Arterial stenosis-induced hemodynamic changes and their evaluation have long been studied by lots of scholars by in vivo and in vitro experiments,clinical observation and improved experimental devices and methods,which has contributed a lot to the diagnosis and treatment of arterial stenosis.This review describes the current research results.

Objective To observe clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist (GnRH-a ) in the treatment of endometriosis (EMs).Methods 158 patients who underwent laparoscopic surgery and were diagnosed endometriosis in our hospital during Sep.2010 to Dec.2010 were chosen and divided into three groups:control group were treated with pure laparoscopic surgery,group A were treated with laparoscopic surgery and follow-up GnRH-a medication,and group B were treated with laparoscopic surgery,follow-up GnTH-a medication and add-back therapy.The total effective rates,recurrence rates,the changes of hormone levels before and after the treatment and adverse reaction rates after treatment were compared and analyzed to evaluate the efficacy of different treatments.Results The total effective rates of group A and group B (84.6%,86.2%) were significantly higher than that of control group (58.3%),and the difference was statistically significant (P=0.032,P=0.032).The recurrence rates of group A and group B (15.4%,13.8%)were significantly reduced compared with that of control group (41.6%)(P=0.012,P=0.012).The hormone levels decreased dramatically after treatment in three groups.The adverse reaction rate of group B was apparently reduced compared with that of group A,and the difference was statistically significant (P=0.001 ).Conclusion Laparoscopy combined with GnRH-a medication was a safe and effective treatment for endometriosis.The application of GnRH-a after laparoscopy can significantly increase the total effective rate of the operation and reduce the postoperative recurrence rate.For the patients who need to take long-term GnRH-a treatment,add-back therapy need to be given to decrease its adverse reaction and recurrence rate,or to delay its recurrence,thus could improve patients' living qualities significantly.

Objective To investigate the value of the diagnosis of contrast-enhanced ultrasound(CEUS) in renal tumors. Methods Nineteen patients with hyperechoic renal tumors detected by CEUS underwent resection for suspected renal malignant and benign tumors. The characterization of hyperechoic renal tumors on CEUS was evaluated. Results Histopathologic results of resected lesions showed benign tumors in 11 patients with angiomyolipoma and malignancy in 8 patients with clear cell carcinoma. Six patients with angiomyolipoma showed rapid wash in contrast enhancement and slow wash out on all tumor and focal tumor (6/11). One patient with angiomyolipoma was observed in rapid wash in and wash out (1/11). Four patients with angiomyolipoma showed rapid wash in and negative contrast enhancement after rapid wash out(negative contrast enhancement compared to renal cortex,4/11). Five patients with clear cell carcinoma showed rapid wash in and wash out (5/8). Two patients with clear cell carcinoma showed rapid wash in and delayed wash out (2/8). One patient with showed no enhancement on CEUS (1/8). The pseudocapsule could be seen at 5 patients with clear cell carcinoma. Wash in enhancement and wash out on clear cell carcinoma were significant in comparison to these of angiomyolipoma (P<0.05). Wash in enhancement,delayed wash out and negative contrast enhancement were no significant between clear cell carcinoma and angiomyolipoma (P>0.05). Conclusions CEUS is useful for discriminating between benign and malignant renal tumor.

Objective To study the formations of several ridges in peripheral artery velocity tracing. Methods The experimental models of constrainting limb and adrenaline were performed in 6 juvenile susscrota domesticas,tbe variations of the external lilac artery velocity tracing observed,and the parameters of peak systolic velocity (PSV), minimum post-systolic velocity (MPV), peak diastolic velocity(PDV) and end diastolic velocity(EDV) were obtained. Results With the increase of downstream circulation resistance, systolic waveshape inclined to acumination, MPV gradually degraded to zero and negatively increased subsequently, diastolic wave amplitude lowered, and EDV gradually decreased to zero. The stronger vasoconstriction was, the more striking the variations were. Conclusions Cardiac ejection forms systolic dominant wave, post-systolic backward ware is the result of backstreaming because of elastic recoil of downstream artery,and diastolic forward ware is the result of blood transient acceleration caused by elastic recoil of upstream artery. Systemic vascular resistance has significant effect on diastolic waveshape,and the occurrence of post-systolic backward ware implies downstream circulation resistance obviously increases.

Objective To study the haemodynamics changes in the proximal upstream artery caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of the abdominal aorta extremity were pinched with the vascular clamp to achieve 1/4,1/2 and 3/4 stenosis or occlusion in 6 juvenile susscrota domesticas,the velocity tracing of the proximal artery recorded,and the parameters of the peak systolic velocity(PSV)and minimum diastolic velocity(MDV)were obtained and statistically analyzed for their correlation with different degrees of abdominal aorta extremity stenosis.Results The diastolic velocity tracing vanished when stenosis reached a certain degree,the needle ridge and low amplitude diastolic velocity tracing emerged when stenosis to a certain extent,and only the needle ridge was present when the abdominal aorta extremity was completely obstructed.PSV reduced with the aggravation of stenosis.Conclusions The proximal upstream artery systolic ridge caused by abdominal aorta extremity stenosis tends to be acUminate,which indicates serious stenosis of the downstream artery.The systolic needle ridge and the absence of diastolic velocity tracing would suggest a complete obstruction of the blood stream in the downstream lumina.

Objective To study the common femoral artery haemodynamics caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of abdominal aorta extremity were pinched with vascular clamp resulting in 1/3,1/2,2/3,3/4 stenosis by turns in 6 juvenile susscrota domesticas.The parameters of peak systolic velocity(PSV),minimum diastolic velocity(MDV),PSV/MDV(S/D)and MDV/PSV(D/S)of common femoral artery were obtained and their correlations with degrees of abdominal aorta extremity stenosis were confirmed by statistical analysis.Results The backwardware vanished or turned to forwardware when stenosis achieved certain degree.PSV had significant negative correlation with stenosis degree(R=0.985,R2=0.969),but D/S had significant positive correlation with stenosis degree when stenosis degree exceed 1/3(R=0.918,R2=0.843).Conclusions It can be concluded there is proximal stenosis disease and change of distal effective circulating blood volume according to the Doppler velocity tracing analysis.PSV and D/S are valuable parameters,however waveform should be ignored.

Objective To explore the influence of core competence evaluation on continuing education of training nurses in operation room.Methods Questionnaires were administered to 42 training nurses by using the registered nurse core competence scale (CIRN) in operation room.Results The level of core competence of training nurses in operation room was medium (3.25 ± 0.45).Legal and ethical practice dimension of scores was the highest (3.55 ± 0.63).The single average of clinical nursing dimension was the advanced lowest (3.11 ± 0.54).The nurses self identity was the core influencing factors by multiple stepwise regression analysis in regression.Conclusions The core competence of training nurses in operation room is on the middle level,The focus is to improve the ability of clinical nursing in continuing education.To give more attention and support in self identity of the operation room training nurses,and to provide the scientific basis for the training plan and specialist training for them,in order to promote the continuing education projects of training nurses.

Objective To analyze the misdiagnosis reasons in renal tumors with contrast-enhanced ultrasound (CEUS) and to improve cognition on CEUS. Methods Two-hundred and eighty-five cases were compared with pathology, the images in 22 cases misdiagnosed on CEUS were reviewed retrospectively and the reasons were analyzed. Results The diagnosis accuracy and misdiagnosis rate of CEUS were 92. 28 % (263/285) and 7. 72%(22/285), respectively. In these 22 cases, 9 cases misdiagnosed as renal cell carcinoma (RCC) were conformed by pathology as renal angiomyolipoma(RAMD), showed 5 cases "fast wash-in and fast wash-out", 4 cases "fast wash-in and slowly wash-out". Seven cases were conformed as RCC, in which 5 were misdiagnosed as RAML, showed 4 cases "fast wash-in and slowly wash-out", 1 cases "simultaneously wash-in and simultaneously wash-out", and 2 were misdiagnosed as renal cyst with no enhancement founded. Four cases misdiagnosed as hematoma were conformed as pyelo-carcinoma, with no enhancement founded in renal pelvis. The remaining 2 cases misdiagnosed as inflammatory pseudotumor were conformed as RCC, showed "fast wash-in and slowly wash-out". Conclusions With the high diagnosis accuracy,CEUS is an important method in diagnosis of renal tumors. Analyzing the misdiagnosed reasons may improve the cognition on CEUS and decrease the misdiagnosis.

Objective: To investigate the diagnose nutcracker syndrome with color Doppler flow imaging.Methods:Doppler sonographic findings in 47 children with orthostatic proteinuria or idiopathic hematuria and in 23 healthy control subjects were compared.The peak velocity,anteroposterior diameter and anteroposterior diameter ratio(hilar segment/aortomesenteric segment) were measured in the left renal vein.Results: The anteroposterior diameter ratio of the 2 segments were 4.13?2.34 in the patient group and 2.16?0.56 in the control.The anteroposterior diameter and the peak velocity in the aortomesenteric segment were(0.16?0.07)cm/s and(83.3?37.2)cm/s in the patient group and(0.24?0.09)cm/s and(43.1?10.8)cm/s in the control,with significant difference in between(P

Metabolic-associated fatty liver disease (MAFLD), which is previously known as non-alcoholic fatty liver disease (NAFLD), represents a major health concern worldwide with limited therapy. Here, we provide evidence that ferroptosis, a novel form of regulated cell death characterized by iron-driven lipid peroxidation, was comprehensively activated in liver tissues from MAFLD patients. The canonical-GPX4 (cGPX4), which is the most important negative controller of ferroptosis, is downregulated at protein but not mRNA level. Interestingly, a non-canonical GPX4 transcript-variant is induced (inducible-GPX4, iGPX4) in MAFLD condition. The high fat-fructose/sucrose diet (HFFD) and methionine/choline-deficient diet (MCD)-induced MAFLD pathologies, including hepatocellular ballooning, steatohepatitis and fibrosis, were attenuated and aggravated, respectively, in cGPX4-and iGPX4-knockin mice. cGPX4 and iGPX4 isoforms also displayed opposing effects on oxidative stress and ferroptosis in hepatocytes. Knockdown of iGPX4 by siRNA alleviated lipid stress, ferroptosis and cell injury. Mechanistically, the triggered iGPX4 interacts with cGPX4 to facilitate the transformation of cGPX4 from enzymatic-active monomer to enzymatic-inactive oligomers upon lipid stress, and thus promotes ferroptosis. Co-immunoprecipitation and nano LC-MS/MS analyses confirmed the interaction between iGPX4 and cGPX4. Our results reveal a detrimental role of non-canonical GPX4 isoform in ferroptosis, and indicate selectively targeting iGPX4 may be a promising therapeutic strategy for MAFLD.