ABSTRACT Atherosclerosis (AS) is the principle cause of cardiovascular disease. For many years, AS was regarded as irreversible. However, recent accumulated evidence suggests that AS can regress with proper manipulation. Studies from animal models show that low cholesterol diet can induce obvious regression of AS plaques; Drugs, such as probucol, clolestyramine, lovastatin, isradipine, fosinopril, etc, can reverse the AS respectively by manipulating plasma lipoprotein, scavenging free radicals, blocking calcium channel or inhibiting an-giotensin converting enzyme. Clinical trials furthersubstantiate that good lifestyle and effective control of plasma lipoprotein can reduce clinical events and cause AS plaques regression. Although, AS plaques can regress is no longer in doubt, the mechanism is still unknown. The HDL-mediated reverse cholesterol transport system, apoptosis of the plaque cells may play an important role.

Objective To explore the characteristics of childhood tuberculosis and recent advances in the diagnosis and treatment of this disease in order to improve its diagnosis and treatment. Methods Key words“child”“tuberculosis”“diagno-sis” and “treatment” were used to retrieve relevant literatures from Pubmed,Web of Science,CNKI and Wanfang databases.The literatures were reviewed and clinical experience summarized. Results Disseminated tuberculosis and extrapulmonary tubercu-losis were common in children with tuberculosis. It was difficult to collect with samples of diagnostic value for detection. There counterparts were no systematic diagnosis and treatment programs available for children with drug-resistant tuberculosis,and phar-maceutical dosage forms tailored for children were lacking. Conclusion Tuberculosis in children is more complex to diagnose and treat than in adult counterpart.Diagnosis of this disease relies on a variety of diagnostic methods.It's still challenging to control childhood tuberculosis.

Objective To evaluate the clinical value of application of mesh plug tension-free repair of ingui-nal hernia in grass-roots hospital .Methods A total of 32 patients with inguinal hernia treated by benison-free ingui-nal herniorrhaphy with mesh plug and 28 patients treated with the traditional herniorrhaphy were retrospectively ana-lysed.Results The mean operation time and the postoperative hospital stay of group A were 56.94min and 5.25d, and those of group B were 69.61min and 5.96d,the mean operation time and the postoperative hospital stay of group A were significantly shorter than those of group B (t=-2.891、-3.284,all P<0.05).Patients needed postoperative analgesic therapy (10 cases) and patients suffered from urine retation ( 2 cases ) of group A were less than group B(χ2 =8.014,5.357,all P<0.05).There were 3 cases with postoperative scrotum hematoma in each group and they had no statistical difference for that(P>0.05).All cases received follow-up for 20-40 months,there were no recur-rence in group A during the follow-up period,but 2 cases recurrence in group B .Conclusion Mesh plug tension-free repair of inguinal hernia has the advantages of shorter operation time ,more rapid recovery ,less complications and low-er recurrence rate ,so it is suitable for popularization and application in grass-roots hospital .

Objective:To investigate high sensitivity-C reactive protein (Hs-CRP) as a prognostic factor in non-Hodgkin lympho-ma (NHL). Methods:Data for 85 consecutive non-Hodgkin lymphoma patients were followed up and reviewed to determine the value of Hs-CRP relative to known prognostic parameters. Results:The progression-free survival (PFS) and overall survival (OS) times of pa-tients with pre-therapeutic baseline serum Hs-CRP levels of≥4 mg/L were shorter than those of patients with basal serum Hs-CRP lev-els of<4 mg/L (P>0.05). However, the post-therapeutic, early-to-mid serum Hs-CRP level was not significantly correlated with the OS and PFS times (P>0.05). Multivariate Cox regression analysis showed that the pre-therapeutic baseline serum Hs-CRP level may be an important prognostic parameter for the relapse and survival of NHL patients (P<0.05). Conclusion:The baseline Hs-CRP level can be a major indicator of prognosis in NHL patients.

Objective: To design a set of digital medical record MIS. Methods: According to the problems of paper-based medical records management, the protocol of digital medical record MIS using micro-digital imaging technology was proposed. Results:It realized electronic medical record storage, the front page information of medical records, medical record circulation and statistics of medical information. Conclusion: The storage of paper based medical record was effectively compressed, the information level of medical record management was clearly promoted after using the digital medical record MIS. It realized the conservation and usage for current medical records, guaranteed information security and data sharing etc.

Objective :To study the effects of NO precursor, L-arginine(L-Arg) and constitutive nitric oxide synthase(cNOS) inhibitor, L-nitroarginine(L-NNA)) on the expression of cNOS in facial nerve and surrounding tissues in traumatic facial paralysis rats. Methods:Facial paralysis was surgicaly created by impact in 57 SD rats. The rats were divided into 3 groups with 18 in each group, another 3 rats were used for morphological study. L-Arg at 40 mg/kg or L-NNA at 50 mg/kg were intraperitoneally injected into rats 2 times a day, from 4 days before untill 14 days after surgery(group L-Arg and group L-NNA). In control group(NS) same volume of normal saline was given to the rats after creation of facial paralysis. The facial nerve and surrounding tissue samples were obtained at different time. Immunohistochemical ABC method was used to examine cNOS and inducible NOS (iNOS) expression in facial nerve and surrounding tissues. Results:cNOS immunoreactivity was observed in traumatic facial nerve in L-Arg group 7 days after trauma and in the adjacent muscle in the 3 groups from 6 h to 3 d after trauma. iNOS was found in the paralyzed nerves from 1 d to 7 d after trauma in the 3 groups, and in the adjacent tissues from 6 h to 3 d after trauma in the 3 groups. Conclusions:L-Arg may stimulate constitutive NOS expression in facial nerve and probably promote the nerve regeneration.

Objective To investigate the correlation between regional cerebral oxygen saturation (rSO2) value and the prognosis of comatose patients in the intensive care unit (ICU).Methods From January 2013 to September 2014, a total of 64 comatose patients admitted in the department of ICU were enrolled.The patients were divided into two groups : consciousness group (n =25) and coma group (n =39).The level of the Glasgow coma scale (GCS), APACHE Ⅱ score and Full Outline of UnResponsiveness score (FOUR) of patients were monitored.The rSO2 was measured by Somanetics INVOS 5100 monitor.Results The differences in levels of FOUR and GCS at admission and GCS at discharge between the two groups were statistically significant (P ＜ 0.05).In the consciousness group, the levels of GCS、 FOUR and rSO2 were higher compared with the coma group (P ＜ 0.05).ROC curve analysis revealed that the areas under the curve of GCS, FOUR and rSO2 for predicting prognosis were 0.823 (0.718-0.928), 0.820 (0.728-0.912) and 0.924 (0.863-0.985) respectively.Conclusions The rSO2 was useful for estimating the prognosis of comatose patients in general ICU.

Objective To explore the clinical and coronary angiographic characteristics in acute myocardial infarction (AMI) patients with new-onset atrial ifbrillation in early or later stages. Methods From Jun. 2010 to Jun. 2013, 1358 cases of AMI were hospitalized in which 88 were proved to have AMI complicated with new-onset atrial ifbrillation. Eligible patients were divided into early onset group (group1, n=40 cases) and the later onset group (group2, n=48 cases) according to the occurrence of atrial ifbrillation within or after 24 hours of admission. The clinical characteristics and the pathological changes of coronary arteries of the two groups were compared respectively. Results The incidence of inferior wall AMI was signiifcantly higher in group 1. The incidence of anterior wall AMI was signiifcantly higher in group 2 (P<0.05). The incidence of congestive heart failure, the incidence of three-vessel lesions and the in-hospital mortality in group 2 were higher than which in group 1 (P < 0.05). Conclusions The new-onset atrial ifbrillation in different stages may be regarded as a useful indicator for evaluating the clinical characteristic and the infarct-related coronary artery lesions and prognosis of patients with AMI.

Objective To compare the diagnostic efficiency in showing the responsible blood vessels for neurovascular compression in patients with trigeminal neuralgia by 3D‐FIESTA‐C and 3D‐TOF‐MRA sequences .Methods The imaging data of 60 patients with primary trigeminal neuralgia were analyzed retrospectively .After MRI examination ,all of the patients underwent micro‐vascular de‐compression (MVD) .3D‐TOF‐MRA and 3D‐FIESTA‐C sequences were performed to evaluate the three‐dimensional relationship be‐tween trigeminal nerve and blood vessels through the original and reconstructed image .The intraoperative endoscopic findings were set as the gold standard comparing to the manifestations of 3D‐TOF‐MRA and 3D‐FIESTA‐C .Results The sensitivities of 3D‐TOF‐MRA and 3D‐FIESTA‐C for the diagnosis of the existence of responsible vessels were 85 .7% ,89 .3% ,the specificities were 75 .0% , 100% ,and the accuracies were 85 .0% ,90 .0% ,respectively (P=1 .000) .Furthermore ,the sensitivities of 3D‐TOF‐MRA and 3D‐FIESTA‐C for the diagnosis of the existence of responsible arteries were 94 .1% ,88 .2% (P=0 .244) ,while the sensitivities of the responsible veins were 0 .00% and 88 .2% (P=0 .009) .Conclusion Both the 3D‐FIESTA‐C and 3D‐TOF‐MRA sequences can accurately deter‐mine the existence of responsible vessels in trigeminal neuralgia before surgery .3D‐FIESTA‐C sequence is superior to 3D‐TOF‐MRA for presenting the responsible veins ,which can be used as a supplemental diagnostic tool before operation .

BACKGROUND:The carotid siphon has a complex structure, which is difficult for two-dimensional imaging observation due to shelter from the basicranial bone. Digital subtraction angiography is conducive to display the course of carotid siphon, but there is a lack of anatomical landmarks. Three-dimensional CT imaging is beneficial to show the structure of carotid siphon and have its measurement, which provides a new and effective means in relevant studies.
OBJECTIVE:To clarify the morphology and calcification distribution of the carotid siphon, thereby providing an objective basis for relevant clinical and basic research.
METHODS: A total of 206 patients, over 50 years old, with no lesions or variation under head and neck CT angiography were selected and divided into non-calcification group (n=70) and calcification group (n=136). The carotid siphon was reconstructed on the imaging workstation to observe the classification (“U”, “V”, “C” and “S” types) and calcification distribution, the bending angles of C4 and C5 segments as wel as lumen diameter were measured.
RESULTS AND CONCLUSION:The 70 patients in the non-calcification group were at a mean age of (59.17±10.27) years, and the “U” type accounted for 35.7%, “V” type for 30.7%, “C” type for 27.2%, and “S” type for 6.4%; Among them, 33.3% patients (25/70) had the same type at both sides; the lumen diameter was (4.92±0.63) mm, and the blending angles of C4 and C5 were (87.23±16.66)° and (49.21±16.01)°. In the calcification group, the mean age was (67.39±9.32) years, and there were 41.5% of “U” type, 33.1% of “V” type, 24.3% of “C” type, 1.1% of 24.3%, and among the 136 patients, 43.4% (59/136) showed the same type at both sides; the lumen diameter was (4.90±0.44) mm, and the blending angles of C4 and C5 segments were (84.44±17.20)° and (52.57±14.16)°. There were significant differences in age and “S” type between the two groups (P < 0.05), but no statistical difference in the lumen diameter and blending angles of C4 and C5 (P > 0.05). In the calcification group, the calcification percentage of inwardly and outwardly curved regions was 13.60% and 19.01% for C4, 27.34% and 16.52% for C5, 9.94% and 13.60% for C6. The morphology of the carotid siphon is mostly seen as “U”, “V”, “C” types, and over 50% types are different at both sides. Calcification of the lumen wal is seen most in the inwardly curved region of C5 segment, folowed by the outwardly curved region of C4 segment. The incidence of calcification is increased with age, which is lower in the S-type carotid siphon. The lumen diameter and blending angle of the carotid siphon show no correlation with calcifications.