Objective To investigate the risk factors and their prevention and treatment approaches for occurring radial artery spasm (RAS) during the brain digital subtraction angiography (DSA) with transradial catheterization in patients with ischemic cerebrovascular disease.Methods The patients who underwent DSA of transradial approach because of ischemic cerebrovascular disease were enrolled.Their clinical data,surgical complications,and radial artery spasm were collected.The data of occurring RAS or not during DSA of transradial approach in patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors for occurring RAS during DSA of transradial approach.Results A total of 100 patients with ischemic cerebrovascular disease who underwent DSA of transradial approach (74 ischemic stroke,26 transient ischemic attack) were enrolled,of which 21 (21％) had RAS.Of the 21 patients with RAS,4 suspended their operations and completed their DSA after spasm relief; another 17 were treated with intrathecal cocktail (heparin 2500 U,nitroglycerin 0.5 mg,verapamil 1.25 mg) and completed their DSA after spasm relief.There were significant differences in the proportions of radial artery diameter (1.89 ±0.28 mm vs.2.12 ± 0.17 mm; t =1.582,P =0.041),duration of operation (12.3 ± 3.1 min vs.9.8 ±2.7 min; t =1.264,P =0.038),and radial artery diameter ＞2 mm (9.52％ vs.65.82％ ;x2 =9.624,P =0.002),radial artery anatomy variation (23.81％ vs.0.27％; x2 =14.185,P＜ 0.001),and the first successful puncture (42.86％ vs.78.48 ％ ;x2 =5.335,P =0.021) in patients between RAS group and the non-RAS group.Multivariate logistic regression analysis showed that the radial artery anatomy variation (odds ratio [OR] 1.940,95 ％ confidence interval [CI] 1.372-2.241; P=0.023) was an independent risk factor for the occurrence of RAS.Radial artery diameter ＞2 mm (OR 0.752,95％ CI 0.352-0.847;P=0.043) and the first successful puncture (OR 0.843,95％ CI 0.367-0.941; P=0.045) were the independent protective factors for RAS.Conclusions RAS is a common complication of DSA of transradial approach.Repeated puncture,radial artery diameter,and radial artery anatomy variation are its most important influencing factors.

Objective:This study was aimed to investigate the influence of CDK7 siRNA on the sensitivity of endometrial carci-noma cell line HEC-1-A to cisplatin (DDP)-based chemotherapy. Methods:Different CDK7 siRNA fragments were synthesized based on the designs of the CDK gene sequence and were transfected into HEC-1-A. Real time reverse transcription polymerase chain reac-tion (RT-PCR) and Western blot analysis were employed to demonstrate the effects of transfection. The best CDK7 siRNA was chosen to specifically silence CDK7 expression in HEC-1-A.The sensitivity of the cells to DDP therapy before and after transfection was deter-mined by methyl thiazol tetrazolium (MTT) cytotoxicity assay, flow cytometry, and Hoechst/PI double-staining fluorescence microsco-py. Results:A total of four different CDK7 siRNA segments were designed and successfully transfected into HEC-1-A cells. The inter-ference effect in each group was confirmed by real time RT-PCR and Western blot assays. CDK7-423 was determined as the best per-forming CDK7 siRNA (over 70%) to transfect into HEC-1-A cells. MTT cytotoxicity test showed that IC50 of DDP decreased to a range from 45.122 μg/mL and 3.200 μg/mL after inhibition of CDK7 expression. DDP toxicity to the endometrial carcinoma cells sig-nificantly increased (P<0.05). Flow cytometry revealed that the average cell apoptosis rate significantly increased after the inhibition of CDK7 expression (11.66%to 37.57%, P<0.05). Similar results were observed using Hoechst/PI double-staining fluorescence microsco-py, and the number of apoptotic corpuscle demonstrated an apparent increase in the low CDK7-expressing group compared with the pa-rental cells. Conclusion:After the downregulation of CDK7 expression by CDK7 siRNA transfection, DDP chemotherapy sensitivity and apoptosis of endometrial carcinoma cells significantly increased. Further research is anticipated on the use of CDK7 as a new treat-ment target for endometrial carcinoma.

AIM:The limitation of materials' strength results in the external fixation of patients with patellar fracture following absorbable screw fixation.This study was aimed to guide the patients do progressive rehabilitation and observe the recovery of knee joint function.METHODS:Totally 35 patients with patellar fractures were enrolled from the Sixth People's Hospital in Shanghai Jiao Tong University between June 2004 and June 2006,including 27 cases of transverse fractures and 8 cases of comminuted fractures.They were all treated with BIOFIX self-reinforced poly-lactide absorbable screws,which were produced by Finland BIONX Company.Postoperatively isometric contraction training of quadriceps femoris was followed,and then progressive knee joint range of motion was carried out.The curative effect was evaluated by the recovery of knee joint function and radiograph.Normal knee joint function was taken as excellent effect,while nearly normal knee joint function and slightly poor squatting were taken as good effect.RESULTS:All the patients completed the treatment and rehabilitation,followed up for no less than 12 months,with a mean of 22 months.The average healing time was 6 weeks,excellent result cases were seen in 29 patients and good in 6.There was two cases occurred postoperative complications(wound swelling).CONCLUSION:Self-reinforced poly-lactide absorbable screws for treatment of patellar fractures and appropriate postoperative rehabilitation is believed to prevent the second operations.

Cerebrovascular Intervention is to study the subject of diagnosing and treating cerebrovascular disease with interventional endovascular techniques monitored and guided by neuroimaging. With the continuous development of computer, imaging and angiography techniques, their study method and category are being innovated and expanded continuously in recent years. This article reviews the novel techniques of imaging diagnosis, intra-arterial thrombolysis, angioplasty and endovascular embolization in cerebrovascular diseases, and also evaluates their clinical applications.

Objectives:To study the role of COX-2 and bFGF in the development of oral squamous cell carcinoma(OSCC).Methods:The expressions of COX-2 and bFGF were exmined by immunohistochemical staining with anti-COX-2 and anti-bFGF monoclonal antibodies respectively in 23 cases of OSCC,25 of oral leukoplakia(OLK)and 10 of normal oral mucosa.Results:COX-2 was detected in 20/23 cases of OSCC,13/25 of OLK and 0/10 of normal oral mucosa(P

Using immunoenzymatic technique,we have observed the localization ofimmunoglobulins in human palatine tonsils,of patients suffering from chronictonsilitis and hyperplasia.The result as follows:1.Epithelium:The outer surface of tonsil is lined by stratified squamous epithelium,the epithelium rarely shows keratinization and lacks a well-defind and continuousbasement membrane.In the basal layer of epithelium,it is reticular structure andspaces between the cords of epithelium cells are filled with Ig~+ lymphocytes andplasma cells,the reticular structure is particularly pronounced near the crypts.Thisspecial structure is regarded as an expression of active immune function.In thesuperficial layer of epithelium,the predominate cells are Ig~- small lymphocytes,maybe T lymphocytes.2.Follicle:All follicles have germinal centres,especially hyperplastic tonsils.The follicle has polarity,each follicle may be divided into three Zones(a b c),twozones(a b)form the centre of the follicle and the thired(c)is the mass of smalllymphocytes“capping”and enclosing the centre.The upper limits of zone(c)areoften indistinct,from the presence of many lymphocytes in the epithelium.Thedistribution of Ig~+ cells in follicle are different from their three zones.In the centre,IgG cells are most numerous,next most numerous are IgA~+ cells,and considerablyfewer IgM positive cells.In the c zone,only a few Ig~+ cells are seen(IgG IgM).Itis found that the germinal centre may produce more than one type of Ig,it differsfrom the report of Sordat,but quite agrees with Curran's result.However the numbersof cells containing the various types of Ig show a great difference.3.Other lymphoid tissue:The tissue between the follicles are rich in small Tlymphocytes and a few Ig~+ containing cells,this area was called thymic dependentarea.At an older age,this region is always enlarged,but the density of the cellswill decrease,meanwhile much connective tissues are seen in the stroma.

BACKGROUND:Medical stuff have significant impacts on the development of organ donation and transplantation, however, medical students present insufficient knowledge and ambivalent attitude towards organ donation and transplantation. OBJECTIVE:To perform a systemic review on the effectiveness of educational program intervention on medical students’ knowledge and attitudes toward organ donation and transplantation. METHODS:PubMed, WILEY ONLINE LIBRARY, ProQuest Health, Medline, EMbase, CNKI, Wanfang and VIP databases were ful y searched for the published literature of medical students receiving an educational program intervention on organ donation and transplantation. According to the inclusion criteria, randomized control ed trials and quasi-experimental study were evaluated with the standard of Joanna Briggs Institute. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework was used to guide the assessment of the methodological quality of the studies. The outcomes were mainly medical students’ knowledge and attitudes toward organ donation and transplantation.
RESULTS AND CONCLUSION:Eight studies from three countries were summarized. The methods were employed in two studies of randomized control ed trials and quasi-experiment received a high quality rating, five studies received middle quality rating and one study received low quality rating. Educational program increased the knowledge in six studies, and changed the attitudes in six studies. Educational program intervention is a significant strategy to increase medical student’s knowledge about organ donation and transplantation. The majority of involved study are
quasi-experiment study, so more high-quality randomized control ed studies are needed.

Objective:To observe the efficacy and safety of compound danshen dripping pills(DDP)combined with intralesional tri-amcinolone acetonide(TA)injection in the treatment of oral submucous fibrosis(OSF).Methods:34 patients with clinically con-firmed OSF were randomly divided into 2 groups(n =17)and treated with DDP +TA and TA respectively,meanwhile the VAS of pain and mouth opening were recorded and compared.Results:Before treatment there was no statistical difference of the VAS scores and mouth opening between 2 groups(P >0.05),12 weeks after treatment,the difference was significant(P ＜0.05).The clinical condi-tion of treatment group were improved(χ2 =6.051,P ＜0.05),but there were no improvement in control group(χ2 =3.429,P >0.05).Conclusion:Compound danshen dripping pills combined with intralesional triamcinolone acetonide injection can significantly enhance the effects safely in the treatment of OSF.

Objective To investigate the diagnostic value of barium stury of small bowel obstruction due to various bowel diseases.Methods Barium meal study and enteroclysis (small bowel enema)were performed in 23 patients with incomplete small bowel obstruction due to small bowel diseases confirmed by operation.The imaging data were retrospectively analysed.Results Of the 23 patients,14 cases were malignancy,9 cases were benignant.Conclusion Both barium meal study and enteroclysis( small bowel enema) with air-barium double-contrast technique are of diagnostic value in incomplete small bowel obstruction due to small bowel diseases.

Objective To obsevre the clinical efficacy of acupuncture at bilateral sphenopalatine ganglions in treating allergic rhinitis. Methods Patients with allergic rhinitis were selected, and then were randomly divided into bilateral group, unilateral group, and control group, with 35 cases in each group. By the end of the study, 5 cases of bilateral group, 3 cases of unilateral group, and 2 cases of control group were removed. The bilateral sphenopalatine ganglions were acupunctured simultaneously in bilateral group, and the unilateral sphenopalatine ganglion was treated by acupuncture in unilateral group, once a week, for 4 weeks. The control group received routine acupuncture on Yingxiang (LI20), Bitong (EX-HN8), Yintang (EX-HN3), and Hegu (LI4), twice a week, for 4 weeks. Rhinitis symptom scale and life quality of nasal conjunctival scale score before and after treatment in the three groups were observed. The clinical efficacy was evaluated and the adverse reactions were recorded. Results The total effective rates of bilateral group, unilateral group and control group were 93.33% (28/30), 90.63% (29/32) and 72.73% (24/33), respectively, and the bilateral group and unilateral group were better than the control group (χ2=19.507, P=0.001), without statistical significance between bilateral group and unilateral group (P>0.05). Rhinitis symptoms and life quality were improved in the three groups (P<0.05), and the bilateral group and unilateral group were better than the control group (P<0.05), without statistical significance between bilateral group and unilateral group (P>0.05). Only 1 case of subcutaneous hematoma showed in unilateral group. Conclusion Acupuncture at sphenopalatine ganglions has confirmed efficacy, and there is no difference in the efficacy between acupuncture on bilateral sphenopalatine ganglions and unilateral sphenopalatine ganglion.