Objective To assess the feasibility of evaluation of coronary flow reserve (CFR) for left anterior descending (LAD),left circumflex (LCx),and right coronary posterior descending artery(PDA) as well as diagnostic accuracy for patency of each branches by transthoracic Doppler echocardiography (TTDE). Methods CFR of main coronary artery branches at the distal sites were studied by TTDE with adenosine infusion (140 μg · kg-1 · min-1) in 439 consecutive patients with suspected coronary heart disease. The relations between CFR and stenosis rates of coronary bifurcations were analyzed. Results Twenty-eight of LAD,12 of LCx and 21 of PDA were occluded in 439 patients. The success rate of CFR assessment of LAD, LCx and PDA were 96.8% (395/411), 74.9% (320/427), 83.0% (347/418)respectively. Then CFR≤2.0 and CFR≤1.7 were chosen as the criteria of coronary stenosis (≥50 %) and severe stenosis(≥75%). The sensitivity and specificity of detection of LAD,LCx and PDA stenosis were 81% and 87% ,64% and 82%, 79% and 85%, respectively. The sensitivity and specificity of diagnosis of LAD, LCx and PDA severe stenosis were 86% and 81%, 70% and 85%, 81% and 82%, respectively.Conclusions CFR evaluation of main coronary artery branches has high feasibility and can provide valuable information for relevant vessel patency.

Objective To construct the recombinant plasmid that highly expressed human subcellular PTEN,in order to provide a basis for further study on its anti-tumor effect. Methods PTEN cDNA was amplified by RT-PCR based on mRNA of placenta.The PCR product was ligated into T-vector,and transfected into E.coli;the obtained T-PTEN plasmid was identified with restrictive digestion and sequencing.PCR was used to incorporte nuclear signal of localization(NSL) into PTEN when T-PTEN was used as template.Then the PCR product was ligated into T-vector,and transfected into E.coli,and T-NSL-PTEN plasmid was obtained.pcDNA3.1 and T-NSL-PTEN were ligated after digested with EcoRⅠand BamHⅠ,and transfected into E.coli,the recombinant vector pcDNA3.1-NSL-PTEN was obtained,and identified with digestion and sequcncing.Results The recombinant expression vector DUM-PTEN and PUM-NSL PTEN were identified by restrictive digestion and DNA sequencing.As expected,by EcoRⅠ and BamHⅠ digestion,it showed the band of 1 200 bp.The sequencing result showed the NSL was incorporated successfully.The recombinant pcDNA3.1-PTEN was obtained with 1 200 bp,the sequencing result showed that its sequence was same as target gene;the recombinant pcDNA3.1-NSL-PTEN was comfirmed by restrictive digestion and sequencing,and the NSL was incorporated successfully. Conclusion The recombinant expression plasmid pcDNA3.1-NSL-PTEN is constructed successfully which can highly express human subcellular PTEN.

Objective: To repaire the posterior tooth defects in the elderly people with CEREC chairside CAD/CAM restorations, and to evaluate the clinical curative effect 1 year after treatment. Methods: A total of 52 posterior teeth from 48 aged patients were selected. Among them, 24 cases were onlays, 18 cases were inlays, and 10 cases were crowns. The inlays/onlays/crowns were designed and manufactured by CEREC chairside CAD/CAM system, and then bonded with resin cement. After 12 months, the patients were followed up. The teeth with restorations were assessed by using the modified USPHS criteria including restorations, tooth, and periodontal. At the same time, the patient' s satisfaction was evaluated. Results: In all of the 52 restorations, the success rates of inlay, onlay and crown were 94. 4%, 91. 7% and 80. 0%, respectively; among them, one inlay was fractured, one onlay did not close the edge, one onlay's edge integrity was mild defect, one teeth was fractured, one crown's adjacent relationship was not close, and one crown appeared papillitis. Conclusion: The restorations manufactured by CEREC chairside CAD/CAM system have a good short-term clinical curative effect. It is an effective way to repair the posterior tooth defects in the elderly people.

Objective To probe into clinical value of real-time three-dimensional echocardiography (RT-3DE) in evaluating global and regional left ventricular function in patients with acute inferior, posterior and lateral myocardial infarction(MI).Methods The study consisted of 41 normal subjects and 23 patients with acute MI.RT-3DE was performed and three-dimensional image data was analyzed offline with software.A series of global and regional left ventricular volume curves were plotted.Regional and global diastolic volumes, regional and global systolic volumes, regional and global ejection fractions, regional stroke volume to global diastolic volume were compared respectively between control group and MI group.Results By contrast with control group, global left ventricle function and regional left ventricle function in the zones with infarction and part of the zones close to infarction had significant difference( P＜0.05),however,no effective statistic change was found in the most of the distal zones of infarction( P＞0.05).Conclusions RT-3DE can accurately evaluate measurement the left ventricular global and regional function in patients with acute MI.

Objective To observe the influence of different doses of intravenous immunoglobulin (IVIG) on function of T cells in cord blood of premature infants and to explore the immunomodulating mechanism of IVIG.Methods Cord blood mononuclear cells (CBMC) were isolated by density gradient centrifugation method from 15 preterm infants born between June 1,2011 to December 31,2011 at 32 34 gestational weeks.Three groups were formed according to the concentrations of IVIG used for CMBC culturing in vitro (Group A,6 mg/ml; Group B,9 mg/ml; Group C,12 mg/ml).After 72 hours in sterile conditions,the levels of IFN 7,IL 4,IL-10 and TGF β1 in the supernatant were determined by enzyme-linked immunosorbent assay.The expression of CD4+ CD25+ Foxp3+ Treg cells was examined by fluorescent activated cell sorter.Differences among groups were compared by one way analysis of variance.For comparison between two groups,LSD test was used.Results (1) The level of IFN γ secreted by CBMC in Group C was 0.03 ± 0.02,which was much lower than that in Group A(0.18±0.08) and Group B(0.13±0.05) (F=5.72,both P＜0.01).The level of IFN-γ in Group B and Group A did not show statistical difference (P＞0.05).Compared with Group A(0.03±0.01),the level of IL4 was much lower in Group B (0.02±0.01) and Group C(0.01±0.01) (F=20.38,both P＜0.01),while no significant difference was shown between Group B and Group C (P＞0.05).(2) No significant difference was found in the expression of CD4+CD25+Foxp3+Treg cells among different groups (F 0.67,P＞0.05).(3) The level of IL 10 in Group C was 3.02 ± 3.79,which was significantly lower than that in Group A (10.78±5.44) and Group B (6.90±4.64)(F=4.68,P＜0.01 and 0.05).The level of IL-10 inGroup B was still lower than that in Group A (P＜0.05).The levels of TGF-β1 in Group C(8.44± 13.71) and Group B(16.15 ±13.94) were significantly lower than that in Group A(30.23 ± 16.32) (F=5.22,P＜0.01,P＜0.05),but there was no significant difference between Group B and Group C (P＞0.05).Conclusions IVIG might inhibit the function of Th cells in CBMC of preterm infants in a dose dependent manner.IVIG could inhibit the function of natural Treg cells by regulating the secretion of cytokines IL-10 and TGF-β1 in a dose dependent effect.

Objective: To observe the therapeutic effect of Jingyuankang capsule on peripheral leukopenia in patients with HIV/AIDS.Methods: The methods of randomized,double blind,double analogue clinical trials were used for two groups: 58 cases treated with Jingyuankang capsule,Likejun tablet analogue and HAART therapy;58 cases treated with Likejun tablets,Jingyuankang capsule analogue and HAART therapy.Both groups had systematic administration of 6 weeks.The peripheral blood cells were examined to observe the therapeutic effect of Jingyuankang capsule on peripheral leukopenia.Results: Jingyuankang capsule had a good therapeutic effect in treating peripheral leukopenia.It signifi cantly increased the numbers of leukocytes and granulocytes.As the time of administration,it could promote the growth of leukocyte more obviously.It was clinical safe and effective.No toxic and side effect was found in the process of treatment and later follow-up visit.Conclusion: Jingyuankang capsule can effectively treat peripheral leukopenia in patients with HIV/AIDS.

Objective To establish a method for the rapid detection of hepatitis E virus (HEV)from serum samples based on fluorescence quantitative PCR.Methods (1 )One-hundred HEV sequences including our country popular three major genotypes were obtained from the GeneBank with the Vector NTI software.The proper sequence was selected to design and synthesize the primers of the fluorescence quantitation and the Taqman probe.(2)The amplification region PCR fragment was transcribed in vitro to synthesize cRNA standard,at the same time the trace serum virus lysate was introduced into a universal real-time TaqMan PCR assay.(3)10 clinical serum samples were collected from the patients with clinical hepatitis E and detected by using the established method for further verifying this method.Results This detection technique could effectively detect the serum samples in the pa-tients with genotype I and genotype IV hepatitis E positive,while the serum detection in the patients with other virus infectious dis-eases had the negative results,which verified that this RT-PCR detection technique had higher specificity and good reliability.The detection results from 10 clinical serum samples further verified that this method was rapid,convenient and sensitive with good re-peatability.Conclusion A fluorescence quantitative RT-PCR detection technique suitable for detecting main genotypes of HEV in China population is established,which can meet the demand of early and rapid diagnosis for HEV.

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

OBJECTIVE:To observe the efficacy and safety of mecobalamin combined with folic acid in the treatment of dia-betic peripheral neuropathy(DPN)with hyperhomocysteinemia. METHODS:Data of 40 DPN patients with high hyperhomocystein-emia were enrolled into high Hcy group and 30 DPN patients with normal Hcy were enrolled into normal Hcy group. Normal Hcy group was given diet control,hypoglycemic drugs or insulin for controlling glucose and other conventional treatment to make the fasting plasma glucose was lower than 7.0 mmol/L and 2 h postprandial glucose lower than 11.0 mmol/L;based on it,high Hcy group was given Mecobalamin injection 500 μg by intramuscular injection,once a day+Folic acid tablet 5 mg,once a day. 14 d was a treatment course and it lasted 2 courses. Clinical efficacy,Hcy level,the motor nerve conduction velocity(MNCV)and sen-sory nerve conduction velocity (SNCV) of tibial and peroneal nerve and total symptom scale (TSS) score before and after treat-ment in high Hcy group were observed and compared with normal Hcy group,and the incidence of adverse reactions in high Hcy group was recorded. RESULTS:After treatment,the total effective rate in high Hcy group was 75.0%;Hcy and TSS score in high Hcy group were significantly lower than before and higher than normal Hcy group,MNCV and SNCV of tibial and peroneal nerve were significantly higher than before and lower than normal Hcy group,the differences were statistically significant(P<0.05). Th incidence of adverse reactions of high Hcy group was 5.0%. CONCLUSIONS:Based on the conventional treatment,Mecobalamin combined with folic acid has good efficacy in the treatmen of DPN with hyperhomocysteinemia,it can significantly reduce plasma Hcy levels and improve nerve conduction velocity in patients with DPN,with good safety.

Objective To analyze setup errors and guide the calculation of margins from clinical target volume (CTV) and planning target volume (PTV) in esophageal cancer patients treated with tomothcrapy by the MVCT image-guided system.Methods Sixty-four esophageal canccr patients trcated with tomotherapy in our hospital in 2016 were randomly selected.MVCT images were acquired after patients' positioning and co-registered with KVCT images.The setup errors of x,y,and z translations and roll rotation were analyzed with the t-test or one-way ANOVA.Meanwhile,PTV margin was calculated based on the formula of M =2.5 Σ + 0.7δ Results According to the formula,the CTV-PTV margins in the x,y and z directions are slightly different between cancers located in the cervical,upper thoracic,middle thoracic,and lower thoracic segments.In patients with upper thoracic esophageal cancer,the average setnp error in the yaxis was lower when the head-neck-shoulder thermoplastic film fixation was used than when somatic thermoplastic film fixation (P=0.000);the setup errors of z-axis with somatic thermoplastic film fixation in the fifth and sixth weeks were slightly less than those in the first several weeks (P =0.036);the setup errors acquired by three image registration patterns were similar (x-axis P=0.868,y-axis P=0.491,z-axis P=0.169,roll P=0.985).Conclusions In the treatment of patients with esophageal cancer,the setup errors are large,but the MVCT in the TOMO HD system can greatly reduce the setup errors,ensuring the accuracy of each treatment.It is further recommended that in clinical practice,different CTV-PTV margins should be used for the treatments of esophageal cancers located in different segments.Patients with upper thoracic esophageal cancer are advised to use the head-neck-shoulder thermoplastic film fixation.