Objective To find out the sensitivity and s pecificity of intravascular ultrasound (IVUS) in identification of unstable atherosclerotic plaques. Methods Fourty-three patients diagnosed coronary heart disease, receiving coronary angiography and intravascular ultrasound examination,were divided into soft plaque and hard plaque group according to the echo reflectivity of atherosclerotic plaque by IVUS. Quantitative determination was performed between the two groups. Results The sensitivity of IVUS in detecting soft plaques from patients with acute coronary artery syndrome was 81.4 %, specificity 75.0 %, accuracy 79.1 %, positive predictive value 84.6 %. The lipid core areas and lipid to plaque ratio of soft plaques were significantly larger than those of hard plaques (P 0.05 ).Conclusions IVUS had higher sensitivity and specificity in detecting coronary vulnerable plaques in live bodies.

Objective The purpose of this study was to assess the effectiveness and safety of distal filtration protection devices during carotid artery stenting.Methods Between June and July in 2002, carotid artery stenting (CAS) were performed in 4 patients with asymptomatic severe carotid artery stenosis. Self-expendable stents (Smart, Cordis) and distal filtration devices (Angioguard XP, Cordis) were used in all patients. Primary endpoints were perioperative neurologic complications and mortality. Data were collected prospectively.Results All patients were male, their age were 59?4 years old. One patient had history of transient ischemic attacks(TIAs); and another had inferior myocardial infarction, and right coronary intervention was performed before CAS, and another one underwent CABG 6 months ago. There were two right internal carotid and two left internal carotid severe lesions (82.5?6.0)% were treated. The filtration devices and stents were delivered and deployed successfully in all target artery (technical success rate was 100%) and

Cotinus coggygria Scop. is theAnacardiaceae Cotinus L. plant and used for natural drugs in the treatment of acute icteric infectious hepatitis. The pharmacological research showed thatCotinus coggygria Scop. has the effects of reducing jaundice and enzyme, gallbladder Cholagogic and strengthen immune function. The current research onCotinus coggygria Scop. is still not deep enough, the pharmacological effects ofCotinus coggygria Scop. are mostly limited to the anticoagulant, hemolytic and anti liver chemical injury. In order to better study the scientific connotation of antitumor ofCotinus coggygria Scop., the active ingredient ofCotinus coggygria Scop., pharmacological action and clinical application were reviewed.

Objective To explore the feasibility of single port laparoscopy in classification and treatment of Meckel's diverticulum in children and its guiding treatment.Methods The clinical data in 75 children cases of Meckel's diverticulum with symptoms treated in our hospital from Aug.2011 to Aug.2015 were retrospectively analyzed.Meckel's diverticulum was classified under single port laparoscopy.The operation modes were selected according to different classifications.The excised materials were submitted to the pathologic examination.Results Among 75 children cases,50 cases were the simple type of Meckel's diverticulum and 25 cases were complex type of Meckel's diverticulum.The average operative time in the simple type and complex type was (38.93±8.75) min and(55.64 ± 13.27) min respectively,average bleeding amounts were (46.58 ± 15.81) mL and (50.12 [16.90) mL respectively,average postoperative hospitalization time was (7.33±1.41)d and (7.52 ± 1.68)d respectively,the operative time in the simple type was less than that in the complex type(P＜0.05),the other two indexes had no statistical difference between the two groups(P＞0.05).The ectopic gastric mucosal pathological change was only seen in the simple type,while the inflammatory manifestation in the complex type had higher proportion.The main clinical manifestations were lower gestational tract bleeding and infection.The two groups all obtained follow up.One case of simple type appeared the symptoms of abdominal pain and hematochezia and was cured after the second operation.Conclusion Meckel's diverticulum can be divided into the simple type and complex type under single port laparoscopy.The operation mode can be selected according to different types.This method is safe and reliable and is worthy of being clinically promoted.

Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) derived cardiac function index (Tei index) in patients with acute coronary syndrome under different plasma glucose levels and to evaluate the influence of hyperglycemia on the preciseness of cardiac function assessment with NT-proBNP.Methods Consecutive patients with acute coronary syndrome admitted to the department of cardiology in Guangdong General Hospital were prospectively enrolled.Based on their plasma fasting glucose level,patients were divided into hyperglycemia group (fasting plasma glucose ≥ 6.1 mmol/L) and euglycemia group (fasting plasma glucose ＜ 6.1 mmol/L).All the patients underwent transthoracic echocardiagraphy and tissue Doppler imaging (TDI) investigations.Blood samples were obtained within 24 hours of hospitalization for measurment of NT-proBNP level.Relationship between TDI-Tei index and the level of NT-proBNP in the two groups were analyzed respectively.Results The TDI-Tei index,the systolic index and the diastolic index were all significant higher in the hyperglycemia group (n =27) than those in the euglycemia group (n =35)(0.68±0.14) vs.(0.61 ±0.10),P =0.03; (0.29±0.07) vs.(0.26±0.05),P =0.045; (0.38±0.08) vs.(0.35 ±0.050,P =0.03,respectively.In both groups,TDI-Tei and In NT-proBNP showed significant linear regression.In the hyperglycemia group,TDI-Tei =0.175 + 0.068 In NT-proBNP,R2 =0.702,P ＜ 0.01.In the euglycemia group,TDI-Tei =0.185 + 0.060 In NT-proBNP,R2 =0.405,P ＜ 0.01.Conclusions (1) Compared with patients suffering from an acute coronary syndrome with euglycemia,the global cardiac function of patients with hyperglycemia is poorer; (2) NT-proBNP correlates significantly with TDI-Tei in both hyperglycemia and euglycemia patients with acute heart syndrome.It is appropriate to assess global cardiac function with NT-proBNP in patients suffering from ACS complicated with hyperglycemia.

Objective To characterize the clinical features of patients with cardiac amyloidosis (CA).Methods Totally 42 patients with CA admitted to Guangdong General Hospital since 2008 were included and retrospectively analyzed in the present study.CA was confirmed by abdomen and endocardium biopsy examination.Clinical manifestations,electrocardiogram and echocardiography were collected for the evaluation.Results Several clinic features are common in CA.In the present study,37 cases (88.1％) presented with chest tightness,dyspnea,20 cases(47.6％) with chest pain,27 cases(64.3％) with right heart failure,27 cases (64.3％) with fatigue,and 30 cases (71.4％) with renal insufficiency and proteinuria.Electrocardiogram (ECG) showed that 32 of the patients (76.2％) were with low voltage in limb leads,29 cases (69％) of them were with poor R wave progression in precordial leads,17 cases (40.5％) with ST-T change,28 cases(66.7％) with pseudo-necrotic Q wave and 36 cases (85.7％) with various kinds of arrhythmia.Echocardiography indicated that all of the subjects (100％) were with different degrees of left ventricular posterior wall or ventricular septal thickness,and left atrial hypertrophy with different degree of myocardial grain appearance or ground-glass opacity.Thirty-six cases (85.7％) were with pericardial effusion,and 27 cases (64.3％) were with abnormal left ventricular eject function.Conclusion For those who were with unexplained clinical cardiac insufficiency,renal insufficiency,myocardial hypertrophy,but normal of ventricular size in echocardiography and low voltage on ECG limb leads,a tissue biopsy from abdomen,labial glands or endocardium should be considered in the diagnosis of CA.

The most common metastatic site of prostate cancer is the bone, followed by the lung, bladder, liver, and adrenal gland. We report on a rare case of pancreatic metastasis from prostate cancer. A 52-year-old patient was admitted to the hospital with epigastric pain for 20 days. PET-CT showed malignant lesions in the prostate and pancreas, and prostate and pancreas puncture biopsies were performed, respectively. The patient was diagnosed as prostate cancer with pancreatic metastasis according to the pathological findings. After undergoing androgen deprivation therapy and docetaxel chemotherapy for 6 cycles, reexamination revealed that the pancreatic metastases had disappeared.

Ammonia ; blood ; Humans ; Liver Failure ; blood ; pathology ; therapy ; Liver, Artificial ; Urea ; blood

OBJECTIVETo summarize the experience of a single treatment using molecular adsorbent recirculating system (MARS) in patients with acute-on-chronic liver failure.

METHODSTwenty-five eases treated by MARS-artificial liver were followed up and reviewed.

RESULTSThe levels of serum total bilirubin, non-conjugated bilirubin and blood ammonia were significantly decreased from (618.51 200.68) mmol/L to (390.81 146.02) mmol/L (t=2.729, P<0.01), (490.03 163.39) mmol/L to (303.28 113.06) mmol/L (t =2.516, P<0.01), and (152.44 82.62)mmol/L to (84.80 13.30)mmol/L (t=2.174, P<0.05), respectively. Prothrombin activity was significantly increased from 70.55% 32.39% to 93.63% 14.20% (t=1.728, P<0.05) in patients during a single 6 h treatment with MARS. No difference was presented in the markers of liver zymogram, serum protein, kidney function, electrolyte, blood routine and blood gas analysis before and after the MARS. Thirteen of 17 patients have been cured or improved, 4 died, and the survival rate was 76.5%.

CONCLUSIONSMARS is a safe and an effective treatment for patients with liver failure.

Adult ; Aged ; Ammonia ; blood ; Bilirubin ; blood ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Kidney Function Tests ; Liver Failure, Acute ; blood ; therapy ; Liver Function Tests ; Liver, Artificial ; adverse effects ; Male ; Middle Aged

OBJECTIVETo investigate the effect of astragaloside IV (As IV) on the activation of rennin-angiotensin system in rats with pressure-overload induced cardiac hypertrophy.

METHODLeft ventricle hypertrophy was induced by abdominal aorta banding between bilateral renal aortas for 12 weeks. Rats were given astragaloside IV 1.0 mg x kg(-1) and 3.3 mg x kg(-1) for 12 weeks, respectively. After treatment, the left ventricular mass index (LVMI)was calculated by morphometry methods. Plasma and cardiac tissue angiotensin II, and plasma aldosterone were measured by ELISA method. Gene expressions of ACE, AT1 and AT2 in cardiac tissue were detected by real time PCR. Protein expressions of AT1 and AT2 in cardiac tissue were detected by Western blot.

RESULTCompared with model rats, LVMI was decreased by astragaloside IV treatment. Biochemical results indicated that the contents of angiotensin II in plasma and cardiac tissue as well as aldosterone in plasma were all increased in abdominal aorta banding rats comparing with sham-operated rats, then, decreased by astragaloside IV treatment. Gene expressions of cardiac ACE was downregulated by astragaloside IV, however, gene and protein expressions of cardiac AT2 were upregulated by astragaloside IV. Both elevated gene and protein expressions of AT1 were not attenuated by astragaloside IV.

CONCLUSIONExcessive activated rennin-angiotensin system in rats with pressure-overload induced cardiac hypertrophy is inhibited by astragaloside IV treatment.

Aldosterone ; blood ; Angiotensin II ; blood ; metabolism ; Animals ; Blood Pressure ; physiology ; Cardiomegaly ; drug therapy ; Enzyme-Linked Immunosorbent Assay ; Hypertrophy, Left Ventricular ; drug therapy ; metabolism ; Male ; Peptidyl-Dipeptidase A ; genetics ; Polymerase Chain Reaction ; Rats ; Rats, Sprague-Dawley ; Receptor, Angiotensin, Type 1 ; genetics ; Receptor, Angiotensin, Type 2 ; genetics ; Renin-Angiotensin System ; drug effects ; Saponins ; therapeutic use ; Triterpenes ; therapeutic use