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.

AIM: The aim of the present study was to clarify the mechanism of intracellular signal transduction in Ang Ⅱ- induced proliferation of vascular smooth muscular cells (VSMC) by observing the effect of c- Src on Ang Ⅱ- mediated mitogen- activated protein kinase (MAPK) activation and c- Fos protein expression in cultured VSMC of rats. METHODS: Cultured aortic VSMCs from SD rats were transfected with anti-sense c-Src oligodeoxynucleotides (ODNs) wrapt with lipofectin to inhibit c- Src activity and protein production. Untransfected VSMCs were used as control. We observed the role of Ang Ⅱ stimulation in MAPK activation and c- Fos protein expression. c- Src kinase activity was measured by protein immunoprecipitation and kinase autophosphorylation. The phosphorylation rate of the substrate myelin basic protein (MBP) was employed to assess MAPK activity.Western immunoblot was used to detect protein expression of c- Src and c-Fos. RESULTS: c-Src protein expression in VSMC transfected with different concentrations of anti- sense ODNs significantly decreased in a negative dose- effect manner. c- Src kinase activity was also markedly inhibited. Following the stimulation of Ang Ⅱ on transfected VSMCs with anti-sense ODNs, the increase rate of c- Src activity was 8.7% of that in control, the activity of MAPK was 1.6% compared with control and c- Fos protein expression was as 30.0% as that of control. CONCLUSION: Ang Ⅱ induces c- Src activation. MAPK activation and c - Fos protein expression by Ang Ⅱ is dependent on c- Src activation. These findings indicate that c- Src is an important signal factor in Ang Ⅱ-induced VSMC proliferation.

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 the strategies of nutritional support for patients with hyperlipidemic acute pancreatitis (HLAP). Methods The clinical data of six HLAP patients who were treated in our department from January 1998 to December 2009 were retrospectively reviewed. Results The disease conditions of all patients were improved after fasting and early nutritional support and lipid-lowering treatment. Three cases with severe HLAP received enteral nutrition via a nasojejunal tube. Another three patients with milder HLAP obtained low-fat diet and orally administered lipid-lowering drugs. The plasma triglyceride levels decreased from (25.30 ± 20. 48 ) mmol/L to (5.41 ±4.55) mmol/L. No relapse was noted during follow-up (range: 3 -24 months). Conclusions The approaches of nutritional support for HLAP patients should be customized based on the specific disease conditions,and the enteral nutrition and lipid-lowering drugs should be reasonably and carefully designed and applied. For severe HLAP, nasojejunal tube should be maintained in the early stage to ensure the application of enteral nutrition and lipid-lowering drugs, protect the integrity of gut mucosal barrier, and decrease the fluctuation of blood glucose.

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.

Objective To investigate the clinical efficiency and security of Fe(OH) 3-sncrose-compond combined with erythropoietin on renal anemia.Methods 30 cases of oral iron combined with erythropoietin in the unsatisfactory uremia patients undergoing maintenance hemodialysis,the cases were randomly divided into two groups:the treatment group(n =16) using intravenous sucrose iron 100mg,twice a week,after a total of 1000mg,then l00mg,once 1 -2 weeks;the control group(n =14) continue to oral:ferrous succinate 0.2g,three times everyday,erythropoietin dose was the same in lothgroups for g weeks.Results Hemoglobin was significantly higher(P ＜ 0.01) and hematocrit was significantly higher(P ＜0.01),and serum ferritin significant increased(P ＜0.0l) in sucrose iron treatment group than these of the control group;the patients of treatment group have obviously improved in spirit,appetite,physical and life quality and so on.Sometimes,nausea,vomiting,skin itching were complained lut without significant side effects.While in the control group limited increase in the level of hemoglobin was seen,the majority had nausea,abdominal discomfort,poor appetite.Conclusion The efficiency of intravenous sucmfer combined with erythropoietin in treatment of renal anemia was effective than conventional oral iron combined with erythropoietin and with fewe adverse reactions.

Objective To investigate influence of hohstic nursing intervention on psychological state and gastrointestinal function of patients after abdominal operation. Methods 48 patients undergoing abdominal surgery with epidural anesthesia were divided into the intervention group and the control group. Holistic nursing intervention and routine nursing were given to the two groups respectively. Self-rating anxiety scale (SAS) and serf-rating depression scale (SDS) were used to evaluate the psychological state of all patients and gastrointestinal tract function were also measured. The result underwent t test. Results SAS and SDS scores were lower on the fifth day after operation and the time of borborygmus recovery, anal exsufflation and defecation was shorter in the intervention group when compared with those of the control group. Conclusions Hohstic nursing to patients after abdominal surgery can eliminate anxiety and depression and improve recovery of gastrointestinal tract function.

As China witnesses constant development of its market economy and gradual deepening of reform in its medical and health cause,the ability of domestic hospitals to adjust their operational management strategies in due course is crucially related to their survival and development amidst market competition.Hospital managers,while stressing quality and economic control,should attach special importance to the brand effect of their hospital and step up hospital brand building,the focus of which lies in patient satisfaction and loyalty and hospital popularity and reputation.Only in this way can they constantly create advantages,enhance core competitiveness and put their hospital in an invincible position amidst market competition.

The Eleventh Five-year Program period will be a very important period in the historical development of China;it will also be a key period for domestic hospitals to deepen reform and achieve steady growth.Doing a good job of the five years' work will be of great significance to promoting reform of the medical and health system,strengthening and developing the hard-won good situation,speeding up hospital construction and growth,and solving such problems facing the common citizens as "it is difficult and expensive to see a doctor".The authors offer suggestions and hope to arouse discussions as to how hospitals ought to formulate a Eleventh Five-year Program that will meet their own growth needs with the guidance of a scientific approach to development.

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.