Objective:To investigate the efficacy and safety of different doses of tirofiban combined with coronary artery intervention in treatment of Non ST-segment elevation acute coronary syndromes (NST-ASC).Methods:110 cases with NST-ACS from October 2014 to January 2016 in our hospital were chosen and divided into the all dose group and half dose group.The TIMI blood grade before and after treatment,cardiac function before and after treatment for 30 d,major adverse cardiac events and bleeding events,hospitalization expenses and hospitalization days were recorded and compared between two groups.Results:Compared with before treatment,the TIMI 2 grade and 3 grade were obvious decreased,and the left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) after treatment for 30 d were all obvious decreased,while the left ventricular ejection fraction (LVEF) were significant increased,P＜0.05.And the TIMI blood flow grading,LVEDV,LVESV and LVEF before and after treatment in two groups had no significant difference (P＞0.05),and the major adverse cardiac events and hospitalization days of two groups had no significant difference,P＞0.05.While the bleeding events and hospitalization expense of all dose group was obvious higher than those of half dose group,P＜0.05.Conclusions:The half dose group of tirofiban combined with coronary artery intervention in treatment NST-ACS has obvious efficacy,it can decrease the bleeding events and hospitalization expense.

Objective To summarize the experience of unilateral endonasal transsphenoidal pituitary adeno-ma resection under neuroendoscopy. Methods 48 patients with pituitary adenoma were treated by unilateral en-donasal transsphenoid under neuroendoscopy. During the dissection of the adenoma, attention should be paid to pro-tect pituitary stalk and gland. Results The postoperative MRI detection revealed that the tumor was totally removed in 40(83.3%) cases,subtotally in 6(12.5%) ,and partially in 2(4.2%). All patients were followed up for 10 -36 months. Among the 38 patients with increased hormone level ,24 recovered to normal hormone level postoperatively; 14 were improved evidently;pituitary insufficiency was not found in 38 cases;7 patients have temporary diabetes in-sipidus but the symptom was released in three weeks. Conclusion The surgical treatment of pituitary adenoma by neuroendoscopic unilateral endonasal transsphenoid has its advantage in achieving both complete resection of tumor and sound protection of pituitary stalk and gland. Neuroendoscopic operation offers greater help in improving the pa-tients' quality of survival.

Background:Screening of colorectal cancer (CRC) and colorectal adenoma (CRA), the precursor of CRC, is crucial for CRC prevention.It is believed that opportunistic screening of CRC in high risk population would narrow down the screening scope and save the health resources, and is suitable for the present status in China.Aims:To analyze the performance of high risk factors in predicting CRC/CRA, for exploring the feasibility of opportunistic screening for CRC in high risk population.Methods:A total of 1 862 outpatients and health examination subjects undergoing colonoscopy from Feb.2015 to Aug.2016 at the PLA 281 Hospital were recruited and asked to complete a questionnaire of high risk factors for CRC and CRA before colonoscopy.The questionnaire was designed based on the updated consensus on the screening and management of early colorectal cancer and precancerous lesion in China.Using the results of colonoscopy as gold standard, the predictive performance of high risk factors for CRC/CRA was analyzed.Results:Four hundred and sixty-eight (25.1%) individuals with high risk factors for CRC/CRA were screened out by the questionnaire.The detection rate of CRC in individuals with high risk factors was significantly higher than those without (17.5% vs.0.9%, P=0.000).The sensitivity, specificity, positive and negative predictive values of high risk factors in predicting CRC were 87.2%, 78.2%, 17.5% and 99.1%, respectively, and the missed diagnosis rate was 12.8%.For CRC/CRA, the corresponding figures were 83.2%, 87.0%, 57.3%, 96.1% and 16.8%, respectively.The risk ratios (RR) of high risk factors for CRC and CRC/CRA were 20.35 and 14.78, respectively.Conclusions:Opportunistic screening of CRC in high risk population is feasible and applicable in China under present condition.

Objective To study the scan parameter of spiral CT angiography in aortic dissection.Methods 34 cases with aortic dissection successively underwent SCTA were studied retrospectively.The CT scan parameters,methods of posteriorimage treating were reviewed and analysed one by one.Results In 34 cases,32 cases were diagnosed as aortic dissection and classified correctly,in accordance with the result of operation and DSA,the quality of image was satisfied and the rate of success at least above 88.9%.The use of main scan parameters:(1)the ascend aortic dissection:slice thickness 4 mm,reconstruction interval 2 mm,pitch 1.25;tube current 175 mA;(2)involed in ascend,arch,descend and throacic aorta dissection:slice thickness 5 mm,reconstruction interval 2～3 mm,pitch 1.5;tube current 150 mA;(3)involved in abdominal aortic dissection:slice thickness 6～8 mm,reconstruction interval 2～3 mm,pitch 1.5 or 1.75;tube current 125 mA.The tube voltage all were 120 kV,the dosage of contrast media was 90～100 ml;the delayed scan time was choiced 20 second in throacic aortic and 25 second in abdominal aortic.The posterior image methods main used MPR,SSD,MIP and VR. Conclusion To set a sensible scaning plan,choose and match scan parameters properly according to the scaning length,can avoid the shortage of restrain SCTA scaning length and get satisfied image.

Objective:To explore the differences of CBCT image gray value of commonly used dental materials.Methods:CBCT was used to scan 36 kinds of commonly dental material blocks,the tomographic image gray value was measured by Mimics software.Re-sults:CBCT image gray values of the materials were obtained.There were differences of the gray values of the materials not only among the different types,but also among the different varieties of the same materials.Conclusion:The discipline of CBCT image gray value differences of commonly used dental materials provided an objective basis for the establishment of 3D digital model including dental ma-terials.

Objective: To evaluate the inhibitory role of a novel oncolytic adenovirus (OA), GP73-SphK1sR-Ad5, on the growth of hepatocellular carcinoma (HCC). Methods: GP73-SphK1sR-Ad5 was constructed by integrating Golgi protein 73 (GP73) promoter and sphingosine kinase 1 (SphK1)-short hairpin RNA (shRNA) into adenovirus serotype 5 (Ad5), and transfecting into HCC Huh7 cells and normal human liver HL-7702 cells. The expression of SphK1 and adenovirus early region 1 (E1A) was detected by quantitative real-time PCR (qRT-PCR) and western blot, respectively. Cell viability was detected by methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay, and apoptotic rate was determined by flow cytometry. An Huh7 xenograft model was established in mice injected intratumorally with GP73-SphK1sR-Ad5. Twenty days after injection, the tumor volume and weight, and the survival time of the mice were recorded. The histopathological changes in tumor tissues were observed by hematoxylin-eosin (HE) staining and transmission electron microscopy (TEM). Results: Transfection of GP73-SphK1sR-Ad5 significantly upregulated E1A and downregulated SphK1 in Huh7 cells, but not in HL7702 cells. GP73-SphK1sR-Ad5 transfection significantly decreased the viability and increased the apoptotic rate of Huh7 cells, but had no effect on HL7702 cells. Intratumoral injection of GP73-SphK1sR-Ad5 into the Huh7 xenograft mouse model significantly decreased tumor volume and weight, and prolonged survival time. It also significantly decreased the tumor infiltration area and blood vessel density, and increased the percentages of cells with nucleus deformation and cells with condensed chromatin in tumor tissues. Conclusions: GP73-SphK1sR-Ad5 serves as a novel OA and can inhibit HCC progression with high specificity and efficacy.

In order to study the analgesic effect of Shaoyao Gancao Decoction, this paper discussed material basis and mechanism from the perspective of macromolecules in traditional Chinese medicine. Inspired by the phenomenon of turbidity after boiling Chinese medicine, this experiment took Shaoyao Gancao Decoction as the research object to study the formation process of precipitation during boiling. The results showed that aggregates with a certain shape were formed in the solvent during the boiling process, and the precipitate was obtained by standing and centrifuging. Analysis found that the precipitation was mainly composed of small molecules such as paeoniflorin, albiflorin, liquiritin, glycyrrhizic acid, isoliquiritin and gallic acid, and macromolecules such as protein and polysaccharide. The composition of precipitate was consistent with that of Shaoyao Gancao Decoction, but the analgesic effect of Shaoyao Gancao Decoction after removing the precipitate was significantly reduced. Based on these results, we isolated small molecular compounds, polysaccharides and protein from Shaoyao Gancao Decoction and their contents are 60.4, 700.7 and 207.2 mg·g^-1 respectively. We get the ratio, polysaccharide: small molecule = 11.6∶1, protein: small molecule = 3.4∶1, the precipitate is prepared in the state of boiling. The characterization results showed that the particle size of the precipitate will change significantly after co-heating, and the content determination results showed that the content of the six small molecular compounds which was free in solvent was significantly reduced after the formation of the precipitate. The acetic acid writhing experiment proved that the precipitate has a good analgesic effect, and effectively reduced the levels of inflammatory factors prostaglandin E2 and nitric oxide, and increased the level of anti-inflammatory factor interleukin-10. These results proved that the precipitate in Shaoyao Gancao Decoction is an important material basis for analgesic effect, and macromolecules such as protein and polysaccharide are the main components of the precipitate. The study of macromolecules in the precipitate of Shaoyao Gancao Decoction not only provides new ideas and methods for elucidating the pharmacodynamic material basis of Shaoyao Gancao Decoction, but also provides a reference for analyzing the scientificity of traditional decoction.

Objective To detect plasma amino-terminal pro-brain natriuretic peptide (NT-ProBNP) ,D-Dimer levels in the pa-tients with acute pulmonary embolism (APE) in order to investigate their change characteristics and significance .Methods Among 60 patients with suspected APE ,40 cases diagnosed by CT and meeting the thrombolytic condition were set as the experimental group and other 20 cases of excluded APE by CT as the control group .Plasma NT-ProBNP and D-dimer before treatment in the two groups and after 2-week thrombolytic therapy in the experimental thrombolysis were detected and compared .Results The diagnos-tic sensitivity of NT-ProBNP for early APE was 92 .3% and the specificity was 65% ,while the diagnostic sensitivity of D-dimer for early APE was 100% and the specificity was 70% ;the plasma NT-ProBNP and D-dimer levels before thrombolysis in the experi-mental group were significantly higher than those in the control group with statistical differences (P<0 .01) .Conclusion Plasma NT-ProBNP and D-dimer has important clinical significance for APE and can provide the basis for the early diagnosis and the cura-tive effect observation of the patients with APE .

Objective To analyze the mammographic features of invasive lobular carcinoma (ILC)compared to those of invasive ductal carcinoma (IDC).Methods Twenty cases with ILC and 95 cases with IDC were retrospectively evaluated by two breast radi-ologists according to the Breast Imaging Reporting and Data System (BI-RADS)lexicon.The mammographic findings were com-pared between ILC and IDC with the independent samples chi-square test or Fisher’s exact test,as appropriate.Results Mass was the most common finding in both ILCs and IDCs,but less frequent in ILCs (36.4% vs 63.9%,P =0.008).Mass in ILCs was more frequently lobular or irregular shape with spiculated margin.Architectural distortion and focal asymmetry were more frequent in ILCs than in IDCs,however,the differences were no significant.The frequency of calcifications was not significantly different between the two groups.The distributions of calcifications were more regional in ILCs,and more segmental or linear in IDCs (P =0.01).Conclu-sion ILCs are more usually shown as non-mass appearances on mammography.ILCs that appeared as mass are more frequently ir-regular in shape with spiculated margins.

Objective To investigate the incidence and risk factors of surgical site infection(SSI) in patients with internal fixation surgery for limb fracture.Methods Medical data of patients with internal fixation surgery for limb fracture in a hospital from January 2013 to January 2016 were collected, 39 patients with SSI following internal fixation was as infection group, according to the 1:2 ratio, 78 patients without SSI following operation during the same period were randomly selected as the control group, risk factors of SSI were analyzed.Results Among 4 125 patients undergoing internal fixation surgery, incidence of SSI was 0.95% (n=39), the positive rate of bacterial culture in infection group was 87.2% (34/39), a total of 38 strains of pathogenic bacteria were isolated, among which 22 were gram-positive strains (57.9%), 15(39.5%)were gram-negative strains,1(2.6%) was fungi,Staphylococcus aureus was the main pathogenic bacteria (47.4%), and there were 20 isolates of multidrug-resistant organisms.Univariate analysis showed that infection group and control group was significantly different in the following aspects: combined underlying diseases, time from injury to operation≥8 hours, open fracture, multiple fracture, duration of operation≥180 minutes, intra-operative blood loss≥400 mL, allogeneic blood transfusion, duration of postoperative indwelling drainage tube≥5 days, and average length of hospital stay≥14 days (all P<0.05).Multivariate logistic regression analysis showed that the following factors were risk factors for SSI following internal fixation surgery for fracture: time from injury to operation≥8 hours, open fracture, duration of operation≥180 minutes, duration of postoperative indwelling drainage tube≥5 days, and average length of hospital stay≥14 days (all P<0.05).Conclusion Risk factors for SSI in patients with internal fixation surgery for limb fracture are multiple, reducing risk factors has a positive effect on decreasing the incidence of SSI and improving the cure rate.