OBJECTIVE:To investigate the effects,prognosis and safery of recombinant human brain natriuretic peptide on the treatment of patients with acute decompensated heart failure. METHODS:90 inpatients with acute decompensated heart failure were divided into observation group and control group according to the use of recombinant human brain natriuretic peptide or not,with 45 cases in each group. Control group received rountine anti-heart failure therapy and intravenous dripping of Nitroglycerin injection at 20 μg/min continuously for 72 h. Observation group was additionally given Lyohilized recombinant human brain natriuretic peptide with initial loading amount of 1.5 μg/kg,iv,then intravenous dropping at 0.007 5 μg/(kg·min)continuously for 72 h,on the basis of control group. Hemodynamic parameters,brain natriuretic peptide level,the difference of liquid intake and output,dyspnea,lung rales,systemic edema,the improvement of cardiac function were observed and compared between 2 groups before and after treat-ment as well as re-hospitalization rate and surriral rate 30 d after medication,the occarrence of ADR. RESULTS:After treatment, left ventricular ejection fraction of observation group was significantly higher than that of control group,and central venous pressure and brain natriuretic peptide level were lower than those of control group,with statistically significance (P<0.05). The difference of liquid intake and output after treatment was (1 171.60 ± 444.80)ml in observation group and (822.30 ± 268.40)ml in control group,with statistical significance between 2 groups(P<0.05). After treatment,the scores of dyspnea,lung rales and systemic ede-ma were decreased in 2 groups;the improvement of observation group was significantly better than that of control group,with statis-tical significance(P<0.05). Total effective rates of observation group and control group were 95.56% and 82.22%;re-hospitaliza-tion rates 30 d after medication were 17.78%and 26.67%;survival rates 30 d after medication were 88.89%and 75.56%,with sta-tistical significance between 2 groups (P<0.05). There was no statistical significanse in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Recombinant human brain natriuretic peptide can significantly improve hemodynamic parameters and heart function of patients with acute decompensated heart failure,and effectively relieve dyspnea,lung rales and systemic edema. It is better than routine treatment in prognosis with good safety.

Cellular FADD-like interleukin-1-? converting enzyme inhibitory protein (c-FLIP) is a kind of inhibitory protein of caspase with the death effector domain (DED), naturally existing in many species such as virus, eukaryote and mammal inclusively. Recently, it has been discovered that c-FLIP participates the regulation of apoptosis. Overexpression of c-FLIP may inhibits the apoptosis induced by the death receptor of Fas and TRAIL-R. With the development on the mechanism of action and molecular regulation of c-FLIP, its multi-biology function has been found, and also it is associated with the nosogenesis and progression of many diseases.

Objective To study the effects of melatonin (MT) on hepatic tissue of autoimmune hepatitis (AIH). Methods AIH model rats were divided randomly as model group, MT group and pig hepacyte growth factor (pHGF) group, to observe the pathological changes of hepatic tissue of the three groups. Results Hepatic tissue inflammation and accrementition graded of elastic fibers, reticular fibre, collagenous fibrils of MT group [(0.97±0.16),(1.09±0.17),(1.31±0.17)] were much lighter than model group [(1.55±0.18),(2.00±0.14),(3.00±0.14)](all P<0.01). The expression of VEGF was weaker in MT group than in pHGF group. There was no distinct difference between MT group and pHGF group. Conclusion MT can obviously improve the pathological changes of hepatic tissue of rats with AIH.

Objective:To evaluate the influence of platelet-rich plasma(PRP) on periodontal healing of replanted teeth in 6 Beagle dogs.Methods:The second incisors were pulled out and re-implanted after 60 min dry storage.In group A,PRP were applied before replantation,and 7days later the teeth received root canal treatment.In group B,PRP were applied before replantation either,but without root canal treatment.In group C,PRP were not applied and 7 days later,the teeth received root canal treatment.In group D,no PRP were applied and no root canal treatment.All the dogs were sacrificed after 12 weeks and the histological parameters were observed.Results:There were no significant differences between group A and C.Group B showed a lower incidence of ankylosis,and higher incidence of healed PDL compared with group D.Conclusion:Under the definite condition,PRP can help to decrease the incidence of ankylosis and increase the incidence of healed PDL in groups that the pulps were not removed.

Objective To observe the effects of intrabepatic injection with bepatocyte growth factor and dexamethason on stereological quantitative changes of hepatic sinusoidal tissues and expression of IV-collagen on hepatic sinusoidal walls of patients with hepatic cirrhosis.Methods Under the guide of hypersound,98 cases of hepatic cirrhosis were intrahepatic injected with 80mg hepatocyte growth factor and 1mg dexamethason at one time,twice a week,12 times a course,pathological changes of hepatic sinusoidal tissues and the expression of IV-coliagen on hepatic sinusoidal walls were detected by liver biopsy after one course.Results Pathological changes of hepatic sinusoidal tissues were improved obviously(P＜0.01 ) and the expression of IV-collagen was alleviated significantly(P＜0.01 ) on 98cases of hepatic cirrhosis after one course.Conclusion Pathological changes of hepatic sinusoidal tissues and the expression of IV-collagen on hepatic sinusoidal wails can be improved obviously on patients with hepatic cirrhosis who had been intrahepatic injected with hepatocyte growth factor and dexamethason under the guide of hypersound.

Objectives To compare clinical manifestations and electrophysiological features in patients with chron?ic inflammatory demyelinating polyneuropathy (CIDP) and Type-I Charcot Marie Tooth Disease (CMT-I) for guiding dif?ferential diagnosis. Methods Data including clinical manifestations and electrophysiological indexes was collected from thirty-one CIDP cases and 28 CMT-I cases. Correlation analysis was used to assess the association of the severity of electrophysiology with the severity of clinical symptoms. Results There were statistically significant differences in onset site, sensory dysfunction, foot deformity and cerebrospinal fluid protein between these two groups (P<0.05). There were significant differences in indexes of nerve conduction and needle electromyography between these two groups (P<0.05). The severity of clinical symptoms was not related with the severity of electrophysiology in CMT-I group (r=0.27,P>0.05). Conclusions Differential diagnoses of CIDP and CMT-I can be made based on clinical manifestations and electro?physiological features.

Objective To explore the value of CT venography in the surgical treatment of falcotentorial junction meningiomas. Methods CT venography was carried out in 25 patients with falcotentorial junction meningiomas. 2-D and 3-D images were reformatted at the workstation. The classification and relationship between the tumors and veins were determined, and the degree of venous stenosis and collateral were assessed. The safe surgical pathway was chosen to avoid the injury of main draining vein. Results Falcotentorial junction meningiomas were divided into 5 types according to the relationship between the tumors and veins and the direction of the tumors. There were 5 cases of forward type, 4 cases of backward type, 3 cases of inferior type, 6 cases of superior type and 7 cases of lateral type in this group. The relationship between tumors and veins was accordant with the findings in surgery. Of all 25 cases, 19 underwent total removal, 6 underwent subtotal removal and all of the main driving veins were reserved. There were 3 cases of quadrantanopsia or hemianopsia after the operation, and all of them recovered after 3 months of follow-up. Conclusion CTV technique can classify the falcotentorial junction meningioma and is helpful for choosing the appropriate surgical approaches.

BACKGROUND:Condylar fracture can occur under direct and indirect forces, and however, its risk and correlation with the impact site are rarely reported. OBJECTIVE:To quickly establish normal mandible three-dimensional finite element model and to analyze the strain conditions of the condyle under force at different parts of the mandible. METHODS: An adolescent volunteer was examined by multilayer spiral CT scans, whose mandible was normal and oral cavity was healthy. We used the reverse engineering software Mimics and large finite element software MSC.Patran to establish the three-dimensional finite element model of the mandible and to verify the feasibility of the model in the impact test at the body of the mandible, chin, mandibular angle and condyle. RESULTS AND CONCLUSION:A rapid establishment of mandible dimensional finite element biomechanical model could reproduce the morphology of the mandible, which was able to obtain the overal visual impression of the mandibular condyle. Geometric model included 80 044 nodes and 18 441 units. The mandibular chin, one side of the body, mandibular angle and condyle were given 100 N force respectively. The maximum equivalent stress of the bone cortex appeared in condylar region. So the mandibular condylar fractures were at the greatest risk. Experimental results contribute to mechanicaly analyze the condylar fracture type and to judge the severity of fractures.

Objective To explore the effect of different scan parameters and algorithm on detection of iron deposition with coexsiting fat by dual soure CT.Methods One ml homogenate of normal rat liver tissues and 1 ml iron dextran solution with different concentrations (50.000,25.000,12.500,6.250,3.125,and 1.560 mg/ml) were fully mixed respectively.The 6 test tubes were scanned by dual source CT in the mode of dual energy to gain the iron specific slope.Different concentrations of dextran iron(50,40,30,20,10,and 5 mg/ml),triglyceride(volume percent were 60％,30％,and 10％,respectively),and homogenate of normal rat liver tissues were mixed.All 18 tubes were scanned by dual source CT with 80-140 kVp and 100-140 kVp,and all these images were reconstructed by filtered back projection (FBP) and singogram affirmed iterative reconstruction(SAFIRE).Raw data were reconstructed by filtering and iterative method.△H value (△H =CT value low kVp-CT valuehigh kVp) and overlay value of three substances decomposition algorithm were measured and analyzed by t test.The Spearmen correlation was applied in iron concentration and measured values.Results Iron specific slope was found to be 1.9392.When 80-140 kVp and 100-140 kVp were applied,△H values were (198 ± 28) and (152 ± 18) HU by using FBP reconstruction,and △H values were (191 ± 23) and (149 ± 17) HU by using SAFIRE reconstruction.The differences were statistically significant(t =-2.934 and-3.492,P =0.032 and 0.017).Overlay values were (381 ±54) and (236 ±31) HU by using FBP reconstruction,and overlay values were (399 ±53) and (276 ± 43) HU by using SAFIRE reconstruction.The differences were also statistically significant (t =-5.739 and-7.949,P =0.002 and 0.001).Under the same energy portfolio but different reconstruction,both △H and overlay value showed no differences (P ＞ 0.05).Except for the conditions with 100-140 kVp tube voltage,△H had no correlation with iron solution concentration (P ＞ 0.05) under either FBP or SAFIRE reconstruction.When other reconstruction methods and tube voltage combination were used,overlay or △H value showed correlation with iron solution concentrations (r value ranged from 0.959 to 0.997,P values ＜ 0.01).Conclusions Different energy portfolios of dual source CT will act on the measured value of iron deposition.The measured values will not be affected by ways of reconstruction.For the detection of iron coexisting in fat,overlay values of material decomposition algorithm is better.

Objective To analyze the reason of post-operative infection of tibial plateau fracture, the therapeutic effect of using pedicle musculocutaneous flaps of proximal leg was researched and summarized. Methods There were 52 patients of tibial plateau fracture after internal fixation complicated by disunion of infected wound and soft tissue defects, traumatic osteomyelitis from January 2005 to May 2009. After pre-operative physical examination, laboratory examination, X-ray, CT scan and bacterial culture of the secretion,the operation, such as debridement, dead bone moving, medullary cavity cleaning, transferring to the external fixation when the internal fixation lost efficacy and bacterial culture of granulation tissue of different levels. The cavity was filled with RBK combined with vancomycin or tobramycin. If the cavity was rather large, autografts from the iliac bone were combined. The tissue defects were covered with pedicle musculocutaneous flaps of proximal leg, and the wound had effective drainage. The antibiotic was used for 3-4 weeks, and the X-rays were given at fixed period until the fracture was cured. Results The soft tissue defects of all 52 patients were repaired well. They were followed from 1 year to 5 years, and the time of bone union ranged from 4 months to 1 year. Two patients of osteomyelitis had a relapse after 3,4 months, then they were cured by the second operation. Three patients had unhealed fracture after 6 months, then they were cured by bone grafting again after 4-6 months. Conclusion Patients of tibial plateau fracture after internal fixation complicated by disunion of infected wound and soft tissue defects, traumatic osteomyelitis should be cured by comprehensive treatments, one of the crucial treatment for success is using pedicle musculocutaneous flaps of proximal leg to fill in lacuna, close wound, improve the local blood supply and promote bone union.