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Outcomes of catheter-directed thrombolysis versus systemic thrombolysis in the treatment of pulmonary embolism: a metaanalysis

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Journal of Geriatric Cardiology 2023年第6期20卷 459-468页

作者： Huang-Tai MIAO Ying LIANG Xiao-Ying LI Xiao WANG Hui-Juan ZUO Zhe-Chun ZENG shao-ping nie Center for Coronary Artery Disease Beijing Anzhen HospitalCapital Medical UniversistyBeijingChina Emergency&Critical Care Center Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Health Care for Cadres Beijing Jishuitan HospitalBeijingChina Department of Clinical&Community Cardiovascular Disease Prevention Beijing Institute of Heart Lung and Blood Vessel DiseaseBeijing Anzhen HospitalCapital Medical UniversityBeijingChina

OBJECTIVE To evaluate the safety and efficacy of catheter-directed thrombolysis(CDT)versus systemic thrombolysis(ST)in the treatment of pulmonary embolism(PE).METHODS The Cochrane Library,PubMed,and Embase databases were searched to collect the literature on the comparison of the results of CDT and ST in the treatment of PE from the beginning of their records to May 2020,and meta-analysis was performed by STATA software(version 15.1).Using standardized data-collection forms,the authors screened the studies and independently extracted data,and assessed the quality of the studies using the Newcastle-Ottawa Scale for cohort *** studies that examined the following results were included in the current study:in-hospital mortality,all-cause bleeding rate,gastrointestinal bleeding rate,intracranial hemorrhage rate,the incidence of shock,and hospital length of *** A total of eight articles,with 13,242 participants,involving 3962 participants in the CDT group and 9280 participants in the ST group were *** compared with ST in the treatment of PE can significantly affect in-hospital mortality rate[odds ratio(OR)=0.41,95%CI:0.30–0.56,P<0.05],all-cause bleeding rate(OR=1.20,95%CI:1.04–1.39,P=0.012),gastrointestinal bleeding rate(OR=1.43,95%CI:1.13–1.81,P=0.003),the incidence of shock(OR=0.46,95%CI:0.37–0.57,P<0.05),and hospital length of stay[standard mean difference(SMD)=0.16,95%CI:0.07–0.25,P<0.05].However,there was no significant effect on intracranial hemorrhage rate in patients with PE(OR=0.70,95%CI:0.47–1.03,P=0.070).CONCLUSIONS CDT is a viable alternative to ST in the treatment of PE,as it can significantly reduce in-hospital mortality rate,all-cause bleeding rate,gastrointestinal bleeding rate,and incidence of ***,CDT may prolong hospital length of stay to a certain *** research is needed to evaluate the safety and efficacy of CDT and ST in the treatment of acute PE and other clinical outcomes.

关键词： thrombolysis mortality treatment

Efficacy of Intra-aortic Balloon Pump before versus after Primary Percutaneous Coronary Intervention in Patients with Cardiogenic Shock from ST-elevation Myocardial Infarction

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Chinese Medical Journal 2016年第12期129卷 1400-1405页

作者： Lin Yuan shao-ping nie 1Emergency Critical Care Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China Emergency Critical Care Center Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

Background： Previous studies showed that patients with cardiogenic shock （CS） from ST-elevation acute myocardial infarction （STEMI） supported by intra-aortic balloon pump （IABP） before primary percutaneous coronary intervention （PCI） decreased the risk of in-hospital mortality than patients who received IABP after PCI. However, little evidence is available on the optimal order of IABP insertion and primary PCI. The aim of this study was to investigate the impact of the sequence of IABP support and PC1 and its association with major adverse cardiac and cerebrovascular events （MACCEs）. Methods： Data were obtained from 218 consecutive patients with CS due to STEMI in Beijing Anzhen Hospital between 2008 and 2014% who were treated with 1ABP and PCI. The patients were divided into two groups： Group A in whom IABP received before PCI （n = 106） and Group B in whom IABP received after PCI （n = 112）. We evaluated the myocardial perfusion using myocardial blush grade and resolution of ST-segment elevation. The primary endpoint was 12-month risk of MACCE. Results： Most baseline characteristics were similar in patients between the two groups. However, patients received 1ABP before PCI were associated with a delay of door-to-balloon time （DBT） and higher troponin I level （P 〈 0.05）. However, myocardial perfusion was significantly improved in patients treated with IABP before PCI （P 〈 0.05）. Overall, IABP support before PCI was not associated with significantly lower risk of MACCE （P 〉 0.05）. In addition, risk of all-cause mortality, bleeding, and acute kidney injury （AKI） was similar between two groups （P 〉 0.05）. Multivariate analysis showed that DBT （odds ratio [OR] 2.5, 95% confidence interval [C/] 1.1-4.8, P=0.04）, lABP support after PCI （OR 5.7, 95% Cl 2.7-8.4, p〈0.01）, and AKI （OR 7.4, 95% CI 4.9 10.8, P- 0.01） were the independent predictors of mortality at 12-month follow-up. Conclusions： Early IABP insertion before primary PCI is associated with improved myocardial perf

关键词： Acute Myocardial Infarction Cardiogenic Shock Intra-aortic Balloon Counterpulsation Mortality PercutaneousCoronary Intervention

Protocol for the FACE study:frailty and comorbidity in elderly patients—a multicenter,Chinese observational cohort study

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Journal of Geriatric Cardiology 2023年第1期20卷 83-90页

作者： Wen ZHENG Xin HUANG Min SUO Xiao WANG Xue-Dong ZHAO Wei GONG Yan YAN Xiao-Na WANG Li SHENG shao-ping nie Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Cardiology Beijing Shijitan HospitalCapital Medical UniversityBeijingChina Department of Geriatric Cardiology National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina

The present protocol describes an observational cohort study that was designed to propose a therapeutic scheme and formulate an individualized treatment strategy for frail elderly patients diagnosed with multiple diseases in a Chinese,multicenter *** a 3-year period,we will recruit 30,000 patients from 10 hospitals and collect baseline data including patient demographic information,comorbidity characteristic,FRAIL scale,age-adjusted Charlson comorbidity index(aCCI),relevant blood tests,the results of imaging examination,prescription of drugs,length of hospital stay,number of overall re-hospitalizations and *** patients(≥65 years old)with multimorbidity and receiving hospital care are eligible for this *** collection is being performed at baseline and 3,6,9 and 12 months after *** primary analysis was all-cause death,readmission rate and clinical events(including emergency visits,stroke,heart failure,myocardial infarction,tumor,acute chronic obstructive pulmonary disease,etc).The study is approved by the National Key R&D Program of China(2020YFC2004800).Data will be disseminated in manuscripts submitted to medical journals and in abstracts submitted to international geriatric *** Trial Registration:[***],identifier[ChiCTR2200056070].

关键词： patients morbidity prescription

Effect of complete revascularization in acute coronary syndrome after 75 years old:insights from the BleeMACS registry

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Journal of Geriatric Cardiology 2023年第10期20卷 728-736页

作者： Ge WANG Xiu-Huan CHEN Si-Yi LI Ze-Kun ZHANG Wei GONG Yan YAN shao-ping nie JoséP.Henriques on behalf of the BleeMACS registry investigators Center for Coronary Artery Disease Beijing Anzhen HospitalCapital Medical UniversityBeijingChina Department of Cardiology Amsterdam University Medical CenterAmsterdamthe Netherlands 不详

BACKGROUND The prognostic benefit of complete revascularization in elderly patients(aged over 75 years)with multi-vessel disease and acute coronary syndrome(ACS)is currently *** study aimed to determine the long-term prognostic impact of complete revascularization in this *** We conducted this study using data obtained from the BleeMACS(Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome)registry,which was carried out from 2003 to *** objective was to categorize older patients diagnosed with ACS into two groups:those who underwent complete revascularization and those who did *** score matching and the Kaplan-Meier analysis were employed to examine differences in one-year clinical *** primary endpoint was major adverse cardiovascular event(MACE),which encompassed a combination of all-cause mortality and myocardial *** Out of 1263 patients evaluated,445 patients(35.2%)received complete *** who underwent complete revascularization had a higher prevalence of hypertension and prior percutaneous coronary intervention compared to those who did *** the one-year follow-up period,complete revascularization was associated with a significantly decreased risk of MACE[13.7%vs.20.5%,hazard ratio(HR)=0.63,95%CI:0.45–0.88,P=0.007]and a lower risk of myocardial infarction(5.9%vs.9.9%,HR=0.55,95%CI:0.33–0.92,P=0.02).However,it was not linked to a lower risk of all-cause death(9.5%vs.13.5%,HR=0.68,95%CI:0.45–1.02,P=0.06).Similar results were observed in the subgroup *** Long-term clinical improvements were observed in ACS patients aged over 75 years with multi-vessel disease who achieved complete ***,adhering to guidelines for complete revascularization should be recommended for elderly patients.

关键词： coronary revascularization acute

Mild haemoglobin drop and clinical outcomes in acute coronary syndrome patients:finding from the BleeMACS registry

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Journal of Geriatric Cardiology 2022年第12期19卷 981-989,1016页

作者： Ze-Kun ZHANG Yan YAN Si-Yi LI Sergio Raposeiras-Roubín Emad Abu-Assi JoséPHenriques Fabrizio D’Ascenzo Jorge Saucedo Wei GONG shao-ping nie on behalf of the BleeMACS registry investigators Center for Coronary Artery Disease Division of CardiologyBeijing Anzhen HospitalCapital Medical UniversityBeijingChina National Clinical Research Center for Cardiovascular Diseases BeijingChina Beijing Institute of Heart Lungand Blood Vessel DiseasesBeijingChina Department of Cardiology Álvaro Cunqueiro University HospitalVigoSpain Department of Cardiology Amsterdam University Medical CenterAmsterdamthe Netherlands Division of Cardiology Department of Medical ScienceUniversity of TurinTurinItaly Division of Cardiovascular Medicine Medical College of WisconsinWisconsinUSA 不详

BACKGROUND Haemoglobin drop is common in acute coronary syndrome(ACS)patients and correlates with poor ***,the association between mild haemoglobin drop and adverse clinical outcome remains insufficiently *** study aimed to examine the association between in-hospital haemoglobin drop and risk for adverse clinical outcomes in ACS patients,especially those with mild *** Included patients from the BleeMACS(Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome)registry were categorized into three groups by the presence and amount of in-hospital haemoglobin drop(non-drop,mild drop and severe drop).The cut-off point between mild drop and severe drop is≥3 g/*** Cox regression was used to assess the association between haemoglobin drop and major adverse cardiac endpoints(MACE).Patients taking potent P2Y_(12) inhibitors were selected for the additional *** score matching was used to avoid selective bias in the additional *** Of 6911 patients,4949 patients(71.6%)experienced in-hospital haemoglobin *** with non-drop group,patients with haemoglobin drop had higher risk of MACE[adjusted hazard ratio(HR)=1.36,95%CI:1.03–1.80 for mild drop group;adjusted HR=1.70,95%CI:1.07–2.68 for severe drop group].Patients in mild drop group were less likely to receive potent P2Y_(12) inhibitors at discharge(mild drop group *** drop group ***-drop group:10.9%vs.10.7%vs.23.8%).After propensity score matching adjustment among patients with potent P2Y_(12) inhibitors,patients in mild drop group were not associated with an increased risk of MACE than those in non-drop group(adjusted HR=1.52,95%CI:0.49–4.72).CONCLUSIONS In-hospital haemoglobin drop was common in ACS patients and associated with a higher risk for adverse *** prescription for potent P2Y_(12) inhibitors may be responsible for poor prognoses among patients with mild haemoglobin dro

关键词： patients clinical coronary

Immediate bail-out TAP-stenting for the treatment of iatrogenic aortocoronary dissection involving left main bifurcation

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Journal of Geriatric Cardiology 2013年第2期10卷 202-204页

作者： Edmundo Patricio Lopes Lao shao-ping nie Chang-Sheng Ma Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Iatrogenic aortocoronary dissection is a rare but potentially disastrous complication of percutaneous coronary intervention. The left main dissection extending into distal bifurcation involving both the left anterior descending and left circumflex is a complex and vital complication, which is classified as Eshtehardi Type II dissection. We presented a case of iatrogenic left main coronary artery dissection with upcoming closure of both major branches, which was successfully managed by immediate bail-out TAP-stenting. The 77-year-old patient was discharged without any complication, and 1-year follow-up indicated stent patency and favorable clinical result. Immediate bail-out stenting is a feasible and reasonable initial management for this lethal complication.

关键词： Aorta Bail-out stenting Coronary artery Dissection Percutaneous coronary intervention

Advancements in S-scheme heterojunction materials for photocatalytic environmental remediation

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Journal of Materials Science & Technology 2024年第2期169卷 182-198页

作者： Changliang nie Xiaohan Wang ping Lu Yukun Zhu Xin Li Hua Tang School of Environmental Science and Engineering State Key Laboratory of Bio-fibers and Eco-textilesQingdao UniversityQingdao266071China Institute of Biomass Engineering Key Laboratory of Energy Plants Resource and UtilizationMinistry of Agriculture and Rural AffairsSouth China Agricultural UniversityGuangzhou510642China School of Environmental Science and Engineering Shandong UniversityQingdao266237China

Recently,S-scheme heterojunctions have gained considerable attention in the field of photocatalytic environmental remediation as their potential to achieve efficient spatial charge separation coupled with strong redox ***,this review provides an overview of the current state-of-the-art in the development of S-scheme-based photocatalysts for the purification of environmental *** review first covers the fundamentals of heterogeneous photocatalysis for environmental ***,an introduction to the background,mechanism,design principles,and characterization techniques of S-scheme heterojunctions is ***,the review presents a comparison and summary of using various S-scheme photocatalysts for the removal of several target pollutants,such as bacteria,heavy metals,nitrogen oxides,antibiotics,and ***,the modification strategies of S-scheme heterojunction photocatalysts are also ***,a brief discussion of the challenges and prospects associated with S-scheme photocatalytic systems is demonstrated.

关键词： S-scheme heterojunctions Photocatalyst Pollutant Environmental remediation

Integrated interconnected porous and lamellar structures realized fast ion/electron conductivity in high-performance lithium-sulfur batteries

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Chinese Chemical Letters 2024年第6期35卷 161-167页

作者： Ya Song Mingxia Zhou Zhu Chen Huali nie Jiao-Jing shao Guangmin Zhou School of Materials and Metallurgy Guizhou UniversityGuiyang 550025China Medical College of Guizhou University Guiyang 550025China College of Biological Science and Medical Engineering Donghua UniversityShanghai 201620China Shenzhen Geim Graphene Center Tsinghua Shenzhen International Graduate SchoolTsinghua UniversityShenzhen 518055China

The practical application of high-energy-density lithium-sulfur(Li-S)batteries have been highly praised for energy storage devices,while are largely hindered by the“shuttling effect”.Herein,core-shell carbon spheres composed of interlinked porous core and lamellar shell were designed to restrain the polysulfide *** microporous structure with pore size of around 1 nm effectively trap lithium ***,the interconnected porous core shortens the ion transfer distance and the lamellar carbon shell endows the carbon spheres with fast electron conduction,finally facilitating polysulfide conversion ***,the Li-S batteries with the carbon spheres as the interlayer show high discharge specific capacity of 1002 m Ah/g at 2 C with 574 m Ah/g remaining after 600 cycles,and high areal capacity of 5.48 m Ah/cm^(2) with sulfur loading of 4.67 mg/cm^(2) at 0.1 *** corresponding pouch cells also exhibit stable cycling stability with an initial discharge specific capacity of 1082 m Ah/g at 0.1 C.

关键词： Interlayer Shuttle effect Strong adsorption Porous carbon spheres Lithium-sulfur batteries

Acute- and Long-term Outcomes of Rotational Atherectomy followed by Cutting Balloon versus Plain Balloon before Drug-Eluting Stent Implantation for Calcified Coronary Lesions

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Chinese Medical Journal 2018年第17期131卷 2025-2031页

作者： Hui Ai Xiao Wang Min Suo Jing-Chen Liu Cheng-Gang Wang Lei Zhen shao-ping nie Emergency and Critical Care Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

Background： Coronary calcification is a major determinant ofstent underexpansion and subsequent adverse events. This study aimed to evaluate the acute- and long-term outcomes of rotational atherectomy （RA） followed by cutting balloon （CB） versus plain balloon before drug-eluting stent implantation for calcified coronary lesions. Methods： From June April 2013 to March 2016, a total of 127 patients with moderately or severely calcified coronary lesions were treated with RA. Patients were divided into two groups according to the balloon type after RA： RA＋CB group （n = 75） and RA＋plain balloon group （n = 52）. Minimal lumen diameter and acute lumen gain were analyzed by quantitative coronary angiography. In-hospital and long-term （〉1 year） outcomes were recorded. Multivariate Cox regression analysis was performed to determine the independent predictors of in-stent ***： The mean age of the patients was 65.5 years, and 76.4% were men. Total lesion length and minimal lumen diameter at baseline were similar in the two groups. After RA and balloon dilation, the lumen diameter was significantly larger in the RA＋CB group than in the RA＋plain balloon group （1.57 ±0.46 mm vs. 1.10 ± 0.40 mm, t = 4.123, P 〈 0.001）. The final lumen diameter was also larger in the RA＋CB group compared to that in the RA group （2.81± 0.41 mm vs. 2.60± 0.25 ram, t = 2.111, P = 0.039）. Moreover, patients receiving RA and CB tended to have larger final lumen gain （2.15 - 0.48 mm vs. 1.95 ± 0.47 mm, t = 1.542, P = 0.132）. Multivariate Cox regression analysis indicated that the strategy of RA＋CB was a significant protective factor against long-term （〉1 year） in-stent restenosis （hazard ratio： 0.136, 95% confidence interval： 0.020-0.936, P = 0.043）. Conclusions： In patients with moderately or severely calcified lesions, a strategy of RA followed by CB before stent implantation can increase lumen diameter and acute lumen gain. This strategy is safe with lower risk of long-term in-stent resteno

关键词： Calcification Cutting Balloon Rotational Atherectomy