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.

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 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.

10.3969/j.issn.2095-4344.2013.26.011

Objective To analysis the effect of stem cell transplantation on serum homocysteine ( Hcy ) , C reactive protein ( CRP ) and brain derived neurotrophic factor( BDNF) in patients with ischemic stroke.Methods 42 patients who were diagnosed with ischemic stroke in Yichang First People's Hospital were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.The control group was treated with conventional therapy, and the experimental group was treated with autologous bone marrow mesenchymal stem cell transplantation for treatment on the basis of conventional therapy, after treatment, the serum levels of serum homocysteine, CRP, BDNF and clinical curative effect were detected in all patients.Results After treatment, compared with control group, the serum Hcy level was lower in the experimental group(P<0.05);the serum CRP level was lower in the experimental group (P<0.05); the serum BDNF level was higher in the experimental group (P<0.05); the FIM, ADL and Fugl-Meyer score were higher in the experimental group(P <0.05).Conclusions The stem cell transplantation can significantly reduce the serum Hcy and CRP levels in patients with ischemic stroke, increase the content of BDNF in serum, improve the therapeutic effect, and have a guiding significance for clinical.

Objectives: To evaluate the efficacy of phacoemulsification and foldable IOL implantation with limbal tunnel incision.　Methods: A 3.2mm limbal tunnel incision was made on 72 eyes of 66 patients with senile, complicated and traumatic cataract. Phacoemulsification and foldable IOL implantation was performed. Visual acuity, corneal curvature and corneal topography were measured after the surgery.　 Results: One day, one week and one month after the surgery, visual acuity exceeded 0.5 in 69.4%, 80.6%,86.1% of the patients respectively. One week after the surgery, the mean astigmatism was (1.85±0.89)D(P<0.01), 0.30 D more than that before the surgery. Corneal topography showed that the incision was steep or flat. One month after the surgery, the mean astigmatism was (1.48±1.02)D，P>0.05,corneal topography had recovered.　 Conclusions: Phacoemulsification and foldable IOL implantation with limbal tunnel incision have comparatively simple, with less postoperative inflammation and faster recovery of visual acuity.

Anopheles minimus collected from Yuanjiang, Yunnan Province, were bred with standard methods in lab. The ovarian nurse cells of A.minimus were separated and stained, and the whole polytene chromosomes were photographed under light microscope and compared with A.minimus from Guangxi. 365 samples of ovarian nurse cells were observed. The chromosomes included one telocentric sex-chromosome X, two submetacentric autosomes II(autosome II right arm, 2R and autosome II left arm, 2L) and two metacentric autosomes III(autosome III right arm, 3R, and autosome III left arm, 3L). The X is the shortest chromosome and the 2R is the longest one. In comparison with the pattern of polytene chromosomes of A. minimus from Guangxi, difference at 12 positions has been found at the parts of arms in banding sequences.

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.

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