BACKGROUND: Growth factor can promote the development of collateral vessels. The synergistic effects of multiple factors are obvious. Many kinds of growth factors are enriched in bone marrow serum. OBJECTIVE: To determine effects of bone marrow serum on angiogenesis in chick chorioallantoic membranes following vascular intimal injury. METHODS: A total of 70 fertilized chick eggs were incubated at (37.5±0.5) ℃ and made a window in every egg at day 7. The survival chick embryos were randomly divided into six groups: normal saline group, normal blood serum group, normal bone marrow serum group, blood serum of rabbit suffered with vascular intimal injury group, bone marrow serum of rabbit suffered with vascular intimal injury group and vascular endothelial growth factor group (n=10), which were respectively treated with 5 μL rabbit normal blood serum, 5 μL rabbit normal bone marrow serum, 5 μL blood serum of rabbit suffered with vascular intimal injury, 5 μL bone marrow serum of rabbit suffered with vascular intimal injury, 5 μL normal saline and 0.3 μg vascular endothelial growth factor in chick chorioallantoic membranes, for 3 consecutive days. Pictures were taken by a digital camera, and the total number of the vessels around the disc was measured. RESULTS AND CONCLUSION: The total numbers of vessels in normal bone marrow serum group and blood serum of rabbit suffered with vascular intimal injury group were obviously higher than that of normal blood serum group. Large and middle vessels were obviously proliferated. Large and middle vessels were more observed in the blood serum of rabbit suffered with vascular intimal injury group. These indicated that normal bone marrow serum can stimulate angiogenesis in models of chick chorioallantoic membranes. Compared with vascular endothelial growth factor, both the normal bone serum and the bone marrow serum of rabbit suffered from vascular intimal injury were more effective in angiogenesis. The blood serum and bone marrow serum from vascular intimal injured rabbit at day 7 can significantly promote angiogenesis in chick chorioallantoic membranes, which was better than the vascular endothelial growth factor group.

Objective To evaluate the efficacy and safety of the improved percutaneous balloon mitral valvuloplasty (PBMV) in elderly patients with mitral stenosis. Methods Elderly patients with severe mitral stenosis received an improved PBMV which included a modified way of atrial septal puncture and technique across the mitral valve. The left atrial pressrue (LAP), mean pulmonary pressure (MPA), mean gradient across the mitral value (MPG) and mitral valve area (MVA) were recorded and compared before and after the operation. Long term follow up were made. Results After operation, the LAP decreased [(25.3±6.7) mm Hg vs.(16.4±5.8) mm Hg,1 mm Hg=0.133 Kpa], MPG decreased [(17.6±6.7) mm Hg vs.(6.8±2.9) mm Hg], MPA decreased [(38.6±12.1) mm Hg vs. (29.2±9.8) mm Hg], MVA increased [(1.05±0.22)cm2 vs.(1.61±0.38)cm2] and the New York heart association heart function classification improved. The follow-up result showed that the effect of PBMV was constant. Conclusions Improved PBMV may be an effective and safe measure for patients with mitral stenosis.

[ABSTRACT]AIM:Tostudytherelationshipbetweenhuman8-oxoguanineglycosylase1(hOGG1)gene Ser326Cys polymorphism and severity of coronary artery lesions in the patients with diabetes mellitus .METHODS: We retrospectively analyzed 323 patients with diabetic mellitus receiving coronary angiography .These patients underwent the test of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), and were divided into Cys/Cys genotype (n=85), Ser/Ser genotype (n=121) and Ser/Cys genotype (n=117) according to the results of PCR-RFLP. All clinical data including history of diseases , complications and biochemical markers , such as blood glucose , blood lipids and so on, were recorded.hOGG1 mRNA and 8-hydroxydeoxyguanosine (8-OHdG) were measured by RT-PCR and ELISA, respectively.The results of coronary angiography such as number and severity of coronary artery with lesions were analyzed by 2 cardiovascular physicians .Gensini score and SYNTAX score were also detected by the unitary criteria .RE-SULTS:(1)8-OHdG in Cys/Cys genotype was higher than that in Ser /Ser genotype and Ser/Cys genotype (P<0.05), but there was no statistical difference between Ser /Ser genotype and Ser/Cys genotype (P>0.05).(2)hOGG1 mRNA ex-pression in Cys/Cys genotype was lower than that in Ser/Ser genotype and Ser/Cys genotype (P<0.05), and no statistical difference between Ser/Ser genotype and Ser/Cys genotype (P>0.05) was observed.(3)The probability of triple vessel lesions in Cys/Cys genotype was high and the probability of single vessel lesions in Ser /Cys genotype was low , but the difference among 3 genotypes was not statistically significant (P>0.05).(4)Gensini score and SYNTAX score in Cys/Cys genotype were 48.7 ±15.3 and 39.5 ±17.2, respectively, and the ratio of complex lesions in Cys/Cys genotype was 73.0%.These scores and the ratio of complex lesions were higher than the other 2 genotypes (P<0.05), and no statisti-cal difference between Ser/Ser genotype and Ser/Cys genotype was observed (P>0.05).CONCLUSION:hOGG1 gene Ser326Cys polymorphism has relationship with coronary artery lesions in the patients with diabetes mellitus and Cys /Cys genotype might have some impacts on the severity of lesions .The mRNA expression of hOGG1 in the patients with diabetes mellitus carrying Cys/Cys genotype is lower than that in the patients carrying the other 2 genotypes , then decreases the abil-ity of identification and removal of 8-OHdG and the capacity of repairing DNA oxidative damage , and accelerates the devel-opment of atherosclerosis .

Objective: To compare the efifcacy between emergent and delayed stent implantation in patients with ST-elevation myocardial infarction (STEMI) after thrombus extraction.
Methods: A total of 82 STEMI patients who received thrombus extraction and intracoronary injection of tiroifban, sodium nitroprusside, nitroglycerin via thrombus extraction catheter and with recovered TIMI 3 lfow from 2012-11 to 2014-01 were retrospectively studied. The patients were randomized into 2 groups by SAS software: Emergent group, the patients received stent implantation immediately upon diagnosis and Delayed group, the patients were treated by anti-platelet and anticoagulant medication for 10-14 days, and then received stent implantation. n=41 in each group. The primary and secondary indicators were compared between 2 groups which including ST-segment resolution (STR), the occurrence rate of no-relfow/slow-relfow, myocardial blush grade (MBG) 3, parameters of stent, ventricular remodeling condition, the incidence of major adverse cardiac events (MACE).
Results: ①Delayed group had the post PCI STR at (68.2 ± 9.2)%, TIMI 3 grade at 97.5%, MBG 3 at 69.0%and corrected TIMI frame count (CTFC) at (19.5 ± 5.2), compared with Emergent group, P<0.05. The occurrence rate of no-relfow/slow-relfow in Delayed group and Emergent group were 2.5% and 31.0%, P<0.01. ②The parameters of stents in Delayed group and Emergent group were as the number at (1.21 ± 0.32) vs. (1.76 ± 0.76), the mean length at (28.3 ± 11.7) mm vs. (33.7 ± 12.9) mm, the mean diameter at (3.17 ± 0.76) mm vs. (2.82 ± 0.87) mm, all P<0.01. Delayed group had the higher dilating pressure than that in Emergent group, (18.5 ± 6.2) atm vs (13.6 ± 7.1) atm, P<0.01, and more patients in Delayed group receive high-pressure non-compliant balloon dilation 75% vs 23.8%, P<0.01. ③With 6 months of follow-up study, there were slightly declining trend for LVEF and LVSF in both groups than that at 1 week condition, P>0.05, while LVEDV and LVEDD increased than 1 week, P<0.05, the changes were more obvious in Emergent group, P<0.05. Delayed group had less MACE occurrence, P<0.05.
Conclusion: Delayed stent implantation in STEMI patients after thrombus extraction had reduced incidence of post PCI no-relfow/slow-relfow phenomenon, improved myocardial reperfusion and less MACE occurrence.

Objective To explore the short term efficacy and safety of percutaneous transluminal renal artery stenting in patient with renal artery stenosis.Methods From January 2003 through June 2012,fifty hypertension patients with unilateral or bilateral renal artery stenosis ≥70％ were successfully treated by percutaneous translumminal renal angioplasty with stent (PTRAS).There were 32 males and 18 females with an average age of (51.2 ± 12.3) years ranged from 21 ～78 years.The blood pressure level,dosage of anti-hypertension drugs and serum creatinine (Scr) of patients were documented and analyzed before and after stenting.All patients were clinically followed up for 6 months after stenting.Continuous variables were analyzed by using t-test for comparison among patients.Results The technical success rate was 100％.Of them,16 patients were cured,30 patients improved and 4 patients ineffective.There were significant differences in blood pressure,sCr and dosage of anti-hypertension drugs between post-stenting and prestenting [SBP (145.7 ±11.3) vs.(179.1 ±22.3) mmHg; DBP [(75.1±9.2) vs.(112.5 ±19.2)mmHg],sCr [(138.2 ±20.3) vs.(191.1 ±36.5) μmol/L] (P＜0.01) and the dosage of antihypertension drug was dramatically decreased.And there were no adverse events found during follow-up period.Conclusions The success rate of PTRAS technique was high,and the blood pressure of patients could be effectively controlled by it,being beneficial to renal function.

Objective to determine predictive factors of intestinal obstruction in acute myocardial infraction (AMI) patients after primary percutaneous coronary intervention (PCI) and to establish predictive model.Methods A total of 1220 AMI patients underwent primary PCI in Jiangxi provincial people's hospitalfrom June2004 toJune 2014were retrospectively analyzed.And 1025 cases of them whichall met the inclusion and exclusion criteriawere randomlydivided by using random number generated by SPSS 17.0 into two cohorts:model derivation cohort (MDC) and model validation cohort (MVC).MDC was divided into intestinal obstruction group and control group.predictive factors were identified using univariable andmultivariable logistic regression analysis in MDC.Interger point values were assigned to each predictor based upon their coefficient in multivariable logistic regression model to establish scoring model.The summed scores of each case in MVC were calculated to test predictive ability of the model by ROC cure.Results Total of 1 025 patients,103 patients were diagnosed with different types of intestinal obstruction and the incidence of intestinal obstruction was 10.0％.Low position intestinal obstruction,incomplete intestinal obstruction and simple intestinal obstructionwere main characteristics in these patients.logistic regression analysis identified ten risk factorscan predict the appearance of intestinal obstruction:age ＞ 65years old (OR =1.44,95％ CI:1.26-4.63,P =0.000),diabetes mellitus (OR =3.37,95％ CI:2.39-9.47,P =0.000),habitual constipation (OR =4.75,95 ％ CI:3.58-11.24,P =0.024),inferior and extensive anterior wall myocardial infarction (OR =2.16,95％ CI:1.94-4.79,P =0.017),cardiac functiongrade≥3 class (Killip classification) (OR=2.86,95％CI:1.98-5.67,P=0.002),femoral approach (OR=2.76,95％CI:1.38-6.12,P=0.002),K+ ＜3.5 mmol/L (OR=1.86,95％CI:1.11-5.47,P =0.005),taking laxative (OR =3.59,95％ CI:2.99-10.21,P =0.000),using morphine (OR =1.98,95％ CI:1.07-3.12,P =0.021) and estimated glomerular filtration rate (eGFR) ＜60 mL · min-1 · 1.73m-2 (OR =1.19,95％ CI:1.10-3.22,P =0.031).and areas under the ROC cure was 0.815 (95％ CI:0.802-0.883,P =0.000) and indicating the accuracy of predicting intestinal obstruction.Conclusions age ＞ 65 years old,diabetes mellitus,habitual constipation,inferior and extensive anterior parts of myocardial infarction,cardiac functiongrade ≥3class (Killip classification),femoral approach,K + ＜3.5mmol/L,taking laxative,using morphine and eGFR ＜ 60 ml.min-1.1.73m2 were important predictive factors for intestinal obstruction in AMI patients after underwent 0 and the scoring model can predict accurately intestinal obstruction in such patients.

Objective To design and develop a cardiovascular automatic feedback control instrument for rescuing the critical patients.Methods Ten dogs used this kind instrument and the effects were obserred.Resuts The experiment of the dogs showed:the computer collected samples promptly,accurately and rapidly,and the instrument could help us to reach the expected goal.Conclusion In animal experiments,it showed that the whole cycle,from obtaining blood pressure to adjusting the amounts of medicine through feedback,was shortened.The calculating was accuratel and curative effect was reliable.This instrument is wait to be apprnsed by clinic.

Objective To research the relationship between the myocardiac ischemic activity and degree of depression in elderly patients.MethodsThe Center For Epidemiological Studies-Depressive Scale(CES-D) was administered to evaluate depressive degree for 121 patients who were defined as coronary artery diseased by coronary angiography (CAG); group A (n=64) for no depressive symptoms,group B (n=34) for minor depression, group C (n=23) for major depression were studied to observing the myocardial ischemia using Holter's recording and exercise testing.ResultsCAG showed that single vessel disease was more frequently in group A;single,double and three-vessel disease showed approximative proportion in group B,three-vessel disease was more frequently in group C.The times of ST-depress were (4.2±1.3),lasting time of ST-depress was (35.8±9.2) min,and index of ST-depress was (3.28±0.9) min/h,which were higher than those of group A [(1.8±0.3),(16.6±4.2) min,(1.76±0.4) min/h] and group C [(2.1±0.7),(17.8±5.8) min,(1.69±0.5)min/ h](P<0.05);There was significantly frequent myocardial ischemia in group B than in group A during exercise testing (χ2=3.274,P<0.05). patients in group C tended to have approximative incidence of ischemia compared with group A during daily living,but more incidence of ischemia than group B during exercise testing(χ2=5.473,P<0.05).ConclusionThe depressive degree was associated with severity of coronary artery disease,mild to moderate symptoms of depression are associated with an increased likelihood of myocardial ischemia during daily living and exercise,but patients with severity depression absence symptoms of myocardial ischemia during daily living,and exhibit markedly myocardial ischemia during exercise.

Objective To evaluate the effect of limited open reduction in the treatment of femoral shaft fractures with intramedullary nail.Methods The clinical data of 39 patients with femoral shaft fractures in the Department of Orthopedic Surgery,Southern Medical University Xiaolan Affiliated Hospital from January 2016 to December 2017 were retrospectively analyzed.All patients were treated with intramedullary nailing.Among them,25 cases were treated with limited open reduction (observation group) and 14 cases were treated with closed reduction (control group).The operation time,fluoroscopy frequency,blood loss volume,infection rate and curative effect were compared between 2 groups.Results The 39 patients were followed up for 7 to 25 (10.3 ± 2.8) months.The operation time and fluoroscopy frequency in observation group were significantly lower than those in control group:(111.4 ± 20.3) min vs.(129.3 ± 21.4) min and (7.0 ± 2.6) times vs.(22.6 ± 7.8) times,but the blood loss volume was significantly higher than that in control group:(454.0 ± 131.4) ml vs.(342.9 ± 120.7) ml,and there were statistical differences (P＜0.05 or ＜0.01);there was no statistical difference in the infection rate and excellent/ good rate between 2 groups (P＞0.05).Conclusions Limited open reduction simplifies the operation steps,shortens the operation time,and has fewer fluoroscopy times and less X-ray time.It can achieve the same effect as closed reduction,and can be used as an effective supplementary means when closed reduction equipment and technology are deficient.