Objective To research the clinical efficacy of alprostadil injection in treatment of patients with emergency percutaneous coronary intervention (PCI).Methods Eighty-five patients with acute myocardial infarction(AMI) were enrolled in this study,and they were randomly divided into treatment group (45 patients) and control group (40 patients).All patients were given 300 mg aspirin and 300 mg clopidogrel before operation,anti-platelet aggregation and long-term hpid regulation were given.On the basisof conventional treatment,0.9％ sodium chloride (NaCl) 100 ml and alprostadil injection 10 μ g were given in treatment group,2 times one day,a total of 14 d.After treatment for 1,6 months,the heart function and systohc function were assessed by echocardiography.High sensitive C reactive protein (hs-CRP),endothehn (ET)-1 and interleukin (IL)-6 were measured with ELISA,nitric oxide (NO) was measured with chromatometry.The basic clinical characteristic,inflammatory markers and major adverse cardiac events (MACE) were analyzed during in-hospital and follow-up period between two groups.Results The level of IL-6,hs-CRP,ET-1,NO in two groups had no significant difference before treatment and after treatment for 1 month (P ＞ 0.05).After treatment for 6 months,the level of IL-6,hs-CRP,ET-1,NO in treatment group had significant difference compared with that in control group [(1.04 ± 1.10) ng/L vs.(3.82 ± 1.34) ng/L,(1.5 ±1.2)mg/Lvs.(3.5 ±0.8) mg/L,(62.18 ± 20.22) ng/L vs.(85.56± 16.55) ng/L,(55.25 ± 8.25) μmol/L vs.(46.16 ±9.20) μ mol/L] (P ＜0.05).The level of left ventricular end-systolic volume (LVESV),left ventricular end-diastolic volume (LVEDV),left ventricular ejection fraction (LVEF) in two groups before treatment and after treatment for 1 month had no significant difference (P ＞ 0.05).After treatment for 6months,the level of LVESV,LVEDV in treatment group were significandy lower than those in control group [(82.5 ± 20.6) ml vs.(90.5 ± 20.1) ml,(130.5 ± 33.8) ml vs.(144.3 ± 28.6) ml],the level of LVEF was significantly higher than that in control group [(57.8 ±6.3)％ vs.(48.5 ±6.5)％],there was significant difference (P ＜ 0.05).The mortality rate and the incidence of MACE was 7.5％ (3/40),25.0％ (10/40)in control group,which were significantly higher than those in treatment group [4.4％ (2/45),13.3％ (6/45)],there were significant differences (P ＜0.05).The incidence of heart failure in control group was 22.5％(9/40),which was significantly higher than that in treatment group [11.1％(5/45)],there was significant difference (P ＜ 0.05).Conclusions Using alprostadil injection for patients with AMI after emergency PCI can prevent left ventricular remodeling,improve left ventricular function,and can reduce the incidence of MACE.Alprostadil injection can reduce the inflammatory reaction in patients with AMI,inhibit catecholamine release,inhibit platelet adhesion and aggregation,and stable plaques,reduce the incidence of MACE.

The ischemia-modified albumin(IMA) forms after the human serum albumin experiences ischmia/reperfusion,which is a novel marker for myocardial ischemia.IMA exhibits a reduced capacity to bind to certain transition metals,such as cobalt.It can be measured by the Albumin Cobalt Binding test in serum.Several clinical researches suggested that IMA is an ideal biomarker for myocardial ischemia and an important assay for diagnosis of acute coronary syndromes.

A considerable proportion of patients with non small cell lung cancer (NSCLC) require postoperative adjuvant therapy,postoperative radiotherapy is an important part of the treatment,this article review the role and value of postoperative radiotherapy for NSCLC patients in recent years.

Gene Expression Regulation, Viral ; Proteomics ; methods ; trends ; Viral Proteins ; analysis ; genetics ; Viruses ; genetics ; growth & development ; metabolism

Objective To investigate the application of 3D scanning system in medical education technology.Methods David 3D scanning system had its advantages,calibration technique,working flow and post-processing of scanning data described,and then introduced into medical education and underwent series of tests.Results David 3D scanning system gained high modeling speed,and spent only 2 h for actual specimen scanning,modeling as well as synchronized collection and mapping.The scanning accuracy reached industrial level.Conclusion David 3D scanning system gains advantages over the traditional 3D scanning technique,and facilitates medical digital modeling by transforming object information into digital signal.

Objective To investigate the apoptosis response to mechanical stretch in human alveolar type Ⅱ epithelial cells A549.Methods First,A549 cells were given different stretch(0%,5%,15%,30%) at frequency of 0.5 Hz for 4 h.Then,A549 cells were stretched for different periods(0 h,2 h,4 h,8 h) at stretch 15%,0.5 Hz.Last,A549 cells were stretched for different frequency(0 Hz,0.2 Hz,0.5 Hz and 1 Hz) at stretch 15% for 4 h.The early apoptosis was detected by flow cytometry. Results A549 cells submitted to cyclic stretch caused the early apoptosis in a time-,stretch-and frequency-dependent manner.In details,at 0.5 Hz and 4 h stretch-dependence occurred,at 15% stretch and 0.5 Hz time-dependence occurred,and at 15% stretch and 4 h frequency-dependence occurred. Conclusion Mechanical stretch can induce the early apoptosis in human alveolar type Ⅱ epithelial cells A549,which may be one of the mechanisms of ventilator-induced lung injury.

Objective To study the pathogenesis of anemia in chronic aristolochic acid nephmpathy(CAAN) rats. Methods The hemoglobin(Hb)values of sixty-two male SD rats were assayed to determine its normal range.Among them,24 rats with normal Hb value were randomly divided into 2 groups:model group (MG)in which rats received the extract of Aristololochia manshuriensis Kom (AmK) by gavage,and control group (CG) received tap water only by gavage.Body weisht(BW),Hb,24 h urinary protein excretion(UP)and creatinine clearance (Ccr)of 6 rats in each group were measured before administration and at the end of the 8th week, respeetively.then these rats were sacrificed.The relative area of renal interstitial fibrosis was measured by microscopy.The mRNA expression of erythropoietin (EPO)in kidney tissue Was determined by real-time RT-PCR;protein expression of type I collagen(Coll),aminopeptidase P (APP),hypoxia indHeible factor let and 2α(HIF-1α and HIF-2α)in kidney tissue Was examined by immunohistochemistry staining. Results Hb values of normal rats presented normal distribution. The normal Hb was (155.9±16.5) g/L. Rat anemia was diagnosed when Hb was below 123.6 g/L. There was no difference in all the examination results between CG and MG before administration (P>0.05). Compared with CG, the Hb and Cer in MG were significantly decreased [(121.66±15.68) g/L vs (169.00±12.89) g/L, (0.63±0.13) ml/min vs (1.27±0.18) ml/min, P< 0.01], and the UP in MG was significantly increased at the end of the 8th week [(27.04±9.40) mg/d vs (6.11±0.84) mg/d, P<0.01]; the relative areas of fibrosis and Col l in renal interstitium of MG were significantly enlarged [(12.89±2.33)% vs (0.55±0.10)%, (13.92±2.92)% vs (1.32±0.84)%, P<0.01]; the protein expression of APP and the mRNA expression of EPO in the kidney tissue of MG were significantly down-regulated [(0.55±0.23)% vs (3.77±1.06)%, 0.005±0.001 vs 0.032±0.013, P<0.01]; the protein expression of HIF-lα and HIF-2α in the kidney tissue of MG was significantly up-regulated (2.55±0.16 vs 1.12±0.46, 2.33±0.33 vs 1.15±0.27, P<0.01), at the end of the 8th week. Conclusions The pathogenesis of anemia in CAAN may be due to the decreased production of EPO caused by the destruction of peritubular capillary. The compensatory up-regulation of HIF-lα and HIF-2α expression can not prevent the anemia development.

Objective To study the CT perfusion features of various lymph nodes in the neck.Methods Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology,including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes,and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were (28. 13 ±5.08), (31.08 ±5.82),and ( 11.24 ±5.31 ) s,respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma (P ＜ 0. 05). Their frequencies of marginal blood flow were 5/9,4/19, and 39/55 (70. 9% ), respectively. The frequency of marginal blood flow in the tuberculosis lymph nodes and metastatic lymph nodes was statistically higher than that of lymphoma ( P ＜ 0. 05 ). Their frequencies of central blood flow were 2/9, 11/19, and 9/55 (16.4%), respectively. The frequency of central blood flow in the lymphoma was statistically higher than that of tuberculosis lymph nodes and metastatic lymph nodes ( P ＜ 0. 05 ). Their values of L/T were 1.82 ± 0. 32, 1. 80 ± 0. 39, and 1.84 ± 0. 36,(40. 98 ±6. 62) s,respectively. There were no significant differences in L/T, BF, BV and TTP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes( P ＞ 0. 05 ). Conclusion CT perfusion,especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes.

BACKGROUND:Currently, the study of total hip arthroplasty in elderly is more. Perioperative treatment and postoperative rehabilitation are increasingly perfect, but the study of middle-aged total hip arthroplasty is less, especialy long curative effect in postoperative and long-term folow-up stil has many problems to be solved. In China, there are few studies addressing how to select the prosthesis during total hip arthroplasty in middle-aged patients, which kind or material of prosthesis is better, so the evidence for clinical application is less. OBJECTIVE:To compare and analyze the repair effects of bone cement total hip arthroplasty and uncemented total hip arthroplasty in middle-aged patients. METHODS:A total of 60 middle-aged patients who received total hip arthroplasty in the Department of Orthopedics, Xinjiang Uygur Autonomous Region Chinese Medicine Hospital from January 2005 to January 2008 were folowed up for 5 years. Their mean age was (37±6) years. There were 32 cases undergoing uncemented total hip arthroplasty and 28 cases receiving bone cement total hip arthroplasty. At 6 months, 2 and 5 years after replacement, Harris score for recovery of limb function and imaging findings were compared and analyzed. RESULTS AND CONCLUSION: Harris score for recovery of limb function was significantly better in the uncemented total hip arthroplasty group than in the bone cement total hip arthroplasty group at 6 months, 2 and 5 years after replacement (P < 0.01). No complications were found at 6 months in the uncemented total hip arthroplasty group, but one case affected osteolysis at 2 years and two cases experienced prosthesis loosing at 5 years after arthroplasty. In the bone cement total hip arthroplasty group, two cases had osteolysis and one case had prosthesis loosing at 6 months after arthroplasty, three cases had prosthesis loosing at 2 years, and two cases affected linear permeability dissolvement at 5 years after arthroplasty. These findings suggest that uncemented prosthesis achieved a high rate of functional restoration and a low rate of complications in middle-aged patients. Uncemented total hip arthroplasty had satisfactory clinical and radiographic outcomes at a minimum of 5-year folow-up.

Objective To evaluate the correlation between RPA or the polymorphism of CYP 2C19 and the incidence of ischemic events and the influence on the clinical prognosis .Methods A case-control study was used.A total of 202 patients [male 66%,(63 ±11) years] with ACS on aspirin and clopidogrel treatment were recruited , whose RPA were measured by whole blood aggregometry ( WBA ) , and their CYP2C19 polymorphism were also tested .Their clinical ischemic events were recorded in the mean follow-up period of 16 months.The RPA cut-off values for antiplatelet low-responsiveness were defined by the receiver operator characteristic curve ( ROC); the relationships of clinical outcomes with RPA and CYP 2C19 were assessed by the Kaplan-Meier survival analysis.Results CYP2C19*2 (681G>A) present in 52.5% of recruited patients and*3 (636G>A) present in12.9%.RPA induced by adenosine diphosphate ( ADP) showed significant difference among CYP 2C19*2 or *3 heterozygotes, CYP2C19*2 or *3 homozygotes and noncarriers (χ2 =9.318, P=0.009);whereas, RPA induced by arachidonic acid (AA) (χ2 =2.441, P=0.295) and the incidence of ischemic events (χ2 =0.513, P=0.774) were not.During follow-up, 18 (9%) patients experienced clinical ischemic episodes , and their RPA were higher than patients without ischemic episodes [(8.6 ±4.8) Ωvs (5.2 ±3.7) Ω, P =0.013; (8.6 ±6.8) Ωvs (1.6 ±3.7) Ω, P <0.001].Moreover, employing 6.5 Ω(induced by ADP) and 2.5 Ω(induced by AA) as cutoff values,RPA showed optimal negative predictive values (97%, 96%) and poor positive predictive values (16%,29%).Survival analysis showed, statistically, patients with clopidogrel low-responsiveness had higher riskof ischemic episodes than patients with clopidogrel responsiveness (HR =2.86, χ2 =11.27,P =0.0008);however, patients with aspirin low responsiveness (HR =1.77, χ2 =1.74, P =0.19) or patients withCYP2C19*2 or *3 (HR =0.89, χ2 =0.12, P =0.73) did not.Conclusion Clopidogrel lowresponsiveness is associated with the occurrence of clinical ischemic events ; however, patients withCYP2C19 function reduced genetypes do not show higher risk of ischemic episodes though it presented slighlyhigher RPA.