Objective To present the authors' initial experience of treating auricular arteriovenous malformations (AVMs) with ethanol embolization and to assess the clinical effectiveness of this therapeutic method. Methods Twenty-two patients with AVMs were enrolled in this study. Through local puncturing or super-selective catheterization the absolute ethanol, or diluted alcohol (based on the pattern of the AVMs), was manually injected into the abnormal vascular plexus of the auricular lesion. The clinical results were estimated with physical examination or angiography at intervals of 3 ～ 4 month, and telephone questionnaire was made at monthly intervals for all patients. Results Thirty-eight ethanol embolization procedures were performed, the amount of ethanol used during the procedure ranged from 4 ml to 65 ml. After the treatment the clinical symptoms were improved, which were manifested as healing of the ulceration, stop of bleeding, disappearing or alleviation of tinnitus. Angiographic examination showed that the abnormal vascular lesion was completely vanished in 9 cases, decreased by 50% -75% in 8 cases and decreased less than 50% in remaining 5 cases. The common complications included irreversible local necrosis and vesiculation. Conclusion For the treatment of auricular AVMs ethanol embolization is an effective and safe method, which might become the therapy of first choice.

Objective To evaluate reverse effect of recombinant human Endostatin on drug-resistance of A549/DDP cells to cisplatin (DDP). Methods Lung adenocarcinoma cell line A549 and its DDP-resistant cell line A549/DDP were treated with DDP and recombinant human Endostatin. Difference in drug resistance was analyzed between different regimens ( DDP, Endostatin and combination) and between different cell lines ( human lung adenocarcinoma A549 and drug resistant A549/DDP), after a 72h-treatment in vitro. Reverse effect of recombinant human Endostatin on drug-resistance of A549/DDP to DDP was tested by MTT assay. Results The observed 50% inhibitory concentration ( IC50 ) was (0.72 ± 0.05 ) ug/ml against A549 and ( 11.54 ± 0.64)against A549/DDP in DDP, and (2.0 ± 0.1 ) μg/ml against A549/DDP in rh-Endostatin- DDP combination respectively, with a reversal fold (RF) of 5.77 and a relative reversal rate of 88. 2%. Conclusion rh-Endostatin may reverse drug-resistance of A549/DDP cells to DDP.

Objective To investigate the posttraumatic stress disorder(PTSD) and ethical decision-making in nurses suffered workplace violence, and analyze the relmionship between them. Methods Totally 340 nurses suffered workplace violence were questionnaired by the PTSD Scale and the Ethical Decision- making Scale. Results The incidence rate of PTSD was 17.06%(58/340), the total score of PTSD was (38.77± 13.57).The scores of ideal ethical practice, actual ethical practice and ethical decision- making in the PTSD group were 121.36±8.33, 105.56±7.76, 226.92±15.52, and were significantly lower than that in the non-PTSD group (140.60±9.01, 117.65±8.41, 258.27±16.73) (t=-14.996, -10.015, -13.153, P < 0.01). The score of PTSD was negtively correlated with the scores of ideal ethical practice, actual ethical practice and ethical decision- making (r=-0.415, -0.431,-0.420, P < 0.05). Conclusions The PTSD probably occurred after workplace violence, nursing administrators should pay close attention to the PTSD and therefore improve nurses′ethical decision-making.

Objective To study the significance of discrimination of scarce cardiac masses by echocardiography. Methods Twenty-nine patients with cardiac masses selected randomly were examined by transthoracic echocardiography and transesophageal echocardiography to observe their shape, internal echo, margins, membrane and blood flow. Results Twenty-three patients in twenty-nine cases were confirmed by surgery and pathology including eight benign masses and fifteen malignant masses, but the other six patients with metastasis carcinoma had no pathologic results. Eighteen patients got correct diagnosis, nine patients weren′t diagnosed in character and two patients were made a wrong diagnosis. Conclusions Echocardiography is the only noninvasive method which can provide reliable evidences for clinic before surgery to discriminate scarce cardiac masses.

Objective To evaluate a new computer-aided technique applicable for myocardial contrast echocardiography(MCE) to quantitate automatically calibrated myocardial contrast intensity(CD and to test the feasibility of calibrated CI in assessing myocardial perfusion. To analyze the relationship on myocardial perfusion,regional contractile function and cell apoptosis in stunned myocardium. Methods According to coronary occlusion and reperfusion at different times, rabbits were divided into three groups: 15 min occlusion/30min reperfusion (group Ⅰ ),30 min occlusion / 60min reperfusion (group Ⅱ ) and 120 min occlusion / 60min reperfusion (group Ⅲ ). MCE was performed on all rabbits at baseline,occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique. Myocardial calibrated CI of each segment was measured automatically by software. Percentage wall thickening (WT) of each risk segment at each stage were also measured by echocardiography. The apoptotic index(AI) in regional left myocardial dysfunction was calculated by terminal deoxynucleotidyl transferease-mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL ). Results (1) During occlusion, WT in the areas at risk decreased to zero or negative and the calibrated CI values were significantly lower than those at baseline ( P ＜0.01 ). After reperfusion, WT in all risk segment remained depressed, but calibrated CI significantly improved in group Ⅰ and Ⅱ while those remained unchanged in group Ⅲ. (2)AI in risk myocytes were (13. 70 ± 5.48 ) %, (36.25 ± 5.55 ) % and ( 62.06 ± 6. 70 ) %, respectively, both statistically significant difference between the two groups ( P ＜0.05 or P ＜ 0.01 ). AI were negatively correlated to WT and calibrated CI ( r = - 0. 87 and r = - 0. 77, P ＜0.05). Conclusions MCE with computer-aided technique can assess quantitatively myocardial perfusion and regional contractile function. Short-term ischemiareperfusion does not cause myocardial necrosis, but it will lead to myocardial cell apoptosis and the phenomenon of myocardial stunning. Prolonged ischemia, even if given sufficient reperfusion, can lead to apoptosis and necrosis simultaneously.

BACKGROUND: Previous studies demonstrated that smooth muscle injury or ischemia/reperfusion injury result in tissue factor (TF) increasing. However, few reports concern the expression and mechanism of TF in venous bypass grafting.OBJECTIVE: To examine changes in TF protein expression in response to venous bypass grafting.DESIGN, TIME AND SETTING: The animal observation experiment was performed at the Department of Cardiovascular Surgery, Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from May 2006 to May 2008.MATERIALS: A total of 30 Sprague-Dawley (SD) rats.METHODS: Rats were underwent interposition bypass grafting of the common carotid artery via the ipsilateral external jugular vein. Namely, the proximal end of external jugular vein was ligated at the joints of external jugular vein and internal jugular vein, and the distal end of external jugular vein was ligated before branches. The proximal and distal ends of common carotid artery were occluded by artery clamp, and a 5 mm artery was removed. The proximal end of artery was anastomosed with distal end of artery, and the frontal wall was sutured with posterior wall. After that, the proximal end of external jugular vein was cut down and coincided with the distal end of common carotid artery.MAIN OUTCOME MEASURES: The expression of TF and proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. Meantime, TF activity in vessel protein extracts was determined with TF activity assay kit, and the thickness of intima, media were calculated by computer imaging analysis system. The contralateral external jugular veins were served as the control.RESULTS: The adventitia of all vessels showed abundant TF staining. In early vein grafts, TF staining was markedly increased in the intima and media. However, intimal and media TF staining was absent in the contralateral control jugular veins and late vein grafts. The number of PCNA positive cells was increased in the vein grafts at day 3 after grafting, obvious increased at day 7, and reached the peak at day 14. TF activity in whole-vessel protein extracts was similar in control veins and early and late vein grafts. The thickness of neointima of the vein graft increased significantly at days 7, 14, and 28, and the thickness of media increased significantly at days 14 and 28.CONCLUSION: The changes of TF expression at various time points may relate to hyperplasia of neointima.

Objective To investigate the value of diffusion kurtosis imaging (DKI) in differential diagnosis of parotid gland disease and diagnosis of parotid adenolymphoma (PAL).Methods DKI and DWI data of 57 patients with parotid gland disease were etrospectively analyzed.Totally 57 cases were divided into infectious lesions group (n=10),pleomorphic adenoma group (n=19),PAL group (n=14),other benign parotid tumor group (n=4) and malignant parotid tumor group (n=10).Contralateral normal parotid glands in 19 patients with unilateral parotid gland lesions were treated as control group.The quantitative parameters including kurtosis concerning parameters (K Krad,Kax),diffusivity concerning parameters (D Drad,Dax),fractional anisotropy (FA) and conventional apparent diffusion coefficient (ADC) values were retrospectively reviewed.The binary Logistic regression method was used to confirm parameters with significant difference in diagnosing PAL.And Logistic regression equation was constructed to diagnose PAL.ROC analysis was conducted to evaluate the diagnostic value of the confirmed parameters and the Logistic regression equation.Results Significant difference of the parameters including K Krad,Kax,D Drad,Dax,FA and ADC values were found among different groups (all P＜0.05).ROC analysis demonstrated a higher area under the curve (AUC) for FA+Kax [0.88±0.06 (0.79-0.94)] than Kax[0.80±0.07 (0.70-0.88)] and FA [0.63±0.10 (0.52-0.73)],respectively (both P＜0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value was 71.43％,95.78％,91.77％,76.92％ and 94.44％.Conclusion DKI showed high diagnostic capacity in differential diagnosis of parotid gland disease.The combination of FA and Kaxcan improve the diagnostic accuracy in diagnosis of PAL.

phological changes in rat liver tissues. TLR4 and NF-κB expression in the liver tissues were measured by im-munohistochemistry . The results showed that compared with the normal group , the serum levels of transaminase ( ALT , AST ) and endotoxin of the model group were higher ( P < 0 . 01 ); and the degree of liver pathology injury was significantly increased; the TLR4 and NF-кB expression were increased (P < 0.01). Compared with the model group, the serum levels of transaminase (ALT, AST) and endotoxin of the experimental group were lower (P < 0.01), the degree of liver pathology injury was significantly lighter; the TLR4 and NF-кB expression were significantly lower (P < 0.01). It was concluded that the WYJDHY granules has a good role in the prevention and treatment of liver injury of rat model of hepatic failure IETM through the downregulation of liver expression of TLR4 and NF-кB in rat liver tissues , reducing serum levels of endotoxin , which may be one of the mecha-nisms on hepatic failure treatment .

Objective To select sonogram features for the differential diagnosis of benign and malignant thyroid small nodules by Logistics regression analysis,and to contribute the binary Logistic regression model of sonogram features as independent variable and evaluate the value of conventional ultrasonography and ultrasound elastography (UE) in the differential diagnosis of benign and malignant thyroid small nodules.Methods 166 thyroid nodules (≤ 10 mm) in 140 patients were reviewed and analyzed by 2D ultrasound,color Doppler flow imaging and UE.A Logistic model was obtained based on pathology as golden diagnosis criteria.The odds ratio of variables in the equation were compared to assess various variables,especially the efficacy of elastography in the diagnosis.Results Four statistically significant features were finally entering the Logistic stepwise regression model,including shape,calcification,the internal component of nodules and elasticity score.And the odds ratio of the elasticity score was higher than other features.Conclusions The analysis of binary Logistic regression can select the valuable variables for the diagnosis of pathological nature of thyroid small nodules.UE has much more dominances than other features.The combinated application of UE and 2D ultrasonic features plays a great clinical role in the final diagnosis of thyroid small nodules.

Objective To investigate whether the activation of secretory prophospholipase A2 (sPLA2) plays the role in the pathophysiological mechanism of acute aristolochic acid nephropathy (AAN) in rats. Methods Wistar rats were randomly divided into two groups. Model group received decocted Aristolochia Manshuriensis Kom 30 g·kg-1d-1 by gavage for 7 days following tap water in same way for additional 7 days. Control group received only tap water by garage at parallel time. The renal pathological changes were observed at the 4th, 8th and 14th day. The injury of renal tubules and interstitium was observed under light microscope following a semi-quantity grade. The level of Scr was measured to evaluate glomerular function. Urinary N-acetyl-beta-glucosaminidase (NAG) was tested as renal tubular injury marker. The activity of sPLA2 in serum was detected by manifesting the color of thiols in the substrate. The protein expression of renal cortex and medulla COX-2 was analyzed by Western blot. The metabolic products of pretaglandins (PC, s) including 6-kcto-PGF1α and TXB2 in the plasma and urine were assayed by radioimmunoassay. The ratio of 6-keto-PGF1α/TXB2 was calculated. Results After Aristolochia administration, the tubulointerstitial injury and Scr increased in AA rats and reached the peak at the 8th day, the tubulointerstitial injury index(8.14±2.55 vs 1.50±0.71, P<0.05) and Scr[(0.24±0.10) vs (0.19±0.02) μmol/g, P<0.05] increased significantly in AA rats compared with control group. The activity of sPLA2 (μmol ·min-1·mg-1) in AA group elevated by 1.3-fold compared to control group at 8th day (133.15±17.05 vs 101.3±16.07, P<0.05), while theexpression of COX-2 in renal cortex increased (1.16±0.36 vs 0.69±0.28, P<0.05) with no change in renal medulla. Even though the levels of serum 6-keto-PGF1α and TXB2 did not change obviously in both AA and control group, but urinary levels of 6-keto-PGF1α and TXB2 increased by 2-fold and 3-fold in AA group compared to control group, respectively (all P<0.05), while the ratio of 6-keto-PGF1α/TXB2 decreased significantly (207.53±17.52 vs 296.64±51.31, P<0.05). All of above changes recovered to the control level at the 14th day except the tubulointerstitial injury index. Conclusion Serum sPLA2 is activated in the rots with acute kidney injury induced by aristolochic acid, which accompanied by up-regulated expression of COX-2 in renal cotex and increased the metabolic products of vasoconstrictive PG s in urine. These changes may participate the mechanism of renal peritubular ischemia in AAN.