BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists.Left main(LM)bifurcation lesions have a higher risk due to the vast blood supply in this area and treatmen...BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists.Left main(LM)bifurcation lesions have a higher risk due to the vast blood supply in this area and treatment choice is difficult.Ostial compromise of the side branch decreases patient prognosis,and its management is still an issue despite the different strategies and devices available.CASE SUMMARY A 42-year-old male patient was admitted to hospital due to chest pain and syncope.Coronary angiography showed acute LM occlusion.Following thrombus aspiration,a LM bifurcation lesion remained.Coronary angiography was repeated one week later,and at the same time,3D optical coherence tomography(OCT)was carried out to better show the geometry of the bifurcation,which confirmed that the stenosis in the ostial left circumflex artery was caused by a long carina.After assessment of the plaque characteristics and the minimum lumen area,the cross-over strategy,kissing balloon inflation and proximal optimization technique were chosen to treat the bifurcation lesion.A“moving”carina was found twice during the intervention.Good stent apposition and expansion were confirmed by OCT after proximal optimization technique.The three-month follow-up showed good recovery and normal cardiac function.CONCLUSION 3D-OCT can facilitate decision-making for coronary interventions in patients with critical bifurcation lesions.展开更多
AFTER the publication of the fossil bird Confuciusorins, additional skeletons of fossil birds have been found by Hou Lianhai, Hu Yaoming, Wang Ping, Gu Yucai and Sun Yutie in the Yixian Formation of Beipiao, Liaoning ...AFTER the publication of the fossil bird Confuciusorins, additional skeletons of fossil birds have been found by Hou Lianhai, Hu Yaoming, Wang Ping, Gu Yucai and Sun Yutie in the Yixian Formation of Beipiao, Liaoning Province. The new locality is about 3 km southwest of that of Confuciusorins. Among those specimens were two of Confuciusorins and two new birds. A well-developed carina was found on the smallest specimen, a feature not found in the Jurassic birds, such as Archaeopteryx and Confuciusorins. The new Jurassic fossil bird is described in the present note.展开更多
The trachea is an anatomical structure of 10–12 cm of length in adults,which could appear just a simple conduit that brings the air to the lungs,but it is a very complex organ with a lot of functions and is supplied ...The trachea is an anatomical structure of 10–12 cm of length in adults,which could appear just a simple conduit that brings the air to the lungs,but it is a very complex organ with a lot of functions and is supplied by many arterial branches arising from inferior thyroid artery,bronchial,intercostal arteries or direct branches from descending aorta,that create a vascular reticulum entering inside and feeding the ciliated pseudostratified columnar epithelium.The literature search has been made by using keywords“Tracheal tumors”,“Trachea surgery”,“Carina surgery”,“Engineered trachea”.We selected 74 articles from 15,191 papers.According to the literature search,we can say that,because of its own structure,it’s not simple to resect and reconstruct the trachea by direct end-to-end anastomosis,especially for more than 50%of its length and it cannot be easily replaced or transplanted.Although surgery is not the only possible therapy,the radiotherapy and the endoscopic treatments are so far from guarantee an adequate survival,and they are usually employed as adjuvant therapies after surgery or they are reserved to non-surgical patients for medical problems or oncological criteria.To overcome the surgical limits in direct reconstruction,have been developed different autogenic or allogenic grafts and nowadays there are different vascularized biocompatible scaffolds till the tissue engineered neotrachea,but more studies are still needed to standardize a valid reconstructive system for tracheal major resections or transplantation.展开更多
基金Supported by National Natural Science Foundation of China,No.81570360Beijing Lisheng Cardiovascular Grant,No.LHJJ201612425
文摘BACKGROUND Coronary intervention for bifurcation lesions is still challenging for interventional cardiologists.Left main(LM)bifurcation lesions have a higher risk due to the vast blood supply in this area and treatment choice is difficult.Ostial compromise of the side branch decreases patient prognosis,and its management is still an issue despite the different strategies and devices available.CASE SUMMARY A 42-year-old male patient was admitted to hospital due to chest pain and syncope.Coronary angiography showed acute LM occlusion.Following thrombus aspiration,a LM bifurcation lesion remained.Coronary angiography was repeated one week later,and at the same time,3D optical coherence tomography(OCT)was carried out to better show the geometry of the bifurcation,which confirmed that the stenosis in the ostial left circumflex artery was caused by a long carina.After assessment of the plaque characteristics and the minimum lumen area,the cross-over strategy,kissing balloon inflation and proximal optimization technique were chosen to treat the bifurcation lesion.A“moving”carina was found twice during the intervention.Good stent apposition and expansion were confirmed by OCT after proximal optimization technique.The three-month follow-up showed good recovery and normal cardiac function.CONCLUSION 3D-OCT can facilitate decision-making for coronary interventions in patients with critical bifurcation lesions.
文摘AFTER the publication of the fossil bird Confuciusorins, additional skeletons of fossil birds have been found by Hou Lianhai, Hu Yaoming, Wang Ping, Gu Yucai and Sun Yutie in the Yixian Formation of Beipiao, Liaoning Province. The new locality is about 3 km southwest of that of Confuciusorins. Among those specimens were two of Confuciusorins and two new birds. A well-developed carina was found on the smallest specimen, a feature not found in the Jurassic birds, such as Archaeopteryx and Confuciusorins. The new Jurassic fossil bird is described in the present note.
文摘The trachea is an anatomical structure of 10–12 cm of length in adults,which could appear just a simple conduit that brings the air to the lungs,but it is a very complex organ with a lot of functions and is supplied by many arterial branches arising from inferior thyroid artery,bronchial,intercostal arteries or direct branches from descending aorta,that create a vascular reticulum entering inside and feeding the ciliated pseudostratified columnar epithelium.The literature search has been made by using keywords“Tracheal tumors”,“Trachea surgery”,“Carina surgery”,“Engineered trachea”.We selected 74 articles from 15,191 papers.According to the literature search,we can say that,because of its own structure,it’s not simple to resect and reconstruct the trachea by direct end-to-end anastomosis,especially for more than 50%of its length and it cannot be easily replaced or transplanted.Although surgery is not the only possible therapy,the radiotherapy and the endoscopic treatments are so far from guarantee an adequate survival,and they are usually employed as adjuvant therapies after surgery or they are reserved to non-surgical patients for medical problems or oncological criteria.To overcome the surgical limits in direct reconstruction,have been developed different autogenic or allogenic grafts and nowadays there are different vascularized biocompatible scaffolds till the tissue engineered neotrachea,but more studies are still needed to standardize a valid reconstructive system for tracheal major resections or transplantation.
