Objective To investigate the incidence and clinical significance of “no flow” (NF) phenomena after primary percutaneous coronary intervention (PCI) in the treatment of acute myocardial infarction (AMI). Methods ninety nine consecutive AMI patients underwent primary PCI were devided into NF group (18 cases) and non NF group (81 cases). The incidence of NF, clinical characteristics, blush grade, ST T segment elevation, peak CPK, left ventricular function and cardiac events were analysed. Results Eighteen patients demonstated NF, the incidence of NF was 18.2%. Compared with non NF, previous MI、diabetes、anterior MI and multivessel disease were more frequently observed in the cases with NF ( P 0.05). Conclusions The incidence NF after primary PCI in the treatment of AMI is 18.2%. The patients with NF show malperfusion in the myocardial microcirculation, larger infarct size, ventricular dysfunction and poor prognosis.

Objective: To investigate the diagnosis and treatment effect of early inflammatory bowel obstruction after operation. Methods: The clinical data of 20 patients with early inflammatory bowel obstruction were analyzed.The therapeutic effect was analyzed. Results: 20 patients were treated with significant improvement in abdominal pain and abdominal distention, and gastrointestinal decompression volume was (221.6±138.6)mL/d.Patients with abdominal flat tablet showed that the intestinal canal was significantly reduced or disappeared, and all patients were cured and discharged. Conclusion For the patients with early inflammatory intestinal obstruction after operation, we should pay close attention to the clinical response of patients, adopt comprehensive treatment to relieve patients' pain.

Objective To evaluate the emergency treatment strategy of acute intestinal obstruction induced by left colorectal cancer.Methods 50 patients with acute intestinal obstruction caused by left colorectal cancer were selected as the research subjects .The clinical data were retrospectively analyzed .Results Of 50 patients,6 cases of postoperative incision infection occurred in phase I excision anastomosis surgery ,no anastomotic fistula.21 cases received ileus tube decompression and phase I excision anastomosis of incision ,there were no postoperative complica-tions.50 patients recovered after surgery , no patients died in the follow-up.Conclusion For acute intestinal obstruction caused by left half colon cancer ,the method ofⅠ resection and heal surgery is the most safe ,and can be used as the preferred way to make a diagnosis and treatment ,but for patients can't tolerance emergency surgery,need the help of colonoscopy,through anal insertion catheter colon decompression and lavage and clean the dirt .

This paper was designed to investigate the effect of laminar shear stress on matrix metalloproteinase -9 (MMP-9) expression in rat bone marrow-derived mesenchymal stem cells (MSCs), and the possible signal transduction mechanism involved. Rat bone marrow MSCs were isolated and cultured, then, exposed to laminar shear stress at indicated strengths such as low (5dyne/cm2), medium (15 dyne/cm2) and high (30 dyne/cm2) via parallel plate flow chamber. RT-PCR was used to analyze the expression of MMP-9. The signaling inhibitors such as Wortmannin (PI3K specific inhabitor), SB202190 (p38MAPK specific inhabitor), and PD98059 (ERK1/2 specific inhabitor) were used to investigate the possible mechanical signal transduction pathway. The results showed: (1) The expression of MMP-9 was weak in static state, however, MMP-9 expression increased when MSCs were exposed to 15 dyne/cm2 shear stress for 2 hours, and MMP-9 expression increased with the extension of stimulating time, and it reached the peak at 24 h; (2) MSCs were stimulated by shear stress for 2 hours at different strengths (5 dyne/cm2, 15 dyne/cm2, 30 dyne/cm2), and under all these conditions, the expression of MMP-9 increased, and reached the peak at 15 dyne/cm2; (3) After MSCs were pretreated by three kinds of signal pathway inhibitors, the expression of MMP-9 did not change obviously in Wortmannin group and PD98059 group, but it was significantly inhibited in SB202190 group. This study demonstrated that shear stress could induce the expression of MMP-9 in rat bone marrow-derived mesenchymal stem cells; the amount of MMP-9 expression was closely related to stimulating time and the strengths of shear stress; and p38MAPK signal pathway played a critical role during the process.
Animals ; Bone Marrow Cells ; cytology ; metabolism ; Cells, Cultured ; Matrix Metalloproteinase 9 ; genetics ; metabolism ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Rats ; Signal Transduction ; Stress, Mechanical

Objective To compare the clinical efficacy and safety of second -stage and one -stage extra-dissection and loose seton operation in the treatment of complex anal fistula complicated with abscess . Methods From May 2015 to December 2016 ,100 patients with complex anal fistula complicated with abscess were chosen in the First People's Hospital of Wuyi County .The patients were randomly divided into two groups , with 50 patients in each group .The control group received second -stage extra-dissection and loose seton operation ,and the observation group received one -stage extra-dissection and loose seton operation .The clinical effects ,operation time,wound healing time , hospital stay and the incidence of complications after operation of the two groups were compared.Results The total effective rates of the control group and the observation group were 94.00％,96.00％, respectively,there was no statistically significant difference between the two groups (χ2 =8.78,P >0.05).The operation time,wound healing time and hospital stay of the observation group were shorter than those of the control group,and the differences were statistically significant (t=3.72,2.96,3.40,all P<0.05).The incidence rates of urinary retention,bleeding and wound infection after operation of the control group were 2.00％,4.00％,6.00％, respectively,which of the observation group were 4.00％,2.00％,8.00％,respectively,there were no statistically significant differences between the two groups (χ2 =1.04,0.79,1.13,all P>0.05).Conclusion Second-stage and one-stage extra-dissection and loose seton operation in the treatment of complex anal fistula complicated with abscess has the same clinical effects and safety;but one -stage extra -dissection and loose seton operation can efficiently shorten the operation time and speed up the postoperative rehabilitation .

To summarize the nursing experience of 5 patients with severe ARDS complicated with hypercapnia who underwent extracorporeal carbon dioxide removal(ECCO2R).Key points of nursing care included:establishing a rapid emergency response nursing team for ECCO2R;PETCO2 real-time monitoring to grasp the timing of the machine;ensuring continuity of treatment and improving the removal efficiency;respiratory-related monitoring;prevention of complications of blood coagulation and hypothermia;and weaning from extracorporeal carbon dioxide removal.After careful treatment and care,all the 5 patients were successfully removed from ECCO2R treatment.

【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P< 0.05), and there was no significant difference in all above basic platelet parameters and other TEG parameters (P>0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.