AIM: To investigate the role of nitric oxide in proliferation and secretion of vascular endothelial cells induced by vascular endothelial growth factorr (VEGF). METHODS: The in vitro cultured vascular endothelial cells of rabbit aorta were divided into control group, VEGF-treated group and VEGF+L-NAME treated group, the absorbance (A) value of vascular endothelial cells, endothelin-1(ET-1) and von Willebrand factor (vWF) in the supernatant were examined by WST-1 assay, radioimmunoassay and ELISA. RESULTS: The A value in VEGF and VEGF+L-NAME treated group were higher than that in control group (P

Objective: To explore characteristics and influencing factors for blood pressure variability (BPV) in aged patients with H type hypertension.Methods: A total of 100 patients with essential hypertension, who were treated in our hospital from Dec 2012 to Dec 2013, were selected.According to serum level of homocysteine (Hcy), patients were divided into pure hypertension group (n=42, Hcy<15.4 μmol/L) and H type hypertension group (n=58, Hcy≥15.4 μmol/L).All patients received 24h ambulatory blood pressure monitoring (24hABPM), and BPV indexes were recorded and compared between two groups.Correlation among BPV indexes and general data were analyzed, and multi-factor linear regression analysis was used to analyze influencing factors for BPV indexes.Results: Compared with pure hypertension group, there were significant rise in 24h systolic blood pressure standard deviation [24hSSD, (12.80±2.23) vs.(16.01±3.11)], daytime SSD [dSSD, (11.58±2.30) vs.(13.86±2.26)] and nighttime SSD [nSSD, (9.41±1.64) vs.(11.71±2.34)] in H type hypertension group, P<0.05 or <0.01.Pearson correlation analysis indicated that Hcy, total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were significantly positively correlated with 24SSD, dSSD and nSSD (r=0.201~0.508, P<0.05 or <0.01).Multivariate linear regression analysis indicated that Hcy and TC were significantly positively correlated with 24SSD, dSSD and nSSD (B=0.194~0.546, P<0.05 or <0.01).Conclusion: Systolic blood pressure variability in aged patients with H type hypertension is significantly higher than that of patients with pure hypertension,their serum Hcy level, TC elevating level are significantly positively correlated with systolic blood pressure variability and are major influencing factors for BPV in these patients.

Objective To explore the interventional methods to treat recurrent jaundice after palliative bilio intestinal anastomosis in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods Ten patients with recurrent jaundice after bilio intestinal anastomoasis were retrospectively evaluated. Nine of ten underwent PTCD with metallic stent placement, one underwent the inner outer draining catheter procedure. The patients were evalualed with comparison in regard to preoperative conditions, TBIL,ALT,GTP and AKP values.Results Stent placement was successful only once in all 10 cases with successful rate of 100%. TBIL,ALT,GTP and AKP values were significantly lower 7 days postoperative by than that preoperation. Subsidence of jaundice was satisfactory for 100% in all patients after the treatment. Conclusions Percutaneous placement of biliary metallic stents is a safety, simple, low complication method for managing recurrent jaundice after palliative bilio intestinal anastomosis for the terminal stage of malignant obstructive jaundice.

Objective To study the effects of the pediatric sinusitis patients using furoic acid momethasone nasal spray after the treatment.Methods 60 pediatric sinusitis patients were divided into the two groups by the random number table method,gien the control group conventional treatment,and the observational group furoic acid momethasone,pediatric sinusitis nasal spray treatment,then the clinical effect and safety of the two groups of children were observe dand compared.Results After the treatment of the two groups,the observational group total effective rate(96.67%)was significantly higher than that of the control group (70.00%)(χ2 =10.23,P <0.05 ),the incidence of adverse reactions(3.33%)in children with significantly less than the control group(33.33%),which was statistically significant (χ2 =12.48,P <0.05 ).The observational group with bacterial clearance rate was significantly higher than that of the control group(90.91%)in children with bacterial clearance rate(61.90%), which was statistically significant(χ2 =13.26,P<0.05).Conclusion Using mometasone furoate nasal spray in the treatment of sinusitis in children can improve the total efficiency,and with low incidence of adverse reactions,which can effectively improve the clearance rate of bacteria,beneficial to restore the health of children,safe and effective and should be widely used in clinical practice.

Objective To compare the sensitivity between forceps biopsy and brushing, and to explore a feasible approach to pathological diagnosis of the obstructive jaundice.Methods 92 consecutive patients with obstructive jaundice underwent transluminal foreceps biopsy and brushing during percutaneous transhepatic cholangiography and percutaneous transhepatic cholangiodrainage. The technique was performed through an preexisting percutaneous transhepatic tract with multiple specimens obtained after passing the forceps biopsy or brush into a 8-French sheath. Finally the specimens were fixed with formalin for pathologic or cytologic diagnosis. Results The histopathologic diagnosis was acquired in 81 out of 92 patients with forceps biopsy reaching the successful rate of 97.83%. Sensitivity of forceps biopsy in 92 patients was higher than that of brush in 84 patients(88.04% vs 76.19%,? 2=4.251,P=

Objective To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods 7 bili ary metallic stents were placed in 7 patients with recurrent jaundice after T tube drainage in cholangiocarcinoma cases. Results Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL,ALT,GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment.Conclusions Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma induced obstructive jaundice.

Objective To explore the technical feasibility and sensitivity of percutaneous transhepatic cholangiobiopsy in malignant obstructive jaundice, together with the guidance for clinical managements.. Methods 31 patients with obstructive jaundice after percutaneous transhepatic cholangiography and drainage were undesgone percutaneous transhepatic cholangiobiopsy. The technique was performed through an preexisted percutaneous transhepatic tract with a 8 Frerch sheath, multiple specimens were obtained after passing the forceps for the biopsy. The specimens were fixed with formalin, and then taken for histopathologic diagnosis. Results The histopathologic diagnosis was acquired in 30 of 31 patients(sensitivity, 96.8%). Conclusions Percutaneous transhepatic cholangiobiopsy is an accurate, safety and reliable way, easy to perform with a histopathologic diagnosis sensitivity rate of 96.8%.

Objective To evaluate the accuracy and reliability of 4D time-resolved MRA with keyhole (4D-TRAK) for the detection and characterization of cerebral aneurysms ( CAs),with a comparison of 3D time-of-flight MRA (3D-TOF-MRA).Methods3D-TOF-MRA,4D-TRAK and 3D-DSA were performed sequentially in 52 patients with suspected CAs.4D-TRAK was acquired using a combination of sensitivity encoding (SENSE) and contrast-enhanced (CE) timing robust angiography ( CENTRA ) k-space sampling techniques at a contrast dose of 10 ml at 3 T scanner. Accuracy,sensitivity,specificity of 4D-TRAK and 3D-TOF-MRA were calculated and compared for the detection of CAs on patient-based and aneurysm-based evaluation using 3D-DSA as a reference. Wilcoxon signed rank test were used. Results The overall image quality of 4D-TRAK was appropriate for the diagnostic purpose,but yet not comparable with that of 3D-TOF-MRA.In 52 patients with suspected GAs,58 CAs were confirmed on 3D-DSA finally.Fifty-one (with 2 false-positives and 9 false-negatives) and 58 (with 1 false-positive and 1 false-negative)CAs were visualized on 4D-TRAK and 3D-TOF-MRA,respectively.Accuracy,sensitivity and specificity on patient-based evaluation of 4D-TRAK and 3D-TOF-MRA were 92.31％ ( 48/52 ),93.33％ ( 42/45 ),85.71 ％ (6/7) and 98.08％ ( 51/52 ),100.00％ ( 45/45 ),85.71％ ( 6/7 ),respectively,and 74.07％(20/27),75.00％ ( 18/24),66.67％ (2/3) and 96.30％ (26/27),95.83％ (26/27),100.00％ (3/3)on aneurysm-based evaluation in patients with multiple CAs,respectively.Subgroup analysis revealed that for 19 very small CAs ( maximal diameter ＜3 mm,measured on 3D-DSA),9 were missed on 4D-TRAK and 1 on 3D-TOF-MRA( Z =- 2.464,P ＜ O.01 ). However,for 39 CAs with maximal diameter more than 3 mm,there was no significantly difference in the diagnostic accuracy (39 on 4D-TRAK vs.39 on 3D-TOFMRA) (Z =0.000,P ＞0.05).In 4 large CAs with maximal diameter more than 10 mm,4D-TRAK provided a better characterization of morphology than 3D-TOF-MRA.Conclusions 4D-TRAK with a combination of SENSE and CENTRA at 3 T shows potential value in the diagnosis of cerebral aneurysms.However,due to the compromise in spatial resolution and vascular edge artifacts,it does not yet have a diagnostic accuracy of CAs comparable with 3D-TOF-MRA.TRAK imaging can be of great help in patients with large-giant CAs to characterize the morphology of CAs and to diminish the risk of NSF in patients with renal impairment by using a lower-dose contrast.

A giant basilar artery aneurysm of young woman with endocrine disturbance was misdiagnosed as a large pituitary adenoma and treated surgically via a trans-sphenoidal approach was planned.But the neurosurgery was finally aborted because of massive bleeding during the procedure. One year later, a cerebral angiography confirmed this basilar artery aneurysm was obviously regressed and then endovascular coiling was successfully performed. No neurological complication occurred post-procedure and the endocrine dysfunction symptom was obviously improved.

Objective To explore the effects of Sanchi gel on MMP-1 and TIMP-1 expression in epidural adhesion after laminectomy. Methods Laminectomy model was set up in SD rats. 72 SD model rats were divided randomly into Saline group, Zhanlp group, Carbopol Gel group and Sanchi Gel group, with 18 rats in each group. On 7, 14 and 21 days after the laminectomy, immunohistochemistry (method of S-P) was adopted to detect the expression of TIMP-1 and MMP-1. Results Different treatments had different influence on TIMP-1 and MMP-1 expression in epidural adhesion. The expression of TIMP-1 increased gradually on 14 dand 21 d after operation, and Sanqi Gel group showed weaker expression than the other groups (P＜0.05), but the number of positive cells decreased gradually. As to the expression of MMP-1, there was no difference among each group at the end of the second week (P＞0.05). There was a difference between Sanchi Gel group and the other groups at the end of third week (21 d) (P＜0.05) after operation. Sanchi Gel group showed higher expression of TIMP-1 than the other groups. The number of positive cells sharply decreased from 14 d to 21 d after operation. Conclusion Sanchi Gel has a significant preventive effect on fibrous scar formation after laminectomy. The possible mechanism of preventing epidural adhesion after laminectomy by Sanchi Gel could be its regulating and controlling the expression of TIMP-1 and MMP-1 in epidural tissue.