Atherosclerosis is a chronic inflammatory vascular disease developing from early fatty streaks to highly rupture-prone unstable plaques.Many cellular and molecular events are involved in each step.With the development of targeting probe technology,molecular magnetic resonance imaging techniques are expected to revolutionize the treatment strategies of atherosclerosis in the near future.Many desirable molecular probes targeting various components of plaque have emerged in recent years.This article reviews the molecular magnetic resonance imaging techniques of atherosclerosis and their application.

Objective To investigate risky factors,and predictability of portal vein thrombsis in patients with portal hypertension caused by hepatic cirrhosis after spleenectomy and portaazygous devascularization. Methods Between Jan 2004 to Nov 2009,clinical data of 27 patients suffering from postoperative PVT were compared with 37 patients admitted during the same period without postoperative PVT. Results There were 4 factors proved to be risk factors for PVT.Perioperative peripheral platelet count (postoperative to preoperative) 、D-dimer、the whole blood viscosity and the blood flow of portal vein postoperatively.The right predictive rate of PVT was 87.3%. Conclusion The risk factors of PVT are the ratio of platelets、D-dimer、the whole blood viscosity and the blood flow of portal vein postoperatively.By this method it is probable that postoperative PVT is predictable.

Objective To screen key genes related to deep vein thrombosis (TDVT) after trauma using gene function assembly analysis. Methods Thirty Sprague Dawley rats were randomized into control, thrombosis and non-thrombosis groups. Traumatic limb DVT models were established in rats through quantitative beating on the bilateral posterior limbs. The Genechip Rat genome 430 2. 0 genechips were applied to detect changes in genes expressions on difference phases of DVT. On the basis of the differential gene expressions in the thrombosis and non-thrombosis groups, the gene function assembly analysis was conducted to define the most significant and concentrated gene functions leading to the biological characters of DVT.Results B factor (bf), complement 4 binding protein α (C4bpα), plasminogen activator inhibitor 1 (serpinel), urokinase-type plasminogen activator receptor (plaur) were screened to be the key genes related to DVT, because they were found to be involved in the functions like complement activation, development,growth, morphogenesis, primary metabolism, cell motility, protein metabolism, localization of cell, locomotion and localization. The abundance values of the genes expressed were 1.6, -0. 2, 2. 1, 5. 1 in the thrombosis group, and -0. 5, - 1.4, 2. 7, 3. 3 in the non-thrombosis group. Conclusion Bf, C4bpα,serpinel, plaur may be the key genes that play a role in the process of DVT.

OBJECTIVE:To explore security of interstitial chemotherapy by implanting 5-fluorouracil sustained-release reagent into interstitial tissues of oesophageal tumor tissue and tumor peripheral tissue under orthoptic endoscope. METHODS:Relative articles were retrieved from Pubmed database from January 1988 to December 2008 and CNKI database from January 2000 to December 2008. Inclusion criteria:articles which were related to 5-fluorouracil sustained-release reagent for the treatment of esophageal carcinoma were included;Exclusion criteria:Duplicated articles were excluded. A total of 29 patients with grade Ⅲ-Ⅳ esophageal carcinoma who received implantation of 5-fluorouracil sustained-release reagent under orthoptic endoscope were collected from Department of Oncology,Shenyang Red Cross Hospital from March 2001 to December 2007. There were 22 males and 7 females,aging 51-82 years and mean age of 60.2 years. 5-fluorouracil sustained-release particles were implanted into tumor interstitial tissue under orthoptic endoscope. 800 mg 5-fluorouracil sustained-release particles were gradually implanted for 3-5 particles each time. RESULTS:Implantation of 5-fluorouracil sustained-release reagent has been reported to safely and effectively treat esophageal carcinoma. Clinical results indicated complete remission(n=3) ,partial remission(n=16) ,stable pathogenetic condition(n=6) ,and no remission(n=4) . Body mass increased in 21 patients(72.4%) ,and average effectiveness level was 70.9%. Symptoms including hemorrhage,light descent of leukocyte,light malignancy,diarrhea but excluding functional disorder of liver and kidney were found. Easement of pain in 22 patients was 75.8%,and discontinuing analgesics accounted for 50%(P

Currently,tracheal stents used in clinic include silicone,dynamic and metal types.The metal stents contain Ni-Ti memory alloy,stainless steel,and coating stents,which are cylinder and network structured.These stents are more expensive than silicone stents.The internal stents,mainly metal stents,have been used recently in clinic to treat tracheal stenosis.Tracheal stenting methods are divided into bronchofibroscope and hard lens implantation.Both tracheal and esophageal stent implantations are invasive treatment.However,tracheal stent implantation is different from esophageal stent implantation.As patients with airway obstruction are always complicated by dyspnea and hypoxemia,even respiratory failure,which increases risk and difficulty of stent implantation.During tracheal stent implantation,the bronchofibroscope or stent entering the stenosis site may lead to complete tracheal obstruction-induced asphyxia.Corrosion of metal wire of stent to airway mucosa and vessels may result in hemorrhea,leading to postoperative hemoptysis.Stent dislocation is mainly caused by inappropriate selection of stent,inappropriate implantation position or severe cough.Carcinoma tissue growing along stent lumens can induce re-obstruction in stent,resulting in atelectasis relapse.Although there are many unsolved problems and the incidence of complication is 10%-20%,tracheal stent is still a safe,effective and simple therapy for tracheal stenosis.Prevention and treatment of tracheal stenosis following stent implantation and development of novel stents with better effect and fewer side effects is future study focus.

Objective To survey on the condition of critically ill children in emergency room (ER) for improving the care for them.Methods Data of 374 critically ill children in emergency intensive care unit (EICU) were recorded in the respects of mode of sending them to ER,rescue during transport,length of stay in ER,blood gas,electrolytes,accuracy of assessing pediatric critical illness score/neonate critical illness score (PCIS/NCIS) and Glasgow Coma Scale (GCS),correctness of determining SIRS,sepsis and septic shock.Results Of 374 patients,neonates were 29.9％,and the mean age of children patients not including neonate was 37.4 months.The mean length of ER stay was 4.7 hours (0.42-96 hours).Of 374 patients,those with infection diseases were 47.6％,and the main vehicles for transportation of patient sent to ER were Taxi (38.3％),ambulance (28.4％) and private cars (21.5％).Total fatality was 12.3％ and ER fatality ( 15.6％ ) was higher than in - hospital fatality ( 10.3％,P ＜0.01 ).The mean PCIS/NCIS of 374 patients were 81.92 ± 9.66,and the PCIS/NCIS ≤ 90 accounted for 81％.Of assessed GCSs of 172 patients,GCS≤8,GCS 9-12 and GCS 13-15 accounted for 35.5％,21.5％ and 43.0％ respectively,and fatalities were 26.23％,10.81％ and 5.41％ correspondingly (P ＜0.01 ).The PCIS values of GCS≤8 and GCS 9-12 patients were lower than those of GCS 13-15 patients (P ＜ 0.01 ).There was no significant difference in PCIS between GCS≤8 and GCS 9-12 ( P ＞ 0.05 ).PCIS and GCS were positively correlated (r=0.454,P=0.01).Of374 patients,41.7％ had SIRS,and 25.7％ had sepsis.Of 262 children not including neonates,43.5％ had shock,and 61.4％ of these shock children were septic shock.In 374 patients,those with hyponatremia accounted for 37.2％,and those with hyperkaliemia accounted for 22.0％.The rate of hypoglycemia found in neonates was 20.91％ and rate of hyperglycemia occurred in neonates was 29.1％.The rate of hypoglycemia found in children patients was 9％ and hyperglycemia was 66.7％.Patients with pH ＜ 7.35 accounted for 67.8％ and those with pH ＜ 7.2 were 33.1％.Conclusions The majority of children patients in pediatric ER were neonates and infants.The length of ER stay was short with mean value of 4.7 hours (0.42-96 hours).ER fatality was higher than in - hospital fatality,suggesting the critically ill children patients should be admitted as early as possible.The rate of using ambulance was only 28.4％.The Emergency Medical Service (EMS) should be improved to enhance the public sense of the EMS available.PCIS/NCIS can be used in ER for assessing the conditions and prognosis of critically ill children.GCS ≤8 and GCS 8-12 patients accounted for 57％ with majority of nontrauma brain injury.The values of PCIS in GCS≤8 and GCS 9-12 patients were much lower than those in GCS 13-15 patients.Patients with GCS ＜ 13 might be in critical settings.Majority of shock patients were septic shock (61.4％).Hyponatremia,hyperkalemia,hyperglycemia and hypoglycemia often occurred in critically ill pediatric patients and hypoglycemia not excepted in the neonates should have attention paid to.The main factor of acid -base balance disorder in critically ill children was acidosis (67.8％).

ObjectiveTo investigate the genotype of a case with abnormal hemoglobin combined with hereditary persistence of fetal hemoglobin (HPFH).Methods Male patient,26 years old,were suspected abnormal hemoglobin combined with HPFH after receiving medical examination including hematology exmination,hemoglobin electrophoresis,erythrocyte osmotic fragility analysis in Guangzhou Kingmed Diagnostics in September 2010.Routine examination of anemia and hemoglobin electrophoresis at alkaine pH on agarose gels were applied to analyze the phenotype.Direct sequencing of the complete HBB gene was utilized to identify the hemoglobin variant.Multiplex ligation-dependent probe amplification (MLPA) assay was used to identify the presence of β-globin gene cluster deletion.Gap polymerase chain reaction (gap-PCR) was used to amplify the HBB gene fragment across the breakpoint,and the deletion breakpoint was characterized by direct sequencing the gap-PCR product and comparing the sequencing result with the reference sequence NC_000011.9.ResultsBy direct sequencing of the complete HBB gene,the patient in this study was found to carry a hemoglobin Ta-Li (HBB:c.250G ＞ T) mutation.By combining use of MLPA and gap-PCR with gene sequencing,we found that it had a gross deletion in the β-globin gene cluster,the deletion region was NC_000011.9:g.5222878_5250288del.Therefore,the genotype of this subject was SEA-HPFH combined with abnormal hemoglobin Ta-li.ConclusionCombining application of MLPA and gap-PCR with gene sequencing can help to make sure the genotype.

Percutaneous vertebroplasty has many advantages such as minimal trauma, simple mode of operation, rapid and correct therapeutic effect, high safety, and wide indications. Therefore it has been generally paid close attention and accepted. Percutaneous vertebroplasty has conspicuous curative effect, especially in vertebral compression fracture. Polymethyl methacrylate is the most used filling materials at present; There is not significant difference between unipedicular and bipedicular vertebroplasty; Using vertebral body venography and appropriate dense bone cement can reduce leakage of bone cement; Bolster for self-replacement can rebound vertebral body height, and balloon kyphoplasty and sky bone expander kyphoplasty can be avoided; In order to reduce refracture of vertebral body, anti-osteoporosis drugs should be used in the treatment of percutaneous vertebroplasty.

BACKGROUND: Non-adherence to fluid restrictions is common in patients maintained on hemodialysis prior to and after kidney transplantation,which has a profound influence on the development and transfer of illness of the patients.Mental factors have great influences on adherence to fluid restrictions.OBJECTIVE: To investigate the effects of rational-emotive therapy on adherence to fluid restrictions of patients maintained on hemodialysis prior to and after kidney transplantation.METHODS: In total 100 patients maintained on hemodialysis were randomly assigned to an intervention group(n = 50)and a control group(n = 50).The control group received the conventional therapy.At the same time,the intervention group received the conventional therapy combined with rational-emotive therapy.All cases were assessed with the Symptom Checklist 90(SCL-90)and Medical Coping Modes Questionnaire(MCMQ)prior to and after intervention.Clinical indices related to adherence to fluid restrictions were measured three successive times and the average score of each index was calculated.RESULTS AND CONCLUSION: Forty-eight patients from the intervention group and 44 patients from the control group accomplished the study.After intervention,the scores of the two subscales,confronce and avoidance,were significantly higher than those in the control group(P < 0.05).However,some scores were significantly lower than those in the control group,including the score of acceptance/resignation subscale of MCMQ,total average score of SCL-90,the score of somatization,obsessive-compulsive,interpersonal sensitivity,depression,anxiety,hostility,photic anxiety and additional items,and the score of four clinical indices related to adherence to fluid restrictions(the ratio of interdialysis weight gain to dry weight,mean systolic blood pressure,mean diastolic blood pressure,and mean ultrafiltration volume prior to hemodialysis)(P < 0.05).All these findings suggest that rational-emotive therapy can effectively amend the coping modes and the mental states of the patients,and then improve their adherence to fluid restrictions.

Objective To investigate the clinical value of continuity nursing model in caring patients with malignant obstructive jaundice treated with percutaneous transhepatic biliary drainage (PTBD).Methods A total of 120 patients with malignant obstructive jaundice treated by PTCD were enrolled in this study.The patients were divided into the control group (n=60) and the observation group (n=60).Routine discharge guidance and health education was conducted for the patients of control group,while for the patients of observation group,in addition to conventional discharge education,the continuity nursing was executed by the responsible nurse.Continuity nursing was meant to continue the service,to guide the observation of the wound and dressing change,the observation of the quantity and quality of drainage solution,to teach the knowledge of the management of PTCD catheter as well as its complications,to guide patient's diet and rest,and to establish the continuity nursing records.Results The patients of both groups were followed up for 3 months.The patients' awareness rate of the knowledge related to PTCD tube in the observation group was significantly higher than that in the control group.The wound infection rate,the rate of PTCD tube prolapse or blockage,and the tube-related re-hospitalization rate in the observation group were strikingly lower than those in the control group (P＜0.05).Conclusion The continuity nursing model can significantly improve patients' awareness rate about the knowledge related to PTCD tube,reduce the incidences of biliary tract infection,PTCD tube prolapse or blockage,wound infection,and tube-related re-hospitalization,therefore,the quality of life can be surely improved.