The changes of Fas.FasL and Bcl-2 expression in thyrocytes of patients with Graves'disease were investigated before and 2 weeks after 131Ⅰ administration. The results showed that 131Ⅰ couhl induce thyrocytes to express the apoptotic protein Fas, FasL and the anti-apoptotic protein Bet-2 in patients with Graves'disease. A statistically significant correlation was found between the dose of 131Ⅰ and the expression levels of Fas and FasL but not Bet-2 ,suggesting that early onset of hypothyroid after 131Ⅰ administration may be due to the increased expression of Fas and FasL in thyrocytes.

Objective To evaluate the safety,feasibility and efficacy of emergency percutaneous coronary intervention(PCI)on the spot in the patients with acute myocardial infarction(AMI)in country hospitals by interventional cardiologists from higher-level hospitals(converse transport).Methods A total of 81 AMI patients received emergency PCI on the spot by interventional cardiologists from other higher-level hospitals (transported doctors)from Mar 2004 to Sep 2008 in our hospital.The mean age of patients was 68.6 ± 3.6 years (36.0-83.0 years).Forty-six patients were male and 35 were female.There were 56 cases with anterior myocardial infarction and 25 with inferior myocardial infarction(including 11 cases combined with right ventricular infarction).The average time from symptom onset to admission was 6.2 ± 1.8 hours(2.0-12.0hours).Results Three cases were transported to higher-level hospitals for CABG because of severe conditions.The other 78 cases received emergency PCI on the spot,among whom 66 cases received primary PCI.Another 12 cases received rescue PCI.Eight one stents were implanted in total into the infarcted arteries.One operation was failed because the balloon could not go through the lesion.The success.rate was 98.7％.Four patients occurred peri-operative cardiac adverse events and 2 cases died.Four cases died during the 32-86 months follow-up,of whom I was cardiac death and 3 was non-cardiac deaths.No fatal cardiovascular events occurred in the remained cases.Conclusion Emergency PCI on the spot by interventional cardiologists from other cities(converse transport PCI)in AMI is safe,feasible and effective.But it needs to be confirmed in a large-scale study in the future.

Objective To evaluate the therapeutic effcacy with CT-guided percutaneous radiofrequency ablation(RFA)for the liver tumor.Methods 60 cases of patients with a total of 73 lesions were treated with radio-frequency ablation.The diameter of the lesions was 1.4～7.0cm.with a mean diameter of 4.2cm.The therapeutic efficacy was evaluated with enhanced CT scanning and AFP.Results 45 patients of 60 cases with lesions were full damaged,no blood flow Was found on enhanced CT scans.39 patients with significantly increased blood-AFP before treatment were decreased significantly after treatment,Complications occured in 11 patients,including refractory hiccup (n=2),epidermal scald(n=3),intrahepatic hemorrhage(n=2)and hepatic abscess(n=1).Conclusion The radiofrequency ablation was simple and effective treatment of liver tumor.The effect could be similar to that of surgical resection.

Objective To investigate the effects of weightlessness on the apoptosis of hepatocytes in rats.Methods Eighty-four adult male Wistar rats were randomly divided into weightlessness group and control group according to the random number table.Tail-suspension was used to simulate the weightlessness model.Six rats were sacrificed in each group at the end of day 1-7.Hepatocyte apoptosis and p53 expression were detected by TUNEL assay and immunohistochemistry PV-6001,respectively.All data were analyzed by variance analysis.Results An increase of apoptosis index and up-regulated expression of p53 were detected in weightlessness group.The level of apoptotic index Was significantly higher in weightlessness group than in control group from day 1 to day 5(F=77.608,P<0.05),and the apoptotic indexes of the 2 groups were close at day 6 and day 7.The p53 proteins with positive expression were mainly detected in the nucleus.The level of positive expression of p53 in liver tissue in weightlessness group was higher than that in control group at the early stage(F=113.063,P<0.05).Few hepatocytes with positive expression were detected in control group and weightlessness group at a later stage.Conclusion There is a close relationship between hepatocyte apoptosis,changes of P53 expression and stress response and tolerance to weightlessness.

Clinical data of 108 patients with adult-onset Still's disease(AOSD)were analyzed.The results showed that 56 patients(51.9%)developed liver damage and abnormal liver functioil(alanine aminortransferase and aspartate aminortransferase were significantly increased).Gender,age,time from disease onset to confirmed diagnosis,fever,rash,arthritis,pharyngeal pain,splenomegaly,lymphadenopathy,anemia,leukocvtosis,thrmbocytosis,and increased erythrocyte sedimentation rate,serum C-reactive protein,and serum iton protein showed no significant difierence between the two groups (P＞0.05).Clinical symptoms of liver damage were atypical.Among the 56 patients with liver damage,8 were presented with gastrointestinal symptoms,and 24 showed enlarged liver iu B.ultrasound examination.Our results suggest the prevalence of liver damage in AOSD patients may be hiSh,which could attribute to the disease itself and the medication.The patients would expect good response to corticosteroid treatment and satisfactory outcomes.

Objective To summarize the therapeutic results and experience of the interventional managements for pseudoaneurysms occurred after surgery. Methods Five pseudoaneurysms with different location that occurred after surgery in five patients were treated with different interventional managements. One patient suffered from a ruptured pseudoaneurysm of left common iliac artery, which was treated by obstructing the diseased artery with balloon via the abdominal aorta followed by the replacement of vascular prostheses. One patient had a pseudoaneurysm of right subclavian artery and endovascular covered stent was employed to isolate it. The remaining three patients were affected by pseudoaneurysm of terminal arteries and intraarterial embolization with gelfoam and/or steel coils was camed out. Results Complete closing of the pseudoaneurysm was obtained in all five patients and no therapy-related complications occurred. Conclusion Pseudoaneurysms occurred after surgery can be effectively treated with different interventional managements, it is worth popularizing this technique in clinical practice.

Objective To observe the protective effect of gradual ischemic postconditioning (IP) capable of improving reperfusion on reperfusion injury in patients with ST-segment elevation acute myocardial infarction (STEAMl) undergoing primary percutaneous coronary intervention (PPCI).Methods 102 in-patients with STEAMI undergoing PPCI in the Department of Cardiology in the First People's Hospital of Kunshan City Affiliated to Jiangsu University from February 2011 to August 2014 were enrolled in this study. They were divided into three groups by a random number table: IP group (32 cases), gradual IP group (30 cases) and routine reperfusion group (40 cases). In IP group, after the opening of the infarction related blood vessel, ischemic postconditioning within the first minute of arterial reperfusion was made through three episodes of 1 minute inflation and 1 minute pressure withdrawn of an angioplasty balloon, and then persistent reperfusion was carried out. In the gradual IP group, the patients received three times of gradual angioplasty balloon inflation and denation, 1 minute/1minute, 30 seconds/30 seconds and 15 seconds/15 seconds respectively, presenting the gradual change of IP time. In the routine reperfusion group, after the opening of blocked blood vessel, the patients underwent routine PCI to persistently recover the coronary artery blood supply. The changes of related lead ST segment regression (Sum-STR), incidence of reperfusion arrhythmia, corrected thrombolysis in myocardial infarction (TIMI) franle count (CTFC), peaks of MB isoenzyme of creatine kinase (CK-MB), left ventricular ejection fraction (LVEF) and frequency of adverse events in follow-up period were compared among the three groups.Results The baseline characteristics were comparable in three groups. The incidence of ventricular premature beats was significantly lower in gradual IP group than that in routine reperfusion group [30.0% (9/30) vs. 55.0% (22/40),P < 0.05], and although theincidence of ventricular premature beats was lower in IP group than that in routine reperfusion group [34.4% (11/32) vs. 55.0% (22/40)], no statistically significant difference was found (P > 0.05). The incidence of ventricular tachycardia was significantly lower in IP and gradual IP groups than that in routine reperfusion group [15.6% (5/32), 13.3% (4/30) vs. 40.0% (16/40), bothP < 0.05]. The incidences of ventricular fibrillation, bradyarrhythmia and sinus arrest were lower in IP group and gradual IP group than those in routine reperfusion group, but no statistically significant differences were found (allP > 0.05). In IP group and gradual IP group, the Sum-STR incidence, CTFC, CK-MB peaks were lower than those of routine reperfusion group [Sum-STR: (56.7±18.3)%, (57.3±21.5)% vs. (44.6±21.6)%; CTFC: 25.47±5.37, 24.46±6.41 vs. 31.62±7.56; CK-MB peaks (U/L): 126.3±78.5, 121.6±82.5 vs. 147.4±72.5; allP < 0.05], the effect of gradual IP group being the best among the three groups. The levels of LVEF were slightly higher in IP and gradual IP groups than the level in routine reperfusion group (0.507±0.042, 0.511±0.062 vs. 0.497±0.062), but no statistically significant difference was found (bothP > 0.05). In routine reperfusion group, one patient died because the ventricular fibrillation could not be corrected and another one died of no-reflow during operation. Each group had 1 patient died during the 4 weeks of follow-up after operation, in the routine reperfusion group, one died of refractory heart failure, and the cause of death of other two patients, one in IP group and another in gradual IP group, was considered due to subacute thrombosis in stent. Major bleeding events were not found in each group.Conclusion Gradual IP can ameliorate myocardial reperfusion injury more significantly in patients with STEAMI undergoing PPCI.

Objective To investigate the method and clinical effect of interventional treatment on placenta increta.Methods Fifteen patients with placenta increta were treated interventionally through uterine artery.and Methotrexate 50-100 mg were superselectively infused.Then gel foam particulate or stripes were used for embolization of uterine artery.The therapeutic effect,prognosis and side effects were observed and analyzed.Results All patients underwent uterine artery embolization (UAE) .One week after UAE,curettage was successfully performed.No heavily hemorrhage nor hysterectomy occurred.Conclusion Transcatheter uterine artery intervention is simple,safe and effective with highly successful rate and has little side effects for the treatment of placenta increta.

Objective To establish the anti-infective tissue engineered bones (TEBs) and evaluate the anti-infective and osteogenic effects of the infection-prevention TEBs on femoral large bone defects in goats.Methods Based on the controlledrelease antibiotic system fibrin gel-coated vancomycin alginate beads (FG-Vanco-AB),the infection-prevention TEBs were established and evaluated.They were transplanted into the critical-size defects in the right femurs of goats.TEBs without the controlled-release antibiotic system were used as controls and transplanted into the left femoral defects.The breakpoint sensitivity of vancomycin (5 mg/mL) for S.aureus was used as a standard concentration.Postoperatively,the vancomycin concentrations in the lesion site,in the adjacent site and in the circulation,as well as the anti-infective effects of the infection-prevention TEBs were evaluated by High-performance liquid chromatography (HPLC).Bone hcaling was assessed by histology,CT and ECT.The results were used to evaluate the osteogenic effect of the infection-prevention TEBs.Results Results from ESM,CLSM and in vivo tracing showed that the in vitro and in vivo survival conditions of seeded cells were analogous to those of TEBs.The effective concentration (over the bactericidal concentration) of vancomycin in bilateral defects and in blood lasted for 28 days,2 days and 7 days,respectively.The concentration of vancomycin in the femur decreased gradually from the grafted site to both ends.At 28 and 56 days postoperatively,the ECT results showed no significant difference between the right and left femurs.CT and histology demonstrated that at 14,28 and 112 days after surgery,bone defects in the bilateral femurs were repaired synchronously,and were completely covered by new bone tissue after 112 days.Conclusion The anti-infective TEBs were successfully established.FG-Vanco -AB in the transplanted sites provided the local bone tissues with anti-infective capability whilst not interfered the process of bone reconstnction and wound healing.

BACKGROUND:Bone defects are the leading cause of nonunion after firearm injury. Firearm injury is relatively special. Autograft and alograft al have big drawbacks, which cannot meet the requirements of basic-level hospitals. Using tissue-engineered bone with good blood vessels and osteogenic capability in repair of firearm bone defect wil be an ideal and feasible restoration method. OBJECTIVE: To explore the application of human vascular endothelial growth factor 121 gene-modified materials in the repair of firearm-induced radial injury in rabbits. METHODS: A total of 128 rabbits were randomly divided into surgical injury group and firearm injury group (n=64 per group). In the firearm injury group, 0.25 g steel bal was launched using 56-style musket to establish a firearm radial injury model; in the surgical injury group, surgical methods were used to produce a 1.2 cm radial injury model. Human vascular endothelial growth factor 121 gene-modified materials were used. The related histocytes from rabbits were harvested to obtain bone marrow stromal cels for culture. A porous scaffold material was prepared. The obtained materials were respectively implanted into radial defect sites in the surgical injury and firearm injury groups. The application of human vascular endothelial growth factor 121 gene-modified materials in rabbit radial defect repair was analyzed. RESULTS AND CONCLUSION: Compared with the surgical injury group, at 8, 12 and 16 weeks after repair, the gray level ratio of bone defect site and the anti-compression mechanical ratio at the healthy and repairing sides of the radius in the firearm injury group were decreased (P < 0.05), and the new bone area increased (P < 0.05). At 2 and 4 weeks after repair, the local blood flow at the repair area was significantly increased (P < 0.05). These results suggest that compared with the surgical injury group, the curative effect of human vascular endothelial growth factor 121 gene is more ideal in the firearm injury group because of the emergence of local ischemia and hypoxia in the process of radial defect repair. Human vascular endothelial growth factor 121-modified material can repair bone marrow stromal cels. The application of human vascular endothelial growth factor 121 in firearm burns can enhance the synthesis and secretion of angiogenic factors, improve the local blood flow, reduce anti-compression mechanical ratio, and increase the new bone area.