Objective To evaluate the efficacy and safety of open occluded coronary artery branch through outside stent balloon expansion technique.Methods A retrospective analysis of 26 patients,26 interventional treat-ment of coronary bifurcation lesions were taken.All patients initially used conventional interventional techniques, branch reserve protection guidewire and main branch stent.When branch occlusion occured during operation and failed again through guidewire,small outer diameter of the balloon branch guidewire which was squeezed could be used to branch opening.The blocked branch opening was expanded outside of the stent,and the balloon was expanded after the guide wire enter into branch again.The main branch/branches kissing balloon inflation or main branch /branch double stenting would be used when necessary.Results Among 26 cases of bifurcation branch occlusion,25 cases successfully completed the outer stent balloon,achieved a branch balloon expansion after reentry guidewire,saved blocked branches and the rate of success was 96.2%,and 6 cases of the main branch and the branch kissing balloon dilatation,2 cases of remedial double stenting.Following -up for 1 -12(5.3 ±6.8)months after operation in 25 cases of patients,there was no death and myocardial infarction and other adverse cardiovascular events.Conclusion Out-side stent balloon expansion technique can improve the success rate of coronary occlusion branch opening,and it have fewer complications and worth of clinical application becasuse of its satisfactory results.

Objective: To establish a new specific and high-throughput method for CYP450 quantification, and to investigate the effect of drugs on rat liver CYP450 using Salvia miltiorrhiza and Panax ginseng as tool drugs. Methods: Mass spectrometry with multiple reaction monitoring (MRM) was applied to quantify nine rat liver enzyme CYP450 isoforms from the rat model with S. miltiorrhiza and P. ginseng. With QconCAT heavy peptides as internal standard, we aimed to assess the effects of S. miltiorrhiza and P. ginseng on CYP450 isoforms. Results: The relative standard deviation and relative error of this method were less than 5.9% and 6.8%, respectively, with good linearity (r2>0.9). Nine CYP450s isoforms (CYP1A1, CYP1A2, CYP2B1, CYP2B2, CYP2C6, CYP2C11, CYP3A1, CYP3A2, and CYP17A1) in rat liver microsome treated with S. miltiorrhiza and P. ginseng were also quantified. Compared with the control, S. miltiorrhiza downregulated the expression levels of CYP1A1, CYP2B2, CYP3A2, CYP2C11, and CYP17A1, while upregulated CYP1A2 and CYP2B1. For the effects of P. ginseng, the expression of CYP1A1 and CYP2B2 was decreased, while CYP1A2, CYP2B1, CYP3A2, CYP2C11, and CYP17A1 were increased. Conclusion: We successfully construct a method with MRM to quantify rat liver CYP450 isoforms. And we firstly quantify CYP2B1, CYP2B2, and CYP17A1 in rat liver. The results reveal the regulation of CYP450 by S. miltiorrhiza and P. ginseng, which could provide clinical application for drug compatibility in practice, and avoid adverse drug reactions.

In order to assess the effect of long-term versus short-term intravesical chemotherapy in preventing the recurrence of patients with non-muscle-invasive bladder cancer, we searched several databases with words as mesh terms and free text words to find all eligible randomized clinical trials (RCTs) for the comparison of the two strategies of instillation durations. "Observed-Expected events research (O-E)" and "Variance (V)" for calculating hazard ratio (HR) were used in Revman 5.2 software recommended by Cochrane Collabration for data analysis. Sensitivity and subgroup analysis were selected to minish heterogeneity. GRADEpro 3.6 profile recommended by Cochrane Collabration was employed for quality assessment of analyses. Finally, 13 eligible RCTs with 4216 patients were included in this review and 16 comparisons from 13 trials were involved for analysis. The pooled analysis revealed no significant difference between long-term and short-term duration [HR=0.99, 95% CI (0.89, 1.11), P=0.89]. Within the subgroup analysis, patients benefited from long-term instillations with a start regimen of one immediate instillation [HR=0.83, 95% CI (0.69, 1.00), P=0.05]. But patients were not suitable to receive long-term instillations with epirubicin (EPI) [HR=1.01, 95% CI (0.91, 1.13), P=0.78]. The progression rate was not reduced after long-term instillations [HR=0.96, 95% CI (0.66, 1.39), P=0.82]. From our results, patients should not receive introvesical chemotherapy more than half a year. In contrast, patients with one immediate instillation are preferred to have a long-term duration at least one year. Long-term instillations can not reduce the progression rate.

Objective:To develop and evaluate the improved Chinese hearing questionnaire for school children(CHQS)for mass epidemiology study on hearing impairment in China.Method:Using the probability proportion to size(PPS) method, 8 412 residents were investigated in 40 clusters in Jiangsu province with the WHO ear diseases and hearing disorders survey protocol.87.9% of the residents aged 7 years and over answered the questionnaire and accepted the pure tone audiometry.Result:The prevalence of hearing impairment was 12.9% by the questionnaire. Compared with golden standard(pure tone audiometry), Sen=58.5%, Spe=96.7%, PV+=78.9%, PV-=91.7%, overall accuracy=90.0% . The sensitivity for women was higher than men.Conclusion:The questionnaire produced high efficiency and specificity values.It could be used in mass hearing screening, particularly in remote and rural area, although the sensitivity was as low as most questionnaires.

OBJECTIVETo explore an ideal method for repairing the skin-soft tissue defects according to the different anatomical units of cheek, and find reasonable design principles to transfer the expanded flaps.

METHODSAccording to the location of the defect, we placed 1-3 appropriate expanders nearby, when the flap expanded enough we adopted advanced skin flaps, rotation-advanced skin flaps or transposition skin flaps to repair the defect. In this group of 269 cases, the defects were secondary to hemangioma, various scars, nevus or nevus excision.

RESULTSIn all 269 cheek defects, 305 expanded flaps were developed which included 145 rotation-advanced flaps, 121 advanced skin flaps and 39 transposition skin flaps. 52 of them generated complications, including blood circulation disorder of the distal part of flaps, hematoma, infection, injection, lower eyelid ectropion, expander extrusion and capsule contracture. Mostly, these complications didn't affect the final results.

CONCLUSIONSThe principles presented in this article are the guidelines to treat the skin-soft tissue defect of check with tissue expansion. The satisfied results come from the reasonable flap designs.

Adolescent ; Adult ; Cheek ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Tissue Expansion ; methods ; Young Adult

ObjectiveTo explore the clinical significance of heart-type fatty acid-binding protein (H-FABP) in acute myocardial infarction(AMI) patients. MethodsThe level of H-FABP was assayed within 30 min, 1 h, 2 h, 4 h,6 h and 12 h by enzyme linked immunosorbent assay (ELISA) in 46 AMI patients, and cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase(CK-MB) also was assayed by routine method.The diagnostic accuracy was compared among different methods. ResultsThe diagnostic accuracy of H-FABP[95.7％ (44/46)] was significantly higher than cTnⅠ[65.2％(30/46)] and CK-MB[41.3％ (19/46)](P ＜0.05). The levels of H-FABP, cTnⅠ and CK-MB significantly increased after AMI onset 4,6,12 hrespectively. ConclusionThe diagnosticaccuracy of H-FABP is higher and can be used as a parameter for the early diagnosis of AMI.

OBJECTIVETo observe MET-associated alteration during the trans-differentiation from MSCs to neuron-like cells, and to explore the possible molecular mechanism.

METHODSBone marrow MSCs were isolated from rat femur and purified in continuous cell culture. After induced differentiation to neuron-like cells by the combination of butylated hydroxyanisole (BHA) and dimethyl sulfoxide (DMSO), cells were tested by comparative polymerase chain reaction (PCR) for the relative expression of MET biomarkers and transcription factors, and for cell cycle by flow cytometry. Meanwhile, target genes of Wnt/β-catenin pathway were also analyzed by comparative PCR to determine the possible involvement.

RESULTSIn MSC-induced neuron-like cells, MET-associated transcription factors such as Snail, Slug, ZEB1, ZEB2, and Twist were significantly attenuated in expression level. The Mesenchymal marker Vimentin expression level was increased. Membrane protein E-cad was slightly down-regulated, while N-cad level was marginally elevated. Percentage of proliferating cells (S phase in cell cycle) markedly shrank from 40.42% for MSCs to 6.76% for MSC-derived neuron. Additionally, Wnt/β-catenin target genes β-catenin and c-myc were decreasingly expressed.

CONCLUSIONChemically induced trans-differentiation from MSC to neuron caused similar MET-featured alteration in gene expression and proliferation to known MET, which might be underlied by deactivation of Wnt/β-catenin pathway.

Animals ; Epithelial-Mesenchymal Transition ; Mesenchymal Stromal Cells ; cytology ; Neurons ; cytology ; metabolism ; Proto-Oncogene Proteins c-myc ; metabolism ; Rats ; Wnt Signaling Pathway ; beta Catenin ; metabolism

BACKGROUNDPathological fractures signify a potentially more aggressive subset of the original disease with higher misdiagnosis rates and inferior oncologic results. The purpose of the present study was to explore the clinical features of neoplastic pathological fracture in extremities.

METHODSFrom August 2002 to December 2010, a consecutive series of 139 patients suffering neoplastic pathological fracture were recruited, including 79 males and 60 females with a mean age of 31.3 years. Fractures were classified into five groups: tumor-like lesions (55), benign bone tumors (13), giant cell tumors (7), primary malignant bone tumors (28), and metastatic bone tumors (36). Based on their inducing forces, pathologic fractures were classified into four grades: spontaneous fracture, functional fracture, minor injury, and traumatic injury. Patients' age, fracture site, histological diagnoses, fracture forces, prodromes, and misdiagnosis were well reviewed. Kruskal-Wallis and χ(2) tests were used to compare forces and prodromes within different types of bone tumors.

RESULTSThe highest pathologic fracture morbidity was 32.3% (45/139), which lay in the 11 - 20 year group, and 86.1% of metastatic tumors occurred in the 50 - 80 year group. The common sites of fractures were femur, humerus, and tibia. The fracture forces in benign bone tumors and tumor-like lesions are the strongest, followed by metastatic tumors and primary malignant bone tumors (H(C) = 80.980, P = 0.000). Sixty-seven patients (48.2%) had local prodromes before pathologic fracture. The incidence rates of prodromes between primary malignant tumors and metastatic bone tumors had no significant difference (P = 0.146), but they were all obviously higher than that of benign bone tumors and tumor-like lesions. Twenty patients experienced misdiagnosis.

CONCLUSIONMinor injury forces and local prodromes are clinical features of neoplastic pathologic fractures and they are also the critical factor avoiding misdiagnoses.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Neoplasms ; complications ; pathology ; Child ; Child, Preschool ; Diagnostic Errors ; Female ; Fractures, Spontaneous ; diagnosis ; Humans ; Male ; Middle Aged

OBJECTIVE To construct the neuroendocrine immunomodulation (NIM) sub-network regulated by Liuwei Dihuang decoction (LW) and analyze its characteristics. METHODS We took the GSE57273 in GEO database and screened the differentially expressed genes (DEGs)(P<0.01) by the GEO2R tool as gene expression signature of LW. The global PPI network was constructed in the context of whole PPI network through direct interaction algorithm and forest algorithm respectively.Then the enrichment and the topological characteristics of NIM signaling molecules were evaluated by permutation test. Finally, we abstracted the NIM sub-network by NIMNT, which combined the NIM molecular network and forest algorithm, and analyzed the topological characteristics of it by the Network Analyzer(release 2.7)plugin in Cytoscape v3.5.1.RESULTS We got 2468 DEGs in the gene expression signature of LW.After analyzing the global PPI network of LW got by two kinds of algorithms,we found that the NIM signaling molecules significantly enriched and located in important positions in the global PPI network. The NIM sub-network regulated by LW contained 1099 nodes and 1056 edges. We screened out 22 hub nodes (Degree>10). Among them, there were 19 NIM signaling molecules in which only ESR1 changed significantly and 3 non-DEGs(NFATC2,RARA,TP53).However,the down-stream of the hub nodes were significantly changes. CONCLUSION The results suggested that LW might mainly regulate the non-hub nodes to recovery of the network imbalance of the body in the state of disease.

OBJECTIVETo study the incidence of injuries among residents living in the communities in Zhejiang.

METHODSA household questionnaire survey was conducted to 16 899 residents in four communities.

RESULTSThe incidence of injuries was 16.11% in total, higher in urban area than in rural area and higher in men than in women. The leading causes of injuries were falls (4.80%), knife-cutting or by sharp articles (3.86%), traffic accident (2.07%), collision (1.99%), scalds (1.13%) and animal bites (1.06%). Peak incidence of age group was different in different injuries, such as traffic accident was high in 45 - 60 age group and falls was high in 5 and 60 age group. Direct economic loss for each case with injury would cost 324.21 RMB yuan.

CONCLUSIONInjury was common and frequently occurred among residents at the community level which seriously on danger their health and families.

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Animals ; Bites and Stings ; epidemiology ; Burns ; epidemiology ; Child ; China ; epidemiology ; Community Health Services ; Dogs ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Wounds and Injuries ; epidemiology ; mortality