Objective To explore clinical application of coronary artery imaging with 64-slice spiral CT.Methods 46 patients with coronary heart disease were undergone both coronary artery imaging with 64-slice spiral CT and coronary angiography,and the effects on coronary display respectively were compared Results Coronary display in coronary artery imaging with 64-slice spiral CT was better than that of the coronary angiography, which was a inspection pattern of noninvasive coronary display. Conclusion Coronary artery imaging with 64-slice spiral CT can accurately evaluate coronary artery stenosis, which was worth to application.

Objective To observe the clinical effect of procedure for prolapse and hemorrhoids (PPH) in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale(WHOQOL-BREF) was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale (VAS) at postoperative six hours was (7.6 ± 2.1),which reduced to (1.3 ± 1.1) at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains (t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05).There was modest improvement in environmental domain,while no change was found in social domain (P ＞ 0.05).Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.

Objective To understand the drug-resistance of MRSA patients in neurosurgery intensive care unit,raise the prevention of MRSA and provide doctors the basis for controlling it. Methods The 5 year(20012005) MRSA patients were tested by Kirby-Bauer in neurosurgery intensive care unit of a third-tier general hospital in Shanghai. Statistic and analysis the drug-resistance of the patients. Results The rates of 121 MRSA drug-resistance to penicillin G,erythromycin, ciprofloxacin, amikacin and the cephalosporins are 92.3 % to 100 %, totally senaitire to teicoplanin and vancomycin and lower drug-resistance to rifampin,netilmicin and fosfomycin, but it rapidly raised from 10.0 % (2001 ) to 95.2 % (2005) to sulfamethoxazole. Conclusion It is time to take care of the drug-resistance of MRSA. Prevention and use antibiotics properly are the important ways to decrease the hospital infection and to improve the quality of recovered.

Objective To analyze the complications and short-term effects of laparoscopic surgery for achalasia.Methods The clinical data of 41 patients with achalasia who were treated by laparoscopic surgery were analyzed retrospectively.Results The 41 patients were no deaths.All patients underwent Heller cardiomyotomy and fundoplication,39 patients with Dor anterior fundoplication,2 patients had the presence of hiatal hernia with Toupet fundoplication.The mean surgical time was 142 min.Intraoperative complications occurred in 7 cases,including 6 cases of mild complications.The mean follow-up was 21 months.The clinical efficacy excellent in 27 cases,good in 7 cases,generally in 5 cases,poor in 2 cases.Conclusions Heller cardiomyotomy should be the treatment of choice in achalasia patients,because of its short and medium term outcomes,and its low morbidity.

Objective: To compare the clinical effects of different minimally invasive surgeries in the treatment of varicose veins of lower extremities, and to explore their application values. Methods: A total of 201 patients with varicose veins of lower extremities were selected and treated with different operation methods. 52 cases were treated by endovenous laser therapy (EVLA group), 46 cases were treated by transilluminated powered phlebectomy (TIPP group), 49 cases were treated by EVLA combined subfascial endoscopic perforator surgery (SEPS) (EVLA + SEPS group) and 54 cases were treated by TIPP combined SEPS (TIPP + SEPS) group. The operation time, the intraoperative blood loss, the postoperative hospitalization cost, the hospitalization time, the incidence rates of postoperative complications (residual varicose veins, subcutaneous induration, superficial phlebitis, skin necrosis differences in the operation time, the intraoperative blood loss and the postoperative hospitalization time, the hospitalization cost of the patients between various groups (P<0.05). Compared with EVLA group, the incidence rats of residual varicose veins, superficial phlebitis, and lower extremity swelling and ecchymosis of the patients in TIPP group were significantly decreased (P<0.05); the incidence rates of subcutaneous induration, wound hematoma, saphenous nerve injury and skin numbness were increased, but there were no significant differences (P>0.05). Compared with EVLA group and TIPP group, the incidence rates of reidual varicose veins and superficial phlebitis in EVLA + SEPS group and TIPP + SEPS group were significantly decreased (P<0.05). The healing rates of the patients 3 months after operation in TIPP group, EVLA + SEPS group and TIPP + SEPS group were significantly increased compared with EVLA group (P<0.05). The recurrence rates 1 year after operation in TIPP group, EVLA + SEPS group and TIPP + SEPS group were lower than that in EVLA group (P<0.05). Conclusion: The curative effects of EVLA combined with SEPS and TIPP combined with SEPS in treatment of varicose veins in lower extremities are superior to EVLA and TIPP, with the advantages of safe and reliable methods, complete varicose vein resection, less postoperative complications, quick ulcer healing and low recurrence rate and so on.

Objective:To investigate the diagnostic value of different detection methods for Mycobacterium tuberculosis in bronchoalveolar lavage fluid (BALF) from patients with pulmonary tuberculosis.Methods:BALF from l00 patients in Changsha Central Hospital from January 2013 to December 2015 was collected.Among 100 patients,65 cases were clinically diagnosed as tuberculosis,and 35 cases served as control.BALF smear method,polymerase chain reaction (PCR) and membrane reverse dot blot (RDB) were used for synchronous detection of Mycobacterium tuberculosis.Results:The positive rates by BALF smear method,PCR and RDB were 43.08％,73.84％ and 92.31％,respectively (P＜0.05).Sensitivity,specificity,accuracy,and negative predictive value for BALF smear were 43.08％,88.57％,59.00％,and 45.59％,respectively;for PCR were 73.85％,100％,83.00％,and 67.31％,respectively;for RDB were 92.31％,100.00％,95.00％,and 87.50％,respectively.Conclusion:The technique of membrane RDB can not only accurately diagnose Mycobacterium tuberculosis,but also can rapidly and easily identify the resistance of Mycobacterium tuberculosis to streptomycin (SM),rifampicin (RFP) and isoniazid (INH) genotypes.It possesses high clinical value.

Objective To evaluate the effectiveness and safety of open tension-free hernioplasty and two kind of laparoscopic hernia repair for the treatment of primary unilateral inguinal hernia. Methods Patients suffering from primary unilateral inguinal hernia were randomly divided into 3 groups to undergoopen operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty (TAPP) or totally extraperitoneal hernioplasty (ZEP). Results From February 2006 to February 2009, a total of 164patients were divided into 3 groups, with 62 undergoing open tension-free mesh-plug hernia repair, 50receiving TAPP and 52 receiving TEP. Postoperative patients were then followed up for a period of(16±8)months. The average operating time for the patients in the open mesh repair group was significantly shorter compared to the other two groups (P＜0.01 ). The cost in the open mesh repair group was also significantly lower than the other two groups (P＜0.01). The pain scores in open mesh group were significantly higher than those in the other two groups (P＜0.01). The hospital stay and the recovery time were both significantly longer in the open mesh repair group (P＜0.01) compared to the other two groups. No major complications and recurrence was found in neither groups. Conclusions Open tension-free mesh-plug hernia repair, TAPP and TEP are all safe and effective for the treatment for patients with primary unilateral inguinal hernia. TAPP and TEP are superior to open tension-free mesh-plug hernia repair as these two procedures involve less postoperative pain and fast recovery.

Objective To investigate the blood pressure control effect of captopril sustained-releasetablets based combination, antihypertensive therapy on hospitalized high-risk patients with hypertension in high altitude region. Methods According to the blood pressure,risk factors and combined target organ damage,331 hospitalized patients with essential hypertension were divided into 2 groups and accepted different treatment:low-risk group had monotherapy (n=102) , and night-risk group had captopril sustained-release-tablets based combination antihypertensive therapy (n =229). The discharge blood pressure,extent of SBP/DBP decrease and the compliance rate of discharge blood pressure of two groups were compared. Results The extent of SBP/DBP decrease in hight-risk group was significantly greater than low-risk group (SBP [36. 83 ± 22. 23] mm Hg vs.[28. 74 ±18.71] mm Hg,t=-3. 207,P <0. 05;DBP[22. 04±13. 57]mm Hg vs. [17. 98 ± 13.63] mm Hg,t =-2. 509, P < 0.05). The average discharge blood pressure in both groups reach the standard criterion, but no significant difference was observed between the two groups (SBP [125. 62 ± 14. 74] mm Hg vs. [122. 28 ±13.13]mmHg,t=-1. 962,P>0. 05;DBP[80. 67 ±9. 82]mm Hg vs. [78. 40 ±9. 97]mm Hg,t =-1.910,P > 0. 05). Furthermore we found no significant difference in the control rate of blood pressure between high-risk and low-risk group (72. 06% vs. 71. 57% , x2 = 0.928, P > 0. 05). Conclusion The captopril sustainedrelease-tablets based combination antihypertensive therapy is a reliable treatment in high-risk patients with hypertension from high altitude region,which shows satisfying blood pressure control rate.

Objective To investigate the effects of exogenous wild DCC gene stably transfection on growth of colorectal carcinoma cell line SW1116 in vitro. Methods DCC gene domain was amplified from human normal colon tissue by reverse transcript-polymerase chain reaction(RT-PCR). At first,a recombinant expression plasmid pcDNA3. 1( + )-DCC was constructed. Human colorectal carcinoma cell line SW1116 with-out DCC gene was transfected with pcDNA3. 1-DCC. Cell viability was tested by methyl thiazolyl tetrazolium (MTT)assay. Immunofluorescence staining was used to determine the effects of pcDNA3. 1-DCC and expres-sion of carcino-embryonic antigen(CEA)in human colorectal carcinoma cell line SW1116 which was transfect-ed with pcDNA3. 1-DCC. Results The population of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )-DCC plasmid and normal cells(t = 3. 645,P ﹤ 0. 05;t = 3. 132,P ﹤0. 05)at 3 ~ 6 days after transfection,and the proliferation rate of cells transfected with pcDNA3. 1( + )-DCC plasmid was lower than those with pcDNA3. 1( + )plasmid and normal cells(t = 2. 134,P ﹤ 0. 05;t = 2. 736, P ﹤ 0. 05). Cell line SW1116 transfected with pcDNA3. 1( + )-DCC plasmid total viability was lower than nor-mal cells(t = 3. 053 ,P ﹤ 0. 05)at 2 ~ 6 days after transfection. Cell line SW1116 transfected with pcDNA3. 1 ( + )-DCC plasmid total viability was lower than those with pcDNA3. 1( + )plasmid(t = 2. 816,P ﹤ 0. 05)at 2,4,5,6 days after transfection. The population of flavo-green colour cells transfected with pcDNA3. 1( + )-DCC plasmid and the fluorescent intensity of these cells were lower than those with pcDNA3. 1( + )plasmid and normal control cells. Conclusion Transfected DCC gene can suppress the cell proliferation and make CEA expression of cell line SW1116 down regulation to weaken its infiltration and metastasis abilities.

Purpose To study the expression of TMPRSS2, ERG and ETV1 in prostatic cancer and their clinical pathologic signifi-cance. Methods Tissue microarray and immunohistochemistry (MaxVision) were used to detect TMPRSS2, ERG and ETV1 expres-sion in 70 prostatic cancer tissues, 10 prostatic intraepithelial neoplasia tissues and 18 benign prostate tissues. Results There was no statistical significance on positive rate of the expression of TMPRSS2 among prostatic cancer tissues, prostatic intraepithelial neoplasia tissues and benign prostate tissues (P>0. 05). The positive rate (81. 4%) of ERG in prostatic cancer tissues was significantly higher than that in prostatic intraepithelial neoplasia tissues ( 30. 0%) and benign prostate tissues ( 0. 0 ) ( P <0. 05 ) . The positive rate (68. 6%) of ETV1 in prostatic cancer tissues was significantly higher than that in prostatic intraepithelial neoplasia tissues (50. 0%) and benign prostate tissues (22. 2%) (P<0. 05). There was no correlation among the positive rates of TMPRSS2, ERG and ETV1 in prostatic cancer tissues and age (P>0. 05). The expression of TMPRSS2, ERG and ETV1 was positively correlated to Gleason score and clinical stage (P<0. 05). TMPRSS2 had positive correlation with ERG (rs =0. 465, P<0. 01). TMPRSS2 had positive correla-tion with ETV1 (rs =0. 590, P<0. 01). ERG had no positive correlation with ETV1 (rs =0. 151, P>0. 05). Conclusion ERG and ETV1 are expected to become therapeutic targets for prostate cancer. Detecting TMPRSS2, ERG and ETV1 at the same time is helpful to diagnosis and differential diagnosis of prostatic cancer, which might be new molecule markers of prostate cancer.