Objective The purpose of this study was to assess the effectiveness and safety of distal filtration protection devices during carotid artery stenting.Methods Between June and July in 2002, carotid artery stenting (CAS) were performed in 4 patients with asymptomatic severe carotid artery stenosis. Self-expendable stents (Smart, Cordis) and distal filtration devices (Angioguard XP, Cordis) were used in all patients. Primary endpoints were perioperative neurologic complications and mortality. Data were collected prospectively.Results All patients were male, their age were 59?4 years old. One patient had history of transient ischemic attacks(TIAs); and another had inferior myocardial infarction, and right coronary intervention was performed before CAS, and another one underwent CABG 6 months ago. There were two right internal carotid and two left internal carotid severe lesions (82.5?6.0)% were treated. The filtration devices and stents were delivered and deployed successfully in all target artery (technical success rate was 100%) and

Objective To investigate the safety and feasibility of carotid artery stenting (CAS) and evaluate its clinical outcomes. Methods From July 1998 to December 2003, 30 consecutive patients with 32 lesions underwent extracranial CAS procedures. Thirteen patients had a history of stroke or TIAs, 22 were hypertensive, 11 were diabetic and 8 had history of MI. Neurological assessment, Carotid duplex ultrasound, carotid and intracranial angiography were done before CAS in all patients. All the cases were done percutanously from femoral arteries and stenting was applied in all procedures. Carotid duplex ultrasound, cardiac and neurological elevation were performed post procedure. Results 30 patients (26 male and 4 female) underwent a total of 32 CAS procedures. Total 32 self-expandable stents and 1 tubular stent were implanted in all the cases. Direct stenting technique was applied in 9 cases. The other 21 procedures were performed with distal filtration supporting devices. The device can not be delivered due to tortuous target vessel in one case (success rate 95%) and CAS success rate was 97%. The particles were found in all filter baskets. Four patients underwent coronary artery bypass grafting 1 month later post CAS without perioperative neurological and cardiac events. One patient had contralateral cerebral hemorrhage during CAS and died three days later. Another patient died three days after CAS due to acute pulmonary edema. No restenosis was found by means of carotid duplex ultrasound during the follow-up (3-60 months) study. Conclusion CAS is safe and feasible in preventing ischemic stroke. This new alternative has satisfied clinical outcomes in managing cardiac and neurological ischemic diseases. Operative embolic complication can be potentially prevented by neurological protective device.

Objective To discuss the effect of pericardial devascularization plus gastric fundus transaction in advance schis?tosomiasis patients with portal hypertension. Methods Thirty?six advanced schistosomiasis patients with portal hypertension treated with devascularization plus gastric fundus transaction(a portal hypertension group),as well as 10 patients treated with modified Sugiura operation(a modified Sugiura operation group)in the Third People’s Hospital of Yangxin County since 2006 were chosen as the observation objects,and the clinical effects of the two groups were observed and compared. Results The op?eration time,indwelling time of stomach tube,time to taking food after operation,drainage tube removal time of the portal hy?pertension group were all shorten than those of the modified Sugiura operation group(all P<0.05). The hospitalization expenses of the two groups were(25 466.00 ± 2 888.48)Yuan and(34 517.10 ± 4 948.39)Yuan respectively,and the difference was al?so statistically significant(P<0.05). The incidence rates of portal thrombosis of the portal hypertension group and modified Sug?iura operation group were 33.33%(12/36)and 40.00%(4/10),respectively,and the incidence rates of rehaemorrhagia of the two groups 12 months after the operation were 16.67%(6/36)and 10.00%(1/10),respectively,but the differences had no sta?tistically significance(both P>0.05). In addition,1 case with delayed gastric emptying and 1 case with stomal leak of esopha?gus happened in the modified Sugiura operation group,while no corresponding complications happened in the portal hyperten?sion group. Conclusions Pericardial devascularization plus gastric fundus is a relatively easy procedure which has a good short?term clinical effect,and therefore it is suitable for application in primary hospitals. However,its long?term effect still needs fur?ther observation.

Objective To compare the clinical effect of the peripheral balloon closure with surgical intervention for developed retroperitoneal hematoma(RPH) caused by femoral artery perforation .Methods A retrospecive analysis was performed on 2 492 consecutive patients underwent PCI from January 2005 to December 2013 in Guangdong people′s hospital .Twenty -four cases of developed RPH caused by femoral artery puncture operation for PCI were retrospectively analyzed ,13 cases of patients who took peripheral balloon closure were divided into balloon block group and the other 11 patients adopted surgery vascular repair process‐ing ,were enrolled in the surgical treatment group .Comparison was done among the hemostatic effect and the time ,and postoperative adverse events ,including lower limb blood supply obstacles for puncture side postoperative ,major adverse cardiovascular events (MACE) during hospitalization ,all‐cause mortality ;Multivariate logistic regression was used to assesse the RPH risk factors .Re‐sults The incidence of RPH caused by femoral artery perforation was about 0 .96% .During coronary intervention ,the following variables were found to be independent predictors of RPH caused by femoral artery perforation:female gender(OR=8 .94 ,95% CI:3 .75-21 .98 ,P< 0 .01) ,femoral artery ulcer(OR= 6 .43 ,P<0 .05) and multiple puncture (> 3 times) (OR= 7 .39 ,95% CI:2 .74-13 .76 ,P<0 .01) .Hemostatic success rates of the two groups were all 100% ;the average times of processing perforation were (76 .8 ± 34 .6) min and ((88 .5 ± 37 .3) min ,P<0 .05 ,the difference was statistically significant ;3 cases (23 .1% ) and 2 cases (18 .2% ) developed into postoperative severe anemia (Hgb<60 g/L) in each group ,P>0 .05;Each group had 1 case for in‐hospital MACE (7 .7% vs .9 .1 % ,P>0 .05);In the two groups ,there was no lower limb blood supply obstacles and death case .Conclusion For progress RPH caused by femoral artery perforation ,peripheral balloon closure can be a faster ,better sealing hemostatic ,and shorten the rescue time ,and the success rate is high ,and there is less postoperative adverse events .The safety and effectiveness be‐have good .

Objectives To investigate the recurrence risk factors and the protective factors of aortic dissection (AD) DeBakey type Ⅲ. Methods 43 patients with AD DeBakey type Ⅲ who were in Guangdong General Hospital from May 2014 to September 2014, were enrolled as the case group, while 27 volunteers exclude AD as the control group. Blood chemistries and other information obtained immediately after admissions , χ2 test or T test was used for univariate analysis of independent samples. Multivariate Logistic regression analysis was used to screen patients with recurrence risk factors or protective factors. Results The prevalence of hypertension (93.02%vs. 18.52%, P = 0.000) and proportion of smokers (34.88% vs. 11.11%, P = 0.027) were significantly higher in case group than control group. Logistic regression analysis showed that hypertension (OR=5.148, 95%CI= [2.209~13.058], P=0.001) and albumin level (OR=0.709, 95%CI = [0.541~0.929], P=0.013) were significantly associated with recurrence of aortic dissection DeBakey type Ⅲ. Conclusion Hypertension is an independent risk factor for recurrence of aortic dissection DeBakey type Ⅲ, and albumin level is a protective factor.

Objective To evaluate the prevalence and impact of coronary artery disease (CAD) in aged patients with Stanford type B aortic dissection(AD).Methods From January 2008 to December 2011,CAG was routinely performed before aortography and thoracic aortic repair(TEVAR) to determine the prevalence of concomitant CAD in 200 consecutive Stanford type B AD patients who were older than 50 years.All patients received 1 year follow-up.Adverse events were compared between patients with and without concomitant CAD.Data analysis by SPSS 17.0 statistical software,using Student t test,Chi-square test and Fisher exact test.Results CAG showed 53 patients (26.5％) had CAD.Multivariate logistic regression analysis showed that male gender(OR =4.415,95％ CI:1.131-17.237,P =0.033) and age (OR =1.061,95％ CI:1.017-1.108,P =0.006) were independent predictors of Stanford type BAD coexisted with CAD.Age was also independent predictor of multi-vessel disease(MVD) and/or left main disease(LMD) (OR =1.096,95％ CI:1.009-1.191,P =0.023).At 30-day follow-up,there was no difference in the incidence of adverse events between patients with and without concomitant CAD.Patients with concomitant CAD showed higher incidence of myocardial infarction[3 (5.66％) vs.0(0),P =0.018] and stroke [4 (7.55 ％) vs.1 (0.68 ％),P =0.018].Conclusion The prevalence of CAD in aged patients with Stanford type BAD is relatively high.Concomitant CAD is associated with higher risk of cardio-cerebrovascular ischemic events while dose not increase the risk of adverse aorta related events.

Objective To investigate the protective effects of memantine on isofluane￣induced decrease of proliferation in neural stem cells ( NSCs) and the potential mechanisms in vitro. Methods Neural stem cells were isolated from rat hippocampi (postnatal day 1) and grew in culture. Cultured NSCs were randomly divided into the control ( Group Control), Vehicle (Group Vehicle), Isoflurane ( Group Iso), Isoflurane +Memantine ( Group Iso +Mem) and Isoflurane + Memantine +LY294002 groups (Group Iso+Mem+LY).Proliferation was assessed by cell counting and BrdU incorporation.Western blot was conducted to detect protein expression of phospho￣Akt. Results Compared with the control group,BrdU incorporation and phospho￣Akt expressions in neural stem cells significantly declined after 2.4% isoflurane exposure for 6 h (P<0.01).However, isofluane￣induced decrease of BrdU incorporation and phospho￣Akt expressions was attenuated by the treatments of memantine (P<0.01)). It was showed that Akt inhibitors LY294002 reversed the protective effects on neural stem cells proliferation by memantine(P<0.01). Conclusion The results suggest that memantine treatment might attenuate isofluane￣induced decrease of proliferation in neural stem cells via Akt signaling pathway.

Objective To summarize the effect of supra-arch branches bypass combined with endovascular aortic repair for aortic diseases.Methods From January 2012 to August 2015,120 cases of thoracic aortic diseases (aortic dissection 103,aortic aneurysm 16,penetrating aortic ulcer 1) received hybrid operation in Guangdong Cardiovascular Institute.Vascular bypass was established among the brachiocephalic arteries,followed by endovascular repair through femoral artery either one-stage or two-stage.Patients were followed up for 3-24 months.Results Technical success was achieved among all the patients.Five patients died after the operation(one patient had retrograde aortic dissection,2 patients had pericardial tamponade,one patient had apnea,and one patient had respiratory and cardiac arrest.The death rate is 4.1％),4 patients had stroke,among them,symptoms were relieved in three patients,one patient was not cured.Total 92 patients were followed-up and had no symptoms of up-limb ischemia or dizziness.CT scan showed bypass graft and endovascular stent patency.6 patients had endoleak (type Ⅰ b 2 cases,type Ⅱ 3 cases,and type Ⅲ 1 case),distal aortic dissection occurred in one patient,three patients had mild contrast agent leakage around the distal endovascular stent,type A aortic dissection occurred in one patient,there were no late stage death.Conclusion Supraarch branches bypass combined with endovascular aortic repair for treating aortic disease is minimally invasive,safe,and can reduce the incidence of postoperative complications.

ObjectiveTo identify the presence of side population (SP) cells in human ovarian cancer cell line OVCAR-3 and to investigate whether SP cells have the characteristics of cancer stem cells.MethodsSP and non-SP (NSP) cells from OVCAR-3 were isolated by fluorescence-activated cell sorting after being stained by DNA-binding dye Hoechst 33342.Limiting dilution transplantation assay,realtime PCR,and drug sensitivity assay were performed to compare the tumorigenic ability,differentiation ability in vivo,the mRNA expressiou of stemness marker (Oct-4,Klf4,and Nanog) and ATP-binding cassette (ABC) transporter (ABCG2,ABCB1,and ABCC2),and response to multiple drugs (cisplatin,paclitaxel,doxorubicin,and mitoxantrone )between SP and NSP cells.ResultsA few of SP cells [ ( 1.13 ±0.39) ％ ] which were sensitive to reserpine were identified in OVCAR-3 cells.The injection of as few as 102 SP cells initiated tumors in two of five mice.Tumor latency was 52 -61 days.However,the NSP cells did not generate any tumors in mice until 104 NSP cells were injected (two of five mice).Tumor latency was 64 - 98 days.Tumorigenicity of SP cells was enhanced by at least 100-fold than that of NSP cells.The SP cells regenerated both SP [ ( 2.09 ± 0.73 ) ％ ] and NSP populations in vivo with a fraction size that was comparable to the original population.The mRNA expression ofstemness genes Oct-4,Klf4 and ABC transporters ABCG2,ABCC2 genes were elevated in SP cells compared to NSP cells,the fold changes were 1.95±0.41 (P＜0.05),4.26 ±0.63 (P＜0.01),3.22±0.36 (P＜0.01),and 1.76±0.26 (P＜0.01 ),respectively.The relative activity of SP and NSP cells were 0.757 ± 0.105 versus 0.474 ± 0.035 (P＜0.01),0.521 ±0.092 versus 0.384 ±0.073 (P＜0.05),0.742 ±0.051 versus 0.526 ±0.088 (P ＜0.01 ),and 0.690 ± 0.096 versus 0.466 ± 0.112 ( P ＜ 0.01 ) when they exposed to 0.25 μg/ml cisplatin, 0.01μmol/Lpaclitaxel, 0.25μmol/Ldoxorubicin, and0.05μg/mlmitoxantrone,respectively.ConclusionsSP cells from OVCAR-3 have enhanced self-renewal,differentiation,and tumorinitiating capacity compared to NSP cells.The mRNA expression of stemness genes and ABC transporters are markedly elevated in SP cells,which showed resistance to multiple chemotherapeutic drugs and have characteristics of cancer stem-like cells.Therefore,SP phenotype could be used as a marker to isolate the cancer stem-like cells in ovarian cancer.

Objective To explore the correlation between Th1,Th2,Th17,and Treg cells differentiation and related cytokines in patients with rheumatoid arthritis (RA).Methods Seventy-one patients with active RA were enrolled in this study.They were divided into low,moderate and high disease activity groups according to disease activity score (DAS28).The frequencies of Th1,Th2,Th17,and Treg cells in the peripheral blood of RA patients group (n=71) and healthy conlrol group (n=18) were determined by flow cytometry.T test was used for statistical analysis.Results Significant difference could be detected between the proportions of Th1 [ (6.2±4.5)％],Th17 [ (1.1±0.9)％] and Treg [(1.8±1.2)％] cells in the peripheral blood of RA patients and the control group (P＜0.05),and there was correlation between proportions of these three kinds of cell and the DAS28.Conclusion Th1 and Th 17 cells may promote the development of RA disease,but Th2 and Treg cells could prevent further development of RA disease.