0.05). Conclusion The sinus node arteries can generally be found by angiography. There is no significant relationship between coronary artery diseases of sinus node and sick sinus syndrome.

[Objective]To assess the influence of three-dimensional computed tomography (3D CT) reconstruction on preoperative fracture classification of intraarticular fractures by comparing 3D CT and 2D CT in preoperative fracture classification of tibial plateau fractures and acetabular fractures.[Method]A retrospective study was performed to evaluate 28 tibial plateau fractures and 19 acetabular fractures.Four attending traumatic orthopaedic surgeons used 3D CT and 2D CT respectively to evaluate fractures and rendered fracture classification.Test of agreement was performed to evaluate interobserver and intraobserver agreement about fracture classification.[Result]With the use of 3D CT images,interobserver and intraobserver reliability for fracture classification increased to perfect agreement.[Conclusion]3D CT could improve the reliability of preoperative fracture classification for tibial plateau fractures and acetabular fractures.3D CT is helpful and worthwhile for preoperative evaluation for fracture classification of intraarticular fractures.

Objective To investigate the effects of local delivery c-myc antisense oligodexynucleotides on neointimal hyperplasia after angioplasty in rabbits. Methods The celiac arterial endothelium of 75 male Japanese white rabbit (2.5?0.5 kg) were denuded after being fed with cholesterol-supplemented diet to establish the model of atherosclerotic stenosis of celiac arteries. The animals were randomized into the antisense DNA group (Group Ⅰ), sense DNA group (Group Ⅱ), saline control group (Group Ⅲ) and simple angioplasty group (Group Ⅳ). The drugs were injected intramurally using a porous balloon. The local vessels were collected at the 24 th hour and the 4 th week after the procedure for morphological observation. C-myc mRNA level was measured by means of RT-PCR and c-myc protein with immunohistochemical staining. Results RT-PCR showed that c-myc mRNA level in Group Ⅰ was lower than that of Group Ⅱ, Group Ⅲ and Group Ⅳ after the first 24 hours. The ratio of neointimal area (NEA) to medial area (MA) and NEA/MA in Group Ⅰ were significantly less than those of Group Ⅱ, Group Ⅲ and Group Ⅳ. Immunohistochemical staining showed that the percentage of c-myc protein positive cells was less in Group Ⅰ than those of the other groups. Conclusion Transcatheter local delivery of c-myc antisense oligonucleotides reduces neointimal hyperplasia after angioplasty in rabbits.

Objective To observe the curative effect of using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia and its effect on nursing.Methods A prospective study was conducted, 146 patients with hyperbilirubinemia admitted to Mianyang Central Hospital from January 2015 to December 2016 were enrolled, and they were divided into an observation group (77 cases) and a control group (69 cases) according to random number table method. The observation group was treated by medical treatment and the artificial specific liver bilirubin adsorption, while the control group only treated by medical therapy. The changes of levels of liver function indexes alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil) before and after treatment and clinical curative effect were observed in the two groups.Results Before treatment, there were no statistical significant differences in levels of the ALT, AST, TBil, DBil between the two groups (allP > 0.05), after treatment, the above indexes were significantly decreased compared to those before treatment, and the degrees of decrease in observation group were more obvious than those in control group [ALT (U/L): 341±42 vs. 455±37, AST (U/L): 120±35 vs. 197±37, TBil (μmol/L): 185.4±20.6 vs. 302.6±30.6, DBil (μmol/L): 42.6±10.8 vs. 87.5±11.6, allP < 0.05]. The total effective rate in observation group was obviously higher than that of control group [62.3% (48/77) vs. 40.6% (28/69),P < 0.05].Conclusions Based on liver protection, symptomatic and supportive medical treatment, using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia is safe and effective, and in addition, close observation and careful nursing is beneficial to the reduction of incidence of complications and elevation of therapeutic efficiency.

Objective To assess the predictive value of coronary angiography TIMI myocardial perfusion grade (TMPG), electrocardiogram (ECG) single-lend ST segment resolution (STR), ECG Max-ST-segment deviation (MaxSTE) on judging myocardial reperfusion after primary angioplasty in the patients with acute myocardial infarction (AMI). Methods Primary percutaneous coronary intervention(PCI) was performed in 42 patients within 12 hours after AMI onset. Coronary angiography and ECG was done before and after angioplasty. TMPG, ECG single-leed STR and MaxSTE were used to assess myocardial reperfusion immediately after PCI. Myocardial perfusion scan was examined in all the patients using99mTc-MIBI SPECT on day 7±2. Results Compared with the level of myocardial perfusion demonstrated in myocardial scan of 99mTc-MIBI SPECT, the sensitivity, specificity and accuracy of TMPG, single-lead STR and MaxSTE was calculated. The sensitivity of TMPG, single-lead STR and MaxSTE was 93.75%, 87.50% and 81.25%, respectively, the specificity of them was 20.00%, 80.00% and 80.00%, respectively, and the accuracy was 76.19%, 85.71% and 80.95%, respectively. The findings in single-lead STR and MaxSTE matched well with the results of myocardial scan of 99mTc-MIBI SPECT. Conclusion In the patients suffering from AMI treated with PCI, ECG is an effective method to assess myocardial tissue reperfusion.

Objective To explore the observation and nursing of traumatic mediastinal hematoma.Methods The clinical data in 44 cases of mediastinal hematoma treated in our department from July 2006 to May 2016 were analyzed retrospectively.Results Forty cases were cured,4 cases(9％) died,the mortality rate was 9％,in which 1 case died from postoperative consumptive coagulopathy,1 case died from acute coronary syndrome and 2 cases died from traumatic hemorrhagic shock.Conclusion Timely diagnosis and treatment of intrathoracic cardiac and vascular injury are the key to save the lives of patients;the nursing focuses include observing the hematoma progress,adopting the comprehensive treatment measures such as controlled hypotension,limited fluid resuscitation and correctly selecting infusion approach for preventing hematoma enlargement and rupture.

Objective To explore the effect of immunogenicity of freeze-dried bone allograft on different in vitro experimental models. Methods The lymphocytes were obtained respectively from 10 healthy young human volunteers, 10 Balb/c and 10 C57 mice and 10 New Zealand rabbits. The experiment was carried out in 6 groups: positive control group (PHA/ConA+lymphocyte), negative control group (Hydroxyapatite powder + lymphocyte), allogeneic bone group A (Freeze-dried bone powder 2. 0 g/L + lym-phocyte), allogeneic bone group B (Freeze-dried bone powder 1.0 g/L + lymphocyte), allogeneic bone group C (Freeze-dried bone powder 0.5 g/L + lymphocyte), and negative control group (culture solution + lym-phocyte). Lymphocyte transformation test (Alamarblue) was conducted to culture the 6 kinds of experimental materials in vitro. After 72 hours, samples were scanned with ELISA muhiscan at wave lengths 570 nm and 600 nm to fetal the light absorption value. Pearson analyses were performed 10 determine the relationships a-mong the 3 animals and 1 human groups and find out which animal would be highly correlated to human. Results In the human and Balb/c mice lymphocyte transformation tests, there was no significant difference (P > 0.05) between allogeneic bone groups A, B, C and negative control group (HA) ; but there was sig-nificant difference (P < 0.001) between allogeneic bone groups A, B, C and positive control group (PHA/ConA); there was no significant difference between the 3 allogeneic bone groups (P > 0.05). There was no significant difference among the 6 groups of C57 mice and New Zealand rabbits (P > 0.05). The coefficient r between Balb/c mice and human groups was 0.959, P = 0.003, showing a highly positive correlation. The coefficient r between C57 mice and human groups was 0.527, P = 0.283, while the coefficient r between New Zealand rabbits and human groups was 0.866, P =0.026. Conclusions The immunogenicity of freeze-dried bone powder in this experiment may not be sufficient enough to induce significanrt immunologic response. Balb/c mice may be preferable for immunogenicity related experiments.

ObjectiveTo investigate the application of the ratio of early diastolic peak velocity of mitral valve(E) and early diastolic peak velocity of mitral annular(Ea) on evaluating left ventricuiar diastolic function in patients with chronic heart failure.MethodsLeft atrial diameter(LAD),left ventricular end-diastolic diameter (LVEDd),interventricular septal thickness (IVST),left ventricular ejection fraction (LVEF),E and late diastolic peak speed of mitral valve (A) of 30 patients with diastolic heart failure(DHF,DHF group),30 patients with systolic heart failure(SHF,SHF group) and 30 healthy persons (control group) were detected by conventional echocardiography.E/A ratio and E-wave deceleration time (DT) were calculated.Early diastolic peak velocity of longitudinal septal and left ventricular lateral part of mitral annulus (Esep,Elat) were measured by tissue Doppler imaging (TDI).Ea and E/Ea ratio were calculated as well as the relevant analysis was made.Results ( 1 ) LAD and IVST in DHF group were significantly higher than those in control group [(44.90±8.31) mm vs.(30.87±3.48) mm,(9.43±2.18) nn vs.(8.17 ± 1.12)mm,P＜0.05].LVEDd in SHF group was obviously higher than that in control group and DHF group [(66.30 ± 10.21) mm vs.(44.77 ± 4.17) mm,(48.60 ± 8.85) mm,P＜0.05],and LVEF and DT were significantly lower than those in control group and DHF group(P ＜ 0.05 ).(2) Esep,Elat and Ea in DHF and SHF group were significantly lower than those in control group( P ＜ 0.01 ),and E/Esep,E/Elat and E/Ea ratios were obviously higher than those in control group (P ＜ 0.01 ).( 3 ) The level of B type natriuretic peptide (BNP) in DHF and SHF group was significantly higher than that in control group [(477.73 ± 722.76),(978.60 ± 825.04) ng/L vs.(29.23 ± 17.84) ng/L,P ＜ 0.05 ].The level of BNP in SHF group was significantly higher than that in DHF group (P＜0.05 ).(4) Multivariate linear regression analysis showed that NYHA classification and BNP were correlated with E/Ea ratio (P ＜ 0.05).(5) The area under curve (AUC) of E/Ea in diagnosing chronic heart failure was 0.984 (95％ CI:0.000-1.000).AUC of E/Ea in identifying DHF and SHF was 0.857(95％ CI:0.773-0.940).The sensitivity and specificity of E/Ea were much higher than those of E/A.Conclusions Chronic left ventricular systolic insufficiency is commonly combined with different-degree diastolic dysfunction.The evaluation of left ventricular diastolic function can be more simple and accurate combined with pulse wave Doppler and TDI.

Objective The use of in vivo cryotechnique (IVCT) in combination with electrocardiograph (ECG) to study cardiac microcirculation under different hemodynamic conditions in living mouse.Methods Living mouse heart monitored by electrocardiograph was suffered from IVCT and freezing substitution under normal blood flow,myocardial ischemia or cardiac arrest conditions.Hematoxylin eosin (HE)staining,Schiff's staining and immunofluorescence staining for serum albumin,immunoglobulin were utilized on continuous paraffin sections,respectively.Confocal microscopy and statistical analyses were used.Results Comparing with normal hemodynamics,microvascular red cell volume reduction,morphology changed,myocardial cell glycogen loss,serum albumin ectopic distribution to myocardial cytoplasm,T tubular network failure and spacing width were happened in myocardial iscbemia condition; different shapes of red blood cells,myocardial cells glycogen deficiency,T tubular network failure and interval narrowing were found under cardiac arrest conditions.Conclusions Cardiac microcirculation,pathological changes of myocyte and its surrounding microenviroument in living mouse heart can be immediately captured in situ by the application of IVCT and ECG.