Fibromuscular dysplasia, a cryptogenetic segmental, nonatherosclerotic, noninflamma-tory arterial disease that most commonly involves the renal and carotid arteries, is one of the causes of ischemic stroke in young adults. With the development of various angiographic techniques, the detection rate of fibromuscular dysplasia becomes higher and higher, This article reviews the advances in fibromuscular dysplasia.

Objective: To study the relationship between slow coronary lfow (SCF) and coronary microcirculatory dysfunction in relevant patients and to explore the risk factors for SCF development. Methods: Our research was conducted in 2 groups: SCF group, the patients with coronary angiography conifrmed diagnosis and Control group, the subjects with normal coronary lfow.n=32 in each group. The general information, blood levels of biochemical indicators, hs-CRP levels, TIMI lfow frame and the index of microcirculatory resistance (IMR) were examined, their relationships to SCF were analyzed. Results: Compared with Control group, the patients in SCF group showed the lower levels of HLL-C (1.57 ± 0.38) mmol/L vs (1.62 ± 0.43) mmol/L and Apo-A1 (1.41 ± 0.31) mmol/L vs (1.57 ± 0.38) mmol/L, while higher level of hs-CRP (3.63 ± 1.67) μg/mL vs (1.74 ± 0.75) μg/mL; SCF groups had increased IMR (29.28 ± 7.68) vs (24.94 ± 6.67), all P<0.05. IMR was positively related to TIMI lfow frame (r=0.766, P=0.019) and hs-CRP (r=0.565, P=0.000). Conclusion:①Microcirculatory dysfunction was related to SCF.②Inlfammatory reaction, decreased blood levels of HDL-C and Apo-A1 might be involved in pathological process of SCF.

Objective: To explore the relationship between slow coronary lfow (SCF) and characteristics of coronary lumen condition in relevant patients.
Methods: We retrospectively summarized 2117 patients who received coronary angiography (CAG) in Weifang people’s hospital from 2012-08 to 2014-04 and 2 groups of patients were enrolled in our study. SCF group, according to TIMI frame count, the patients had coronary stenosis<50%, without coronary thrombosis, expansion and dissection,n=110. Control group, the patients had normal CAG at meanwhile,n=49. The diameters of left main (dLM), left anterior descending proximal section (dLADp) and middle section (dLADm), left circumlfex (dLCXp) and dLCXm, right coronary artery (dRCAp) and dRCAm were measured; the ratios of dLADp/dLADm, dLCXp/dLCXm, dRCAp/dRCAm were compared between 2 groups.
Results: The ratios of dLADp/dLADm, dLCXp/dLCXm, dRCAp/dRCAm were similar between 2 groups,P>0.05. Compared with Control group, SCF group had increased dLM, increased dLADp and dLADm, dLCXp and dLCXm, dRCAp and dRCAm, allP<0.05. Pearson correlation analysis showed that coronary TIMI frame counts were positively related to the diameters of distal and middle sections of each vessel, the correlation coefifcients in LAD were 0.036 and 0.204, in LCX were 0.368 and 0.183, in RCA were 0.253 and 0.209, allP<0.05. Left coronary TIMI frame count was positively related to the diameter of LM, the correlation coefifcient was 0.501,P<0.05.
Conclusion: Elevated coronary TIMI frame count was related to increased vessel diameter, the expended diameter of left and right coronary arteries may promote SCF development in relevant patients.

Objective To evaluate the value of ghrelin on predicting prognosis in patients with chronic heart failure (CHF) after hospital discharge.Methods Totally 145 patients withCHF (age≥60 years,83 males and 62 females) were divided into 3 subgroups by New York Heart Association classification (NYHA):class Ⅱ (n=48),class Ⅲ(n=57) and class Ⅳ(n =40).According to the basic diseases,the CHF group was divided into five subgroups.All patients were followed up for about 2 years.The study included 55 healthy control subjects (30 males and 25 females).Results Plasma ghrelin level was lower in CHF cases (1.66±0.28) μg/L than in control subjects (2.27±0.26) μg/L (t 3.77,P＜0.01).The ghrelin level in NYHA Ⅱ(1.85±0.13) μg/L were higher than in NYHA Ⅲ (1.56±0.28) μg/L,the latter were higher than in NYHA Ⅳ (1.27±0.24) μg/L (P＜0.05).The plasma ghrelin level of patients after treatment (1.98±0.25) μg/L was increased compared with that of before treatment (1.66±0.28) μg/L (P＜0.05).No significant difference was found among the five basic disease groups (P＞0.05).During the follow up periods of (637±97)days,plasma ghrelin level was decreased in patients with cardiovascular event (1.26±0.38) μg/L than in patients without cardiovascular event (1.86±0.34) μg/L.The plasma ghrelin was negatively correlated with left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (P＜0.05).Conclusions The plasma ghrelin in elderly patients with CHF is decreased than in healthy adults,and its level is lower in patients with severe heart failure.The plasma ghrelin is a predictor of cardiovascular event and death in elderly patients with CHF.

Objective To evaluate the validity of lipoprotien(a) [Lp(a)] concentration as diagnostic test for coronary heart disease (CHD) and stegnotic degree of coronary artherosclerosis. Methods 416 cases of patients who were assessed with coronary angiography were divided into four groups according to the stegnotic degree of coronary artherosclerosis. There were no stenosis and lipid plaque group, single branch group, double branch group, three branch and suffusive stenosis group. TC, HDL - C, LDL - C, ApoAl, ApoB, Lp(a) were examined in early morning fasting for 12 hours after the next admission day. Other risk factors were also recorded, such as hypertension. Results When Lp(a) concentration was used alone to diagnose CHD, the best cutoff value was 15 mg/dl. The crude agreement was 58.2% , the sensitivity was 57.5% , and the specificity was 59.3% . Along with the stegnotic degree of coronary artherosclerosis heavier, the levels of the crude agreement and the sensitivity had a indreasing trend,and levels of the false negative rate had a deoreasing trend. Conclusion The validity of Lp(a) concentration as diagnostic test for CHD is not satisfactory.

BACKGROUND: An effective preservation method must preserve the integrity of tissue structure. OBJECTIVE: To compare the effects of vitrification and cryopreservation method on the artery morphology and mechanical properties. DESIGN, TIME AND SETTING: The randomized controlled animal experiment was done at the Department of Orthopedics, General Hospital of Chinese PLA, between September 2001 and August 2004. MATERIALS: Eighteen New Zealand rabbits were randomly divided into vitrified artery group, cryopreserved artery group and fresh artery group, with 6 rabbits in each group. METHODS: Femoral arteries were removed from rabbits and put in balanced solution. Arteries in the vitrified artery group were immersed in the 25%, 50% and 100% gradient vitrified solution at 4 ℃ and then were put in liquid nitrogen. Arteries in the cryopreserved artery group were cooled from normal temperature to 0, -20, -70 ℃, and balanced for 60 minutes, then were put in liquid nitrogen. Samples were preserved in liquid nitrogen for more than 14 days. MAIN OUTCOME MEASURES: The morphology changes of preserved arteries observed through naked eye and microscope; hysteresis loop; stress relaxation; breaking strength. RESULTS: Artery structures were all preserved well in the three groups, the integrity rate of vitrified artery group was 91.67%, which was significantly better than 54.17% of cryopreserved artery group (P 0.05). CONCLUSION: There influences of vitrification and cryoprsesrvation on the artery morphology and mechanical properties were not significant, while arteries preserved by vitrification had less tissue ruptures, so vitrification is suitable for preserving long vessels.

Background Cysteine-rich 61 (Cyr61)/CCN1 has been reported to stimulate retinal neovascularization (RNV) in retinopathy of prematurity (ROP).However, whether CCN1 small interfering RNA (CCN1 siRNA) can inhibit or cure ROP has not been extensively investigated.Objective This study was to investigate the regulation effect of CCN1 specific siRNA expression vector on retinal endothelial cells.Methods Rhesus choroid-retinal vascular endothelial cells (RF/6A) were cultured under the normoxic (normoxia control group) and hypoxic condition (1％ O2,5％ CO2 with 94％ N2) in vitro, and then lipofectamineTM 2000 (LF2000) vector plasmid with or without CCN1 siRNA was transiently transfected in the hypoxic-cultured cells as the CCN1 siRNA transfected group and hypoxic control group, respectively.Reverse transcription PCR was employed to detect the expression of CCN1 siRNA plasmid 24 hours after transfection.The vatality of the cells was assayed by cell counting kit-8 (CCK-8) 0,24,48,72 and 96 hours after cultured.Twenty-four hours after cultured,the apoptosis of the cells was evaluated by flow cytometry, and the expressions of CCN1 and vascular endothelial growth factor (VEGF) proteins were detected by immunofluorescence technique and Western blot assay.Results The expression band of CCN1 siRNA was detected in the cells 24 hours after transfection of CCN1 siRNA.CCK-8 assay showed that RF/6A cells were significantly increased over time, and the proliferating value (absorbancy) of the cells was significantly reduced in the CCN1 siRNA transfected group compared with in the normoxia control group and hypoxic control group (Fgroup =198.45, P＜0.05;Ftime =39.26, P＜ 0.05).The apoptosis rates of the cells were (68.9± 1.1) ％ , (18.9±1.3)％ and (39.6± 1.8)％ in the CCN1 siRNA transfected group, normoxia control group and hypoxic control group,and the apoptosis rates of the CCN1 siRNA transfected group were evidently higher than those of the normoxia control group and hypoxic control group (t =2.93 ,t=2.56 ,both at P＜0.05).CCN1 and VEGF proteins were weakly expressed in the normoxia control group and strongly expressed in the hypoxic control group,however,their expression intensity was evidently weakened in the CCN1 siRNA transfected group.The related expression levels of CCN1 and VEGF proteins in the CCN1 siRNA transfected group were significantly lower than those in the hypoxic control group (both at P＜0.05).Conclusions RNA interference targeting CCN1 can inhibit proliferation and promote apoptosis of RF/6A cells.CCN1 siRNA can arrest RNV probably by downregulating the expression levels of CCN1 and VEGF in the cells.

Objective To fabricate cartilage extracellular matrix (ECM) oriented scaffolds and investigate the attachment, proliferation, distribution and orientation of bone marrow mesenchymal stem cells (BMSCs) cultured within the scaffolds in vitro. Methods Cartilage slices were shattered in sterile phosphate-buffered saline (PBS) and the suspension were differentially centrifugated untill the micro- fiber of the cartilage extracellular matrix was disassociated from the residue cartilage fragments. At last the supernatant were centrifugated, the precipitation were collected and were made into 2%-3% suspension. Using unidirectional solidification as a freezing process and freeze-dried method, the cartilage extracellular matrix derived oriented scaffolds was fabricated. The scaffolds were then cross-linked by exposure to ultraviolet radiation and immersion in a carbodiimide solution. By light microscope and scan electron microscope (SEM) observation, histological staining, and biomechanical test, the traits of scaffolds were studied. After being labelled with PKH26 fluorescent dye, rabbit BMSCs were seeded onto the scaffolds. The attachment, proliferation and differentiation of the cells were analyzed using inverted fluorescent microscope. Results The histological staining showed that toluidine blue, safranin O, alcian blue and anti-collagen Ⅱ immunohistochemistry staining of the scaffolds were positive. A perpendicular pore-channel structures which has a diameter of 100 μm were verified by light microscope and SEM analysis. The cell-free scaffolds showed the compression moduli were (2.02±0.02) MPa in the mechanical testing. Inverted fluorescent microscope showed that most of the cells attached to the scaffold. Cells were found to be widely distributed within the scaffold, which acted as a columnar arrangement. The formation of a surface cells layer was found on the surface of the scaffolds which resembled natural cartilage. Coclusion The cartilage extracellular matrix derived oriented scaffolds have promising biological, structural, and mechanical properties.

Objective To determine the effect of NEL-like type 1 gene (NELL-1) transfection in vivo in the repair of traumatic femoral head necrosis.Methods Twenty-four SD rats were randomly divided into three groups (8 rats per group) according to the lottery method,ie,sham group (served as normal control),NELL-1 treatment group (injected NELL-1 gene by recombinant adenovirus vectors around the hip one week after osteonecrosis model induced surgically) and placebo group (given an equal volume of saline solution at the same time after the induction of osteonecrosis).Femurs were taken from the animals 5 weeks after surgery.Gross observation was performed for morphology changes,X-ray assessment for femoral head height and length ratio (H/L),Micro-CT measure for bone parameters of femoral head including total volume (TV),bone volume (BV),total mineralized content (TMC),trabecular thickness (Tb.Th) and trabecular space (Tb.SP),and histological study for osteocytes,osteoblasts and osteoclasts.Results Preserved femoral head shape was noted in NELL-1 treatment group compared to the obvious flattening of the femoral head in placebo group.No heterotopic osteogenesis was observed in any group.Femoral head H/L ratio for 0.753 2 ± 0.040 2 in NELL-1 treatment group was higher than 0.598 4 ± 0.037 0 in placebo group (P ＜ 0.05),but lower than 0.920 2 ± 0.037 0 in sham group (P＜0.05).TV,BV,TMC and BMD between NELL-1 treatment and sham groups did not differ significantly (P ＞ 0.05),but all were increased compared to placebo group (P ＜ 0.05).There was no significant differences in Tb.Th and Tb.SP among three groups (P ＞ 0.05).Most osteocytes were alive in NELL-1 treatment group.More active osteoblasts and osteoclasts were noted in NELL-1 treatment group than those in placebo group.Conclusion NELL-1 gene transfection can preserve femoral head shape and bone content,promote osteoblast activity and neovascularization and hence is an effective treatment for rat traumatic osteonecrosis.However,the activity of osteoclasts is stimulated simultaneously.

Objective To observe the analgesic effect of quadratus lumborum block (QLB) in cesarean section under general anesthesia.Methods 50 patients underwent cesarean section under general anesthesia were randomly divided into two groups (n =25):patients in QLB group (group Q) received QLB at the end of surgery with 0.3％ ropivacaine 25ml,and the control group (group C) patients were disinfected at the same site but did not puncture.The visual analogue scale (VAS) and pain Bruggrmann comfort score (BCS) were recorded at 2,6,12,24,and 48 hours after surgery.The patient's general condition,vital signs and postoperative analgesia-related adverse reactions were recorded.Results There were no significant differences between the two groups in general information and surgical related indexes (P ＞ 0.05).The VAS scores of the Q group were lower than the control group at 2,6,12 and 24 hours,and the BCS score was higher than that in the control group (P ＜ 0.05).There was no difference in VAS score,BCS score after 48 hours,and no difference in adverse reaction rate between the two groups (P ＞ 0.05).Conclusions Quadratus lumborum block combined with intravenous analgesia can reduce the pain score within 24 hours after cesarean section under general anesthesia and improve postoperative analgesia comfort.