Introduction: No reflow during primary angioplasty is associated with a poor prognosis despite the reopening of the culprit coronary. The aim of our work was to determine the predictive factors of no reflow. Methodolo...Introduction: No reflow during primary angioplasty is associated with a poor prognosis despite the reopening of the culprit coronary. The aim of our work was to determine the predictive factors of no reflow. Methodology: Single-center retrospective analytical study from June 2000 to December 2016 that included patients presenting with STEMI took care of by primary angioplasty. No reflow was defined according to angiographic criteria: a TIMI flow Results: The prevalence of no reflow was 24%. In univariate analysis mean age, diabetes,hypertension, tachycardia, hypotension, killip stage 4 left ventricular failure, hyperglycemia > 11, renal failure, left ventricular dysfunction, tritruncal status, common trunk involvement, initial TIMI flow at 0, significant thrombotic load, delay to angioplasty > 6 hours, and predilation were all correlated with no reflow with a p 75 years [OR = 6.02, 95% CI 1.4 - 27, p = 0.014], tachycardia [OR = 4.3, 95% CI 1.6 - 7.4, p = 0.037], delay to angioplasty > 6 hours [OR = 1.3, 95% CI 1.1 - 2.1, p = 0.003] and high thrombotic load [OR = 1.5, 95% CI 1.3 - 3.2, p = 0.02] were independent predictors of no reflow. Conclusion: No reflow is associated with a poor short-term prognosis. Its care requires knowledge of predictive factors, prevention and treatment.展开更多
Coronary no-reflow phenomenon belongs to a type of coronary microcirculation disturbance,and its main pathogenic factors are vascular endothelial cell injury,microembolism and inflammatory reaction,which are correspon...Coronary no-reflow phenomenon belongs to a type of coronary microcirculation disturbance,and its main pathogenic factors are vascular endothelial cell injury,microembolism and inflammatory reaction,which are corresponding to the pathogenesis of choroid injury,blood stasis and heat toxin in traditional Chinese medicine,such as NO,ET-1,chemokine,IL and other cytokines.The degree of improvement of patients'symptoms and laboratory examination data provide a basis for traditional Chinese medicine compound prescription,monomer and traditional Chinese medicine characteristic therapy for the treatment of no-reflow phenomena(NRP).Combined with related factors,the author summarizes the research progress of traditional Chinese medicine treatment of NRP in recent years,in order to provide clinical reference.展开更多
针对某航天电子管壳焊接组件冷却过程中的热力耦合影响问题,建立了焊接组件的有限元热分析模型,研究了在快速冷却过程中梯度材料分布对低温共烧陶瓷(low temperature co-fired ceramic,LTCC)基板、梯度管壳的残余应力和变形的影响。以...针对某航天电子管壳焊接组件冷却过程中的热力耦合影响问题,建立了焊接组件的有限元热分析模型,研究了在快速冷却过程中梯度材料分布对低温共烧陶瓷(low temperature co-fired ceramic,LTCC)基板、梯度管壳的残余应力和变形的影响。以不超过基板断裂强度为前提条件,以降低管壳整体的残余应力与变形为优化目标,采用了多因素变换优选法,确定了管壳材料的最优梯度分布方案,即合金管壳自上而下的梯度分布为Al-35Si、Al-42Si、Al-50Si、Al-60Si、Al-70Si。其中,Al-35Si厚度为2.5mm,Al-42Si与Al-60Si的厚度均为1.6mm,Al-50Si厚度为0.8mm,Al-70Si厚度为2mm。在该方案下,LTCC基板冷却至室温时的最大变形量为4.86μm,最大第一主应力为6761MPa,远小于LTCC材料的断裂强度320MPa;管壳冷却至室温时的最大变形量为18.291μm,最大残余应力值为20.46MPa,远小于管壳材料的屈服强度100MPa。管壳各层之间的应力集中现象不明显,管壳的整体焊接质量得到提升。展开更多
Objective To evaluate effects of preinfarction angina(PA) on no reflow phenomenon after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI).Methods one hundred patients with first...Objective To evaluate effects of preinfarction angina(PA) on no reflow phenomenon after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI).Methods one hundred patients with first AMI were divided into no reflow group( n =15)and reflow group( n =85). All patients undervent PCI within 12h after onset of AMI.No reflow phenomenon,defined as TIMI grade 2 flow or less without apparent residual stenosis .Myocardial enzyme was continuously measured;Left ventricular function was assessed by radionuclideimaging; The incidence of ventricular aneurysm and in hospital mortality was observed. Results (1)Patients with no reflow had a significantly lower incidence of PA( 20% vs 61% , P <0.01 ), a higher incidence of anterior infarction (67%vs35%, P <0.05 ), and had significantly higher peak creatine MB fraction than those with reflow(403±132vs277±151, P <0.01 ).(2) Patients with no reflow had significantly larger myocardial infarction area (MIA) ( 27.6 ±9.1% vs 20.9 ±9.4% , P <0.01 ), significantly higer left ventricular ejection fraction (46±8% vs 53±9%, P <0.01 ),and had a higher incidence of ventricular aneurysm and mortality than those with reflow (20%vs4%,p<0.05;20% vs 2%, P <0.05 ). (3)Multivariate Logistic analysis showed that the absence of preinfarction angina was a major independent determinant of no reflow( OR = 6.12 , P =0.01 ).Conclusions The absence of preinfarction angina is a high dangerous factor of no reflow phenomenon; No reflow phenomenon is associated with a high incidence of heart failure and mortality.展开更多
文摘Introduction: No reflow during primary angioplasty is associated with a poor prognosis despite the reopening of the culprit coronary. The aim of our work was to determine the predictive factors of no reflow. Methodology: Single-center retrospective analytical study from June 2000 to December 2016 that included patients presenting with STEMI took care of by primary angioplasty. No reflow was defined according to angiographic criteria: a TIMI flow Results: The prevalence of no reflow was 24%. In univariate analysis mean age, diabetes,hypertension, tachycardia, hypotension, killip stage 4 left ventricular failure, hyperglycemia > 11, renal failure, left ventricular dysfunction, tritruncal status, common trunk involvement, initial TIMI flow at 0, significant thrombotic load, delay to angioplasty > 6 hours, and predilation were all correlated with no reflow with a p 75 years [OR = 6.02, 95% CI 1.4 - 27, p = 0.014], tachycardia [OR = 4.3, 95% CI 1.6 - 7.4, p = 0.037], delay to angioplasty > 6 hours [OR = 1.3, 95% CI 1.1 - 2.1, p = 0.003] and high thrombotic load [OR = 1.5, 95% CI 1.3 - 3.2, p = 0.02] were independent predictors of no reflow. Conclusion: No reflow is associated with a poor short-term prognosis. Its care requires knowledge of predictive factors, prevention and treatment.
基金Shandong traditional Chinese Medicine Science and Technology Development Plan Project(No.2015-075)Shandong traditional Chinese Medicine Science and Technology Development Plan Project(No.2019-0191)+1 种基金Shandong Natural Science Foundation Project(No.ZR2019MH032)Shandong Natural Science Foundation Youth Project(No.ZR2020QH333)。
文摘Coronary no-reflow phenomenon belongs to a type of coronary microcirculation disturbance,and its main pathogenic factors are vascular endothelial cell injury,microembolism and inflammatory reaction,which are corresponding to the pathogenesis of choroid injury,blood stasis and heat toxin in traditional Chinese medicine,such as NO,ET-1,chemokine,IL and other cytokines.The degree of improvement of patients'symptoms and laboratory examination data provide a basis for traditional Chinese medicine compound prescription,monomer and traditional Chinese medicine characteristic therapy for the treatment of no-reflow phenomena(NRP).Combined with related factors,the author summarizes the research progress of traditional Chinese medicine treatment of NRP in recent years,in order to provide clinical reference.
文摘针对某航天电子管壳焊接组件冷却过程中的热力耦合影响问题,建立了焊接组件的有限元热分析模型,研究了在快速冷却过程中梯度材料分布对低温共烧陶瓷(low temperature co-fired ceramic,LTCC)基板、梯度管壳的残余应力和变形的影响。以不超过基板断裂强度为前提条件,以降低管壳整体的残余应力与变形为优化目标,采用了多因素变换优选法,确定了管壳材料的最优梯度分布方案,即合金管壳自上而下的梯度分布为Al-35Si、Al-42Si、Al-50Si、Al-60Si、Al-70Si。其中,Al-35Si厚度为2.5mm,Al-42Si与Al-60Si的厚度均为1.6mm,Al-50Si厚度为0.8mm,Al-70Si厚度为2mm。在该方案下,LTCC基板冷却至室温时的最大变形量为4.86μm,最大第一主应力为6761MPa,远小于LTCC材料的断裂强度320MPa;管壳冷却至室温时的最大变形量为18.291μm,最大残余应力值为20.46MPa,远小于管壳材料的屈服强度100MPa。管壳各层之间的应力集中现象不明显,管壳的整体焊接质量得到提升。
文摘Objective To evaluate effects of preinfarction angina(PA) on no reflow phenomenon after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI).Methods one hundred patients with first AMI were divided into no reflow group( n =15)and reflow group( n =85). All patients undervent PCI within 12h after onset of AMI.No reflow phenomenon,defined as TIMI grade 2 flow or less without apparent residual stenosis .Myocardial enzyme was continuously measured;Left ventricular function was assessed by radionuclideimaging; The incidence of ventricular aneurysm and in hospital mortality was observed. Results (1)Patients with no reflow had a significantly lower incidence of PA( 20% vs 61% , P <0.01 ), a higher incidence of anterior infarction (67%vs35%, P <0.05 ), and had significantly higher peak creatine MB fraction than those with reflow(403±132vs277±151, P <0.01 ).(2) Patients with no reflow had significantly larger myocardial infarction area (MIA) ( 27.6 ±9.1% vs 20.9 ±9.4% , P <0.01 ), significantly higer left ventricular ejection fraction (46±8% vs 53±9%, P <0.01 ),and had a higher incidence of ventricular aneurysm and mortality than those with reflow (20%vs4%,p<0.05;20% vs 2%, P <0.05 ). (3)Multivariate Logistic analysis showed that the absence of preinfarction angina was a major independent determinant of no reflow( OR = 6.12 , P =0.01 ).Conclusions The absence of preinfarction angina is a high dangerous factor of no reflow phenomenon; No reflow phenomenon is associated with a high incidence of heart failure and mortality.