Objective To explore the value of glypican-3(GPC-3)mRNA and paternally expressed 10(PEG10)mRNA in peripheral blood in diagnosis of metastasis in hepatocellular carcinoma(HCC). Methods With SYBR Green I as fluorescence signal,real-time fluorescent quantitative reverse transcription-polymerase chain reaction was employed to detect the expression of GPC-3 mRNA and PEG10 mRNA in peripheral blood from patients with HCC with metastasis(n=8),HCC without metastasis(n=12)and hepatic cirrhosis(n=11),and receiver operator characteristics curve(ROC)and specific parameters were adopted to analyse their value in predictive and exclusive diagnosis. Results The expression of GPC-3 mRNA and PEG10 mRNA in HCC with metastasis was significantly higher than that in HCC without metastasis and in hepatic cirrhosis(P<0.05),while there was no significant difference in the expression of GPC-3 mRNA and PEG10 mRNA between HCC without metastasis and hepatic cirrhosis.In single test,the sensitivities in the differential diagnosis between HCC with metastasis and HCC without metastasis were 66.7%for GPC-3 mRNA and 72.2%for PEG10 mRNA,and the specificities were 91.7%and 91.7%.respectively.The areas under ROC were 0.748 for GPC-3 mRNA and 0.812 for PEG10 mRNA.With two markers in parallel test,the sensitivity,specificity,negative likelihood and diagnostic accuracy were 90.7%,84.O%,0.11 and 83.3%,respectively.In serial test,the sensitivity,specificity,positive likelihood and diagnostic accuracy were 60.5%,98.7%,45.5 and 73.3%,respectively. Conclusion Detection of GPC-3 mRNA and PEG10 mRNA in peripheral blood may help to predict blood metastasis and extrahepatic metastasis of HCC,and PEG10 mRNA works better than GPC-3 mRNA.The serial test of GPC-3 mRNA and PEG10 mRNA is helpful to the predictive diagnosis of peripheral blood metastasis of HCC.

Objective To assess the value of SYNTAX score to predict major adverse cardiac and cerebrovascular events (MACCE) among patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention.Methods 190 patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention (PCI) with Cypher select drug-eluting stent were enrolled.SYNTAX score and clinical SYNTAX score were retrospectively calculated.Our clinical Endpoint focused on MACCE,a composite of death,nonfatal myocardial infarction (MI),stroke and repeat revascularization.The value of SYNTAX score and clinical SYNTAX score to predict MACCE were studied respectively.Results 29 patients were observed to suffer from MACCE,accouting 18.5％ of the overall 190 patients.MACCE rates of low ( ≤ 20.5 ),intermediate ( 21.0-31.0 ),and high ( ≥ 31.5 ) tertiles according to SYNTAX score were 9.1％,16.2％ and 30.9％ respectively.Both univariate and multivariate analysis showed that SYNTAX score was the independent predictor of MACCE.MACCE rates of low ( ≤ 19.5 ),intermediate( 19.6-29.1 ),and high( ≥29.2) tertiles according to clinical SYNTAX score were 14.9％,9.8％ and 30.6％ respectively.Both univariate and multivariate analysis showed that clinical SYNTAX score was the independent predictor of MACCE.ROC analysis showed both SYNTAX score ( AUC =0.667,P =0.004) and clinical SYNTAX score ( AUC =0.636,P =0.020) had predictive value of MACCE.Clinical SYNTAX score failed to show better predictive ability than the SYNTAX score.Conclusions Both SYNTAX score and clinical SYNTAX score could be independent risk predictors for MACCE among patients with three-vessel or left-main coronary artery disease undergoing percutaneous coronary intervention.Clinical SYNTAX score failed to show better predictive ability than the SYNTAX score in this group of patients.

OBJECTIVE:To investigate the method for rapid and effective isolating of calcium-tolerant cardiomyocytes(CTC) from rats. METHODS: CTC were obtained by retrograde perfusion using modified Langendorff heart perfusion apparatus. After incubation of cardiomyocytes in KB solution, the ion currents were recorded with patch-clamp technique in whole-cell mode. RESULTS: Of the whole isolated cells, 70% were survival. Of which, 80% were CTC. A typical outward potassium current was recorded. CONCLUSIONS: A large number of CTC with normal electrophysiological characteristics can be obtained by mastering the digestion time based on variation of perfusion pressure and keeping all the factors in cell isolation under control.

Objective To develop and manufacture new-type dermabrasive cosmetic instrument and investigate its clinical value.Methods WDJ-CP-I dermabrasive cosmetic instrument was developed by using medical brushless magdyno and then was applied to 296 cases.Results WDJ-CP-I dermabrasive cosmetic instrument had such advantages as small volume,lower noise,long duration of life,simple operation,high-temperature & high-pressure sterilization,safety,high dermabrasive rate,ect.Conclusion WDJ-CP-I dermabrasive cosmetic instrument is a good tool for dermabrasion and is worth popularizing.

Objective To explore a reliable parameter for primary closure of the donor site of the descending branch of the circumflex femoral lateral artery perforator flap and analysis its effective factors.Methods Between August,2014 and December,2015,149 patients undergoing reconstructive procedures using the descending branch of the circumflex femoral lateral artery perforator flaps were included in the study.All patients were divided into two groups:primary closure of the donor site (135 cases) and none primary closure of the donor site (14 cases).The receiver operating characteristic curve for biostatistical analysis was performed to identify the reliable width of the descending branch of the circumflex femoral lateral artery perforator flap.The parameter,including the age,patients' body mass index,subcutaneous fat thickness,thigh circumference and the maximum flap width,were recorded in 79 patients who were randomly choose from all patients.The method through stretching donor site skin was used to assess the maximum flap width.The maximum flap width-to-thigh circumference ratio was calculated.The Pearson test was used to analysis the correction between those parameters.Results Primary closure of the donor site was possible in 135 patients and impossible in 14 patients.The receiver operating characteristic curve for biostatistical analysis identifying the reliable width of the descending branch of the circumflex femoral lateral artery perforator flap was 8.75cm.The method assessed the reliable width of the flap was (8.37±1.67) cm through stretching donor site skin.the reliable width of the flap was (8.55±1.65) cm in the male patients and (7.42±1.5) cm in the female patients.There was significant different between the two group (P ＜ 0.05).Primary closure can be achieved if the flap width-to-thigh circumference ratio was less than (17.23±3.84) percent.There was a significant negative correlation between subcutaneous fat thickness and the ratio (R=-0.299,P ＜ 0.05) and between body mass index and the ratio (R=-0.21,P ＜ 0.05).Conclusion The width of flap less than 8.75 cm is a reliable parameter for primary closure of the descending branch of the circumflex femoral lateral artery perforator flap donor site.The patient's body mass index and subcutaneous fat thickness of the thigh should be taken into consideration.

Objective To establish the normal parameters of psychometric measures such as the number connection tests A(NCT-A)and digit symbol tests(DST)in assessment of minimal hepatic en- cephalopathy(MHE).Methods One hundred and sixty healthy volunteers(aged 25 to 64 years;educa- tional level＞9 years)were divided into＜35 ys,35～44 ys,45～54 ys and 55～64 ys groups.All of the healthy volunteers were assessed with NCT-A and DST to establish the normal value of age-related parameters,which can be used for diagnosis of MHE in patients with liver cirrhosis.Two standard devi- ation of the normal mean was used as a diagnostic criterion for MHE.One hundred and six cirrhotic patients were assessed with these parameters.Results The parameters of NCT-A were(25.1?4.6) sec in＜35 ys group,(32.1?6.8) sec in 35～44 ys group,(38.6?7.1)sec in 45～54 ys group or (49.3?6.3)sec in 55～64 ys group.The scores of DST were 49.9?4.7 in＜35 ys group,44.6?4.8 in 35～44 ys group,38.5?5.0 in 45～54 ys group or 35.4?4.7 in 55～64 ys group.Thirty one out of 106 cirrhotic patients were diagnosed as MHE based on these parameters.Conclusion The NCT- A and DST are psychometric assessments for diagnosis of MHE.Age-based normal paramerters of NCT- A and DST are needed to be established.

Objective:To analyze the long-term prognosis of undergoing drug-eluting stent implantation (DES) or coronary artery bypass grafting (CABG) in patients with unprotected left main (ULM) coronary artery disease complicated with chronic renal failure (CRF).Methods:Patients with UML coronary artery disease complicated with CRF admitted to the department of cardiology intensive care unit (ICU) and cardiac surgery ICU of Beijing Anzhen Hospital Affiliated to Capital Medical University were enrolled. According to the estimated glomerular filtration rate (eGFR), the patients were divided into two layers, and the clinical characteristics of DES patients and CABG patients were analyzed. Log-Rank method and Cox regression were used to analyze the coronary artery disease and long-term clinical prognosis of patients with two surgical strategies.Results:A total of 353 patients were enrolled, including 150 patients with eGFR < 45 mL·min -1·1.73 m -2 (DES 67 cases, CABG 83 cases), eGFR 45-59 mL·min -1·1.73 m -2 in 203 cases (DES 80 cases, CABG 123 cases). In terms of demography and clinical history, compared with CABG group, DES group had lower proportion of complete revascularization and lower proportion of chronic totalocclusion (CTO) and multi vessel disease in each eGFR level. All patients were followed up for an average of (30.74±15.05) months. Log-Rank analysis showed that there was no significant difference in the incidence of major cardiovascular and cerebrovascular adverse events (MACCE), all-cause death, cardiogenic death and stroke between DES group and CABG group in each eGFR level. In eGFR 45-59 mL·min -1·1.73 m -2, the proportion of target vessel revascularization (TVR) in DES group was higher than that in CABG group (18.8% vs. 0.8%, P < 0.01); in eGFR < 45 mL·min -1·1.73 m -2, the incidence of myocardial infarction in DES group was higher than that in CABG group (10.4% vs. 1.2%, P < 0.05). Cox analysis showed that after adjusting for age, gender, history of hypertension, diabetes, left ventricular ejection fraction, smoking history, previous cerebrovascular disease, complete revascularization, multiple vessel disease and CTO, TVR proportion in DES group was still higher than that in CABG group in eGFR 45-59 mL·min -1·1.73 m -2 [hazard ratio ( HR) = 46.463, 95% confidence interval (95% CI) was 4.558-473.693, P = 0.001]; in eGFR < 45 mL·min -1·1.73 m -2, the incidence of myocardial infarction in DES group was still higher than that in CABG group ( HR = 14.098, 95% CI was 1.123-176.988, P = 0.040), there was no difference in TVR proportion between the two methods. Conclusions:eGFR < 45 mL·min -1·1.73 m -2 is an independent risk factor for DES in ULM patients. DES is safe and effective for ULM patients with CRF, but for patients with more severe CRF (eGFR < 45 mL·min -1·1.73 m -2), there was more myocardial infarction in DES group than that in CABG group, which should be carefully selected.

OBJECTIVETo evaluate the treatment for patients with major vascular injuries associated with traumatic orthopedic injuries.

METHODSA total of 196 patients, aged from 4-67 years with the mean age of 29.88 years, had major vascular injuries associated with traumatic orthopedic injuries and were treated in our hospital in a period of 44 years. The most common mechanism of trauma was blunt trauma (67.3%), open injuries accounted for 32.4% and 54.5% of the injuries were located in the lower extremities. The vascular injury frequently happened in the femoral artery (26.7%) and popliteal artery (20.3%). The treatment principle consisted of aggressive resuscitation, Doppler imaging and stable bone internal fixation with subsequent vascular repair and debridement. The vascular repair for injuries included end-to-end anastomosis (80 cases, 39.6%), interpositional vein graft (94, 46.5%), vascular decompression through fracture distraction (18, 8.9%), arterial ligation (6, 3.0%), vein patch (2, 1.0%), bypass graft (2, 1.0%), venous repair including autogenous vein graft (9, 24.3%) and ligation (28, 75.7%) and prophylactical fasciotomy (15, 7.4%). Postoperative amputation was performed in 16 cases (16.3%).

RESULTSNo intraoperative death was observed and all fractures united within 6 months. Limbs were salvaged in 180 patients (91.8%). Among these patients, early complications were found in 19 patients (9.7%) and late complications were observed in 8 patients (4.1%).

CONCLUSIONSA well-organized approach, based on a specific treatment principle, not only improves clinical outcome but also does good to excellent functional recovery for patients with severe orthopedic injuries and concomitant vascular lesion.

Adolescent ; Adult ; Blood Vessels ; injuries ; Child ; Child, Preschool ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; complications ; Fractures, Open ; complications ; Humans ; Male ; Middle Aged ; Prospective Studies

Objective To explore the safety and feasibility of guiding catheter passing through spasmodic vessels in patients undergoing percutaneous coronary intervention (PCI) via radial artery access by the aid of PCI guiding wire and balloon .Methods The clinical data of 33 coronary artery disease (CAD) patients undergoing PCI via radial artery access with radial artery or (and) brachial artery spasm ( group A ) were retrospectively analyzed .Among all these patients , guiding catheters were delivered through the spasmodic vessels successfully by the aid of PCI guiding wires and balloons .The clinical data of other 38 CAD patients having PCI during the same period performed by other operators via radial artery or ( and ) brachial artery approach and experienced vessel spasm were anlysed as the control ( group B ) .All patients in group B received conventional anti-spasm management during PCI .All vessel spasm was identified by angiography.For patients in group A , a diameter of 0.014 inch guiding wire was chosen to pass through the spasmodic vessel segment carefully and gently .The diameter of balloon should be chosen according to the diameter of guiding catheter .A balloon diameter of 2.0 mm and 2.5 mm was corresponded to 6F and 7F guiding catheter respectively .The balloon was advanced to the tip of guiding catheter , keeping a half in catheter and a half in vessel followed by inflating the balloon with a pressure of 8 atm.The balloon was kept inflated the guiding catheter was pushed in vitro carefully and slowly until the catheter passed through the spasmodic vessel segment .Then the balloon was deflated and pulled out together with PCI guiding wire . Exchanged a diameter of 0.035 inch wire and completed the positioning of guiding catheter .After finishing the PCI, radial or ( and) brachial angiography was performed again to observe if spasm disappeared and to determine if there any contrast medium exudation .For patients in group B , routine approach was applied including administration of nitroglycerine , diltiazem or nitroprusside etc . to relieve vessel spasm. Results The location of vessel spasm was similar in group A and group B ( P=0.150 ) , and the incidence rate of spasm in brachial artery was higher than that in radial artery in both groups .The chance of guiding catheter crossing the spasmodic vessel segment was significantly higher in group A than in group B ( 100%vs.39.5%, P=0.00).In patients whose guiding catheter could pass through the spasmodic vessel segment successfully , time spent in group A was shorter than in group B ( P=0.000 ) .The patient number which time spent was less than five minutes , five to 15 minutes and more than 15 minutes was 30 and 2 ( 90.1%vs.13.3%) , 3 and 7 ( 9.9% vs.46.7%) and 0 and 6 ( 0% vs.40.0%) in group A and in group B respectively.The incidence of forearm hematoma was lower in group A than in group B without statistical difference [6.1%(2/33) vs.18.4%(7/38), P =0.113].Conclusions It is safe and feasible for passing guiding catheter through spasmodic vessels during PCI via radial artery access by the aid of PCI guiding wire and balloon .

Objective To investigate the feasibility and clinical effects of deep femoral artery third perforating artery perforator flap for reconstruction of soft tissue defect in lower limbs.Methods From September,2008 to October,2016,8 cases of soft tissue defect in lower limbs which were repaired by deep femoral artery third perforating artery perforator flap,including 4 cases of traffic accident trauma,2 cases of chronic ulcer,1 case of a fall injury,1 case of the scar after fracture operation.The area of wounds was 8.0 cm×7.0 cm-19.0 cm×8.0 cm.Seven patients were accompanied by different degrees of infections.The deep femoral artery third perforating artery perforator flap was designed to repair,including 5 cases of pedicled flaps and 3 cases of free flaps.The flap's appearance,color,texture,infection recurrence and the recovery of lower limb function were recorded at 1,3,6,9 and 12 months followed-up.Results One flap suffered partial necrosis due to cross-zone backflow disorder,the ipsilateral medial sural artery pedicled perforator flap was used to repair.The rest of the flaps survived successfully.Skin graft was used to close the donor site in 1 case,and other donor sites were closed directly.All patients had no postoperative hematoma or secondary infection.The followed-up periods ranged from 2 to 28 months (mean,8.1 months).All flaps had satisfied appearance and texture.There were no complications such as paresthesia and numbness in the donor sites.And no motion limitations in hip and knee joint of the operated leg.Conclusion Deep femoral artery third perforating artery perforator flap can be used for both free flaps and pedicled flaps,which is a feasible method to repair soft tissue defect in lower limbs.