Objective To evalute perioperative whole course cerebral protection for patients undergoing carotid endarterectomy (CEA) Methods From 2002 to 2004, 20 patients received CEA in our hospital using whole course perioperative cerebral protection Preoperatively carotid angiography was performed in only one patient, while Doppler ultrasonography and CTA were applied to all patients Measures of intraoperative cerebral protection included general anaesthesia, selective shunting, and transcranial Doppler monitoring (TCD), followed by postoperative delayed removal of tracheal cannula, brain ice bag, maintaining blood pressure and appropriate use of diuretics under the guidance of TCD Results Shunt was used in 7 cases (35%), 15 patients (85%) underwent patch angioplasty There were no postoperative cranial nerves related complications Mortality was 0% Conclusion Perioperative whole course cerebral protection could effectively decrease postoperative cranial nerves related complications in patients undergoing carotid endarterectomy

Objective The purpose of the experiment is to research the effects of different kind of anti-platelet drugs and their combinations in prevention of vascular restenosis after ballon-injury, and to evaluate the best way of clinical utility of anti-platelet drugs.Methods Fifty-six male New Zealand White Rabbits were randomly assigned to 3 groups: the control group (ML) , the model group (M) , the experimental group.The experimental group was divided to 5 subgroups, the aspirin group (A), the cilostazol group (B) , the clopidogrel group (C), the aspirin plus cilostazol group (A + B) , and the aspirin plus colopidogrel group (A + C).Femoral artery stenosis model was induced by halloon injury except the control group.The rabbits were fed different drugs 3 days before operation except the normal group and the model group.On the 14th day after operation, the rabbits were sacrificed and the iliofemoral arteries were removed and made to the pathological section.We measured the internal elastic lamina, external elastic lamiua and luminal areas measured.Then calculate the area of intima, media and the ratio of intima vs.media.Results ①There is no endothelium hyperplasia in control group.Compared with the control group, we observed endothelium hyperplasia in both model group and the experimental groups.Compared with the model group, endothelium hyperplasia in all experimental groups is in a lower degree;② Cilostazol alone works better than aspirin alone and clopidogrel alone in prevention of vascular restenosis after ballon-injury.Clopidogrel combined with aspirin and cilostazol combined with aspirin both work better than aspirin alone in prevention of vascular restenosis after ballon-injury.There is no apparent difference between the effect of clopidogrel combined with aspirin and cilostazol combined with aspirin.Conclusions ① Different anti-platelet drugs and different combinations of them can prevent the happening of vascular restenosis after ballon-injury.② Cilostazol works better than aspirin and clopidogrel in prevention the happening of vascular restenosis after ballon-injury, and combination of anti-platelet drugs which contains cilostazol works better than other way of combination of anti-platelet drugs.③ Cilostazol and combination of anti-platelet drugs which contains cilostazol is potential useful in clinical uses to prevent restenosis after PTA.

Objective To evaluate glycemic control,complication and influence factors of glycosylated hemoglobin(HbA1c) in type 2 diabetic(T2DM) patients with hypertension in retired and veteran of military communities in Kunming.Methods Cross-sectional study was conducted and 216 T2DM patients with hypertension were enrolled in current study.A self-made questionnaire was used to collected information including age,course of the disease,complication,hypoglycemic agents and status of glucose controlling.The levels of HbA1 c,fasting blood-glucose (FBG),2h postprandial blood glucose (2hPBG),total cholesterol (TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol (LDL-C),Blood urea nitrogen(BUN),creatinine(Cr) and uric acid(UA) were measured.Relative factors of HbA1c were analyzed.Patients were divided into the standard (HbA1c ＜ 7％) and substandard groups (HbA1c ≥ 7％) according to the level of HbA1c,and divided into the oral-medication,insulin-treatment and oral medication combined insulin groups according to therapeutic regimens.Results The goal attainment rate of HbA1c(HbA1c ＜7％) in retired and veteran of military communities in Kunming was 44.9％ (97/216).The levels of FBG,postprandial plasma glucose(PPBS) and TG in standard group were (6.1 ± 1.2) mmol/L,(9.4 ± 1.8) mmol/L and (1.9 ± 1.3) mmol/L,significant different from those in substandard groups [(7.8 ± 1.6) mmol/L,(11.5 ±2.2) mmol/L and (2.4 ± 1.3) mmol/L],and the differences were significant (t =11.6,9.1,2.2; P ＜ 0.05 or P ＜ 0.01).Meanwhile,the rate of cardiovascular disease,cerebrovascular disease,proteinuria,peripheral neuropathy and retinopathy were 69.8％,34.5 ％,20.5％,20.5％,29.6％,respectively,significantly different between the standard and substandard groups (P ＜ 0.05).HbA1 c level was linear correlated with FBG (r =0.76,P ＜ 0.01),PBG (r =0.61,P ＜ 0.01),TG (r =0.24,P ＜ 0.05) and the frequency of glucose monitoring (r =-0.55,P ＜ 0.01).As the increasing of the stage of diabetes,the selected therapeutic regimen were oral anti-diabetic agents,followed by insulin and insulin combined oral antidiabetic agents.The levels of PBG and serum creatinine in patients with insulin monotherapy were higher than those in other groups (P ＜0.05).Conclusion The level of glucose controlling of retired and veteran of military communities in Kunming is better.The prevalence of diabetic chronic complications is higher in patients with poor glucose controlling.HbA1c level is correlated with FBG,PBG,TG and the frequency of glucose monitoring.Oral antidiabetic agents is the primary therapeutic regimen.

Objective To analyze the risk factors of restenosis after renal artery endovascular treatment in patients with Takayasu arteritis.Methods In this study,39 patients with Takayasu arteritis underwent endovascular therapy from January 2003 to March 2014.Univariate and multivariate logistic regression analysis were used to analyze the risk factors relating to restenosis.Results There were 13 males and 26 females.The mean age was (27 ± 11) years.Seventeen unilateral and 22 bilateral renal artery stenosis were treated.A total of 54 endovascular procedures were successfully performed including 23 cases of unilateral percutaneous transluminal angioplasty (PTA),14 cases of unilateral stent implantation,12 cases of bilateral PTA,and 5 cases of bilateral stent implantation.The mean follow-up was (48 ±34) months,the restenosis rate was 38.9％ (21.54) and the mean time of restenosis was (11.5 ± 2.3) months.Elevated erythrocyte sedimentation rate (ESR) (OR =6.624,95 ％ CI:1.222-35.902) was independent risk factors for restenosis.Antiplatelet therapy (OR =0.158,95％ CI:0.028-0.887) and glucocorticoids or i mmunosuppressive therapy (OR =0.035,95 ％ CI:0.003-0.349) were protection factors against renal artery restenosis.Conclusion The elevated ESR increases the risk of restenosis after endovascular treatment in Takayasu arteritis associated renal artery stenosis.Antiplatelet therapy and glucocorticoids or immunosuppressive therapy were protection factors for renal artery restenosis.

OBJECTIVE: To summarize the clinical effect of TPF regimen in the treatment of hypopharyngeal carcinoma and explore various clinical factors affecting treatment efficacy. METHOD: The clinical data of 20 cases with hypopharyngeal carcinoma, who received TPF treatment, were analyzed retrospectively. After two courses of chemotherapy, based on radiographic outcomes, next treatment plan was developed. To sum up the clinical information, including the clinical type, patterns of tumor growth, pathologic type, tumor stage, lymph node metastasis, age and so on. To analyze possible influencing factors affecting curative effect. RESULT: (1) After 20 cases with hypopharyngeal carcinoma received two courses of TPF treatment, the effect was evaluated. Objective response rate was 65%. (2) In patients with hypopharyngeal carcinoma, the efficacy of TPF therapy was significantly related to the clinical type, patterns of tumor growth and pathologic type; there was no statistical significance in tumor stage, lymph node metastasis and age. CONCLUSION According to the clinical type, patterns of tumor growth and pathologic type of hypopharyngeal carcinoma, resistance to chemotherapy in hypopharyngeal carcinoma can be assessed, which provides important basis for designing individualized treatment plan.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Humans ; Hypopharyngeal Neoplasms ; therapy ; Lymphatic Metastasis ; Retrospective Studies ; Taxoids ; therapeutic use ; Treatment Outcome

BACKGROUND: Endothelial progenitor calls are the cells that can form new blood vessels in the way of angiogenesis in the body,which updates the conventional theory of angiogenesis, vascular damage and repair after birth and provides new ideas for research and treatment of ischemic diseases.OBJECTIVE: To investigate the effects of dog umbilical cord blood endothelial progenitor call (UCB-EPC) transplantation on angiogenesis after myocardial infarction.DESIGN, TIME AND SETTING: An in vivo cytological experiment was performed at the Laboratory Center of Xinhua Hospital between May 2006 and March 2007.MATERIALS: One full-term pregnant hybrid dog was included for preparation of UCB-EPCs. Thirty-six adult dogs were randomly divided into a cell transplantation group (n = 18) and a model control group (n = 18).METHODS: Acute myocardial infarction model was established in each group by ligation of antedor descending coronary artery.In the cell transplantation group, 2 mL physiological saline containing 5×10<'6> BrdU-labeled EPCs was injected into the coronary artery, while in the model control group, simple physiological saline of the same amount was given. At 1,4, and 8 weeks after transplantation, dogs were sacrificed for harvesting myocardial tissue.MAIN OUTCOME MEASURES: Myocardial infarction was confirmed by hematoxylin-eosin staining. Myocardial angiogenesis was observed by BrdU immunohistochemical staining. The number of infarcted myocardial vessels was calculated by yon Willebrand (vW) factor staining.RESULTS: There was plenty of scar tissue, flbroblasts, and small vessels in the myocardial infarction region. In the cell transplantation group, brown yellow particles (BrdU-positive expression) appeared in some nuclei in small vessels from infarcted myocardium. Newly formed vessels were not found in the model control group. In the cell transplantation group, brown yellow particles (vW factor-positive expression) appeared in the cytoplasm of the vascular endothelial cells in the myocardial ischemia and infarction regions, vW factors were not expressed in the model control group. At 1, 4, and 8 weeks after myocardial infarction,there was no significant difference in vessel counts no matter in myocardial ischemia region or in myocardial infarction region between the call transplantation and model control groups.CONCLUSION: EPCs derived from UCB of pregnant dog can participate in the formation of blood vessels but can not promote angiogenesis after acute myocardial infarction.

Objective To explore the change of monocyte chemotactic factor-1 protein(MCP-1)and matrix metalloproteinase-9( MMP-9)of patients with coronary artery disease( CAD)following percutaneous coronary interventional( PCI). Methods Fifty patients underwent PCI procedures for CAD compromising a single coronary artery were selected as PCI group and 30 healthy individuals with normal findings by coronary angiography were selected as the control group. Plasma MCP-1 and MMP-9 were measured in all the subjects. Results The plasma MCP-1 level of patients with CAD after PCI was(19. 87 ± 5. 31)ng/ L,higher than that before operation((15. 71 ± 5. 23)ng/ L,t = 3. 95,P < 0. 01). Whereas in the control group,the MCP-1 level after coronary angiography was(13. 78 ± 5. 58)ng/ L,which was as same as that before operation (12. 42 ± 5. 39 ng/ L,P = 0. 34). Plasma MMP-9 level in the CAD patients after PCI procedures was(22. 69 ± 5. 97)mg/ L,higher than that before operation((19. 52 ± 5. 72)mg/ L,t = 2. 71,P < 0. 01). There was no significant difference in term of plasma MMP-9 level in control group befor and after operation((17. 53 ± 5. 51) mg/ L vs.(16. 69 ± 5. 42)mg/ L,P = 0. 55). Conclusion Plasma MCP-1 and MMP-9 increase in CAD patients following PCI procedures. But their roles in the vascular restenosis following the procedures need further investigation.

Objective: To verify the current cut off points of physical activity intensity for adolescents to assess moderate to vigorous physical activity (MVPA) among overweight or obese adolescents. Methods: The total activity counts, heart rate and steps indicators most commonly used to reflect physical activity intensity were adopted, and a total of 15 MVPA cut off points standards for adolescents were included. Ninety four overweight or obese adolescents were tested for walking and running at 3-7 km/h in a free state, while simultaneously wearing MetaMax 3B gas metabolism analyzer, polar belt and actigraph w-GT3x BT triaxial accelerometer to collect energy consumption and activities count, heart rate and steps. Kappa consistency test and paired χ 2 test were used for statistical analysis. Results: Kappa consistency coefficients (0.27-0.53) <0.60 between all cut off points standards and the "gold standard" and the P <0.01, indicating that the consistency is varied and not strong. In the standard diagnosis of each cut points, low sensitivity (49.11-67.59), high specificity (92.50-97.65), high - LR (0.14-0.52, >0.1) and low DOR (8.26-25.19, <30) indicated high rate of misdiagnosis. Low specificity (36.75-69.41), high sensitivity (84.82-96.36) and low + LR (1.52- 9.83 , <10) indicated a high rate of misdiagnosis; AUC of 0.67-0.80 suggested lower diagnostic performance. Conclusion Existing physical activity intensity cut off points for overweight or obese adolescents were not consistent with MVPA and have low diagnostic capabilities. The following criteria of MVPA for overweight or obese adolescents are supposed.

OBJECTIVETo evaluate the corresponding influence on pulmonary embolism incidence between immobilization and exercise in different stage of thrombus after acute deep vein thrombosis in rabbits.

METHODSForty-eight New Zealand rabbits were randomly divided into three groups depending on the different organized stage of thrombus: the early, medium and later stage group.Each group was subdivided into two sub groups: the immobile and mobile subgroup. Rabbit modeling of deep vein thrombosis was made by ligating the right femoral vein. Among the early-stage group, rabbits of the immobile subgroup were fixed for 3 days, while that of the mobile subgroup were free to move for 3 days, then each was euthanized to extract the lungs for pathological examination. Among the medium-stage group, each of the immobile subgroup were fixed for 7 days, while the mobile subgroup ones were fixed for 3 days, then released free-moving for 4 days following the pathological extraction. Among the later-stage group, animals in the immobile subgroup were fixed for 14 days comparing the mobile subgroup fixed for 7 days and next free-moving for 7 days, then each was euthanized.

RESULTSAmong the early-stage group, pulmonary embolism incidence (PEI) of the immobile and mobile subgroup was 4/8 vs.3/8, the pulmonary lobe embolism incidence (PLEI) was 17.5% (7/40) vs. 15.0% (6/40). Among the medium-stage group, PEI of the immobile and mobile subgroup was 3/8 vs. 2/8, PLEI was 37.5% (7/40) vs. 25.0% (10/40). Among the later-stage group, PEI of the immobile and mobile subgroup was 3/8 vs. 3/8, PLEI was 12.5% (5/40) vs. 15.0% (6/40). There was no statistical difference between immobilization subgroup and mobilization subgroup among different stage group.

CONCLUSIONOn the premise of given anticoagulation treatment, early ambulation do not significantly increase pulmonary embolism incidence after acute deep vein thrombosis of lower extremity in rabbits.

Animals ; Disease Models, Animal ; Immobilization ; Lung ; pathology ; Motor Activity ; Pulmonary Embolism ; etiology ; Rabbits ; Time Factors ; Venous Thrombosis ; complications

OBJECTIVETo evaluate the significance of cerebral protection applied at carotid endarterectomy (CEA) at perioperation, intraoperation, and postoperation.

METHODSThirty patients underwent CEA with application of cerebral protection at perioperation, intraoperation, and postoperation in our hospital from January 2002 to August 2005. Perioperative carotid Doppler ultrasound and computed tomography angiography (CTA) were applied in 29 patients and carotid angiography applied in only one patient. The key methods of intraoperative cerebral protection included general anaesthesia, selective shunting, monitoring of transcranial Doppler, and careful manipulation. The methods of postoperative cerebral protection included leaving tracheal cannula and brain ice-bag, maintaining normal blood pressure, and applying dehydrant under guidance by monitoring of transcranial Doppler.

RESULTSAmong all the 30 patients, shunts were used in 10 patients (33%), and angioplasty by patch was applied in 17 patients (57%). No cranial nerve-associated complications or death was documented.

CONCLUSIONApplication of cerebral protection at CEA at perioperation, intraoperation, and postoperation can effectively prevent the occurance of cranial nerve-associated complications.

Aged ; Anesthesia, General ; Diuretics ; administration & dosage ; Endarterectomy, Carotid ; Female ; Follow-Up Studies ; Humans ; Intubation, Intratracheal ; Male ; Middle Aged ; Monitoring, Intraoperative ; Perioperative Care ; methods ; Treatment Outcome ; Ultrasonography, Doppler, Transcranial