Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; therapy ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Stents ; Vascular Malformations ; therapy

Adult ; Carcinoma, Adenoid Cystic ; complications ; Female ; Humans ; Thyroid Gland ; pathology ; Thyroid Neoplasms ; secondary ; Ultrasonography

OBJECTIVE: To investigate the clinical significance of plasma homocysteine Hcy in patients with coronary atherosclerosis. METHODS Plasma Hcy levels of 85 patients with coronary atherosclerosis and 68 normal controls were determined by fluorescence polarization immunoassay. RESULTS The mean levels of plasma Hcy were (9.31+/-3.80)&mgr;mol/L in normal controls and (13.39+/-6.06)&mgr;mol/L in patients with coronary atherosclerosis. That was (11.36+/-3.86)&mgr;mol/L in the patients with micro-pathological changes of coronary artery, (13.32+/-6.09)&mgr;mol/L with single-vessel disease,(13.39+/-4.92)&mgr;mol/L with double-vessel disease, and (18.23+/-8.98)&mgr;mol/L with three-vessel disease by coronary angiography. Statistically, the mean plasma Hcy concentrations in male and female patients was higher than that in the corresponding control subjects(13.77+/-6.68 compared with 10.50+/-4.07, 11.50+/-3.58 compared with 7.80+/-2.85 &mgr;mol/L,P<0.001 respectively). CONCLUSION The patients with coronary atherosclerosis present hyperhomocysteinemia is very important to determine plasma homocysteine for diagnosis and therapy in the patients with coronary heart disease.

AIM:To investigate the expression and significance of thrombospondin-1(TSP-1)in left ventricular myocardium of type 2 diabetic cardiomyopathy(DCM).METHODS:The rat model of DCM was established by eating a high-fat diet together with injection of low dose streptozocin(30 mg/kg)intrapertoneally.After 12 weeks,the content of collagen was quantified by Masson staining.The mRNA level of TSP-1 was determined by quantification real-time RT-PCR,while the protein level of TSP-1 was analyzed by Western blotting and immunohistochemistry.RESULTS:Compared with the control group,the content of collagen in the DCM group was increased greatly(11.01?3.05 vs 16.92?3.18,P

Objective To observe the diagnostic value of non-invasive 128-slice computed tomography coronary angiography(CTA)in comparison with invasive coronary angiography.Methods 128-slice CTA and invasive coronary angiography were performed in 78 unselected consecutive patients(63 patients with suspected coronary artery disease and 15 patients with previous coronary stenting,56 males,mean age 61±10 years)and ＞50% reduction of minimal lumen diameter was defined as significant coronary stenosis.Results Fifty-eight out of 879 segments(7%)from CTA were not assessable because of irreguldr rhythm,vessel calcification or tachycardia.Compared with invasive coronary angiography,segmentbased analysis from the 821 segments showed the sensitivity by CTA was 87%,specificity 97%,PPV 83% and NPV 97%.Four out of 22 stents implanted in 15 patients were not assessable by CTA because of poor image quality.Compared with invasive coronary angiography,the sensitivity of diagnosing in-stent restenosis by CTA was 100%,specificity 77%,PPV 63% and NPV 100% for the remaining 18 stents-Conclusions One hundred and twenty-eight-slice CTA has a high accuracy for detecting coronary artery disease and instent restenosis after coronary stenting and could be considered as a valuable noninvasive technique for screening coronary artery disease in suspected patients.

OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory dis?tress syndrome (ARDS) induced by endotoxin lipopolysaccharide (LPS) in rabbits. METHODS Thirty-six healthy male New Zealand white rabbits were randomly divided into six groups: normal control group, model group, dexamethasone group, Renqing Changjue high, middle and low dose group, with six rabbits in each group. LPS was used to replicate the ARDS model after five consecutive days of gavage. Arterial pressure, respiratory rate and anal temperature blood were recorded for arterial blood gas analysis at 0, 0.5, 1, 2 and 4 h, respectively. At the end of the four-hour experiment, rab?bits were killed by bloodletting, and the lung tissue was quickly removed to determine the cytokines, SOD, MDA and pathological examination of rabbit lung. RESULTS Renqing Changjue can significantly reduce the pathological changes of lung in ARDS model group. The expression of AQP1 and MPO in rabbit lung was significantly decreased by immuno?histochemistry (P<0.05) ,reduce the lung wet/dry weight ratio, increase the ratio of PaO2/FiO2, inhibit the release of inflammatory factors and scavenge free radicals and antioxidant effects. CONCLUSION Renqing Changjue can effec?tively protect rabbits with acute respiratory distress syndrome induced by LPS, and may protect the lung by inhibiting the release of cytokines and anti-oxidation.

OBJECTIVETo evaluate coronary artery atherosclerotic plaque characteristics and changes post coronary stenting by optical coherence tomography (OCT).

METHODSOCT images were obtained in 22 diseased coronary vessels after coronary angiography or percutaneous coronary interventions (PCI) in 20 patients and in 23 stents [7 sirolimus-eluting stents (SES) follow up at 4-29 months post stenting and 8 bare mental stents (BMS) at 4-35 months post stenting, 8 stents immediately after PCI].

RESULTSAll 22 vessels and 23 stents OCT images were successfully acquired. Two thromboses, 8 fibrous, 9 lipid-rich and 3 calcium plaques as well as 3 plaque ruptures were visualized by OCT. No significant neointimal proliferation and restenosis were found in SES stents and some struts were not covered with neointima even at 29 months post stenting. Significant neointimal proliferation on surfaces of stent struts were visualized in all 8 BMS stents and restenosis was detected in 3 BMS stents. OCT images obtained immediately after PCI showed that 3 stents were well positioned, tissue prolapse between coronary stent struts occurred in 4 stents and stent dissociation with vessel wall could be seen in 1 stent.

CONCLUSIONSOCT imaging can clearly visualize different types of atherosclerotic plaques. By providing detailed information on plaque characteristics, this technique might help cardiologists in choosing suitable stents and guiding preventive therapy for patients with coronary heart disease.

Adult ; Aged ; Coronary Disease ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radiography ; Sirolimus ; administration & dosage ; Stents ; Tomography, Optical Coherence

Objective: To compare and correlate the findings of intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging and arterial spin labeling (ASL) imaging in characterizing parotid gland tumors. Materials and Methods: We retrospectively reviewed 56 patients with parotid gland tumors evaluated by MR imaging. The true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and fraction of perfusion (f) values of IVIM imaging and tumor-to-parotid gland signal intensity ratio (SIR) on ASL imaging were calculated. Spearman rank correlation coefficient, chi-squared, Mann-Whitney U, and Kruskal-Wallis tests with the post-hoc Dunn-Bonferroni method and receiver operating characteristic curve assessments were used for statistical analysis. Results: Malignant parotid gland tumors showed significantly lower D than benign tumors (p = 0.019). Within subgroup analyses, pleomorphic adenomas (PAs) showed significantly higher D than malignant tumors (MTs) and Warthin’s tumors (WTs) (p < 0.001). The D* of WTs was significantly higher than that of PAs (p = 0.031). The f and SIR on ASL imaging of WTs were significantly higher than those of MTs and PAs (p < 0.05). Significantly positive correlation was found between SIR on ASL imaging and f (r = 0.446, p = 0.001). In comparison with f, SIR on ASL imaging showed a higher area under curve (0.853 vs. 0.891) in discriminating MTs from WTs, although the difference was not significant (p = 0.720). Conclusion IVIM and ASL imaging could help differentiate parotid gland tumors. SIR on ASL imaging showed a significantly positive correlation with f. ASL imaging might hold potential to improve the ability to discriminate MTs from WTs.

Objective To study the related factors of central lymph node(CLN) metastasis in papillary thyroid carcinoma ( PTC ),the indications and the extent of central neck dissection ( CND ).Methods A total of 153 cases treated between Jan.2009 and Dec.2010 was analysed retrospectively.Of the cases 28 males and 125 cases females,with a mean age of (44 ± 14) years.T1,T2,and T3 diseases accounted for 51,10 and 81 cases,respectively; Ⅰ,Ⅱ,Ⅲ and Ⅳ diseases for 88,3,26 and 36 cases,respectively.Multifocal tumors were found in 63 cases.The related clinicopathologic factors were analyzed,including sex,age,tumor size,extrathyroidal extension,and multifocal tumor.Results All the cases had total/near total thyroidectomy and CND,of them 64 cases had unilateral neck dissection and 18 cases had bilateral neck dissection.CLN metastases existed in 68.6％ ( 105/153 ) cases,37.2％ (57/153) for unilateral and 31.4％ (48/153) for bilateral respectively.The rates of CLN metastasis were 86.6％ (71/82)in cN1 cases and 47.9％ (34/71) cN0 cases,respectively,and the rates of bilateral CLN metastases were 45.1％(37/82) in cN1 cases and 15.5％ (11/71) in cN0 cases. Multivariate analysis showed that extrathyroidal extension( P =0.002,OR =3.502) was an independent risk factor for CLN metastasis and that lateral neck lymph node metastasis( P =0.028,OR =3.080),surrounding tissue invasion ( P =0.014,OR =3.113 ),and maximum tumor diameter greater than 1 cm ( P =0.012,OR =3.732) were independent risk factors for bilateral CLN metastases.Conclusions It is indicated that ipsilateral CND should be obligatory for PTC. Intraoperative frozen section examination should be routine.Bilateral CND should be conducted when ipsilateral CLN metastases accompanied by one of following issues such as more invasive tumor(surrounding tissue invasion,T3 or T4 disease),maximum tumor diameter greater than 1 cm,and lateral neck lymph node metastasis.

Objective To study the pattern of lymph node spread in papillary thyroid carcinoma (PTC) with clinically negative node(cN0).Methods A total of 106 patients with cN0 PTC who underwent total or subtoyal thyroidectomy plus unilateral or bilateral lateral neck dissection ( LND,level Ⅱ - Ⅴ or level Ⅰ - Ⅴ ) at West China Hospital of Sichuan University between April 2004 and August 2010 were analyzed retrospectively.Results The lateral neck lymph node metastasis in cN0 PTC was significantly associated with sex ( male,P =0.007 ),tumor stage ( T3/T4,P =0.006 ),tumor size ( ＞ 1 cm,P =0.014) and the number of positive central lymph nodes( ≥2,P ＜0.001 ),but not with age and multifocal tumor.Level Ⅲ (47/116,40.5％ ) was the most prevalent metastatic site,followed by level Ⅳ (41/116,35.3％),level Ⅱ (18/116,15.5％) and level Ⅴ (2/29,6.9％).Of the cases with lymph node metastases in level Ⅲ and Ⅳ,89.8％ ( 79/88 ) of primary thyroid tumors existed in the lower and middle sites of the thyroid lobes,while in the cases with lymph node metastases in level Ⅱ,77.8％ (14/18) of primary thyroid tumors in the upper sites of the thyroid lobes,and 83.3％ of cases with level Ⅱ metastases were accompanied with level Ⅲ metastases.Two cases with level Ⅴ metastases were accompanied with metastases in levels Ⅱ,Ⅲ and Ⅳ.Conclusions LND should be considered for cNO PTC in male,with T3/T4 lesions and positive central lymph nodes≥2,and the range of dissection should include level Ⅲ and Ⅳ.Dissection of level Ⅱ should be considered in cNO PTC with primary tumor localized in the upper site of the thyroid lobe or with level Ⅲ metastasis.Dissection of level Ⅴ should be considered at present of metastases in level Ⅱ,Ⅲ,and Ⅳ.For cN0 PTC with tumor size ＜ 1 cm,confined to the thyroid and without lymph node metastasis in the central compartment,LND is not recommended.