Objective To study the relationship between plasma level of tissue factor(TF)and severity of coronary heart disease(CHD).Methods Coronary angiography was performed in 237 patients with suspected CHD,with 149 diagnosed as CHD and 88 excluded.Seventy of stenosis of coronary arteries (CA)was evaluated by modified Gensini score on the basis of angiographic imaging.Blood glucose,serum levels of total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein(a)[Lp(a)],uric acid,high sensitivity C-reactive protein(Hs-CRP),fibrinogen(FIB)and plasma level of TF were determined for all the subjects.Relationship between plasma level of TF and severity of pathological changes in CA was evaluated by linear correlation and multiple regression analyses for controlling other relevant factors.Results Plasma level of TF in patients with CHD[(138±39)ng/L]was significantly higher than that in controls[(61±19)ng/L](P＜0.01).Plasma level of TF obviously correlated with severity of pathological changes in CA(r=0.710,P＜0.01).Partial correlation analysis showed a positive correlation between plasma TF and severity of pathological changes in CA,independent of other potential influential factors,with a partial coefficient of correlation of 0.509(P＜0.01).Multiple stepwise regression analysis indicated that plasma level of TF associated with severity of pathological changes in CA,as well as with diabetes,LDL-C,Lp(a),Hs-CRP and FIB,with coefficients of correlation of 0.172,0.180,0.147,0.308 and 0.175,respectively(P＜0.05).Conclusion Elevated plasma level of TF may be one of important risk factors for CHD,which reflects severity of pathological changes in CA.

Base on the data of blood pressure, plasma lipid, Glu and UA by physical test, Support Vector Machine (SVM) was applied to identify coronary heart disease (CHD) in patients and non-CHD individuals in south China population for guide of further prevention and treatment of the disease. Firstly, the SVM classifier was built using radial basis kernel function, liner kernel function and polynomial kernel function, respectively. Secondly, the SVM penalty factor C and kernel parameter sigma were optimized by particle swarm optimization (PSO) and then employed to diagnose and predict the CHD. By comparison with those from artificial neural network with the back propagation (BP) model, linear discriminant analysis, logistic regression method and non-optimized SVM, the overall results of our calculation demonstrated that the classification performance of optimized RBF-SVM model could be superior to other classifier algorithm with higher accuracy rate, sensitivity and specificity, which were 94.51%, 92.31% and 96.67%, respectively. So, it is well concluded that SVM could be used as a valid method for assisting diagnosis of CHD.
Algorithms ; China ; Coronary Artery Disease ; diagnosis ; Discriminant Analysis ; Humans ; Models, Theoretical ; Neural Networks (Computer) ; Sensitivity and Specificity ; Software ; Support Vector Machine

Objective To summarize our operational experience in using unusual renal allografts.Methods The plastic operations of 326 unusual renal allografts were retrospectively and the renal transplant outcome was compared with 542 normal renal allografts an the same time. Results All the 326 unusual renal allografts were utilized. There was no significant difference between unusual renal allografts and usual ones in average serum creatinine level, acute tubular necrosis (ATN) and the survival rate of renal allgraft after 1 year. There was no complications related to plastic operation during or after kidney transplantation.Conclusions By making good use of various kinds of plastic operation, abnormal or injuried renal allografts can also be used safely without affecting the outcome after renal transplantation.

Objective To investigate the time-course of mRNA and protein expression of inducible nitric oxide synthase (iNOS) in pulmonary artery and thoracic aorta and the difference in mRNA and protein expressions of iNOS between pulmonary artery and thoracic aorta induced by endotoxemia in rats. Methods Forty-eight Wistar rats of both sexes weighing 350-450g were randomly divided into 2 groups: control group in which animals received normal saline intraperitoneally (ip) and were killed 3h later by dislocation of cervical vertebrae (n=12); test groups in which animals were injected intraperitoneally lipopolysaccharide (LP) 4mg-kg-1 in 2ml of normal saline and were killed after 3h ( n = 12), 8h ( n = 12) , and 48h( n = 12) . Chest was opened immediately and pulmonary artery (PA) and descending thoracic aorta ( TA) were removed. mRNA and protein expression of iNOS in PA and TA were measured by RT-PCR and Western blot.Results The mRNA and protein expressions of iNOS in PA peaked at 8h and that in TA at 3h after ip LPS injection. The levels of mRNA and protein expressions of iNOS in both PA and TA returned to control level at 48h after ip LPS injection. The levels of mRNA and protein expressions of iNOS in PA at 3h and 8h after ip LPS injection were significantly higher than those in TA.Conclusion The mRNA and protein expressions of iNOS in PA and TA after LPS injection are time-dependent. The mRNA and protein expressions of iNOS in TA after LPS injection are earlier than those in PA but the level of mRNA and protein expressions of iNOS in PA after LPS injection is higher than that in TA.

Objective To investigate the use of cardiopulmonary auscultation model in clinical skills teaching, and students' feeling about this teaching form. On the basis of this teaching model, we have reflected on the teaching mode. Methods Through the questionnaire survey, 145 medical stu-dents of grade 2009 were asked to investigate their learning experience about cardiopulmonary aus-cultation model and other aspects of it. Results There are 71.7% students liking cardiopulmonary auscultation model in teaching; 96.5% students can establish contacting abnormal cardiopulmonary auscultation signs with cardiovascular diseases after the training; There are 91.7% students thinking teaching hours about auscultation model is not enough. For the open question “what do you think is the difficulty of cardiopulmonary auscultation learning?” The representative answer is: I think car-diopulmonary auscultation is unable to recognize visual things. Conclusion Cardiopulmonary aus-cultation model can successfully improve the students' clinical skills and achieve good teaching effect. Students have a positive and supportive attitude to it.

20% ) were assigned to 2 groups according to study intervention: group A ( n =72) receiving DFPP and group B ( n =41) as controls.Group A was subdivided into 2 groups:group A1 ( n =44) was treated by DFPP alone and group A2 ( n =28) was treated by DFPP plus Dac.The incidence rates of HAR,AR,adverse reaction,patie nt/kidney survival,kidney function were observed. All the patients obtained a fo llow-up ≥12 months. Results In 72 patients of group A ,the level of PRA decreased from (60.5?17.7)% to (19.3?11.2)%,with a mean of (41.2?16.9)% ( P 0.05),with 1 kidney-year survival of 94.4% in group A and 78.0 % in group B ( P 0.05);those of AR were 36.4% and 14.3%,respectively ( P 0.05).No difference in infection episodes an d adverse events between group A and PRA-negative recipients, the same as those between group A1 and A2. Conclusions DFPP can decrease the level of PRA significantly before transplantation by selectively eliminating the sensitive antibody,especially when combined with Dac,which can make sensiti zed recipients get the chance of transplanting and further reduce the incidence of AR.The patient/kidney survival rates of 1 year are satisfactory.Being well to lerated by the sensitized patients,treatment of DFPP combined with Dac is safe a nd effective.

Objective To evaluate surgical treatment of infected femoral artery pseudoaneurysm.Methods The data on surgical treatment of 45 patients with infected femoral artery pseudoaneurysm admitted from January 2003 to June 2008 were analyzed retrospectively.Fourty-three patients underwent operative treatment including excision of infected femoral artery pseudoaneurysm,exhaustive debridement and bypass graft with vascular prosthesis.Two patients were unavoidable to undergo removing of infected femoral artery pseudoaneurysm and ligating the proximal and distal artery of pseudoaneurysm because of severe infection and large volume.Results The patients were followed up from 3 to 12 months(mean 7.82 months).The limbs of all the patients underwent bypass graft with vascular prosthesis were salvaged successfully,patients of which had secondary wound healing and had not intermittent lameness.One of two patients performed ligation of artery was salvaged successfully but had severe intermittent lameness,another patient underwent high amputation above knee because of ischemic gangrene.ConclusionFor infected femoral artery pseudoaneurysm,the operative treatment including excision of infected femoral artery pseudoaneurysm,exhaustive debridement and bypass graft with vascular prosthesis is effective and safe.

Uninephrectomy was performed in a ll rats of this study, and diabetic model was induced in partial rats by streptozo tocin. Then these rats were divided into uninephrectomy group, diabetes group an d benazepril-treated diabetes group. After 4 weeks, renal tubulo-interstitial morphological change was observed and type Ⅳ collagen, fibronectin and transfor ming growth factor ? 1 (TGF-? 1) proteins as well as TGF-? 1 mRNA were d etermined. The results suggested that benazepril played a protective role in ren al tubulo-interstitial injury, which was associated partially with down-regula ted overexpression of TGF-? 1.

Objective To elucidate the clinical features of nutcracker syndrome complicated with IgA nephropathy (IgAN) and to increase its level of diagnosis and treatment. Methods Clinical data of 14 cases of nutcracker syndrome complicated with IgA nephropathy (patient group) and 36 cases of nutcracker syndrome (control group) were analyzed retrospectively. Nutcracker syndrome was diagnosed by ultrasonography and magnetic resonance angiography (MRA) and IgAN by renal biopsy. Differences of clinical data and images in two groups were analyzed. Results Gender, age and blood pressure of two groups were not significantly different. Higher Scr level [(81.2±21.3) μmol/L vs (61.2±11.8) μmol/L, P<0.01], more severe proteinuria [(1.1 ± 0.6) g/d vs (0.3±0.2) g/d, P<0.01] and hematuria (2.3±0.9 vs 1.5±1.3, P<0.05) in patient group were found. Differences of ultrasonography and MRA in two groups were not significant. Conclusion Renal biopsy should be considered in cases of nutcracker syndrome with persistence of proteinuria, hematuria or abnormal morphology of urinary red blood cell.

Objective:The clinicopathological features, diagnosis, and prognosis of follicular thyroid carcinoma (FTC) with distant me-tastasis as the first manifestation were evaluated in this study. Methods:A total of 129 FTC cases with clinical data were retrospective-ly analyzed in the Department of Pathology, Tianjin Medical University Cancer Institute and Hospital (January 2001 to January 2016). Survival analysis and conjoint analysis on FTC with clinical data, diagnosis, and morphological characteristics with distant metastasis as the first manifestation were performed. Results:Among the 129 FTC cases, 24 cases demonstrated distant metastasis as the first mani-festation (18.6%). Bone metastasis was the most common (13.2%). The presence of mass and pain at the metastatic sites were the usu-al clinical complaints. The morphological characteristics of FTC with distant metastasis can be classified into four subtypes:microfollicu-lar (10 cases), solid (4 cases), normofollicular (9 cases), and macrofollicular (1 case). Immunostaining tests on thyroglobulin and thyroid transcription factor-1 showed positive results in FTC with metastasis. Survival analysis showed that the five-year survival rates in the 24 cases were 87.1%. The prognosis of patients with solitary metastasis was better than that of patients with multiple metastasis (P=0.022). A higher survival rate was found in the normofollicular and macrofollicular subtypes than that detected in the microfollicular and solid subtypes (P=0.012). Conclusion:FTC is susceptible to distant metastasis. Some patients with FTC demonstrated distant me-tastasis as the first manifestation, and their diagnosis can be confirmed by pathological feature analysis and immunostaining. The prog-nostic significance is possibly related to the number of lesions of FTC with distant metastasis and histopathological subtypes.