Clinical data of 151 patients with acute occlusion of right coronary artery were retrospectively analyzed.Coronary angiography and electrocardiography (EEG) were performed in all 151 patients,angiography showed proximal-middle segment occlusion in 114 cases and distant segment occlusion in 37 cases.The correlation of ECG findings with coronary artery occlusion sites was analyzed.Results showed that EEG findings related to proximal-middle segment occlusion were:ST segment elevation in lead V4R ≥0.05 mV,Ⅲ degree atrioventricular block,ST segment depression in lead Ⅰ ＞0.1 mV,ST segment depression in lead AVL≥0.2 mV,ST segment elevation in lead l ≥0.25 mV,the total ST depression in lead V2,V3 and V4 ≥0.4 mV,the total ST depression in lead Ⅰ and aVL ≥0.25 mV;among which ST depression of Lead Ⅰ ＞0.1 mV,ST elevation of Lead V4R ≥0.05 mV and Ⅲ degree atrioventricular block were used to predict occlusion of proximal-middle segment of right coronary artery with 100％ specificity.ECG findings related to distal segment occlusion were:ST depression in lead Ⅰ ≤ 0.1 mV,ST segment depression in lead AVL ＜0.2 mV,ST elevation in lead Ⅲ ≤0.25 mV,the total ST depression in lead V2,V3 and V4 ＜ 0.4 mV,ST segment were not depression in lead V1-V5,the total ST depression in lead Ⅰ and aVL ＜ 0.25 mV.Based on a 4-step flow method,ECG might be adopted to identify the acute occlusion sites in proximal-middle segment and distal segment of right coronary.

Objective To investigate the effect of butylphthalide and sodium chloride injection postconditioning on focal cerebral ischemia-reperfusion (I/R) injury and endoplasmic reticulum stress in rats.Methods Thirty-six male SPF Sprague-Dawley rats,aged 2-3 months,weighing 260-280 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),focal cerebral I/R group (group I/R) and butylphthalide and sodium chloride injection postconditioning group (group Buty).The animals were anesthetized with intraperitoneal 10 ％ chloral hydrate 300 mg/kg.Focal cerebral I/R was induced by occluding right middle cerebral artery for 2 h followed by 24 h reperfusion in I/R and Buty groups.Butylphthalide and sodium chloride injection 2.5 mg/kg was injected via the tail vein immediately after onset of reperfusion in Buty group,while the equal volume of normal saline was injected in I/R group.Neurological deficits were assessed and scored at 24 h of reperfusion,and then the brain was isolated for detection of neuronal apoptosis (by TUNEL) and the expression of glucose-regulated protein 78 (GRP78) and caspase-12 in ischemic cerebral cortex (by immunohistochemistry) in brain tissues.Apoptosis index was calculated.Results Compared with group S,the neurological deficit scores and apoptosis index were significantly increased,and the expression of GRP78 and caspase-12 was up-regulated in I/R and Buty groups (P ＜ 0.05 or 0.01).Compared with group I/R,the neurological deficit scores and apoptosis index were significantly decreased,the expression of GRP78 was up-regulated,and the expression of caspase-12 was down-regulated in group Buty (P ＜ 0.05).Conclusion Butylphthalide and sodium chloride injection postconditioning can reduce focal cerebral I/R injury in rats,and inhibition of endoplasmic reticulum stressmediated cell apoptosis is involved in the mechanism.

10.3969/j.issn.2095-4344.2013.26.011

Objective To obtain more detailed microsurgical anatomical data and multi-slice helical CT scanning of cochlear aqueduct for the translabyrithine approach. Methods Twenty cadaver heads(40 sides)fixed with formalin were dissected under a microscope ,and cochlear aqueducts were found and measured. Five cadaver heads(10 sides) were scanned by multi-slice helical CT. Results The width of external aperture of cochlear aqueduct was (2.64?0.82)mm. The length of cochlear aqueduct was (8.40?1.35)mm. The distance between cochlear aqueduct and cranial nerves Ⅸ, Ⅹ, Ⅺ, and that between the inferior petrosal sinus was(1.08?0.36 )mm,(2.71?0.63)mm,(4.52?1.25)mm, (1.14?0.46)mm, respectively. The distance between external aperture of cochlear aqueduct and the inferior margin of internal acoustic meatus aperture was (5.53?0.93)mm. The otic capsule segment of cochlear aqueduct could not be demonstrated on the coronal section. The petrosal portion could be demonstrated by both coronal and axial scannings. Conclusion The axial scanning was useful for detecting cochlear aqueduct. Cochlear aqueduct could be regarded as one of the landmarks in translabyrithine approach for cerebellopontile angle operation.

Objective:To explore effect of serum leptin level on nutriture in the patient of chronic renal failure(CRF)and the relation with TCM syndrome types of CRF.Methods:110 cases in CRF group were divided into 5 subtypes and 30 normal persons were used as control group.Serum leptin level,body height,body weight,and body mass index(BMI)were determined in both groups;and serum albumin,serum pre-albumin,transferin,serum creatinine,urea nitrogen,C-reaction protein,blood insulin,and nutrition risk index(NRI)were detected in CRF group.Results:Serum leptin level in CRF group was higher than that in the control group,and leptin level and nutritional index level in both the subtype groups of Qi-and Yang-deficiency of spleen and kidney were significantly different with those in other 3 subtype groups.Conclusion:High blood leptin is possibly one of the reasons inducing malnutriture of CRF patient,and serum leptin is possibly a partial basis of substances of Qi-and Yang-deficiency syndrome of CRF.

Objective To compare the serum protein profiles between people with successful aged 80 years and over in Bama versus Nanning,to identify the possible causes of the long life expectancy in Bama.Methods We evaluated the serum protein profiles using surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS) with 4 different chromatographic surfaces,including the weak cation exchange (CM10),immobilized metal affinity capture (IMAC) 30-Cu,strong anion exchange (Q10) and hydrophobic surface (H50) protein chip arrays in people with successful aged 80 years and over living in Bama versus in Nanning city.SELDI-TOF-MS had a molecular mass detection range of 2000-50,000 D,with a first signal-to noise (S/N) ratio of 5,frequency of peak cluster of over 15 ％,and second S/N ratio of 2 and peak fluctuation of 0.3％ (m/z).Results The total numbers of serum protein (peptide) peaks for people with successful aging in Bama and Nanning were 71 on CM10,46 on IMAC30-Cu,81 on Q10,and 52 on H50.Among subjects from Bama as compared with Nanning (P＜0.05; mean ＞SD for each protein peak),there were 8 differently expressed protein peaks on CM10,of which 2 were upregulated and 6 downregulated; 7 on IMAC-Cu,of which 2 were upregulated and 6 downregulated; 5 on Q10,all of which were upregulated; and 6 on H50,of which 3 were upregulated and 3 downregulated.Conclusions There are marked differences in the serum protein profiles between people with successful aging living in Bama versus in Nanning.Most of the proteins are downregulated among people aged over 80 years in Bama.

Objective:To observe the changes in the anterior chamber before and after cataract surgery by ultrasound biomicroscopy (UBM) in eyes with primary angle closure glaucoma. Methods: Ultrasound biomicroscopy was used for anterior chamber imaging in 78 eyes of 50 patients with primary angle closure glaucoma before and 1 month after cataract phacoemulsification and intraocular lens implantation. And the intraocular pressures were recorded at the same time. Results: UBM allowed the imaging of the entire anterior eye segment. In the images, the differences between iris thickness (IT), iris zonule distance (IZD) and iris lens angle (?2) before and after the operation were statistically insignificant. After the operation, marked increases were observed in the anterior chamber depth (ACD), angle opening distance at 500 ?m from the scleral spur (AOD500), trabecular iris angle (?1) and trabecular ciliary process distance (TCPD), with statistically very significant differences from preoperation (P

Objective To analyze the curative effect of super-early keyhole surgery in treatment of hypertensive cerebral hemorrhage. Methods Clinical data of patients with hypertensive cerebral hemorrhage who received treatment in our hospital from April 2010 to October 2012 were retrospectively analyzed. Patients were divided into the observation group ( keyhole surgery group) and the control group ( routine group) by different therapeutic methods. The operation time, rate of hematoma clearance, postoperative complications, and recovery of neu-ral function of the two groups were compared. Results The observation group had a shorter operation time than the control group, and the difference was statistically significant(P<0. 001). There was no singnificant difference between the two groups in rate of hematoma clear-ance at the time of tube drawing(P>0. 05). The observation group had less postoperative complications than the control group, and the difference was statistically significant(P<0. 05). The observation group had a lower rate of metabolic disorders than the control group with a statistically significant difference(P<0. 05). Patients of the observation group had a higher scores of SSS than patients of the control group 28 days after operation, and the difference was statistically significant(P<0. 05). 6 months after operation, the observation group had a bet-ter ADL than the control group, and the difference was statistically significant(P<0. 05). Conclusion Super-early keyhole surgery which has less intraoperative injury, postoperative complication, and metabolic disorders, can achieve a better effect than routine operation. And it is of better neural functional recovery.

Background Carbachol solution (0.01％) is an agonist of M cholinoceptor and skeletal muscle N cholinoceptor,and it is used to play miotic effect and open peripheral iridectomic hole during the surgery of implantable collamer lens (ICL) implantation in order to lower intraocular pressure (IOP).However,the anterior chamber injection of 0.01％ carbachol solution often causes relevant complications,while whether lower dose of carbachol solution is effective and safe is unclear.Objective This study was to compare the effectiveness and safety between 0.01％ carbachol solution and 0.005％ carbachol solution after anterior chamber injection during the ICL implantation.Methods One hundred and fifty-two eyes of 76 cataract patients were included in Daping Hospital of Third Military Medical University from September 2014 to September 2015.ICL implantation and periphery iridectomy were carried out on both eyes of the patients and the 0.01％ carbachol solution was injected into the anterior chamber during the surgery of the right eyes and 0.01％ carbachol solution was used in the left eyes.The operation duration and IOP at postoperative 2 hours and systemic choline-like reaction were compared between 0.01％ carbachol solution group and 0.005％ carbachol solution group.Results The mean operation duration was (11.86± 2.39) minutes and (11.22 ± 1.85) minutes in the 0.01％ carbachol group and 0.005％ carbachol group,without significant difference between two groups (t =1.851,P =0.066).IOP was (15.76 ± 2.18) mmHg and (13.58 ±2.24)mmHg in the 0.01％ carbachol group before and after surgery,and those in the 0.005％ carbachol group was (15.70±2.35)mmHg and (13.12±2.17)mmHg,there was no significant difference in the IOP between the two concentrations of carbachol (Fsroup =0.986,P=O.322).The IOP at postoperative 2 hours was lower than that before operation,the difference was statistically significant(Ftime =97.339,P =0.000).There was no interaction between drug concentration and time (Fcorrelation =0.772,P =0.381).The incidences of complications,such as dizziness,nausea and vomiting,were lower in the 0.005％ carbachol group than those in the 0.01％ carbachol group (x2 =13.01,5.16,4.03,all at P＜0.05).Conclusions Carbachol solution (0.005％) can play intraoperative miosis effect and maintain effective operation duration in ICL implantation.In addition,the application of 0.005％ carbachol solution is quite safe in both intraoperation and postoperation.

AIM: To observe the curative effect of titanium wiring in treatment of the fractures of Neer Ⅱ type distal clavicle and dislocation of Tossy Ⅲ type acromioclavicular joint. METHODS: From March 2004 to December 2006, 37 cases with Neer Ⅱ type distal clavicle fractures or Tossy Ⅲ type acromioclavicular joint dislocation were treated with titanium wiring in Changzheng Hospital, Second Military Medical University of Chinese PLA. Titanium wiring (produced by Sofamor-Danek Company in USA) had good histocompatibility, intensity of tension and flexibility. The broken coracoclavicular ligament was repaired directly by titanium wiring in all cases. The outcomes were evaluated according to Herscovici's criteria. RESULTS: All the cases were followed up for 6 to 24 months. All the dislocated acromioclavicular joints returned to normal 2 weeks after operation. Excellent and good rate of shoulder function was 100% according to Herscovici standard. X-ray imaging showed all clavicle fractures united, acromioclavicular joint had no redislocation or titanium wiring breaking. The incisions of all cases had no obvious swelling and exudation. CONCLUSION: When Neer Ⅱ type distal clavicular fracture and Tossy Ⅲ type acromioclavicular joint dislocation are treated with titanium wiring, the acromioclavicular joint can exercise earlier and recover quickly.