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 investigate the diagnosis and treatment of hepatolithiasis complicated by bronchobiliary fistula.Method The data of 35 patients with hepatolithiasis and bronchobiliary fistula treated in our department in the last 10 years were retrospectively studied.Results The operations were:-repair of fistula in the diaphragm (n=35),hepatic segmentectomy (n=22) biliary stricturoplasty (n=13),T-tube drainage of common bile duct (n=19),hepaticojejunostomy (n=3) and bilateral hepatojejunostomy with a Roux-en-Y loop of jejunum (n=13).Residual stones were left in 4 patients.There was no recurrence of the bronchobiliary fistula on follow-up.Conclusions Expectoration of bitter and purulent yellow sputum was an important clinical feature of bronchobiliary fistula.The key steps in a successful operation were reliefing the obstructed bile duct and re-establishment of adequate biliary drainage.

OBJECTIVE Apolyclonalantibody-basedhomogeneouschemiluminescenceimmunoas-say was developed and optimized using AlphaLISA technology for the quantitative detection of microcys-tin-LR(MC-LR)inwatersamples.METHODS Thismethodwasbasedonacompetitivemodelin which an immune complex was formed from the ingegral binding of artificial MC-LR antigen-coated lumi-nescene beads,free MC-LR standards or sa mples,antibody and biotinylated second antibody.Next sensor bead were added that approached the i mmune co mplex through biotin-streptavidin interaction. With the exciting light,the energy was passed from the sensor luminescer before a special emission light could be observed.To opti mize the reaction conditions,working dilutions of polyclonal antibody and bioti-nylated second antibody were assayed while the effect of buffer syste ms and ti me of each reaction were evaluated.RESULTS Maininfluencingfactorsoftheassaywerediscussedasworkingdilutionsofpoly-clonal antibody and biotinylated goat anti rabbit IgG,assay buffer and reacting ti me.After opti mization of reaction conditions,MC-LR AlphaLISA could be finished in 40 min,with a sensitivity of 0.006 μg·L-1 and a dynamic range of 0.006 -5 μg·L-1 .The coefficient of variation was below 10% and average recovery was 1 07.7%.Moreover,the cross reactivity rates of MC-RR and MC-RY to MC-LR were 13.2%and0.91%,respectively.CONCLUSION Thismethodishighlysensitiveandspecific,time-saving and quite suitable for high throughput determination of MC-LR water samples.

Objective To explore the reasons,diagnosis and treatment of residual cholecystitis(RCC) with gallstones. Methods The clinical data of 36 RCC patients with gallstones identified by operation were retrospectively analyzed. Results All the 36 patients were cured by reoperation. Residual cholecystectomy was performed on 8 patients, and residual cholecystecomy plus common bile duct exploration and T tube drainage on 28 patients. Thirty one patients were followed up for 3 months to 12 years,93.55% of the patients had good results. Conclusions The main reason of residual cholecystitis with gallstones was not followed the principle of "identify cut identify" during cholecystectomy .The clinical presentation of RCC is similar to that of cholecystitis with gallstones .The accurate rate of auxiliary examinations is low,so the results of these exammations should be analyzed comprehensivly in the diagnosis. The principle of "identify cut identify" should be followed during the reoperation. The common bile duct and common hepatic duct should be opened first and then the residual gall be resected.