Abstract:
OBJECTIVE:The management strategies after acute myocardial infarction (AMI) have been evolving from simple supportive treatment to various protocols of thrombolytic therapies, and then to mechanical revascularization by balloon angioplasty in recent years. However, controversies still exist between which is the best treatment approach. METHODS:An extensive analysis was carried out in over 120 articles reported recently in the literature. RESULTS:Most reported series have shown that direct angioplasty is a feasible and safe option for the management of acute myocardial infarction. Large scale randomised studies comparing direct angioplasty versus thrombolytic therapy in acute myocardial infarction have also reported very favourable acute and long term outcomes by direct angioplasty as compared to thrombolytic therapy. The results are at least equivalent, if not better, by direct angioplasty. Acute results include better reperfusion rate of infarct related artery, less bleeding and stroke complications, shorter hospital stay, and most importantly, lower in-patient mortality (around 2% in direct PTCA group versus 6% in thrombolysis group) and less recurrent ischaemic event (around 10% in direct PTCA group versus 30% in thrombolysis group). Despite some delay in the commencement of treatment by direct angioplasty than thrombolytic therapy, the left ventricular function remains comparable in the two groups and the overall long term outcomes are very favourable with direct angioplasty. Specific indications for direct angioplasty include patients with cardiogenic shock after AMI and patients with contraindications to thrombolysis. No reflow phenomenon is still an issue of concern. It is in general contraindicated to use angioplasty after failure of thrombolysis. The cost implication is not far exceeding that of thrombolysis therapy. CONCLUSIONS:Direct angioplasty for acute myocardial infarction should be established as a treatment option if the circumstances allow. Planning should be carried out at the hospital and community level in order to make direct angioplasty a high priority treatment option for patients with acute myocardial infarction.
journal_name
Chin Med J (Engl)journal_title
Chinese medical journalauthors
Lee SW,Chan HW,Lam Lsubject
Has Abstractpub_date
1997-06-01 00:00:00pages
413-9issue
6eissn
0366-6999issn
2542-5641journal_volume
110pub_type
杂志文章,评审abstract:BACKGROUND:It is difficult and time-consuming for carrying out conventional hand-sewn bilioenteric anastomosis, especially for small bile duct anastomosis and laparoscopic procedure. In order to simplify it, we have developed a novel procedure of sutureless bilioenteric anastomosis with an intraluminal degradable stent...
journal_title:Chinese medical journal
pub_type: 杂志文章
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journal_title:Chinese medical journal
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Anti-HNK-1 monoclonal antibody (MAb) was reactive with non-cancerous and cancerous prostatic epithelia, as well as natural killer cells, myelinated nerves and cells from APUD systems. The expression of HNK-1 antigen on prostate cancer was investigated immunohistochemically by avidinbiotin-peroxidase complex (ABC) meth...
journal_title:Chinese medical journal
pub_type: 杂志文章
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更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Von Hippel-Lindau (VHL) disease is a hereditary tumor disorder caused by mutations or deletions of the VHL gene. Few studies have documented the clinical phenotype and genetic basis of the occurrence of VHL disease in China. This study armed to present clinical and genetic analyses of VHL within a five-gener...
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
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abstract::Nimodipine, produced in China, was applied to lower the blood pressure (BP) in 20 cases in craniocerebral operation. 0.02% solution of Nimodipine was dripped intravenously (by 0.02% of density), at a preliminary speed of 600-800 micrograms/min, and 4-12 mg of total dose. Mean arterial pressure (MAP) decreased and main...
journal_title:Chinese medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-06-01 00:00:00
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journal_title:Chinese medical journal
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doi:
更新日期:2003-03-01 00:00:00
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doi:
更新日期:2014-01-01 00:00:00
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pub_type: 杂志文章
doi:
更新日期:2004-12-01 00:00:00
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journal_title:Chinese medical journal
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doi:
更新日期:2009-08-20 00:00:00
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doi:
更新日期:2010-08-01 00:00:00
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pub_type: 杂志文章,meta分析
doi:
更新日期:2013-11-01 00:00:00
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更新日期:2011-10-01 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
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abstract::This is China's pilot study in the assessment of the diagnostic value of serum soluble IL-2 receptor (sIL-2R) in gastric cancer. We measured its level by ELISA method in 45 patients with gastric cancer (without metastasis: 32; with metastasis: 5; recurrence: 8) 27 gastric ulcer, 27 superficial gastritis and 44 healthy...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
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pub_type: 杂志文章
doi:
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更新日期:2007-03-05 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1995-10-01 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2009-02-20 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
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pub_type: 杂志文章,随机对照试验
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更新日期:2015-03-20 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
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