Purpose:To evaluate the feasibility of balloon catheter dilatation and internal stent placement in the treatment of Takayasu's arterial stenosis.Materials and Methods:Three patients with stenosis of common carotid arteries caused by Takayasu' s disease were treated with PTA by balloon catheter and intravaseular stent placement,the lenghs of stenosis were all beyond 8cm.Balloon angioplasty was performed in one patient,the others were treated with Wallstent stents after PTA.Result:Immediately after treatment,angiography and ultrasound showed that the proportion of stenosis was zero and all appeared to achieve in good result.The artery treated with PTA was completely occluded after 1 year follow-up;the other two patients with stents placement were also examined by angiography and ultrasound at 4,5 months and 4 months respectively after the praeedure.For the patient with left carotid artery stenosis,the proximal part of the segment with the intravascular stent showed a restenosis;the other patient was normal.Conclusion:We considered that intravascular stent placement be might to the treatment for Takayacu' s arteritis with long segment stenosis of common carotid artery.

Objective To explore the ability of advanced oxidation protein products (AOPP)in predicting the progression of diabetic retinopathy (DR)in patients with type 2 diabetes mellitus (T2DM). Methods 363 T2DM patients were enrolled in this prospective cohort study. According to the quartile points of baseline AOPP level,patients were divided into four groups (Q1,Q2,Q3 and Q4 ). The progression rate of DR was calculated according to the changes of non-mydriatic fundus photography after a 5-year follow-up. Results With the increase of baseline AOPP level,the rate of progression of DR increased (19.51% vs 28.42% vs 37.36% vs 47.37%,P <0.01). Logistic regression analysis showed that baseline level of AOPP was an independent risk factor for the progression of DR (OR=1.833,95%CI:1.573~1.982,P<0.05).Area under the curve of AOPP in predicting DR is 0.883 (95% CI:0.842~0.924)with the sensitivity 86.1% and specificity 91.9%. Conclusion AOPP may be one of the biomarkers for the prediction of type 2 diabetic retinopathy progression.

Objective To discuss the relationship between diabetic macular edema(DME) and visual field defects and evaluatethe therapeutic effect of micro-pulse laser.Methods A total of 117 patients (149 eyes) with diabetic retinopathy(DR) were enrolled in this study and divided into two groups according to early treatment diabetic retinopathy study(ETDRS) DME diagnostic criteria:DME group(n=50,70 eyes) and N-DME group(n=67,79 eyes).Healthy subjects(n=40,80 eyes)were selected as NC group in thisstudy.The clinical data and biochemical index were collectedand visual fields were examined in all the subjects.Then the DME group was further divided into two subgroups:micro-pulse laser subgroup(35 eyes) and conventional laser subgroup(35 eyes).The vision recovery after treatment was evaluated on different time points.Results Diabetes duration,FPG,HbA1c and HOMA-IR were significantly higher in DME group than in N-DME group (P<0.05).RF value was less than 15% in each group,suggestingreliable test results.The levels of MD index[(7.81±0.75) vs (4.32±0.67) vs (1.14±0.22) dB],LV[(20.17±4.85) vs (15.34±3.19) vs (4.72±1.11) dB] and sLV[(10.71±1.37) vs (7.22±1.12) vs (2.35±0.41) dB] were significantly higher in DME group and N-DME group than in NC group,and those in DME group were higher than in N-DME group(P<0.01).After three month's treatment,the levels of MD index,LV and sLV were lower in micro-pulse laser subgroup than in conventional laser subgroup(P<0.05).There were no statistically significant difference in MD index,LV and sLV in conventional laser subgroup on different time points(P>0.05).Multiple logistic regression analysis showed that DM duration,FPG,HbA1c and HOMA-IR were riskfactors for DME(all P<0.01).Conclusion Patients with DME have severe vision loss.Micro-pulse laser therapy is helpful invision recovery,while conventional laser therapy have no obvious effect on it.Longer duration of DM,higher level of FPG,HbA1c,and IR severity may increase the risk of DME.

Chinmedomics is a newly emerging discipline in recent years,integrating the theory and technology of system biology and serum pharmacochemistry of traditional Chinese medicine (TCM).It has formed and established the evaluation system for identifying the syndrome biomarkers and evaluating the effectiveness of prescriptions,and discovering the efficacy substances.The theory and method of chinmedomics is beneficial to establishing a Chinese-style precision medicine,and also helping further enhance the original innovation ability of TCM research and development.

Objective To investigate the clinical effects of high-density micropulse photocoagulation (HD-SDM) combined with intravitreal injection of ranibizumab for diabetic macular edema (DME).Methods Thirty-one patients (31 eyes) with DME were randomly divided into two groups.Group A (15 eyes) received HD-SDM combined with intravitreal injection of ranibizumab.Group B (16 eyes) only received intravitreal injection of ranibizumab.The best corrected visual acuity (BCVA) and central macular thickness (CMT) of the two groups before and after treatment were analyzed,and the annual injection times of the two groups were compared.Results The average annual injection times was 3.67 ± 1.11 in group A,and 9.12 ±2.63 in group B.The difference was significant between the two groups (t =2.05,P ＜ 0.05).There were significant differences in CMT before and after treatment in both groups (all P ＜ 0.05).There was no significant difference in CMT between the two groups(t =1.19,P ＞ 0.05).There were significant differences in BCVA before and after treatment in both groups (all P ＜ 0.05),but there was no significant difference before and after treatment between the two groups(all P ＞ 0.05).Conclusion Both HD-SDM combined with intravitreal injection of ranibizumab and single intravitreal injection of ranlbizumab are effective for DME,but the combining treatment can remarkably decrease the annual injection times and had a good compliance of patients,is a good choice for DME patients.

Objectives:To compare the advantage and the disadvantage between the normally inserted central venous catheter(NICC) and the peripherally inserted central venous catheter(PICC). Methods:The patients were divided into two groups by different insertion methods:NICC group and PICC group.The success rate of first insertion point,the time of insertion, the symptom of patients during insertion, the complication of insertion and the rate of catheter septicemia were compared. Results:The group of PICC had a higher rate of successful insertion, a less time of insertion, a less time of insertion, a lower rate of complication, but a higher rate of catheter septicemia,when compared with the group of NICC. Conclusions:①PICC have some advantages being simple in insertion and of less complications.②The PICC patients have more chances to suffer from the catheter septicemia.③Perepheral venous inflammation and veno-occlusion more earily occurr in PICC patients.

BACKGROUND:Inflammatory factor plays an important role in restenosis after bal oon injury. Sphingosine1-phosphate receptor 1 can enhance the expression of inflammatory factor and promote development and progression of this pathological process.
OBJECTIVE:To observe the expression of the inflammatory factors and sphingosine1-phosphate receptor 1 after bal oon injury of the rat carotid artery and effects of fingolimod hydrochloride on reducing inflammatory reaction.
METHODS:Sixty Sprague-Dawley rats were equal y and randomly divided into four groups. In the blank control group and negative control group, left common carotid artery was only isolated, and left external carotid artery was ligated. In the bal oon injury group and drug intervention group, rat models of carotid artery injury were
established by bal oon injury on the left common carotid artery. In the negative control and drug intervention groups, the rats were intraperitoneal y injected with fingolimod hydrochloride 1 mg/kg. In the blank control and bal oon injury groups, the rats were intraperitoneal y injected with an equal volume of saline. Samples were col ected at 3, 7 and 21 days.
RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that the proliferation of blood vessel was remarkable in the bal oon injury group, but attenuated in the drug intervention group. The appearance of blood vessels was normal in the blank control group and negative control group. Real-time fluorescent quantitative PCR revealed that cyclooxygenase 2 and prostaglandin E2 mRNA expression levels were significantly lower in the drug intervention group than those in the bal oon injury group at 7 days (P<0.05). Cyclooxygenase 2 and prostaglandin E2 mRNA expression levels were significantly higher in the bal oon injury group and drug intervention group than those in the blank control group and negative control group at the same time point (P<0.05). Western blot assay results revealed that sphingosine1-phosphate receptor 1 expression was high in early stage of injury, and then reduced in late stage of injury. In particular, protein expression further decreased after drug intervention. Results indicated that fingolimod hydrochloride suppressed inflammatory reaction of injured blood vessels and lessened the stenosis of injured blood vessels by regulating cyclooxygenase 2 and prostaglandin E2 mRNA expression using sphingosine1-phosphate receptor 1.

Objective:To investigation of the long-term-siRNA treatment with HBV transgene mice on inhibit replication of hepatitis B virus .Methods:The constructed siRNA expressed vectors was transfected HBV transgene mice by hydrodynamics -based in-jection via vena caudalis .Different groups were set including:specificity siRNA groups ( pSilencer5.1/C2,pSilencer4.1/C2,pSilenc-er3.1/C2),PBS group and negative vector group (n=10).The effect was observed in different periods (6 d,21 d,1 months,3 months, 6 months and 9 months after injection ) .HBsAg was analyzed by Chemiluminescence method , HBV-DNA was analyzed by real time quantitative PCR ( RQ-PCR) .Results:Compared with the PBS group , specificity siRNA groups showed decreased levels of HBsAg and HBV-DNA (P<0.05).Negative vector group did not show such changes ,there were no significant differences (P>0.05).Conclu-sion:The siRNA based on the expression vector can suppress the expression and replication of HBV in HBV transgene mice .The inhi-bition effects of long-term-siRNA treatment was specific .

Objective To evaluate the plasma levels of D‐dimer in lung cancer and pulmonary tuberculosis (PTB) patients and their clinical significances .Methods The plasma of 130 patients with lung cancer ,126 patients with PTB and 50 healthy controls were collected .All the patients were enrolled in Beijing Affiliated to Chest Hospital Capital Medical University ,from July 2014 to October 2014 .Full‐automatic analyzer was used to examine the level of plasma D‐dimer .Results The levels of plasma D‐dimer in patients with lung cancer were significantly higher than patients with PTB and healthy controls (Z=2 .704 ,P<0 .01);The levels of plasma D‐dimer in patients with PTB were significantly higher than healthy controls (Z=2 .54 ,P<0 .05);The levels of plasma D‐dimer were significantly higher in stages Ⅲ and Ⅳ than stages Ⅰ and Ⅱ(Z=2 .195 ,P<0 .05);The positive rate in patients with lung cancer was significantly higher than patients with PTB (χ2 =10 .525 ,P<0 .01) .Conclusion Activation of coagulation and fi‐brinolysis exist in lung cancer and PTB patients ,the level of plasma D‐dimer is related to the clinical stage of lung cancer .

OBJECTIVE To investigate the prevalence,antibiotic resistance and genotype of the extended-spectrum ?-lactamases(ESBLs)-producing clinical isolates of Klebsiella pneumoniae.METHODS A total of 104 isolates of K.pneumoniae were examined for the ESBLs production and the susceptibilities of the bacteria to 15 antimicrobial agents.PCR was performed to detect the genes encoding the ESBLs belonging to SHV and TEM families as well as CTX-M-1 and CTX-M-9 groups.RESULTS The ESBLs-producers of K.pneumoniae were 54.0% in the total of 104 isolates.Almost all of the ESBLs-producing isolates were resistant to the antibiotics commonly used,and only remained susceptible to carbapenems and the combination of cefoperazone with sulbactam.The genes of SHV,CTX-M-1 and TEM groups were detected in the ESBLs-producing isolates by 64.3%,46.4%,and 32.1%,respectively,and 35.7% and 8.9% of ESBLs-producing K.pneumoniae strains carried two and three genes.CONCLUSIONS The clinical isolates of K.pneumoniae in Tianjin Nankai Hospital are shown a high rate of ESBLs-producing and antibiotic resistance.SHV and CTX-M-1 groups of ESBLs are the dominant genotypes in the isolates of ESBLs-producing K.pneumoniae.