Objective:In recent years, the risk of depression has increased among young people, and changes in body mass index (BMI) during childhood may be important factors in their development. However, the relationship between changes in BMI during childhood and the risk of depression needs further research and exploration. Methods:The annual health examination data were collected from Physical Examination Center of Wuhan Mental Health Center Hospital, including 1226 students. The height and weight of students at the age of 11, 14, and 17 were recorded in sequence, and at 18 years old, these students were followed up according to the Hamilton Depression Scale (HAMD) to evaluate the depression. The relationship between BMI trends and depression was analyzed through Logistic regression analysis. Results:The growth trend of BMI was divided into normal growth, slow growth, and excessive growth. The odds ratio (OR) value for depression in the slow growth was 1.218 (95% CI, 0.995-1.493) compared to the normal growth, which was no significant difference (P = .056). The OR value for depression in the excessive growth was 1.982 (95% CI, 1.243-3.177) compared to the normal growth, which was significant difference (P = .003). Conclusion:The rapid growth of BMI is correlated with the occurrence of depression in young individuals and may be a contributing factor to the development of depression in this demographic.

目的 探讨早期颅骨修补术对脑外伤患者临床疗效及不良反应的影响.方法 选取2020-03至2022-03于医院治疗的脑外伤恢复期合并颅骨缺损患者98例,根据去骨瓣减压术后颅骨修补手术时机分为两组,对照组术后6个月后行颅骨修补术,研究组术后3个月内行颅骨修补术,观察对比两组患者术后的不良反应发生率、认知功能、神经功能、日常生活能力、生活质量改善程度.结果 研究组不良反应发生率(6.12％)低于对照组(24.48％)(P<0.05);研究组术后NIHSS评分(11.20±2.65)低于对照组(15.41±2.62),MMSE评分(27.02±1.77)高于对照组(20.33±2.46)),BI评分(84.08±6.28)高于对照组(71.61±7.42),差异均有统计学意义(P<0.05).研究组术后KPS、GOS评分均高于对照组(P<0.05).结论 早期颅骨修补术能有效改善患者的认知、神经功能,减少不良反应,改善患者预后.

目的:分析脉搏指示连续心排血量(Pulse indicator Continous Cardiac Output,PiCCO)检测仪对重症感染患者心脏功能的监测作用和对预后的预测性.方法:纳入2017年4月～2021年4月入院治疗的60例重症感染患者.根据预后分为死亡组21例和存活组39例.对所有患者进行PiCCO检测仪监测,对比相关指标.分析PiCCO检测仪心功能指标与其他指标相关性.结果:两组患者的PiCCO检测仪心功能指标、传统指标与APACHEⅡ评分对比有差异(P<0.05).PiCCO检测仪心功能与其他指标具有相关性.结论:PiCCO检测仪心功能指标可以评估重症感染患者的预后情况,且与临床传统指标和健康状态具有相关性.

High penetration of renewable energy in power grid challenges power system operation and stability evaluation, due to the fast dynamic behaviours of power electronic devices. The accurate broadband impedance measurement is one of the critical aspects of power system stability analysis. The impedance measurement method of injecting harmonics to the actual power system may bring the risk of instability. The hardware-in-the-loop simulation technology can achieve accurate broadband impedance measurement with lower cost and risk. The computing accuracy and simulation scale of realtime simulators depend on the computing power of the target computer. As the demands of large-scale power system increase, a single real-time simulation system may not meet the requirements. Co-simulation between multiple real-time simulators is an effective way to increase the scale of the simulation. This paper proposed an online impedance analysis co-simulation framework based on the CloudPSS-RT and RT-Lab platform. The co-simulation framework was verified with A PV and DFIG power generation system.

目的 探讨脑出血开颅术后气管切开时机不同对患者的影响.方法 264例脑出血开颅术后患者,根据治疗方案不同分为早期组(148例)和晚期组(116例).早期组患者存在气管切开指征,主张有气管切开指征时在开颅术后1～3 d内行气管切开手术;晚期组患者主张延长经口气管插管至10 d,根据10 d后患者情况再次评估是否需要气管切开,仍存在手术指征者在术后14 d内行气管切开手术,无手术指征者14 d内拔除经口气管插管.比较两组患者格拉斯哥昏迷指数量表(GCS)评分、临床肺部感染评分、呼吸机使用时长、重症加强护理病房(ICU)入住时长、气管切开率、3个月死亡率、因呼吸问题重返ICU率.结果 早期组患者术后7 d的GCS评分(6.57±0.95)分高于晚期组的(6.26±0.75)分,临床肺部感染评分(6.80±0.83)分低于晚期组的(7.08±0.56)分,差异有统计学意义(P<0.05);两组患者术后14 d的GCS评分和临床肺部感染评分比较差异无统计学意义(P>0.05).早期组患者呼吸机使用时长(72.11±24.39)h和ICU入住时长(285.02±38.53)h均短于晚期组的(174.41±60.43)、(394.31±24.71)h,差异有统计学意义(P<0.05).晚期组患者气管切开率91.4％低于早期组的100.0％,差异有统计学意义(P<0.05);两组3个月死亡率及因呼吸道问题重返ICU率比较差异均无统计学意义(P>0.05).两组GCS评分3～5分患者的气管切开率均为100.0％.结论 脑出血开颅术后患者延长经口气管插管时间不利于肺部感染的控制,但不会增加对患者预后的负面影响,而且延长经口气管插管时间使部分患者免于气管切开手术,从而减少了更多的创伤性治疗.GCS评分低患者气管切开不可避免,应尽早积极采取气管切开治疗.

BACKGROUND:Magnetic Seizure therapy (MST) is an effective treatment for major depressive disorder (MDD) but its mechanism of action is not fully understood. The present study sought to characterize neuroimaging correlates of response and side effects of MST in a MDD cohort.METHODS:Fifteen severe MDD patients underwent a six-day course of MST treatment to the vertex. Before and after treatment, participants received rs-fMRI and structural MRI scans as well as assessments of depressive symptoms and neuropsychological functioning. 10 healthy volunteers received functional and structural MRI scans at similar time intervals.RESULTS:MST treatment was associated with increased functional connectivity between the subgenual anterior cingulate cortex (sgACC) and the parietal cortex, which positively correlated with clinical improvement. In contrast, greater decrease in functional connectivity between the right anterior hippocampus and the prefrontal cortex was correlated with lesser clinical and cognitive improvements. Changes in gray matter volume were evident in the bilateral parietal cortex, but were not associated with treatment outcomes.LIMITATIONS:The sample size was small and results warrant replication.CONCLUSIONS:This is the first quantitative fMRI study to investigate the neural correlates of MST treatment for MDD patients. While preliminary, these findings suggest that the modulation of sgACC activity is integral to the antidepressant mechanisms of MST. In contrast, changes in the hippocampus were not associated with symptom improvement, and appeared to contribute instead to side effects. Future studies in larger samples are warranted and explore the effect of e-electric field and correlates of response.

目的 探讨腰大池-腹腔分流术治疗40例交通性脑积水的临床效果.?方法 回顾性分析首都医科大学附属北京康复医院神经康复中心自2016年1月至2018年12月期间采用腰大池-腹腔分流术治疗的40例交通性脑积水患者的临床资料,主要临床表现有意识障碍、认知障碍、肌张力增高等.术前头颅CT检查证实存在脑室系统扩大,行腰穿放液试验或腰大池引流试验后症状改善,采用可调压脑脊液分流阀行腰大池-腹腔分流术.?结果 随访6～24个月,脑积水症状均有不同程度改善,无死亡、无分流管相关感染、无分流管堵塞.术后3个月,患者日常生活能力(ADL)、神经功能缺损评分(NIHSS)、简易精神状态(MMSE)、上肢运动功能(Fugl-Meyer)评分均较术前明显改善(t=2.816、3.483、16.306、14.033,P<0.05);术后6个月,患者ADL、NIHSS、MMSE和Fugl-Meyer评分较术后3个月时的评分进一步改善(t=2.109、16.708、10.449、4.749,P<0.05).术后3个月,患者Evan's指数与术前比较差异无统计学意义(P>0.05);术后6个月,患者Evan's指数较术前明显降低(t=7.602,P<0.05).?结论 腰大池-腹腔分流治疗交通性脑积水疗效确切,对中枢神经系统基本无损伤,具有创伤小、恢复快、并发症少等优点.

目的 比较既往有冠状动脉旁路移植术(CABG)和无CABG的原位血管慢性完全闭塞(CTO)病变行经皮冠状动脉介入治疗(PCI)的临床结果.方法 选取2014年1月至2019年1月于首都医科大学附属北京安贞医院治疗的CTO病变行PCI的既往有CABG的CTO-PCI组患者(219例),同时选择既往无CABG的CTO-PCI组患者(528例).比较两组患者的基线资料、PCI成功率和介入方法以及并发症等.结果 既往有CABG的CTO-PCI组患者年龄[(66.5±9.4)岁比(61.1±10.2)岁,P=0.002]、高血压病(90.0％比83.0％,P=0.015)、糖尿病(40.6％比30.1％,P=0.005)和卒中史(8.7％比4.4％,P=0.020)显著高于既往无CABG的CTO-PCI组患者,差异均有统计学意义.既往有CABG的CTO-PCI组患者技术成功率(77.6％比87.1％,P=0.001)和手术成功率(74.9％比84.8％,P=0.001)显著低于既往无CABG的CTO-PCI组患者,而两组患者住院期间主要并发症的发生率(2.7％比2.3％,P=0.705)比较,差异无统计学意义.既往有CABG的CTO-PCI组患者2014年1月至2016年12月入组技术成功率[71.8％(94/131)比86.4％(76/88),P=0.038]显著低于2017年1月至2019年1月入组;既往无CABG的CTO-PCI组患者2014年1月至2016年12月入组技术成功率[83.5％(258/309)比92.2％(202/219),P=0.007]显著低于2017年1月至2019年1月入组,差异均有统计学意义.结论 既往有CABG的CTO病变患者介入难度更高,可以更多地应用逆向技术来提高手术成功率.

目的 探讨冠状动脉慢性完全闭塞病变(CTO)患者在经皮冠状动脉介入(PCI)治疗后非闭塞病变进展的危险因素.方法 回顾性分析2017年9月至2018年9月于首都医科大学附属北京安贞医院行PCI治疗后12个月内进行第2次冠状动脉造影的90例患者.依据非闭塞病变进展情况分为未进展组(61例)和进展组(29例).比较2组临床资料并分析与非闭塞病变进展相关的危险因素.结果 进展组替格瑞洛使用率高于未进展组,氯吡格雷和血管紧张素转换酶抑制剂使用率均低于未进展组,差异均有统计学意义(均P ＜0.05).进展组C反应蛋白、二磷酸腺苷(ADP)途径血小板聚集率高于未进展组[2.76(1.19,5.92) mg/L比0.95(0.45,3.11) mg/L、(52±15)％比(40±17)％],差异均有统计学意义(均P＜0.05).进展组置入支架总长度短于未进展组,差异有统计学意义(P＜0.05).偏相关分析结果显示,ADP途径血小板聚集率水平与非闭塞病变进展呈正相关(r=0.351,P＜0.001).以ADP途径血小板聚集率水平30％为界值预测非闭塞病变进展为最佳,其敏感度和特异度分别为86.2％和68.9％.结论 ADP途径血小板聚集率可能是CTO介入治疗后非闭塞病变进展的预测因素.血小板功能监测和充分的抗血小板治疗对接受复杂PCI的患者是十分必要的.

慢性完全闭塞病变(chronic total occlusion,CTO)在临床实践中并不少见,但只有很少一部分患者接受冠状动脉介入治疗(percutaneous coronary intervention,PCI).慢性完全闭塞病变的冠状动脉介入治疗(chronic total occlusion percuta-neous coronary intervention,CTO-PCI)是目前冠状动脉介入治疗方面仍具挑战性的领域.近一段时间由于技术方面的重大突破,CTO-PCI成功率得到了提高,并发症的发生率进一步降低.本篇综述总结了CTO-PCI临床获益和并发症风险方面的现有资料,希望能为CTO-PCI的临床实践提供参考.

BACKGROUND:Magnetic Seizure therapy (MST) is an emerging treatment for major depressive disorder (MDD) that is associated with fewer cognitive side effects compared to electroconvulsive therapy. The present pilot study sought to investigate whether daily MST treatments were associated to antidepressant effect and assess cognitive side effects associated with an accelerated MST (aMST) treatment schedule.METHODS:Fifteen MDD patients underwent a six-day course of MST treatment to the vertex following assessment of symptom severity and neuropsychological testing. The primary outcome was severity on the Hamilton Rating Scale for Depression 17-item (HRSD-17). Patient also underwent neuropsychological assessment with the RBANS and Stroop Colour-Word test.RESULTS:There were no instances of delirium or disturbance of consciousness following aMST sessions. Patients showed significant decreases on indices of depression and anxiety symptoms, with 9 (60%) patients showing a clinical response and 7 (47%) patients experiencing remission. Significant improvements were reported in RBANS total score, as well as indices of immediate memory and delayed memory. No changes at follow-up were reported for visuospatial/constructional, language, and attention RBANS indices, nor for Stroop Colour/Word performance.LIMITATIONS:The results should be interpreted with caution as they are part of a non-randomized, open-label pilot study. Further, the short duration of the study does not provide longitudinal follow-up to determine whether treatment response lasts a meaningful duration of time.CONCLUSIONS:aMST well tolerated without significant evidence of cognitive side effects and rapid improvement in symptoms. Further research is required to fully characterize these changes and replicate them in independent samples.

目的 探讨阿尔茨海默病患者生活质量的影响因素.方法 选取首都医科大学良乡教学医院收治的64例阿尔茨海默病患者及其照料者作为研究对象,采用阿尔茨海默病生活质量测评量表(QOL-AD)、日常活动能力量表(ADL)、简易智能量表(MMSE)、临床痴呆评定量表(CDR)、Zung氏焦虑自评量表(SAS)和Zung氏抑郁自评量表(SDS)收集患者的一般资料和临床资料,采用Zarit照料负担量表(ZBI)、家庭负担量表(FBS)评估照料者照料负担情况,应用统计学软件分析患者生活质量及其相关影响因素.结果 64名患者QOL-AD平均(29.30±3.22)分,其中ADL得分越高的患者QOL-AD总分越高(P<0.05),而CDR、ZBI得分越高的患者QOL-AD总分越低(P<0.05);有焦虑抑郁情绪、合并慢性疾病、伴有精神行为异常、无配偶或非配偶照顾的患者QOL-AD明显降低(P<0.05),而MMSE、药物治疗对患者的QOL-AD评分差异无统计学意义(P>0.05);多因素Logistic回归分析显示,ADL、ZBI、SDS、SAS、照料者角色是QOL-AD的影响因素.结论 日常生活能力、心理状态、照料者角色和照料负担是患者生活质量的主要影响因素,可根据相应的影响因素采取综合性措施以提高患者的生活质量.

目的 评估药物治疗基础上使用快速磁惊厥疗法(accelerated magnetic seizure therapy,aMST)治疗重性抑郁障碍(major depressive disorder, MDD)的疗效和安全性.方法 招募MDD患者15例,在抗抑郁药物治疗基础上8 d内进行6次MST治疗,治疗前后均使用17项汉密尔顿抑郁量表(17-item Hamilton depression rating scale, HAMD-17)、汉密尔顿焦虑量表(Hamilton anxiety rating scale, HAMA)、可重复的成套神经心理状态测验(the repeatable battery for the assessment of neuropsychological status, RBANS)及Stroop词色测验评估患者症状及认知和执行功能.结果 aMST治疗前后比较,患者HAMD-17总分下降(Z=10.42,P＜0.01),5项因子分差异均有统计学意义(P＜0.05);HAMA评分下降(Z=7.71,P＜0.01);RBANS总分增加(t=-5.80,P＜0.01),其中即刻记忆因子及延时记忆因子评分在治疗前后有统计学差异(P＜0.05);Stroop测试在治疗前后差异无统计学意义(P＞0.05).15例MDD患者均未发生严重不良副反应,治疗期间无患者脱落.结论 aMST治疗抑郁障碍快速且安全有效,患者可以耐受.

这天门诊又来了这样一位患者,是一位70多岁的老奶奶,在儿子的陪同下来到精神心理科. 老奶奶虽然坐在了诊桌边上,但还是一副不情愿的模样.旁边40多岁的儿子陪着笑脸,小心翼翼地对老奶奶说:“既然医生建议了,您还是好好看看吧”.

目的:观察缺血后适应对非梗死相关动脉组织细胞凋亡及其相关基因的影响.方法:制备兔高脂血症心肌缺血再灌注模型,实验动物随机分为三组(每组10只):A组:假手术组.B组:心肌缺血再灌注组.C组:心肌缺血后适应再灌注组.通过Tunel荧光染色和实时荧光定量PCR(qRT-PCR)检测比较各组非梗死相关动脉组织细胞凋亡程度以及血管紧张素Ⅱ1型受体(AT1)、缝隙连接蛋白43(Cx43)、β微管蛋白(β-tubulin)等相关基因的差异.结果:心肌缺血再灌注1周后,非梗死相关动脉出现动脉粥样硬化斑块.非梗死相关动脉组织Tunel荧光染色分析显示,与假手术组相比,急性心肌缺血再灌注组的凋亡细胞增加[(8.14±2.05)％vs.(46.11±5.92)％,P＜0.001].与急性心肌缺血再灌注组相比,急性心肌缺血后适应再灌注组的凋亡细胞减少[(46.11±5.92)％vs.(28.36±9.41)％,P＜0.001].非梗死相关动脉组织qRT-PCR检测显示,与假手术组相比,急性心肌缺血再灌注组的[AT1(1.002±0.068)vs.(30.576±1.760),P＜0.01]、CX43(1.009±0.133)vs.(15.171±1.736),P＜0.01)、β-tubulin基因[(1.003±0.083)vs.(1.361±0.042),P＜0.01]上调.与急性心肌缺血再灌注组相比,急性心肌缺血后适应再灌注组[AT1(30.576±1.760)vs.(4.697±0.227),P＜0.01]、CX43(15.171±1.736)vs.(2.267±0.312),P＜0.01]、β-tubulin基因下调[(1.36±0.042)vs.(1.083±0.098),P＜0.01].结论:心肌缺血再灌注1周后,非梗死相关动脉出现动脉粥样硬化斑块,伴随凋亡细胞增加和AT1、CX43、β-tubulin基因上调.缺血后适应可减少非梗死相关动脉凋亡细胞数量并可使AT1、CX43、β-tubulin基因下调,从而抑制非梗死相关动脉病变进展.

Objective To analyze the relation between fasting blood glucose and nonculprit vessel lesion (NCL) progression after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods Clinical data of 192 patients who were diagnosed of AMI from January 2016 to December 2017 and had reexamination of coronary angiography before June 2018 in Beijing Anzhen Hospital,Capital Medical University were analyzed.They were divided into NCL progression group (82 cases) and NCL progression-free group(110 cases).Basic information and the correlation between fasting blood glucose and NCL progression were analyzed.Results Levels of body mass index,serum creatinine,fasting blood glucose,glycated serum albumin,glycated hemoglobin and homocysteine in NCL progression group were significantly higher than those in NCL progression-free group(all P ＜ 0.05).Logistic regression showed that fasting blood glucose(odds ratio =1.274,95％ confidence interval:1.077-1.505,P=0.005) and serum creatinine (odds ratio =1.020,95％ confidence interval:1.002-1.038,P =0.027) were independent predictors of NCL progression.Partial correlation analysis showed that fasting blood glucose was positively correlated with NCL progression (r =0.231,P =0.001).Receiver operating characteristic curve showed that the boundary point of fasting blood glucose to predict NCL progression was 5.715 mmol/L;the sensitivity was 74.4％ and the specificity was 46.4％.Conclusion Fasting blood glucose is valuable in the prediction of NCL progression and risk stratification after PCI in patients with AMI.

Objective To observe the change of functional connectivity(FC) between default mode network (DMN) and the other brain regions in patients with depression before and after magnetic seizure therapy(MST),and explore the role of DMN in therapeutic mechanism of MST.Methods Fifteen patients with depression who met the criteria of enrollment underwent rs-fMRI scanning before and after the MST treatmerts.As a very important region of DMN,the posterior cingulate cortex(PCC) was selected as the region of interest(ROI)to make the functional connectivity analysis with other brain regions,then the differences in FC before and after MST treatments were tested.The correlation of FC index changes with the score changes of HAMD-17 and five factors of HAMD-17 was analyzed after MST treatments.Results A comparison of the differences in DMN before and after treatments showed that the connection between left PCC and bilateral medial temporal lobe connectivity decreased significantly (left:MNI:x,y,z =-66,-39,-15,right:MNI:x,y,z =69,-30,-6) (P＜ 0.05).The connection between left PCC with left cerebellum (MNI:x,y,z =-33,-42,-42) and left occipital lobe(MNI:x,y,z=0,-84,24)significantly increased(P＜0.05).The changes of sleep factor of HAMD-17 were positively correlated with the functional connectivity changes of bilateral medial temporal lobe (left:r=0.670,P=0.006;right:r=0.570,P=0.026),but negatively correlated with the functional connectivity changes of the left cerebellum (r=-0.543,P=0.037).Conclusion MST can play an antidepressant role by regulating DMN functional connection of depressive patients and it may be a neuromodulation mechanism of MST in the treatment of depression.

Objective To investigate the preventive effect of ischemic postconditioning on non-culprit lesion progression in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention(PCI).Methods A total of 200 STEMI patients undergoing primary PCI from January 2010 to December 2013 in Beijing Anzhen Hospital,Capital Medical University were randomly divided into ischemic postconditioning group and eontrol group,with 100 cases in each group.Postoperative recovery,non-culprit lesion progression and related clinical indicators were analyzed.Results Secondary PCI rate of non-culprit lesion in 12 months after operation in ischemic postconditioning group was significantly lower than that in control group [7.0％ (7/100) vs 21.0％ (21/100)] (P ＜0.01).Seventy-nine patients did not have reoperation(group A) and 21 patients had secondary PCI (group B) in control group;93 patients did not have reoperation (group C) and 7 patients had secondary PCI (group D) in ischemic postconditioning group.Serum levels of adrenaline and noradrenaline in group B were significantly higher than those in group A;levels of adrenaline and noradrenaline in group D were significantly higher than those in group C(P ＜0.001).Types of non-culprit lesion showed no significant difference among group A,B,C and D (P ＞ 0.05).Serum levels of adrenaline,noradrenaline and C-reactive protein in patients without reoperation(n =172) were significantly lower than those in patients with secondary PCI (n =28) [(223 ± 48) ng/L vs (309 ± 52) ng/L,(1 807 ± 365) ng/L vs (2 528 ± 421) ng/L,(18 ± 6) mg/L vs (24± 8)mg/L] (P ＜0.001).Conclusions Revascularization after primary PCI is related to non-culprit lesion progression in patients with STEMI.Ischemic postconditioning may prevent non-culprit artery lesion progression.

目的 比较冠状动脉旋磨术中使用低转速和高转速旋磨的安全性和有效性,探讨冠状动脉旋磨术应用不同旋磨速度的临床结果.方法 采用单中心前瞻性随机对照研究方法,将2012年9月1日至2017年9月1日因严重冠状动脉钙化行冠状动脉旋磨术的患者随机分成低转速组(140000 r/min)和高转速组(180000 r/min),比较手术结果和围术期及30 d内的主要并发症.结果 冠状动脉旋磨术86例中共入选患者50例,高转速组25例,低转速组25例.两组冠状动脉旋磨术手术成功率为100.0％ 比96.0％(P=1.000),其中低转速组1例患者旋磨后仍有球囊扩张不良,放弃置入支架.两组均未发生严重并发症,高转速组4例发生分支急性闭塞(16.0％ 比4.0％,P=0.346),其中3例有夹层(12.0％ 比4.0％,P=0.602);2例慢血流或无复流(8.0％ 比0.0,P=0.470),与低转速组比较差异均无统计学意义.低转速组中1例出现失速、磨头嵌顿.结论 冠状动脉旋磨术中选择140000 r/min和180000 r/min的转速均可取得较高的手术成功率,高转速可能会增加慢血流或无复流和夹层尤其是分支急性闭塞的发生率,在严重迂曲钙化病变中选择低转速时要预防旋磨头卡住和旋磨效果不良的情况.

Objective: The objective of this study was to determine the expression of beta-tubulin in non-culprit arteries and investigate the effect of ramipril on progression of non-culprit lesions in rabbits. Methods: A myocardial ischemia-reperfusion model in the rabbit was prepared. Smooth muscle cells in non-culprit arteries were divided into 4 groups (10 samples in each group) at random:. Hyperlipidemia control group,. Myocardium ischemia group,. Myocardium ischemia reperfusion group,. Myocardium ischemia reperfusion and the ramipril intervention group. Immunohistochemistry was used to analyze for beta-tubulin in non-culprit arteries, and expression of beta-tubulin in each group was analyzed. Results: The thickness of atherosclerotic plaque in the myocardium ischemia reperfusion group was more than in then myocardium ischemia group (113.61 +/- 25.67 mu m vs 35.42 +/- 11.19 mu m, P < 0.0001). The thickness of atherosclerotic plaque in the myocardium ischemia reperfusion and ramipril intervention groups was less than that in myocardium ischemia reperfusion group (82.79 +/- 17.24 mu m vs 113.61 +/- 25.67 mu m, P < 0.001). Expression of beta-tubulin in the myocardium ischemia reperfusion group was higher than that in the myocardium ischemia group, (413.61 +/- 50.46 vs 83.15 +/- 21.12, P < 0.0001). Expression of beta-tubulin in myocardium ischemia reperfusion and ramipril intervention group was lower than that in the myocardium ischemia reperfusion group (312.79 +/- 37.33 vs 413.61 +/- 50.46, P < 0.0001). Conclusions: Non-culprit arteries may progress after primary PCI, which may be involved with beta-tubulin, ramipril may inhibit the progression of non-culprit arteries by decreasing expression of beta-tubulin.