Objective To investigate the ultrasonic performance of carotid atherosclerotic plaque and the correlation between microvessel density in plaque .Methods 87 cases of patients undergoing carotid artery plaque dissection were selected .113 plaques were found .All patients were taken carotid color Doppler sonography test and analysis of the plaque .The maximum thickness of plaques was taken HE stained ,and the vessel density in the plaque was counted .The correlation with sonographic performance of plaques was analyzed .Results The maximum plaque thicknesses in hard plaque ,soft plaque and mixed plaque were (0.49 ±0.05)mm,(0.36 ±0.08)mm and (0.39 ± 0.10)mm,respectively,and cross-sectional area stenosis rates were (88.32 ±6.51)%,(68.92 ±12.05)% and (71.95 ±13.04)%,respectively,the differences were statistically significant (F=16.329,23.723,all P<0.05). The maximum plaque thickness and cross -sectional area stenosis rate in hard plaque were all larger than soft plaque and mixed plaque,the differences were statistically significant (t=7.091 7,2.501 and 6.452,6.086,all P<0.05). The microvessel density values in different plaques were (2.11 ±0.48)strips/mm2,(5.91 ±1.03)strips/mm2 and (3.82 ±0.99)strips/mm2,the differences were statistically significant (F=143.541,P<0.05),soft plaque>mixed plaques>hard plaque,the differences were statistically significant (t=6.579 and 9.392,all P<0.05).Pearson cor-relation analysis showed that the maximum plaque thickness and cross -sectional area stenosis rate in soft plaque were positive correlation between microvascular density values (r=0.372,P=0.011;r=0.438,P=0.000).Conclusion Color Doppler ultrasound examination might indirectly reflect microvessel densities in carotid artery plaque .It could be used preliminary assessment of vulnerability of carotid artery plaque .

BACKGROUND:There are some controversies on the choice of immediate or delayed weight-bearing schemes of implants.
OBJECTIVE: To explore the weight bearing scheme for Bego implants based on implant stability quotient (ISQ) measured by Osstel, and to analyze the factors which influence implants’ stability.
METHODS:Seventy-four single Bego implants with ISQ≥ 50 in 62 patients were selected and randomly
divided into test group (36 single Bego implants in 31 patients) and control group (38 single Bego implants in 31 patients). Patients in the test group were given immediate loading, and patients in control group were given
delayed loading. Two groups’ ISQ of Bego implants after loading (1, 2, 3, 4, 6, 8 and 12 weeks) were compared, and factors which influence implants’ stability were analyzed.
RESULTS AND CONCLUSION:The lowest ISQ for immediate loading of the test group appeared in 2-3 weeks after loading, and that of the control group appeared in 3-4 weeks. There was no statistical difference between two groups on ISQ of Bego implants after bearing (1, 2, 3, 4, 6, 8 and 12 weeks) (P > 0.05). Multiple regression analysis showed that the factors including age, types of osseous substance and implant length were positively related with stability of Bego implants, yet oral hygiene was negatively related with stability of Bego implants. Immediate loading and delayed loading have similar stability to single Bego implants with ISQ≥ 50 measured by Osstel, so individualized weight bearing scheme may be selected according to patient’s own condition under the guidance of Osstel, further to improve implants’ success rate after loading.

Objective To investigate the value of contrast -enhanced ultrasound combined with serum homocysteine in determining the stability of atherosclerotic plaques.Methods 96 cases with cerebrovascular disease accompanied by carotid atherosclerotic plaques were selected.All patients were taken ultrasonography and contrast -enhanced ultrasound.Semi -quantitative grading was used for plaque according to the reinforced.The serum homocys-teine levels were detected.Results A total of 146 plaques of 96 cases were found out.Hard plaques were 13(8.9%),soft plaques were 71(48.6%)and mixed plaques were 62(42.5%).All cases were divided into three groups according to the plaque ultrasound contrast semiquantitative grading.24 cases were in Ⅰ grade group,46 cases were in Ⅱ grade group,26 cases were in Ⅲ grade group.The differences of serum homocysteine levels among the three groups were statistically significant(F =59.942,P <0.05),pairwise compared,the differences were statistically significant(t =16.837,20.682 and 15.416,all P <0.05).Pearson linear correlation analysis showed that contrast -enhanced ultrasound plaque classifications were positively correlated with serum homocysteine levels(r =0.709,P =0.000).Conclusion Contrast -enhanced ultrasound could accurately assess the neovascularization in the plaque. Semi -quantitative grading of ultrasound contrast are positively correlated with serum homocysteine levels.Combined the two could provides scientific basis for early and accurate prediction the stability of plaque.

Objective Adenosine receptor agonist NECA has a certain myocardial protection, but the specific mechanism is not clear.This paper aimed to study the effect and mechanism of NECA inhibiting endoplasmic reticulum stress to against myocardial ischemia reperfusion injury in rats.Methods 56 Wistar rats of SPF grade were selected and divided into Sham group, I/R group, NECA group and TUDCA group through random number table method.We established the isolated rat heart ischemia reperfusion model by using the Langendorff device.Sham group: heart threaded but not ligated, Kerb-Henseleit buffer continuous infusion 170min;I/R group: heart stability 20min, ischemia 30min, reperfusion 2h;NECA group and TUDCA group: heart stability 20min, ischemia 30min, reperfusion 2h, perfusion solutions containing 0.1μmol/L NECA and 30μmol/L TUDCA were respectively given at 5min before reperfusion, and ended at 30min after reperfusion.Transmission electron microscope was used to evaluate alterations of the myocardial ultrastructures.Western blot analysis was used to detected the expression levels of endoplasmic reticulum stress IREl-XBPl signaling pathway marker protein IRE1α, XBP1s.Immunohistochemical staining was used to detect the expression of IRE1α.Results The results of transmission electron microscopy showed that most of the myofilament ruptured, sarcomere contracture deformation, visible mitochondrial vacuoles degeneration in I/R group, and injury in NECA group and TUDCA group were less than the I/R group, appeared as the filaments arranged more neat, sarcoma only had mild contracture.Immunohistochemical results showed that IRE1αpositive staining was not found in the sham group, and the area of positive staining of IRE1α in I/R group was significantly increased, while the NECA group and TUDCA group were significantly decreased.Compared to the Sham group, the expression level of IRE1α and XBP1s was significantly increased in I/R group(P<0.05);but compared with the expression level of IREα and XBP1s in I/R group(1.72±0.27, 0.97±0.19), the NECA group(1.14±0.16, 0.6±0.13) and the TUDCA(1.07±0.27, 0.58±0.15) group were significantly decreased(P<0.05).Conclusion NECA can reduce endoplasmic reticulum stress through inhibiting IREl-XBPl pathway to protect the myocardium.

Objective To analyze the risk factors of voiding dysfunction after mid-urethral sling surgery for stress urinary incontinence.Methods Clinical data of 573 consecutive patients undergoing midurethral sling surgery from January 2003 to December 2010 were collected and analyzed retrospectively.All relative risk factors were evaluated by univariate and multivariate Logistic analysis to identify risk factors of voiding dysfunction.Results Voiding dysfunction occurred in 28 patients,with an incidence of 4.9％ (28/573).Univariate analysis showed that age,previous pelvic surgery,pre-operative postvoid residuals,maximum flow rate,average urine flow rate,Valsalva leak point pressure,concomitant anterior pelvic repair and operator performing＜50 procedures were the relative risk factors (P＜0.05) for voiding dysfunction.Multivariate logistic regression analysis revealed that the maximum flow rate (Qmax) ≤ 15 ml/s (OR=3.782,P=0.003) was an independent risk factor for voiding dysfunction and surgery experience was its protection factors (OR=0.295,P=0.016).Conclusions Qmax ≤ 15 ml/s on preoperative urodynamic study is an independent risk factor for voiding dysfunction after mid-urethral sling procedure.Improving skill of surgery and strengthening technical training will help to reduce the incidence of this complication.

Objective To explore the nursing problems and application value of intrauterine instruments positioning in assistance of tubal interventional treatment. Methods Uterine probe or expanding-uterus stick was used in 66 cases who had abortde with routine methods for rectifying the position of uterus or adhesion re-lease, then the selected catheter was inserted to the targeted fallopian tube for interventional aim. Nurses paid at-tention to the nursing cooperation and summarized the nursing points during the whole processes. Results With this technique, the achievement ratio of selected insertion to fallopian tube was 100% and that of recanaliza-tion was 92.68%. The major adverse effects were hypogastralgia and little vaginal bleeding. Pneumogastric nervereactions were found in 3.03% cases. Conchusions The assistant-immanent could elevate the achievement ra-tio of selected insertion to the targeted fallopian tubes, but the nursing problems shouldn't be neglected.

Objective To investigate the effects of prophylactic antiviral therapy for HBV DNA negative HBV-relat-ed hepatocellular carcinoma (HCC) patients undergoing hepatic arterial chemoembolization (TACE). Methods Fifty-four consecutive patients with HBV-related HCC and received TACE were enrolled in this study. Thirty patients received pre-emptive antiviral drugs before TACE were defined as the treatment group. Twenty-four patients, who did not use antiviral drugs until HBV reactivation after TACE, were included in control group. The incidence of HBV reactivation, duration from HBV DNA positive point to the last time of TACE, the occurrence of abnormal alanine aminotransferase (ALT) caused by HBV reactivation, the peak of aspartate aminotransferase (AST) and the number of liver failure caused by HBV reactivation were observed after TACE in two groups. Results The incidence of HBV reactivation, the occurrence of abnormal ALT, the occurrence of abnormal ALT caused by HBV reactivation, the peak ALT and peak AST were significantly lower in treatment group than those of control group (P ＜ 0.05). No liver failure caused by HBV reactivation was found in treatment group. There were four patients with liver failure caused by HBV reactivation in control group. There was no significant difference in cumulative survival rate between two groups (P=0.071). Conclusion It is suggested that preemptive antiviral therapy can prevent the reactivation of hepatitis B virus, prevent the deterioration of liver function,and decrease the occurrence of liv-er failure caused by HBV reactivation in patients receiving TACE.

Aim Toexplorethemechanismofupregu-lation of osteopontin ( OPN ) expression induced by high glucose in human renal tubular epithelial cells (HK-2cells).Methods Afterstimulationwithhigh-glucose (25 mmol·L-1 ) culture medium, HK-2 cells were then treated with the specific inhibitors or siRNA to inhibit the activity of PI3K and/or mTOR. Subse-quently, Real-time PCR was used to investigate the mRNA level of OPN, and Western blot was performed to detect the protein expression of OPN, p-AKT, p-S6,RaptorandRictor.Results Theexpressionlevel of OPN was increased in a time-dependent manner in HK-2 cells followed by high-glucose stimulation. The mRNA level of OPN peaked at 48 h; while the protein expression of OPN reached the highest level at 72h. Meanwhile, high glucose activated the PI3K/AKT/mTOR signaling pathway. Moreover, inhibition of the PI3 K/AKT/mTOR pathway by LY294002 and/or rapa-mycin led to significant down-regulation of OPN. Addi-tionally, the treatment with Raptor siRNA, but not Rictor siRNA resulted in reduction of OPN expression. Conclusion Highglucoseincreasestheexpressionof OPN through the activation of PI3 K/AKT/mTORC1 signaling pathway in HK-2 cells.

The re-evaluation of clinical post-marketing herbs in special populations, such as children, the aged, pregnant women, lactating women, has attracted attention in our country. The media is drug adverse reaction reports and package insert. The safety of combined administration in aged and children's growth should have been taken long-term follow-up study. Perfecting traditional chinese medicine FDA system will be beneficial to the re-evaluation of clinical postmarketing herbs in pregnant women. Dose-effect study in children also should cause the concern of researchers.
Adverse Drug Reaction Reporting Systems ; Aged ; Child ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Medicine, Chinese Traditional ; adverse effects ; Polypharmacy ; Pregnancy ; Product Surveillance, Postmarketing

Objective:To investigate the possible pathological mechanisms of tardive dyskinesia (TD) by analyzing brain cortex morphological changes and it's correlation to abnormal involuntary movement in schizophrenic patients with TD.Methods:Thirty-two schizophrenia patients with TD (TD group),31 schizophrenia patients without TD (non-TD group) and 21 healthy volunteers (control group) were recruited.Combined TD and non TD group into schizophrenia group.The psychopathological symptoms and abnormal involuntary movement were assessed with the Positive and Negative Syndrome Scale (PANSS) and Abnormal Involuntary Movement Scale (AIMS).The brain magnetic resonance imaging (MRI) data and Freesurfer software were used to measure the gray matter volume,cortical thickness,cortical surface area and volume of sub-conical regions among the three groups.Results:Schizophrenia group had significantly smaller gray matter volume in right nucleus accumbens,bilateral hippocampus,left superior frontal gyrus,left precentral sulcus superior part,and cortical surface area in left precentral sulcus superior part than the controls.The TD group had significantly smaller gray matter volume in right nucleus accumbens,larger gyrus gray matter volume and conical surface area in left precentral sulcus superior part than non-TD group (Ps ＜ 0.05).To test the difference between TD and non-TD group further,the chlorpromazine equivalent dose and PANSS negative scores Was controlled,the TD group still had significantly larger gray matter volume and surface area in left precentral sulcus superior part than the non-TD group [(2.03 ±0.07) × 103mm3 vs.(1.68-± 0.07) × 103 mm3,(1.01 ± 0.03) × 103 mm2 vs.(0.84 ± 0.03) × 103 mm2;Ps ＜ 0.05].Correlation analyses showed in schizophrenia group the cortical thickness in right inferior frontal gyrus correlated negatively with PANSS positive and general scores,positively with total scores;cortical volume in left occipital temporal sulcus correlated negatively with PANSS general and total scores,right inferior frontal gyrus correlated positively with PANSS positive scores,right intraparietal sulcus correlated positively with PANSS positive scores.In TD group,the cortical volume in left precentral sulcus superior part correlated positively with AIMS scores (r =0.46,P ＜0.01).Conclusions:The schizophrenia patients with TD had significantly increased gray matter volume and cortical surface area in left precentral sulcus superior part,which suggested there were motion compensation in the left precentral sulcus superior part in the pathogenesis of TD.