Objective To assess the value of high-resolution ultrasonography in diagnosis of cubital tunnel syndrome. Methods Forty-two patients (43 elbows) initially diagnosed as cubital tunnel syndrome underwent ultrasonography (US), while 15 healthy contralateral elbows of these patients taken as self controls, and 15 healthy volunteers as normal controls underwent US of the ulnar nerve. The findings of US measurements were compared with that of intra-operative results and pre-operative electromyography. Results High-resolution US displayed changes and some etiological factors of cubital tunnel syndrome. The measurements of ulnar nerve at the proximal part of the compression were higher than those in the control groups. The cut-off point of cross-sectional area (CSA) and CSA tumefaction ratio was 0.11 cm~2 and 141.50%, respectively. The sensitivity of US was 92.86% compared with intra-operative results, and was 100% when combined with pre-operative electromyography. Conclusion High-frequency ultrasound can be used as an effective method to diagnose cubital tunnel syndrome.

Objective To determine the anatomical and visual outcome of indocyanine-green (ICG)-assisted internal limiting membrane (ILM) peeling for idiopathic macular holes. Methods Thirty-one eyes of 31 patients with 3- (14 eyes, 45.2%) and 4-staged (17 eyes, 54.8%) primary idiopathic macular holes were analyzed. All the patients underwent the subtotal pars plana vitrectomy with removal of the posterior vitreous. ICG solution with the concentration of 1.25 mg/ml was injected into vitreous cavity. The ILM was stained and removed in a circular fashion of 2 to 3 disc-diameter from the edge of the hole. At the end of the surgery, 14% C 3F 8 mixed gas was used and the patients were required to maintain a prostrate posture for two weeks postoperatively. The mean follow-up duration was 9.1 months. Results The preoperative median visual acuity was 20/200. In the final follow-up, 28 eyes (90.3%) had anatomical restoration of the macular holes, 21 eyes had improvement of two lines or more of visual acuity. There was no direct complication or toxicity related to ICG-assisted ILM peeling except one patient with retinal detachment caused by peripheral retinal hole. Conclusion ICG-assisted retinal ILM removal appears beneficial and safe for primary idiopathic 3 and 4-staged macular holes.

Objective To study the incidence of coronary artery aneurysm (CAA) in patients under coronary angiography (CAG), its clinic features and prognosis Methods Retrospective studies were conducted of the clinical features, treatment and outcome of 2?876 patients under CAG Results Among the 2?876 patients, 26 had CAA, the total incidence of CAA was 0 904% Among these patients, 14 had myocardial infarction, and 24 had narrowing coronary artery (stenosis≥50%) Among the 26 cases of CAA, 20 ateries had thrombosis No CAA had ruptured Conclusion The incidence of CAA in the studied CAG population was 0 904%, CAA could be responsible for myocardial ischemia and myocardial infarction

Objective To evaluate the irreversible ischemia injury in patients with acute coronary syndrome using Cardiac MRI. Methods We have studied 35 patients with acute coronary syndromes who received standard medical therapy. Coronary angiogram confirmed that all the patients had suffered from multi-coronary artery stenosis without total occlusion. Cardiac MRI (CMRI) examinations were performed 6-12 weeks after the coronary angiography and revascularization. IR-GRE was used in the CMRI protocal to detect myocardial delayed enhancement (viability). The definition of hyperenhancement was that the signal of the region was two times that of the remote myocardium. The hyper-enhanced volume was presented as a percentage of LV mass (%LV), i.e. The total number of hyperenhanced pixels divided by the total number of pixels of the LV myocardium and multiplied by 100. Results CMRI revealed that all the patients had hyperenhanced region, of whom 30 (85.7%) had non-transmural enhancement and only 5 (14.3%) had transmural enhancement. The average size of the enhancement of non-transmural was significantly smaller than that of transmural hyperenhancement (45.7?7.3%). Conclusion The CMRI can demonstrate that infarction has occurred in patients with multi-coronary arteries stenosis.

Objective To use the antisense of Platelet-derived growth factor ? chain (PDGF-?) gene to inhibit the proliferation of rabbit vascular smooth muscle cells(VSMCs) in order to provide in situ basis on prevention and treatment of human restenosis. Methods A rabbit restenotic vascular model was constrcted and an antisense designed according to PDGF-? cDNA sequence as a drug was used to observe its effects on the expression of proliferating cell nuclear antigen and in situ expression of platele-derived growth factor ? chain by the VSMCs and the formation of neointima after injury. Results The antisense could significantly inhibit the expression of proliferating cell nuclear antigen and downregulate in situ expression of PDGF-? mRNA by intimal VSMCs one week after injury with inhibitory rates of 93.44% and 88.40%, respectively. Conclusion The antisense designed could inhibit the formation of neointima after injury through downregulating the expression of PDGF-? mRNA by local VSMCs, which provides the experimental basis of the antisense for the prevention and treatment the human restenosis.

Objective To evalute the feasibility and safety of sirolimus (rapamycin)-eluting stent for the treatment of in-stent restenosis (ISR). Methods Eleven patients with ISR were treated with one or more Cypher~ TM sirolimus-eluting stents. All these patients received angiographic follow-up at 6 months. Results The success rate of the procedure was 100%. All patients were free of angina after 6 months. There were no repeat revascularizations, stent thrombosis or major adverse clinical events during the follow up period. No ISR was noted in the follow-up coronary angiography. Conclusion This study demonstrates the safety and potential of sirolimus-eluting stents for the treatment of ISR.

Objective　To study the experience in prevention and treatment of iatrogenic bile duct trauma(IBDT). Methods　A retrospective study was made on the clinical data of 118 patients with iatrogenic bile　 duct trauma admitted to the Hunan Provincial People's Hospital from March 1990 to September 2000. Results　50.8%　(60/118) of patients with IBDT resulted from the wrong identification of the anatomy of the Calot' Triangle during cholecystectomy. The clinical diagnosis of IBDT depended on the clinical findings, diagnostic abdominocentesis and image examination. The diagnostic rate of ultrasonography for IBDT was 93.2%(110/118). According to the injury site of bile duct, IBDT could be divided into 6 types, the most common type of　 IBDT was resection of partical hepatic duct and part common bile duct(type Ⅲ) which occurred in 83.9%　(99/118) of the patients. The cure rate of IBCT was 100%(118/118) in this series due to the choice of operation according to the trauma type. Conclusions　The key of prevention to IBDT lies in abiding by the princible of “identifying-cut-recognazing” during cholecystectomy. The choice for surgical operative procedure should agree with the trauma type.

Objective To observe the clinical efficacy of electroacupuncture in treating deglutition disorders after radiotherapy of nasopharyngeal carcinoma. Method Forty nasopharyngeal carcinoma patients with deglutition disorders after radiotherapy were randomized into a treatment group and a control group, 20 in each group. The control group was intervened by nourishing nerve, improving microcirculation, promoting nerve growth factor, and physical rehabilitation. Based on the treatment given to the control group, the treatment group was additionally intervened by electroacupuncture. Water drinking test was adopted to evaluate the deglutition function before and after intervention, and the clinical efficacy was compared. Result After intervention, there was no significant difference in comparing the deglutition function between the two groups (P>0.05). The total effective rate was 80.0%in the treatment group versus 50.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Electroacupuncture is an effective method in treating deglutition disorder after radiotherapy of nasopharyngeal carcinoma.

Objective To investigate the role ot adhesion molecule CD44 in respiratory syncytial virus (RSV) infection induced bronchiolitis.Methods Thirty-six children with RSV infection induced bronchiolitis (infection A group),34 children with only RSV infection (infection B group) and 40 healthy children (control group) were selected.The proportion of peripheral blood CD44+ cell was determined by flow cytometry.The levels of peripheral blood interferon (IFN)-γ,interleukin (IL)-4,IL-10 and IL-12 were determined by enzyme-linked immunosorbent assay.Results The expression of CD44 and the level of IL-4 in peripheral blood in infection A group were significantly higher than those in infection B group and control group,there were statistical differences (P ＜ 0.05).The level of IFN-γ in peripheral blood in infection A group was significantly lower than that in infection B group and control group,there were statistical differences (P ＜0.05).The levels of IL-12 in peripheral blood in infection A group and infection B group were significantly lower than that in control group,there were statistical differences (P ＜ 0.05).There were no statistical differences in the level of IL-10 in peripheral blood among the 3 groups (P ＞ 0.05).In the children with RSV infection,the expression of CD44 in peripheral blood was positively correlated with the level of IL-4 (r =0.798,P ＜ 0.05),the level of IL-12 was negatively correlated with the level of IL-4 (r =-0.186,P ＜0.05).Conclusion The expression of adhesion molecule CD44 may play a role in the RSV infection induced bronchiolitis,and the high expression of CD44 in children with RSV infection may increase the susceptibility to bronchiolitis.

Objective To explore the relationship between bronchoalveolar lavage fluid (BALF) Mycoplasma load and clinical characteristics in children with Mycoplasma pneumoniae (MP) pneumonia.Methods MP DNA was quantitatively detected by fluorescent real-time PCR in BALF from 67 children with MP pneumonia.They were classified into three groups:low MP load group (＜ 103/ml,21 cases),moderate MP load group (103-106/ml,22 cases) and high MP load group (＞ 106/ml,24 cases).Clinical symptom,main laboratory and imaging results of children among three groups were compared.Results When compared with low MP load group and moderate MP load group,high MP load group had longer fever duration [(7.4 ± 2.6),(10.0 ± 2.4) d vs.(12.4 ± 2.7) d],longer time to normalization of temperature with macrolide administration [(4.2 ± 1.0),(8.5 ± 2.4) d vs.(10.8 ± 4.4) d],more patients with high fever,there was significant difference (P ＜ 0.05).Statistically significant difference existed in C-reactive protein among three groups [(3.0 ± 1.4),(11.5 ±7.6),(34.0 ± 10.1) mg/L] (P =0.004).Large field of consolidation or atelectasis were found in 58.3％ (14/24) of high MP load group,much higher than 22.7％ (5/22) in moderate MP load group and 14.3％ (3/21) in low MP load group.Bilateral or massive pleural effusion was not found in low MP load group,while in moderate MP load and high MP load group,they were 13.6 ％ (3/22) and 25.0％ (6/24)(P =0.033).Conclusions There is a close relationship between MP load in BALF and clinical characteristics in children with MP pneumonia.Those with high MP load have a more severe process.