Background We developed a new combined strategy of thrombus aspiration plus intra-infarct-related artery （IRA） bolus administration of tirofiban via the aspiration catheter in patients with ST-segment elevation myoc...Background We developed a new combined strategy of thrombus aspiration plus intra-infarct-related artery （IRA） bolus administration of tirofiban via the aspiration catheter in patients with ST-segment elevation myocardial infarction （STEMI）. This strategy can reduce the distal embolism and achieve highly localized concentrations of tirofiban, which can improve myocardial reperfusion without increasing the risk of bleeding. The aim of this study was to investigate whether this combined strategy is superior to thrombus aspiration alone in improving myocardial perfusion in patients with STEMI undergoing primary angioplasty.Results Baseline characteristics of the two groups were well-balanced. The TIMI 3 flow showed a better tendency in the intra-IRA group than in the aspiration alone group （97.22% vs. 87.04%, X2=7.863, P=0.049）. The peak of CK-MB （83.9 （68.9-310.5） U/L vs. 126.1 （74.7-356.7） U/L, P=0.034） and Tnl （42.7 （14.7-113.9） ng/ml vs. 72.5 （59.8-135.3） ng/ml, FMD.029） were lower in the intra-IRA group than in the aspiration alone group. LVEF in the hospital favored the intra-IRA group, （45.7±8.3）% to （42.9±12.1）%, t=1.98, P=0.049. There was a tendency towards a lower MACE at 9-month follow-up in the intra-IRA group although it did not reach statistical difference （Log-rank X2=2.865, P=0.09）. There was no statistical difference in any bleeding events between the two groups.Conclusions Thrombus aspiration plus intra-IRA bolus administration of tirofiban combined with angioplasty may be related with improved myocardium perfusion, saved more myocardium, and resulted in a better clinical prognosis.展开更多
AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritone...AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC i展开更多
Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.M...Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...展开更多
文摘Background We developed a new combined strategy of thrombus aspiration plus intra-infarct-related artery （IRA） bolus administration of tirofiban via the aspiration catheter in patients with ST-segment elevation myocardial infarction （STEMI）. This strategy can reduce the distal embolism and achieve highly localized concentrations of tirofiban, which can improve myocardial reperfusion without increasing the risk of bleeding. The aim of this study was to investigate whether this combined strategy is superior to thrombus aspiration alone in improving myocardial perfusion in patients with STEMI undergoing primary angioplasty.Results Baseline characteristics of the two groups were well-balanced. The TIMI 3 flow showed a better tendency in the intra-IRA group than in the aspiration alone group （97.22% vs. 87.04%, X2=7.863, P=0.049）. The peak of CK-MB （83.9 （68.9-310.5） U/L vs. 126.1 （74.7-356.7） U/L, P=0.034） and Tnl （42.7 （14.7-113.9） ng/ml vs. 72.5 （59.8-135.3） ng/ml, FMD.029） were lower in the intra-IRA group than in the aspiration alone group. LVEF in the hospital favored the intra-IRA group, （45.7±8.3）% to （42.9±12.1）%, t=1.98, P=0.049. There was a tendency towards a lower MACE at 9-month follow-up in the intra-IRA group although it did not reach statistical difference （Log-rank X2=2.865, P=0.09）. There was no statistical difference in any bleeding events between the two groups.Conclusions Thrombus aspiration plus intra-IRA bolus administration of tirofiban combined with angioplasty may be related with improved myocardium perfusion, saved more myocardium, and resulted in a better clinical prognosis.
基金Supported by Funds for Breakthroughs in Key Areas of Guang-dong and Hong Kong Projects, No. 2006Z1-E6041funds for Guangdong Provincial Science and Technology Programs, No. 2009A030301013
文摘AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC i
基金Supported by the National Key Technologies Research and Development Program of China during the 10th Five-Year Plan Period(No.2003BA712A11)
文摘Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...
