Objective To summarize the experience of 40 patients with carotid artery stenosis treated by carotid artery stenting (CAS). Methods Endovascular plasty and stent placement were performed in 40 patients with carotid artery stenosis from October 2000 to July 2002. A total of 43 stents were placed into, comprising 39 WALLSTENT stents and 4 SMART stents. Out of the 40 cases, cerebral protection devices were used in 5 cases. Results The stent placement was completed successively in all the patients.Diameters of carotid artery all returned to 4mm or above.Mild intraoperative ischemic stroke occurred in 2 cases, and severe intraoperative ischemic stroke was found in other 2 cases: visual field loss of the left eye in 1 case, with after-effects even 3 months after surgery; loss of consciousness and right hemiplegia in 1 case, whom was cured to full consciousness subsequently. The complication rate was 10% (4 of 40) and the rate of severe ischemic stroke was 5% (2 of 40). No complications were seen in patients with cerebral protection devices. Conclusions CAS is effective in the treatment of carotid artery stenosis. Carotid stenting with cerebral protection devices may further ensure the patients' safety.

Objective To investigate the protective effect of desflurane preconditioning on human umbilical vein endothelial cells against anoxia-reoxygenation(A/R)injury.Methods The human umbilical vein endothelial cell line(ECV304)was provided by the Liver Cancer Institute,Zhongshan Hospital,Fudan University.ECV304 cells were randomly divided into 5 groups:group Ⅰ normal control;group Ⅱ A/R;group Ⅲ A/R+rhTNF-α;group Ⅳ Des + A/R and group Ⅴ Des + A/R + rhTNF-α.In group Ⅱ-Ⅴ the cells were exposed to 95% N2 + 5% CO2 in an incubator for 30 min followed by 60 min reoxygenation.In group Ⅲ and Ⅴ rhTNF-α(10 ng/ml)10 μl was added to the cells as soon as reoxygenation was started,while in group Ⅳ and Ⅴ the cells were pretreated with 7.2% desflurane for 30 min followed by 10 min washout before A/R.Apoptosis in endothelial cells was detected by fluorescence flow cytometry and TUNEL.Endothelial cells were examined with electron microscope for apoptosis and necrosis.Results The rates of apoptosis in the endothelial cells were significantly higher in A/R group and A/R + rhTNF-α group than in control group.Desflurane preconditioning significantly attenuated apoptosis in the endothelial cells induced by A/R and A/R + rhTNF-α respectively.Electron microscopy showed that there were significantly more necrotic cells in A/R group and A/R + rhTNF-α group.However in the two desflurane preconditioning groups(Ⅳ and Ⅴ)the cells were in a state of duplication and self-repairing.Conclusion Preconditioning with 30 min 7.2% desflurane can attenuate the A/R-induced injury to human umbilical vein endothelial cells.

Objective To evaluate hybrid therapy in patients with complex arteriosclerosis obliterans.Methods From Sep 2006 to Oct 2011,66 patients with complex arteriosclerosis obliterans were treated by hybrid therapy.A retrospective review was performed in all cases.Primary patency rate analyses were performed using Kaplan-Meier life tables.Results The technical success rate was 100％,and no patients died in perioperative period.12.1％ patients improved 3 levels,22.7％ patients improved 2 levels,and 65.2％ patients improved 1 level in Fontaine grade after procedures.The average ABI before and after procedures were 0.38 and 0.67 (P ＜ 0.05).2 patients died and other 64 patients completed 24 months follow-up.The primary patency rates and second patency rates were 75.0％ and 92.2％ at 24 months respectively.Primary patency rates of Fontaine Ⅱ patients were better than Fontaine Ⅲ and Ⅳ patients (P ＜ 0.05),and primary patency rates of Fontaine Ⅲ patients were better than Fontaine Ⅳ patients (P ＜ 0.05).Conclusions Hybrid therapy procedures provide an effective treatment in complex arteriosclerosis obliterans patients.

Objective The aim of this study was to evaluate the diagnostic value of thyroglobulin(Tg)mRNA in peripheral blood samples of patients with differentiated thyroid carcinoma(DTC)after remnant ablation.Methods Tg mRNA Was detected by reverse transcription-polymerase chain reaction(RT-PCR)in peripheral blood of 162 patients.SPSS 13.0 was used for date analysis.Results The Tg mRNA assay had higher sensitivity than the conventional serum Tg measurement[86.61%(97/112)vs 53.57%(60/112),X2=29.153,P＜0.001]which Was the"gold standard"for the identification of recurrence or metastases.In the anti-Tg antibodies(TgAb)positive DTC patients,the sensitivity of Tg mRNA was higher than that of serum Tg[86.54%(45/52)vs 0]in identifying recurrent or metastatic thyroid disease(X2=79.322,P＜0.001).There was a significantly positive correlation between Tg mRNA expression and the clinical stages(Kendall correlation coefficient=0.515,P＜0.001).There was no difference of Tg mRNA expression in peripheral blood among ages,sex,pathological types and location of metastases,respectively(Kendall correlation coefficient=0.020,0.069,0.050 and 0.028;all P＞0.05).Conclusions Circulating Tg mRNA is a more sensitive marker than serum Tg in identifying recurrent or metastatic DTC,particulady in patients during levo-thyroxine(l-T4)therapy and with TgAb-positive.The DTC patients who have positive expression of Tg mRNA indicates poor prognosis.

Objective To evaluate the clinical significance of serum thyroglobulin autoantibody(TGAb) in thyroglobulin(TG)-negative and TGAb-positive patients with differentiated thyroid carcinoma(DTC)after thyroid ablation and ascertain the optimal operating point(OOP)of TGAb.Methods A total of 169 patients with histologically confirmed DTC and thyroid remnant ablation showed TG-negative and TGAb-positive results which were assessed by electrochemiluminescence immunoassay(ECLIA).The cases were divided into group A(59 cases)and group B(110 cases)with or without evidence of recurrence or metastasis,respectively.The receiver operating characteristic(ROC)curve and positive likelihood ratio of different threshold values were analysed according to their serum TGAb level.Results Serum TGAb level(1368?1343)IU/ml in group A was significantly higher than that(154?539)IU/ml in group B(P1000 IU/ml was 1.12 times that of 204 IU/ml≤TGAb≤1000 IU/ml,4.03 times that of 100 IU/ml≤TGAb

Objective:To research the value of diagnosis of traumatic rib fractures by multislice CT VRT and DR plain film. Methods: Seventy-two cases of traumatic rib fracture patients were diagnosed by DR film and multislice CT VRT. Results:Multiple rib fractures than single, most of them occurred in the 4-10 ribs and axillary segment, 97.2%of 16-slice spiral CT three-dimensional reconstruction of patients with rib fracture diagnosis rate significantly higher than DR plain film diagnosis rate 80.3%(x2=19.15, P<0.01), DR plain film missed rib fractures are mainly located in the costal cartilage (58.1%), 16-slice spiral CT reconstruction is still found 19 other fractures and lung complications 16cases. Conclusion:16-slice CT the thin layer VRT diagnosis of rib fractures greatly improves the diagnostic accuracy.

Objective To observe the influence of endoscopic harvesting technique on the prevalence of leg-wound complications after coronary artery bypass grafting, and to assess histologically the potential trauma to the vein. Methods From August,2003 to August, 2005, 256 patients undergoing CABG had saphenous vein harvested by endoscopic harvesting system. About 4 mm proximal and distal vein end segment of 10 patient undergoing endosocopic and conventional harvesting respectively were examined with light and electro-microscope. Results The mean number of vein grafts of ESVH was 2.2 and the mean endoscopic harvest time was (45?20) minutes. There was no complication (incision infection, edema of lower extremity, lymphangitis and fat necrosis) occurred. Stay in bed time was 2～3 days. There was no difference in result of light and electro-microscopy. Conclusion Endoscopic vein harvesting in coronary artery bypass grafting can decreases the prevalence of postoperative leg-wound infections, postoperative pain, lying time and hospital stay, and increase the postoperative mobility ability, especially in patient with obesity and diabetes mellitus. Furthermore, the endoscopic harvesting technique may do no additional trauma to the saphenous vein.

ObjectiveTo study the changes of iodine uptake of the follicular thyroid carcinoma cell line (FTC-133) and nude mice bearing human follicular thyroid carcinoma after the induction with alltrans retinoic acid (ATRA),trichostatin A (TSA) or ATRA combined with TSA.MethodsAfter the induction with ATRA,TSA,or ATRA combined with TSA in different concentrations for 96 h,the iodine uptake of FTC-133 cells was observed.The concentrations for different groups were as follows:ATRA 1.0 ×10-6 mol/L(Alow group),ATRA 1.0 × 10-4 mol/L(Ahigh group),TSA 1.65 ×10-7 mol/L(T group),Alow +T group,Ahigh +T group and ethanol (control group).Cell quantities and morphology were observed by HE staining.FTC-133 cells were subcutaneously injected into nude mice.Twelve nude mice were randomly divided into 4 groups after tumor formation:ATRA group (2 mg/kg,intragastric administration),TSA group (10 mg/kg,intraperitoneal injection),combined therapy group (ATRA + TSA,the same doses as above) and saline control group (10 ml/kg,intragastric and intraperitoneal administration,respectively).Drugs were administered to the tumor-bearing mice according to the mouse body mass daily.At the 22nd day,the tumor-bearing mice were injected with 37 MBq 131I intraperitoneally.The biodistribution of 131I and gamma imaging were performed at 4,6,12 and 24 h after the injection respectively.Histopathological examinations of the tumor samples were taken after imaging completion.The results were analyzed by analysis of variance (ANOVA) with SPSS 13.0.ResultsThe cellular iodine uptake were (23 885 ± 616.0 ) and ( 13 849 ±728.2) counts · min-1 · 10-6 cells in the Alow + T group and Ahigh + T group respectively,and the data were (985 ± 84.2) - ( 17 600 ± 782.7 ) counts · min-1 · 10-6 in the other groups ( F =600.879,P ＜0.001 ).The ％ ID/g of tumor at 6 h was 6.17 ±0.46 in the combined group and it increased to 9.34 ±0.61 at 12 h and 11.19 ± 0.98 at 24 h.The ％ ID/g of tumor in the other groups were from ( 1.97 ± 0.34)to (5.14 ± 0.65 ).The tumor qualities of the 4 groups were significantly different ( F =3.723,P ＜ 0.05 ).ConclusionThe iodine uptake of the tumor could be enhanced in the tumor-bearing mice administered with ATRA combined with TSA,a potential way for treating follicular thyroid carcinoma.

Humans ; Organophosphorus Compounds ; analysis ; pharmacokinetics

Objective To study the expression of clock genes in Parkinson's disease(PD) and also the molecular clock machinery of PD.Methods Seventeen PD patients(nine men,eight women)and sixteen agematched controls(nine men,seven women) were investigated in this study.Bload samples were collected over a 12h span at 21:00,00:00,06:00 and 09:00.Using a real-time PCR assay,the peripheral molecular clock was examined by measuring Bmall and Bmal2 expression in total leukocytes during the dark span(from 21:00 to 09:00)in PD patients and age-matched healthy controls.Results At PD,the relative abundance of Bmall was significantly lower at 21:00,00:00 and 06:00(21:00:(22.17±4.09)vs(51.14±8.31),P=0.003,00:00:(30.30±5.45)vs(100.00±24.71),P=0.008,06:00:(19.02±3.33)vs(65.61±14.11),P=0.002).The relative Bmal2 levels in PD patients were significantly less abundant than controls at 21:00 and 00:00(21:00:(48.09±7.40)vs(84.96±9.34),P=0.005;00:00:((65.85±7.88)vs(100.00±11.78),P=0.025).Conclusion These results suggest that a peripheral molecular clock is altered in PD patients.In addition,the relative abundance of Bmall and Bmal2 was significantly lower in PD patients versus control subjects,which can provide a molecular basis to help monitor disease progression and response to investigational drugs.