Objective: To study clinical application value of 320-slice spiral computed tomography (SCTCA) for diagnosing coronary artery disease. Methods: A total of 85 patients underwent 320-slice spiral CT and selective coronary angiography (CAG). With CAG as gold standard for diagnosing coronary heart disease (CHD), sensitivity, specificity, positive predictive value, negative predictive value and accuracy were compared between 320- SCTCA and CAG. Results: Sensitivity was 95.65%, specificity was 74.36%, positive predictive value was 81.48%, negative predictive value was 93.55% and accuracy was 85.9% diagnosing coronary artery disease by 320-slice spiral CT. Conclusion: 320-slice spiral computed tomography is a simple, safe, reliable non-invasive measurement, may be used for screening coronary heart disease and reviewing after operation.

Objective To observe histologic changes of human cytomegalovirus(hCMV)-infected explants of first trimester human placenta and expression of hCMV gene in the hCMV-infected explants, and investigate the mechanism of intrauterine transmission of hCMV from mother to fetus.Methods The first trimester placenta explants cultures were carried out, and they were infected with hCMV for 10 days. The expression of hCMV immediate early protein(IEP) 72-IEP86 were determined using indirect-immuno fluorescent assay, and in situ hybridization method was used to examine the hCMV late gene (LG)mRNA. For histologic evaluation of morphological changes in villi, transmission electron microscope was used.Results (1) Typical hCMV-induced lesions bearing hCMV IEP72-IEP86 were consistently localized in the trophoblast of covering placenta villi, interstitial cell and vascular endothelia cell 12 hours after infection, and were predominant in cytotrophoblast. (2) Replication of hCMV in placenta explants culture occurred from 12 hours to 24 hours and disappeared since 48 hours after infection with different concentrations of hCMV when examined by in situ hybridization. (3) Tissue integrity and viability of first trimester placenta explants were obtained in culture for 10 days and then explants were infected with different concentrations of hCMV 100 tissue culture infectious doses(TCID_ 50 ),200 TCID_ 50 and 300 TCID_ 50 , the progression of the infection was observed in the tissue that maintained its normal cellular organization under light microscope. But typical inflammation of cellular organization was observed under transmission electron microscope. Conclusions (1) A flash replication of hCMV in placental explants culture occurs; IEP72-IEP86 may be in intrauterine infection of hCMV for a long time. (2) There are pathological ultrastructure changes in hCMV-infected explants.

Objective To discuss the application of Apofix interlaminar clamp for the treatment of atlantoaxial instability. Methods From April 2000 to July 2004, 30 patients with atlantoaxial instability were treated with posterior atlantoaxial fusion and Apofix fixation. There were 24 males and 6 females. The mean age of the patients was 41 years (range, 19 to 67 years). The patients included 5 with atlantoaxial dislocation, 25 with odontoid fracture (including fresh fracture for 21, old fracture and nonunion for 4; Anderson Ⅱ for 23 and Anderson Ⅲ for 2). After reducted by skull traction, atlanto-occipital space, arcus posterior atlantis and axial laminar were exposed during operation, upper and lower hooks were inserted. The iliac bone graft was inserted into the space of C1 and C2, the connecting rod of the clamp was compressed and fixed. Results The follow-up of all cases ranged from 8 months to 3 years and 10 months (with the mean of 27 months). There were 28 cases with complete reduction of fracture and dislocation, 2 cases in incomplete reduction. The operation time was 70 to 150 minutes, and the average blood loss was 65 ml. Patients could sit up 3 days (2 to 6 days) after surgery with soft collar. The mean off-bed time was 7 days (2 to 10 days) after operation in the patients without or less spinal cord injury. All cases obtained solid bony fusion 3 months postoperatively. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Apofix interlaminar clamp has advantages of convenience in operation, provided reliable and safe stability for atlatoaxial segment. The results suggested that this technique is an efficient, reliable segmental posterior fixation.

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

ObjectiveTo study the necessity of treating prolapse of lumbar intervertebral disc by active movement treatment. Methods68 patients with prolapse of lumbar intervertebral disc were divided into the group of active movement treatment (31 cases) and the control group (37 cases). One year later, the recurrence rate and F wave motor nerve conduction velocity of two groups were compared. ResultsThere is a lower recurrence rate (P<0.05) and a faster F wave motor nerve conduction velocity (P<0.01) in the group of active movement treatment compared with the control group. F wave motor nerve conduction velocity of the group of active movement treatment is also faster than that of 1 year ago (P<0.001). Conclusions It is necessary for patients with prolapse of lumbar intervertebral disc doing active movement.

Objective To evaluate the effect of dexamethasone on lumbar plexus combined sciatic nerve block (CLPSNB). Methods Sixty patients were randomly allocated into three groups with 20 cases each. Guided by a nerve stimulator,CLPSNB was performed with 0. 5% ropivacaine 45 ml plus dexametbasone 10 mg in group A,0. 5% ropivacaine 45 ml plus normal saline(NS) 2 ml and dexametbasone 10 rng Ⅳ. in group B,or 0. 5% ropivacaine 45 ml plus NS 2 ml in group C. ResultsThe durations of sensory and motor blockade in group A were [(15. 2 ± 3. 3)h and (12. 6 ± 2. 8)h], respectively, which were significantly longer than [(10. 1 ± 2. 1)h and (7. 9 ± 1.6)h]in group B and [(10. 4±2. 5)h and (7. 6±2. 3)hi in group C(P<0. 05). Conclusion Dexarnetbasone added to 0. 5% ropivacaine significantly prolonges CLPSNB.

Objective To investigate the expression of Skp2 and Cx43 in cervical carcinoma and to study their relationships and clinical significance. Methods The expression of Skp2 and Cx43 was examined by immunohistochemical method in 48 cases of cervical carcinoma tissue, 84 cases of cervical intraepithelial neoplasia (CINⅠ - Ⅱ 45 cases, CINⅢ 39 cases), 28 cases of chronic cervicitis. Results Skp2 expression in cervical carcinoma was higher than that in the CINⅠ - Ⅱ and chronic cervicitis (P <0.05), Cx43 expression was lower in cervical carcinoma than that in the CINⅢ, CINⅠ - Ⅱ and chronic cervicitis (P <0.05). The expression of Skp2 was correlated with histological differentiation and lymph node metastasis (P <0.05). The expression of Cx43 was correlated with the lymph node metastasis (P <0.05). Besides, the expression of Skp2had a negative correlation with that of Cx43. Conclusion Skp2 and Cx43 may play an important role in the genesis and development of cervical carcinoma.

Angiogenesis Inducing Agents ; metabolism ; Angiogenesis Inhibitors ; therapeutic use ; Animals ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; therapeutic use ; Bevacizumab ; Drug Delivery Systems ; Endostatins ; therapeutic use ; Humans ; Neoplasms ; drug therapy ; Neovascularization, Pathologic ; drug therapy ; Receptors, Vascular Endothelial Growth Factor ; metabolism ; physiology ; Vascular Endothelial Growth Factors ; metabolism ; physiology

Objective To analyze the changing process and development trend of deaths (mortality)in patients with viral hepatitis after the use of the Internet-based National Notifiable Infectious Disease Reporting System.Methods Descriptive statistical and moving average methods were employed to analyze the infectious disease reports released by the Chinese government during 1992-2013,and the changing process and development trend of deaths (mortality)in patients with viral hepatitis in China over the past 10 years were investigated.Re-sults The annual deaths (mortality)in patients with viral hepatitis showed a decreasing trend.The deaths (mortality)from hepatitis B showed a slight declining trend,accounting for a great proportion (over 70%)of the deaths (mortality)from viral hepatitis;the deaths (mortality)from hepatitis C had shown a slight downward trend since 2007;the deaths (mortality)from hepatitis A and unclassified hepati-tis decreased to different extents;the deaths (mortality)from hepatitis E remained at a relatively low level.Conclusion The treatment of viral hepatitis has been gradually improved in China and the public awareness of viral hepatitis keeps increasing.However,much attention still needs to be given to the prevention and treatment of viral hepatitis,especially hepatitis B and C,by the government.