0.05). Conclusion The sinus node arteries can generally be found by angiography. There is no significant relationship between coronary artery diseases of sinus node and sick sinus syndrome.

[Objective]To assess the influence of three-dimensional computed tomography (3D CT) reconstruction on preoperative fracture classification of intraarticular fractures by comparing 3D CT and 2D CT in preoperative fracture classification of tibial plateau fractures and acetabular fractures.[Method]A retrospective study was performed to evaluate 28 tibial plateau fractures and 19 acetabular fractures.Four attending traumatic orthopaedic surgeons used 3D CT and 2D CT respectively to evaluate fractures and rendered fracture classification.Test of agreement was performed to evaluate interobserver and intraobserver agreement about fracture classification.[Result]With the use of 3D CT images,interobserver and intraobserver reliability for fracture classification increased to perfect agreement.[Conclusion]3D CT could improve the reliability of preoperative fracture classification for tibial plateau fractures and acetabular fractures.3D CT is helpful and worthwhile for preoperative evaluation for fracture classification of intraarticular fractures.

Objective To observe the curative effect of using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia and its effect on nursing.Methods A prospective study was conducted, 146 patients with hyperbilirubinemia admitted to Mianyang Central Hospital from January 2015 to December 2016 were enrolled, and they were divided into an observation group (77 cases) and a control group (69 cases) according to random number table method. The observation group was treated by medical treatment and the artificial specific liver bilirubin adsorption, while the control group only treated by medical therapy. The changes of levels of liver function indexes alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil) before and after treatment and clinical curative effect were observed in the two groups.Results Before treatment, there were no statistical significant differences in levels of the ALT, AST, TBil, DBil between the two groups (allP > 0.05), after treatment, the above indexes were significantly decreased compared to those before treatment, and the degrees of decrease in observation group were more obvious than those in control group [ALT (U/L): 341±42 vs. 455±37, AST (U/L): 120±35 vs. 197±37, TBil (μmol/L): 185.4±20.6 vs. 302.6±30.6, DBil (μmol/L): 42.6±10.8 vs. 87.5±11.6, allP < 0.05]. The total effective rate in observation group was obviously higher than that of control group [62.3% (48/77) vs. 40.6% (28/69),P < 0.05].Conclusions Based on liver protection, symptomatic and supportive medical treatment, using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia is safe and effective, and in addition, close observation and careful nursing is beneficial to the reduction of incidence of complications and elevation of therapeutic efficiency.

Objective To investigate the effects of local delivery c-myc antisense oligodexynucleotides on neointimal hyperplasia after angioplasty in rabbits. Methods The celiac arterial endothelium of 75 male Japanese white rabbit (2.5?0.5 kg) were denuded after being fed with cholesterol-supplemented diet to establish the model of atherosclerotic stenosis of celiac arteries. The animals were randomized into the antisense DNA group (Group Ⅰ), sense DNA group (Group Ⅱ), saline control group (Group Ⅲ) and simple angioplasty group (Group Ⅳ). The drugs were injected intramurally using a porous balloon. The local vessels were collected at the 24 th hour and the 4 th week after the procedure for morphological observation. C-myc mRNA level was measured by means of RT-PCR and c-myc protein with immunohistochemical staining. Results RT-PCR showed that c-myc mRNA level in Group Ⅰ was lower than that of Group Ⅱ, Group Ⅲ and Group Ⅳ after the first 24 hours. The ratio of neointimal area (NEA) to medial area (MA) and NEA/MA in Group Ⅰ were significantly less than those of Group Ⅱ, Group Ⅲ and Group Ⅳ. Immunohistochemical staining showed that the percentage of c-myc protein positive cells was less in Group Ⅰ than those of the other groups. Conclusion Transcatheter local delivery of c-myc antisense oligonucleotides reduces neointimal hyperplasia after angioplasty in rabbits.

Objective To assess the predictive value of coronary angiography TIMI myocardial perfusion grade (TMPG), electrocardiogram (ECG) single-lend ST segment resolution (STR), ECG Max-ST-segment deviation (MaxSTE) on judging myocardial reperfusion after primary angioplasty in the patients with acute myocardial infarction (AMI). Methods Primary percutaneous coronary intervention(PCI) was performed in 42 patients within 12 hours after AMI onset. Coronary angiography and ECG was done before and after angioplasty. TMPG, ECG single-leed STR and MaxSTE were used to assess myocardial reperfusion immediately after PCI. Myocardial perfusion scan was examined in all the patients using99mTc-MIBI SPECT on day 7±2. Results Compared with the level of myocardial perfusion demonstrated in myocardial scan of 99mTc-MIBI SPECT, the sensitivity, specificity and accuracy of TMPG, single-lead STR and MaxSTE was calculated. The sensitivity of TMPG, single-lead STR and MaxSTE was 93.75%, 87.50% and 81.25%, respectively, the specificity of them was 20.00%, 80.00% and 80.00%, respectively, and the accuracy was 76.19%, 85.71% and 80.95%, respectively. The findings in single-lead STR and MaxSTE matched well with the results of myocardial scan of 99mTc-MIBI SPECT. Conclusion In the patients suffering from AMI treated with PCI, ECG is an effective method to assess myocardial tissue reperfusion.

Objective To explore the observation and nursing of traumatic mediastinal hematoma.Methods The clinical data in 44 cases of mediastinal hematoma treated in our department from July 2006 to May 2016 were analyzed retrospectively.Results Forty cases were cured,4 cases(9％) died,the mortality rate was 9％,in which 1 case died from postoperative consumptive coagulopathy,1 case died from acute coronary syndrome and 2 cases died from traumatic hemorrhagic shock.Conclusion Timely diagnosis and treatment of intrathoracic cardiac and vascular injury are the key to save the lives of patients;the nursing focuses include observing the hematoma progress,adopting the comprehensive treatment measures such as controlled hypotension,limited fluid resuscitation and correctly selecting infusion approach for preventing hematoma enlargement and rupture.

To study the characteristics of eye signs in chronic hepatitis B patients with blood stasis syndrome and the association between blood stasis syndrome and eye signs.

BACKGROUND: Vascular endothelial growth factor (VEGF) can promote angiogenesis, and has been extensively used in treatment of bone defect. However, few studies have addressed its isomer VEGF121. OBJECTIVE: To construct adenovirus vector carrying VEGF121-FLAG and humanized Renilla reniformis green fluorescent protein 1(hrGFP-1) and observe its expression in bone marrow stromal stem cells (BMSCs). METHODS: Using polymerase chain reaction technique, VEGF121 gene contained in the plasmid of pTG19T-VEGF121 was used to remove termination codon. NotI and Xho I restriction sites were added before and after gene sequence. Obtained gene subclone was moved onto pMD19-T plasmid. The pMD19-T-VEGF121 and pShuttle-CMV-IRES-hrGFP-1 plasmids underwent double enzymatic digestion. Small fragment and big fragment were retrieved utilizing gel. Subsequently, coupled reaction was conducted to complete the construction of shuttle plasmid. After measuring virus titer, BMSCs were transfected and the fluorescence intensity was observed under fluorescence microscope.RESULTS AND CONCLUSION: Recombinant adenovirus plasmid was successfully constructed by enzymatic digestion determination and gene sequence. Fluorescence microscope has shown that BMSCs transfected with recombinant adenovirus presented significantly green fluorescence expression. Thus, adenovirus vector carrying VEGF121-FLAG and hrGFP-1 gene can express in eukaryotic cells, which can be used for gene therapy for ischemic disease.

BACKGROUND: Hypoxia-inducible factor-1 (HIF-1) can regulate the co-expression of various genes, and can induce angiogenesis with integrated physiological function.OBJECTIVE: To construct a novel adenoviral eukaryotic expression vector that can co-express mutant hypoxia-inducible factor-1 alpha (HIF-1a) target protein and humanized Renilla reniformis green fluorescent protein (hrGFP) reporter molecule under normoxic conditions.METHODS: The human HIF-1α gene carried by target gene donor plasmid pCMV6-XL5-HIF1α was sequenced and the site of restriction enzyme in above gene was analyzed. Site-directed mutagenesis of three amino acids including the 402 location, the 564 location, and the 803 location in gene coding region in HIF-1α were performed by polymerase chain reaction and sequencing was also done for monitoring mutation. The HIF-1α gene mutated correctly (HIF-1αmu) was coupled to adenoviral shuttle vector pShuttle-CMV-IRES- hrGFP-1. The recombinant adenovirus shuttle vector carrying HIF-1αmu gene was transferred to BJ5183-AD-1 electroporation competent cells after sequencing identification and Pme I restriction enzyme linearization.HIF-1αmu and hrGFP gene as well as hemeo-expression elements of hrGFP gene were reconstructed into adenoviral genome plasmids using homologous recombination mechanism in bacterium. Recombinants were obtained by Pac I restriction enzyme digestion and sequencing identification.RESULTS AND CONCLUSION: Amino acids including the 402 location, the 564 location and the 803 location in gene coding region in HIF-1α had become alanine after site-directed mutagenesis. Recombinant adenoviral expressing vector was successful as confirmed by restriction enzyme digestion and sequencing. These findings demonstrate that a novel recombinant adenoviral mutant eukaryotic expression vector pAd-HIF1αmu-IRES-hrGFP-1 was successfully constructed.

OBJECTIVE:To explore the reasons,occurrence mechanisms,as well as prevention methods for complications following cerebrovascular stent implantation.METHODS:A computer-based online search was performed by the first author.The databases of Medline and CNKI were searched with year's limitation of 1989-2009.According to the inclusive and exclusive criteria,the documents were screened,collected and evaluated from the following aspects:treating progress of cerebrovascular stent implantation;category and biocompatibility of cerebrovascular stent;as well as occurrence and prevention methods for complication following cerebrovascular stent implantation.RESULTS:A series of complications,such as carotid sinus response,hyper-perfusion syndrome,cerebral anglo spasm,bleeding at puncture locus,thrombosis,restenosis,as well as cerebral ischemia,would occur following cerebrovascular stent implantation.The complications were difficult to eliminate,but should be avoided by selecting correct implanting cases,elevating operator's proficiency,enhancing understanding of complications,obeying perioperative management,as well as correctly and in-time treatment.Polymer stent,coating stent,and drug eluting stent presented superior biocompatibility to metal stent,which could prevent restenosis following implantation.CONCLUSION:Cerebrovascular stent implantation is one of the main treatments for cerebrovascular disease.Polymer stent,coating stent,and drug eluting stent exhibit excellent biocompatibility.The complications associate to stent implantation are preventable and remediable via sufficient preoperatively preparation,exactly operation and perioperative management.