Subintimal angioplasty had been widely used in the intervention of lower extremity arterial obliterans disease in recent years.True lumen re-entry is the key to subintimal angioplasty.This comprehensive exposition of the true lumen re-entry can improve the chances of ultrasound and subintimal arterial flossing with antegraderetrograde intervention and catheter systems and other emerging technologies in the application of subintimal angioplasty,and various types of technology advantages and disadvantages.

Objective To investigate the effects of 1,25-dihydroxyvitamin D3 in the prevention of corneal allograft rejection. Methods Forty-five SD rats (only right eyes) were used as recipients,and 15 Wistar rats (double eyes) were used as donors. SD rats were randomly divided into 3 groups: the autograft control group,the allograft control group (receiving peanut oil as placebo),and the allograft group were treated with 1,25-dihydroxyvitamin D3 (1.0 ?g.kg-1.d-1,3 times/d for 13 d,i.p.). Drugs were injected intraperitoneally for 14 d after transplantation. Routine antibiotic eye drops were used. Grafts were observed by operating microscopy everyday after transplantation. Five SD rats in each group were killed respectively at the 14,21,and 30 d postoperatively. Neovascularization and inflammation were evaluated with HE staining. ELISA was used to detect the contents of IL-1?,IL-2,IL-8,and IL-10 in the peripheral blood. Results The mean survival time (MST) of the graft was (21.7?6.8) d in the autograft control group,(11.2?2.5) d in the allograft control group,and (19.3?5.2) d in the allograft group. There was statistically significance between the latter 2 groups (P

Isolation of ?- aminobutyric acid in Hedysarum polybotrys Was accomplished by HPTLC and the content of the sail component in the herb and its preparation determined by dual wave length seanning at ?5 580nn and ?R700nm, The method was simple and accurate.

With the progress of minimally invasive surgical techniques,the vast majority of general surgery can be safely carried out laparoscopically.But the development of the pancreas laparoscopic surgery is lagging behind.Initially laparoscopy was used only as a diagnostic and staging tool.Nevertheless with more and more successful launch of laparoscopic surgery.Surgeons devoted a great deal of energy to this field in order to benefit more patients.This review focused on the literature of laparoscopic pancreatic surgery in resent years,although the majority of literature suggests that the minimally invasive pancreatic surgery has advantages of rapid recovery,low complication rate compared to traditional open surgery.However,most studies are limited to a small sample and a single institution results.The promotion of this emerging technology still needs more rigorous evidence based medicine.

Objective To explore the drainage effect of drainage tube with different materials on the basis of a constant nega tive pressure drainage,and its impact on flap survival.Methods The most common clinical used Polyvinyl chloride resin (PVC)pipe,latex tubes,silicone tube drainage tubes,and flaps were compared at different phases of the drainage,to determine the best clinical flap with drainage material.After three groups of flaps were designed,including a constant negative pressure drainage device,without a constant negative pressure drainage system,and drainage alone (no negative pressure) drainage flap,the flap survival was observed at different phase space.Three different drainage drainage ways of the flap and the flap survival area of effect were statistically analyzed.Results The silicone tube drainage was more fully and effectively.Constant negative pressure drainage volume of liquid was up to the flap with drainage to the fullest,the highest rate of skin flap healing,and better healing.Conclusions The constant negative pressure in the drainage of the flap makes drainage more fully,and promotes rapid healing of wounds,while the silicone tube is suitable for flap drainage.

Objective To observe the clinical efficacy of LiQiDingChuan pill combined with Dexamethasone on the treatment of patients with acute asthma.Methods 93 patients with acute asthma from July 2015 to September 2016 were randomly divided into the observation group(47 cases)and the control group(46 cases).The control group were received dexamethasone, and the observation group were given LiQiDingChuan pill combined with Dexamethasone.The main symptoms disappeared time, forced expiratory volume in 1 second, peak expiratory flow rate value, hs-CRP, TNF-α and clinical efficacy were recorded and analyzed.Results ①After treatment, wheezing cough, chest tightness and wheezing disappeared time were(4.71±0.59)d,(2.85±0.49)d,(4.93±0.70)d in the observation group, which were shorter than(7.76±1.02)d,(5.16±0.74)d,(8.67±1.12)d in the control group, and the differences were statistically significant(P<0.05).② After treatment, FEV1 and PEF levels were(65.69±3.74)V/L,(218.92±16.09)L/s, which were better than(57.45±3.62)V/L,(176.34±15.14)L/s in the control group, and the differences were statistically significant(P<0.05).③ After treatment, hs-CRP and TNF-α levels were(6.76±0.78)mg/L,(7.99±1.87)pg/mL, which were better than(6.76±0.78)mg/L,(7.99±1.87)pg/Ml in the control group, and the differences were statistically significant(P<0.05).④The total effective rate in the observation group was 91.49%, which was significantly higher than 71.74% in the control group, and the differences were statistically significant(P<0.05).Conclusion Liqidingchuan pills combined with dexamethasone treatment has a good therapeutic effect on acute phase of asthma, which can reduce asthma related symptoms, reduce the inflammation level in the patients, optimize the forced expiratory volume in 1 second and peak expiratory flow rate.The combination is better than the single drug.

Gene mutation is the molecular basis of the pathogenesis of primary liver cancer, and precise treatment based on gene mutation is an important direction for the treatment of liver cancer in future.This article introduces the current status, complexity, and prospects and future directions of precise treatment for liver cancer from the aspects of complex gene mutations in liver cancer, level of mutation detection, and limitations of clinical trials.It is pointed out that there are many challenges in precise treatment for liver cancer, but precise treatment still has a promising future.

Objective To observe the apoptosis and expression of Toll-like receptor (TLR)-4's mRNA in ischemia-reperfusion injured rat renal tubular epithelia cells (NRK-52E) in vitro, and effect of Cordyceps Sinensis (CS) extractant.Methods Cultured NRK-52E cells were divided into a control group, a model group, and a CS preincubated group. All first removed media and incubated with antimycin A for 1 h, and then recovered the media to simulate the ischemia-reperfusion injury in vitro. We detected the apoptosis ratio of cells by flow cytometer and the mRNA expression of TLR-4, Bax, Bcl-2 gene by reverse transcription-polymerase chain reaction at different time points.Results In ischemia-reperfusion injured NRK-52E, the apoptosis ratio rose as time passed (P＜0.05). We also observed increased mRNA expression of TLR-4, Bax (P＜0.05) and deceased expression of Bcl-2 (P＜0.05). Compared with the model grpup, the CS preincubated NRK-52E cells showed apparent tolerance to ischemia-reperfusion injury, which manifestated lower apoptosis ratio (P＜0.05), decreased expression of mRNA of TLR-4, Bax and increased expression of Bcl-2 (All Ps＜0.05). Conclusion The number of apoptosis cells and the expression of TLR-4 mRNA inceased with ischemia-reperfusion injury of NRK-52E in vitro. CS can prevent the NRK-52E cells from ischemia-reperfusion injury by downregulating TLR-4 gene.

Objective: To observe the clinical therapeutic effect of Pyretic Arthralgia granules in treating rheumatoid arthritis of moist heat arthralgia spasm syndrome,so as to provide scientific evidence in clinical Medication.Methods: Adopted random and positive parallel contrast methods,60 cases of active stage rheumatoid arthritis(RA) patients whom were differentiated of symptoms and signs as moist heat arthralgia spasm syndrome were divided into groups.Experimental group took Pyretic Arthralgia granules 2.0 g every time and 3 times a day orally;control group took Loxonin orally,60 mg every time and 3 times a day.Both course of treatment in two sets were 4 weeks.Results: Experimental group and control group all could improve present symptoms,physical signs and physical-chemical index.There was not significance variance in two groups comparing the disease therapeutic effect with the therapeutic effect of syndrome of traditional Chinese medicine.Conclusion: Pyretic Arthralgia granules has the effects of detumescence,alleviating pain and improving Joint function,and has not obvious poison and side reaction.It is good for further generalizing and applying.

Objective Health education provided by medical staffs can promote the patients 'abilities of self management . This article explored the teaching mode of health education course for nursing students of college to undergraduate level . Methods Reform took place in the course of health education for nursing students of Grade 2009 to 2012 who studied in the medical school of col-lege to undergraduate in Nanjing Genernal Hospital .The unidirectional teaching method was replaced by trinity teaching method which included cases , situational analogue training and clinical situation experience .In their clinical internship , the same questionnaire was used by designated personnel to survey the satisfaction degree of the patients , the clinical teachers and the nurses themselves .Analysis and comparison were conducted on the materials of satisfaction degree from 2009 to 2011 . Results Significant difference was found in the satisfaction degree of the patients , the clinical teachers and the nurses before and after the application of trinity teaching model (93.4%vs 56.9%, 91.6%vs 59.7%, 99.3% vs 78.1%). Conclusion The trinity teaching model is of high practical value , which is worth popularizing .