One hundred carotid arteries were investigated with both Duplex and DSA.The accuracy of Duplex was acceptable.Systolic peak frequency and the appearance of spectral broadening were used toanalyse the Doppler spectrum.The sensitivity,and specificity were satisfactory to identify internal carotidstenosis particularly critical stenosis.The results show that duplex scanning is a reliable noninvasive ex-amination method for internal carotid stenosis.

BACKGROUND:The purpose of the treatment of lumbar spondylolisthesis is to reconstruct the spine sequence and vertebral stability, relieve nerve compression, and achieve permanent lumbar fusion.
OBJECTIVE:To explore the restore of vertebral stability of the lumbar spondylolisthesis patients after lumbar fusion and implant internal fixation.
METHODS:The lumbar spondylolisthesis was often divided into dysplastic, isthmic, degenerative, traumatic and pathological with Wiltse classification. The slip degree of upper vertebra relative to lower vertebra on the lumbar X-ray film was divided into five grades, and then the appropriate treatment method was selected according to the classification, grading and specific circumstances of the lumbar spondylolisthesis patients.
RESUTLS AND CONCLUSION:The strong fusion and internal fixation and the rigid connection between
implants and vertebra are often used to stabilize the spine and correct deformities with high bone fusion rate, thus reducing pseudoarticulation formation. Dynamic fusion and internal fixation can distribute the load conduction of rigid internal fixation with elastic material or micro-devices, thus reducing stress shielding and adjacent segment stress concentration. Dynamic non-fusion and internal fixation can change the load transfer mode of spinal
motion segment, inhibit spinal movement and prevent adjacent segment degeneration, in order to make the instable lumbar spine reach its normal activity characteristics, and achieve dynamic reconstruction of lumbar sequence. Lumbar isthmus defects directly repaired with graft is suitable for the young adult with the
symptoms of lumbar spondylolisthesis and without degenerative disc disease. There is no consistent option on which materials and position is suitable for graft in the lumbar spondylolisthesis patients, as wel as which methods for fusion and implant internal fixation can achieve ideal effect.

Essential hypertension (EH) is an escalating problem for developed and developing countries.It is currently seen as a 'complex' genetic trait caused by multiple susceptibility genes which are modulated by gene-environment and gene-gene interactions.Over the past 10 years,mitochondrial defects have been implicated in a wide variety of degenerative diseases,aging,and cancer.Recently several studies showed that human essential hypertension has excess maternal transmission which suggests a possible mitochondrial involvement.However,the exact pathophysiology of mitochondrial DNA mutation (mtDNA) in essential hypertension still remains perplexing.With the application of a variety of imaging approaches and successive mouse model of mitochonddal diseases we convince that these problems will be resolved in the near future.(J Geriatr Cardiol 2008;5(1):60-64)

BACKGROUND:After articular cartilage injury, the injured cartilage almost has no self-healing ability. Articular cartilage injury repair has been always a difficulty in clinical work.
OBJECTIVE:To explore the types and biological characteristics of stem cels for articular cartilage repair and to ensure the role and relative merits of stem cel transplantation in articular cartilage repair.
METHODS:PubMed and CNKI were retrieved by the first author for relevant articles published from 1998 to 2015 using the keywords of “articular cartilage injury, mesenchymal stem cels, regeneration” in English and Chinese, respectively. Finaly, 47 articles were included in result analysis.
RESULTS AND CONCLUSION: Stem cel therapy is the most effective method for repair of articular cartilage injury. Mesenchymal stem cels from bone marrow, adipose and umbilical cord have strong chondrogenic and cloning capacities. Bone marrow mesenchymal stem cels have a stronger differentiation potential, and can be used for repair of cartilage injury. Umbilical cord-derived mesenchymal stem cels have a low tumorigenicity. Adipose-derived stem cels can proliferate and grow faster. Stem cels combined with natural carrier materials, such as colagen, gelatin, fibrin and alginate, can promote cel adhesion, differentiation and proliferation, in order to build an effective tissue engineered cartilage for repair of articular cartilage defects.

Objective To explore the application of near infrared fluorescent dye C-dots in cell labeling.Methods B16 melanoma cells were cultured with C-dots of various diameters.The distribution of C-dots in cells was observed by laser confocal fluorescent microscope.The proliferation of both C-dots-labeled and unlabeled cells were measured by MTT colorimetry.The viability of labeled cells was checked by trypan blue staining.Results C-dots with diameter of 5 or 10 nanometers can be used to label cells.The near infrared fluorescence of C-dots was taken into the cells and observed on the cellular membrane.No difference of cellular viability was found between the labeled and unlabeled cells.Conclusion C-dots can be used as an intracellular marker for the research on trace and proliferation of cells.

Objective To study the feasibility and efficacy of endovascular thoracic aortic repair supported by preliminary arterial bypass. Methods From June 2003 to Jan. 2005, eight patients underwent endovascular repair (EVR) combined with supportive arterial reconstruction in the thoracic aorta. Five patients had Debakey type Ⅲ aortic dissection aneurysm (ADA), and the remaining 3 had descending thoracic aortic aneurysm (DTAA), aortic arch aneurysm and aortic arch pseudoaneurysm respectively. The proximal landing zone was measured less than 15 mm in all instances by contrast-enhanced CT scan and digital subtraction angiography. The preliminary right-left axillary bypass was performed in an ADA case in whom the distance from the primary entry site to the origin of the left common carotid artery was longer than 15mm,and the right- left carotid and left carotid-subclavian bypass in the remaining 7 cases. EVR was conducted 1 week after the bypass. Results All procedures were performed successfully. However, the DTAA patient died of the hemispheric cerebral infarction and subsequent multiple system organ failure, albeit the uneventful recovery from the prior cervical reconstruction. Type Ⅱ endoleak occurred at the completion of EVR in the patient receiving the axillary bypass, but disappeared on 3-month CT. No neurological deficits or limb ischemia developed perioperatively or during the follow-up raging from 3 to 22 months, and complete thrombosis of the thoracic aortic false lumen or of the aneurysm/pseudoaneurysm was revealed on CT at 3 months in the 7 patients. Conclusion The adjunctive surgical bypass appeared to be feasible and effective in creating extra proximal landing zone for endovascular thoracic aortic repair, and thus broaden its application.

Objective To make recommendations on the development of private hospitals,by means of investigation and analysis of their business operations.Methods Quantitative and descriptive analysis were used to study business operation data from 2011 to 2013 of the 172 private hospitals,in order to learn their present status and development trends.These data were compared with public hospitals in average to identify problems.Results The revenue and expenditure of theses private hospitals increased at a fast pace,with a revenue growth rate of 22.0% and an expenditure growth rate of 15.7% in 2013.Number of visits gradually improved,with an increase of 12.9%.But the rate of bed occupancy was only 68.1%,lower than the average of public hospitals.Conclusions In view of the low resource utilization,the authors recommend such hospitals to improve hospital management systems,and uphold the integrity of business,so as to compete with public hospitals differentially.

Objective To evaluate the mid-term outcomes of endovascular repair of descending thoracic aortic aneurysm(DTAA) in high-risk patients.Methods Twenty four patients with DTAA received stent-grafts implantation between January 2001 and July 2007 and their clinical data were retrospectively analyzed.All patients were considered high-risk for open surgical repair due to the location or rupture of the aneurysm,high age and severe comorbidities.Spiral computed tomography angiography and 3-dimentional reconstructions were performed at 1,3,6 and 12 months postoperatively and thereafter every year.Results The primary operational success rate was 100%.There were 2 deaths(8.3%) during perioperative period due to multiorgan failure and acute myocardial infarction respectively.Two(8.3%) patients had severe post-operational complications(1 stroke and 1 acute renal insufficiency).Eleven cases of type Ⅰ(46%) endoleak were detected immediately after the operation and among them,the endoleak disappeared after balloon dilatation in 3 cases while the other 8 patients were treated conservatively.Follow-up of 1 to 60 months(mean 18.6?4.2 months) was completed in 19 patients(79.2%).Stent displacement with type Ⅰ endoleake was found in 1 patient at 4 years after the operation and delayed type Ⅲ endoleak occured in another patient at 2 years post-operation.Both patients received endovacular repair again and the endoleaks were closed successfully.One patient died of colon cancer during the follow up.Complete thrombosis of the thoracic aneurysm sac and no stent migration or endoleak was found on the followup CT at 3 months after the operation in all the patients.The decrease in maximal aneurysm diameter was 0-18 mm(mean 6.3?3.1 mm).The prosthetic vascular grafts implanted in 4 patients with preliminary carotid subclavian bypass surgery were patent during the follow-up period.Conclusion Treatment of descending thoracic aortic aneurysm in high-risk patients with endovascular approach showed acceptable early mortality and morbidity and may be considered as a treatment alternative for carefully selected patients.

AIM:To determine the right ventricular angiotensin converting enzyme2 (ACE2) activity in adult SD rats under normoxia and hypoxia environment,and to detect the relationship between ACE2 and high altitude heart disease initially. METHODS:Adult male Sprague Dawley (SD) rats were raised under hypoxia environment simulated to high altitude (5 000 m,23 h/d),then divided into hypoxia 1 d,15 d and 30 d groups randomly. The control group was set up under normoxia environment. The right ventricular function,ponderal index,pulmonary artery pressure and right ventricular ACE2 activity were determined. The effect of captopril or nitrendpine on cardiac ACE2 activity in hypoxia 30 d group was also observed. RESULTS:The dramatic up-regulation of cardiac ACE2 expression of mRNA and protein and its activity in hypoxia 30 d group was observed,together with obvious increase in right ventricular function,ponderal index and pulmonary artery pressure. Although captopril or nitrendipine depressed pulmonary artery pressure and cardiac function dramatically,no significant alteration of right ventricular ACE2 activity was detected. CONCLUSION:Chronic hypoxic exposure promotes the ACE2 expression and activity in right ventricular,indicating that ACE2 may be correlated to the changes of cardiac architecture and function induced by hypoxia. Up-regulation of ACE2 expression maybe contribute to the increase in right ventricular ACE2 activity,and pulmonary artery hypertension may not be the main reason for the changes of ACE2 activity under hypoxia environment.

Objective [WT5”BZ] To evaluate the preliminary clinical results of the endovascular grafts for the treatment of abdominal aortic aneurysms (AAA).[WT5”HZ]Methods [WT5”BZ] Fourteen patients with infrarenal abdominal aortic aneurysms underwent transluminal endovascular graft placement for the exclusion of AAA.[WT5”HZ]Results [WT5”BZ] Two patients received tubular and 12 patients received bifurcated endograft, the placement was successful in all cases. Aortography carried out immediatly after the procedure showed the AAA were completely excluded by endografts, and no endoleaks both on the proximal or distal connections. Myocardial infarction developing in a patient postoperatively was successfully treated by thrombolysis. Perioperative death occurred in 2 cases. Technical success at 30 days was 85 7%. 24 month follow up in 12 cases found migration of the graft in none and endoleaks in 2 cases.[WT5”HZ] Conclusion [WT5”BZ] Based on our initial results and a rather short follow up period of 24 months, the endovascular treatment of AAA with stent graft is safe and effective. Long term follow up is needed to evaluate the feasibity of this procedure.