Objective: This paper focuses on the most commonly used Guiding Catheter and conduct study on material selection, push force, torque and twist controllability. Methods:In contrast to the method used in our clinical surgery three foreign manufacturers of medical guidelines for catheter materials, testing foreign manufacturers’ products. Conclusions analyzing t foreign products their own characteristics, provide the technical basis for better medical research and clinical guidelines for catheter performance. Results: Three foreign guiding catheter manufacturers selected the same materials, after testing, the guiding catheter has the best maximum pushing force, can quickly reach the site of disease. Conclusion: The guiding catheter has the best torque control, can better use in distorted vessel;the guiding catheter has the best twist controllability, can deal with complex vascular anatomy.

BACKGROUND: During plasty of breast, innervation in nipple and areola of breast should be comprehended particularly in order to avoid sensory and motor disorder induced by nerve injury. OBJECTIVE: To observe the courser and distribution of nerve in nipple and areola of breast and provide anatomic data for plasty of breast. DESIGN: Single sampling study. SETTING: Department of Human Anatomy, Medical College of Qingdao University; Department of Pathology, Affiliated Hospital of Medical College of Qingdao University. PARTICIPANTS: The experiment was carried out in the Department of Human Anatomy, Medical College of Qingdao University and Department of Pathology, Affiliated Hospital of Medical College of Qingdao University from September 1999 to April 2001. Sixteen breasts of 8 adult female corpses aged 20-40 years and 10 breasts (5 right and 5 left) of 10 adult females with cancer of the breast aged 43-58 years were selected in this study. All patients or relations were consent. METHODS: ① Breast samples of 16 adult female corpses were scanned layers by layers with stereo anatomic micro scope to chase courser and distribution of nerve in subcutaneous fascia of mammary cancer. ② Ten fresh breast sam pies were frozen, cut into sections and stained with haematine-eosin. The typical transects were selected to observe dis tributed density of nerve fiber in 4 quadrants at various layers with stereology. MAIN OUTCOME MEASURES: ① Innervation in nipple and areola of breast,, ② numbers of nerve fiber of the same sample in various transects. RESULTS: ① Nerve which was distributed in nipple and areola of breast was derived from the lateral cutaneous branch and anterior cutaneous branch of the 3rd, 4th and 5th intercostal nerves and deep branch of mammary cancer. ② The lat eral cutaneous branch of the 4th intercostal nerves went into nipple and areola of breast with the directions like 4 o'clock in the left and 8 o'clock in the right, and nerves dominated nipple were derived from the lateral cutaneous branch of the 4th intercostal nerves. ③ Numbers of nerve fiber in extra-inferior quadrant of nipple and areola of breast were more than those in intra-superior, intra-inferior and extra-superior quadrants (8.06±0.18, 4.63±0.14, 4.43±0.16, 2.13±0.11, P ＜ 0.01). ④ Density of innervation in nipple and areola of breast was decreased centripetally. CONCLUSION: Operation of chest, especially plasty of breast, had better not damage lateral cutaneous branch and ante rior cutaneous branch of the 3rd, 4th and 5th intercostal nerves. Extraordinarily, the lateral cutaneous branch of the 4th inter costal nerves and nerve in extra-inferior quadrant of nipple and areola of breast should be protected carefully in order to avoid sensory disorder.

Objective To investigate papillary muscle function and construction in myocardial infarction(MI) patients by two-dimensional speckles tracking imaging(2D-STI),and to analyze the influence factors of ischemic mitral regurgitation.Methods Fifty myocardial infarction with ischemic mitral regurgitation(IMR) patients were brought into case group.The patients were divided into two groups:Ant MI group and Inf-Pos-MI group.Forty-five health volunteers were involved as control group.Anterior,posterior papillary muscle longitudinal strain (ALS,PLS),delay time(DT),fractional shortening (FS),length between the posterior or anterior papillary muscle tips and the contralateral anterior mitral annualr (APM AMA,PPM AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD) were aquired respectively.Papillary muscle function and construction among the groups were compared,and the effective factors of IMR were evaluated.Results Between the control group and Ant-MI group,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic and end-systolic volume(LVEDV,LVESV),left ventricular ejection fraction(LVEF),ALS,delay time(DT),A FS,IPMD,MLC,APM-AMA,PPM-AMA were significantly different(all P ＜0.05).Between the control group and Inf-Pos-MI group the LVEDD,LVEDV,LVESV,EF,DT,PPM-AMA,MLC,PLS,P-FS were significantly different(P ＜0.05).Between the Ant-MI group and Inf-Pos-MI group,the LVEDD,LVEDV,LVESV,EF,MLC,ALS,PPM-AMA,PLS were significantly different (all P ＜ 0.05).In the Ant-MI group,LVEDV,ALS,MLC were significantly correated with Gensini score(r =0.71,-0.65,0.56;P ＜0.05).In the Inf-Pos-MI group,PPM AMA,PLS were significantly correated with Gensini score(r =0.65,-0.76;P ＜0.05).In the Ant MI group and Inf-Pos-MI group,the ALS,PLS,PPM-AMA were significantly different (P ＜ 0.05).Its correlates in Logistic analysis of Ant-MI group included LVEDV,MLC,DT with OR 1.48,1.72,1.54(P ＜0.05),respectively.Its correlates in logistic analysis of Inf Pos-MI group included PLS,PPM-AMA,DT with OR 1.78,1.57,1.56 (P ＜0.05),respectively.Conclusions There are different extent of damage of papillary muscle function and construction in Ant-MI group and Inf-Pos-MI group.The increases of LVEDV and MLC and desynchronization of PMs are risk factors of IMR in Ant-MI group.The increases of PMP-AMA,decrease PLS and desynchronization of PMs are risk factors of IMR inInf-Pos-MI group.

Childhood acute lymphoblastic leukemia (ALL) is a kind of abnormal proliferation of malignant tumor diseases originated in lymphocytes,which is the most common malignant tumor in children.Although stratified treatment has significantly improved the efficacy of ALL in children,but 15％-20％ of the patients still have ultimately relapsed due to the minimal residual disease(MRD).MRD refers to the leukemia patients after induction chemotherapy complete remission (or bone marrow transplant),in vivo residual morphology which could not be detected in trace amounts of leukemia cells.The detection methods of MRD mainly include flow cytometry,quantitative real-time polymerase chain reaction and immune repertoire sequencing.MRD level detection is of great important to judge the prognosis,and to guide the risk grouping and individual treatment,and so on.Now,the progress in the clinical application of MRD in children with ALL in recent years was reviewed.

Purpose To evaluate papillary muscle function in ischemic mitral regurgitation (IMR) with two-dimensional speckle tracking imaging (2D-STI) and three-dimensional ultraphonic technology,and to investigate the primary factors influencing IMR so as to provide clinical information for the prediction of IMR.Materials and Methods Seventy-six IMR patients were enrolled as research group and other 66 healthy volunteers as control group.Two groups were both examined by transthoracic echocardiography and 2D-STI.The parameters including fractional shortening of anterior and posterior papillary muscles (AFS,PFS),length of anterior or posterior papillary muscle tips to contralateral anterior mitral annular (APM-AMA,PPM-AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD),the angle between the anterior papillary muscle and the anterior LV free wall (Ang Ⅰ) and the angle between the posterior papillary muscle and the anterior LV free wall (Ang Ⅱ),anterior and posterior papillary muscle longitudinal strain (ALS,PLS) and peak time (APT,PPT),delay time (DT),left ventricular end-diastolic diameter (LVIDD),left ventricular end-diastole volume (LVEDV),and left ventricular ejection fraction (LVEF) were compared.Results Compared with control group,LVIDD,LVEDV,LVEF,AFS,PFS,IPMD,MLC,ALS,PLS and DT in research group were all significantly different (all P＜0.05).ALS,PLS,AFS,and PFS had positive correlation with LVEF (P＜0.05) and negative correlation with LVEDV (P＜0.05).MLC,IPMD,DT had negative correlation with LVEF (P＜0.05).ALS,PLS,MLC,AFS,PFS,IPMD were significantly correlated with Gensini score (r=-0.65,-0.78,0.54,-0.51,-0.57,0.49,respectively,P＜0.05).The multivariant Logistic regression analysis showed that IMR was correlated with IPMD,MLC,PLS and DT (OR=1.26,1.32,1.37,1.52,respectively,P＜0.05).Conclusion 2D-STI can accurately evaluate the papillary muscle dysfunction caused by myocardial ischemia.Moreover,the risk factors of IMR include increase of IPMD and MLC,decrease of PLS,and desynchronization of papillary muscles.These findings contribute to the clinical prediction of IMR.

Objective:To explore therapeutic effect of pharyngeal treatment machine (PTM) combined resuscitating acupuncture (RA) on patients with dysphagia after stroke.Methods: A total of 98 stroke patients with dysphagia were selected.According to random number table, they were randomly and equally divided into pure pharyngeal treatment group (received pure PTM therapy based on routine treatment) and combined treatment group (received RA based on pure pharyngeal treatment group).Video fluorography (VFG) score and swallow-quality of life (SWAL-QOL) score before and after treatment, and total effective rate were evaluated and compared between two groups.Results: Compared with before treatment, there was significant rise in VFG score, and significant reduction in SWAL-QOL score in both groups after treatment, P<0.01 all;compared with pure pharyngeal treatment group after treatment, there was significant rise in VFG score [(5.46±2.04) scores vs.(6.54±2.75) scores], and significant reduction in SWAL-QOL score [(741.33±25.92) scores vs.(632.54±26.77) scores] in combined treatment group, P=0.032, 0.001 respectively.Total effective rate of combined treatment group was significantly higher than that of pure pharyngeal treatment group (93.88% vs.75.51%), P=0.014.Conclusion: Compared with pure pharyngeal treatment machine, pharyngeal treatment machine combined resuscitating acupuncture possesses better therapeutic effect for recovery of swallowing function, which is worth extending.

10 units allows identification of patients a high risk factors in development ARDS.The high risk fac- tors providing the greatest contribution to improve therapy in acute lung injury and prevent ARDS to occur.

Objective To promote rational drug use by investigating quality of the outpatient and emergency prescriptions in the hospital .Methods We statistically summarized the evaluations of prescriptions and analyzed the drug use from January to Novem-ber ,2012 .Results The outpatient and emergency prescriptions were compliant to relevant writing standards ,without missing i-tems .The inaptitude of prescriptions were mainly in forms of inappropriate indication ,usage ,and dosage of drug and menstruum . The irrational prescriptions accounted for 5 .5% of those evaluated .Conclusion Rational drug use has been basically ensured through implementation of prescription evaluations and interventions .Irrational prescriptions exist in relatively small scale and are to be eliminated .

ObjectiveTo investigate the association between a new identified Gly82Ser polymorphism of RAGE gene and diabetic microangiopathy,a case control study of 260 Chinese subjects (including 156 type 2 diabetics with or without nephropathy or retinopathy and 104 non diabetic control) was performed.MethodsGenotype frequencies of Gly82Ser polymorphism were studied by PCR RFLP analysis with AluI digestion.ResultsThe most frequent genotype and allele of Gly82Ser polymorphism of RAGE gene in Chinese were genotype GG and allele G.Their frequency distribution showed significant difference between Chinese and Caucasian.There was no difference in genotype frequencies or allele frequencies between type 2 diabetic patients (DN 0) and the control subjects.Genotype and allele frequencies did not differ in type 2 diabetic subjects with nephropathy or without nephropathy.Moreover,there were no associations between diabetic patients with or without retinopathy in genotype and allele frequencies as well (two tailed Fisher’s exactP >0.05).ConclusionOur results showed that Gly82Ser polymorphism in RAGE gene was not associated with diabetic microangiopathy,which suggests that these genetic variants may not be involved in the mechanism of diabetic microangiopathy in Chinese type 2 diabetics.

Objective To summarize and analyse the clinical data of death cases in the department of emergency internal medicine. Methods The clinical data of patients presenting at the department of emergency internal medicine from January 2005 to July 2010 were analyzed retrospectively. Results Among 13 211 patients of department of emergency internal medicine, 145 died. More cases died in winter( 32.0% , 39/122 ).More than half of deaths occurred within 6 hours after admission( 54.5% ,79/145 ). The top six death causes were sudden death, pulmonary infection, cerebrovascular accident, advanced cancer, gastrointestinal bleeding,cardiovascular diseases and the occurrence rates were 18. 6%, 13.8%, 13.8%, 10.3%, 9. 7% and 9.0%respectively. Conclusion The first three death causes in department of emergency internal medicine were sudden death, cerebrovascular accident, pulmonary infection. Prevention of these diseases, cooperation between emergency department and other departments and special training on standardized treatment of critically ill patients should be enhanced.