Resulting from the shape stability, metal vascular stent has limited the vascular retraction, and subsequently prevent the unfavorable vascular remodeling. However, the metal stent requires further anticoagulant therapy after implantation, induces the hyperplasy of vascular smooth muscle cells, and cannot completely prevent the occurrence of in-stent restenosis. Surface modification of metal stent may reduce thrombogenesis. Based on the metal stent, drug eluting stent can transfer the active drugs to the damaged vessels, release them into the vascular wall and inhibit the in-stent restenosis. The eluting drugs restrain both the proliferation of smooth muscle cells and the regeneration of normal endothelial cells, leading to delay the vascular endothelialization and increase the risk of delayed thrombogenesis. The effect of stent implantation on the modus and size of vascular injury varies according to different operational techniques, processing technologies and designs, thus influencing the occurrence of in-stent restenosis. It is a potential study topic of interventional therapy to develop new eluting materials and eluting drugs, modify formulation, as well as facilitate the stent structure.

Coronary stent can cause mechanical injury to tunica intima and stimulation to vessel wall, resulting to platelet and inflammatory cell aggregation and infiltration, release of inflammation mediators, chemotatic factor, adhesion molecule and growth factor, and promoting migration and proliferation of vascular smooth muscle cells. The inflammatory reaction post stenting is highly correlated with intravascular restenosis. The drug-eluting stent against proliferation of vascular smooth muscle cells and inflammatory reaction can reduce the intensity and duration of body inflammatory reaction, improve stent technique, relieve damage of stenting to vessel wall, and reduce incidence of intravascular restenosis.

Objective To compare the efficacy of arthroscopic assisted percutaneous plate osteosynthesis and conventional open reduction and plate internal fixation in treatment of tibial plateau fractures of SchatzkerⅠ ~ Ⅳ . Methods Clinical data of 60 patients with tibial plateau fractures from July 2014 to July 2016 was retrospectively analyzed. All the patients were divided into observation group (30 cases) and control group (30 cases). Patients in observation group underwent arthroscopic assisted percutaneous internal fixation surgery, while patients in control group underwent conventional open reduction and plate internal fixation. Then record the operation index, the incidence of postoperative complications, maximum active angle of knee joint and the excellent rate of treatment. Results The operation index, postoperative complication rate, maximum active angle of knee joint and the treatment excellence rate in observation group was superior to control group. Conclusion With better clinical value, arthroscopic assisted percutaneous plate fixation was more satisfactory than conventional open reduction and plate internal fixation in treatment of tibial plateau fractures of Schatzker Ⅰ ~ Ⅳ .

Objective To explore the effect of arthroscope assisted percutaneous plate fixation combined with early postoperative rehabilitation training in the treatment of 27 cases tibial plateau fractures. Method From 2012 July to 2014 December, we treated 50 patients who got tibial plateau fractures. Random grouping is used in this experiment. 27 cases as experimental group were treated with arthroscopic surgery, after surgery all the patients were treated with early comprehensive rehabilitation therapy; 23 cases as control group were treated with traditional open surgery and rehabilitation therapy. Using the hospital for special surgery knee score ( HSS ) after operation respectively in 3, 6, 12 months to assess limb knee joint function. Results Postoperative patients incisions were healed, patients were followed up for 3 ~ 12 months, average 12 months. According to the HSS score, the excellent rate of knee function in the experimental group was 55.6 %, 70.3 % and 85.2 % respectively. The excellent rate of the control group was 47.8 %, 60.8 % and 73.9 %, respectively. Conclusion For the treatment of fracture of tibial plateau. There is a good effect in recovering the function of the patients’ knees by using arthroscope assisted combined with minimally invasive technique and postoperative early rehabilitation exercise.

Objective To observe the effects of salvianolate injection on blood levels of high sensitively C-reactive protein (hs-CRP),pregnancy associated plasma protein-A (PAPP-A) and brain natriuretic peptide (BNP) in elderly patients with acute myocardial infarction.Methods The elderly patients with AMI (AMI group,n=160) and healthy controls (control group.n=30) were enrolled in this study and their blood concentrations of PAPP A,hs CRP and BNP were detected before and two weeks after treatment.The elderly patients in AMI group were randomized into conventional treatment group (n =80) and salvianolate group (n =80).Results The levels of PAPP-A,hs-CRP and BNP were significantly higher in AMI patients [(12.88±2.56) mg/L,(20.13 ±5.35) mU/L,(412.0±69.5) ng/L,respectively] than in healthy subjects[(1.20±0.88) mg/L,(1.90±0.46) mU/L,(89.0±5.6) ng/L,respectively] (t=24.670,3.780,11.939,respectively,P ＜0.01).But,before treatment there were no significant differences in the levels of PAPP-A,hs-CRP and BNP between the AMI group and control group (t=0.864,0.712,0.985,all P＞0.05).After two weeks of treatment,as compared with control group,AMI group showed that the serum concentrations of PAPP-A,hs-CRP and BNP were decreased significantly (P＜0.05).The levels of PAPP A,hs-CRP and BNP were (3.83±1.20) mg/L,(1.33±0.38) mU/L,(105.0±31.2) ng/L in salvianolate group and (5.71± 1.93) mg/L,(1.81±0.72) mU/L,(150.0±36.7) ng/L in conventional treatment group respectively,and the decrements in levels of PAPP-A,hs CRP and BNP were greater in the former than in the latter(t=7.399,5.273,8.356,respectively,all P＜0.05).Conclusions The dynamic serum concentrations of PAPP-A,hs CRP and BNP can be used as clinical indexes for the prognosis of acute myocardial infarction.Salvianolate injection can significantly decrease the serum levels of PAPP A,hs CRP and BNP.The salvianolate injection may have anti inflammatory effect and improve cardiac function in elderly patients with acute myocardial infarction,but the mechanism is still to be further discussed.