关键词： Perfusion balloon   Nicorandil   Vulnerable plaques  

关键词： Myocardial infarction   cardiogenic shock   heart failure   mechanical circulatory support   heart transplantation   tracheal stenosis   case report  

摘要： Herein, we review the critical role of a multi-disciplinary team approach in managing the intricate complications of ST-elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). Mechanical circulatory support (MCS) implantation represents a potentially life-saving intervention, often serving as a bridge to heart transplantation (HTx). However, complications from prior interventions, in patients receiving MCS due to STEMI-CS, may present additional challenges to successful HTx candidacy. A 63-year-old male suffered out-of-hospital cardiac arrest and was hospitalized due to acute anterior STEMI-CS. Emergency percutaneous coronary intervention was performed in the setting of cardiopulmonary resuscitation. Despite successful revascularization and subsequent optimal medical therapy hemodynamic status remained compromised, the decision was made to implant a HeartMate 3 (HM3) left ventricular assist device (LVAD) as a bridge to HTx. HM3 LVAD was implanted without complications and patient was weaned from mechanical ventilation. The later postoperative period was complicated by infections leading to the LVAD-related complications. Moreover, the patient experienced repeated episodes of stridor, which were attributed to significant tracheal stenosis (due to temporary tracheostomy). Finally, a suitable heart donor was found and a successful HTx was performed.

关键词： Indigeneity   S & aacute   mi culture   YA literature   literature pedagogy  

摘要： This article is about how Elsa, a young S & aacute;mi girl in Ann-Hel & eacute;n Laestadius' Stolen, learns to resist hate crimes that seek to sever her roots in traditional Indigenous herding practices. The nine-year old Elsa witnesses the killing of her personal reindeer and is threatened into a decade-long silence by the killer. There are more attacks which we read as the violent enforcement of western linear time on traditional seasonal herding cycles. The novel charts Elsa's coming-of-age as a rebel able to seek retribution not just for herself and her reindeer but also to fight for a vital future for her culture. We read Stolen together with "revolutionary theory" to show how imposed settler temporality is harmful to sustainable modes of living. We emphasise a range of eco-activist responses to the novel, among them rebel reading itself as one of several forms of political engagement available for the eco-rebel. We consider teaching Stolen at secondary school level focusing on how readers can practice risk-taking engagement with a text while learning "how to read our world now" in solidarity with Elsa's struggle for her people's survival within an ecologically and socially just future for all. Ultimately, Elsa's emergent rebellion suggests forms of activism based on a commitment to ancestry, especially its future.

摘要： Metabolic syndrome (MS) has gained attention as a newly discovered risk factor for coronary artery disease (CAD). Studies have demonstrated that individuals with MS have a higher risk for coronary artery disease (CAD), and the risk is higher in females compared to males. Patients with metabolic syndrome have a higher incidence of ST-elevation myocardial infarction (STEMI), making it a significant risk factor that has to be well-treated for successful secondary prevention. The study’s objective is to determine the frequency of MS in patients with acute STEMI according to the new “obesity-centric” IDF definition and to compare the clinical outcomes of acute STEMI patients with and without MS. A total of 132 consecutive patients with acute STEMI were analyzed, and 100 patients were included. MS was identified using criteria based on the “International Diabetes Federation 2005.” The frequency of metabolic syndrome in patients with STEMI was 46%. The frequency was greater in females (53.2%) than in males (43.2%). Patients who had MS had poor clinical outcomes when compared to patients without MS, including mortality. Mortality due to STEMI in patients with MS was 15.2%, whereas in patients without MS was just 2% (p < 0.05). In addition to being a significant risk factor for cardiovascular disease, metabolic syndrome can also be a strong predictor of the severity and immediate prognosis of the condition.

关键词： COVID-19   Chest pain center   ST-segment elevation myocardial infarction   D-to-W   Time prediction  

摘要： Introduction ST-segment elevation myocardial infarction (STEMI) is a life-threatening cardiovascular emergency necessitating rapid reperfusion. During the COVID-19 pandemic, healthcare providers faced the challenge of ensuring timely STEMI interventions while managing the risk of viral transmission in hospitals. This study aims to analyze changes in the door-to-wire (D-to-W) time for STEMI treatment across three pandemic phases-early pre-epidemic phase (Group C), initial lockdown phase (Group A), and intermediate normalization phase (Group B). It also examines the impact of digital communication tools, collectively referred to as "InterNet+" (e.g., Twitter, WeChat), on treatment processes. Methods Based on data of 630 STEMI patients treated in Chest Pain Center in a particular hospital in China from 2019 to 2020, changes in D-to-W time in different groups are measured. Time intervals in STEMI treatment process are also predicted by Bayesian statistics approach. The study investigated the influence of InterNet+ utilization before and after the pandemic through a questionnaire-based assessment. Results For transfer-non-emergency- treatment, the time from first-electrocardiogram to preliminary-diagnosis in Group-A is significantly longer than that in Groups-B and -C (p = 0.004, p = 0.004);the time from decision-on-intervention to catheterization-room-activation in Group-A and -B is significantly longer than that in Group-C (p = 0.003, p < 0.001). For transfer-emergency- treatment, the time from first-medical-contact to arterial-puncture in Group-A and -B is remarkably shorter than that in Group-C (p = 0.006). Meanwhile, Bayesian method performs well in forecasting time intervals, so it can provide effective assistance for STEMI treatment. The findings from the questionnaire indicated that physicians perceived a significant association between the optimal management of STEMI and an increased frequency of InterNet+ tool usage following the pandemic (p = 0.019). Conclusio

关键词： Acute myocardial infarction   Quality of care   Mortality   Patient selection   Data accurracy   Acute myocardial infarction   Quality of care   Mortality   Patient selection   Data accurracy  

摘要： The recording of mortality after acute myocardial infarction can be based on different data, some of which yield very different results. These differences are due to a number of factors, including the definition of acute myocardial infarction, patient selection and the methods used to determine mortality. While routine data are primarily used for billing purposes, procedural data for coronary angiography and percutaneous coronary intervention (PCI) are used for external quality assurance and therefore only include patients who undergo invasive diagnostic procedures. Registries include patients with a disease, e.g., ST-segment elevation myocardial infarction, according to defined criteria. The mortality data published for Germany differ considerably depending on the source of the data. The manuscript discusses the problems of recording the mortality of myocardial infarction in Germany and attempts to propose solutions for improving data quality in order to be able to evaluate possibilities for optimizing treatment.

关键词： 机制砂   质量控制   管理模式  

摘要： 国家绿色环保发展大背景下,建筑企业对施工用料逐年增加,天然河砂开采量及成本已经无法满足施工需求.在机制砂的使用逐步占据主流市场的背景下,如何让机制砂性能达到天然砂水平并替代,是目前建筑企业积极探索的方向.文章介绍建筑施工企业机制砂应用现状、行业监管要求、机制砂加工模式现状,研究影响机制砂质量控制的要素,探索机制砂的未来发展方向,以供参考.