BACKGROUND:Latest researches suggest that delayed endothelial repair in drug-eluting stents may cause thrombosis and coronary occlusion.Therefore,a novel kind of drug stent,which is characterized by satisfactory anti-proliferative action as well as inhibitive effects on thrombosis,needs to be developed.OBJECTIVE:To summarize the recent research progress and clinical applications of drug-eluting stents (DES) and to seek the direction of new developments.RETRIEVE STRATEGY:The retrieve staffs were the research personnel for this paper.A computer-based online search was conducted in PUBMED for English language publications containing the key words of "drug eluting stents,percutaneous coronary intervention,coronary disease" from January 2002 to April 2007.Relevant data were also searched in international conference reports on the Internet between January 2005 and June 2007.The number of total retrieved Iiteratures was 15.Inclusion criteria:①reports about drug stents;②reports on research progress in the field of drug stents;③reports on the clinical application of drug stents.Exclusion criteria:low relevance and duplicated articles.LITERATURE EVALUATION:There were 264 articles about research and clinical applications of DES.Of those,42 literatures and 5 conference reports with high relevance and timeliness were included in this report.DATA SYNTHESIS:An ideal DES is comprised of a platform,a drug carrier vehicle and a pharmaceutical compound in harmony with each other.Given the ongoing development of DES materials and drugs,more effective DESs are introduced in the clinical practice.Recently,clinical data on DES encourage the interventional cardiologist to use DES in more challenging coronary lesions,such as chronic total occlusions,complex lesions and multivessel lesions.However,concern that DES may be associated with a risk of late thrombotic events arose,suggesting an imbalance between safety and efficacy of DES.Therefore,novel strategies including bioabsorbable stents,and stents coated with pro-healing agents are promising.CONCLUSION:The development of DES is a breakthrough in interventional cardiology that bring great benefit to patients with coronary disease,especially for restenosis and revascularization.Nevertheless,more endeavour will be necessary to create DES with high efficacy as well as low risk.

Acquired aplastic anemia(AA) is a disease of bone marrow failure mediated by autoimmune T cells. CD4+CD25+ regulatory T cells, which have immunosuppressive and anergic, belong to a subpopulation of T cells specialized for immune regulation and play important roles in the development of autoimmune T cells. Foxp3 plays a significant role in the development and function of regulatory T cells which have been confirmed by many investigations. In recent years, the relationship between CD4 +CD25 +Foxp3 + regulatory T cells and AA has become a hot spot of research. What’s more, its clinical significance is becoming more and more obvious in AA.

First of all,all tutors as well as postgraduates should have concept of innovation.Secondly,favorable environment should be built up for innovative thoughts.Finally,tutors should try their best to cultivate students'innovative thoughts and direct their creationary practice.

Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; Female ; Humans ; Receptor, ErbB-2 ; metabolism ; Trastuzumab

Objective To evaluate quantification of metamorphopsia in eyes with idiopathic macular hole (IMH) before and after surgical treatment, and investigate its relationship between postoperative visual acuity, the macular hole index (MHI), and the macular hole prognostic factor (HPF). Methods Thirty eyes of 30 patients, who underwent successful vitrectomy and internal limiting membrane (ILM) peeling for IMH and were followed up more than 6 months, were included in the study. The uncorrected visual acuity of the fellow eyes was better than 20/25 and there was no metamorphopsia in that eye. The macular hole closure was confirmed by optical coherence tomography (OCT) scans. Metamorphopsia was evaluated by metamorphopsia-charts (M-chart). OCT, best corrected visual acuity (BCVA) and metamorphopsia were obtained before and after surgery. Vertical (MV) and horizontal (MH) metamorphopsia, macular hole index (MHI, the ratio of the height to the diameter of the base) , and macular hole prognostic factor (HPF,the ratio of the height to the minimum diameter) were measured. The metamorphopsia score was the average value of MV and MH. SPSS 16. 0 statistical analysis software was used for data analysis. Results Preoperative MV and MH were (1.82±0.04)° and (1.81±0.04)°, respectively. Six months after surgery,the MV and MH were (0.17±0.03)° and (0.11±0.03)° respectively. There was significant difference between pre- and post-operative metamorphopsia results (Z=-0.788, P＜0.05). The metamorphopsia score at 6 months after surgery were positively correlated with the value of the postoperative BCVA (LogMAR) (r=0.540, P=0.004) and negatively correlated with the values of preoperative MHI and HPF (r=-0.676,-0.518; P＜0.05). Conclusions Successful vitrectomy and ILM peeling can improve metamorphopsia of IMH. Postoperative metamorphopsia was correlated with the postoperative BCVA and the preoperative macular hole contour.

Objective To evaluate metamorphopsia and vision-related quality of life (VRQoL) and its influencing factor after vitrectomy for idiopathic macular hole (IMH).Methods This is a prospective and nonrandomized clinical cohort study.Thirty eyes of 30 IMH patients who received vitrectomy and inner limited membrane (ILM) peeling were included.The best-corrected visual acuity (BCVA),medical refraction test and optical coherence tomography (OCT) were performed.BCVA was recorded as logarithm of the minimum angle of resolution (logMAR).The macular hole index (MHI) was measured using OCT.The average logMAR BCVA and MHI in suffering eyes at baseline were 1.02± 0.07 and 0.47 ± 0.02,respectively.The uncorrected visual acuity of the fellow eyes was less than 0.1.Follow-up period was longer than 6 months.At 6 months after surgery,the central retinal thickness (CRT) was measured by OCT;vertical and horizontal metamorphopsia were measured by metamorphopsia charts;VRQoL was evaluated by Chinese VRQoL-25.Spearman correlation analysis was performed to analyze the relationship of VRQoL and postoperative BCVA,metamorphopsia and preoperative MHI.Results At 6 months after surgery,macular hole closure was confirmed by OCT in all patients.The vertical and horizontal metamorphopsia were (0.17± 0.03)° and (0.11 ± 0.03)°,respectively.The VRQoL-25 composite score was 79.81 ± 1.29.The average BCVA was 0.59±0.05.The average CRT was (155.10± 6.27) μm.The postoperative VRQoL was positive correlated with preoperative MHI (r=0.491,P=0.002),and negative correlated with preoperative BCVA (r=-0.445,P=0.014),postoperative BCVA (r=-0.530,P=0.003) and postoperative metamorphopsia (r=-0.532,P=0.006),but not correlated with the postoperative CRT (r=0.231,P＞0.05).Conclusions IMH patients improved their visual acuity after surgery,but still have metamorphopsia.VRQoL was negative correlated with metamorphopsia,positive correlated with preoperative MHI.

Objective To study the protective effects of total flavones of Herba Epimedii(TFE)on focal cerebral ischemia of rats.Methods Rat model of middle cerebral artery occlusion was established.With Jinnaduo as a positive control drug,the effect of TFE on the neurological behavior of cerebral ischemia rat,the cerebral water volume,the cerebral infarction area,the cerebral biochemistry and the pathologic change of brain were evaluated.Results TFE improved rats neurological behavior,decreased the cerebral water volume,reduced cerebral infarction area,increased ATPase and SOD activity,decreased MDA content,and also improved the pathological changes of ischemic brain.Conclusion TFE have the protective effect on cerebral ischemia in rats,its mechanism may be concerned about improving energy metabolism and anti-oxidation.

Objective To evaluate the safety of intracoronary Doppler flow measurement using Doppler FloWire  Methods and Results A total of 906 patients were examined with intracoronary Doppler using a 0 014″ or a 0 018″ Doppler FloWire  For coronary flow reserve measurement, intracoronary injection of adenosine or papaverine was used Of the patients studied, 77 were cardiac transplant recipients, 829 were nontransplant patients, of whom 617 patients underwent diagnostic coronary procedures and 212 had coronary interventions In 27 (2 98%) of 906 patients adverse cardiac events were observed Fifteen (1 66%) of 906 patients developed severe transient bradycardia (asystole or Ⅱ? to Ⅲ? atrioventricular block) after intracoronary administration of adenosine Of which, 14 occurred in RCA and 1 in LAD Nine (0 99%) of 906 patients experienced coronary spasm during the passage of the Doppler wire (5 in RCA, 4 in LAD) Two (0 22%) of 906 patients developed ventricular fibrillation during the procedure Hypotension with bradycardia and ventricular extrasystole each occurred in one (0 11%) of 906 patients The incidence of complication was significantly higher in transplant recipients than in nontransplant patients underwent either diagnostic or interventional procedures (12 99% vs 2 43% vs 0 94%, P

Objective To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) pathway in the protective effect of remifentanil or ischemic preconditioning (IPC) against hepatic ischemia-reperfusion (I/R) injury in rats.Methods One hundred and forty-four male SD rats,weighing 200-250 g,were randomly assigned into 6 group ( n =24 each):sham operation group (group S),I/R group,remifentanil group (group R),IPC group,SB203580 (a specific p38MAPK inhibitor) + remifentanil group (group SB + R),and SB + IPC group.The animals were anesthetized with intraperitoneal 20％ urethane 1 mg/kg.Partial liver ischemia was produced by clamping the hepatic pedicle supplying left lobe and middle lobe for 30 min,followed by 120 min reperfusion.In group R,remifentanil was infused intravenously at 2μg· kg- 1 · min- 1 starting from 30 min before ischemia until the end of reperfusion.In IPC group,the rats were subjected to 3 episodes of 5 min ischemia at 5 min intervals before I/R.SB203580 0.2 mg/kg was injected intravenously at 5 min before remifentanil infusion or IPC in groups SB + R and SB + IPC,and the equal volume of normal saline was given in the other groups.Six rats in each group were selected at 30,60,90 and 120 min of reperfusion and venous blood samples were taken from inferior vena cava for measurement of serum ALT and AST activities and concentrations of TNF-a and 1L-1β.The rats were then sacrificed and liver tissues were taken for microscopic examination and determination of phosphor-p38MAPK expression by Western blot.Results Compared with group S,serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased at each time point (P ＜ 0.05) and pathological injury was aggravated in group I/R.Compared with group I/R,serum AST and ALT activities and serum levels of TNF-a and IL-lβ were significantly decreased and phosphor-p38MAPK expression was up-regulated at 90 min of reperfusion in groups R and IPC ( P ＜ 0.05).The serum AST and ALT activities and serum levels of TNF-α and IL-1β were significantly increased,phosphor-p38MAPK expression was down-regulated at 90 min of reperfusion ( P ＜ 0.05),and pathological injury was aggravated in group SB + R compared with group R,and in group SB + IPC compared with group IPC.Conclusion Activation of p38MAPK pathway and inhibition of inflammatory response may be involved in the mechanism by which remifentanil or IPC reduces the hepatic I/R injury in rats.

ObjectiveTo evaluate the value of early secretory antigenic target 6 (ESAT-6) in monocytes of cerebrospinal fluid (CSF) in the early diagnosis and judgment of the tuberculous meningitis (TBM). MethodsForty cases with TBM (TBM group) and 40 patients with other meningitis patients (control group,9 cases with purulent meningitis,24 cases with viral meningitis,3 cases with cryptococcal meningitis,3 cases with cerebral cysticercosis, 1 case with neurosyphyilis) were involved in this study.Conventional examination of CSF was inspected after admission, and the ESAT-6 in monocytes of CSF was detected by immunocytochemical stain. ResultsThe positive rate of ESAT-6 was 24％ in TBM group and 0 in control group (P ＜ 0.01 ). In ROC curve, if the rate of ESAT-6 ≥8.5％ judged as positive, and ＜ 8.5％ judged as negative, 35 patients of TBM group and 4 patients of control group were ESAT-6 positive. The sensitivity of the ESAT-6 in the diagnosis of TBM was 87.5％, and the specificity of TBM was 90.0％. Thirty patients in TBM group were not given anti-tuberculosis drug treatment, and the positive rate of ESAT-6 was 93.3％ (28/30) before treatment, and was 46.7％ (14/30) after treatment of 2 weeks (P =0.000).ConclusionsESAT-6 in monocytes of CSF detected by immunocytochemical stain has higher sensitivity and specificity in the diagnosis of TBM in early stage. Observing the positive rate of ESAT-6 dynamicly has practical value in judgment the severity of TBM.