AIM: To determine whether CRP is relevant to pathological arterial smooth muscle and to investigate both aorta and carotid arteries response to CRP in LDLr(-/-),eNOS(-/-) and db/db(+/?) mice arteries. METHODS: CRP was added in these kinds of arterial rings in order to check arterial tension response. Tension was recorded in isolated rings of aorta and carotid arteries taken from low-density lipoprotein receptor gene knockout mice, endothelial nitric oxide synthase knockout mice (eNOS(-/-) mice), diabetes mellitus mice (db/db+/? mice) and the corresponding wild-type strain. RESULTS: CRP relaxed aorta and carotid artery by phenylephine or prostaglandin F2? (PGF_ 2? ) in normal mice, LDLr(-/-), eNOS(-/-) and db/db(+/?) mice. CRP relaxed aorta to (90?2)% and carotid to (54?3)% in LDLr(-/-), aorta to (74?2)% and carotid to (38?4)% in eNOS, aorta to (47?6)% and carotid to (52?8)% in db/db(+/?), and aorta to (66?8)% and carotid (32?4)% in normal mice. CRP-induced vessel dilation was abolished in carotid impaired endothelium, but not in aorta. CRP relaxed aorta, and carotid in LDLr(-/-) mice better than others. CRP only relaxed (9?4)% in carotid endothelium damaged and relaxed (58?4)% in aorta endothelium damaged. CONCLUSION: CRP is a very strong vascular muscle relaxation similar to NO. Its effect time is similar to that in NO. It is similar to normal mice arteries in CRP relaxing aorta and carotid, and independent of and depend on endothelium to dilate artery smooth muscle.

AIM　To study the effects and mechanisms of cromakal im, an ATP-sensitive K+(KATP) channel opener, on rat vascular smooth mu scl e. METHODS　Isometric tension recording of aorta rings. RESULT S　Vasorelaxant effects to cromakalim which contracted by phenylephrine we re markedly reduced in the old rats. Endothelium removal or treatment either wit h the NO synthesis inhibitor L-NAME or the guanylate cyclase inhibitor meth ylene blue reduced the effects, however with the change of age, the IC50 v alues and maximal relaxation responses to cromakalim had little difference. Ach and SNP, which are the endogenous and exogenous donors of NO respectively, induc ed a lesser vasodilator effect in aortic segments from old compared with the oth er groups of rats. CONCLUSIONS　The vasodilator responses to cromaka lim decreased in old rats, its mechanism may be involved the lower release of NO or the lower sensitivity of vascular smooth muscle to NO.

Astrocytes play many important roles in the nervous system.In recent years,researchers are paying attention to the roles of astrocytes in the process of stroke.This article mainly reviews the biological functions of astrocytes and the gene expression changes of astrocytes after ischemic stroke,thereby providing new potential therapeutic targets for the treatment of ischemic stroke.

Objective To observe the therapeutic effects and side effects of FLAG regimen(fludarabine, Ara-C, and granulocyte-colony stimulating factor( C-CSF) for refractory or relapsed acute myeloid leukemia( AML). Methods Twenty-six AML were treated with fludarabine plus intermediate-dose Ara-C and G-CSF,of whom 15 cases belonged to refractory and 11 cases belonged to relapsed. Results After two courses of treatment, 14 cases were completely relieved (53. 8% ) and 5 cases were partially relieved (19.2% ). The overall effective rates was 73.1%. The main side effects were severe myelosuppression and non-hematological toxicity was mild. Conclusion FLAG regimen was very effective for refractory or relapsed acute myeloid leukemia and was well tolerated. The treatment-related mortality rate was low,so it provided a treatment choice for these patients.

Objective To observe the efficacy and safety of tirofiban combined with lowmolecular-weight heparin in treatment of acute coronary syndrome.Methods 138 patients with acute coronary syndrome were divided into two groups(observation group and control group).In observation group,80 cases were treated with tirofiban combined with low-molecular-weight heparin on the basis of conventional therapy.In control group,58 cases were treated with low-molecularweight heparin on the basis of conventional therapy.The efficacy and safety were compared between the two groups.Results The total efficacy was higher in observation group than in control group (x2=8.589,P＜ 0.01).The improvement of 24 h anginal attacks,decrease in values of ECG ST segment and cardiac troponin T value were better in observation group than in control group(all P＜ 0.05).The blood platelet count and adverse reactions were not different between the two groups(t=0.294,x2 =0.747,both P ＞ 0.05).Conclusions Tirofiban combined with low-molecular-weight heparin is effective and safe in the treatment of acute coronary syndrome.It can increase the clinical effect,improve clinical symptoms and signs in the patients,and is worthy of clinical application.

Combined with the features of clinical practice teaching of cardiothoracic surgery ,we discuss how to improve the quality of clinical practice teaching of cardiothoracic surgery and strengthen the cultivation of medicos'capability and diathesis,thus correctly guiding medicos to finish their interim study commendably and change their roles from students to doctors.

[Objective]To study the pathogenesis,clinical manifestation and surgical treatment of the posterior margin separation of lumbar vertebral epiphysis.[Method]Sixteen patients suffering from the posterior margin separation of lumbar vertebral epiphysis were followed up.The clinical manifestation and radiologic examination were analyzed and results of surgical treatment were evaluated.[Result]The patients were usually young and manifested with the sign and symptom of lumbar disc herniation and/or lumbar stenosis.CT was helpful for the accurate diagnosis of this disease.The different surgical measures were taken for the treatment according to the type and range of protrusion.[Conclusion]The posterior margin separation of lumbar vertebral epiphysis were divided into three types:end plate separation and moving into posterior margin,Schmorl node and avulsion fracture.The good results can be obtained with surgery.

[Objective]Through the analysis of 82 cases of spondylolisthesis treated with surgery,the different types of surgical procedures were evaluated.[Method]Patients with spondylolisthesis were divided into 4 groups based on their pathology and different surgical procedures were used accordingly.Group Ⅰ consisted of 18 patients with degenerative spondylolisthesis with back pain(3 cases)and isthmic spondylolisthesis(13 cases)and traumatic spondylolisthesis(2 cases)of Ⅰ degree;They were treated with posterior interlaminar and interspinous process fusion;Group Ⅱ consisted of 31 cases with degenerative spondylolisthesis(2 cases)and isthmic spondylolisthesis(23 patients)and traumatic spondylolisthesis(6 cases)of Ⅰ degree(11 cases)and Ⅱ degree(20 cases);They were treated with reduction of sliding vertebra and posterior interlaminar and interspinous process fusion;Group Ⅲ consisted of 19 cases with degenerative spondylolisthesis(2 cases)and isthmic spondylolistbesis(17 cases)of Ⅰ degree(2 cases),Ⅱ degree(13 cases)and Ⅲ degree(4 cases);They were treated with laminectomy and decompression,with reduction of sliding vertebra and transverse process fusion;Group Ⅳ consisted of 14 cases with isthmic spondylolisthesis of Ⅰ degree(1 case),Ⅱ degree(10 cases)and Ⅲ degree(3 cases);They were treated with laminectomy and decompression,with intervertebral body fusion,with reduction of sliding vertebra and transverse process fusion.[Result]In group Ⅰ,solid fusion were in 15 cases giving a fusion rate of 83%,0.03% rate of reduction,52.69% rate of improvement;In group Ⅱ,solid fusion were in 30 cases giving a fusion rate of 96%,56.20% rate of improvement,83% rate of reduction;In group Ⅲ,fusion rate,reduction rate and improvement rate reached 89%,90%,59.85% respectively;In group Ⅳ,the fusion rate,reduction rate and improvement rate were as high as 100%,92%,61.08% respectively.[Conclusion]Different operative methods have different operative indications.Operative methods differ from different patients.

Objective: To present a modified method for harvesting and shaping fibular flap in reconstruction of mandibular defect. Methods: Fibula flap harvesting was performed under non-blood-evacuation of the donor limb and two gaps were made at the upper and lower ends of the fibular flap during the flap harvesting. Step-like osteotomy was performed to obtain 3 segments(each segment was 3~5 cm in length) of fibular bone. The shaping was achieved by fitting the bone segments together based on the natural contour of the mandible. The modified operation was conducted in 7 patients for mandibular reconstruction. Results:The method was successfully used in all patients with less bleeding during the flap harvesting and after reconstruction.The bone segments were rigidly fixed with good bony consolidation and contour. No complications occurred.Conclusion: The modified fibular flap harvesting method is feasible in mandible reconstruction.

Objective To analysis curative effect of triple therapy and sequential therapy for eradication of Helicobacter pylori in patients with long-term aspirin use.Methods 52 patients with long-term aspirin use who were diagnosed with helicobacter pylori infection were collected.All patients were divided into sequential group and triple group according to different drugs classified, each 26 cases in each group were given corresponding drug treatment, after the end of treatment, the serum pepsinogen, Hp-IgG antibody levels and Helicobacter pylori clearance rate were detected in all patients. Results After treatment, compared with the triple Group, in the sequential group, the levels of serum PG I and PG II were lower, and PGⅠ/PGⅡwas higher, and the differences were statistically significant (P<0.05);the serum Hp-IgG antibody levels were lower in the sequential group (P<0.05);the Hp clearance rate of patients in the sequential group was higher (P<0.05).Conclusion Compared with triple therapy, sequential therapy can lower serum PG, PG II and Hp-IgG levels, and improve the Hp clearance rate and clinical efficacy, have guiding significance to clinical.