Feasibility and clinical benefits of the double-ProGlide technique for hemostasis after cryoballoon atrial fibrillation ablation with uninterrupted oral anticoagulants

OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants(OAC),and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study.METHODS Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing,China from May 2019 to May 2021 were enrolled in this study.From October 2020,double-ProGlide technique was consistently used for hemostasis(ProGlide group),and before that conventional manual compression was utilized(manual compression group).The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up.RESULTS A total of 140 participants(69.30%of male,mean age:59.21±10.29 years)were evaluated,70 participants being in each group.Immediate hemostasis was achieved in all the patients with ProGlide closure.No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group.The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices(15.71%vs.2.86%,P=0.009).In addition,compared with the manual compression group,the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory[112.0(93.3–128.8)min vs.123.5(107.3–158.3)min,P=0.006],time from sheath removal until venous site hemostasis[3.8(3.4–4.2)min vs.8.0(7.6–8.5)min,P<0.001],bed rest time[8.0(7.6–8.0)h vs.14.1(12.0–17.6)h,P<0.001]and hospital stay after the procedure[13.8(12.5–17.8)h vs.38.0(21.5–41.0)h,P<0.001].CONCLUSIONS Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe,which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure.

Using shape-memory alloy staples to treat comminuted manubrium sterni fractures: A case report

BACKGROUND Comminuted manubrium sterni fractures are rare,and internal fixation methods are limited.This report explored a practical and feasible method of internal fixation for comminuted manubrium sterni fractures.CASE SUMMARY A 17-year-old female was injured in a car accident for which she underwent debridement and suturing of her head and anterior chest wounds in another hospital.Eight days later,the patient was transferred to our hospital for surgical treatment.The manubrium sterni was found intraoperatively to be split into three irregular fragments with obvious overlap and separation displacement.Meanwhile,a manubriosternal joint dislocation and left first rib cartilage fracture were observed.The retraction force of the shape-memory alloy staples was used to pull the fracture fragments together.Two more titanium locking plates were then used to fix the manubrium sterni and corpus sterni longitudinally,and the left first rib cartilage fracture was repositioned and fixed with a titanium locking plate.A postoperative computed tomography scan showed reduced and rigid fixation of the comminuted manubrium sterni fractures.The patient recovered well with no significant complaints of discomfort.The patient was discharged 10 days postoperatively after the stitches had been removed.CONCLUSION Shape-memory alloy staples had the advantage of being safe and effective during the repositioning and internal fixation of comminuted manubrium sterni fractures.Therefore,they provided a new surgical option for comminuted manubrium sterni fractures.

Obstructive sleep apnea is associated with severity and long-term prognosis of acute coronary syndrome

BackgroundObstructive 睡觉呼吸暂停(OSA ) 是在有急性冠的症候群(交流) 的病人的普通疾病并且与致命、非致命的心血管的事件的增加的风险联系。然而，在以前的学习的大多数病人与赤裸的金属 stents 被对待，样品尺寸是相对低的。学习是在病人的严厉和预后上评估 OSA 的影响的这的目标为 ACS.MethodsIn 承认了这未来的队研究，我们与交流注册了病人为冠的 angiogram/percutaneous 被就医冠的干预和经历的 polysomnography。我们把病人划分了成二个组：对严重 OSA 组中等[呼吸暂停呼吸过慢过浅索引(AHI )> 15 events/h ] 并且控制组(AHI 15 events/h ) 。他们被跟随在上面为在 32 个月上面。然后，我们在病人把 ACS 严厉和长期的主要不利心血管的事件(向) 与 OSA.ResultsFive 的不同严厉作比较百和 29 个病人总之被包括，与他们中的 76% 个一起是人和一般水准 59

Comparison of very-high-frequency ultrasound assessment of radial arterial wall layers after first and repeated transradial coronary procedures

Transradial 冠的过程(TRP ) 使光线的动脉(RA ) 受伤，特别导致动脉的墙形态学的变化。这研究探索了创伤的效果的早发作的意义围用很高周波的 ultrabiomicroscopy ( VHFUBM )跟随第一 TRP ( FTRP )和重复 TRP ( RTRP )的 RA 的层收到了 TRP 的 1431 个病人全部的 .MethodsA 被划分成包括了 781 个病人的 FTRP 组并且包括了取决于过程的数字的 650 个病人的 RTRP 组。二维的 RA 图象以前并且有天被 30-55 MHz 超声一天在 procedure.ResultsAfter TRP，内层的眼泪的发生，中间的解剖和外部有弹性的薄板骨折以后获得在 RTRP 是更大的(P < 0.001 ) 。 RTRP 组显示出显著地更厚的内层的厚度(信息技术)，媒介厚度( MT )，外膜厚度和所有复杂的层厚度作为与 FTRP 相比组织( P < 0.001 )线性回归分析发现了的 .ConclusionsMultivariate 那重复 TRP 和另外的观察是在手术后的 RA 的增加的信息技术的独立预言者。VHFUBM 提供一条途径在显示出增加的损伤到 RA 后面的 RTRP 的 RA 的墙层学习结构、组织病理学说的损害。

Effects and mechanisms of glucose-insulin-potassium on post-procedural myocardial injury after percutaneous coronary intervention

Objective To evaluate the effects and mechanisms of glucose-insulin-potassium(GIK)on post-procedural myocardial injury(PMI)after percutaneous coronary intervention(PCI).Methods A total of 200 non-diabetic patients with documented coronary heart disease(CHD)were divided into the Group GIK and Group G,with 100 patients in each group.Patients in Group G were given intravenous infusion of glucose solution 2 hours before PCI.As compared,patients in Group GIK were given GIK.Results Both post-procedural creatine phosphokinase isoenzyme MB(CK-MB;62.1±47.8 vs.48.8±52.6 U/L,P=0.007)and cTnI(0.68±0.83 vs.0.19±0.24 ng/mL,P<0.001)in Group GIK were significantly higher than those in Group G.In Group G,9.0%and 4.0%of patients had post-procedural increases in CK-MB 1-3 times and>3 times,which were significantly lower than those in Group GIK(14.0%and 7.0%,respectively;all P values<0.01);13.0%and 7.0%of patients had post-procedural increases in cTnI 1-3 times and>3 times,which were also significantly lower than those in Group GIK(21.0%and 13.0%,respectively;all P<0.001).Pre-procedural(10.2±4.5 vs.5.1±6.3,P<0.001)and post-procedural rapid blood glucose(RBG)levels(8.9±3.9 vs.5.3±5.6,P<0.001)in Group G were higher than those in Group GIK.In adjusted logistic models,usage of GIK(compared with glucose solution)remained significantly and independently associated with higher risk of post-procedural increases in both CK-MB and cTnI levels>3 times.Furthermore,pre-procedural RBG levels<5.0mmol/L were significantly associated with higher risk of post-procedural increases in both CK-MB and cTnI levels.Conclusions In non-diabetic patients with CHD,the administration of GIK may increase the risk of PMI due to hypoglycemia induced by GIK.

Microstructure and dry sliding wear behavior of laser clad AlCrNiSiTi multi-principal element alloy coatings

The approximately equimolar ratio A1CrNiSiTi multi-principal element alloy （MPEA） coatings were fab- ricated by laser cladding on Ti-6Al-4V （Ti64） alloy. Scanning electron microscopy （SEM）, equipped with an energy-dispersive spectroscopy （EDS）, and X-ray diffrac- tion （XRD） were used to characterize the microstructure and composition. Investigations show that the coatings consist of （Ti, Cr）5Si3 and NiA1 phases, formed by in situ reaction. The phase composition is initially explicated according to obtainable binary and ternary phase diagrams, and the formation Gibbs energy of TisSi3, VsSi3 and CrsSi3. Dry sliding reciprocating friction and wear tests of the A1CrNiSiTi coating and Ti64 alloy substrate without coating were evaluated. A surface mapping profiler was used to evaluate the wear volume. The worn surface was characterized by SEM-EDS. The hardness and wear resistance of the A1CrNiSiTi coating are well compared with that of the basal material （Ti64）. The main wear mechanism of the AICrNiSiTi coating is slightly adhesive transfer from GCrl5 counterpart, and a mixed layer com- posed of transferred materials and oxide is formed.

Preparation of Au/Ag Multilayers via Layer-by-Layer Self-assembly in Spherical Polyelectrolyte Brushes and Their Catalytic Activity

Spherical polyelectrolyte brushes （SPBs） consisting of polystyrene （PS） core and poly（2-aminoethyl methacrylate hydrochloride） （PAEMH） shell were prepared by photo-emulsion polymerization. Au nanoparticles （Au-NPs） with controlled size and size distribution were synthesized in situ using SPBs as nanoreactors. Via layer-by-layer deposition technique on the surface of SPBs, nano-composite particles with Au/Ag-NPs bilayer and Au/Ag/Au-NPs trilayer were prepared. The structures of the as-prepared Au/Ag multilayer SPBs were characterized by UV-Vis spectroscopy, TEM, ICP-AES and DLS. The charge reversal of the nano-composite particles observed by zeta potential confirmed the success of layer-by-layer assembly. The Au/Ag-NPs bilayer nano-composite particles showed high catalytic efficiency with an apparent activation energy of about 41.2 kJ/mol in the reduction reaction of 4-nitrophenol to 4-aminophenol in the existence of sodium borohydride monitored. The catalytic activity ofAu/Ag-NPs multilayer SPBs close to that of Au-NPs SPBs and much higher than that of Ag-NPs SPBs reveals its potential applications in cost-effective catalysts with high-performance.

Effects of Ausforming Procedure and Following Annealing Treatment on Microstructural Characteristics in Cobalt

The effects of ausforming procedure and subsequent annealing treatments on microstructures of cobalt（Co）samples are investigated by electron channeling contrast and electron backscatter diffraction techniques.Results show that the ausformed Co samples consist of coarsen blocky laths（single ε phase）with the irregular morphology and the ultra-fine acicular laths（dual phase：γ and ε）with the slender and rectangular morphologies.As compared to the slight reduction sample,the much denser acicular laths are observed in the heavily ausformed sample.In addition,recrystallization behavior and annealing-induced 7--＋ e transformation have occurred in ausformed Co samples during the annealing treatment.

Microstructural Characterization of Pure Titanium Treated by Laser Surface Treatment Under Different Processing Parameters

Advanced characterization techniques are utilized to investigate the effect of laser surface treatment on microstructural evolution of pure titanium（Ti）.The results show that there are three distinctly different types of microstructure from surface to substrate in Ti samples,including phase transformation and solidification microstructure in zone I（melting zone）;insufficient recrystallization grains with residual a martensitic plates in zone II（heat-affected zone,HAZ）;fully recrystallization microstructure in zone III（base metal,BM）.The hardness evolution profiles under different laser treatment parameters are similar.The highest hardness in MZ is ascribed to α plate,while the lowest hardness value in HAZ is due to the insufficiently recrystallized grains.The metallurgical process on the laser-modified Ti samples is systematically discussed in this work.