Objective To evaluate the prognosis and influencing factors of unprotected left main coronary artery lesion intervention with drug-eluting stents.Methods Forty-five patients with unprotected left main coronary artery disease were treated with percutaneous coronary intervention (PCI).According to whether the lesions involving the distal left main bifurcation,the patients were divided into two 2 groups:nonbifurcation lesion group (26 cases) with opening or body disease,bifurcation lesion group (19 cases) with involving the distal left main or anterior descending artery,circumflex openings.Fifteen patients were guided by intravascular ultrasound (IVUS) during PCI,and 13 patients were reviewed by coronary angiography at (9.5 ±6.3) months after PCI.Results All the 45 patients were successful.There were 42 patients successfully finished the follow-up study for the average of 8-48 (19.9 ± 10.2) months,non-bifurcation lesion group was 24 cases,bifurcation lesion group was 18 cases.The incidence of recurrent angina pectoris during the follow-up period in bifurcation lesion group was significantly higher than that in non-bifurcation lesion group [6/18 vs.12.5％ (3/24)],there was statistical difference (P ＜ 0.05),but there was no statistical difference in the incidence of major adverse cardiac events (MACE) between 2 groups [3/18 vs.12.5％ (3/24),P ＞ 0.05].Single-variable analysis results showed that MACE in IVUS guided during PCI was less than that in non-IVUS guided during PCI [1/15 vs.18.5％(5/27)],there was statistical difference (P ＜0.05).In 13 patients who reviewed by coronary angiography,4 patients were found in-stents restenosis,all in bifurcation lesion group,the rate of restenosis in double stents was 3/6,in simple stents was 1/4.Conclusions PCI with drug-eluting stents is safe and feasible for the treatment of selective left main coronary artery lesion,it could bring the better short and long-term outcomes.IVUS guided PCI could significantly reduce MACE.

Objective To investigate the effects of GSTT on expression of inflammatory molecule ICAM-1 and the infiltration of neutrophils in rats after myocardial ischemia/reperfusion (MI/R) injury. Methods A model of myocardial ischemia 45min followed by 2h reperfusion was made by reversibly ligating coronary left descending artery. 32 Sprague Dawley (SD) rats were divided randomly to 4 groups, ie: sham-operated group, model group, large and dosage of GSTT. HE staining was used to observe infiltrating neutophils. The activity of MPO was measured, too. Immunohistochemistry was used to determine ICAM-1 expression in myocardium. Results Light microscopy showed that the infiltration of neutrophils in both large and low dosage of GSTT group was less serious than that in model group. Both large and low dosage of GSTT significantly decreased MPO activity (P

Objective To investigate the effects of gross saponin from Tribulus terrestris (GSTT) on myocardial ischemia/reperfusion (MI/R) injury. Methods A model of myocardial MI/R injury of the myocardium was reproduced by ligation of left descending artery for 45min followed by releasing the ligation for 2 hours in rats. 64 SD rats were divided randomly to 4 groups, i.e. sham-operated group, model group, large and low dose of GSTT groups. HE staining was examined to assess myocardial pathological changes. TTC staining was used to determine myocardial infarction area. Serum contents of lactate dehydrogenase (LDH), creatine phosphokinase (CPK) and malondialdehyde (MDA) were also determined. Results Both large and low dose of GSTT improved myocardial pathological changes after ischemia/reperfusion. Large dose of GSTT reduced myocardial infarction area (P

Objective To investigate the preventive effects of total saponin from Tribulus terrestris (GSTT) on cardiomyocytes subjected to low oxygen tension and re-oxygenation injury in vitro. Methods First passage of cultured cardiomyocytes was subjected to hypoxia followed by oxygenatim. The cells were divided into 4 groups, namely normal group, injury group, and large and low dose of GSTT groups. The frequency of contraction, survival rate and release of myocardial enzymes were determined. The morphologic changes were observed with light and electron microscopy. Results Both large and low dose of GSTT significantly improved the survival rate of cardiomyocytes after hypoxia and re-oxygenation injury (P

Objective To investigate the effect of GSTT on the release of inflammatory molecules such as TNF-? and IL-1? in rats after ischemia/reperfusion injury. Methods An in vivo model of myocardial ischemia 45min followed by 2h reperfusion was made by reversibly ligating coronary left descending artery. 32 Sprague Dawley (SD) rats were divided randomly to 4 groups, ie: sham-operated group, model group, large and dosage of GSTT. TNF-? and IL-1? concentrations were examined by radioimmunoassay. Results Compared with model group, large dosage of GSTT significantly decreased the contents of TNF-? and IL-1?(P

Objective To investigate the effects of gross saponins from Tribulus terrestris L (GSTT) on myocardial apoptosis, and its related gene bcl-2 and bax expression after hypoxia/reoxygenation in cultured myocardial cells of neonatal rat. Methods After myocardial hypoxia/ reoxygenation model was established by culturing primary myocardial cell of neonatal rat in vivo. The myocardial cells were divided into four groups, the sham-operated group, model group, large- and low-dose of GSTT groups. The apoptotic rate of myocardial cells was determined by flow cytometry, and the expression of bcl-2 and bax was detected by using immuno-histochemical method. Results Both large- and low- dose of GSTT could significantly decrease the apoptotic rate (P

Objective To probe into the variation law of seasons factor on medical consumables and dispose resources sci- entifically. Methods The data of supplying sorts and times during the past 5 years was analyzed. Results The analysis shows evidently that there exists the highest point and the lowest point in demands of medical consumables varying with the seasons. Conclusion The law of medical consumables supplying can be given reference reasonably and scientifically for procurement and supply job in supply department.

A 28-year-old male patient presented with a 4-year history of a solitary brown mass, and a 1-year history of multiple small papules on the left chest. Skin examination showed a quasi-round brown firm mass measuring about 1.2 cm × 1.1 cm × 1.0 cm in size on the left chest, and several brown papules with diameters ranging from 3 to 5 mm on the right side of the mass; no enlarged lymph nodes were detected in the left axilla on palpation. The mass and papules were completely resected, and histopathological examination showed clustered nevus cells in the superficial dermis of the mass and small papules, and the diagnosis of intradermal nevus was considered. There was a desmoplastic nodule in the mass, nevus cells were scattered among the fibers in the nodule, and giant nevus cells were also observed; the nevus cells in the nodule were relatively larger, epithelioid or spindle-shaped with round or spindle-shaped nuclei, obvious nucleoli, and rare mitotic figures. Immunohistochemical study showed that the nevus cells in both the intradermal nevus and proliferative nodule were positive for S100; the nevus cells in the superficial dermis of the intradermal nevus were positive for Melan-A and HMB45, while the nevus cells in the proliferative nodule were negative for Melan-A and HMB45; both the intradermal nevus and proliferative nodule tissues showed a Ki-67 index of 1%, positive staining for CD34, but negative staining for P16 and P63. Finally, the patient was diagnosed with intradermal nevus associated with desmoplastic nodule.

A 74-year-old man presented with yellowish red nodules and plaques on the trunk for more than one year.Physical examination showed more than 20 scattered,irregularly shaped,well-demarcated,yellowish red nodules and plaques measuring 0.5-15 cm in diameter on the trunk.The plaques on the right lower abdomen showed central ulceration and atrophy with scar formation.Plasma protein electrophoresis revealed that the levels of immunoglobulin G (IgG) and kappa light chain were 18.3 g/L and 20.70 g/L respectively.Histopathologically,large necrobiotic areas and granuloma were observed alternately in the dermis and subcutis.There were numerous Touton giant cells,foreign body giant cells and foamy histiocytes in the granuloma,and many cholesterol clefts were found in the center of necrobiotic areas with the formation of lymphoid follicles in some regions.Both eyes of the patient were involved to different degrees.He was diagnosed as necrobiotic xanthogranuloma with IgG kappa paraproteinemia and eve involvement.

Objective To explore the feasibility of continuous sciatic nerve block via lateral poplit eal approach with single shot femoral nerve block for enhanced recovery after surgery in ankle and foot surgery.Methods Sixty adult patients scheduled for elective ankle and foot surgery were randomly assigned into 2 group (n =30 each):Group A received sciatic nerve block via lateral popliteal approach with a catheter placed and a single shot femoral nerve block under ultrasound guidance followed by patient-controlled postoperative analgesia with 0.2％ ropivacaine through the perineural catheter;Group B received the routine epidural puncture and a catheter placement at L2-3 level followed by postoperative analgesia with 0.2％ ropivacaine through the catheter.Systolic blood pressure (SBP),diastolic blood pressure (DBP) and heart beat (HR) were recorded before and after anesthesia.The block efficacy,the volume of fluid influsion during operation and the usage of ephedrine were recorded.The pain severity at rest and upon movement with a 0-10 numeric rating scale (NRS,0 =no pain and 10 =worst possible pain),the modified Bromage score of the motor block of the affected extremity,the number of effective patient-controlled bolus of ropivacaine and the number of need for opioid rescue within 48 h after surgery were assessed.The first time of leaving bed after operation,the length of hospital stay and the occurring of complication related to puncture and analgelsia were also recorded.Results SBP and DBP at each time point after anesthesia were higher in group A than those in group B (P ＜ 0.05).The volume of fluid infusion during operation and the occurence of ephedrine use were less in group A than those in group B (P ＜0.05).There was no indifference in terms of the NRS scores at rest and upon movement,the number of effective patient-controlled bolus of ropivacaine and the number of need for opioids rescue (P ＞ 0.05),but the complications such as nausea and vomiting,urinary retention occurred more in group B (P ＜0.05).The modified Bromage score of the motor block at each time point within 24 h after surgery was lower in group B than that in group B (P ＜ 0.05).The first time of leaving bed after operation and the length of hospital stay were shorter in group A than those in group B (P ＜ 0.05).Conclusions Ultrasound-guided continuous sciatic nerve block via lateral popliteal approach with single shot femoral nerve block can provide exact anesthetic effect with minimal interference on haemodynamics and excelent postoperative analgesia with less influence on movement.It's helpful in the ankle and foot surgery to improve the recovery after surgery.