Objective　To study the recurrent cause of pulmonary hemoptysis post-BAE.Methods　BAE was performed in 50 cases with pulmonary hemoptysis.The hemostatic agents included Geifoam(GS)strip in 13 cases,GS pellet in 29 cases,ethanol plus GS pellet in 8 cases.Results　Hemoptysis was recurrent post-BAE in 7 patients,of them 4 cases in GS strip group,2 cases in GS pellet group and 1 case in ethanol plus GS pellet group were recurrent.Of this 7 patients 4(4/30) were bronchiectasis;2(2/6) were tuberculosis and 1（1/11) was cryptogenic.Conclusion　GS strip group has highest recurrent rate.GS pellet group has low reculrrent rate and is relatively safe,ethanol plus GS pellet group has a good curative effect,but it has limitation in a way,the pulmonary tuberculosis has the highest recurrent rate of hemoptysis,the bronchiectasis has relatively low recurrent rate of hemoptysis,while cryptogenic hemoptysis has the highest cure rate.

Objective To explore the clinical curative effects of angiotensin Ⅱ 1 receptor blocker in treating primary hypertension and its effects on insulin sensitivity.Methods Eighty primary hypertension patients were divided into the treatment group ( 40 cases,treated with telmisartan ) and the control group (40cases,treated with amlodipine) by random digits table.The treatment period was 8 weeks.After treatment,the clinical curative effect and insulin sensitivity was compared between the two groups.Results In treatment group and control group,the total effective rate was 75.0％(30/40) and 72.5％(29/40),there was no significant difference (P＞ 0.05 ).Before treatment,the insulin sensitivity index ( ISI ) in treatment group and control group was -4.5 ±0.8 and -4.7 ±0.7 (P ＞ 0.05),after treatment,the ISI was -3.2 ±0.5 and -4.4 ±0.6 (P＜0.05).Conclusion The clinical curative effects of angiotensin Ⅱ 1 receptor blocker in treating primary hypertension are obvious,and may improve the insulin sensitivity.

[Objective] To study the relevance between “Sui-hai deficiency” and classification vertebral artery caused by less blood provide with morphological changes.[Method] 84 cases accord with the diagnosis standard of vertebral artery,all these patients were tested morphological changes by a three dimensional computed topographic angiograpy(3D-CTA),and then measured by transcranial Doppler(TCD)to test the changes of blood,research mechanism of “Sui-hai deficient” vertigo.[Results]168 vertebral arteries of 84 cases in this group,low flow speed(Vm40cm/s)was18.45%,and the abnormal rate was 66.07%.126 vertebral arteries morphological abnormal rate was 75%.Changes of low flow speed was 63.50%,high flow speed was 24.60%,the abnormal rate was 88.10%.[Conclusion] Morphology of vertebral arties changes is the direct reason to make the defficiency of vertebral artery.Morphological changes → blood flow abnormal → vertebral artery with less blood provide → “Su-hai deficient” → vertigo,which is the major cause of vertigo.

BACKGROUND:Artificial hip replacement by the posterolateral approach is generally introduced as a treatment for femoral neck fracture in the elderly, but it is limited by the need for a large incision, cutting off the extortor, and postoperative hip dislocation. The supercapsular percutaneously-assisted total hip (SuperPATH) approach was developed based on the original lateral approach. The SuperPATH approach for hip replacement is characterized by the reduced chance of damaging blood vessels and nerves, reducing intraoperative blood loss, retaining all the joint capsules and supinator, and significantly reducing the incidence of postoperative hip dislocation. OBJECTIVE:We hypothesized that the SuperPATH approach for hip replacement can achieve better efficacy in the elderly with femoral neck fractures and promote the recovery of postoperative hip function compared with the posterolateral approach. METHODS/DESIGN:This is a prospective, single-center, open-label, randomized control ed clinical trial that will be completed at the Pudong Hospital of Fudan University, Shanghai, China. Forty patients with femoral neck fractures were randomly divided into two groups to undergo femoral head replacement by the SuperPATH approach in the experimental group, and by the conventional posterior approach in the control group. The follow-up period is 1 week and 6 months. The main outcome measures are Harris hip scores at baseline, and at 1 week and 6 months postoperatively to assess functional recovery of the hip. Secondary outcome measures to evaluate the advantages of the SuperPATH approach include the length of surgical incision, intraoperative blood loss, operative time, 24-hour postoperative drainage, and hospital stay. Other outcome measures include the incidence of adverse reactions at 1 week and 6 months after surgery. The study protocol was approved by the Ethics Committee of the Pudong Hospital of Fudan University, China, and performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Written informed consent was obtained from all participants. DISCUSSION:The aim of this trial is to test our hypothesis that the SuperPATH approach is safer and more reliable for hip functional recovery compared with the posterolateral approach for the artificial hip replacement in femoral neck fractures of the elderly.

Objective To explore the clinical value of 3-dimensional CT angiographic (3D-CTA) imaging of vertebral artery. Methods Volume rendering (VR) and shaded surface display (SSD) of 3D-CTA were adopted to examine 67 patients whose primary clinical diagnosis was vertebral artery insufficiency. Among them, 7 were examined with selective vertebral artery angiography.Results One hundred and thirty-three vertebral arteries (52 normal ones and 81 with lesions) were displayed and the rest one was not displayed due to complete occlusion. The lesions consisted of congenital abnormities, compression or displacements caused by traction, rough vascular surface, calcification, lumen stenosis, partial occlusion etc.. The vertebral arteries with developmental abnormities could be complicated with various other lesions, also the lesions might occur on multiple sections of a single vertebral artery; the description was as follows: there were 31 vertebral arteries with congenital abnormities (17 with developmental thinness and 14 with abnormally extended courses); 11 with lesions on initial sections (V1) (10 with roughened vascular surfaces and thin diameter, among which 3 were twisted in an anglular shape and 1 was calcified ); 30 with lesions (13 with the displacements caused by hyperosteogeny compression, 7 with internal displacements caused by traction, 10 with local lesions) on cervical vertebrae sections (V2) and atlanto-occipital section (V3); 55 with lesions (52 with beaded shapes and coarse walls, among which 2 had calcification and 3 partially blocked ) on intracranial sections (V4). Thirteen lesions on 8 abnormal blood vessels out of the 14 blood vessels of 7 patients, who were examined with the selective vertebral artery angiography, had lesions including stenoses displayed as significant by 3D-CTA but displayed as mild by DSA on 2 intracranial sections, and the examining results of 3D-CTA conform to those of DSA for lesions on other 11 sections. Conclusion 3D-CTA can distinctly display the whole course of the vertebral arteries and show its anatomical relationships with vertebrae. 3D-CTA is superior to other angiographic method to display congenital abnormalities and/or calcification of the vertebral arteries and assess the status of vertebral bones. It provides important information for diagnosis of vertebral artery disease.

Objective The research is to study the temperature rising situation in the thermochemotherapy process of the domestic dog through the hepatic artery, and the bearing ability of heart, liver, and kidney during the process, as well as the biochemical and histological change of the liver after the procedure. Methods A thermostated container of water bath and an infusion pump, both designed domestically, were adopted. Ten domestic dogs were divided into 2 groups of A and B with 5 dogs respectively. Through hepatic artery infusion for group A, glucose solution (GS) was administered at 43?C for 30 minutes, with the flowing rate of 30ml/min, in group B 5% GS at 45?C for 30 minutes, with the flowing rate of 40ml/min added with chemotherapy drug MMC(0.2mg/kg) was administered to 3 dogs and 5% GS with the same flowing rate added with CDDP(1mg/kg) into other 2 dogs. Results The temperature of anus and liver was 0.3～0.5?C and 0.5～1.0?C higher than before the procedure respectively, there was no significant rate changes of heart and respiration during and before the procedure. Four dogs were radiographied after 15 minutes' infusion, showing different degrees of hepatic artery dilation accompanied with relevant increase of infusion. Six dogs were radiographied after 30 minutes' infusion, 5 of them showed arterial contraction astescal on accompanied with relevant decrease of infusion. There appeared slight or moderate increase of aminopherase after the procedure, but in actually returned to normal within a week. Pathologically, there appeared no acute effect on heart, lung and kidney other than slight and reversible damage to hepatic tissue. Conclusions Healthy dogs can endure the chemotherapy treatment of infusion through hepatic arterial fistula at 43?C 45?C for 30 minutes.

Objective To investigate the risk factors for persistent hemodynamic depression after carotid angioplasty and stenting(CAS). Methods Sixty-one patients with CAS were included. By univariate Logistic regression analysis,the influencing factors for persistent hemodynamic depression were analyzed,by stepwise Logistic regression analysis and adjustment for age and gender factors,the independent risk factors for persistent hemodynamic depression were analyzed. Results In 61 patients,25 cases had hypotension,25 cases had bradycardia,all for 41.0% incidence. According to the patients intraoperative and postoperative blood pressure,heart rate conditions,the duration of hemodynamic depression,the cases were divided into persistent hemodynamic depression group (20 cases) and no-persistent hemodynamic depression group(41 cases). Univariate Logistic regression analysis indicated that persistent hemodynamic depression influencing factors were the symptomatic stenosis, severe stenosis, using balloon dilatation, implantation of laser-carving stent(P<0.05). With adjustment for age and gender factors, stepwise Logistic regression analysis showed that using balloon dilatation, implantation of laser-carving stent were the independent risk factors for persistent hemodynamic depression (OR = 5.046,95%CI 1.342-18.977,P = 0.017;OR = 4.142,95%CI 1.151-14.902, P= 0.030),symptomatic stenosis was the independent protective factor for persistent hemodynamic depression (OR = 0.264,95% CI 0.073-0.964,P= 0.044). Conclusions Persistent hemodynamic depression after CAS is a common complication.CAS patients with using balloon dilatation, implantation of laser-carving stent are more susceptible to persistent hemodynamic depression, while symptomatic stenosis is its protective factor.

BACKGROUND:Macropore morphology of a composite scaffold prepared by the three-dimensional printing technique is of great importance in determining the physicochemical and biological properties of tissue engineering scaffolds.OBJECTIVE:To fabricate strontium-containing mesoporous (Sr-MBG) bioactive glass (PCL) scaffolds by the three-dimensional printing technique, and to explore the effect of these scaffolds on MC3T3-E1 proliferation and osteogenic differentiation, thereby to find out the optimal macropore morphology.METHODS: Sr-MBG/PCL composite scaffolds were fabricated by the three-dimensional printing technique. The angles between fibrous latitudes and longitudes were set to 45°, 60° and 90°. Then the proliferation and alkaline phosphatase activity of MC3T3-E1 cells on the scaffolds were tested.RESULTS AND CONCLUSION: Cell counting kit-8 results showed that MC3T3-E1 cells could proliferate on all the three kinds of scaffolds. The proliferation rate of MC3T3-E1 cells on the 45° Sr-MBG/PCL scaffolds was just slightly higher than that on the 60° and 90° Sr-MBG/PCL scaffolds at days 1 and 4 (P > 0.05), but there was a significant increase at day 7 (P < 0.05). The 45° Sr-MBG/PCL scaffolds exhibited a significant increase in alkaline phosphatase activity of MC3T3-E1 cells compared to the 60° and 90° Sr-MBG/PCL scaffolds at day 14 (P < 0.05), while there was no significant difference among three groups at day 21 (P > 0.05). These results indicate that the 45° Sr-MBG/PCL scaffold is more suitable to promote the proliferation and osteogenic differentiation of the MC3T3 cells than the 60° and 90° Sr-MBG/PCL scaffolds.

BACKGROUND: Three-dimensional (3D) printing technique has showed unparalleled advantages in the field of tissue engineering scaffold preparation because of its outstanding merits of convenience, efficiency, controllability and ability to construct complex shapes.OBJECTIVE: To fabricate Fe-containing mesoporous calcium-silicate (MCS) /poly (3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) composite scaffolds using the 3D printing technique and to test the characterization and cellular biocompatibility of the composite scaffolds.METHODS: Four groups of Fe-containing MCS/PHBHHx composite scaffolds were fabricated using 3D printing technique. The molar percentage of Fe in these four groups was 0%, 5%, 10%, 15%, respectively and they were marked as 0Fe-MCS/PHBHHx, 5Fe-MCS/PHBHHx, 10Fe-MCS/PHBHHx and 15Fe-MCS/PHBHHx. The scanning electron microscopy was used to observe the microstructure of the scaffolds after being soaked in the simulated body fluid.Osteoblast cell lines MC3T3-E1 were seeded on these four groups of scaffolds as well. Cell counting kit-8 method was adopted to test the cell proliferation at 1, 3, 7 days of culture. Intracellular alkaline phosphatase activity was tested at 7 and 14 days of culture.RESULTS AND CONCLUSION: (1) Compared with the scaffolds with no soaking process, spherical particles were formed on the scaffolds because of mineralization after soaking 3 days in the simulated body fluid. (2) At 1 day of culture,there was no difference in cell proliferation among the four groups. At 3 days of culture, the proliferation rate of the 15Fe-MCS/PHBHHx scaffold was remarkably higher than that of the rest three groups (P < 0.05). At 7 days of culture,the proliferation rate was significantly higher in the 10Fe-MCS/PHBHH and 15Fe-MCS/PHBHHx scaffolds than the 0Fe-MCS/PHBHH scaffold (P < 0.05), as well as significantly higher in the 15Fe-MCS/PHBHHx scaffold than the 10Fe-MCS/PHBHH scaffold (P < 0.05). (3) At 7 days of culture, no difference in alkaline phosphatase activity could be found among these four groups of scaffolds; however, at 14 days, the 5Fe-MCS/PHBHHx, 10Fe-MCS/PHBHHx and 15Fe-MCS/PHBHHx scaffolds exhibited an enhanced alkaline phosphatase activity compared with the 0Fe-MCS/PHBHHx scaffold. Meanwhile, the 15Fe-MCS/PHBHHx showed the highest alkaline phosphatase activity.These findings indicate that the MCS/PHBHH scaffolds containing Fe could promote the proliferation and osteogenic differentiation of the MC3T3-E1 cells.

Objective To investigate the incidence of atherosclerotic renal artery stenosis (ARAS), the relationship between ARAS and cerebral artery stenosis, and the risk of ARAS in patients with brain infarction. Methods The clinical data of 1 650 brain infarction patients were analyzed, which were carried out digital subtraction angiography(DSA) of cerebral and renal artery.The incidence of ARAS was counted out, and the relationship was analyzed between the different degree and number of cerebral artery stenosis and the rate of RAS. The demographic characteristics and the common risk factors of atherosclerosis were recorded, and the risk factors of ARAS were analyzed. Results The rate of ARAS in moderate stenosis group and severe stenosis and occlusion group of cerebral artery were all significantly higher than that in mild stenosis group and no stenosis group (all P < 0.01). The rates of ARAS in severe stenosis and occlusion group were significantly significantly higher than those in moderate stenosis group (P < 0.01). The rates of ARAS in 2 branch stenosis group and ≥3 branch stenosis group were both significantly higher than those in no stenosis group and 1 branch stenosis group (P < 0.01). The rates of ARAS of ≥3 branch stenosis group were significantly higher than those in 2 branch stenosis group (P<0.05). The rate of ARAS of 1 branch stenosis group were significantly higher than those in no stenosis group (P < 0.05). Age, hypertension, moderate or more artery stenosis or occlusion, and≥2 branch stenosis was independent risk factor of ARAS. Conclusions The incidence of ARAS increasesd with the increase of the degree of cerebral artery stenosis and the number of branch involved.Older age, hypertension, moderate or more artery stenosis or occlusion, and≥2 branch stenosis is risk factor for ARAS.