Purpose To evaluate the application value of rapid exchange method in transnasal intestinal obstruction catheterization. Materials and Methods Fifty-eight patients with adhesive intestinal obstruction underwent transnasal catheterization under X-ray fluoroscopy, of which 31 cases were treated with rapid exchange catheterization method (group A) and the other 27 cases with traditional catheterization method (group B), success rate, operation time and complications were compared between the two groups. Results Catheterization success rate of group A and group B were 96.77%(30/31) and 77.78%(21/27) respectively, which was significantly higher in group A than in group B (χ2=4.907, P<0.05);operation time of group A and group B were (28.2±12.3) min and (25.4±15.7) min respectively, and the difference between them was not statistically significant (t=1.219, P>0.05); no operation associated injury occurred in group A and only one case in group B (3.70%) resulted in bilateral nasal edema with a small amount of bleeding because the operating time was too long, complication rate between the two groups was also not statistically significant (P>0.05). Conclusion Rapid exchange method can improve the success rate of transnasal intestinal obstruction catheterization, but the operation time and complications are comparative to those of the conventional method.

Objective To explore the prediction of sustained virological response (SVR)in the patients with hepatitis C virus (HCV)genotype 1 based on the polymorphism of IL‐28B gene to provide scientific reference basis for the treatment of the patients . Methods the quantitative value of HCV was detected by fluorescence quantitative PCR method ,and the genotype of rs129798600 was detected by gene sequencing method .Results The age in the patients with cevr was significantly lower than that in the patients with no cevr(Non‐cEVR) ,while the male proportion and the level of ALT level were significantly higher than those in the latter ;IL‐28B genotype CC and age less than 40 years old were independent related factors of cEVR occurrence .Conclusion In the pa‐tients with HCV rs129798600 site CT genotype ,it can be considered that the PEG‐IFN combined RBV treatment is conducted in the patients aged less than 40 years old ,while the other patients could be treated by the triple therapy .

Objective To explore the application effect of sufentanil or dexmedetomidine on blind intubation in 88 patients with difficult airway .Methods Eighty eight cases of patients with difficult airways in our hospital were divided into treatment group and control group depending on different preoperative sedation .There were 44 cases in each group .Patients in the treatment group were treated with dexmedetomidine anesthesia treatment ,and patients in the control group were treated in clinical routine application of sufentanil anesthesia ,both groups were taken blind intubation after anesthesia treatment .The heart rate ,systolic arterial pressure , diastolic arterial pressure and respiratory rate of patients before anesthesia ,after anesthesia ,when the intubation tube reached uvu‐la ,epiglottis ,when the intubation finished and 5 minutes after the intubation were recorded .Cases of nausea ,dysphoria ,bucking and respiratory depression during the intubation were also recorded .Results From the induction of anesthesia to 5 min after intubation , the respiratory rate of the treatment group was higher than the control group (P<0 .05);the systolic blood pressure ,diastolic blood pressure and heart rate of treatment group were significantly lower than the control group since intubation tube arrive uvula until the completion of systolic (P<0 .05);The arterial oxygen pressure was (98 .52 ± 9 .18) mm Hg in the treatment group 5 min after intubation ,which was significantly higher than the control group which was (93 .46 ± 10 .81) mm Hg (P<0 .05);cases of nausea , dysphoria ,bucking and respiratory depression in the treatment group were significantly lower than that of control group(P<0 .05) , and the average intubation time of the treatment group were significantly shorter than that of control group (P<0 .05) .Conclusion Dexmedetomidine could effectively improve the condition of the patients with difficult airways ,achieve effective anesthesia ,reduce cardiovascular reactivity in patients ,and ensure the smooth progress of intubation for the difficult airway patients .

In eukaryotic cells,heat shock factor 1 is the main specific transcription factor mediating the enhanced expression of heat shock proteins when cells experience stresses.It is kept in a latent state by inhibitory complexes under unstressed conditions.It is only transiently activated in response to diverse forms stresses.Dominant-positive heat shock factor 1 has been developed through deletion-mutation.It can activate the expression of endogenous heat shock proteins in the absence of stresses.Environmental neurotoxins play an important role in the pathogenesis of Parkinson's disease.The neurotoxins induce cell death of dopamine neurons through oxidative damage.The results of Western blot and dual-luciferase analysis indicate that the expression of HSP70 was greatly up-regulated in dopaminergic SH-SY5Y cells transfected with dominant-positive heat shock factor 1.To investigate the effect of dominant-positive heat shock factor 1 on 6-OHDA-induced apoptosis in dopaminergic SH-SY5Y cells,the release of lactate dehydrogenase was detected.The result argues that dominant-positive heat shock factor 1 significantly inhibits neurotoxin 6-OHDA-induced cell death in SH-SY5Y cells.The cyto-protective role may be attributed to HSP70 activated by dominant-positive heat shock factor 1.Taken together,it is possible that dominant-positive heat shock factor 1 can be used to prevent or cure Parkinson's disease.

Objective To evaluate superselective external carotid artery embolization before transnasal endoscopic resection in treating nasopharyngeal angiofibroma.Methods Superselective external carotid artery embolization was performed in 20 patients with nasopharyngeal angiofibroma one to three days before transnasal endoscopic resection was carried out.The clinical data,including the volume of blood loss during the surgery,the operative time and the complications,were retrospectively analyzed.Results Superselective external carotid artery embolization was successfully preformed in all 20 patients,which was followed by the transnasal endoscopic resection within 3 days.The average volume of blood loss during the surgery was 155 ml and the total time of operation was 75 minutes.Mild complications occurred in 6 patients after embolization,which were subsided after symptomatic management.No serious complications occurred after surgical resection.The mean hospitalization days of the patients were 3.5 days.Conclusion Preoperative superselective external carotid artery embolization of nasopharyngeal angiofibroma can markedly reduce the blood loss during surgical resection,apparently shorten the operative time and effectively lower the occurrence of complication after the operation.Superselective external carotid artery embolization combined with transnasal endoscopic resection should be regarded as an ideal therapy for nasopharyngeal angiofibroma.

Objective To evaluate the technique and result of endovascular treatment for right subclavian artery stenosis or occlusion.Methods Seventeen patients [13 males,4 females ; (56 ± 11)years old] with right subclavian artery stenosis or occlusion were treated with endovascular surgery which included recanalization,balloon angioplasty and stenting via femoral or brachial artery route.Cerebral protection devices were used in 6 cases to avoid cerebral embolism.Results Sixteen of the seventeen patients acquired successful recanalization in 8 cases with subclavian artery stenosis (100％ technical success rate) and in other 8 cases with subclavian artery occlusion (88.9％ technical success rate).Five cases were treated with balloon angioplasty,and 11 cases were treated with balloon angioplasty combined with stenting.Good patency was seen in the 16 cases immediately after the procedure.The cerebral protection devices prevented all the cases from cerebral embolism and were retrieved suceessfully.Sixteen cases were followed up from 1 to 66 months [mean (24 ± 18) months].Restenosis was found in one case 10 months later and was successfully treated with re-PTA.One case with aortoarteritis died of cerebral infarction 18 months later.No symptom recurrence was found in other cases and ultrasound or CTA of followup showed excellent patency.Conclusions Balloon angioplasty and stenting are safe and effective for the treatment of right subclavian artery occlusion.

Objective To evaluate the safety and effectiveness of treating the endovascular stents placement for spontaneous isolated dissection of splanchnic artery ( SIDSA).Methods Sixteen consecutive patients with diagnosis of SIDSA through CTA and DSA were retrospectively analyzed .All patients had acute persistent abdominal pain and treated by endovascular stents placement.The serious complications and symptoms improvement were reviewed after the operation.The symptoms recurrence and repeated color doppler ultrasonography and CTA were also reviewed in the follow up.Results Twelve superior mesenteric artery ( SMA) dissection and four celiac artery ( CA) dissection were diagnosed among sixteen patients.The dissection length was 1.07 to 11.87 cm and the median length was 3.93 cm.The distance from the original dissection to the orifice of superior mesenteric artery or celiac artery was 0.50 to 6.44 cm and the median was 1.98 cm.Eight stent-grafts and 3 bare stents were successfully implanted in 11 patients.One case with celiac dissection was failed to treat because of the severe compression of true lumen and the guide wire cann′t cannulate to the distal true lumen.Four patients with superior mesenteric artery dissection gave up interventional therapy , Among these 4 patients , 2 patients had small tear site and small false lumen , 1 patient had extremely long dissection , and one case had blood supply of target organs from both true and false lumen.No severe complications such as hemorrhage , intestinal necrosis , hepatic failure and splenic necrosis occurred during the eleven successful endovascular interventions.The abdominal pain in 10 cases was disappeared or significantly relieved , 1 case with superior mesenteric vein thrombosis and severe intestinal ischemia before intervention underwent intestinal resection for necrosis.The follow up period was 1 to 74 months in eleven successful cases , and the median follow-up period was 16 months.One patient with SMA dissection after endovascular treatment was died of sudden stroke three months later .Others had satisfactory outcome and the repeated color doppler ultrasonography and CTA were normal .Conclusions Endovascular stents placement is a safe and effective therapy for symptomatic spontaneous isolated dissection of splanchnic artery.

Objective To investigate the long-term prognostic factors and the significance of serum cardiac troponin T (cTnT) and C-reactive protein (CRP) in maintenance hemodialysis (MHD) patients.Methods Clinical data of 76 MHD patients in our hospital from January 2002 to January 2003 were retrospectively analyzed.Time and cause of death in the next 10 years were recorded.Survival rate was calculated by Kaplan-Meier and impact factors of long-term prognosis were explored.Significance of cTnT and CRP was elucidated by COX regression analysis.Results CRP was positive in 28 cases (36.8％) and cTnT was positive in 22 cases (28.9％) among 76 patients.The median survival time was 37.9 months,2-year survival rate was 65.9％ and 10-year survival rate was 24.2％.Univariate analysis found positive CRP,positive cTnT,old age,diabetes,cardiocerebrovascular disease,anemia,low serum albumin,Kt/V decline were associated with long-term prognosis.Multivariate analysis showed that increased age (P =0.010),cardiocerebrovascular disease (P =0.048),positive cTnT (P =0.036),positive CRP (P =0.009) were independent risk factors of the 10-year survival of MHD patients.Ten-year mortality of cardiocerebrovascular diseases in positive cTnT group was not significantly different as compared with negative cTnT group (50.0％ vs 35.4％,P =0.248).But the positive cTnT group had higher 2-year mortality than negative cTnT group (40.9％ vs 14.6％,P =0.015).Mortality of cardiocerebrovascular disease was higher in positive CRP group as compared to negative CRP group at both 2-year and 10-year time (48.1％ vs 7.0％,P =0.000; 66.7％ vs 23.3％,P =0.000).Compared with both negative cTnT and CRP group,both positive cTnT and CRP group had much higher all-cause mortality (92.9％ vs 55.6％,P =0.030),higher mortality of cardiocerebrovascular disease at 10-year (64.3％ vs 25.0％,P =0.009),and higher mortality of cardiocerebrovascular disease at 2-year (57.1％ vs 5.6％,P =0.000).Conclusions Aging,cardiocerebrovascular disease,positive cTnT and positive CRP are independent risk factors of long-term prognosis for MHD patients.Positive cTnT can predict cardiocerebrovascular mortality of MHD patients in 2 years,while positive CRP can predict short-and long-term cardiocerebrovascular mortality.Positive cTnT combined with positive CRP may be more valuable in predicting the poor prognosis of MHD patients.

BACKGROUND:The microcosmic and submicroscopic organizations of tissue engineering scaffold matedals’superficial structure have all important effect on the eell adhesion and growth.By means of nano.Technique and three-dimensional porous technique,the resultant nano-hydroxyapatite/collagen(n-HAC)call imitate the component and microstructure of natural bone.OBJECTIVE:To observe the biocompatibility of human bone m arrow mesenchymal stem cells(MSCs)cultured in vitro with nHAC.DESIGN,TIME AND SETTING :Single samples observation was performed in the Experimental Center of School ofMedical Technology,Jiangsu University from September 2005 to December 2006. MATERIALD:nHAc was provided by the Material Science and Engineering Department of Tsinghua University.Humanbone marrow mesenchymal stem cells were derived from healthy adult volunteers.All the subiects signed the informedconsents. METHODS:Whole bone marrow culture and successive adherence method was used to culture MSCs in vitro,and the cells were then induced to differentiate into the phenotype of osteoblasts by the revulsants(methylprednisolone,vitamin C,β-glycerophosphate and basic fibroblast growth factor).MSCs at passage 3 were co-cultured with nHACfor 14 days.MAIN OUTCOME MEASURES:The cytological characteristics of the osteoblast were identified throue,alkalinephosphatase immunohistochemistry method and Von Kossa stain.The growth condition with or without nHAC wasevaluated through invert microscope and scanning electron microscope,respectively.RESULTS:The cultured MSCs proliferated into uniform fibroblast-like cells rapidly.MSCs reached confluence and started to form multilayers averaging from 10 to 12 days,passaged stably as well.Then the MSCs passaged from 7 to 9 days.Cytochemistry evaluation showed that MSCs in induced culture were positive for alkaline phosphatase and Von Kossa stain,and deposited calcified matrix.It showed a typical ostcoblast feature in morphology and biology.In coculture model ofMSCs with nHAC,cells would attach to the inner surface of nHAC.At 8 days,the osteoblasts proliferated in the nHAC and the secretion of the matrix was observed.Lots ofcells adheredon the surfaceand pores of nHAC at 14 days.There wereextensive prominent connections among cells. CONCLUSION:THE nHAC is suitable for MSCs to adhere,grow and proliferate,with a good compatibility.

Objective To explore the clinical application of adaptive support ventilation (ASV) in elderly patients with acute respiratory failure.Methods A total of 46 mechanically ventilated patients aged over 65 years with acute respiratory failure admitted from January 2013 to June 2015 were enrolled.Comparison between the ASV mode and synchronized intermittent mandatory ventilation (SIMV) mode was carried out in respects of the impacts of both modes on respiratory mechanics, hemodynamics, oxygen availability and comfort rate.Results Difference between ASV and SIMV in respiratory rate was [(20.84 ±4.04) vs.(24.50 ±4.60) cycles/min, t =4.04, P ＜0.05], in inspiratory resistance was [(13.24 ±4.76) vs.(16.54±5.25) cmH2O/ (L·s), t=3.16, P＜0.05], in mean airway pressure was [(13.58±2.58) vs.(16.63 ±1.57) mmHg, t =6.84, P＜0.05], in peak airway pressure was [(25.96 ± 3.69) vs.(27.87 ± 2.45) mmHg, t =2.92, P ＜ 0.05], and tidal volume was [(378.41 ± 85.61) vs.(341.52 ± 86.84) mL, t =2.05, P ＜ 0.05], and comfort rate of patients was increased in ASV mode.There were no statistically significant differences in arterial oxygen partial pressure, carbon dioxide partial pressure, lactate, heart rate, mean arterial pressure and central venous pressure between the two modes (PP ＞ 0.05).Conclusions Compared with the synchronized intermittent mandatory ventilation mode, the adaptive support ventilation mode can improve the respiratory mechanics and can increase the comfort rate in the elderly patients with mechanical ventilation.