Though the primary data on fully covered self-expandable metal stents (FCSEMS) in the treatment of benign biliary strictures caused by chronic pancreatitis and anastomotic stricture following orthotopic liver transplantation is encouraging,the risks including stent translocation,biliary infection,pancreatitis and inability to remove stents should be considered before replacing plastic stents with FCSEMS for the first-line treatment of benign biliary strictures in routine practice.FCSEMS is effective in treating benign pancreatic ductal strictures,but it is also associated with a high rate of stent translocation.To overcome this problem,FCSEMS with better conformability and flared ends need to be designed.There is a theorectial risk of pancreatic ductal infection caused by the blockage of side branches of the pancreas by covering membrane of the stents.However,no such complication was reported.Given the uncertain long-term efficacy and safety of FCSEMS for benign pancreatic ductal strictures,their use may be reserved for the management of retractory,symptomatic benign strictures only in selected groups of patients.

Objective To investigate the occurence of glomus tumor and investigate its diagnosis and treatment. Methods 13 cases of glomus tumors were analyzed retrospectively. There were 9 females and 4 males. All 13 cases were surgically treated under megaloscpe. Results All the cases were testified as glomua tumors by pathology. There was no recurrence during the follow up of 6 months to 1 year. All the patients were symptom free. Conclusion Glomus tumor has specific features on clinical presentation. Mierosurgieal excision under megaloscpe is fill elective method.

Antiplatelet therapy and stent implantation have been the dominant treatment to reduce the mortality of patients with coronary artery disease.Recently,studies have showed that adverse cardiac events still occur in part of patients with coronary artery disease after the antiplatelet treatment with aspirin and/or clopidogrel.Thus,resistance to aspirin and clopidogrel has attracted increasing attention.It will be great benefit to these patients who were identified resistance and made tailoring antiplatelet therapy So far many platelet function tests has been used in clinical to monitor the reaction of the antiplatelet drugs for prevention and treatment of thrombosis in patients with coronary artery disease.These monitoring tests may be chosen based on different antiplatelet drugs including aspirin,clopidogrel and GP Ⅱ b/Ⅲ a antagonist.The results of antiplatelet drug resistance may be different due to different platelet function methods,thus the related clinical adverse events needs further verification.

BACKGROUND:Ankle fractures combined with deltoid ligament injury are not uncommon in clinical practice, prone to misdiagnosis and missed diagnosis, resulting in ankle instability, chronic pain and traumatic arthritis. In recent years, because of the research and development of anatomy and biomechanical characteristics of deltoid ligament, the treatment and surgical methods of ankle fracture combined with deltoid ligament injury have progress and development, but it remains controversial. OBJECTIVE:To evaluate the clinical effect of suture anchor repair in the treatment of ankle fracture combined with deltoid ligament injury. METHODS: Twenty-seven patients with ankle fracture combined with deltoid ligament injury were selected between January 2010 and January 2013. The lateral maleolus and posterior maleolus fracture patients were treated with open reduction and internal fixation, and al the deltoid ligament injury patients were treated with anchor repair. The tibiofibular syndesmosis isolated patients received internal fixation with a cancelous bone screw. RESULTS AND CONCLUSION:Al 27 patients were folowed-up for 11-35 months, averagely 23 months. The evaluation according to the American Orthopaedic Foot and Ankle Society score system showed that the excelent and good rate was 74.1%. The results indicate that anchor could perfectly restore the stability of ankle joint.

Objective To investigate the clinical features of young female patients with acute myocardial infarction (AMI) who were referred to Peking Union Medical College Hospital. Methods A total of 24 consecutive AMI female patients (age≤44 years) who underwent coronary angiography were retrospectively retrieved from the database, and 70 AMI patients whose age ≥ 65 years and who also underwent coronary angiography were enrolled as a control (elderly) group. Clinical features were compared between the two groups. Results Of the 24 young female AMI patients, MI from non-atherosclerosis was identiifed in 9 patients (non-ATS group). Compared to the remaining 15 young female AMI patients (ATS-group), non-ATS group was younger (P<0.05), with lower BMI (P<0.05) and less traditional risk factors of coronary heart disease (P<0.05). Coronary angiography showed more normal artery (P<0.05) and lesions on left main (P<0.05). However, when compared to the elderly group, the young female ATS-group was associated with less hypertension (P<0.01), smoking (P<0.05), traditional risk factors (P<0.01) and lower level of blood pressure (P<0.05), fasting glucose (P<0.05), serum creatine (P<0.01), TC (P<0.05), and LDL-C (P<0.01) at admission. Coronary angiography showed single vessel disease was the most common lesion. Conclusions Acute myocardial infarction in young female might be caused by non-atherosclerosis. Those due to atherosclerosis differ in coronary risk factors and angiographic features from the elderly female AMI patients.

Objective To assess and compare the Beck Depression Inventory-II ( BDI-Ⅱ) , Hospital Anxiety and Depression Scale-Depression Subscale ( HADS-D) and Center for Epidemiologic Studies Depression Scale ( CES-D) as screening instruments for depression in patients with epilepsy .Methods One hundred and seventeen patients diagnosed with epilepsy were evaluated by BDI-Ⅱ, HADS-D and CES-D, the performance of BDI-Ⅱ, HADS-D and CES-D was evaluated by ROC curve .Results There were 33 epileptics with depression .The sensitivity and specificity of BDI-Ⅱfor the diagnosis of depression was around 90% for critical value 16, the sensitivity of CES-D was more than 80%for critical value 15, and specificity was 72.6%.The sensitivity and specificity of HADS-D was more than 80%for critical value 9, and the sensitivity of HADS-D was 91.3% for critical value 7, and specificity was 76.8%.Three instruments showed a negative predictive value of over 90%.Comparisons of the areas under the ROC curve for these instrument were not statistically significant difference (all P>0.05).Conclusion HADS-D is a brief efficient screening instruments to identify depression in patients with epilepsy .

BACKGROUND:There are more ways of internal fixation in treatment of elderly intertrochanteric fracture;however, how to choose a fixed way is the key issue of ensuring the efficacy. OBJECTIVE:To compare the therapeutic effect of proximal femoral anti-rotation intramedul ary nail and proximal femoral locking plate in the treatment of elderly femoral intertrochanteric fractures. METHODS:Total y 100 patients with femoral intertrochanteric fractures who received the treatment at Qionghai City People’s Hospital from December 2009 to December 2013 were randomly divided into locking plate and anti-rotation intramedul ary nail groups. Patients in the anti-rotation intramedul ary nail group underwent internal fixation using proximal femoral anti-rotation intramedul ary nail. Patients in the locking plate group underwent internal fixation using proximal femoral locking plate. RESULTS AND CONCLUSION:Compared with the locking plate group, the amount of bleeding, operation time, postoperative bed activity time and hospital stay in the anti-rotation intramedul ary nail group significantly reduced, the excel ent rate of Harris scores was significantly increased after 1 year of internal fixation and the incidence of complications and adverse reactions was significantly decreased. There was no host response to the material in these two groups.

OBJECTIVE:To establish an HPLC method for determination of triamcinolone acetonide(TA), diphenhydramine hydrochloride(DH) and miconazole nitrate(MN) in compound miconazole nitrate cream(MNC). METHODS: The determination was performed on Hypersil ODS2. The mobile phase consisted of methanol-acetonitrile-0.5% ammonium acetate (45∶35∶20) at a flow rate of 1.0 mL?min-1. The UV detection wavelength was 234 nm; the column temperature was 40 ℃ and the inject volume was 20 ?L. RESULTS: The linear ranges for MN, TA and DH were 0.16～0.64 (r=0.999 8), 0.02～0.06 (r=0.999 9) and 0.08～0.24 (r=0.999 2) mg?L-1 respectively, with their average recoveries at 100.0%, 99.6% and 100.7%, RSD at 1.2%, 0.8% and 0.9%(n=3) respectively. CONCLUSION: The HPLC method can be used for the simultaneous determination of the three constituents in CMNC.

Objective To investigate the role of mitochondrial KATP channel in the mechanism of the protective effect of ischemic preconditioning (IP) against ischemia-reperfusion (I/R) injury.Methods Forty-eight Wistar rats of both sexs weighing 250-350 g were used in this study. Forty rats were randomly divided into 5 groups ( n = 8 each): group A I/R; group B IP+ I/R; group C diazoxide (DZ mito-KATP channel activator) + I/R; group D 5-HD (mito-KATP channel blocker) + IP + I/R and group E 5-HD + DZ + I/R. Another 8 animals were used for electron microscopic examination of normal mitochondria as control. The animals were anesthetized with intraperitoneal pentobarbital 30 mg?kg-1. The hearts were immediately excised and passively perfused in a Langendorff apparatus with K-H solution at 5.8 kPa perfusion pressure and 36.5-37.5℃ via aortic cannulation. A fluid-filled latex balloon was via left atrium in left ventricle for the measurement of left ventricular function. I/R was induced after 30 min stabilization by clamping aortic cannula for 40 min followed by 30 min reperfusion. In group B and D the isolated hearts underwent 2 episodes of 5 min ischemia followed by 5 min reperfusion before I/R. In group C and E DZ 50 ?mol?L-1 was infused for 10 min and in group D and E 5-HD 100 ?mol?L-1 was infused for 10 min before I/R. HR, LVSP, LVEDP and coronary flow (CF) were measured at the end of stabilization (T0 , baseline), immediately before I/R (T1 ) and at 10, 20 and 30 min of reperfusion (T2.3.4.), and left ventricular developed pressure (LVDP= LVSP- LVEDP) was calculated. Myocardial tissue was obtained at the end of 30 min reperfusion for electron microscopic examination of mitochondria. Mitochondrial ultrastructure was assessed by Flameng scoring system (0 = normal, 4 = severely damaged) .Results Ischemic and DZ preconditioning significantly increased LVDP and decreased LVEDP and Flameng score. 5-HD pretreatment partly antagonized the protective effect of IP and completely antagonized that of DZ against I/R injury. Conclusion Ischemic preconditioning protects the heart against I/R injury mainly by activating mitochondrial KATP channel.