Objective To analyze complications of carotid artery stenting (CAS) and preventions.Methods Clinical data and treatment outcomes of 72 consecutive patients ( 80 stents ) from July 2006 to January 2012 with carotid stenosis were analyzed.Asprin 100 mg and clopedigrel 75 mg were given orally 5 days before CAS.Distal embolic protection device were implanted in all patients,pre-dilatation was done for those with carotid stenosis ＞ 90％ and post-dilatation was done for those of residual stenesis ＞ 30％.Severe complications of CAS mean death,myocardial infarction (MI) and stroke.Other minom included transient ischemic attack ( TIA ),hyperperfusion and intracranial hemorrhage ( ICH ),bradycardia and/or hypotension,hypertension,access hematoma or bleeding.Results In 72 patients a total of 80 self-expandable bare stents were successfully implanted.Distal embolic protection devices were used in all cases.Combined procedure was taken in 5 cases including OPCABG in 2 cases,left subclavain artery stenting in 2 cases and renal artery stenting in 1 case.The overall in-hospital complications was 37.5％ (27 of 72).Of these events,1 case had minor strokes defined as a modified Rankin Scale score less than 3 at 1-year follow-up,2 patients (2.78％ ) experienced a hemispheric TIA (neurological symptoms that resolved within 24 hours),1 patient experienced hyperperfusion syndrome.The overall mortality rate was 0,21 cases (29.2％ ) experienced hemodynamic instability (hypotension in 15 cases,bradycardia in 5 cases and hypertension in 1 case) and 2 others had access hematoms.The 30-day death/stroke/myocardial infarction risk was 1.39％ (1 minor stroke).Conclusions Hemedynamic instability (hypotension and bredycardia) is main complications of carotid artery stenting in patients with carotid artery stenosis,severe complications are rare.

Objective To learn the status quo of core competency of registered nurses in tertiary level first-class hospitals in Liaoning Province and compare the level and characteristics of core competency of registered nurses in different working years in order to supply evidence to establish contrapuntal training protocol.Methods "The Competency Inventory for Registered Nurse scale"(CIRN,by LIU Ming)was distributed to investigate the core competency of registered nurses,the data underwent analysis.Results The overall score of core competency level was (174.11±31.89),the score of the nurses with 16～20 years of working experience was the highest,while the score of nurses working for 1～5 years was the lowest.The core competency varied with working years,evident difference existed in different dimensions and total scores.Conclusions The overall core competency is at the upper middle level for registered nurses from five tertiary level first-class hospitals in Liaoning Province.They are competent enough to provide health care.With the increasing length of working time,nurses' core competency level will strengthen gradually.

Potency is one of the most important indexes of inactivated vaccines.A number of methods have been established to assay the potency,of which the NIH test and single-dose mouse protection test are the prescribed methods.Here,we report a method to semi-quantitatively assay the potency of an inactivated rabies vaccine,which uses fewer animals and takes less time to complete.Depending on the quality requirements of a vaccine(e.g.minimum potency),a rabies reference vaccine is,for example,diluted to the minimum potency,and 50 μL of the dilution is taken to inoculate 10 mice.The same amount of the test rabies vaccine is inoculated into another 10 mice.After two weeks,all mice are bled and serum samples are assayed for viral neutralizing antibody by the fluorescent antibody virus neutralization(FAVN) test.By comparing the median and interquartile range of antibody titers of the reference vaccine with those of the test vaccine,the test vaccine potency can be semi-quantitatively judged as to whether it is in accord with the required quality.The reliability of this method was also confirmed in dogs.The procedure can be recommended for batch potency testing during inactivated rabies vaccine production.

Objective To observe the expression of Frizzled protein in mouse tooth germ at bell stage and explore the possible function of Wnt/Frizzled signal molecules. Methods Mouse embryos at 17 and 19 days of gestation (E17 and E19) as well as mice postnatal day 2 (PN2) were employed in our study. The frozen sections of the first lower molar were made and indirect immunofluorescence technique was carried out on the sections. The location of Frizzled protein was observed under the fluorescence microscope. Results Frizzled protein was expressed weakly in the inner- and outer- dental epithelium at E17. At E19,the positive staining was found to distribute at the summit of both pre-ameloblasts and pre-odontoblasts. At P2,Frizzled protein was expressed strongly at the summit of ameloblasts and odontoblasts. Conclusion Wnt/Frizzled signal molecules may be involved in the differentiation of ameloblasts and odontoblasts.

Compounds were isolated through various chromatographic techniques and their structures were identified by spectroscopic data analysis and comparison with those reported in the literatures. Thirteen compounds were obtained from the petroleum ether and ethyl acetate extracts. Their structures were identified as 4,4'-dimethoxy-9,9', 10,10'-tetrahydro-(1, 1'-biphenanthrene) -2, 2', 7, 7'-tetrol (1), 4, 4', 7, 7'-tetrahydroxy -2,2'-dimethoxy-1, 1'-biphenanthrene (2), 3, 5-dihydroxy-2, 4-dimethoxyphenanthrene (3), physcion (4), chrysophanol (5), emodin (6), genkwanin (7), quercetin (8), quercetin 3'-O-beta-D-glucopyranoside (9), 3-methoxy-4-hydroxy phenylethanol (10), syringic acid (11), vanillin (12), and p-hydroxybenzaldehyde (13), respectively. Compounds 1-3 and 5-12 are reported from this genus for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Orchidaceae ; chemistry ; Plant Tubers ; chemistry

Objective: To study the effect of enalapril on inducible atrial fibrillation(AF) in old rats. Methods: Old male Wistar rats were randomly divided into control group(n = 12) and experimental group(n = 13). Rats in control group were fed routinely. Rats were fed with enalapril besides normal diet in experimental group for three months. Rats were then anesthetized, thoracotomy was performed and pericardium was opened to expose heart. Right atrium effective refractory period(ERP) was measured. Sinus conduction time (SCT) and sinus recovery time (SRT) were measured for evaluating sinus function. Interatrial conduction time(IACT) and atrium response to burst pacing were evaluated in vivo. Plasma angiotensinⅡ level and atrial tissue angiotensinⅡ level were determined by radioimmunoassay. Sections were cut from the tissue of atrium and stained with Masson trichrome. The ratio of the area occupied by interstitial to the total area was measured. Results: Contrast to control group,IACT and SRT were shorter in experimental group(P ＜ 0.01 and P ＜ 0.05 respectively). AF were induced in 9 rats in control group and 4 rats in experimental group(P ＜ 0.05). AngiotensinⅡconcentration was significantly decreased in right and left atrium tissues of experimental group compared with that in control group(P ＜ 0.01). A significant decrease in interstitial atrial fibrosis was presented in experimental group compared with that of control group(P ＜ 0.01). Conclusion: Inducible atrial fibrillation rate was decreased in old rats after treatment with enalapril. This effect maybe resulted from the inhibited local atrium renin-angiotensin system and improved sinus node function by enalapril.

Objective To investigate the clinical therapeutic effects of different surgical treatments on cervical spondylotic my-elopathy and the occurrence of postoperative complications .Methods 65 patients with cervical spondylotic myelopathy admitted in our department between January 2010 and January 2013 were retrospectively analyzed ;and among them ,31 underwent anterior cer-vical discectomy and fusion(ACDF) and 34 underwent anterior cervical corpectomy and fusion (ACCF);the general surgical condi-tions ,JOA scores and functional grades of Nurick ,incidences of dysphagia and so on in the patients of the two groups were investi-gated .Results The operative time and intra-operative blood loss of the patients of the ACDF group were better than those of the ACCF group[(88 .70 ± 9 .03)min ,(125 .46 ± 12 .62)min ,(94 .26 ± 10 .34)mL ,(133 .98 ± 12 .09)mL] ,and the differences were sta-tistically significant(P<0 .05) .The postoperative lengths of stay of the two groups were similar ,and the differences in preoperative and postoperative JOA scores and functional grade of Nurick of the two groups were statistically insignificant (P>0 .05);but the differences between the preoperative and postoperative JOA scores and functional grade of Nurick in 6 months after the surgeries and those before the surgeries of the same groups were statistically significant (P<0 .05) .At the same observation time points ,the incidences of dysphagia and the thicknesses of soft tissue before the cervical vertebra in the operated segment of the observation group were all lower than those of the control group ,and the differences were statistically significant (P<0 .05);in the patients of either group ,no loosening ,translocation or non-fusion of the bone graft was observed .Conclusion The two surgeries in treatment of cervical spondylotic myelopathy van both obtain satisfying clinical therapeutic effects ,but ACDF has a lower incidence of postop-erative complications ,and doctors should choose a suitable surgery based on the actual conditions .

Objective To summarize the etiologic factors and evaluate the clinical outcome of reoperations on 119 limbs of recurrent varicose veins.Methods Retrospective analysis was made on etiologic factors of 119 limbs (113 patients) of recurrent varicose veins admitted to our hospital from January 2007 to June 2013.All patients underwent color duplex ultrasonography and anterograde venography of the lower extremity and were treated by reoperations.Results In the 119 limbs,102 limbs (85.7％) had residual main great saphenous veins or tributaries,97 limbs (81.5％) had incompetent perforator veins,23 limbs (19.3％) had neovascularization,9 limbs (7.6％) had incompetent small saphenous veins,21 limbs (17.6％) had incompetent femoral veins,6 limbs (5.0％) had iliac vein compression syndrome,and Budd Chiari syndrome was found as the cause of recurrence in 1 limb (0.8％).Postoperative patients were followed-up for 6-72 m (32-± 7 m).The cure rate of varicose veins were 100％.There was not recurrence of varicose veins,postoperative VCSS was 0-5 (1.2 ±0.5) vs preoperative 1-17 (6.2 ±2.5)(P ＜ 0.01).Conclusions Residual and incompetent great saphenous veins or tributaries and incompetent perforator veins were the main etiologic factors of postoperative recurrent varicose veins.Therapeutic principle for recurrent varicose veins is to eliminating the reverse flow of superficial vein system and ligate incompetent perforator veins.

Objective To observe the osteogenic effect of tissue-engineered bone constructed by poly-L-lysine-demineralized bone matrix (PLL-DBM) enriched bone marrow stem cells in the space of goat transverse process bone fusion model and explore a new tissue-engineered bone construction method. Methods PLL was used to decorate goat DBM to prepare a matrix material (PLL-DBM). The osteo-genic effect of tissue-engineered bone constructed by PLL-DBM enriched bone marrow cells ( Group Ⅰ A) was detected in goat lumbar intertransverse graft bone model; autogenous iliac bone (Group Ⅰ B), DBM enriched bone marrow (Group Ⅱ C) and DBM (Group Ⅱ D) were used as controls. The osteogenesis of the bones in the fused segments of four groups were compared and evaluated by X-ray, three-dimensional CT, CT value testing and biomechanical testing. Results The results of X-ray showed that the fusion ranges in groups ⅠA and ⅠB were basically the same, which were significantly wider than that in Group Ⅱ, with no fusion detected in Group Ⅱ D. The CT value was (696.76±10275) HU in Group Ⅰ A and (766.03±69.24) HU in Group B, which were significantly higher than that in Group Ⅱ C (P <0.05), but there was no statistical difference in CT value between Groups Ⅰ A and Ⅰ B (P > 0.05). The CT val-ue in Group Ⅱ C was significantly higher than in Group ⅡD (P <0.01). There was no statistical differ-ence between Groups Ⅰ A and Ⅰ B in the maximum load and bending strength (P > 0.05). The maxi-mum load and bending strength in Groups Ⅰ A and Ⅰ B were significantly higher than that in Group Ⅱ C (P < 0.05), and the two indices in Group Ⅱ C were significantly higher than that in Group Ⅱ D (P <0.01). Conclusion Tissue-engineered bone constructed by PLL-DBM enriched bone marrow cells is an ideal tissue engineered bone and its osteogenic potential is similar to that of autologous bone.

Objective To undertake a survey on the prevalence, pathogenic factors and treatment needs of hearing impairment in children under 14 years old in Guizhou province. Methods Using the probability proportion to size (PPS) method, 2 068 children aged 0～14 years were included in the study and in 30 clusters in Guizhou province based on the WHO protocol. Results For children aged 0～14 years, the prevalence of hearing impairment was 3.48% and the prevalence of hearing disability was 1.84 %. There were statistically differences of the prevalence of hearing disability between children aged 7～ 14 years (2.66 %) and 0～ 6 years (0. 51%), and the differences also in hearing impairment between male children (4.22%) and female children (2.54%). The main causes of hearing impairment were ear diseases (50.00%), non-infective conditions (11.11%), genetic conditions (20.83 %) and unknown causes (27. 77%). 3. 58% of all subjects needed medical or surgical treatment and 2. 32% needed hearing aids. Conolusion The prevalence of hearing disability of children under 14 years old in Guizhou province was higher than that of other cities. The main cause of the hearing impairment of children was otitis media with hereditary deafness also ranked in top.