Objective To evaluated the safety and complications of endovasdcular stenting for symptomatic carotid stenosis with surgical high risk.Methods A series of 11 vessels in 9 patients at surgical high risk were treated by endovascular stenting. The complications during the procedures and postoperative periods were analyzed within one to five months. Results All of the operations were successfully performed without any serious complications. During the follow up period (averaging 6 months), there were no complications of TIAs, stokes and restenoses.Conclusions The study suggests that endovascular stenting may be safe and effective for patients at surgical high risk, but further more study is needed.

Objective To assess the clinical effect and methods of posterior decompress and fixation for upper-middle thoracic fracture and dislocation. Methods Between September 2002 and September 2007,21 patients suffered from upper-middle thoracic fracture and dislocation were treated with posterior approach, which comprising 5 patients with compressed fracture,4 patients with burst fracture, 12 patients with fracture and dislocation. There were 12 cases companied by complete paraplegia, and 9 cases companied by incomplete paraplegia. All cases adapted to pedicle screw fixation system after decompression and reduction. Reduction or removal of fragments was done through posterior-lateral of the spinal canal for patients with fragments migrated into the spinal canal. The operation time,blood loss volume,preand postoperative transverse displacement degree and angle of the injured vertebra were recorded. The neurological function was assessed by Frankel criteria. Results The patients was followed up for (2.5 ± 0.5 ) years. The Frankel score increased from ( 1.0 ± 0.1 ) scores preoperatively to ( 1.3 ± 0.1 ) scores postoperatively. The incomplete paraplegia patients' score increased from (2.2 ± 0.2) scores preoperatively to (3.1± 0.2) scores postoperatively. The height of injured vertebral body, the interangle of vertebral body and spondylolistheses after operation increased comparing with those before operation(P ＜ 0.05 ). No implant loosening or breakage was found. Conclusions Severe spinal cord injury occurs in upper-middle thoracic fracture and dislocation.Unstable fracture should be treated with internal fixation and fusion in time. Decompression ought to be done in patients who suffering from incomplete paraplegia. Early operation takes advantages of immediate stability and a good improvement of the neurologic function.

OBJECTIVE:To determine 5-Fu concentration in serum,peritoneal fluid and tissue by HPLC in patients undergoing rectal cancer operation and receiving regional chemotherapy.METHODS:20 patients who undergoing rectal cancer operation and receiving regional chemotherapy were administered with drugs,whose blood samples were taken from portal veins,peripheral veins,peritoneal fluid and tissues around tumor at 2,5,10,20,30 and 60min,respectively after administration for the determination of 5-FU by HPLC.RESULTS:Peak concentrations in all samples appeared 2 minutes after administration,but lowered gradually thereafter.The drug level in peritoneal fluid was the highest,but was the lowest in the tissue,and that in the portal vein was higher than in peripheral veins.CONCLUSION:For patients who undergoing rectal cancer operation,regional chemotherapy could maintain 5-FU concentration at a higher level in portal vein,peritoneal fluid and tissue around cancer,which has significance in the prevention of metastasis to the local sites and liver after rectal cancer operation.

Objective To evaluate the clinical results of uncemented fully porous-coated long femoral stems in treating Vancouver type B2 periprosthetic femoral fracture following hip arthroplasty.Methods A retrospective analysis was made on 12 patients (12 hips) with Vancouver type B2 periprosthetic femoral fracture treated using the uncemented fully porous-coated long femoral stem prosthesis combined with cerclage fixation with steal-wire or titanium cable devices from February 2006 to January 2013.There were 5 males and 7 females,aged average 69.8 years (range,62 to 79 years).The status of primary arthroplasty was uncemented bipolar hemiarthroplasty in 2 patients and total hip arthroplasty in 10 patients (2 cement and 8 cementless femoral stems).At the final follow-up,Harris hip score for clinical evaluation,Beals and Tower's criteria for radiological evaluation,and complications were recorded.Results There were no intra-operative complications such as femoral perforation and femoral fracture.All patients were followed up for mean 38 months (range,24-72 months).At the last followup,mean Harris hip score was 87.2 points (range,50 to 100 points).All fractures healed at average 16 weeks (range,12-28 weeks).All the 12 hips showed prosthesis stability despite there was one femoral stem subsidence of 3 mm.One patient slipped and sustained another periprosthetic fracture (Vancouver type B1) at postoperative 4 months and was treated successfully with locking plate and cables.According to the Beals and Tower's criteria,there were 10 excellent,1 good and 1 poor results.Final follow-up revealed no complications of deep vein thrombosis,dislocation and prosthesis loosening.Conclusion Uncemented fully porous-coated long femoral stems provide good primary stability that promotes fracture healing and offers a reasonable treatment of Vancouver B2 femoral periprosthetic fracture.

AIM: To explore the effects of hydrogen sulfide (H_2S) on proliferation of vascular smooth muscle cells (VSMC) stimulated by endothelin (ET-1, 10 -7 mol/L ) and mitrogen-activated protein kinase (MAPK) activity in VSMCs. METHODS: Cultured VSMCs were divided into six groups: (1) control group, (2) serum group, (3) endothelin group, (4) NaHS groups, (5) serum+NaHS group, and (6) endothelin+NaHS group. VSMC proliferation was measured by [ 3H]-TdR incorporation and MAPK activity in VSMC was determined by radioactivity assay. RESULTS: ET-1 increased VSMC [ 3H]-TdR incorporation by 2.39 times ( P

The 3T road map proposed by Dougherty and Conway views translational research as a continuous process that moves from basic research through clinical (T1),postclinical (T2),and practice-based research and ultimately to health policies,outcomes,and impacts (T3).It can be used as a fundamental framework for evaluating and measuring translational research.The citation networks between publications may reveal translational interfaces,translational path,and translational lag in a specific research field,which can help researchers understand the critical content and road maps during their translational research,and thus accelerate translational medicine during T1,T2,and T3 phases of translational research.Based on the citation networks,we built a two-dimensional model for measuring the process of translational research.

Objective To investigate the value of quantitative assessment of hepatic fibrosis and indocyanine green measurement in predicting hepatic functional reserve in rats with liver cirrhosis.Methods Female Wister rats were divided into normal control and cirrhotic group,and cirrhotic models were established.Quantitative assessment of hepatic fibrosis was done by use of computer-assisted digital image analysis,and R15ICG was measured.Results Differences of R15ICG and quantitative assessment of hepatic fibrosis between the two groups at 8 and 10 weers after hepatic fibrosis model was established were statistically significant(P

Objective To compare and analyze MRI characteristics of medical patellofemoral ligament(MPFL) injury patterns in adolescents and adults after acute lateral patellar dislocation.Methods MR images of 42 adolescents and 45 adults after acute lateral patellar dislocation were retrospectively reviewed.Routine MR scanning was performed in axial,sagittal and coronal planes,including T1 WI,T2 WI and fat saturation sequence.The x2-tests were performed to analyze the MPFL injury patterns between adolescent group and adult group.Results The prevalence rate of MPFL injury was 97.6％ (41/42) in adolescent group after acute lateral patellar dislocation,including 57.1％ (24/42) of complete tear and 40.5％ (17/42) of partial tear.The prevalence rate of MPFL injury was 100.0％ (45/45) in adult group,including 64.4％ (29/45) of complete tear and 35.6％ (16/45) of partial tear.There were no statistical difference between adolescents and adults in prevalence rate of MPFL injury,complete MPFL tear,partial MPFL tear (x2 =1.084,0.486,0.223 ; P ＞ 0.05).The prevalence rate of MPFL injury at femoral attachment,patellar attachment and midsubstance were 31.0％ (13/42),78.6％ (33/42) and 26.2％ (11/42) respectively in adolescent group,whereas they were 64.4％ (29/45),40.0％ (18/45) and 15.6％ (7/45) respectively in adult group.It occurred at multiple sites in 33.3％ (14/42) of adolescents,and in 15.6％ (7/45) of adults.There were significant differences between adolescents and adults in the prevalence rate of MPFL tear at femoral attachments and patellar attachments (x2 =9.759,13.324 ; P ＜ 0.05),but there was no statistical difference at its midsubstance (x2 =1.497,P ＞ 0.05).Although not statistically significant (x2 =3.749,P ＞ 0.05),MPFL tear at multiple locations were seen more in adolescents than in adults (33.3％ vs.15.6％).Conclusion The injury degree and distribution of MPFL are similar in adolescents and adults after acute lateral patellar dislocation,but there is significant difference in the site of MPFL injury distribution between adolescents and adults.MPFL is most easily injured at femoral attachment,secondly at patellar attachment in adults,while MPFL is most easily injured at patellar attachment,secondly at femoral attachment in adolescents.Adolescents are more likely to have multiple-site MPFL injury than adults.

Objective To evaluate the clinical significance of juxtapaillary duodenal diverticula (JPDD) in patients of acute calculous cholangitis (AC) with different severity grade.Methods A retrospective analysis was carried out for 488 AC cases of different severity from January 2011 to December 2013 who underwent duodenoscopy in Dongyang People's Hospital.Results Of the 488 patients, the JPDD was found in 2.87％, 6.15％ and 4.10％ in patients with mild, moderate and severe AC, respectively.The prevalence of JPDD in severe AC were significantly higher in the moderate and mild AC (x2 =4.486, P =0.034;x2 =14.686, P ＜ 0.001);Procalcitonin (PCT) concentrations in severe AC of JPDD were significantly higher in moderate and mild AC of JPDD (t =10.420 9, P ＜ 0.001;t =4.870 4, P ＜ 0.001).The cannulation failure rate and the amylase were significantly higher in JPDD patients compares to patients without JPDD (x2 =36.95, P ＜ 0.001;t =8.29, P ＜ 0.001).Conclusions JPDD detection rate increases with aging and seems to be associated with acute cholangitis (AC) with different severity grade and PCT concentration.JPDD predicts a higher cannulation failure rate and the amylase level after duodenoscopy.