ObjectiveTo observe the effects of anti-neurohormone drugs on ventricular remodelling and the plasma concentrations of neurohormone of patients with different grade heart function after myocardial infarction.MethodsAccording to ejection fraction of patients,103 consective patients with myocardial infarction were divided into two groups:normal heart function group:ejection fraction ranged from 50% to 70%.Abnormal heart function group:ejection fraction was less than 50%.All patients were given the same beta-receptor blocking agent and angiotensin-converting enzyme inhibitor and then were followed up 6 months.Heart function and the plasma concentrations of neurohormone were compared before and after anti-neurohormone drugs were given;at the same time,changes of heart function and the plasma concentrations of neurohormone were compared in statistical aspect between two groups.ResultsThe improvement of heart function and change of the plasma concentrations of neurohormone were significantly different in statistics before and after drugs were used.Besides,the patients with different grade heart function had significantly different changes of heart function and plasma concentrations of neurohormone.ConclusionAnti-neurohormone drugs can significantly reduce the level of the plasma neurohormone,improve heart function and inhibit heart remodeling.What’s more,there are better treatment effects in patients with heart failure.

Objective: To study the relationship between different patterns of invasion and extracapsular spread in lymph node metastasis from squamous cell carcinoma of tongue. Methods: Pattern of invasion described by Anneroth was used to evaluate the malignance grade of tongue cancer and immunohistochemical and HE staining were used to detect the extracapsular spread in successive cases of tongue cancer with radical neck dissection. Results: Lymph node metastasis was observed in 0/5 of the cases with pattern I invasion,3/8 pattern II,5/6 pattern III and 1/1 pattern Ⅳ. Extracapsular spread occurred as totally or partly replacement of the lymph node by the tumourcells. The tumour cells infiltrated between lymph nodes, perinodal fibroadipose tissue or sternocleidmastoid muscle in the form of cell cluster or isolated cell. Conclusion: Pattern of invasion is a significant factor for evaluating the malignance grading of tongue cancer. Radical neck dissection should be used to treat the tongue cancer with pattern III or IV invasion.

The Scientific Development Concept provides significant guidance for the discipline construction.This thesis discusses how to embody the scientific development concept in accelerating the all-round construction of disciplines in our unit from the aspects of general target,approaches and talents cultivation.

Objective To evaluate the follow-up diagnostic value of 3 T magnetic resonance angiography (MRA) after intracranial aneurysm coil embolization.Methods The databases such as PubMed,EMbase,Cochrane Library,CBM,CNKI and VIP were retrieved.According to the inclusion criteria of diagnostic tests,the diagnostic tests of the follow-up diagnostic value about MRA were screened after intracranial aneurysm coil embolization.The methodological quality included in the studies was evaluated using QUADAS items and the meta-analysis was conducted using Meta-Disc 1.4 software.The receiver operating characteristic curve was drawn and the area under the curve was calculated.The residual sensitivity and specificity diagnosed by MRA after intracranial aneurysm embolization were evaluated.Results A total of 6 studies were included,including 253 patients.The pooled sensitivity and specificity in 3 T MRA diagnosing residual intracranial aneurysms were 0.915 (95％ confidence interval [ CI]0.850 - 0.959) and 0.847 (95％ CI 0.787 - 0.896) respectively.The area under the receiver operating characteristic curve was 0.951,Q =0.892.Conclusions 3 T TOF MRA can be used as an effective and feasible imaging follow-up method after embolization of intracranial aneurysms,however,because of the methodological limitations,the high-quality research is needed to further validate the application value of the MRA during follow-up after intracranial aneurysm embolization.

Objective To investigate the clinical value of inflammation-related factors [white blood cell count,erythrocyte sedimentation rate (ESR),and C-reactive protein] in predicting delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Methods The aneurysmal subarachnoid hemorrhage in 217 cases according to whether the occurrence of delayed cerebral ischemia were divided into 2 groups:delayed cerebral ischemia (DCI) group (n =69) and non DCI group (n =148).A retrospective analysis of 217 cases of patients was performed with inflammation-related factors,and its relationship with clinical prognosis of patients with DCI was also analyzed.Results The inflammation-related factors (WBC count,erythrocyte sedimentation rate,and C-reactive protein) in DCI group were significantly higher than those in non DCI group with a statistically significant difference (P ＜ 0.05).The follow-up results showed that there were 33 patients died,12 cases of plant survival,and 12 patients with severe disability in DCI group,which had a statistically significant difference relative to non DCI group (P ＜ 0.05).Spearman analysis showed that there was a significantly negative relationship between inflammation-related factors (white blood cell count,ESR,C-reactive protein) and glasgow prognostic score (GOS) in DCI group(r =-0.877,-0.683,-0.841,P ＜0.05).Conclusions The inflammation-related factors can be used as one of method to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Objective To explore the factors which could lead to a preoperative diagnosis and to guide the management of cholecystoduodenal fistula (CDF).Method The experience on the diagnosis and treatment of 22 patients with CDF were retrospectively studied.These patients came from 1242 patients who received biliary tract operation in our hospital from 2001 to 2012.Results 64％ (14 of 22 patients) had 3 out of 5 of the following symptoms/signs:(1) symptoms of recurrent chills and fever,with no or only mild jaundice; (2) significant atrophy or disappearance of gallbladder on computed tomography (CT) ; (3) CT revealed complex anatomy in right upper abdomen with dilated loops of bowel; (4) ultrasound or CT revealed pneumobilia or pneumo-gallbladder; (5) barium study or duodenal endoscopy revealed obvious deformation in duodenal bulb or abnormal opening.There was no perioperative death.Morbidities included biliary fistula which presented on postoperative day 6 and day 7 in 2 patients,respectively.The daily volume of bile drainage was about 500 ml,and the biliary fistula healed after a month of conservative treatment.In addition,there were 6 patients who had infected wound,8 patients with right pleural effusion,and 8 patients with residual calculi.There was no intestinal fistula or biliary stricture.Conclusions Careful preoperative history taking and CT/uhrasound studies significantly improved the diagnostic rate of CDF.Individualized treatment reduced complications and improved clinical results.

ObjectiveTo investigate the efficiency of autologous transplantation of peripheral blood stem cells for treatment of patients with diabetic lower limb ischemia.MethodsEighteen patients of type 2 diabetes with diabetic lower limb ischemia (30 legs) were treated by autologous transplantation of peripheral blood stem cells.ResultsThe limb pain, cool feeling and numbness feeling improved significantly after PBSC transplantation,the improvement rate were 96.7％, 100.0％ and 95.8％ respectively.Intermittent claudication was also relieved significantly, total remission rate was 76.9％.The ABI and TcPO2 of patients increased significantly at 3 months after transplantation.After the transplantation ABI raised from 0.60 ± 0.11 to 0.71 ±0.12(t =-6.882, P ＜ 0.01) .93.3％ of patients' TcPO2 raised in different degrees.The foot infections were well controlled.Ulcer or toes gangrene got better or healed.No obvious complications or adverse reaction were observed after the transplantation.ConclusionAutologous transplantation of peripheral blood stem cells shows to be a simple, safe and effective method in treating patients with diabetic lower limb ischemia.

Objective To investigate the autophagy and apoptosis in acute myelogenous leukemia U937 cell induced by Sirolimus.Methods U937 cells were subcultured, and blank control group(normal) and Sirolimus treated groups(12 h, 24 h,48 h) were established.The Sirolimus treated groups were treated by 2 μmol/L concentration of Sirolimus for 12 h,24 h and 48 h, respectively.The cell morphology of U937 cells treated by Sirolimus was observed after 12 h,24 h and 48 h.The survival rate of cells was detected by cell counting kit-8 method.Cell apoptosis was detected by flow cytometry using Annexin V-FITC/PI double labeled.Real-time PCR was used to detect the level of mRNA expression in autophagy specific protein maker mictotubule-associated protein light chain 3 (LC3)-Ⅱ in different treated times by Sirolimus.Sirolimus LC3 protein expression levels after treatment were detected by Western blot method.Results Under inverted microscope, the cell number of Sirolimus treatment group reduced gradually after 12 h ,24 h and 48 h culture, volume of cells became smaller, cells got ruptured, and the nucleus pycnosis and cellular debris increased.With the extension of time, U937 cells survival rate was falling, and there was statistical differences compared with those of the control group(P =0.031).With Sirolimus treatment, U937 cells after 12 h,24 h and 48 h, U937 cell apoptosis rate increased, and there were statistically significances, compared with those of the control group (P =0.027).With Sirolimus treatment U937 cells after 12 h,24 h and 48 h,LC3-Ⅱ mRNA expression and protein expression were down-regulated compared with those of the control group, and there were statistically significances (P =0.029).Conclusions Sirolimus can induce autophagy and apoptosis in U937 cells.Autophagy protein LC3-Ⅱ in gene and protein expression levels were lowered, and LC3-Ⅱ may play an important role in regulating the leukemia cell autophagy.

BACKGROUND:Many studies concern the comparison of micro-titanium plate fixation and suture suspension fixation during cervical posterior expansive open-door laminoplasty, but the sample size of many studies has limitations. There is lack of objective evaluation on advantages and disadvantages of micro-titanium plate.
OBJECTIVE:To systemicaly evaluate the efficacy and safety of micro-titanium plate fixationversus suture suspension fixation in cervical posterior expansive open-door laminoplasty.
METHODS: English and Chinese randomized controled trials were searched by two reviewers. They retrieved the Cochrane Central Register of Controled Trials (CENTRAL), PubMed, EMbase, the ISI Web of Knowledge Database, CNKI, CMB, VIP and Wanfang database for randomized controled trials addressing micro-titanium plate fixationversus suture suspension fixation in cervical posterior expansive open-door laminoplasty published from database foundation to March 1, 2015. The references were also searched by hand. Meta-analyses were performed by using the Rev-Man 5.3 software, provided by the Cochrane Colaboration.
RESULTS AND CONCLUSION: A total of 9 studies involving 642 patients were included. The results of meta-analyses showed that: (1) safety: There were no significant differences between the two groups in operation time [SMD=-0.02, 95%CI (-0.57, 0.54),P=0.95 > 0.05], and intraoperative blood loss [SMD=0.07, 95%CI (-0.26, 0.40),P=0.69 > 0.05]. (2) Efficacy: compared with suture suspension fixation, Japanese Orthopaedic Association Scores were higher [SMD=0.26, 95%CI (0.10, 0.42),P=0.001 < 0.05], the angle of the opened laminae was bigger [SMD=0.25, 95%CI (0.02, 0.48),P=0.04 < 0.05], cervical curvature was better [SMD=0.46, 95%CI (0.27, 0.65),P < 0.000 01], and incidence of axial symptoms was lower [RR=0.40, 95%CI(0.29, 0.56),P< 0.000 01] after micro-titanium plate fixation. These findings suggest that during expansive open-door laminoplasty for treatment of cervical spondylosis, micro-titanium plate fixation and suture suspension fixation can obtain good clinical outcomes. However, Japanese Orthopaedic Association Scores were higher and the angle of the opened laminae was better in micro-titanium plate fixation than in suture suspension fixation. Micro-titanium plate fixation could effectively prevent loss of cervical curvature and reduce the incidence of axial symptoms. For the poor quality of the original studies and smal sample size, a prudent choice is suggested. More high-quality large-sample studies are needed for further verification.

Objective To investigate the difficulty, safety and clinical efficacy of the pterional approach from the side of open A2 plane vs the approach from the side of closed A2 plane for anterosuperior-pointing anterior communicat?ing artery aneurysms (ACoAA). Methods Forty-two patients with anterosuperior-pointing ACoAA treated by microsurgi?cal clipping were divided into two groups of the approach from the side of open A2 plane (n=22) and the approach from the side of closed A2 plane (n=20). Primary objective endpoints were rates of gyrus rectus aspiration, displacement of the ipsilateral A2 and surgical-related complications, clipping results, incidence of cognitive function impairment and Glasgow Outcome Scale (GOS) at 6 months after treatment. Results The incidence of gyrus rectus aspiration and dis?placement of the ipsilateral A2, cognitive impairment at 6 months after treatment and the surgical-related complications was also significant lower in the approach from the side of open A2 plane than in the approach from the side of closed A2 plane [4(18.2%) cases vs. 11(55.0%) cases, χ2=6.185, P<0.05;4(18.2%) cases vs. 10(50.0%) cases, χ2=4.773, P<0.05;1 (4.5%) case vs. 7(35.0%) cases, χ2=4.481 P<0.05]. There were no significant differences in postoperative clipping results and GOS at 6 months after treatment between two approaches (P>0.05). Conclusions The pterional approach from the side of open A2 plane in patients with anterosuperior-pointing ACoAA allows the aneurysmal necks to be secured safely, decreases operation difficulty and prevents surgical-related complications.