Real-world cost-effectiveness of drug-eluting stents vs. bare-metal stents for coronary heart disease—A five-year follow-up study

Objective

To evaluate the cost-effectiveness of using drugeluting stents (DES) compared to bare-metal stents (BMS) for coronary heart disease (CHD).

Copper Electrodeposition on a Magnesium Alloy (AZ80) with a U-Shaped Surface

Cu electrodeposition was performed on a cylindrical AZ80 substrate with a U-shaped surface. A uniform deposition of Cu was achieved on an AZ80 electrode via galvanostatic etching, followed by Cu electrodeposition in an eco-friendly alkaline Cu plating bath. Improper wetting and lower rotational speeds of the AZ80 electrode resulted in an uneven Cu deposition at the inner upper site of the U-shaped surface during the Cu electroplating process. This wetting effect could be deduced from the variation in the anodic potential during the galvanostatic etching. The corrosion resistance of the Cu-deposited AZ80 electrode can be considerably improved after Ni electroplating.     

“白血”之古籍探微

"白血"一词首次出现在《素问·至真要大论》。通过检索古籍,分析归纳历代医家对"白血"一词的有关论述,归纳针对其本质的探讨,有"肺血""肾精""脾痰"三种观点。对《内经》原文条分缕析,认为"白血"实乃燥气所胜、金实乘木,所吐之"肺血肺阴",并总结历代医家关于"白血"之治法,以丰富对"白血"的认识。     

Fabrication of a metal-ceramic crown to fit an existing partial removable dental prosthesis using ceramic pressed to metal technique: a clinical report

Fabricating a crown to retrofit an existing abutment tooth for a partial removable dental prosthesis (PRDP) is one of the most time-consuming and labor-intensive clinical procedures. In particular, when the patient is concerned with esthetic aspects of restoration, the task of fabricating becomes more daunting. Many techniques for the fabrication of all-metallic or metal-ceramic crowns have been discussed in the literature. This article was aimed to describe a simple fabrication method in which a retrofitting crown was fabricated for a precise fit using a ceramic-pressed-to-metal system.     

Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis

BackgroundIt has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with those of patients with vasospastic angina.MethodsA total of 2797 consecutive patients without significant coronary artery lesion (<70%), who underwent the Acetylcholine (Ach) provocation test, were enrolled between Nov 2004 and Oct 2010. DES-associated spasm was defined as significant CAS in proximal or distal to previously implanted DES site at follow-up angiography with Ach test. Patients were divided into two groups (DES-CAS; n = 108, CAS; n = 1878). For adjustment, propensity score matching (PSM) was done (C-statistics = 0.766, DES-CAS; n = 102, CAS; n = 102). SPSS 20 (Inc., Chicago, Illinois) was used to analyze this data.ResultsBaseline characteristics were worse in the DES-CAS group. After PSM, both baseline characteristics and the Ach test results were balanced except higher incidence of diffuse CAS and ECG change in the DES-CAS group. During Ach test, the incidence of diffuse spasm (93.1% vs. 81.3%, p = 0.012) and ST-T change (10.7% vs. 1.9%, p = 0.010) were higher in the DES-CAS group. At 3-year, before and after adjustment, the DES-CAS group showed a higher incidence of coronary revascularization (9.8% vs. 0.0%, p = 0.001), recurrent chest pain requiring follow up coronary angiography (CAG, 24.5% vs. 7.8%, p = 0.001) and major adverse cardiac events (MACEs, 9.8% vs. 0.9%, p < 0.005).ConclusionIn this study, DES associated CAS was associated with higher incidence of diffuse spasm, ST-T change and adverse 3-year clinical outcomes. Special caution should be exercised in this particular subset of patients.     

Effect of Mucin and Bicarbonate Ion on Corrosion Behavior of AZ31 Magnesium Alloy for Airway Stents

The biodegradable ability of magnesium alloys is an attractive feature for tracheal stents since they can be absorbed by the body through gradual degradation after healing of the airway structure, which can reduce the risk of inflammation caused by long-term implantation and prevent the repetitive surgery for removal of existing stent. In this study, the effects of bicarbonate ion (HCO₃⁻) and mucin in Gamble’s solution on the corrosion behavior of AZ31 magnesium alloy were investigated, using immersion and electrochemical tests to systematically identify the biodegradation kinetics of magnesium alloy under in vitro environment, mimicking the epithelial mucus surfaces in a trachea for development of biodegradable airway stents. Analysis of corrosion products after immersion test was performed using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD). Electrochemical impedance spectroscopy (EIS) was used to identify the effects of bicarbonate ions and mucin on the corrosion behavior of AZ31 magnesium alloys with the temporal change of corrosion resistance. The results show that the increase of the bicarbonate ions in Gamble’s solution accelerates the dissolution of AZ31 magnesium alloy, while the addition of mucin retards the corrosion. The experimental data in this work is intended to be used as foundational knowledge to predict the corrosion behavior of AZ31 magnesium alloy in the airway environment while providing degradation information for future in vivo studies.     

颅内动脉瘤辅助栓塞治疗的回顾性研究

目的 探讨颅内动脉瘤的两种辅助栓塞技术与围手术期预后之间的关系.方法 回顾2006年5月至2010年12月栓塞治疗颅内动脉瘤患者围手术期预后情况,将结果转换为GOS评分,并分组统计；统计学分析两种栓塞技术与围手术期预后之间的相关性.结果 共辅助栓塞治疗动脉瘤患者148例,球囊辅助弹簧圈栓塞技术治疗55例,围手术期预后良好率74.5％,重残率20.0％,死亡率5.5％；支架辅助弹簧圈栓塞技术治疗93例,围手术期预后良好率84.9％,重残率9.7％,死亡率5.4％；两组之间存在统计学差异(P＜0.001).结论 围手术期预后支架辅助栓塞优于球囊辅助栓塞.