Objective To investigate the risk factors and their prevention and treatment approaches for occurring radial artery spasm (RAS) during the brain digital subtraction angiography (DSA) with transradial catheterization in patients with ischemic cerebrovascular disease.Methods The patients who underwent DSA of transradial approach because of ischemic cerebrovascular disease were enrolled.Their clinical data,surgical complications,and radial artery spasm were collected.The data of occurring RAS or not during DSA of transradial approach in patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors for occurring RAS during DSA of transradial approach.Results A total of 100 patients with ischemic cerebrovascular disease who underwent DSA of transradial approach (74 ischemic stroke,26 transient ischemic attack) were enrolled,of which 21 (21％) had RAS.Of the 21 patients with RAS,4 suspended their operations and completed their DSA after spasm relief; another 17 were treated with intrathecal cocktail (heparin 2500 U,nitroglycerin 0.5 mg,verapamil 1.25 mg) and completed their DSA after spasm relief.There were significant differences in the proportions of radial artery diameter (1.89 ±0.28 mm vs.2.12 ± 0.17 mm; t =1.582,P =0.041),duration of operation (12.3 ± 3.1 min vs.9.8 ±2.7 min; t =1.264,P =0.038),and radial artery diameter ＞2 mm (9.52％ vs.65.82％ ;x2 =9.624,P =0.002),radial artery anatomy variation (23.81％ vs.0.27％; x2 =14.185,P＜ 0.001),and the first successful puncture (42.86％ vs.78.48 ％ ;x2 =5.335,P =0.021) in patients between RAS group and the non-RAS group.Multivariate logistic regression analysis showed that the radial artery anatomy variation (odds ratio [OR] 1.940,95 ％ confidence interval [CI] 1.372-2.241; P=0.023) was an independent risk factor for the occurrence of RAS.Radial artery diameter ＞2 mm (OR 0.752,95％ CI 0.352-0.847;P=0.043) and the first successful puncture (OR 0.843,95％ CI 0.367-0.941; P=0.045) were the independent protective factors for RAS.Conclusions RAS is a common complication of DSA of transradial approach.Repeated puncture,radial artery diameter,and radial artery anatomy variation are its most important influencing factors.

The serum level of 25-dihydroxyvitamin D3 was determined in patients with type 2 diabetes,diabetic nephropathy,and healthy objects..The results demonstrated that the serum 25-dihydroxyvitamin D3 level in type 2 diabetic patients with nephropathy was lower than that in the healthy objects or type 2 diabetes objects.Blood β2-M,total cholesterol,creatinine,24 h urinary albumin,and course of illness in type 2 diabetic patients with nephropathy have relationship with serum 25-dihydroxyvitamin D3.

Objective To evaluate the association between serum 25-hydroxyvitamin D3 [25 (OH) D3],parathyroid hormone,and arterial stiffness in patients with type 2 diabetes.Methods Serum 25 (OH) D3 and parathyroid hormone(PTH) were determined in a cross-sectional sample of 258 patients aged 30 years and over.Arterial stiffness was assessed by pulse wave velocity(PWV) obtained with a VP-1000 pulse wave unit.Fasting plasma HbA1c,lipid profile,calcium,and high sensitive-C reactive protein were determined.Results (1)The prevalence of vitamin D3 deficiency was high(79.84％) in patients with type 2 diabetes.(2) Those with lowered serum vitamin D3 levels had raised PWV [(1610.76 ± 142.70 vs 1527.95 ± 58.02) cm/s,P＜0.05].(3) Multiple stepwise regression analysis showed that 25 (OH) D3 was an impact factor of PWV risk score,which was independent of age,duration of diabetes,and systolic blood pressure(β =-0.256,P＜0.01).(4) Serum PTH was positively correlated with PWV (r =0.210,P ＜ 0.05) and systolic blood pressure (r =0.229,P ＜ 0.05),but negatively correlated with 25 (OH) D3 (r =-0.153,P ＜ 0.05).Conclusions 25 (OH) D3 deficiency is common in patients with type 2diabetes,and a low serum 25 (OH) D3 level is significantly associated with increased arterial stiffness in these patients.The association of serum PTH with arterial stiffness may result via changes in vitamin D and blood pressure.

Objective To investigate the risk factors for carotid sinus reactions (CSR) during internal carotid artery stenting (CAS).Methods The clinical data of 36 patients treated with CAS were enrolled retrospectively.The patients were divided into either a CSR group or a non-CSR group according to whether they had CSR or not.The risk factors for CSR during procedure were analyzed using univariate and multivariate logistic regression analysis.Results Of the 36 patients,25 had CRS (7 simple hypotension,4 simple bradycardia,and 14 both co-existence).The constituent ratios of the patients of the age ≥ 75 years (64.00％ vs.27.27％ ;x2 =2.384,P =0.028),degree of CAS 70％ to 99％ (76.00％ vs.36.36％ ; x2 =4.430,P =0.035),symptomatic stenosis (72.00％ vs.36.36％ ; x2 =4.082,P =0.043),calcified plaque (76.00％ vs.36.36％ ;x2 =4.430,P =0.035),distance from stenosis to bifurcation ≤ 10 mm (72.00％ vs.27.27％ ;x2 =5.029,P =0.025) and balloon expansion (64.00％ vs.18.18％ ;x2 =44.483,P =0.000) in the CSR group were significantly higher than those in the non-CSR group.Multivariate logistic regression analysis showed that age ≥ 75 years (odds ratio [OR] 1.520,95％ confidence interval [CI] 1.376-4.369; P =0.034),distance from stenosis to bifurcation ≤ 10 wm (OR 2.432,95％ CI 2.423-3.421; P =0.041) and balloon expansion (OR 3.631,95％ CI 1.764-4.738; P=0.003) were the independent risk factors for occurring CSR during CAS.Conclusions CSR is a common perforrance during CAS.Advanced age,distance from stenosis to bifurcation ≤ 10 mm and balloon expansion are the independent risk factors for occurring CSR.

Objective To assess the feasibility and safety of transradial puncture route for digital subtraction angiography (DSA)in young patients with ischemic cerebrovascular disease. Methods One hundred young patients with cerebrovascular disease who underwent whole brain angiography at the Department of Neurology,the 81 st Hospital of PLA were enrolled. They were divided into either a radial group (n =50)or a femoral group (n = 50)using a computer random number method. The time of puncture,success rate of puncture,success rate of selective angiography,exposure time,and incidence of complications were compared and analyzed. Results (1)The puncture time of the radial group was significantly longer than that of the femoral group,they were 3. 00 ± 0. 50 min and 1. 50 ± 0. 25 min respectively. There was significant difference (t = 18. 97,P < 0. 05). There were no significant differences in the success rate of puncture (98% vs. 100%),success rate of selective angiography (100% vs. 100%),and exposure time (5. 3 ± 2. 2 vs. 4. 8 ± 1. 7 min)between the two groups (all P > 0. 05). (2)The incidence of complications of the radial group (4%,n = 2)was significantly 1ower than that of the femoral group (18%,n = 9 ). There was significant difference between the two groups (χ2 = 5. 01,P < 0. 05 ). Conclusion Transradial route puncture for whole brain DSA in young patients with cerebrovascular disease is safely and feasible.

Objective To investigate the clinical effect of PKP combined with anti osteoporosis drugs in the treatment of osteoporotic vertebral compression fractures.Methods 100 cases of osteoporotic vertebral compression fractures treated in our hospital from January 2014 to December 2016 were compression fracture as the research object in the course of the study, and were randomly divided into control group and experimental group,with 50 cases in each group.Patients in the control group were treated with PKP, while the experimental group was treated with PKP combined with anti osteoporosis drugs.The related clinical indicators of the two groups were compared and analyzed.Results After the corresponding treatment, there was no significant difference between the experimental group and the control group in the rate of cement leakage and the amount of bone cement injection.After operation, the ODI index and VAS scoreof the two groups were significantly better than before treatment, the difference was statistically significant(P<0.05), the patient's cone height was well recovered.After 14 to 24 months of follow-up found that, the fracture rate of the experimental group was 10.0%, significantly lower than the control group 24.0%, the difference was statistically significant(P<0.05).Conclusion PKP combined with anti osteoporosis drugs for the treatment of osteoporotic vertebral compression fractures has good clinical effect, can effectively reduce the adjacent segment cone fracture rate, improve the quality of life of patients, with further clinical promotion and application significance.

Objective To observe hepatocellular apoptosis and inflammatory cytokines expression and their mechanisms for lipopolysaeeharide (LPS)-induced acute liver failure in D-ga|actosamine (D-GalN)-sensitized rats. Methods Fifty-six rats were randomly divided into following groups: 0, 1, 2, 4, 6, 24 and 48 hours. 0 hour group served as control group and the rest did as treatment groups. The rats in the treatment groups received intraperitoneal injections of LPS (50 ng/g) and D-GaIN (300 μg/g) dissolved in 1 mL sterile 0.9% sodium chloride solution, while the rats in control group were treated with 1 mL sterile 0.9% sodium chloride solution only. The rats were sacrificed in the corresponding time points and their sera and liver tissues were collected. Liver tissues were fixed and stained with hematoxylin and eosin for optical microscopy examination. The serum cytokine expressions were detected by enzyme-linked immunosorbent assay (ELISA). The expressions of tumor necrosing factor (TNF)-α, interleukin (IL)-1β, inducible nitric oxide synthase (iNOS) and p53 gene were detected by reverse transcriptase-polymerase chain reaction, and the 24 hours treated rats liver Caspase-3,8,9,12 activity were detected by chromogenie substrate method. Data for the experiments were expressed as x±s, and differences among means were compared using the analysis of variance. Results After drug treatment, liver tissues showed piecemeal necrosis and inflammatory cell infiltration, which significantly increased from 6 hours, 24 hours to 48 hours. The 1 hour treatment group with the highest concentration of TNF-α (727. 8 ± 261. 3) ng/L were significantly higher than the control group and other treatment groups(F= 49.82, P<0.01), 2 hours treatment group (156.4 ± 52.2) ng/L was significantly lower than the 1 hour group, but significantly higher than the control group (F = 30. 23, P< 0.01 ). But serum concentrations of IL-1β gradually increased, reaching the highest level in 24 hours group (360.5±121.6)ng/L (F= 18. 61, P<0. 01). Liver Caspase-3,8,9, 12 activity in 24 hours treatment group was significantly higher than in the control group (F= 84.96, P<0.01). The mRNA expression of iNOS gene, which were not detected in normal controls, reached the peak at 6 hours group after drug treatment and notably dropped in 24 hours and 48 hours groups(F=34.07,P<0.01), p53 gene expression significantly upregulated at 24 hours and 48 hours groups(F=37.43,P<0.01). TNF-α and IL-1β gene expression in the treatment group were higher than in the control group(F=2.94,P<0.05), and both reached the peak at 1 hour treatment group. Conclusions Acute liver failure can be induced by low dose LPS in D-GaiN-sensitized rats. One of the features changes is that Caspase-3,8,9,12 activities are markedly enhanced, and the occurrence of liver injury may be associated with the early high expression of TNF-α, iNOS and p53 gene.

Objective To explore the clinical efficacy and side effects of intraperitoneal perfusion of verapamil and chemotherapeutic drugs in treating patients with gastric cancer after operation.Methods Totally 184 gastric cancer patients accepted radical surgery with postoperative classification (pT1/2/3/4N2/3M0) were randomly divided into control group (n =58) and treatment group (n =126).For the post-gastrectomy chemotherapeuric treatment,1 g of 5-fluorouracil and 70 to 90 mg of cisplatin were administrated for the patients in the control group,while 1 g of 5-fluorouracil,70 to 90 mg of cisplatin and 25 mg of verapamil were given to the patients in the treatment group.Patients in both groups received intravenous administration of 20 to 30 mg of doxorubicin 3 ～ 5 hours before the intraperitoneal chemotherapy,and 0.1 g of leucovorin 30 minutes prior to the intraperitoneal chemotherapy.On the second day,intraperitoneal chemotherapy of 0.5 to 0.75 g 5-fiuorouracil was given to all patients for 3 to 5 days.The disease-free survival rate,overall survival rate,disease-free survival (DFS),overall survival (OS),peritoneal recurrence rate,liver metastasis rate,gastric remnant recurrence rate,adverse reactions were examined and recorded at the time points of 12 and 24 months after the chemotherapy treatment.Results In the treatment group,disease-free survival and overall survival rates at 12 and 24 months were significantly higher than those in the control group,and the median DFS and OS were significantly longer than the control group (P ＜ 0.05).In patients with regional lymph node staging (N2,N3),low differentiated adenocarcinoma,tumor diameter greater than 4-cm,the disease free survival rate and overall survival rate at 12 and 24-months were significantly higher than the control group,and the median DFS and OS were significantly longer than the control group (P ＜0.05).In the treatment group,intraperitoneal recurrence rate and liver metastasis rate at 12 and 24-months were significantly lower than the control group (P ＜ 0.05).There was no significant difference in recurrence rate of gastric stump between the control group and treatment group.Application of verapamil did not increase the incidence rate of adverse reactions.There were 8 patients with mild abdominal pain and 3 patients with incomplete intestinal obstruction,and all of them were cured after one week of treatment.Conclusion The intraperitoneal perfusion of verapamil and chemotherapeutic drugs can significantly increase the disease-free survival rate and overall survival rate,prolong the median DFS and OS,reduce the recurrence rate of intra-abdominal and liver metastasis rate in the gastric cancer patients at 12 and 24 months after chemotherapy.

Objective To explore the clinical efficacy and side effects of intraperitoneal perfusion of verapamil and chemotherapeutic drugs in treating patients with gastric cancer after operation.Methods Totally 184 gastric cancer patients accepted radical surgery with postoperative classification (pT1/2/3/4N2/3M0) were randomly divided into control group (n =58) and treatment group (n =126).For the post-gastrectomy chemotherapeuric treatment,1 g of 5-fluorouracil and 70 to 90 mg of cisplatin were administrated for the patients in the control group,while 1 g of 5-fluorouracil,70 to 90 mg of cisplatin and 25 mg of verapamil were given to the patients in the treatment group.Patients in both groups received intravenous administration of 20 to 30 mg of doxorubicin 3 ～ 5 hours before the intraperitoneal chemotherapy,and 0.1 g of leucovorin 30 minutes prior to the intraperitoneal chemotherapy.On the second day,intraperitoneal chemotherapy of 0.5 to 0.75 g 5-fiuorouracil was given to all patients for 3 to 5 days.The disease-free survival rate,overall survival rate,disease-free survival (DFS),overall survival (OS),peritoneal recurrence rate,liver metastasis rate,gastric remnant recurrence rate,adverse reactions were examined and recorded at the time points of 12 and 24 months after the chemotherapy treatment.Results In the treatment group,disease-free survival and overall survival rates at 12 and 24 months were significantly higher than those in the control group,and the median DFS and OS were significantly longer than the control group (P ＜ 0.05).In patients with regional lymph node staging (N2,N3),low differentiated adenocarcinoma,tumor diameter greater than 4-cm,the disease free survival rate and overall survival rate at 12 and 24-months were significantly higher than the control group,and the median DFS and OS were significantly longer than the control group (P ＜0.05).In the treatment group,intraperitoneal recurrence rate and liver metastasis rate at 12 and 24-months were significantly lower than the control group (P ＜ 0.05).There was no significant difference in recurrence rate of gastric stump between the control group and treatment group.Application of verapamil did not increase the incidence rate of adverse reactions.There were 8 patients with mild abdominal pain and 3 patients with incomplete intestinal obstruction,and all of them were cured after one week of treatment.Conclusion The intraperitoneal perfusion of verapamil and chemotherapeutic drugs can significantly increase the disease-free survival rate and overall survival rate,prolong the median DFS and OS,reduce the recurrence rate of intra-abdominal and liver metastasis rate in the gastric cancer patients at 12 and 24 months after chemotherapy.

Objective To investigate the expression level and promoter methylation of SOX17 gene and the clinical correlations in Chinese patients with chronic myeloid leukemia ( CML ) . Methods The levels of SOX17 expression and methylation were detected by RQ-PCR and RQ-MSP. Results SOX17 expression level was significantly lower in CML compared with 30 controls (P=0.001). The area under the receiver operating characteristic (ROC) curve (AUC) was 0.748 to differentiate CML from control (P=0.001). There was a trend of correlation between SOX17 expression and bcr/abl transcript (r = 0.439,P = 0.068) in CML patients. Hypermethylation of SOX17 promoter was detected in 3 (4%) CML patients, however, there was no difference as compared with 32 controls. In our study, SOX17 hypermethylation was not corrected with its expression. Conclusion Decreased SOX17 expression is a common molecular event in CML and may be considered as an available biomarker to diagnose CML. Dysregulated SOX17 is not caused by promoter hypermethylation in CML.