Objective To investigate the application effect of the health care integration mode after percutaneous coronary intervention (PCI) of patients in cardiology department.Methods 100 patients (the experimental group) were randomly selected from 200 patients to implement integrated health service management model,usual care service mode was given to the other 100 patients (the control group).After 12 months,the incidence of haemorrhage and hematoma,the average length of hospital stay,the patients' quality of life,patients' satisfaction degree in two groups of patients were compared.Results Compared with the control group,the incidence of postoperative haemorrhage and hematoma decreased,the average length of stay shortened,the patients' quality of life and satisfaction degree significantly improved after PCI in the experimental group.Conclusions Compared with ordinary care model,health integration model can reduce the incidence of haemorrhage and hematoma in patients after PCI,alleviate the suffering of patients; shorten the average length of stay and reduce the economic and emotional burden of patients; improve the patients' quality of life and satisfaction degree,deepening nursing work connotation,and promote the development of nursing.

Objective To summarize our experience in percutaneous transluminal angioplasty(PTA) in the management of thoracoabdominal aortic stenosis of Takayasu's arteritis. Methods From 1987～2001, 12 patients of Takayasu's arteritis with thoracoabdominal aortic stenosis underwent PTA. Aortography and pressure of stenotic segment of arota before and after angioplasty were used to evaluate efficacy. Color Doppler ultrasound examination and Doppler segmental pressure measurement were used in follow-up. Results Success was achieved in all cases without mortality and serious complications except for 1 case of acute thrombosis of iliofemoral artery. The residual stenosis were less than 50% in all cases and the pressure gradient was 5 0mmHg～10 5 mmHg with average pressure being 7 2 mmHg after angioplasty ,although they were 25mmHg～46 mmHg averaging of 37 7 mmHg before angioplasty. All cases were followed up for 9(12～72) months and the result was good without lumen restenosis and obstruction. Conclusions PTA is the first choice for Takayasu's arteritis of thoracoabdominal aortic stenosis of local size and proved to be safe, effectiveand economical. It is also effective for long size cases. It is not necessary to dilate aorta stenosis to normal size, and reducing pressure gradient effectively is enough.

Gold nanostructures with unique optical and photo-thermal properties based on their size and shape have wide applica-tion potential in tumor diagnosis, imaging, photo-thermal therapy, and drug delivery because of surface plasmon resonance. The optical properties of gold nanomaterials allow its use for dark field imaging, optical coherence tomography, and two-photon imaging. Gold nanomaterials can also be used as carriers for a variety of fluorescent molecules and drugs, achieving multifunctional imaging, chemo-therapy, photodynamic therapy, and so on. Photon-electron and electron-electron interactions of gold nanomaterials, which are excited by near-infrared laser, will generate heat that can be used for tumor photothermal therapy. This phenomenon promotes drug release, and photoacoustic imaging. The combined application of hyperthermia and chemotherapy based on gold nanoparticles is effective in opti-mizing the efficacy of cancer treatments. Therefore, gold nanoparticles can integrate multiple functions into one single system and real-ize the integration of tumor diagnosis and therapy, which provide new insights for the on-demand therapy and personalized medicine de-velopment. This study reviews the recent progress of several gold nanoparticles in the integrated applications for tumor theranostics, in-cluding gold nanoshells, gold nanorods, hollow gold nanospheres, gold nanocages, and gold nanostars. The major strategies of gold nanomaterials in biomedical applications are also discussed.

Objective To evaluate the safety and efficacy of Safflower Yellow Injection(SYI)in treating coronary heart disease and angina pectoris(CHD-AP)with heart blood stagnation syndrome(HBSS).Methods A randomized,positive parallel contral and multi-center clinical trial was adopted.The SYI injection group was treated with SYI and Xiangdan injection group with Xiangdan injection by intravenous dripping for 2 weeks.Results The efficacy on angina pectoris,electrocardiogram,and traditional Chinese medicine(TCM)syndrome in SYI injection group was superior to that in Xiangdan injection group,showing significant differences(P

BACKGROUND: Chronic musculoskeletal pain can cause disability and decreased quality of life of patients. Probing into the therapeutic methods of musculoskeletal disease and choosing proper treatment drugs are important for patients.OBJECTIVE: To evaluate the efficacy and tolerance of controlled-release tramadol in patients with moderate to severe chronic pain of musculoskeletal origin.DESIGN: A self-control study was conducted.SETTING: Arthrtosis Institute, People' s Hospital Affiliated to Peking University.PARTICIPANTS: Patients who were in the Orthopaedic Outpatient Service,People' s Hospital of Peking University were involved. This observational study was conducted in 40 adults who experienced moderate to moderately severe chronic musculoskeletal pain that was not controlled by routine nonsteroidal anti-inflammatory drugs(NSAID) therapy.INTERVENTIONS: Any NSAIDs and other analgesics were prohibited. Patients initially took 50 mg of controlled-release tramadol (Tramcontin) every 12hours, supplemented by every 50 mg if insufficient pain relieved. Recommended daily maximum dose was 400 mg per day. The observation lasted for 4 weeks. The patients were asked for document therapy-relevant data every day and were interviewed every week to doctor assessment.MAIN OUTCOME MEASURES: Pain intensity before and after treatment, pain remission degree, all side effects and their severity.RESULTS: All cases were finished the study and no one withdrew from follow-up. No eligible patients exited from the study because of therapeutic failure or intolerance. In comparison with the initial visual analogue scale (VAS) mean value 6. 80 ± 1.84, the average VAS value at the end of observation was 1.00 ± 1.46, which had significant difference( P ＜ 0. 001) . An average pain reduction of (85. 50±5.35)%was obtained, among which 78% were absolutely and obviously lessened. Side effects were reported in 9cases (22%).Drowsiness and dizziness(6 cases) was the most common, followed by nausea (3 cases), vomiting (1 case), somnolence (2 cases), constipation and urinary retention (1 case) and blurred vision (1 case).CONCLUSION: Tramcontin, as slow-release tramadol, proved to be an effective, safe, and easy-to-use central acting analgesic has an important role in the management of chronic musculoskeletal pain. Light side effect and good tolerance has provided a new choice for treatment of chronic pain in the orthopaedic department.

Objective To investigate the predictive value of the non-invasive indicator deceleration capacity of heart rate (DC) in the sudden cardiac death (SCD) after acute myocardial infarction. Methods A total of 417 myocardial infarc?tion patients with ST-segment elevation in sinus rhythm were enrolled in this study. DC was assessed from data of 24-hour ECG Holter. Regular follow-ups were carried out within 12 months. The SCD events were recorded and compared with pa?tients without SCD. Results During 12 months of follow-up, 20 patients were died due to SCD (4.8%). Compared with sur?vival group, patients showed significantly lower left ventricular ejection fraction (LVEF, 0.393 ± 0.065 vs 0.528 ± 0.042, P<0.05) and DC [(2.85±1.66) ms vs (5.49±1.71) ms,P<0.05]in SCD group. Multivariate Cox proportional hazard regression analysis showed that lower LVEF(<0.35)[RR: 2.167(1.384-4.661), P=0.013]and DC (DC<4.5 ms)[RR: 3.706(2.709-5.374),P=0.020]were risk factors for the occurrence of SCD. The prediction sensitivity by the decreased LVEF and DC was 52.1%and 76.4%respectively, and the specificity was 84.5%and 86.1%respectively. Conclusion The decreased value of DC after acute myocardial infarction can predict the SCD events.

Objective To study the clinical treatment methods for properties of unknown in elderly patients with atypical squamous cell of undertermind significant and above cervical lesions.Methods According to the clinical grouping of ASCUS in elderly patients with cervical lesions of different treatment methods,observation group 1 (348 cases) underwent colposcopy;observation group 2(316 cases) for high-risk human papillomavirus(HPV) detection,HPV positive colposcopy ;observation group 3 (129 cases) of cervical cytology examination regularly,squamous intraepithelial lesion colposcopy,compared three groups of clinical treatment.Results Liquid based cytology and three groups of 574 patients (TCT) and colposcopy and cervical biopsy,the results of intraepithelial neoplasia(C IN) above cervical lesions in 223 cases(38.9%),in which CIN Ⅰ 136 cases(23.7%),CIN Ⅱ in 64 cases(11.2%),CIN Ⅲ 20 cases(3.5%),3 cases of carcinoma in situ(0.5%) ;the group1 were observed in 348 cases,348 cases underwent colposcopy biopsy(100%),CIN Ⅱ above 36 cases(10.3%) were observed in the group 2;213 cases of colposcopy biopsy(67.4%),CIN Ⅱ above 38 cases (12%) were observed in the group 3 ; colposcopy examination in 13 cases (10.1%),3 cases of biopsy CIN Ⅱ of the cases(2.3%).Biopsy of CIN Ⅱ above the detection rate,the observation group 1,observation of the 2 groups had no significant differences(P ＞ 0.05),and observe the difference between the 3 groups was statistically significant(x2 =7.014,9.156,all P ＜ 0.05).Conclusion High-risk HPV detection of shunt ASCUS can reduce cervical lesions treatment process misdiagnosis,missed diagnosis and treatment of the problem of excessive.

Objective To measure the effect of panax notoginseng saponins (PNS) on renal cortical tubule cell apoptosis and apoptosis-related genes in early stage after renal trauma and to investigate the protective mechanism of PNS for renal trauma.Methods Seventy-eight Wistar rats were divided into trauma group (n =36),trauma + treatment group (treatment group,n =36),normal control group (control group,n =6) according to the random number table.In treatment group,rats received intraperitoneal administration of PNS (70 mg/kg).Instead,substitute of an equal dose of isotonic saline was used for the rats in trauma and normal control groups.Trauma and treatment groups were subdivided at 1,6,12,24,36 and 48 hours posttrauma,with 6 rats per group.The kidney specimens were extracted at each time point to detect Bax expression in the cortex with immunohistochemistry and in situ hybridization histochemistry.Moreover,the positive expression of Bax was compared among groups and its variation regularity with time were detected.Results In trauma group,mRNA transcription of pro-apoptosis gene Bax increased at 12 hours in the superficial cortex,but increased at 1 hour in deep cortex; protein expression of pro-apoptosis factor Bax showed no apparent reduction within 36 hours in the superficial cortex,but evident decrease within 12 hours in the deep cortex.In treatment group,mRNA transcription of pro-apoptosis gene Bax decreased immediately after treatment in the renal cortex and lasted until 48 h; protein expression of pro-apoptosis factor Bax showed unidirectional reduction until 48 h in the renal cortex.Conclusion PNS inhibits cell apoptosis by down-regulating the mRNA and protein expression of Bax.

[ABSTRACT]OBJECTIVETo explore the method on reconstruction of long and special tracheal defects which can mostly match with natural airway: pedicle rib cartilage with cilia endothelial wall.METHODS8 experimental model of rabbits were trained with cervical double belt blood supply fascia embedding and autologous costal cartilage and nasal septum mucos in the first period, then followed by transplantation in the second period. After the operation, we would assess the physiology, breathing and histopathology index of the rabbits, etc. After the animal experiment, we tried to apply the method to an appropriate clinical case.RESULTS8 cases of experimental rabbits dead after the second period operation with the average survival time of 21.9 days and caused by asphyxia. Histopathological results: rib cartilage and trachea ring up of cartilage cells and fibers have high similarity in histology; cartilage of all cases under the cultivation of the pedicle fascial package has not been absorbed; all cases' nasal septum mucosa in the body and blood supply to differentiation under fascia nutrition. Then we applied the method on a clinical case.CONCLUSIONTrachea ring rib cartilage had a higher similarity to the tracheal cartilage on the histology and biological characteristics that can be used as the preparation of artificial trachea shaping material or cell culture to tissue engineering materials. Package of rib cartilage pedicle fascial can provide adequate blood supply to make up for a free training rib cartilage defect to its absorption. Nasal septum mucosa of pressure in the body and blood supply of the fascia nutrition can simulate the trachea ciliated epithelium, which can play its biological characteristics similar to the inner wall of the trachea.

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.