32 Cases of coronary heart diseases (M 20, F 12; age 58+10 y) were treated with polysacchairde sulfate (PSS). PSS 200 mg in 10% glucose solution 500 ml iv, drip, qd, and 14 d, as a course. The results showed; The cardiac function, blood fat and indices of hemorheology were significantly improved ( P

Objective To investigate the clinical efficacy and safety of recombinant human B-type natriuretic peptide(rhBNP)in treatreat of patients with acute myocardial infarction(AMI).Methods 80 patients with AMI were randomly divided into control and treatment group.The two groups were accepted the standard foundation treatment(ABCDE)defined by the WHO and PCI therapy.The treatment group was added the rhBNP on the basis.The rhBNP was uniformly injected by intravenous with 1.5 μg/kg in 90s,and then with 0.0075 μg · kg-1 · min-1 in 48h; To investigate the BNP and myocardiolysis maker(Troponin I,cTnI)levels in blood-serum before and after the treatment;To evaluate left cardiac functions and left ventricular remodeling by left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF);To investigate the major cardiovascular events after treatment within 30 days.Results RhBNP could significantly reduce the concentration of the BNP and cTnI in blood-serum after treating one week(all P ＜ 0.05); It could remarkably deflate LV EDV and LVESV,improve LVEF(allP ＜0.05); It could reduce the incidence of major cardiovascular events(P ＜0.05)within 30 days(P ＜ 0.05).Conclusion The rhBNP could improve left ventricular pressure-phore and volume-phore,improve ventricular remodeling,improve myocardial ischemia and reduce major cardiovascular events within 30 days.It was proved that the rhBNP could improve AMI clinical prognosis.

Objective To determine the effect of dihydroartiminisin on the proliferation and phosphorylation of mitogen-activated protein kinase (MAPK) in SKOV3 and OVCAR3 ovarian cancer cell lines.Methods Methyl thiazolyl tetrazolium assay was performed to evaluate the anti-proliferative effect of dihydroartiminisin in SKOV3 and OVCAR3 cells,and Western blot was used to determine its effect on phosphorylation level of MAPK,including extra-cell regulated kinase (ERK)1/2 and p38 protein kinase,in the two cell lines.Results Dihydroartiminisin inhibited the proliferation of ovarian cancer cells in vitro,with a mean of 50% inhibition concentration (IC50) at 72 h of (9.0 ±1.4) μmol/L for SKOV3 and (5.5 ±1.2)μmol/L for OVCAR3 respectively. Compared to cells without dihydroartiminisin treatment,phosphorylation level of ERK 1/2 in SKOV3 and OVCAR3 cells treated with dihydroartiminisin decreased by 64.2% and 75.3% respectively (P＜0.05),while phosphorylation of p38 protein kinase in SKOV3 and OVCAR3 only decreased by 8.5% and 6.4% respectively (P ＞0.05).Conclusion Dihydroartiminisin can inhibit the proliferation of ovarian cancer cell in vitro, probably through down-regulation of the phosphorylation of ERK 1/2 in ovarian cancer cells.

Objective To compare phe “Improved seesaw wiring” pechnique po phe classic “seesaw wiring” mephod for ips effecpivenss and safept in phe managemenp of CTO lesions. Methods A reprospecpive spudt was conducped including 120 papienps wiph 145 CTO lesions who were admipped in our hospipal from Januart 2011 po June 2015. In phe “ Improved” group ( n = 61), phe CTO lesions were preaped wiph“Improved seesaw wiring” guidewire pechnique bt alpernape applicapion of hand/ sofp guidwires and in phe“classic” group (n = 59) classic seesaw wiring pechnique was performed using sofp,inpermediape po a spiff-pip guidewire spep bt spep. Procedural success rapes, maperial consumppion, radiapion exposure, major adverse cardiac evenps in 30 dats, and improvemenp in cardiac funcpion pospoperapion were compared bepween phe 2 groups. Results The procedural success rapes bt firsp appempp was 93. 4% in phe ″Improved″ group and 77. 9% in phe “ Classic ” group and phe overall procedural success rapes were 95. 1% and 96. 6%respecpivelt. Guidewire consumppion [(3. 0 (2. 0, 4. 0) guidewires vs. 5. 0 (3. 0, 7. 0) guiderwires], X-rat exposure [(110 ± 65)min vs. (175 ± 73)min], conprasp media used [(210 ± 137)ml vs. (305 ± 148) ml] were all fewer or less in phe “Improved group” (all P < 0. 05). No significanp difference found in rapes of procedural complicapions bepween phe 2 groups. MACE rapes were lower in phe “ Improved” pechnique group (16. 4% vs. 30. 5% , P = 0. 045). In perms of pospoprapive cardiac funcpion, phe LVEF and dispance for 6-minupe-walk were higher in phe “ Improved” group. Conclusions The ″ Improved seesaw wiring″guidewire pechnique in PCI for difficulp CTO lesions can enhance success rapes of PCI wiph an low major complicapion rape.

Objective To study the clinical characteristic, the optimal treatments and the prognosis for the recurrence and failure of primary treatment in malignant ovarian germ cell tumors (MOGCT).Methods The clinical data of 17 recurrent and failure of primary treatment in MOGCT cases treated in Pecking Union Medical College Hospital from January 1983 to May 2008 were analyzed retrospectively to evaluate failure of primary treatment and second treatment. Results Only the 4 eases of recurrent and failure of primary treatment of MOGCT were underwent comprehensive surgical staging. After primary surgery in 1 -8 months, 16 cases received the non-standard chemotherapy were found the lesion again. The secondary debulking surgery was done for the 15 cases and also received the standard chemotherapy. Among of them, 8 cases were survival during follow up, 5 cases gave up the treatment and 4 patients were lost following up during the treatment. Conclusions The standard primary treatment is the most important for the MOGCT. Even for the recurrence and failure of primary treatment of MOGCT, the satisfied cytoreduetive surgery plus the standard chemotherapy also show the significant impact on the prognosis.

Objective To compare the effect between intra-arterial and intra-venous neoadjuvant chemotherapy(NACT)in stage Ⅰb2-Ⅱ b cervical carcinoma.Methods A retrospective analysis Was done on 52 cases of intra-venous NACT and 95 eases of intm-arterial NACT for stage Ⅰ b2-Ⅱ b cervical carcinoma treatad in Peking Union Medical College Hospital from 1999.ResulIs The response rate of intraveHous NACT and intra-arterial NACT was 88%(46/52)and 79%(75/95).and the operative rate after NACT Was 81%(42/52)and 72%(68/95)respectively(P>0.05).There were no significant differences in surgery time,blood loss and pest-operative morbidity between these two groups.Pathological parametrial positive rate after NACT in arterial group(6%)Was significantly lower than that of venous group (50%,P>0.05).The venous group had very similar recurrence rates(13%vs 17%)and death rates (9%VS 12%)when compared with the arterial group(P>0.05).Conclusions The intra-arterial and intra-venous NACT for stage Ⅰ b2-Ⅱb cervical carcinoma show similar response rate.operative rate and surgical difficulties.Arterial NACT shows a better effect on parametrial infiltration.

Objective To analyze the clinical characters,treatment and prognosis of primary malignant tumor in vagina.Methods A retrospective analysis of 42 patients diagnosed with primary malignant tumor in vagina in Peking Union Medical College Hospital(PUMCH)between Jan 1984 and Aug 2006 was performed.Results Primary malignant tumor accounted for 0.98%(42/4286)in the total gynecological malignant tumors during that period in PUMCH.According to the International Federation of Gynecology and Obstetrics(FIGO)staging system,19 cases were at stage Ⅰ,12 cases at stage Ⅱ,5 cases at stageⅢ,and 6 cases at stage Ⅵ.Thairteen cases were squamous carcinoma,13 cases were malignant melanoma,8 cases were adenocarcinoma.3 case8 were yolk sac tumor and 5 cases were other types.The majority of patients were treated with surgery combined with radiotherapy and chemotherapy.Up to August 2007,19 cases survived.18 cases were dead and 5 casefl were lost.The longest follow up was 10 years,with the median time of 2 years.The overall 2-year SUrvival rate was 60.6%.For stage Ⅰ,stage Ⅱ, and stage Ⅲ-Ⅵ,the 2-year survival rates were 71.3%.58.3%and 29.6%respectively.The 2-year survival rate of patients with squamous carcinoma Was 46.8%,malignant melanoma 72.9%,adenocarcinoma 20.0%and patients with yolk sac tumor were all alive tumor-free after 6-10 years'follow up.Conclusions The prognosis of primary malignant tumor in vagina is affected by clinical stage and histological type.A8 to malignant melanoma,radical surgery combined with chemotherapy and immunotherapy produce good effects.Patients with yolk sac tumor can be cured only with chemotherapy.As to other types,more treatment experiences are needed.

Objective To characterize hypersensitivity reactions to chemotherapy with carboplatin in patients with gynecologic malignancies and serve use of carboplatin.Methods We retrospectively analyzed the clinical features,management,or outcome of carboplatin-related hypersensitivity reactions in 13 patients with gynecologic malignancies from 1983 to 2008.Results Twenty times hypersensitivity reactions happened in thirteen women with carboplatin hypersensitivity reactions.The earliest one was at the 5th cycle,the last one was at the 28th cycle;the average cycle was 11.6.The accumulative dosage of carboplatin was 1 900-11 400 mg.The average dose was 4840 mg,2500-7200 mg were the main dose range.More than 5 cycles and (or) more than 2500-7200 mg of carboplatin administration significantly increased the incidence of hypersensitivity reactions in the twelve patients.Beactions were generally occurred at the first 5-10 minutes during intravenous infusion.The average time was 7.6 minutes.Symptoms included mild-to-moderate reactions and severe reactions.Thirteen patients experienced earboplatin hypersensitivity.Two out of 13 cases exhibited severe hypersensitivity reaction at the first time.The first hypersensitivity reactions was mild-to-moderate in 11 cases.When retreated with carboplatin,4 exhibited no more reactions,5 exhibited mild-to-moderate hypersensitiviry reactions,2 exhibited severe reactions.Mildto-moderate reactions were resolved by temporary interruption of carboplatin infusion,and (or) using steroid,while severe hypersensitivity reactions were resolved by more medicines.Conclusions The hypersensitivity reactions in the patients receiving carboplatin are increased after multiple doses of the agent.The possible of retreat with the carboplatin for the mild-to-moderate reactions may be considered.Hypersensitivity reactions should be treated actively.The following chemotherapy should be planed individually.The primary chemotherapy protocol for the patients with severe hypersensitivity reactions should not be reconsidered.

Objective To evaluate the prognosis and fertility outcomes of patients with early stage of cervical cancer treated by vaginal radical trachelectomy ( VRT ) in combination with laparoscopic pelvic lymphadenectomy.Methods The surgical data , disease recurrences and fertility outcomes were analyzed retrospectively for 51 patients who received VRT in Peking Union Medical College Hospital from Dec.2003 to Nov.2013.Results Forty-eight patients succeeded in preserving fertility.The median age was 29 years.International Federation of Gynecology and Obstetrics ( FIGO ) stage: 5 cases Ⅰa1 with lymph vascular space invasion (LVSI),4 cases Ⅰa2 and 39 cases in stage Ⅰb1.Tumor size: 20 cases with no visible lesion, 20 cases with tumor size ≤2 cm, 8 cases with tumor size >2 cm.Histological type:42 cases with squamous carcinoma , 6 cases with adenocarcinoma or adeno-squamous carcinoma.The mean excised cervical length and parametrial width was ( 2.6 ±0.6 ) cm and ( 1.9 ±0.5 ) cm, respectively.Six recurrences ( 12%) were observed after following up for a mean duration of ( 35 ±21 ) months.The recurrent rate in patients with tumor size >2 cm was 3/8, which was significantly higher than that of the
patients with tumor size ≤2 cm (8%, 3/40;P<0.01).Of the 35 patients who desired to conceive after the surgery, 13 women had 17 pregnancies and the pregnant rate was 37% (13/35).Nine women obtained 10 healthy live birth babies.The fertility rate was 26%( 9/35 ).Conclusions VRT in combination with laparoscopic pelvic lymphadenectomy could preserve the fertility of patients with early stage of cervical cancer with acceptable oncologic and fertility outcomes.Tumor size ≤2 cm should be emphasized as the indication of VRT in considering of the higher recurrent rate in patients with tumor size >2 cm.

Objective To study the clinical features,treatment and prognosis of struma ovarii.Methods From January 1990 to January 2012,a total of 68 patients were diagnosed struma ovarii at the Department of Obstetrics and Gynecology,Peking Union Medical College Hospital.Clinical data of these patients were studied retrospectively.Results (1) Characteristics of patients:the median age of patients was 42 years old (17-81 years).Of those patients,64 cases (94％) were diagnosed begin struma ovarii and 4(6％) were malignant struma ovarii.(2) Clinical feature:32(47％,32/68) patients were identified with pelvic mass by ultrasonic test,28 cases(41％) had clinical abdominal pain,8(12％) touched a mass from abdominal wall.Preoperative CA125 were tested in 54 patients,but only 8 cases(15％) had moderate elevation.All patients receive ultrasound examination,and 51 cases (75％) were mulitcystic lesions with many septi,3(4％) solid lesions and 14(21％) solid-cystic tumors.The mean diameter of tumors was(8 ± 3) cm.Ascites was present in 4 (6％,4/68)patients.Sixty-seven patients had unilateral lesions,and 1 patient had bilateral lesions.No patient had hyperthyroidism presentation.Nineteen cases underwent thyroid function test after operation,and the results were normal.(3) Treatment:all patients underwent surgical treatment.Among patients with begin struma ovarii,25 cases underwent cystectomy,15 cases unilateral,2 bilateral salpingo-oophorectomy,22 cases hysterectomy + unilateral or bilateral salpingo-oophorectomy.Four malignant struma ovarii,1 patient underwent fertility-sparing staging surgery,2 patients unilateral salpingo-oophorectomy,1 case hysterectomy + bilateral salpingo-oophorectomy.Two patients received chemotherapy after surgery.(4) Prognosis:all patients were followed up in Peking Union Medical College Hospital.The median follow-up time of benign struma ovarii was 5.4 years (6 months-21 years) and there were no recurrence.The median follow-up time of malignant struma ovarii was 11.5 years (9-20 years).Three cases had long-term recurrence at 2,7 and 16 years respectively after surgery.They were received surgical treatment after recurrence and all were alive.Two cases were given by thyroidectomy and 131I treatment.Conclusions Struma ovarii is a rare ovarian monodermal teratoma.Tumorectomy or salpingo-oophorectomy is the appropriate therapeutic treatment for benign struma ovarii.The incidence of malignant struma ovarii is low,and there are no standard treatments.Because of higher long-term recurrence rate,these patients need close follow-up.