Objective To summarize the experience in treating coronary artery fistula (CAF) by using Guglielmi detachable coils. Methods During the period from July 2009 to November 2014 at the Affiliated Changhai Hospital of Second Military Medical University, interventional treatment of CAF by using Guglielmi detachable coils was performed in 40 patients. The clinical data were retrospectively analyzed. The feasibility, safety and effectiveness of this technique were evaluated. Results Successful transcatheter closure of CAF with Guglielmi detachable coils was achieved in all 40 patients; the average Guglielmi detachable coils used in each patient was(2.33±1.38) coils. No procedure-related complications occurred. Intra-operative angiography showed that residual shunt completely disappeared in 12 patients (30%) and blood flow was significantly decreased in 28 patients (70%). All the patients were followed up for 1-65 months, neither complications such as recurrent bleeding and ischemia nor stenosis and occlusion of related arteries, or fistula cavity rupture occurred. Conclusion The use of Guglielmi detachable coil in interventional treatment of CAF is safe and effective, although its long-term effect needs to be further verified.

OBJECTIVE:To provide reference for the establishment of clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of China. METHODS:Retrieved from pharmacy OSCE literatures and the related websites,phar-macy OSCE contents and evaluation in the United States,the United Kingdom,Canada,Japan,Malaysia and other countries were introduced to provide suggestions for clinical skills evaluation system in students majored in clinical pharmacy and pharmacy of Chi-na. RESULTS & CONCLUSIONS:OSCE had widely applied in medicine,nursing and other professional clinical skills,the United States,the United Kingdom and other countries had applied OSCE into pharmacy,and confirmed its important role in assessment of clinical competence in pharmacy students. There was no uniform standard in OSCE,and OSCE examinations were slightly different in different countries and different schools. Pharmacy OSCE usually based on school courses such as pharmacotherapy,clinical pharmacokinetics,medicine information,pharmaceutical care,doctor-patient communication,identification and solving ability of clinical drug-related issues. Numerous college of pharmacy in domestic colleges and universities has added the practice-based cours-es,but evaluation system and assessment methods are poor. Almost no OSCE is applied for the assessment of pharmacy students. OSCE has short application time in pharmacy education and relatively less study,therefore,pharmacy OSCE in foreign countries should be learnt to assess clinical skills of pharmacy students,establish and improve the pharmacy OSCE that is suitable for China by combining with the pharmacy education status.

BACKGROUND: Facial nerve injury causes facial nerve paralysis (or facial palsy) and even results in psychosocial disturbances of the patients. Repair the injured facial nerve and reconstruction of the nerve function as early as possible have been the primary concern in clinical studies.OBJECTIVE: To investigate the timing and surgical approaches for repairing facial paralysis in order to provides evidences for its therapeutic and prognostic evaluation.DESIGN: Case analysis based on patients.SETTING: Hospital of Plastic Surgery of Chinese Academy of Medical Sciences.PARTICIPANTS: Nine patients with traumatic facial paralysis hospitalized in the Hospital of Plastic Surgery of Chinese Academy of Medical Sciences from December 1993 to November 2001.METHODS: Facial nerve anastomosis was performed microsurgically along with the implantation of the sural nerve graft into orbicular muscle of the eye 3 or 4 months after nerve injury in the 9 patients. The clinical data of the patients were retrospectively reviewed.MAIN OUTCOME MEASURES: The facial nerve function was evaluated with House-Brackmann scale and photographs of the patients' faces before and after surgical treatment were taken.RESULTS: In the follow-up of these patients lasting 6 months to 2 years,all the patients attained satisfactory outcome.CONCLUSION: Early operation is crucial for the treatment of traumatic facial paralysis,with facial nerve anastomosis as the primary choice. The implantation of the nerve graft into muscle is also indicated for repairing traumatic facial paralysis in some cases. The importance of individualized treatment choice is reiterated on the basis of cicatrectomy and the extent and specific features of the injury.

Objective To assess clinical features and treatment of angiosarcoma.Methods A retrospective study was carried out among seven patients hospitalized for angiosarcoma in the Department of Plastic Surgery,Zhongshan Hospital of Fudan University from January 2004 to March 2012.Clinical behaviors,therapeutic strategies and outcomes of angiosarcoma were analyzed in these patients.Results Of the seven patients,four were male,and three were female,with a median age of 67 years (range,37-77 years).Clinical presentations were various,including irregular ulcerous nodular masses in four patients,localized ulcer in one patient,and irregular erythematous nodules in two patients.All the patients were treated surgically with or without postoperative adjuvant therapy.Pathological examination revealed various degrees of differentiation and atypia of tumor cells,as well as obvious proliferation of endothelial cells,and all of these patients were diagnosed as angiosarcoma.Immunohistochemical analysis revealed a positive staining for CD31 and CD34.After surgical treatment,angiosarcoma recurred in four patients with the median time to the first recurrence being 3.5 months (range,1-6 months),cerebral metastasis occurred in one patient 5 months later,and two patients died.Conclusions Angiosarcoma is a rare and heterogeneous sarcoma with diverse clinical presentations.Local wide resection is the cornerstone of angiosarcoma treatment,and adjuvant therapy may improve its prognosis.

Objective To analyze the history and present situation of international medical device with visualization softwareto provide references for medical device development in China.Methods CiteSpace visualization software was used to explore international literatures related to medical device from the aspects of yearly quantity,research direction,research organization,quoted literature and etc from 2005 to 2014.Results Medical device drew increasing attention from corresponding researchers,whose development depended on international cooperation.Medical device related closely to engineering and medicine,and had to paid attention to informatization and clinical requirements.Conclusion CiteSpace software is of great value for the study on medical device.

Objective To investigate the role of chemokine CXC-ligand 16 (CXCL16) in renal ischemia-reperfusion (I/R) injury in the mice.Methods Twelve healthy male C57BL/6 mice and 12 CXCL16-knockout (CXCL16-KO) mice,aged 8-10 weeks,weighing 20-30 g,were studied.The 12 C57BL/6 mice were randomly divided into 2 groups (n=6 each) using a random number table:C57BL/6 sham operation group (group C-S) and C57BL/6 I/R group (group C-I/R).The 12 CXCL16-KO mice were randomly divided into 2 groups (n=6 each) using a random number table:CXCL16-KO sham operation group (group KO-S) and CXCL16-KO I/R group (group KO-I/R).The right kidney was removed,and the left kidney was exposed,and the renal artery was then clamped for 45 min with atraumatic microclips followed by 24 h reperfusion to establish the model of renal I/R in anesthetized mice.Venous blood samples were taken at 24 h of reperfusion for determination of the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The renal specimens were obtained at 24 h of reperfusion for microscopic examination of the pathological changes,and the damage to the renal tubules was scored.The number of myeloperoxidase (MPO) positive cells (MPO+ cells),F4/80+ cells and CD3+ cells in renal tissues was counted by immunohistochemistry.The expression of tumor necrosis factor-alpha (TNF-α),interleukin-1beta (IL-1β),IL-6,and macrophage inflammatory protein-2 (MIP-2) mRNA in renal tissues was determined by real-time reverse transcriptase polymerase chain reaction.Results Compared with group C-S,the serum BUN and Cr concentrations,renal tubular damage score,and the number of MPO+,F4/80+,and CD3+ cells were significantly increased,and the expression of TNF-α,IL-1β,IL-6 and MIP-2 mRNA was significantly up-regulated in group C-I/R (P＜0.05).Compared with group KO-S,the serum BUN and Cr concentrations,renal tubular damage score,and the number of MPO+,F4/80+,and CD3+ cells were significantly increased,and the expression of TNF-α,IL-1β,IL-6 and MIP-2 mRNA was significantly up-regulated in group KO-I/R (P＜0.05).Compared with group C-I/R,the serum BUN and Cr concentrations,renal tubular damage score,and the number of MPO+,F4/80+,and CD3+ cells were significantly decreased,and the expression of TNF-c,IL-1β,IL-6 and MIP-2 mRNA was significantly down-regulated in group KO-I/R (P＜0.05).Conclusion CXCL16 is involved in the pathophysiological process of renal I/R injury in the mice.

Objective To explore the application value of preoperative methylene blue staining in locating for the operation of intraspi-nal tumors. Methods The clinical data of patients with intraspinal tumors from September 2010 to September 2012 in our hospital were ret-rospectively analyzed. The patients were divided into tag group and control group according to whether stained by methylene blue or not. The operation time( min) ,intraoperative hemorrhage,the rate of total resection of tumor,spinal instability rate,tumor recurrence rate,and reopera-tion rate of two groups were compared. Results The operation time of tag group was significantly shorter than that of the control group. The amount of intraoperative bleeding was significantly less than that of in control group, the differences were statistically significant(P<0. 05). The total resection rate of tumor was significantly higher than that in control group,the differences were statistically significant(P<0. 05). The spinal instability rate,tumor recurrence rate and operation rate of patients within 1 year in two groups were not significant. Conclusion The methylene blue method is simple and convenient,and provides favorable conditions for the operation,which reduces the operation time and intraoperative hemorrhage,increases the rate of complete tumor resection. There was no difference in recurrence rate,operation rate and the stability of the spine within 1 year compared to traditional method.

Lysophosphatidylcholines belong to a group of lipid components which have a variety of physiological functions. LPCs are known to be linked to metabolic disorders and cardio-vascular diseases,including diabetes,atherosclerosis and dyslip-idemia.LPCs are actively metabolized in liver,which is closely related with liver diseases and hepatotoxicity.The role of LPCs in liver diseases and hepatotoxicities has been extensively investi-gated recently.This review focuses on lysophosphatidylcholines as a biomarker for liver diseases,such as hepatic carcinoma, cholestasis,cirrhosis,hepatitis,and chemical hepatotoxicities, trying to lay a basis for investigation and therapeutics of liver dis-eases.

[Objective] To investigate the efficacy of Xiangsha Yangwei Wan (XYW) on the inhibition of chemotherapy-induced chemical gastritis and upper gastrointestinal symptoms. [Methods] A randomized controlled trial (RCT) was carried out in 87 cases of maligant tumor confirmed by histopathological and cytological examination. All the cases were treated with chemotherapy regimen of adriamycin ( ADM) , adcarbazine ( DTIC) , platinum-based agents, irinotecan (CPT-11) and fluorouraeil (5-FU). Meanwhile, 41 cases in group A were also treated with dexamethason and 5-HT3 receptor antagonist as an essential anti-emesis and with XYW to regulate gastrointestinal function; other 46 cases in group B were given dexamethason and 5-HT3 receptor antagonist only. Seven days after treatment, incidences of chemical gastritis and upper gastrointestinal symptoms were observed and compared between the two groups. [Results] Seven days after chemotherapy, upper gastrointestinal symptoms and signs were relieved in 95.1% (39/41) of the patients of group A and in 76.1 % (35/46) of group B; the occurring rate of chemical gastritis with symptoms was 2.4% (1/41) in group A and 19.6% (9/46) in group B, the differences being significant statistically between the two groups( P - 0.0122) . [ Conclusion ] XYW has an inhibitory effect on chemotherapy-induced chemical gastritis and upper gastrointestinal symptoms.

Objective : To analyze the survival of patients with malignant mesothelioma, so as to provide insights into the management of malignant mesothelioma. Methods : Totally 36 patients with malignant mesothelioma admitted to Cixi Third People’s Hospital from October 2012 to January 2021 were enrolled, and the demographic features, exposure to asbestos, and diagnosis and treatment were retrospectively reviewed. The survival rate and median survival time were calculated with the life-table method, and the factors affecting the survival rate of malignant mesothelioma were identified using the Kaplan-Meier estimate and log-rank test. Results : The 36 patients with malignant mesothelioma included 6 men ( 16.67% ) and 30 women ( 83.33% ), and had a median age of 61 ( interquartile range, 14 ) years. There were 30 cases with pleural malignant mesothelioma ( 83.33% ) and 6 cases with peritoneal malignant mesothelioma ( 16.67% ), 32 cases ( 88.89% ) with a history of occupational exposure to asbestos, and 26 cases ( 72.22% ) receiving palliative treatment. The 1-, 2- and 3-year cumulative survival rates were 30%, 15% and 3%, respectively, and the median survival time was 0.71 years. In addition, there were no significant differences in the survival period among patients with malignant mesothelioma in terms of gender, age, route of asbestos exposure, duration of asbestos exposure, pathogenic site and treatment regimens ( P>0.05 ). Conclusion The 36 patients with malignant mesothelioma had a median survival period of 0.71 years, and no association was found between the survival period and asbestos exposure or pathogenic site.