Objective To explore the effects of nicorandil on cardiac function and clinical outcomes in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Method Sixty-six patients with AMI were randomized into a control group and nicorandil group (n = 33 for each group). In the nicorandil group, nicorandil (4 mg as a bolus injection followed by constant infusion at 8 mg/hour for 24 hours) was administered immediately after admission. Reactive oxygen species (ROS) formation was assessed by measuring urinary excretion of 8-epi-prostaglandin F2α (PGF2α) and compared between the two groups; cardiac function and cardiac events were also compared. Results Urinary 8-epi-PGF2αexcretion was increased 2-fold at 60 to 90 minutes after PCI in the control group, whereas it was unchanged in the nicorandil group (P < 0.001). Left ventricular ejection fraction and cardiac index immediately after PCI and at 6 months were greater in the nicorandil group than in the control group(P < 0.05). Rates of total inhospital cardiac events and rehospitalization were lower in the nicorandil group than in the control group (P<0.05). Conclusions Nicorandil improves cardiac function and clinical outcomes in patients with AMI undergoing primary percutaneous coronary intervention. Suppression of ROS formation may be involved in the potential mechanism.

This study was aimed to establish the classification method of Chinese herbal medicine based on feature parameters extracted from images of herbal transverse section, in order to explore the feasibility of automatic identi-fication method of herbal medicine. The extracted 26 parameters of 18 herbal medicine images by gray-level co-oc-currence matrix and grayscale gradient matrix were used as the basic data set. And the minimum covariance determi-nant (MCD) was used to delete the outliers. A total of 18 identification models were established using the native Bayes method and BP neural network methods. The results showed that the average correct rates of models were 90%. It was concluded the feasibility of using these models in the establishment of the automatic identification method of herbal medicines. It provided new technologies for the quantitative, scientific and objective identification of Chinese herbal medicine.

Objective To evaluate the safety and efficacy of direct celiac ganglion irradiation with 125I seeds for pain relief secondary to advanced pancreatic carcinoma (PC).Methods This study enrolled 23 consecutive patients who had moderate to severe pain resulting from advanced PC.All patients underwent EUS-guided direct celiac ganglion irradiation with 125I seeds.Follow-up was conducted at least once weekly until death.Blood parameters,Visual Analog Scale (VAS) score,mean analgesic consumption,and complications were evaluated during follow-up.Results All patients successfully underwent implantation at one attempt.The mean number of seeds implanted in the celiac ganglion per patient was 4 (range 2-6).Immediately after the procedure,pain relief and analgesic consumption showed no significant changes compared with preoperative values.Six patients (26％) reported pain exacerbation.Two weeks later,the VAS score and mean analgesic consumption were significantly less than preoperative values.No procedure-related deaths or major complications occurred.Conclusion EUS-guided direct celiac ganglion irradiation with 125I seeds can reduce the VAS score and analgesic drug consumption in patients with unresectable PC.

Objective To assess the safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)of pancreatic lesions.Methods Patients who underwent EUS-FNA of a pancreatic lesion between January 2005 and June 2007were studied retrospectively.Possible risk factors were assessed by using logistic analysis.Results In 119 patients who underwent pancreatic EUS-FNA,mild acute pancreatitis were observed in 1(0.84%)patient after the operation.No complication occurred in 12 patients with regional portal vein hypertension.Nine patients(7.6%)showed hyperamylasemia 3 h after the procedure,rangeing from 197 to 835 U/L,with an average of(327±200)U/L.Blood amylase level kept increasing 24 h postoperatively in 6 cases of the 9.Logistic regression analysis showed past history of acute pancreatitis,gender,needle size,number of puncture,cystic foci,preoperative blood amylase level and location of foci would not possibly be the risk factors of hyperamylasemia.Conclusion Incidence of complications after EUS-FNA is 0.84%,and the occurrence rate of hyperamylasemia is 7.6%,indicating,EUS-FNA is a safe procedure.

Objective To investigate the effect of depression-relieving and mind-tranquilizing acupuncture on behaviors and hippocampal neurotransmitters in rats with post-strike depression.Method Rats were randomized to normal, model, medication and acupuncture groups, 20 ratseach. A rat model of post-strike depression was made by middle cerebral artery occlusion and chronic unpredictable mild stress. The medication received an oral gavage of fluoxetine 2 mg/kg and the acupuncture group, acupuncture at points Baihui(GV20), Fengfu(GV6), Shenmen(HT7) and Taichong(LR3), 20 min retention of needles with one manipulation meanwhile, once daily, 7 days as one course of treatment, for a total of three courses with one day of rest between. Rat behaviors were observed and hippocampal neurotransmitters 5-hydroxytryptamine (5-HT), nonepinephrine (NE), acetylcholine (Ach),γ-aminobutyric acid (γ-GABA) and glutamic acid (Glu) were measured.Result The Zea Longa score was lower in the acupuncture group than in the model and medication groups at 15 and 22 days after intervention (P<0.01,P<0.05). Sugar water consumption increased in the acupuncture group compared with the model and medication groups at 7, 15 and 22 days after intervention (P<0.01). Sugar water consumption, open-box horizontal movement and vertical movement increasedin the medication and acupuncture groups at 7, 15 and 22 days after intervention compare with before intervention (P<0.01,P<0.05). Hippocampal 5-HT, NE, Ach,γ-GABA and Glu contents were significantly lower in the model group of rats than in the normal group (P<0.01) and were significantly higher in the acupuncture group of rats than in the model group (P<0.01,P<0.05).Conclusion Depression-relieving and mind-tranquilizing acupuncture can markedly improve behaviors in rats with post-strike depression. Its mechanism may be related to regulating rat neurotransmitters 5-HT, NE, Ach,γ-GABA and Glu expressions.

Objective To evaluate the influence of brachytherapy with 125Ⅰ seeds on celiac ganglia in porcine models. Methods Twelve pigs were randomly assigned into 3 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A (n = 4), 0.4 mCi seeds in Group B (n = 4) and 0.8 mCi seeds in Group C (n = 4), respectively. Prophylactic antibiotics were administered postoperatively. Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds. The animals were sacrificed 14 days and 60 days after the procedure, and TUNEL assay was employed to study neuron apoptosis in ediac ganglia. Results The procedure was succossfully performed in,10 pigs(83.3%)and failed in two others. The rescue procedure was performed on the day after and succeeded in both pigs. Apoptosis of neurons significantly increased in brachytherapy groups than in the control group and it was positively correlated with dose and time of radiation. Conclusion Brachytherapy can cause apoptosis of neurons of celiac ganglion, which could be the basis of its clinical application.

ObjectiveTo assess the safety of celiac plexus brachytherapy with 125Ⅰseeds placementguided by endoscopic ultrasound in porcine model, and to evaluate its effect on surrounding vessels and organs.MethodsFourteen pigs were randomly divided into 4 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A (n=4),0.4 mCi seeds in Group B (n=4),0.8 mCi seeds in Group C (n=4) and one lateral injection with 5 ml dehydrated alcohol,respectively.Abdominal X-ray,Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds in group A,B and C.Routine blood test,liver and renal function,serum amylase and CD4+/CD8+ratio were examined preoperatively and at the end of the follow-up in all groups.Animals were euthanized in batch to observe the position of the implanted seeds.Tissues and organs around the seeds were dissected for pathological examination.ResultsThe procedure succeeded in 12 pigs (85.7%)and failed in two others (1 in group A,and 1 in C) due to inappropriate position.Rescue procedures were performed on another day and succeeded.No significant difference was found in routine blood test,liver and renal func-tion,serum amylase and CD4+/CD8+ratio,except WBC elevation and small abcesses were found 7 days after the procedure in one pig of group C.In the radiated area, there was degeneration,necrosis and mild in-flammation at the outer membrane of blood vessels,with fibrosis around,which was positively correlated with the radiation dosage and duration.There was no change at the muscular layer and the innermost membrane of blood vessels,and no thrombosis was found.In group D,the celiac trunk became slightly brown and wider with obvious hemorrhage,necrosis and infiltration of inflammatory cells in the outer membrane of blood vessles and connective tissues around.ConclusionBrachytherapy has little negative effect on the organs a-round. It does not harm immunnity but induces lesions in blood vessels. Compared with dehydrated alcohol,this negative effect is limited.Therefore,celiac plexus brachytherapy with125Ⅰseeds guided by endoscopic ultrasound is safe.

Objective To evaluate the efficacy and salty of endoscopic ultrasonography-guided celiac plexus neurolysis (EUS-CPN) in the treatment of pain due to pancreatic cancer and celiac metastatic carcinoma.Methods Thirty-three patients with celiac carcinoma were selected for EUS-CPN. Among whom 15 pateints were received chemotherapy before procedure . Using endoscopic ultrasounography,transgastric injection of the celiac plexus with bupivacaine and 98% dehydrated absolute alcohol was accomplished.The abdominal pain was evaluated by the numeric pain intensity scale before and at 24,48,72 hours and one week after the precedure.The successful rate of precedure,the complication and the relief of the pain were observed. Results All procedures were performed successfully . No serious complications such as pancreatitis by trauma,pancreatic fistula,bleeding and celiac infection was found.Compared with baseline,pain was significantly relieved at 12,24,72 hours and 1 week after EUS-CPN (100%,98%,90% and 88%,respectively).The pain remission at 24,48,72 hours and one week in patients who received chemotherapy before procedure were 100%,100%,980% and 98%,respectively,while in those who had not treated chemically were 100%,98%,95% and 90%,respectively.The complete%relief of pain in chemotherapy group was significantly higher than that in nonchemotherapy group (75 % vs 56 %,P%0.05).Conclusions EUS CPN is a safe and effective method for relieving pain with low complications.It can raise the quality life of the patients and chemical therapy may be helpful in pain control.

Objective To evaluate the diagnostic accuracy of contrast-enhanced harmonic EUS (CH-EUS)for pancreatic cancer.Methods Patients with pancreatic occupying lesion underwent CH-EUS with ultrasonic contrast medium Sonovue.Pathological diagnoses by EUS-FNA or surgery and the follow-up results were made as the final diagnosis to evaluate the accuracy of CH-EUS for pancreatic cancer.Character-istics of CH-EUS in different pancreatic tumors were analysed.Results A total of 76 patients were en-rolled,with an average age of 53. 1 ±14. 2.Thirty-five were finally diagnosed as having pancreatic cancer, 21 local mass-type pancreatitis,10 pancreatic neuroendocrine tumor,6 cystadenoma,4 intraductal papillary mucinous neoplasm.Tumor diameter was 3. 4 ±1. 4 cm and there were 18 less than 2 cm.The sensitivity and specificity,positive and negative predictive value of CH-EUS for pancreatic cancer was 97. 1%, 92. 9%,91. 7% and 97. 5% respectively.The sensitivity was 100% combined with FNA.Conclusion CH-EUS is safe,convenient for pancreatic cancer with high accuracy and can be used as an additional diag-nostic method to EUS-FNA.

Objective To evaluate technical efficacy,feasibility and safety of a fully covered self-expanding metal stent for EUS-guided transgastric pancreatic pseudocyst drainage. Methods Data of a total of 11 patients who received EUS-guided transgastric pancreatic pseudocyst drainage with a covered self-ex-panding metal stent at Changhai Hospital from September 2013 to May 2014 were retrospectively studied. The manipulative success rates,curative success rates and complication rates were evaluated. Results All 11 patients were treated by EUS-guided transgastric pancreatic pseudocyst drainage with fully covered self-ex-panding metal stents successfully,with success rate of 100%. Two patients developed infection and displace-ment occurred in 1 patient. There was no hemorrhage,perforation or death. Stents were removed in 7 pa-tients and the pseudocysts vanished. Conclusion Endosonography-guided transgastric pancreatic pseudocyst drainage using a fully covered self-expanding metal stent can be accomplished with high technical and clinical success rate and low rate of complications.