Aim To examine the apoptosis and bFGF expression on the cochlea of guinea pig after administrated streptomycin(SM) and the antagonism of Salvia Miltiorrhiza Injection(DS) on SM ototoxity.Methods Forty guinea pigs were divided into four groups,and treated with DS and SM respectively.The apoptosis and bFGF expression were examined by TdT mediated biotin dUTP nickend labeling(TUNEL) techniques and SABC immunohistochemical staining with paraffin slide.The intensity of images were stored in a computer and analyzed by the image quantitative analysis technique.Auditory brainstem response(ABR) measurement was used to detect the ototoxicity before/after the examination.Results After 10 d treated by drugs,the ABR threshold of SM increased significantly,while the DS+SM reduced more(P

Objective: To investigate the reparative dentine formation induced by the recombinant human bone morphorgenetic protein2(rhBMP2) used as a indirect pulp capping agent in dog teeth. Methods: Type V cavities were prepared in 48 teeth of 2 dogs. rhBMP2 with zinc oxide(A) was lined on the bottom of 24 cavities, saline with zinc oxide(B) in 12 and zinc oxide eugentol cement(C) in 12. 0.5 g of tetracycline was orally administered to the dogs twice a day on day 24, 54, 83 and 111. On day 135, the teeth were extracted and processed for the quantitative observation of reparative dentin under a fluorescent microscope .Results: On day 135, the reparative dentine (expressed as "?m" of diameter of area) in group A, B and C was 825.04? 125.46, 315.33? 80.43 and 415.25? 90.75 respectively(P

BACKGROUND:Studies on the proteomics contribute not only to exploring the laws governing life activities, but also to elucidating the pathogenesis of a variety of diseases to find the treatment strategies. OBJECTIVE:To summarize the application of proteomics in the plateau medical research. METHODS:A computer-based online search was conducted in PubMed and Wanfang databases from 1995 to 2015 to screen the relevant literatures using the key words“proteomics, medical research, plateau medicine”in English and Chinese, respectively. A total of approximately 200 English and 60 Chinese relevant literatures were selected and the 59 eligible literatures were included after screening final y. RESULTS AND CONCLUSION:Currently, the human genome has been decoded through the studies on exploring the proteomics changes under the pathological conditions and the underlying mechanisms. Construction of physiological and pathological mapping based on the human proteome contributes to revealing the novel treatment targets, diagnostic markers, and drugs for the prevention and treatment of diseases. Proteomics has become the frontier and hot research field both at home and abroad, including al the proteins expressed in the tissue, cel or organism, and becomes a bridge between the genome and clinical application.

Objective To evaluate the application of multi-slice computed tomographic coronary angiography in diagnosis of chronic total occlusion (CTO) of coronary artery.Methods Six hundred and thirty eight patients were diagnosed as CTO disease with coronary angiography (CAG) from June 2011 to December 2012 in Zhongshan Hospital;236 of them received multi-slice computed tomographic coronary angiography in 60 days before.Results In total 708 vessels of the 236 patients,244 vessels were proved totally occluded,128 (52.5％) of which were located in left anterior descending artery,31 (12.7％) were located in left circumflex coronary artery and 85 (34.8％) located in right coronary artery.Multi-slice computed tomographic coronary angiography was superior to CAG in judgment of stump anatomy (64.3％ vs.52.5％,F =7.09,P =0.010),plaque calcification (40.2％ vs.26.2％,F =10.68,P =0.001) and distal vessel interpretability (93.9％ vs.74.6％,F =34.06,P ＜ 0.001).There was no significant difference in judging side branch,tortuosity and lesion length between multi-slice computed tomographic coronary angiography and CAG (all P ＞ 0.05).Conclusion Multi-slice computed tomographic coronary angiography provides more detailed anatomy information of CTO lesions and is of value in diagnosis and treatment of CTO lesions.

Coronary Occlusion ; therapy ; Coronary Vessels ; Humans ; Percutaneous Coronary Intervention

BACKGROUND:Transverse acetabular fracture often involves the damage of anterior and posterior columns of acetabulum. The most popular fixation of the anterior and posterior columns needs the combined anterior and posterior approach. Big trauma is not conducive to patient’s recovery after surgery. Limited incision or percutaneous minimaly invasive lag screw placement can reduce soft tissue injuries, but the strength of the fixation lacks of biomechanical verification. OBJECTIVE: To compare different types of fixations for transverse acetabular fracture, explore the appropriate fixation options that can achieve effective fixation and reduce tissue injury by combing with repair approach and the condition of soft tissue. METHODS: The fourth generation of synthetic semi-pelvic sawbones was set as a template to establish a model of acetabular transverse fracture using finite element analysis. Five different fixation options were used to fix the transverse acetabular fracture. The magnitudes of anterior and posterior displacement of transverse fracture were compared to assess the stability of different options under a simulated condition of incomplete weight bearing stand. RESULTS AND CONCLUSION:The motion at anterior column was minimal when fixed by anterior column locking plate + posterior column screw and the minimum displacement at posterior column was the fixation of anterior column screw + posterior column locking plate. Both of the motions of these two fixations were less than the reconstruction plate fixation respectively. The worst fixation was the anterior column and posterior column lag screw fixation with the largest displacement. The anterior column locking plate + posterior column screw, accomplished by single approach, could not only reduce surgical trauma, but also has a stronger stability. Moreover, this fixation option is effective method to place posterior column lag screw under direct vision and reduce the difficulty of screw implantation.

Objective To observe the efficacy of antithrombotic treatment of acute ST-segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden,and its effect on elective percutaneous coronary intervention.Methods Eight acute ST-segment elevation myocardial infarction patients were enrolled,who suffered from failure of primary percutaneous coronary intervention because of high thrombus burden.Summarize the antithrombotic strategies in perioperative and postoperative period,the operative strategies and the follow-up coronary intervention were recorded and reviewed.Results All the patients were male and most of them had acute inferior myocardial infarction with right coronary occluded because of high thrombus burden.Four patients received thrombus aspiration and balloon dilation.One patient received thrombus aspiration and the other three patients did not receive coronary intervention.Tirofiban were given in perioperative period to all the patients.Low molecular weight heparin was given to 6 patients.Dual antiplatelet therapy was given to 6 patients (aspirin 100 mg/day plus clopidogrel 75 mg/day) and 1 patient required up-titration of aspirin to 200 mg/day.Coronary angiography were repeated (29.00 ± 23.25) days later,and the thrombus in the culprit vessels disappeared in two patients,and coronary stent implantation was performed in three patients.Conclusions The routine antithrombotic strategies play limited roles in thrombus clearance in acute ST segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden.The time for the thrombus to be totally organized and the timing of elective percutaneous coronary intervention are still uncertain and need to be further studied.

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

Objective:To establish training system for postoperative delirium (POD) assessment and evaluate the efficacy of training for anesthesia nurses.Methods:Sixteen nurse anesthetists of both sexes in our hospital were selected and received the systemic training for POD assessment.The training system included questionnaire survey, theoretical teaching, simulated visit, clinical observation, independent evaluation, centralized question-answering, evaluation of efficacy and random inspection.The level of POD knowledge tests were performed before the training and at the end of the fourth week of independent evaluation, respectively.At week 1 and 4 of independent evaluation, the diagnostic rate of POD and sensitivity and specificity of the assessment were calculated, and Kappa consistency analysis was used to assess the consistency between anesthesia nurses and training group in diagnosis of POD.In the first week of the third month after the end of training, the evaluation results were randomly inspected, the POD diagnosis rate was calculated between the anesthesia nurses and the training group, and the consistency analysis was conducted.Results:Compared with the scores of POD knowledge questionnaire and sensitivity of the assessment of the anesthesia nurses in the first week of training, the scores were significantly increased ( P<0.05), and no significant change was found in the POD diagnosis rate in the fourth week of training ( P>0.05). Compared with the training group, the diagnosis rate of POD of anesthesia nurses was significantly decreased in the first week of training ( P<0.05), and no significant change was found at the fourth week of training ( P>0.05). In the first and fourth weeks of training, the Kappa value of anesthesia nurses and the training group was 0.676 and 0.954 ( P<0.001), respectively.In the first week of the third month after the end of training, the Kappa value between anesthesia nurses and the training group in diagnosis of POD was 0.862 ( P<0.05). Conclusion:The training system of POD assessment has been successfully established, and the standardized anesthesia nurses training of POD has been achieved with good results.

Objective:To analyze the frequency and alteration of circulating dendritic cells (DCs) and subtypes in patients with ST‐elevated acute myocardial infarction(AMI) .Methods:A total of 17 patients with ST‐elevated AMI(AMI group) and 14 pa‐tients with stable angina pectoris(SAP) as SAP group and 15 people with normal coronary angiogram with matched age and gender(control group) were enrolled .The absolute number and percentage in peripheral blood mononuclear cells of circulating DCs ,myeloid dendritic cell(mDC) and plasmacytoid dendritic cell(pDC) in the three groups were detected using the 3‐colure staining flow cytometry .The levels of interleukin‐6(IL‐6) and tumor necrosis factor‐α(TNF‐α) were detected with enzyme‐linked immunosorbent assay .In the AMI group ,these indexes were measured on the 7th day after the attack .Results:The per‐centage of circulating DCs in peripheral blood mononuclear cells and the absolute number of DCs ,the percentage of circulating mDC and pDC in peripheral blood mononuclear cells and the absolute numbers of mDC and pDC and mDC/pDC ratio in the AM I group on the day of attack(<24 h) were significantly lower than those in the control group and the SAP group(P<0 .01 or 0 .05) .In the AMI group ,on the 7th day after the attack , the percentages of DCs ,mDC and pDC in peripheral blood mononuclear cells and the absolute numbers of DCs ,mDC and pDC and mDC/pDC ratio were higher than those on the day of attack (P<0 .01 or 0 .05) .The level of IL‐6 and TNF‐αin the AMI group on the day of attack were significantly higher than those in the control group and SAP group(P<0 .05) ,and the level of IL‐6 decreased on the 7th day after the attack in the AMI group (P<0 .05) .But there was no significant difference in the percentage of DCs ,mDC and pDC in peripheral blood mononu‐clear cells and the absolute numbers and mDC/pDC ratio between the control group and the SAP group(P>0 .05) .Conclu‐sions:Circulating mDC and pDC are significantly reduced in patients on the day of attack of AM I ,and it can increase to nearly normal on the 7th day after attack .It indicates that the possibility of DCs recruits into coronary plaques and improve the forma‐tion of unstable plaque .