Objective To study the relationship between Noble grade and distribution of myocardial bridge and atherosclerosis. Methods The clinical data of 192 patients with myocardial bridge diagnosed by coronary artery angiography were retrospectively analysed.The clinical symptoms,electrocardiographic and echocardiographic findings were analysed to explore the relationship between Noble grade and distribution of myocardial bridge and atherosclerosis,and the outcomes of medical treatment were also investigated. Results The positive rate of myocardial bridge detected by coronary artery angiography was 10.2%,which was usually observed in the middle part of left anterior descending coronary artery.All the patients with grade 3 of Noble grade experienced chest pain or palpitation,43.8% had ischemic ST-T changes on electrocardiogram,and 37.5% had abnormal segmental ventricular wall on echocardiography.However,patients with Noble grade 1 and 2 did not have ischemic ST-T changes on electrocardiogram or abnormal segmental ventricular wall on echocardiography.The prevalence of atherosclerosis in proximal coronary artery of myocardial bridge was significantly higher than those of mural coronary artery and distal coronary artery(P

0.05).Compared with non-myocardial infarction group,the prevalence of normal segmental ventricular wall motion and ejection fraction in myocardial infarction group was significantly lower,while those of akinesia and paradoxical motion were significantly higher(P

OBJECTIVETo evaluate clinical outcomes of fixation for the treatment of radial head fracture with collapse of anterior articular surface.

METHODSFrom March 2006 to January 2013,17 patients with radial head fractures with collapse of anterior articular surface were analysed. According to the Mason classification, there were 12 cases with Mason type II fractures and 5 cases with Mason type III fractures. All the patients were treated with open reduction through posterolateral entrance of elbow joint and Herbert or titanium cannulated screw internal fixation.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 18 months, with a mean of 11.3 months. According to the Broberg and Morrey score system, 2 patients got an excellent result, 12 good and 3 fair. There were no complications such as infection of elbow joint, nerve injury, non-union, traumatic osteoarthritis, heterotopic ossification and elbow instability. However, the postoperative activity range of elbow in the injuried side was less than that in the normal side.

CONCLUSIONRadial head fracture with collapse of anterior articular surface is easily misdiagnosed, and it can be treated with open reduction and internal fixation through posterolateral entrance.

Adult ; Aged ; Elbow Joint ; physiopathology ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Radius Fractures ; physiopathology ; surgery ; Range of Motion, Articular

Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Angiography ; Coronary Thrombosis ; etiology ; Drug-Eluting Stents ; adverse effects ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Platelet Aggregation Inhibitors ; therapeutic use ; Recurrence ; Sirolimus ; administration & dosage ; Time Factors

Objective To investigate the effect of intravenous fluid infusion combined with water throuth gastrointestinal tract in treating the patients with hyperosmolar hyperglycemic state(HHS).Methods 30 HHS pa- tients were recruited.All the patients were given water throuth gastrointestinal infusion while they were administrat- ed continuously intravenous infusion.Laboratory parameters such as serum natrium,serum potasium,serum glucose and serum osmolarity ect were monitored at the admission and after treatment.Results Serum glucose and serum osmolarity of HHS patients were decreased smoothly at the speed of less than 3 mmol?L~(-1).h~(-1)during the first 12 hours after treatment.After 48 hour-treatment,serum natrium,serum potassium and serum osmolarity recovered to normal levels except 2 deaths,serum glucose decreased to(10.8?5.2)mmol/L.Conclusion Intravenous fluid infu- sion combined with water throuth gastrointestinal tract for the patients could lower smoothly serum glucose and serum osmolarity and decrease the mortality of the HHS patients.

Objective To investigate the danger of iodine excess for people in the downstream area of Yellow River in Shandong Province by describing the distribution of iodine excess water and the gorer of children Methods Water samples were collected from 5 villages of every town of Yuncheng,Jiaxiang and Dongchangfu Counties to determine the iodine of the water using arsenic cerium oxidation reduction method.In the 5 towns having water iodine in the range of 150～300μg/L,200 students aged from 8～10 years received the paJpation of thyroid,half of them were also measured of urinary iodine with As3+-Ce4+ catalytic spectrophotometry using ammonium persulfate digestion method,and 50 of the 100 students further underwent thyroid B-ultrasound.Results Three counties all have high iodine towns.The medium of urinary iodine of 30 town8 in 56 towns was higher than 150μg/L Urinary iodine and sign detection were performed in 13 towns,where water iodine was between 150～ 300μg/L;the medium ofurinary iodine of 11 towns were higherthan 400μg/L,and 3 of the 11 towns were higher than 800μg/L.In all 13 towns,the goiter rate of the students aged 8 to 10 years exceeded 5%by palpation in 11 towns:exceeded 5% by B-ultrasound method in 9 towns.Conclusions There are areas of iodine excess in drinking water and iodine-excess endemic goiter prevails in downstream area of the Yellow River in Shandong Province.It indicates that iodine excess in drinking water has done severe harm in these areas. Active management should be taken to control this endemic disease.

The pathogenesis of steroid-induced osteonecrosis of the femoral head (SONFH) is not very clear at present. For the past few years researches showed that the SONFH related to genetic predisposing factors. The related research progresses were reviewed in this article to show the correlation between genetic mutation and genetic polymorphism of steroid metabolism and transport, resistance and receptor, coagulation and fibrinolysis, lipid and bone metabolism and susceptibility to SONFH. The article also discussed current problems, countermeasure and future applications.
ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; Cytochrome P-450 CYP3A ; genetics ; Femur Head Necrosis ; chemically induced ; genetics ; Genetic Predisposition to Disease ; Glucocorticoids ; adverse effects ; Humans ; Lipid Metabolism ; Polymorphism, Single Nucleotide ; Receptors, Glucocorticoid ; genetics

Catheterization ; adverse effects ; methods ; Catheterization, Central Venous ; adverse effects ; methods ; Female ; Humans ; Middle Aged ; Subclavian Artery ; surgery

Objective Reports are rarely seen about the application of platelet-rich plasma (PRP) combined with surgical dislocation of head and neck fenestration (HNF) in the treatment of osteonecrosis of the femoral head (ONFH) in the peri-collapse stage. The purpose of this study was to investigate the clinical effects of PRP combined with surgical dislocation of HNF in the treatment of ONFH. Methods Using PRP combined with surgical dislocation of HNF,we treated 18 ONFH patients with 22 hips involved,in-cluding 7 cases of ARCO stage Ⅱc,10 cases of stage Ⅲa,and 5 cases of stage Ⅲb, and followed them up for 12.40±3.12 months. We evaluated the clinical results and compared the Harris scores and radiographic manifestations obtained before and after surgery. Results The overall Harris scores of the patients at 12 months after surgery were significantly higher than the baseline(86.84±6.44 vs 73.73±5.42,P=0.04),(87.73±2.43 vs 74.23±7.30,P<0.05) in the stageⅡc group,(85.22±7.63 vs 72.82±5.31,P<0.05) in the stageⅢa group,and(78.86±5.91 vs 69.37±6.13,P<0.05) in the stageⅢb group. The rate of excellence was 90.91% and that of im-provement was 95.45%.There were no such postoperative complications as nonunion,infection,or osteothrombosis. Conclusion PRP com-bined with surgical dislocation of HNF exhibited an excellent short-term effect in the treatment of ONFH in the peri-collapse stage, which has provided a new option for the management of the disease.

Objective:To observe the effect of electroacupuncture (EA) on the expressions of acetylcholine (ACh) and mucin 5AC (MUC5AC) in the lungs of rats with chronic obstructive pulmonary disease (COPD),and explore the mechanism of EA in treating COPD.Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a control group,a COPD group,and an EA group,with 10 rats in each group.The control group was a group of normal rats.The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide (LPS).The COPD rats were treated with EA at bilateral Feishu (BL 13) and Zusanli (ST 36) in the EA group,30 min each time,once a day,successively for 14 d.The lung function was tested.The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs.The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction (RT-PCR) and Western blot (WB),respectively.The immune response of MUC5AC was observed by immunohistochemistry.Results:Eight rats were left in each group,and the other two died.Compared with the control group,the total airway resistance (Raw) increased significantly and dynamic compliance (Cdyn) decreased significantly in the COPD group (P＜0.01);compared with the COPD group,the Raw level declined significantly and Cdyn increased significantly in the EA group (P＜0.01).The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group (P＜0.01,P＜0.001);compared with the COPD group,the contents of ACh and MUC5AC were significantly lower in the EA group (P＜0.05,P＜0.001).There was a negative correlation between MUC5AC content and lung function (P＜0.001).The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group (P＜0.001);compared with the COPD group,the expressions were significantly lower in the EA group (P＜0.01).Compared with the control group,the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group (P＜0.001);the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group (P＜0.001).Conclusion:EA treatment can improve the lung function of COPD rats,which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.