多枚药物洗脱支架治疗冠心病远期疗效

目的 回顾性分析经皮冠状动脉介入治疗(PCI)患者植入单枚与多枚(≥3枚)药物洗脱支架远期预后差异.方法 466例接受PCI治疗并植入药物洗脱支架患者,分为单个药物洗脱支架组(373例)和多枚药物洗脱支架组(93例).比较两组的基础临床情况和12个月主要心脏不良事件(死亡、心肌梗死、靶血管血运重建).结果 与单枚药物洗脱支架组相比,多枚药物洗脱支架组有更多患者伴有高血压、糖尿病和心功能不良,随访17个月主要心脏不良事件发生率(17.2%)较单个药物洗脱支架组(8.6%)明显增加(P＜0.05).结论 与植     

急性心肌梗死急诊经皮冠状动脉介入治疗近期疗效观察

目的探讨直接经皮冠状动脉(冠脉)介入治疗(PCI)对急性心肌梗死(AMI)的疗效.方法 63例AMI患者在发病12 h内接受梗死相关血管急诊PCI,随访1～14个月.结果 63例患者中61例(96.8%)介入治疗获得成功.3例行经皮冠脉腔内成形术(PTCA),58例置入支架.全部获得TIMI 3级血流灌注.5例发生无血流现象,行冠脉内尿激酶溶栓血流改善.5例在术中发生室速、室颤,4例及时除颤转复窦性心律,1例死亡.5例心原性休克患者有2例住院期死亡.随访期主要事件发生率17%(5/60),其中2例猝死,1     

不稳定型心绞痛经皮冠状动脉介入治疗与内科保守治疗的比较

目的探讨经皮冠状动脉(冠脉)介入(PCI)治疗与内科保守治疗对不稳定型心绞痛(UAP)患者的疗效.方法 248例UAP患者,其中保守组123例,接受阿司匹林、肝素和抗心绞痛药物治疗;介入治疗组125例,除上述药物治疗外,于入院后平均4.4 d行PCI治疗,随访两组首次入院后1年内终点事件:死亡、急性心肌梗死(AMI)、心绞痛复发和再入院等.结果介入组与保守组住院期死亡或AMI复合终点发生率无显著差异(分别为0.8%和1.6%,P>0.05),但介入组住院天数缩短,分别为(10.3±5.6)d和(14.6±     

Firebird药物洗脱支架治疗冠状动脉原发病变

目的研究国产雷帕霉素药物洗脱支架(Firebird)在原发冠状动脉(冠脉)病变介入治疗的安全性及疗效.方法 132例患者接受Firebird或普通支架置入术,其中Firebird组60例,Cypher支架组52例,裸支架(Mustang)组20例.比较各组支架术即刻及近期结果.结果 3组手术成功率分别为98.3%、100.0%和100.0%,随访率为88.3%、92.3%和85.0%,硝酸脂药物停用率为32.1%、33.3%和29.4%,再住院率为5.6%、8.3%和11.7%,3组间差异均无显著性.但M     

比较CypherTM和TaxusTM支架在冠心病合并糖尿病患者中应用的安全性和有效性

背景与裸支架相比,药物洗脱支架可以显著降低冠心病合并糖尿病患者PCI术后再狭窄率和靶病变重建率.但目前尚未见关于直接比较雷帕霉素洗脱支架(CypherTM)和紫杉醇洗脱支架(TaxusTM)在治疗冠心病合并糖尿病患者中安全性和有效性的研究.目的观察和比较两种药物洗脱支架在冠心病合并糖尿病患者中应用的安全性和有效性.方法自2002年6月～2004年2月新加坡国立大学医院心脏中心所有置入Cypher或Taxus支架冠心病合并糖尿病患者,观察:术后6个月的主要不良心脏事件(包括死亡、心肌梗死、靶病变重建).结果     

持续ST段抬高对直接经皮冠脉介入治疗疗效的影响

目的探讨心电图梗死相关导联持续ST段抬高对判断直接PCI治疗AMI疗效的应用价值.方法根据心电图梗死相关导联ST段抬高回落情况将229例直接PCI后TIMI血流3级的AMI患者分2组:ST段回落＞50%组(甲组),147例;与ST段回落＜50%组(乙组),82例,比较两组一般临床特征,随访心血管事件的发生率.结果甲乙两组:无复流(blush分级＜2级)为14/147(9.5%)和21/82(25.6%);住院期间病死率5/147(3.40%)和9/82(11.0%);MACE 8/147(5.4%)和11     

晶碳微膜烤瓷支架治疗冠心病的临床观察

目的探讨晶碳微膜烤瓷支架(SORIN冠脉支架)在冠心病介入治疗中的安全性,特别是防止支架内血栓的有效性,及降低再狭窄发生率的作用.方法共10例患者,其中急性心肌梗死(AMI)6例,不稳定心绞痛(UAP)4例.急诊直接PCI 8例、补救PCI 2例.共涉及病变血管12支、病变13处.选择支架直径与靶血管直径之比为1.0～1.1∶1.从较低压力开始扩张,直至残存狭窄<5%.结果共用晶碳微膜烤瓷支架13枚,术后病变血管均达到前向TIMI III级血流,术后抗凝.随访4～18个月,平均(11.6±5.7)个月,全     

急性心肌梗死患者药物洗脱支架植入后光学相干层析成像研究

【摘要】 目的 采用光学相干层析成像（OCT）技术观察急性心肌梗死（AMI）患者药物洗脱支架（DES）植入1年后血管内膜增生及支架小梁覆盖程度,并与稳定型心绞痛（SA）患者作比较。方法 入选2011年3月至2012年7月因冠心病接受DES植入术治疗患者39例,其中AMI患者16例,SA患者23例。术后1年复查冠状动脉造影和OCT检查,测定新生内膜厚度、面积、容积、支架小梁覆盖及贴壁比率。结果 OCT测定结果显示,AMI组与SA组相比,平均新生内膜厚度（66.8 mm±20.7 mm对121.6 mm±135.7 mm,P＝0.022）、新生内膜容量比率（5.66%±3.18%对11.88%±8.22%,P＝0.005）、新生内膜＞100 μm截面数比率（22.56%±23.99%对40.14%±30.01%,P＝0.034）和支架小梁总体覆盖率（93.42%±7.03%对89.27%±6.40%,P＝0.007）均明显较低。结论 AMI患者植入DES后内膜修复情况不佳,内膜增生及支架小梁覆盖率较差。
     

国产雷帕霉素洗脱支架和裸支架植入后血管再内皮化实验研究

目的 评价国产雷帕霉素洗脱支架与裸支架植入兔腹主动脉后不同时间血管再内皮化差异.方法 雄性新西兰大白兔24只,高脂喂养28 d后随机分为两组,分别于腹主动脉植入国产雷帕霉素洗脱支架Firebird(SES)和裸金属支架Mustang(BMS).每组分别于术后第3、7、14和28天各处死3只动物,经处理后以扫描电镜观察支架段血管内皮,应用图像处理系统分析支架植入段血管再内皮化程度.结果 支架植入术后第3天两组儿乎均无新生内皮,炎症反应较明显.术后第7、14和28天,SES组内皮覆盖程度明显低于BMS组(分别为15%±8%比53%±9%;49%±16%比83%±4%和73%±3%比93%±4%,P<0.05).结论 SES植入后靶血管出现明显的再内皮化延迟.     

药物洗脱支架在后循环动脉狭窄治疗中的应用

目的 研究在后循环动脉狭窄治疗中应用药物洗脱支架的安全性和疗效性.方法 经常规造影证实椎动脉狭窄者30例,接受支架置入治疗者19例.局麻或全麻下经右股动脉以Seldinger技术置入6 F导管鞘,在相应导丝辅助下使导引导管进入锁骨下动脉或椎动脉,血管造影后沿导引导管插入0.014英寸、300 cm或205 cm导丝至狭窄远端,经此微导丝交换置入相应规格球囊扩张式CypherTM支架(10例)或TAXUSTM支架(9例).结果 19例患者手术均成功,无死亡和并发症,置入支架贴壁良好,血流明显改善,狭窄远端分支血管(小脑后下动脉等)充盈明显改善,狭窄率由原来的平均87.5%降至平均5.2%.15例表现为眩晕症状的患者术后症状消失12例(80%),改善3例.表现为共济失调的6例患者术后共济运动基本正常4例,明显改善2例,表现为小脑性语言障碍的1例患者术后明显改善.完成至少1次造影随访的患者15例,经DSA证实无再狭窄发生.所有患者门诊随访,最长18个月.结论 药物洗脱支架在后循环动脉狭窄的治疗中安全、有效,在短期内能防止术后再狭窄,长期疗效需进一步观察,需要大样本的随机对照研究进一步证实.     

火电厂节能工作浅析

本文探讨了火电厂节能基本程序和工作方法,分析节能工作要从基础工作、技术创新、设备整治、燃烧管理等方面入手的论述.     

浅析磨合期汽车的使用

如何合理使用磨合期的汽车，使其摩擦机件的磨损量能够平稳、均匀地磨合而不至于过度磨损，对汽车实际使用寿命有着重要的意义。从机器磨合期的特点和磨损机理出发，对汽车磨合期如何正确使用进行了有实际意义的探讨。     

Geothermal energy in agriculture in Yugoslavia

SFR Yugoslavia has natural hot water springs practically all over its territory, indicating the presence of geothermal reservoirs underground. There is no final estimate of how much energy can be expected from this new resource, except for figures based on the results of studies and investigations.The first use of geothermal energy in Yugoslavia in numerous spas dates back to the 19th century. Some remarkable examples of central heating are known, but the most widespread use is in agriculture (in greenhouse heating, farm heating and drying of agricultural products).     

Energy conservation measures in an institutional building in sub-tropical climate in Australia

In this study, various energy conservation measures (ECMs) on heating, ventilating and air conditioning (HVAC) and lighting systems for a four-storied institutional building in sub-tropical (hot and humid climate) Queensland, Australia are evaluated using the simulation software called DesignBuilder (DB). Base case scenario of energy consumption profiles of existing systems are analysed and simulated first then, the simulated results are verified by on-site measured data. Three categories of ECMs, namely major investment ECMs (variable air volume (VAV) systems against constant air volume (CAV); and low coefficient of performance (COP) chillers against high COP chillers); minor investment ECMs (photo electric dimming control system against general lighting, and double glazed low emittance windows against single-glazed windows) and zero investment ECMs (reset heating and cooling set point temperatures) are evaluated. It is found that the building considered in this study can save up to 41.87% energy without compromising occupancies thermal comfort by implementing the above mentioned ECMs into the existing system.     

Uncertainties in decarbonising heat in the UK

Heating is arguably one of the most difficult sectors to decarbonise in the UK's energy system. Meeting the 80% greenhouse gas emission reduction target by 2050 is likely to require that heat related emissions of CO₂ from buildings are near zero by 2050, and there is a 70% reduction in emissions from industry (from 1990 levels). Though it is clear that the use of the natural gas network will reduce over time, recent modelling suggests a limited residual role for gas by 2050 to help meet peaks in heat demand. High levels of uncertainty about the way in which heat will be decarbonised present a number of challenges to policy makers. This paper will explore the risks and uncertainties associated with the transition to a low carbon heat system in the UK as outlined by the 4th carbon budget review. The potential impact of key uncertainties on the levelised costs of heat technologies and the development of energy networks are explored using a sensitivity analysis approach. Policy changes required to decarbonise the heat sector are also examined.     

Solar drying in sludge management in Turkey

Two main wastewater treatment plants in Bursa city in Turkey will start to operate and produce at least 27,000 tons of dry solids per year by the end of 2006. The purpose of this study was to investigate an economical solution to the sludge management problem that Bursa city would encounter. The general trend in Turkey is mechanical dewatering to obtain a dry solid (DS) content of 20%, and liming the mechanically dewatered sludge to reach the legal landfilling requirement, 35% DS content. This study recommends limited liming & solar drying as an alternative to only-liming the mechanically dewatered sludge. Open and covered solar sludge drying plants were constructed in pilot scale for experimental purposes. Dry solids and climatic conditions were constantly measured. Faecal coliform reduction was also monitored. The specially designed covered solar drying plant proved to be more efficient than the open plant in terms of drying and faecal coliform reduction. It was found that, if the limited liming & solar drying method was applied after mechanical dewatering instead of only-liming method, the total amount of the sludge to be disposed would be reduced by approximately 40%. This would lead to a reduction in the transportation, handling, and landfilling costs. The covered drying system would amortize itself in 4 years.     

Viscous heating in liquid flows in micro-channels

Many experimental works on forced convection through micro-channels evidenced that when the hydraulic diameter is less than 1 mm, conventional theory can no longer be considered as suitable to predict the pressure drop and convective heat transfer coefficients. This conclusion seemed valid for both gas and liquid flows. Sometimes the authors justified this claim by invoking “new” micro-effects. On the contrary, in this paper the explanation of the experimental results obtained for micro-channels in terms of friction factors will be researched inside the conventional theory (Navier-Stokes equations). In particular, this paper will focus on the role of viscous heating in fluids flowing through micro-channels. A criterion will be presented to draw the limit of significance for viscous dissipation effects in micro-channel flows. The role of the cross-sectional geometry on viscous dissipation will be highlighted and the minimum Reynolds number for which viscous dissipation effects can no longer be neglected will be calculated as a function of the hydraulic diameter and of the micro-channel geometry for different fluids. It will be demonstrated how viscous effects can explain some experimental results on the Poiseuille numbers in micro-channels, which recently appeared in the open literature.     

Electoral cycles in electricity losses in India

A third of electricity in India is lost each year, where losses refer to power that is supplied but not billed. Utilizing data from the power corporation of Uttar Pradesh, India's most populous state, we study the politics of electricity losses. Examining annual data over four decades, we document that UP's electricity losses tend to increase in periods immediately prior to state assembly elections. Drawing upon geographically disaggregated data for the period 2000–09, we observe higher line losses just prior to the 2002 and 2007 state elections. Our analysis shows that the incumbent party was more likely to retain the assembly seat as line losses in the locality increased. We interpret these results as corroboration that political parties deliberately redirect electricity to flat rate and unbilled users in a context of chronically inadequate supply. Political factors appear to affect line losses in ways that technical and economic factors alone cannot explain.     

Energy consumption in rural transportation in India

Energy consumption in rural transportation has been computed, taking into account the energy embodied in vehicles or bullocks, as well as the fuels or feeds and food (of operators). Bullock cart transport consumes over four times more energy than vehicles. However, animal transport will continue to be preferred because of its availability.