analysis, being female was associated with a higher risk for 3-year NACE and major adverse cardiac or cerebral events compared w

关键词： Percutaneous Coronary Intervention: Prognosis Sex ST-Segment Elevation Myocardial Infarction

Long-term follow-up study of elderly patients with covered stent implantation after coronary perforation

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Journal of Geriatric Cardiology 2014年第3期11卷 218-221页

作者： Geng WANG Ya-Ling HAN quan-min jing Xiao-Zeng WANG Ying-Yan MA Bin WANG Department of Cardiology Shenyang Northern Hospital Shenyang 110016 Liaoning Province China

ObjectiveTo evaluate the long-term efficacy of covered stent implantation in the treatment of elderly patients with coronary perforation while undergoing percutaneous coronary intervention （PCI）.MethodsFrom June 2004 to June 2012, our center has followed ten elderly patients （age≥ 60 years） who sustained coronary perforation during PCI. The major adverse cardiac events （MACE） were observed as well. The patients were advised to take 75 mg/day Clopidogrel for two years, and indefinite use of 100 mg/day enteric-coated *** out of the 10 patients aged from 60 to 76 years old （mean 68.6 ± 5.2 years） were male, four were female. The average diameter of the implanted stents was 3.3 ± 0.3 mm, and the average length was 22.1 ± 3.7 mm. All the ruptures were successfully sealed without intra-procedural death. The follow-up duration ranged from 0.6 to 67 months （mean 31.7 ± 24.5 months）. One patient died of multiple organ failure due to lung infection in 19 days after PCI; one died of cardiac sudden death in 13 months after PCI; one had angina pectoris in 53 months after PCI; one underwent multi-slice CT examination in six months after PCI, and no in-stent restenosis was found. The other four patients received angiography follow-up, and the results showed that three patients had no intra-stent restenosis, while one had left anterior descending （LAD） restenosis in the covered stent in 67 months after PCI. The in-hospital mortality was 10% （1/10）. The MACE rate in 12 months after PCI was 10% （1/10）. During the entire followed-up period, the restenosis rate in target vessels was 20% （1/5）, mortality was 20% （2/10）, and the MACE rate was 40% （4/10）.ConclusionTreatment of coronary perforation by using covered stents can achieve favorable long-term results; a two-year dual antiplatelet therapy （DAPT） after PCI can effectively prevent intra-stent thrombosis.

关键词： Coronary perforation Percutaneous coronary intervention Covered stent

Efficacy and safety of individually tailored antiplatelet therapy in patients with acute coronary syndrome after coronary stenting： a single center, randomized, feasibility study

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Journal of Geriatric Cardiology 2015年第1期12卷 23-29页

作者： Hong-Chang ZHU Yi LI Shao-Yi GUAN jing LI Xiao-Zeng WANG quan-min jing Zu-Lu WANG Ya-Ling HAN Second Affiliated Hospital of Dalian Medical University Dalianl 16023 Shandong Province China Cardiovascular Institute General Hospital of Shenyang Military Region Shenyang 110016 Liaoning Province China

Background Low responsiveness to clopidogrel （LRC） is associated with increased risk of ischemic events. This study was aimed to explore the feasibility of tailored antiplatelet therapy according to the responsiveness to clopidogrel. Methods A total of 305 clopidogrel naive patients with acute coronary syndromes （ACS） undergoing coronary stenting were randomly assigned to receive standard （n = 151） or tailored （n = 154） antiplatelet therapy. The ADP-induced platelet aggregation tests by light transmission aggregometry were performed to identify LRC patients assigned to the tailored group. The standard antiplatelet regimen was dual antiplatelet therapy with aspirin and clopidogrel. The tailored antiplatelet therapy was standard regimen for non-LRC patients and an additional 6-month cilostazol treatment for LRC patients. The primary efficacy outcome was the composite of cardiovascular death, myocardial infarction or stroke at one year. Results LCR was present in 26.6% （41/154） of patients in the tailored group. The percentage platelet aggregation for LCR patients was significantly decreased at three days after adjunctive cilostazol treatment （77.5% ± 12.1% vs. 64.5% ± 12.1%, P 〈 0.001）. At one year follow-up, a non-significant 37% relative risk reduction of primary events were observed in the tailored group as compared to the standard group （5.8% vs. 9.3%, P = 0.257）. There were no differences in the rates of stent thrombosis and hemorrhagic events between the two groups. Conclusions Tailored antiplatelet therapy for ACS patients after coronary stenting according to responsiveness to clopidogrel is feasible. However, its efficacy and safety need further confirmation by clinical trials with larger sample sizes.

关键词： Acute coronary syndrome Antiplatelet therapy Clopidogrel Coronary stenting

Correlation between Sex and Prognosis of Acute Aortic Dissection in the Chinese Population

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Chinese Medical Journal 2018年第12期131卷 1430-1435页

作者： Yan-Jie Liu Xiao-Zeng Wang Ya Wang Rui-Xia He Lin Yang quan-min jing Hai-Wei Liu Department of Cardiology Institute of Cardiovascular Research General Hospital of Shenyang Military Region Shenyang Liaoning 110016 China

Background： The prevalence, presentation, management, and prognosis of coronary heart disease differ according to sex. Greater understanding on the differences between men and women with acute aortic dissection （AAD） is needed. We aimed to investigate whether sex disparities are found in patients with AAD, and to study sex differences in complications, mortality in-hospital, and tong-term. Methods： We included 884 patients enrolled in our institute between June 2002 and May 2016. Considering psychosocial factors, treatments, and the outcomes in men versus those in women with AAD, we explored the association of sex with psychosocial characteristics and mortality risk. For categorical variables, significant differences between groups were assessed with the Chi-square test or Fisher＇s exact test, and continuous parameters were assessed with Student＇s t-test. Univariate and stratified survival statistics were computed using Kaplan-Meier analysis. Results： A total of 884 patients （76.1% male, mean age 51.4 ± 11.8 years） were inchidcd in this study. There were fewer current smokers in female compared with male （ 17.5% vs. 67.2%,χ^2= 160.06, P〈 0.05）. The percentage of men who reported regular alcohol consumption was significantly higher than that in women （40.6% vs. 3.8%, χ^2== 100.18, P 〈 0.05）. About 6.2% （55 of 884） of patients with AAD died before vascular or endovascular surgery was performed, 34.4% （304 of 884） of patients underwent surgical procedures, and 52.7% （466 of 884） and 12.8% （113 of 884） of patients received endovascular treatment and medication, Postoperative mortality similar （6.0% vs. 5.6%, respectively, χ^2= 0.03, P = 0.91） between men and women. Follow-up was completed in 653 of 829 patients （78.8%）. Adjustment for age, history of coronary disease, hypertension, smoking and drinking, Type A and use of beta-blocker, angiotensin II receptor blockers, angiotensin converting enzyme （ACE） inhibitor, calcium-channel blockers and statins by multivariate log

关键词： Aortic Dissection: Prognosis Sex

Predictors of contrast-induced acute kidney injury in patients with coronary artery disease receiving contrast agents twice within 30 days

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Military Medical Research 2020年第3期7卷 350-358页

作者： Chong-Huai Gu Xiao-Zeng Wang Ya-Ling Han quan-min jing Li-Li Ren Yan Zhang Jun-Yin Peng Xin Zhao Cardiovascular Research Institute and Department of Cardiology General Hospital of Shenyang Military RegionShenyang 110840China Department of Cardiovascular Anqing Municipal HospitalAnqing 246000AnhuiChina

Background:None of study mentioned about contrast-induced acute kidney injury(CI-AKI)in people who have received contrast agents twice within in a short period of *** study is trying to identify the ***:We enrolled 607 patients between Oct.2010 and Jul.2015 who received contrast agents twice within 30 days in the Department of Cardiology of the General Hospital of Shenyang Military *** primary outcome was CI-AKI within 72 h after contrast agent *** were divided into groups A(n=559)and group B(n=48)according to whether CI-AKI occurred after the second ***:Patients in group B(CI-AKI occurred after the second agent)had a more rapid heart rate and more usage of diuretics and *** group B,CI-AKI occurred more frequently after the first *** logistic regression showed that diuretic(P=0.006)and intra-aortic balloon pump(IABP)usage(P=0.012)were independent predictors of CI-AKI after the first ***-converting enzyme inhibitor/AngiotensinⅡreceptor antagonist(ACEI/ARB)usage(P=0.039),IABP usage(P=0.040)and CI-AKI occurring after administration of the first agent(P=0.015)were independent predictors of CI-AKI after the ***,dividing the patients into tertiles of the time interval between the two agents showed that CI-AKI occurred more frequently when the second agent was administered within 1–3 days after the first exposure than within 4–6 days(12.4%vs.5.0%,P=0.008)or≥7 days(12.4%vs.6.4%,P=0.039).Conclusions:Diuretic and IABP usage are independent predictors of CI-AKI following exposure to a first contrast *** major predictors of CI-AKI after exposure to a second agent are time since the first contrast exposure,ACEI/ARB usage,and IABP *** importantly,a three-day interval between the two agents is associated with a higher incidence of CI-AKI following the second administration.

关键词： Predictors Contrast-induced acute kidney injury Coronary artery disease

Value of a new post-procedural intravascular ultrasound score in predicting target vessel revascularization after coronary drug-eluting stents implantation

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第8期13卷 624-630页

作者： Kai XU Ya-ling HAN quan-min jing Shou-li WANG Ying-yan MA Xiao-zeng WANG Geng WANG Zu-lu WANG Department of Cardiology Shenyang Northern HospitalShenyang 110016China

Objective:There is no simple or feasible post-procedural intravascular ultrasound (IVUS) score to predict major adverse cardiac events (MACE) in patients undergoing drug-eluting stents (DES) implantation. The aim of this study is to validate a new IVUS score for predicting MACE. Methods:A total of 295 patients (with 322 lesions) were enrolled. IVUS score was calculated in each lesion based on five IVUS morphological characteristics:inflow/outflow disease, malapposition, underexpansion, tissue protrusion, and edge dissection (iMUTE score). We assigned two points to an underexpansion and one point for each presence of other factors. Patients were divided into low score (iMUTE score<2, n=137) and high score (iMUTE score≥2, n=158) groups. Results:At one year follow-up, a trend was seen in favor of the low iMUTE score group in MACE (3.65% vs. 10.10%; P=0.052), and there was more target vessel revascularization (TVR) in the high iMUTE score group compared with low score group (6.96% vs. 1.46%; P=0.044). Low iMUTE score was an independent predictor of freedom from TVR at one year (adjusted hazard ratio (HR) 0.5, 95% confidence interval (CI) 0.1-0.8; P=0.02). Conclusions:Post-procedural IVUS iMUTE scoring was simple and feasible in clinical practice, and can provide independent prognostic value for TVR in patients undergoing DES implantation.

关键词： Intravascular ultrasound Drug eluting stents Scoring schemes percutaneous coronary intervention

Aerial refueling scheduling of multi-receiver and multi-tanker under spatial-temporal constraints for forest firefighting

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Chinese Journal of Aeronautics 2024年第5期37卷 71-91,I0001页

作者： jing HUANG Jiaqi XING Jinrui REN quan quan Youmin ZHANG Department of Information and Control Engineering Xi’an University of TechnologyXi’an 710048China Jiujiang Measuring Test Technology Research Institute Jiujiang 332000China School of Automation Science and Electrical Engineering Beihang UniversityBeijing 100191China School of Automation Xi’an University of Posts&TelecommunicationsShaanxiXi’an 710121China Department of Mechanical Industrial and Aerospace EngineeringConcordia UniversityMontreal H3G 1M8Canada

Forest fires pose a significant threat to human life and property,so the utilization of unmanned aircraft systems provides new ways for forest *** the constrained load capacities of these aircraft,aerial refueling becomes crucial to extend their operational time and *** order to address the complexities of firefighting missions involving multi-receiver and multi-tanker deployed from various airports,first,a fuel consumption calculation model for aerial refueling scheduling is established based on the receiver ***,two distinct methods,including an integrated one and a decomposed one,are designed to address the challenges of establishing refueling airspace and allocating tasks for *** methods aim to optimize total fuel consumption of the receivers and tankers within the aerial refueling scheduling *** optimization problem is established as nonlinear optimization models along with *** integrated method seamlessly combines refueling rendezvous point scheduling and tanker task allocation into unified *** has a complete solution space and excels in optimizing total fuel *** decomposed method,through the separation of rendezvous point scheduling and task allocation,achieves a reduced computational ***,this comes at the cost of sacrificing optimality by excluding specific feasible ***,numerical simulations are carried out to verify the feasibility and effectiveness of the proposed *** simulations yield insights crucial for the practical engineering application of both the integrated and decomposed methods in real-world *** comprehensive approach aims to enhance the efficiency of forest firefighting operations,mitigating the risks posed by forest fires to human life and property.

关键词： Aerial refueling Scheduling Planning Spatial-temporal constraint Firefighting