AIM:To study the effect of neuregulin-1 ( NRG-1β) or captopril alone and their combination on myocardial cell apoptosis and related gene expression in rats with chronic heart failure .METHODS:Young male Sprague-Dawley rats were randomly divided into sham-operated group, heart failure group, NRG-1βgroup, captopril group and combined treatment group .The volume overloaded heart failure model in the rats was established by aortocaval fistula .The cardiac function was evaluated by determining the changes of hemodynamics and plasma BNP level .The apoptotic index ( AI) of myocardial cells was assayed by TUNEL .The protein levels of p-Akt, Bax and Bcl-2 in left ventricular tissue were detected by Western blot .RESULTS: The LVEDP, AI and the expression of Bax were significantly lower in NRG-1βgroup, captopril group and combined treatment group than those in heart failure group ( P<0.05 ) , while the values of ±dp/dtmax and the protein levels of p-Akt and Bcl-2 were significantly higher in NRG-1βgroup, captopril group and com-bined treatment group than those in heart failure group (P<0.05).The effect of combined treatment group was more signifi-cant ( P<0.05) than that in NRG-1βgroup and captopril group .CONCLUSION: Neuregulin-1βor captopril alone and the combination of them effectively improve the cardiac function and inhibit myocardial cell apoptosis in chronic heart failure rats.The therapeutic effect of combination of NRG-1βand captopril is better than that of NRG-1βor captopril alone .

Objective To evaluate the effects of the treatment for femoral neck fractures with closed reduction and cannulated screw fixation.Methods The results of stabilization of the femoral neck fracture with cannulated screws in 62 patients(25 male,37 female)from 2001to 2008 were reviewed retrospectively.The mean age of the patients was 68.6 years old.Results 55 patients(88.7%)had cured,30 patients were been cured,25 patients were been good healthy ,7patients were not cured.The duration of follow up was 8-62 months in 62 patients.Conclusion Closed reduction and internal fixation with cannulated screw is an effective method of minimally invasive,safety and inexpensive for femoral neck fractures.

Objective To evaluate the clinical effect of hydrotalcite in treatment of bile reflux gastritis.Methods66 patients with bile reflux gastritis were chosen in our hospital from May 2013 to May 2014 as the research object, according to the order of admission they were divided into two groups, 33 cases of control group were treated with sucralfate treatment, observation group patients were treated with hydrotalcite comparative analysis, clinical curative effect in the observation group and the control group of patients were compared.ResultsAfter treatment for a period of time after the 33 patients in the control group,the total effective treatment for 28 cases, the total effective rate was 84.85%, the observation group of 33 cases of patients treated with total effective number of 32 cases, the total effective rate was 96.97%.The effective rate of the observation group was significantly higher than that of the control group(P<0.05).After the corresponding treatment, the incidence of complication in the control group was 15.15%, the observation group was 9.09%.There was no significant difference in the incidence of complications between the two groups.ConclusionThe use of hydrotalcite in treatment of bile reflux gastritis clinical curative effect significantly, can improve the treatment efficiency to a certain extent, high safety.

Objective To find an easy and proper way to differentiate metastatic breast cancer from second primary breast cancer by analyzing the histopathological characteristics of 40 patients with bilateral breast cancer.Methods According to the Chaudary histological criteria,the histopathological and biological characteristics of 16 cases of synchronous bilateral breast cancer and 24 cases of metachronous bilateral breast cancer were evaluated.The histopathological and biological characteristics included Nottingham histological grade,immunohistochemistry (IHC) results of the estrogen receptor,progesterone receptor and expression of Her-2.Results The average age of the 40 patients at first diagnosis was 41 years old (range,26-68 years old).The average time interval between first and second diagnosis of tumors was 34 months (range,7-209 months) in metachronous cancer.The concordant histopathological type was found in 93.8 ％ (15/16) of synchronous cancer patients and 58.3 ％ (14/24) of metachronous cancer patients (P =0.02).The concordance rates of tumor stage was 68.8 ％ (11/16) in synchronous cancer patients,while it was 25.0 ％ (6/24) in metachronous cancer patients (P =0.03).For progesterone receptor status,the concordance rates were 87.5 ％ (14/16) and 54.2 ％ (13/24) in synchronous and metachronous cancer patients respectively (P =0.03).There was no statistically significant difference in terms of estrogen receptor status and Her-2 expression (P ＞ 0.05).Conclusions Without considering the limitation of Chaudary criteria and the number of patients,it seems to be an easy and proper way to differentiate metastatic cancer from second primary cancer in the patients with bilateral breast cancer by combining the histopathological type,tumor stage and progesterone receptor status.The synchronous cancer is closer to same clonal lesion (metastatic lesion).

Objective To analyze the efficacy and safety of suprapubic arc sling (SPARC) and transobturater vaginal tape (TOT) for female stress urinary incontinence (SUI). Methods A retrospective study was conducted on 275 women ( 139 in TOT group and 136 in SPARC group) in our institute from September 2008 to January 2011.We had compared the complications of the two groups.All the patient's ICI-Q-SF scores and PISQ-12 scores were collected.We compared the pre- and post-operative Qmax and PVR to find out if SPARC or TOT tap cause bladder outlet obstruction (BOO). Results The operative time was 25.1 ± 3.3 min for TOT and 34.8 ± 5.6 min for SPARC.There was statistical difference between the two groups in the aspects of operative time (P =0.00).The improvements of average symptom and QOL scores in patients undergoing TOT and SPARC were statistically significant (P =0.00).The improvements of the PISQ-12 scores in the two groups were statistically significant (P ＜0.05 ) as well.There was no significant difference (P ＞ 0.05 ) in the total cure rate of TOT and SPARC.The complications post SPARC and TOT were low.In the TOT group,the Qmax changed from 30.2 ± 8.7 ml/s per-operatively to 24.9 ± 8.6 ml/s post-operatively in a week.PVR changed from 1.6 ± 4.2 ml pre-operatively to 3.2 ± 6.5 ml post-operatively in a week.In the SPARC group,the Qmax changed from 31.7 ±9.4 ml/s pre-operatively to 26.9 ± 8.9 ml/s post-operatively in a week.PVR changed from 1.4 ± 3.7 ml pre-operatively to 3.5 ± 6.3 ml postoperatively in a week.All the changes were significant ( P ＜ 0.05 ).And in the SPARC group,the Qmax changed from 31.2 ± 10.0 ml/s pre-operatively to 26.2 ± 9.1 ml/s post-operatively; the PVR changed from 1.8 ± 3.2 ml pre-operatively to 4.7 ± 8.8 ml post-operatively (P ＜ 0.05). Conclusions Both the TOT sling and the SPARC sling have high cure rates for SUI.But the retropubic sling may lead to BOO and other complications,so the transobturate sling is a better treatment option for SUI.

Objective To assess the safety and efficacy of the transohturator tape (TOT) for surgical treatment of female stress urinary incontinence (SUI). Methods Clinical data of 206 TOT procedures for female urinary incontinence from Jan 2007 to Dec 2009 was retrospectively analyzed.Thirty-one women were identified as having mixed stress urinary incontinence.The mean age was 54.29 years(range,32-81 years),themean disease coursewas 10.31 years (range,1-40 years),and the mean follow-up time was 17.3 months (range,3-39 months).Therapeutic effects were assessed by Grouts-Blaivas outcome score.The results of the operation,complications and changes of urodynarnics were observed. Results The TOT operations were conducted under local anesthesia.The mean operative time was 23.9 min (range,16-35 min),Mean blood loss was 17.8 ml(range,15-30 ml).Short-term complications were as follows:thigh pain 14.08%,dysuria 5.83%,urinary posture change 0.97% and urinary retention 0.49%.The long-term complication rate was 0.97%,including vaginal wall defect and tape exposure in one case:the burr of tape exposure and sex life influence in one case.Long-term symptoms disappeared completely in 202 cases.The cure rate was 98.06%,and the rate of satisfaction was 100%. Conclusions Our results demonstrate that TOT procedure is a minimally invasive,safe and effective surgical treatment for stress urinary incontinence.

Objective To explore the effect of the three level storehouse system on ward drug management.Methods The three level storehouse system was established in our hospital,which includes drug demanding quantity of ward,delivering quantity of the drug storehouse,and management supervision of pharmacy.Result After implementing three level storehouse system, the incidence of medicine expiry,improper storage,drug reception,confused marking ,improper placement and incorrect drug administration were decreased(P<0.05).Conclusion The three level storehouse system could improve the quality of hospital drug management as well as ensure clinical medication safety.

Objective To investigate the influence of combined thrombolysis therapy on clinical effects for short -and long -term of patients with acute cerebral infarction caused by sudden occlusion of anterior and posterior circulation.Methods 75 patients with cerebral infarction caused by sudden occlusion of anterior and posterior circulation were chosen and divided into A group (46 patients)with sudden occlusion of anterior circulation and B group (29 patients)with sudden occlusion of posterior circulation by comprehensive therapy for intra -arterial thrombolysis combined with mechanical crushing and dilation.The recanalization rate,the excellent and good rate of ADL -Barthel score,NIHSS score and GCS score before and after treatment,intracranial hemorrhage rate and mortality rate of two groups were compared.Results The recanalization rates of A group and B group were 50.00%(23 /46), 89.66%(26 /29).After treatment,the excellent and good rates of ADL -Barthel score of A group and B group were 58.70%(27 /46),62.07%(18 /29).The recanalization rate of B group was significantly higher than A group(χ2 =7.44,P <0.05).There was no significant difference in the excellent and good rate of ADL -Barthel score after treatment between the two groups(χ2 =1.21,P >0.05).After treatment,the NIHSS scores of A group and B group were (8.66 ±2.48)points,(8.72 ±2.51 )points,the GCS scores of A group and B group were (12.89 ± 3.61)points,(13.10 ±3.72)points.There were no significant differences in NIHSS score and GCS score after treatment between the two groups(t =1.47,1.52,all P >0.05).After treatment,the intracranial hemorrhage rate of B group was significantly lower than A group (χ2 =8.16,P <0.05 ).There was no significant difference in the mortality rate between the two groups(χ2 =0.98,P >0.05).Conclusion Compared with acute cerebral infarction caused by sudden occlusion of anterior circulation,combined thrombolysis therapy in treatment of patients with sudden occlusion of posterior circulation has advantages including higher recanalization rate and lower risk of intracranial hemorrhage.

OBJECTIVE: To provide the anatomic data for the correlated otologic microsurgery by the microdissection of temporal bone through facial recess approach. METHOD: Sixteen human temporal bones of eight adult cadaveric heads were dissected under surgical microscope through facial recess approach, and the relative anatomic structures were observed and measured, such as the bony entrance of facial recess approach, facial nerve, stapes, round window, round window niche, pyramidal eminence, cochleariform process, etc. The data were analyzed statistically. RESULT: The width of the bony entrance of facial recess approach was (2.94 +/- 0.32) mm, the height was (8.83 +/- 0.84) mm, the depth was (3.51 +/- 0.17) mm. The distances from stapes to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, cochleariform process and anterior ligament of malleus were (1.38 +/- 0.21) mm, (6.94 +/- 0.47) mm, (3.60 +/- 0.55)mm, (2.23 +/- 0.33)mm, (4.93 +/- 0.61) mm, respectively. The distances from pyramidal eminence to tympanic segment of facial nerve, mastoid segment of facial nerve, round window, round window niche and cochleariform process were (1.05 +/- 0.09) mm, (5.63 +/- 0.41) mm, (3.01 +/- 0.34) mm, (3.29 +/- 0.44) mm, (4.13 +/- 0.51) mm, respectively. The distances from round window to cochleariform process and tympanic segment of facial nerve were (5.11 +/- 0.61) mm and (3.97 +/- 0.61) mm. The distances from round window niche to tympanic segment of facial nerve and mastoid segment of facial nerve were (4.13 +/- 0.38) mm and (7.28 +/- 0.29) mm. CONCLUSION The facial recess approach played an important role in modern otologic microsurgery. The position of anatomical structure was constant relatively, including short crus of incus, stapes, pyramidal eminence and cochleariform process, etc. These could be used as reference marks for otologic microsurgery.
Adult ; Ear, Middle ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; surgery ; Humans ; Microsurgery ; Round Window, Ear ; anatomy & histology ; surgery ; Stapes ; anatomy & histology ; Temporal Bone ; anatomy & histology ; surgery

Objective To investigate and analyze the clinical effect of neural interventional treatment in cerebrovascu-lar diseases. Methods 50 patients with cerebrovascular disease who hospitalized in our department from May 2010 to May 2014 were selected. According to their willingness, they were divided into the observation group and the control group. They were given the satisfaction investigation after operation, which included patients' symptoms (physical activity, language, consciousness and headache), body condition (muscle tension classification) and satisfaction of related compli-cations (hemorrhage of digestive tract, infection of lung and heart conditions etc.) remission. Results DSA showed that carotid and vertebral artery stenosis of the observation group (with more than 75% reduction) were superior to those of the control group (with about 45%reduction). 1 case in the control group recurred, and the observation group had lower cerebral vascular recurrence rate. Postoperative satisfaction results showed that satisfaction of the observation group (92.68%) was higher than that of the control group (44.44%) and the neural interventional treatment was more satisfying for patients with cerebrovascular disease (P<0.05). Conclusion Neural interventional therapy is not only remarkably curative, but also helpful for the recovery and life quality improvement of patients. It should be promoted in clinic.