Ostial lesions present many challenges for percutaneous coronary intervention (PCI). Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wire technique and focused-force angioplasty.

Vaspin,a serine protease inhibitor derived from visceral adipose tissue,has been identified as an adipokine with insulin-sensitizing effects in a rat model of type 2 diabetes.Recent studies showed that the administration of recombinant human vaspin significantly improved insulin sensitivity and glucose tolerance,and reversed the expression of genes that may promote insulin resistance in diet-induced obese mice.However,the regulation of serum vaspin concentration in individuals with insulin resistance,and the association of vaspin with obesity,type 2 diabetes,and insulin resistance related disorders remain unclear.

Objective To explore the effect of developed operating instrument set for cesarean section. Methods Toally 216 parturients to undergo cesarean section in our hospital during May to December 2014 , were divided into observation group and control group, 108 cases in each group:in the observation group the developed operating instrument set was used and in the control one, the routine operating instrument set was used. The two groups were compared in terms of contamination rate and the time for postoperative operating room preparation. Results The contamination rate of the observation group was significantly lower than that of the control group (P<0.01). The time for postoperative operating room preparation of the observation group was significantly shorter than that of the control group (P < 0.01). Conclusion The developed operating instrument set can reduce the rate of contamination at the operated area during cesarean section and shortned the time for postoperative operating room preparation , thus enhancing the work efficiency.

Objective To investigate the effect of interleukin-17 (IL-17) in the gastric cancer cell migration and invasion via regulating epithelial-mesenchymal transition (EMT) and its potential function.Methods (1) Human gastric cancer cell MGC-803 lines in the logarithmic growth phase were stimulated by 0, 1 ng/mL, 10 ng/mL,100 ng/mL and 1μg/mL of IL-17 for 48 hours, and the phenotypic changes were observed.The concentration of IL-17 was selected for follow-on experiments based on the most obvious phenotypic changes.Gastric cancer cell MGC-803 which were stimulated by 100 ng/mL of IL-17 and PBS for 48 hours were allocated into the experimental group and control group, respectively.(2) The expressions of E-cadherin and Vimentin mRNA in gastric cancer cells were assayed through real-time PCR (RT-PCR).(3) The relative expressions of E-cadherin and Vimentin proteins in gastric cancer cells were assayed by the Western blot.(4) The scratch test and Transwell detection were also utilized to study the migration and invasion of gastric cancer cell MGC-803 in vitro.Measurement data with normal distribution were presented as-x ± s and comparison between groups was analyzed using the t test.Results (1) There were significant phenotypic changes in the gastric cancer cell after the different concentration of IL-17 stimulated gastric cancer cell MGC-803 for 48 hours.Cells were changed from polygonal and tight junction to spindle and loosely junction with a deterioration of cell adhesion.Cell phenotypes were gradually changed as the concentration of IL-17 was changed from 0 to 100 ng/mL.Phenotypic changes were the most obvious when 100 ng/mL of IL-17 was used, but these were non-significant as the concentration of IL-17 increased to 1 μg/mL with the death and floating of some cells.(2) The relative expressions of E-cadherin mRNA and Vimentin mRNA in RT-PCR were 0.45 ±0.13 and 1.06 ±0.23 in the experimental group and 2.39 ±0.55 and 1.23±0.41 in the control group, respectively, with significant differences (t =3.811, 2.923, P ＜0.05).(3) The results of Western blot showed the relative expressions of E-cadherin and Vimentin proteins were 0.86 ± 0.17 and 1.56 ± 0.29 in the experimental group and 1.01 ± 0.12 and 0.56 ± 0.17 in the control group, respectively, with significant differences (t =3.551, 3.601, P ＜ 0.05).(4) Cell migration in the 2 groups were detected by the scratch test at 36 hours after scratch test, and the width of scratch in the experimental and control groups were (0.76 ± 0.13) mm and (0.40 ± 0.15) mm, showing a significant difference (t =3.095, P ＜ 0.05).Transwell detection showed number of transmembrane cell in the experimental and control groups were 159 ±28 and 94 ± 18, respectively, with a significant difference (t =3.307, P ＜ 0.05).Conclusion IL-17 can promote the migration and invasion of gastric cancer cells via stimulating alteration of EMT.

Brain-derived neurotrophic factor (BDNF)is both a neurotrophic substance and a neurotransmitter.BDNF and its receptors are highly expressed in enteric nervous system,intestinal mucosal epithelium and intestinal muscularis, which play an important role in regulating intestinal sensitivity and motility.This article reviewed the expression and role of BDNF in intestinal tract.

Objective To investigate the clinical effect of tension-free hernia repair in the treatment of inguinal hernia combined with ascites.Methods The retrospective cross-sectional study was conducted.The clinical data of 81 inguinal hernia patients with ascites who were admitted to the West China Hospital of Sichuan University from June 2008 to June 2014 were collected.Patients with peritoneal effusion received restriction of sodium in take and diuretic therapy,and patients with severe hypoproteinemia received intravenous injection of albumin.All the patients underwent tension-free hernia repair (Gilbert way).Observation indicators:(1) surgical and postoperative situations:operation time,diameter of hernia ring,defect area of hernia,postoperative plasma drainage,removal time of plasma drainage-tube,postoperative complications and duration of hospital stay;(2) follow-up situation:recurrence and long-term complications of inguinal hernia.Follow-up using telephone interview,outpatient examination and inpatient examination was performed to detect the hernia recurrence and long-term complications for 24 months up to June 2016.Measurement data with normal distribution were represented as (x)±s.Results (1) Surgical and postoperative situations:81 inguinal hernia patients with ascites underwent successful tension-free hernia repair.The operation time,diameter of hernia ring and defect area of hernia were respectively (46± 19) minutes,(3.1-± 0.7) cm and (25 ± 13) cm2.Sixty-five patients received indwelling plasma drainage-tube after repair,volume of light bloodstained fluid was respectively ≥ 100 mL in 39 patients and ＜ 100 mL in 26 patients at 24 hours postoperatively,with a removal time of plasma drainage-tube of (3.2± 1.0)days.Sixteen patients didn't receive indwelling plasma drainage-tube.Of 81 patients,9 and 4 were respectively complicated with mild seroma of incision and scrotal swelling,they were improved and then out of hospital after adequate drainage,with a duration of hospital stay (6.7-± 1.7)days.(2) Follow-up situation:of 81 patients,76 were followed up for 24 months,without recurrence and related complications of inguinal hernia.Conclusion The tension-free hernia repair in the treatment of inguinal hernia combined with ascites is safe and feasible,with good clinical effects.

Anal fistula is a common disease, surgical treatment is the best option. There are many kinds of surgical treatments for anal fistula, traditional surgical methods, such as fistulotomy and fistulectomy are more thorough in treating internal opening, infection and fistula tract, but the injury to the sphincter is also greater. In recent years, surgery is becoming refined, many scholars pay more and more attention to the protection of anal sphincter, which has derived a series of minimally invasive surgeries, such as Endorectal advancement flap procedure, Ligation of intersphincteric fistula tract, Fistula laser closure procedure, Video-assisted anal fistula treatment, Over-the-scope clip, Endofistular polyurethane-sponge vacuum therapy and biological sphincter preservating procedures. This paper describes the application status and progress of sphincter preserving surgeries by reviewing relevant literature, in order to provide relevant reference for clinical workers, optimize the treatment plan and improve the cure rate.

Objective To study the changes of muscle being injected with botulinum toxin A in different period of time,helping for chemically denervated muscle transplantation.Methods Sixteen rabbits were divided into 4 groups.The extensor carpi radialis muscle in one side was chosen for experimental group with the opposite muscle for control group.Morphological changes,histological changes and electron microscopic changes of muscle being injected with botulinum toxin A were observed from the first week to the fouth week.Results The quantity of glycogen and mitochondria in the muscles reduced in the first week.But it was obvious in the third week.We also found some necrotic areas in the fouth week with the muscles restoring.Conclusions The effect of metabolism slowing down and the volume of muscle reducing after botulinum toxin A injection is obvious in third weeks.It could help us choose the best time of chemically denervated muscle transplantation.

Objective To assess the diagnostic value of 99Tcm-ECD SPECT for hyperacute cerebral ischemia using rats models.Methods A stable and permanent acute cerebral ischemia model using unilateral middle cerebral occlusion was tested in 24 healthy SD rats.The rats were randomly divided into 6 groups according to the time duration between imaging and induced-ischemia (1,2,3,4,5 and 6 h,respectively).The rats were sacrificed immediately after 99Tcm-ECD SPECT/CT imaging and then the brain tissue was dissected for triphenyl tetrazolium chloride (TTC) and HE staining.The count ratio of affected cortex to the contralateral cortex of ＜ 50％ was defined as ischemia on micro SPECT/CT.The volume of the ischemic area was calculated on both SPECT/CT and TTC images.Paired t test was used to determine the statistical difference between the volumes on SPECT/CT and TTC staining.Results The ischemia volume evaluated by TTC staining at 1,2,3,4,5 and 6 h after occlusion was (73.98 ± 27.76),(90.75 ±29.00),(135.00±40.83),(136.25±22.51),(158.50±32.72) and (168.00±32.75) mm3,respectively.The corresponding ischemia volume evaluated by micro SPECT/CT was (98.50 ± 27.77),(110.40±26.80),(157.00±36.82),(165.50±26.54),(175.75±31.16) and (177.25 ±34.33) mm3,respectively,which was concordant with that by TTC staining at each time point (t:-1.681 to-0.390,all P ＞0.05).The ischemic area on micro SPECT/CT imaging was consistent with the pink area by TTC staining.The volume evaluated by micro SPECT/CT tended to be constant 3 h after the occlusion.The ischemia volume showed no significant difference among 3,4,5 and 6 h (all P ＞ 0.05).Conclusions Micro SPECT/CT may have an haemodynamic value for evaluating in vivo cerebral ischemia applied in a rat model.It might have clinical value for the evaluation and decision-making of ultra acute cerebral infarctions.

Objective To detect the expression of NRP‐1 in gastric cancer tissue ,to analyze its relationship with clinicopath‐ological features ,and to explore its value in judging the prognosis of gastric cancer .Methods The clinical pathologic data and prog‐nosis situation in 168 cases of gastric cancer were retrospectively analyzed .The expression of NRP‐1 in gastric cancer tissue and normal tissue was detected by the immunohistochemical method .The relationship between the expression of NRP‐1 with the clinico‐pathological features and prognosis was investigated .Whether NRP‐1 serving as a reference indicator for judging the prognosis of gastric cancer was evaluated .Results (1) In 168 cases ,the NRP‐1 expression in gastric cancer tissue was higher than that in nor‐mal tissue (66 .7% vs .8 .33% ,P<0 .05) .(2) The NRP‐1 expression was related with the tumor size ,differentiation degree ,infil‐trative depth ,lymph node metastasis and TNM stage(P<0 .05) .(3)The median survival time in the patients with high NRP‐1 ex‐pression was shorter than that in the patients with low NRP‐1 expression (P<0 .05) .(4) The multiple factor analysis by COX pro‐portional hazard model showed that the NRP‐1 expression was an independent risk factor for the prognosis of gastric cancer(P<0 .05) .Conclusion (1)NRP‐1 plays an important role in the incidence and development process of gastric cancer and its expression is closely related with the malignant biological behavior of gastric cancer .(2)The high NRP‐1 expression prompts poor prognosis .(3) NRP‐1 may be expected to be regarded as one of the indexes for judging the biologic behaviors and prognosis of gastric cancer .