Objective To investigate the misdiagnosed vascular vagovagla reflexes (VVR) and the treat-ments during interventional therapy for peripheral anerial disease (PAD). Methods The clinical data of 5 patients with VVRs from 128 PAD patients undergoing interventional therapy so as to analyse the causes for the misdiag-noses and then render pertinent treatment. Results The VVR in the 5 patients belonged to mixed type and all cas-es occurred after intervention and initially misdiagnosed. All patients were recovered well without adverse reaction. Conclusion Intervention therapy for PAD may be susceptible to VVR. Prompt management may bring in a good prognosis when VVR happens.

Objective To discuss the application of run?through wire stretch technique in the procedure of endovascular therapy for complex subclavian artery occlusive diseases. Methods The clinical data of 22 patients who were diagnosed complex subclavian artery occlusive diseases were retrospectively analyzed from June 2013 to January 2016 in vascular surgery department of Wangjing Hospital .The patients were treated endovascular therapy using run?through wire stretch technique in all procedures successfully. Results The complex subclavian artery occlusive diseases were including long segment occlusion of the left subclavian artery and ostial stenosis or occlusion of the right subclavian artery. The left subclavian artery occlusion patients was 16 and right subclavian artery ostial stenosis or occlusion was 6. The technical success rate was 100%. All patients were using combination of femoral artery and brachial artery approach. Run?through wire stretch technique was used in the procedure of endovascular therapy, which had improved the technical success rate. After the treatment the symptom improvement rate was 88%. The symptoms of upper limb and posterior circulation ischemia were improved. Conlusion Upper limb artery combined femoral artery approachand run?through wire stretch technique can improve the recanalization in the procedure of endovascular therapy for complex subclavian artery occlusive diseases.

Objective To investigate the roles of phosphatase and tensin homolog deleted on chromosome 10(PTEN),insulin-like growth factor 1(IGF-1),and insulin-like growth factor receptor 1 (IGF-1R) in the tumorigenesis,development,invasion and metastasis,and prognostic value of gastric cancer.Methods Immunohistochemical assay was used to detect the expressions of PTEN,IGF-1,and IGF-1R in gastric cancer tissue samples from 74 gastric cancer patients and in normal gastric mucosa of 20 health individuals.All data of these patients were collected including the grading and differentiation of the tumor.Results In gastric cancer,expression of PTEN was decreased,and expressions of IGF-1,and IGF-1R were enhanced.The expressions of PTEN,IGF-1 and IGF-1R had correlation with the outcome and biological behavior of gastric cancer.PTEN expression was higher in no lymph node metastasis group than lymph node metastasis group,higher in stage Ⅰ–Ⅱgroup than stage Ⅲ–Ⅳgroup.IGF-1 and IGF-1R expressions were higher in progressive group than early gastric cancer group,higher in poor differentiation group than moderate and well differentiation group,higher in lymph node metastasis group than no lymph node metastasis group,higher in stage Ⅰ–Ⅱgroup than stage Ⅲ–Ⅳgroup.PTEN-negatively-expressed patients had poor prognosis compared with positively-expressed ones;so did those who expressed IGF-1 and IGF-1R.Conclusion The changes of PTEN,IGF and IGF-1R play roles in gastric cancer genesis,progression and prognostic evaluation.

OBJECTIVE:To evaluate the effects of clinical pharmacists participating in disease management of chronic heart failure(CHF). METHODS:A total of 180 CHF inpatients selected from cardiovascular medicine department of our hospital during Jan. 2013 to Dec. 2014 were divided into control group and pharmacist management group according to random number table,with 90 cases in each group. The control group was given routine treatment. The pharmacist management group additionally received indi-vidualized pharmaceutical care,such as pharmaceutical monitoring,psychological counseling,medication education and 6-month follow-up. The comprehensive self-care ability of the 2 groups were compared on admission and on discharge;re-hospitalization and mortality were compared between 2 groups within 6 months after discharged;the patients’NYHA classification,LVEF,plas-ma level of NT-proBNP and quality of life were compared between 2 groups on admission and 6 months after discharge. RE-SULTS:There was no statistical significance in the cognition of patients to disease,self-care ability,medication compliance score and total comprehensive self-care ability score between 2 groups on admission (P>0.05). Each score and total score of 2 groups were better on discharge than on admission,and the pharmacist management group was better than control group,with statistical significance(P<0.05). Within 6 months after discharge,re-hospitalization rate of pharmacist management group was significantly lower than that of control group,with statistical significance (P<0.05). There was no statistical significance in mortality rate be-tween 2 groups (P>0.05). There was no statistical significance in NYHA classification,LVEF,plasma level of NT-proBNP be-tween 2 groups on admission(P>0.05). 6 months after discharge,the above 3 indexes of pharmacist management group as well as NYHA classification and plasma level of NT-proBNP of control group were improved significantly compared to on admission;NYHA classification,LVEF and plasma level of NT-proBNP of pharmacist management group were better than those of control group at corresponding period,with statistical significance (P<0.05). There was no statistical significance in social limit,mood, symptom score and total score of life quality between 2 groups on admission(P>0.05). 6 months after discharge,each score and total score of 2 groups were all better than on admission,and the pharmacist management group was better than control group, with statistical significance (P<0.05). CONCLUSIONS:The participation of clinical pharmacists in the disease management of CHF can significantly improve comprehensive self-care ability,decrease re-hospitalization rate,ameliorate cardiac function and en-hance the quality of life.

Objective By discussing the state of lifestyle as well as affecting factors of kidney transplant recipients,to provide more health education content and basis for their physical and psychological health.Method With internationally accepted Health-Promoting Lifestyle Profile (HPLP),we surveyed the lifestyle of the selected 104 long-term follow-up cases of kidney transplant recipients.At the same time,163 sex-and age-matched healthy volunteers,who had no obvious abnormalities in the medical test,were chosen.Result For HPLP scores among the 104 cases of recipients,20 cases were excellent,67 cases good,17 cases common,and none was inferior.As a whole,its excellent rate was 83.65％.As for 129 healthy volunteers,their overall excellent rate was 70.55％.The HPLP scores for the nutrition behavior ranked top in kidney transplant recipients,followed by healthy responsibility behavior,and lowest for exercise behavior.For the healthy volunteers,the HPLP scores for interpersonal support behavior ranked top,followed by nutrition behavior,and lowest for healthy responsibility.Correlation analysis revealed that the HPLP scores in kidney transplant recipients were significantly and positively correlated with age (r =0.307,P =0.002) and educational level (r=0.370,P =0.000),and not with gender,ethnicity,occupation and kidney sources (P＞0.05).The HPLP scores in idney transplant recipients were higher than those in healthy volunteers,among which self-actualization and healthy responsibility showed statistically significant differences (P ＜ 0.05),there was no significant difference in exercise,nutrition,interpersonal support and stress management between recipients and healthy volunteers (P＞0.05).Conclusion The HPLP scores in kidney transplants was higher than in healthy volunteers,thereinto,stress management behavior and exercise behavior were relatively weak,which were the focused improvement projects of lifestyle of kidney transplant recipients.

Background and purpose:It was reported that zinc ifnger protein 139 (ZNF139) was expressed aberrantly in gastric cancer. But the relationship between ZNF139 and multidrug resistance (MDR) of gastric cancer is still not clear. The purpose of this research was to investigate the expressions and signiifcance of ZNF139, MRP-1, MDR1/P-gp, GST-π in human gastric carcinoma cell lines SGC7901 and SGC7901/ADR. Methods: The expressions of ZNF139, MRP-1, MDR1/P-gp, GST-πwere determined with RT-PCR and Western blot in SGC7901 and SGC7901/ADR cell lines. Then siRNA recombinant plasmid of targeting ZNF139 gene was constructed and imported into gastric cancer cell line SGC7901/ADR, and the expressions of MRP-1, MDR1/P-gp, GST-πwere tested simultaneously. Results:The expressions of ZNF139, MRP-1, MDR1/P-gp, GST-πwere higher in SGC7901/ADR than in SGC7901(P<0.05). ZNF139 was inhibited obviously after siRNA-ZNF139 was transfected into SGC7901/ADR, and expression of MRP-1, MDR1/P-gp, GST-πdecreased(P<0.05). Conclusion:ZNF139 may be invovled in multidrug resistance (MDR) of gastric cancer by up-regulating MRP-1, MDR1/P-gp and GST-π.

Performances of reliability and portability are important for artificial ventricular assist devices. This paper presents a remote surveillance system that can observe the condition of the patients and the driving condition of artificial heart online. The system is mainly based on the embedded Compact RIO platform and Ethernet technology. Combined with the driver module of the assist device, this remote system has been tested.
Equipment Design ; Heart, Artificial ; Heart-Assist Devices ; Remote Sensing Technology ; Robotics

Objective: To investigate calreticulin (CALR) gene mutations classification in BCR-ABL1 negative myeloproliterative neoplasms (MPN), and its relationship with clinical manifestations. Methods: Genomic DNA polymerase chain reaction (PCR) amplification product Sanger sequencing method was used to detect the mutation of exon 9 of CALR gene in 236 patients with BCR-ABL1 negative MPN (excluding polycythemia vera and negative CALR mutations) in Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from November 2015 to November 2018. The mutations were classified into 52 bp deletion (type 1) mutation, 5 bp insertion (type 2) mutation and other mutation types according to PCR sequencing analysis. The clinical characteristics of the carriers with two kinds of mutations in 198 patients with essential thrombocythemia (ET) and 38 primary myelofibrosis (PMF) were compared. For the types of mutations that could not be determined, they were classified according to the α-helix propensity score of the mutant protein peptide chain or the degree of retention of the negatively charged amino acid residues, and the differences between the two classification methods were also compared. Results: Among 236 patients, the CALR gene type 1 or type 2 mutation was detected in 206 cases (87.3%), including 173 ET patients (99 cases of type 1 mutation and 74 cases of type 2 mutation) and 33 PMF patients (28 cases of type 1 mutation and 5 cases of type 2 mutation). The CALR non-type 1 or non-type 2 mutation was detected in 30 cases, including 25 ET patients and 5 PMF patients. Among 173 ET patients with CALR gene mutation, the white blood cell count (WBC) of patients with type 1 mutation was higher than that of patients with type 2 mutation [(8.6±2.7)×10⁹/L vs. (7.6±2.4)×10⁹/L, t = 2.45, P = 0.015]. Among 33 PMF patients with CALR gene mutation, the age of patients with type 1 mutation was older than that of patients with type 2 mutation [(58±13) years old vs. (41±16) years old, t = 2.51, P = 0.018]. According to the α-helix propensity score of mutant protein peptide chain and the degree of retention of the negatively charged amino acid residues, 27 kinds of non-type 1 or non-type 2 mutations were classified by using sequencing method, and there were differences between the two methods. According to the α-helix propensity score of the mutant protein peptide chain, the proportion of type 1/type 1-like mutation in PMF patients was higher than that in ET patients [78.9% (30/38) vs. 56.6% (112/198), P < 0.01]. According to the degree of retention of negatively charged amino acid residues in the mutant protein peptide chain, the isoelectric point (pI) value of the mutant protein peptide chain was higher than that of the wild type sequence. The pI value of the type 1-like mutant protein peptide chain was higher than that of the type 2-like mutation (11.79±0.15 vs. 10.02±0.42, t = 11.51, P < 0.01). Conclusions Type 1 mutated ET patients may be closely related to the high risk of myelofibrosis transformation. The results of the classification of CALR mutations are different according to the α-helix propensity score of the mutant protein peptide chain and the degree of retention of the negatively charged amino acid residues. Further study is necessary to identify the pathogenesis of MPN caused by CALR mutation, and to determine the relationship between mutation type and prognosis of disease.

Objective:To investigate the clinical effect of arthroscopic minimally invasive Kirschner wire tension band internal fixation in the treatment of transverse patellar fracture.Methods:From March 2016 to March 2018, 108 patients with transverse patellar fracture admitted to the Department of orthopedics, Linxi hospital, Kailuan general hospital, Hebei Province were analyzed retrospectively.According to the different operation methods, the patients were divided into arthroscopic group (68 cases) and control group (40 cases). The patients in the arthroscopic group were treated with arthroscopic minimally invasive Kirschner wire tension band internal fixation, and the patients in control group were treated with open reduction and Kirschner wire tension band internal fixation.The operation condition, clinical efficacy, Lysholm score and visual analogue scale(VAS) score were compared between the two groups.Results:The incision length((3.5±0.8) cm) of arthroscopic group was shorter than that of control group((13.7±2.2) cm), the amount of intraoperative bleeding ((47.4±12.5) ml) was significantly less than that of control group ((86.9±14.7) ml), and the length of hospitalization((11.8±2.6) d) and fracture healing time ((11.5±2.4) weeks)were significantly less than those in control group ((15.8±3.0) d, (15.7±2.8) weeks), the difference was statistically significant( t value were 34.63, 14.85, 7.29, 8.25; all P<0.05). The Lysholm score of two groups increased significantly with time( Fintra-group=87.53, P<0.05). The increasing of Lysholm score in arthroscopic group was significantly higher than that in control group( Finteraction=7.64, P<0.05). The overall level of Lysholm in arthroscopic group was significantly higher than that of control group( Finter-group=11.42, P<0.05). The VAS score of two groups decreased significantly with time( Fintra-group=76.47, P<0.05). The decreased of VAS score in arthroscopic group was significantly higher than that in control group( Finteraction=9.96, P<0.05). The overall level of VASin arthroscopic group was significantly lower than that of control group( Finter-group=10.38, P<0.05). Conclusion:Arthroscopic minimally invasive Kirschner wire tension band internal fixation for the treatment of transverse patellar fracture has better efficacy and safety, less injury, less pain after operation.

Objective To investigate the clinical effect of arthroscopy minimally invasive Kirschner wire tension band internal fixation combined with lower limb feedback training for patellar fracture.Methods Fifty-eight cases of patellar fracture who received arthroscopy minimally invasive Kirschner tension band internal fixation from March 2016 to April 2018 in Linxi Hospital,Kailuan General Hospital were included in this study.All cases were divided into control group (32 cases) and observation group (26 cases) according to the different rehabilitation methods.Control group received routine rehabilitation,observation group received intelligent feedback system of the lower limbs based on the control group.The recovery of joint function was compared between two groups.Results The clinical efficacy of the observation group was excellent (18 cases),good (6 Cases),and medium (2 cases),the excellent and good rate was 92.30％ (24/ 26).In the control group,the clinical effect was excellent (19 cases),good (9 cases),and medium (4 cases).The excellent and good rate was 87.50％ (28/32).There was no significant difference in clinical efficacy (z =0.80,P＞ 0.05) and excellent and good rate (x2 =0.36,P＞ 0.05) between two groups after 6 months follow-ups.The scores and total scores of B(o)stman patellar fracture function before treatment in observation group were pain (3.3 ± 0.8),Knee range of motion (3.2 ± 0.7),work (1.8 ± 0.3),muscular atrophy (1.8±0.2),auxiliaries (2.9 ± 0.6),effusion (1.2 ± 0.4),giving way (0.3 ± 0.2),climb stairs (0.3 ±0.2) andtotal score (15.0 ±2.2) respectively.The scores and total scores of B(o)stman patellar fracture function after treatment in observation group were pain (5.7 ± 0.4),Knee range of motion (5.8 ± 0.2),work (3.6 ±0.5),muscular atrophy (3.5 ± 0.6),auxiliaries (3.7 ± 0.4),effusion (1.8 ± 0.3),giving way (1.7 ±0.4),climb stairs (1.7 ± 0.5) and total score (28.3 ± 1.6) respectively.The B(o)stman patellar fracture functional score in observation group increased significantly (t =14.62,19.15,16.47,14.78,6.96,7.18,17.26,14.16,26.30,P ＜ 0.05).The scores and total scores of B(o)stman patellar fracture function before treatment in control group werepain (3.4 ± 0.6),Knee range of motion (3.1 ± 0.6),work (1.9 ± 0.4),muscular atrophy(1.7 ±0.3),auxiliaries (2.8 ±0.5),effusion(1.1 ±0.3),giving way(0.4±0.2),climb stairs (0.4 ±0.2) andtotal score (14.8 ±2.3),respectively.The scores and total scores of B(o)stman patellar fracture function after treatment in control group were pain(5.2±0.6),Knee range of motion(4.9 ±0.7),work(3.1 ±0.6),muscular atrophy (2.5 ± 0.5),auxiliaries (3.2 ± 0.4),effusion (1.3 ± 0.4),giving way (1.3±0.3),climb stairs (1.2 ± 0.4) and total score (22.7 ± 2.5),respectively.The functional scores of B(o)stman patellar fracture in control group were significantly increased (t =13.26,12.44,10.16,8.17,3.38,3.22,15.14,11.31,14.13,all P ＜ 0.05).The scores and total scores of B(o)stman patellar fracture in observation group after treatment were significantly higher than those in control group (t =3.64,6.34,3.39,6.93,4.73,5.28,4.35,4.23,9.89,P ＜ 0.05).In observation group,the range of knee joint activity at different time were before operation (30.2 ± 6.1) °,2 weeks after operation (85.6 ± 6.8) °,4 weeks after operation (100.6± 7.5) °,6 weeks after operation (118.5 ± 8.3) °,8 weeks after operation (138.9 ± 8.2) °,respectively.In control group,the range of knee joint activity at different time werebefore operation (29.3 ±7.2) °,2 weeks after operation (74.8 ± 6.9) °,4 weeks after operation (92.8 ± 7.8) °,6 weeks after operation(102.8 ± 9.4) °,8 weeks after operation (121.1 ± 7.3) °,respectively.The range of knee joint activity of two groups were significantly increased with the duration of treatment,Fgroup =124.58,P ＜0.05.The increases of range of knee joint activity in observation group was significantly higher than that in control group,Fintersecrion =11.78,P＜0.05.The overall levels of range of knee joint activity in observation group were significantly higher than that of control group,and Fbetween =36.27,P＜ 0.05.The KSS scores of in observation group werebefore operation (40.5 ± 8.8),2 weeks after operation (66.4 ± 9.0),4 weeks after operation(76.8±9.1),6 weeks after operation (83.4 ±9.5) and 8 weeks after operation (89.4 ± 8.1),respectively.The KSS scores in control group at different time were before operation(38.9 ±9.2),2 weeks after operation (60.1 ± 8.3),4 weeks after operation (70.4± 8.2),6 weeks after operation (77.6± 7.3) and 8 weeks after operation(82.5±8.6) respectively.The KSS score of two groups were significantly increased with the duration of treatment,Fgroup =84.32,P＜0.05.The increases of KSS score in observation group were significantly higher than that in control group,Fintersecrion =8.94,P＜0.05.The overall levels of range of KSS score in observation group were significantly higher than that of control group,and Fbetween =28.52,P ＜0.05.Conclusion The application of lower limb feedback training system after arthroscopic minimally invasive Kirschner wire tension band fixation can promote the recovery of knee joint function in patients with patellar fracture.