Objective To observe the real-time effect of retaining needle at Lingtai (GV 10) and Shendao (GV 11) on ST-T segment on cardiogram in patients with angina pectoris of coronary heart disease (CHD).Method Thirty patients with angina pectoris of CHD who received acupuncture at Lingtai (GV 10) and Shendao (GV 11) were divided into group A with needles retained after insertion of the needles and group B without needles retained. The two groups were observed by using 12-lead electrocardiogram (ECG) before and after treatment, to compare the ST segment and T wave atⅡ,Ⅲ, avF lead and V4, V5, V6lead before and after treatment.Result After treatment, ST segment atⅡ,Ⅲ, avF lead and V4, V5, V6lead was changed significantly in group A (P<0.05). T wave was significantly changed atⅡ,Ⅲ, avF lead after treatment in group A (P<0.05). T wave at V4, V5, V6 lead was significantly changed after treatment in both groups (P<0.01,P<0.05).Conclusion Acupuncture at Lingtai (GV 10) and Shendao (GV 11) can improve myocardial ischemia in angina pectoris of CHD; compared to acupuncture without needles retained, retaining needles after acupuncture can produce a more significant effect in improving the inferior and anterior myocardial walls and a better real-time effect on ST-T on ECG of angina pectoris of CHD.

Objective To compare the effects,stress reaction and concentration of ropivacaine in umbilical cord blood of patients who accepted combined spinal epidural analgesia or patient controlled epidural labor analgesia in latent and active phase.Methods After approved by the ethics committee and informed consents from 80 nulliparous parturients who were admitted to Beijing Friendship Hospital,Capital University of Medical Sciences between January to June 2009,and who were term,single,cephalic presentation delivery and ASA Ⅰ-Ⅱ,were divided into two groups randomly:latent phase group (Group L,cervical dilation 0.5-2.5 cm,n=40) and active phase group (Group A,cervical dilation ≥3.0 cm,n =40).Ropivacaine 2 mg and fentanyl 10 μg was administered in subarachnoid space of all patients.Then,patient controlled epidural infusion of 0.1 ％ ropivacaine plus fentanyl 2 μg/ml were administered.Pain scores (visual analogue score,VAS),lower extremity muscle strength,duration of labor,delivery mode,total dosage used,maternal satisfaction,Apgar score (1 min and 5 min) were evaluated; concentration of ropivacaine (high performance liquid chromategraphy) in cord blood,and concentration of cortisol (radioimmunoassay) in maternal venous blood and cord blood were detected.Forty nulliparous parturients without labor analgesia were taken as control group (Group C).Chi-square test and one way analysis of variance was applied for statistical analysis.Results (1) VAS in Group L and Group A were lower than that of Group C when cervix dilated at 7.0-8.0 cm (2.9± 1.4,2.6± 1.5 vs 9.2±0.7,F=201.50,P＜0.01) and fully dilated (4.7±2.2,3.6±2.0 vs 9.1±0.7,F =-62.07,P＜0.01,respectively).(2) Tbe concentration of cortisol in maternal venous blood right after delivery was higher than that before analgesia in all groups,and the change in group C was significantly greater than that in group L and group A [(902±172) μg/L vs (761±125) μg/L and (731±184) μg/L,t =-3.491 and-3.483,all P＜0.01],moreover there was no significant difference between group L and group A (P＞0.05).There were no difference in cortisol concentration of umbilical blood among the three groups [(168±46) μg/L,(159±49) μg/L and (170±86) μg/L,F=0.23,P＞0.05].(3) There was no difference between ropivacaine concentration in umbilical blood of group L and group A [(0.21±0.10) mg/L vs (0.20±0.03) mg/L,t=0.557,P＞0.05].(4) No significant differences was shown among the three groups in the duration of first and second stage of labor,rate of augmentation,neonatal birth weight,Apgar score at 1 min and 5 min (all P＞0.05).Compared with group C,group L and group A had higher rate of vaginal delivery (52.5％ vs 75.0％ and 85.0％,P＜0.05) and lower rate of cesarean section (45.0％ vs 20.0％ and 15.0％,P＜0.05).The duration of analgesia in group L was longer than that in group A [(215±143) min vs (118±50) min,t =3.722,P＜0.01] and the dosage of fentanyl was also higher [(28± 11) μg vs (17±6) μg,t =5.084,P＜0.01].Conclusions Labor analgesia with combined spinal epidural could decrease cesarean section rate and maternal stress reaction without prolonging the duration of labor and inhibiting neonatal stress reaction.Labor analgesia start from latent phase would not increase the concentration of ropivacaine in cord blood.

BACKGROUND:Finite element method is widely used in the femoral neck fracture, but the study concerning different fixation methods of femoral neck fracture is not much. OBJECTIVE:To analyze biomechanical properties of different fixation methods for femoral neck fracture using finite element analysis. METHODS:The femur of voluntters was scanned with CT, at thickness 0.6 mm, from the site above the greater trochanter of the femur. Scanning data were saved in .DICOM format. Data of right proximal femur were imported into Mimics software. Osteotomy was performed according to Pauwels I type fracture. Models of two tensile force screws, ful y threaded hol ow screw and proximal femoral locking plate were established. Three-dimensional finite element method was used to analyze stress distribution, stress concentration position, displacement distribution and maximum displacement in different models of femoral neck fracture with different internal fixation methods. RESULTS AND CONCLUSION:(1) The maximum stress value of two lag screws model was biggest. The maximum stress value of ful y threaded hol ow screw model was minimized. The maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the fixed end of fractures. (2) The femoral maximum stress of two lag screws model was biggest. The femoral maximum stress value of proximal femoral locking plate model was minimized. The femoral maximum stresses of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al were concentrated in the medial femoral smal rotor near and medial femoral and fixation contact points. (3) The maximum displacement of two lag screws model was biggest. The maximum displacement of ful y threaded hol ow screw model was minimized. The maximum displacement of two lag screws model, ful y threaded hol ow screw model and proximal femoral locking plate model al was in the femoral head. (4) The maximum displacement value of two lag screws model fixed place was biggest. The maximum displacement value of ful y threaded hol ow screw model fixed place was minimized. The maximum displacement value of two lag screws model was biggest at femoral head. The maximum displacement value of ful y threaded hol ow screw model was minimized at femoral head. (5) Results showed that the treatment effect of ful y threaded hol ow screw on Pauwels I fractures was better than other two fixation methods.

Objective To study the usefulness of combined flow cytometry (FCM) and polymerasechain reaction examination for clonal TCR gene rearrangements in the diagnosis of T-cell lymphoma (T-NHL). Methods Histopathologic features, immunohistochemistry, flow cytometric immunophenotyping, cytomorphologic evaluation and TCR gene rearrangements of 32 T-NHL were reviewed retrospectively. The control cases were 18 reactive lesions and 1 histiocytic necrotizing lymphaderitis. Results Out of 32 T-NHL,23 were diagnosed as T-NHL by FCM / TCR gene rearrangements. Of 19 control group, 17 were diagnosed as reactive lesions by FCM / TCR gene rearrangements. The sensitivity, specificity and accuracy were 71.9%, 89.5% and 78.4%, respectively. Conclusions FCM / TCR gene rearrangement is a very important technique in diagnosing T-NHL. Thus, patients with fine needle aspiration cytology can be saved from having an invasive surgery.

Objective To investigate the mechanism of acute lung injury after hepatic ischemia / reperfusion and the protective effect of propofol.Method s Forty-eight male SD rats were randomly divided into Sham2 group,Sham6 group; IR2 group (IR2),IR6 group (IR6); P2 group (P2),P6 group (P6).The 1 mg·kg-1·min-1 propofol was infused from 30min before ischemia in P groups,and the same volume sodium lactate Ringer's solution was infused in Sham and IR groups.The concentration of TNF-α,superoxidedimutase(SOD),malondialdehyde(MDA),myeloperosidase(MPO),lung wet/dry weight ratio and lung histological scores were measured at the points of 2 and 6 hour after reperfusion.Results TNF-α levels were higher in IR and P groups than those in sham groups but the values in P groups were lower than those in IR groups.SOD levels decreased greatly in IR groups,there were great difference between P and IR groups.MDA levels increased greatly in IR groups and reached the peak value at 6 hour after reperfusion.MDA levels in P groups were lower than those in IR groups and there were no difference between P and sham groups.The ratio of Wet/dry levels,MPO and lung histological scores were increased greatly after reperfusion in IR and P groups.But the value in P groups was lower than those in IR groups.Conclusions Acute lung injury after hepatic ischemia / reperfusion is mainly induced by the oxidant stress and neutrophil infiltration in lung tissues.Propofol may have effects of antioxidation and decrease neutrophil infiltration which attenuate lung injury induced by hepatic ischemia/reperfusion.

Objective: To explore the characteristics of clinical pathology, diagnosis, and prognosis of primary renal lymphoma (PRL).Methods: The clinical features, pathological features, immune phenotypes, treatment, and prognosis of 22 patients were retrospectively analyzed. Results: The PRL patients' ages ranged from 2 to 72 years (mean, 54.3 years), of which 13 patients were older than 50 years (59.1%). All of the 22 patients were diagnosed with non-Hodgkin's lymphoma (NHL), including 20 cases of B-cell lymphoma and 2 cases of T-cell lymphoma. Seven patients were still alive and survived for 6-50 months, but the other 15 were dead and survived for only 5-35 months. Conclusion: PRL is uncommon. Clinical manifestations and imaging performance specificity are not obvious. and easily misdiagnosed. Histopathology is still the golden standard for the final diagnosis of this entity. The kidney is most easily involved followed by the bladder. B-cell NHL is the common subtype, and the most common type is the diffuse large B-cell lymphoma. Up to now,no standard regime could be performed for PRL patients. At present, comprehensive therapy, including surgery and chemotherapy, is recommended. For patients with locally advanced or highly aggressive status, therapeutic effect with chemotherapy alone is usually satisfied.

Objective Inflammation plays a critical role in the presence , development and maintenance of atrial fibrillation ( AF) , but it remains unclear what factors induce inflammation in AF patients , especially in those with valvular heart disease ( VHD) . The aim of this paper was to investigate the role of the shedding of Syndecan -4 in left atrial inflammation in patients with valvular atrial fibrillation. Methods Sixty VHD patients scheduled for valvuloplasty or valve replacement surgery were divided into three groups of equal number:sinus rhythm (SR), paroxysmal atrial fibrillation (PaAF), and persistent atrial fibrillation (PeAF).Another 10 pa-tients with congenital heart disease but no valve damage and atrial fibrillation were included in a control group .Baseline clinical data were recorded and tissues were obtained from the left atrial appendage during operation .The expressions of iNOS , HMGB1, and Syn-decan-4 in the left atrium were detected by Western blot , and the pathological changes of the left atrial tissue observed by HE staining . Results Western blot analysis was performed to detect expression levels of proteins .The iNOS level was significantly higher in pa-tients from the paroxysmal AF group (1.61 ±0.10) and persistent AF group (1.67 ±0.08) than those from sinus group (1.06 ± 0.11) and control group (1.02 ±0.12), as was the protein level of HMGB1 (0.63 ±0.05, 0.95 ±0.10, 0.45 ±0.07 and 0.46 ± 0.06 in paroxysmal AF group, persistent AF group, sinus group and controlgroup respectively ).Inflammatory cell infiltration in-creased, while syndecan 4 was down-regulated in AF groups.All these comparisons were significant (P<0.05). Conclusion The decreased expression of Syndecan-4 and enhanced inflammatory response in the left atrial tissue indicate that the shedding of Synde-can-4 may play a role in the presence and development of inflamma-tion in the left atrium .

Objective To assess the accuracy of mixed venous oxygen saturation ( S(-v)O2 ) in reflecting the change in CO during off-pump coronary artery bypass grafting (OPCABG) .Methods Twenty-five NYHA Ⅰ -Ⅲ patients of both sexes, aged 50-75 yr, weighing 55-85 kg, undergoing OPCABG, were studied. Anesthesia was induced with midazolam, fentanyl, etomidate and pipecuronium and maintained with propofol infusion and intermittent iv boluses of fentanyl and pipecuronium supplemented with isoflurane if necessary. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 8-10 bpm, I:E 1:2). PETCO2 was maintained at 35-45 mm Hg.Radial artery was cannulated and pulmonary catheter was placed. CI, S(-v)O2 and Hb were monitored and recorded before skin incision, during anastomosis with left anterior descending artery (LAD), right coronary artery (RCA)and left circumflex coronary artery (LCX), when the chest was closed, when the patients' body position was changed and the heart was manipulated. S(-v)O2 and CI were scaled immediately after the pulmonary artery catheter was placed and before anastomosing LAD. Results The CO change in S(-v)O2 was real-time and accurate in reflecting the body positioning and elevation of hearts. There was no simultaneous significant change in CI.Conclusion The CO change in S(-v)O2 is real-time and accurate in reflecting the body positioning and elevation of hearts during OPCABG.

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

Objective To explore the feasibility of high-frequency electric welding systemin cholecyste-ctomy when compared with ultrasound scalpel , Ligasure and traditional scalpel. Methods Ninety-six rabbits were enrolled in the study and divided into high-frequency electric welding system group , ultrasound scalpel group , Ligasure group and traditional scalpel group. The working temperature was recorded. Eight rabbits of each group were killed to observe the occlusion at 1st, 4th, 7th day postoperatively. Tissues were collected for observation under HE staining. Results High-frequency electric welding system group excelled in operative time , bleeding, working temperature, granulation tissue and inflammatory reaction. No significant difference was found in preope-rative and postoperative liver function test. Conclusion High-frequency electric welding system in cholecyste-ctomy has similar effect as ultrasound scalpel and Ligasure.