With the improvement of people's living standard and changes of their lifestyle, the incidence of coronary artery disease (CAD) has increased quite significantly, which has attracted great concern. Examination methods for CAD are more and more advanced, while the cost of inspection is rising. As a traditional test, the exercise treadmill test (ETT) is convenient, safe, and cheap. ETT can be conducted in almost every hospital as it doesn't need advanced equipments. The values of some new evaluation indexes for diagnosis and prognosis of CAD are reviewed in this article.

Objective To investigate the clinical effect of intravenous infusion of dextral metomidine and the analgesia of epidural injection.MethodsAccording to the different ways of labor analgesia will be selected in January 2015 to January 2017 in our hospital childbirth puerpera 120 cases are grouped into: the control group with regular continuous epidural analgesia injection way, observation group with intravenous infusion set beauty holds the mi + right regularity discontinuous epidural analgesic injection mode;Record two groups of patients with various experiment data, and will make an analysis of data obtained, conclusion intravenous infusion set right beauty holds the mi joint regularity the clinical effect of continuous epidural labor analgesia injection.ResultsIntravenous right beauty holds the mi + regularity discontinuous epidural injection way for puerpera childbirth analgesia effect is superior to the pure regularity discontinuous epidural injection way analgesia effect, compare the difference between groups was statistically significant (P<0.05).Conclusionpregnant women choosing to analgesia vein infusion set beauty holds the mi + right regularity discontinuous epidural analgesic injection way, clinical analgesic effect is good, will not cause great influence to own and maternal newborn, worth clinical widely used for childbirth analgesia.

SHP-1 is the protein tyrosine phosphatase which is mainly expressed in the cytoplasm of hematopoietic-derived cells,and it is the key factor to change the levels of intracellular phosphorylation.SHP-1 can generate different intracellular signals in different cells,and it can play various functions.

BACKGROUND: The exact pathogenesis of osteoarthritis is unclear. Studies have shown that macrophages in synovial tissue are involved in sliding-inflammation response and the production of cartilage matrix degradation enzyme. OBJECTIVE: Based on the important role of synovial macrophages in osteoarthritis, to review and summarize the major research achievements and important research methods in this field, laying a foundation for future research on synovial macrophages. METHODS: The first author used computer to search relevant literatures included in PubMed and VIP from 1999 to 2019. The search terms were “osteoarthritis, synovitis, synovial macrophages” in English and Chineserespectively. Manual screening was conducted according to the inclusion criteria, and irrelevant, repetitive and obsolete articles were excluded. Finally, 46 eligible articles were included.RESULTS AND CONCLUSION: There is an inflammatory response in the synovial tissue, and the severity of synovitis is closely related to osteoarthritis symptoms and progression. A large number of macrophages with different activation states are infiltrated in the synovial tissues of osteoarthritis patients at different stages. M1 macrophages are the main subgroup of macrophages involved in the production, cartilage degradation and osteophyte formation of osteoarthritis inflammatory factors, while M2 macrophages have a protective effect on osteoarthritis by secreting anti-inflammatory factors. Inhibiting the differentiation of macrophages into M1 type and promoting their M2 type differentiation can alleviate the pathological changes of osteoarthritis and delay the progression of osteoarthritis. It may be an effective method to treat osteoarthritis by regulating the polarization state of synovial macrophages.

The acetabular fractures are technically challenging due to the deep location in the pelvis and low degree of exposure.Although the classic ilioinguinal approach could treat most anterior acetabulum fractures,the limited surgical field and difficulty in exposure is the main obstacle surgeons should overcome.Various approaches including extended approaches and combined anterior and posterior approaches ensure adequate exposure,but high rate of complications impede it from clinical use.The Stoppa approach has been favored by the orthopedic surgeons in recent years for the minimized surgical dissection and good exposure.It allows for extensive visualization of the pelvic brim and direct manipulation of quadrilateral plate.This approach is indicated in all anterior column and wall fractures,combined anterior column and posterior hemi-transverse fractures,selected both-column fractures,transverse and T-fractures.The utilization of the Stoppa approach developed along with the evolution of the relevant theory of acetabular fractures in the past years.The development such as the precise measurement of “safe zone” and the application of new apparatus could do great help in decreasing the complications and improving the surgical results.This article summarizes the relevant literatures and provides a review of the advances in the Stoppa approach in acetabular fractures.

Objective To evaluate the feasibility of laparoscopic cholangiotomy for radical excision of upper cholangiocarcinoma. Methods Four trocars were placed at the umbilical area, right upper and lower abdomen, and below the xiphoid. A 3 cm incision was made at the left upper abdomen for Roux-en-Y jejunojejunostomy. The gallbladder, inferior segment of the left medial liver, and the middle-upper segment of the bile duct were resected. And then the tumor and the adjacent 1 cm bile duct were excised. Afterwards, the proper hepatic artery, portal vein, and the surrounding connective tissues and lymph nodes were removed. Finally, the bile-jejunum Roux-en-Y anastomosis was performed. Results The hepatic duct bifurcation was involved by the cholangiocarcinoma in all the 4 cases. The diameter of the tumor was 1-1.5 cm. The resection of the inferior segment of the left medial liver and middle and upper segments of the bile duct, and dissection of the lymph nodes at the hepatic porta were completed successfully. The operation was accomplished in all the cases with an operation time of 270, 255, 270, and 230 mins, and the intraoperative blood loss was 500, 400, 300, and 400 ml, respectively. Postoperative pathological examination showed highly differentiated adenocarcinoma in all the cases. Cases 2 and 3 developed bile leakage after the operation and were cured 20 or 15 days later. In all the cases, the jaundice disappeared after the operation. Their appetite recovered, and the body weight was increased by 3, 3.5, 2, and 2 kg, respectively. Conclusions Upper cholangiocarcinoma can be radically excised by using laparoscopy. The resection of cholangiocarcinoma and part of liver tissues, dissection of surrounding connective tissues and lymph nodes, and bile duct reconstruction can be accomplished under a laparoscope. Thus,we consider that laparoscopic cholangiotomy is feasible for radical excision of upper cholangiocarcinoma.

Objective To assess the clinical value of transcatheter arterial chemoembolization(TACE) for the treatment of metastatic liver leiomyosarcoma(MLL).Methods CT triphasic scanning and TACE were performed in 8 patients with MLL,which was proved by fine-needle aspiration biopsy and immunohistochemical study.A follow-up of 1-3 years was conducted.Based on the enhancement degree of the hepatic lesion and the DSA manifestations of the lesion,which were observed both before and after TACE,and also on the survival time,the therapeutic effectiveness was evaluated.Results Of the eight cases,single metastasis was seen in 3 and multiple metastasis in 5.Excellent result was obtained in 6 cases and good result in 2 cases.Based on the imaging findings,marked effect was seen in 3 cases,good effect in 4 cases and no improvement in one case.The surviva1 rate at 1,2 and 3 years was 87.8%,50.0% and 37.8% respectively.Conclusion TACE is a safe and effective treatment for MLL.

Objective:To study the PDT effects on culturing endothelial cell in vitro under the differens content of CPD 4. Methods: According to the existing techniques obtaining prime umbilical vein endothelial cell in 24 well culturing plate,10 5/well.Add 1640 medium mixed with different final concentration of CPD 4 individuallly and incubate for 1h. Then shine them with 630～640 nm red light. Observe the morphological changes of EC. After PDT 6 h,measure the contents of Prostaglandin F 1?(PGF 1?) and and LDH in the culturing medium and the percentage of the residual cell. Results:With the concentration of CPD 4 increasing, the damage degree of EC aggravates. There was emergence of EC contracting ,falling off , cytoplasmic swelling,floating and dying. The contents of PGF 1? and LDH were increasing and the percentage of residual cell decreases simultaneously. There was statistical significance between the five groups. Conclusion:The effect of PDT is direct.The effectiveness has two characteristic: ①CPD 4 induced PDT has direct photosensitised damage to EC. There exists CPD 4 dose dependence.②The PDT target of EC is membrane and cytoplasma organelle. The damage is lethal and irreversible.

?Objective:To investigate the behavior of absorbable coral hydroxyapatite (Interpore 500R) as bone tissue engineering scaffold. Methods: Marrow stromal stem cells harvested from legally aborted human fetus were cultured in DMEM containing 100 ml/L fetal boving serum and induced to differentiate towards osteoblasts.Then the cells were seeded onto absorbable coral hydroxyapatite , then the composite was implanted subcultaneously into the back of nude mice .Cell materia attachement was observed with scanning electron microscope,type I collegen secretion was studied with laser confocal microscope and new bone formation was studied histologicaley. Results: The cells could adhere to absorbable coral hydroxyapatite and secrete collagen I.Mature bone tissue was found in the implanted composite 40 day after transplantation. Conclusion: Absorbable coral hydroxyapatite Interpore 500R is a favorable bone tissue engineering scaffold.

[Objective]To observe the proliferation and plasticity of neural stem cells in sim in adult rats after spinal cord injury.[Method]Spinal cord injury models were made in 60 wistar rats and the dynamic expression of bromodeoxyuridine(BrDU) and polysialylated ependymal cells adhesion molecule(PSA-NCAM) were determined by immuno-histochemisty.[Result]Compared with the controls,the number of Brdupositive cells in the injured spinal cord increased strikingly on the 1 st day (P