Percutaneous coronary intervention(PCI) has been a mainstay in the management of coronary artery disease since its introduction in the late 1970s.Bare-metal stents and,more recently,first-generation drug-eluting stents(DES),such as sirolimus-eluting(Cypher) and paclitaxel-eluting stents(Taxus),have further improved results of percutaneous coronary intervention by improving early results and reducing the risk of restenosis.There are currently debates on the safety of these first-generation DES,given the potential for late stent thrombosis which is a first-generation drug-eluting stent of the largest security issue,especially after discontinuation of dual antiplatelet therapy.Next-generation DES such as everolimus-eluting stents(Xience V) holds the promise of superior anti-restenosis efficacy as well as long-term safety.This review makes a presentation of the evidence-based clinical research according to everolimus-eluting stents(Xience Ⅴ).

Objective:To study the protective effect of electro-acupuncture on glutamate(GLU),glycine(GLY),aspartate(ASP)and NF-?B expression in rat with cerebral ischemia reperfusion.Methods:The middle artery occlusion(MCAO)model was established and high pressure liquid chromatography(HPLC)fluorescence assay was used to detect contents of glutamate(GLU),glycine(GLY)and aspartate(ASP)in rat brain.The effect of electro-acupuncture on the nervous dysfunction score,the water content of cerebral constitution and the expression of NF-?B were observed.The group with non-acupoint group was as control.Results:The nervous dysfunction score,the water content of cerebral constitution,NF-?B,GLUand ASP in model group were higher than those of the sham-operated group.GLY levels had no obvious changes,there was no significant diference between the model group and the non-acupoint group.The nervous dysfunction score,the water content of cerebral constitution,the expression of NF-?B,GLU and ASP in electro-acupuncture group were lighter than that of the model group,GLY levels had no obvious changes.Conclusion:Electro-acupuncture could protect brain cell from damage after focal cerebral ischemia reperfusion injury by inhibiting the cerebral expression of NF-?B and excitatory amino acid.

Objective To discuss the quality of life in the postoperative patients with aortic valve replacement (AVR) and related influencing factors .Methods The changes of preoperative and postoperative survival quality in 102 cases of AVR surgery were assessed by using the SF‐36 scale ,and the Logistic regression was used to analyze the impact of age ,effective valve orifice area and prosthetic valve on the quality of life .Results Five patients died during follow‐up .The relative baseline survey after postopera‐tive 1 year showed that the quality of life of patients was significantly improved ,the Logistic regression analysis revealed that a lar‐ger effective orifice area(EOA) and biological valve replacement could have higher health scale scores ,and showed a positive corre‐lation .Conclusion The quality of life in the postoperative patients with AVR is affected by the valve type and EOA of prosthetic valve .

OBJECTIVE: To study the effects of Naomaitong Recipe, a compound Chinese herbal medicine, on the expressions of nuclear factor-kappaB (NF-kappaB) and nitric-oxide synthases (NOSs) in brain tissue after focal cerebral ischemia reperfusion in aged rats and the dosage-effect relationship. METHODS: We adopted the middle cerebral artery occlusion (MCAO) in aged rats as the focal cerebral ischemia model, with 3-hour ischemia and 12-day reperfusion, and observed the changes of the nerve dysfunction score, the water content of cerebral constitution and the expressions of NF-kappaB, heat-shock protein 70 (HSP70) and NOSs in cerebral cortex. RESULTS: The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-kappaB, HSP70, neuronal nitric-oxide synthase (nNOS), endothelial nitric-oxide synthase (eNOS) and inducible nitric-oxide synthase (iNOS) in the untreated group were higher than those of the sham-operated group. The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-kappaB, iNOS and nNOS were lower, while the expressions of HSP70 and eNOS were higher in the high-, medium- and low-dose Naomaitong-treated groups and nimodipine-treated group than those of the untreated-group. The nerve dysfunction score and the expression of nNOS were lower, while the expression of eNOS was higher in the medium-dose Naomaitong-treated group than those of the nimodipine-treated group. The expressions of HSP70 and eNOS were higher, while the other indices were lower in the medium-dose Naomaitong-treated group than those of the low-dose Naomaitong-treated group. CONCLUSION: Naomaitong Recipe can protect the brain cells from damage after focal cerebral ischemia reperfusion injury by adjusting the expressions of NF-kappaB, HSP70 and NOSs, and the medium-dose Naomaitong Recipe is more effective.

Objective: To study the protective e ects and dosage-e ect relationship of Naomaitong on focal cerebral ischemia reperfusion in aged rats.Methods : Focal cerebral ischemia model ( ischemia 3h and I/R12d)was duplicated with MCAO.The changes of the nervous dysfunction score ,the water content of cerebral constitution and the expression of TNF-?,VCAM-1,ICAM-1and its mRNA were observed. Results :The nervous dysfunction score ,the water content of cerebral constitution, the expression of TNF-?,VCAM-1,ICAM-1and its mRNA in aged model group were higher than those of the sham-operated group;but all of these were decreased in three Naomaitong groups and Nimodipine group compared with that of aged model group;the nervous dysfunction score and the expression of VCAM-1,ICAM-1 mRNA in Naomaitong group(0.9g?kg-1) were lighter than that of the Nimodipine group;the nervous dysfunction score,the water content of cerebral constitution, the expression of TNF-?,VCAM-1,ICAM-1and its mRNA in Naomaitong group(0.9g.g-1.d-1) were higher than that of Naomaitong group(0.45g?kg-1?d-1).Conclusion :Naomaitong could protect brain cell from damage after focal cerebral ischemia reperfusion injury by inhibiting the expression of TNF-?,VCAM-1,ICAM-1, with the middle dose of Naomaitong being more e ective.

Objective Human sperm hyaluronidase in the acrosome is a key enzyme during fertilization.To study and establish a modified substrate film method to improve the diagnotic and treatment of male infertility and investigate the influence of sperm hyaluronidase on male fertility.Methods According to the biochemical feature of sperm hyaluronidase that can dissolve the hyaluronic acid in matrixes,the modified sodium hyaluronate-Gelatin membrane was used as substrate to demonstrate the sperm hyaluronidase activity by incubation and staining.70 human semen samples were selected,categorized and detected for hyaluronidase activity according to the resuh of routine clinical semen examination.The average sperm hyaluronidase activity was statistically anyliezed between the fertile group and infertile group.Results Under general light microscope,the clear and bright digestion circle around the sperm head can be observed against the background of deep purple-blue stained substrate at the positive-reaction area.The amounts of positive reaction and the diameter of the bright circle are positively related to the activity of sperm hyaluronidase.The average hyaluronidase reaction rate and diameter of normal fertile group were 70.84% and 78.17 ?m;What about the infertile group A were 60.02% and 76.92 ?m;The infertile group B were 29.11% and 8.22 ?m; There was statistical difference of HYD activity between the infertile group.B and the fertile group(P

Objective To investigate the value of intervening part (IP)ratio under magnifying endoscopy with narrow-band imaging (ME-NBI )in the diagnosis of early gastric neoplastic lesions. Methods From September 2012 to May 2015 ,a total of 124 patients with suspected superficial gastric neoplastic lesions under white light endoscope (WLI)were enrolled,87 male with mean age of (63.2 ± 7.9)years old and 37 female with mean age of (62.6±8.2)years old.All the enrolled patients received precision endoscopy examination,which were observed under WLI at first followed by ME-NBI.Vessel, surface classification and IP features of the lesions under WLI and ME-NBI were recorded,and targeted biopsies were performed.Patients received endoscopic submucosal dissection (ESD)or surgery according to lesions features,histopathological results.Agreement rate between WLI,VS classification with IP ratio and the histopathological results were analyzed.Chi-square test was performed for rate comparision Receiver operator characteristic (ROC)curve was drawn to compare the diagnostic accuracy in early gastriccancer (EGC)between WLI and ME-NBI.Results Among the 124 patients,a total of 118 patients completed precision endoscopy examination.A total of 162 lesions were detected,and 161 of which were analyzed.A total of 84 low grade intraepithelial neoplasia (LGIN),63 high grade intraepithelial neoplasia (HGIN), seven mucosal cancer and seven submucosal cacinoma were detected. The incidences of demarcation line (32.1 %(27/84)vs 96.1 %(74/77)),irregular microsurface pattern (45 .2%(38/84)vs 87.0%(67/77)),irregular-microvascular pattern (16.7%(14/84)vs 62.3%(48/77 )),increased gland tube density (48.8%(41/84)vs 85 .7%(66/77 ))and increased microvessel density (21 .4%(18/84)vs 80.5 %(62/77))of non-cacinoma lesions (LGIN)were significantly lower than those of cacinoma lesions (including HGIN, mucosa cancer and submucosa cacinoma ), and the differences were statistically significant (χ2 =67.6,29.1 ,33.5 ,22.9,53.7,all P <0.05).The sensitivities of WLI and ME-NBI in EGC diagnosis were 89.6% and 94.8%,respectively;the specificities were 61 .9% and 83.3%, respectively,area under curve (AUC)were 0.84 and 0.93,respectively.The diagnostic accuracy of ME-NBI in early gastric cancer was higher than that of WLI,and the difference was statistically significant (χ2 =49.0, P <0.01).The sensitivities of vessel plus surface (VS)classification and VS classification with IP ratio were 90.9% and 94.8%,respectively;and the specificities were 81 .0% and 83.3%,respectively;AUC were 0.89 and 0.93,respectively.The diagnostic sensitivity of vessel classification with IP ratio was higher than that of simple vessel classification,and the differnce was statistically significant (χ2 =41 .0, P <0.01).Conclusion Compared with WLI,the diagnostic accuracy of ME-NBI is higher in gastric superficial neoplasia lesions,and IP ratio is helpful in diagnosis of gastric superficial neoplasia lesions.

Background:Esophageal cancer is a commonly seen gastrointestinal malignancy. Early detection of superficial neoplastic lesions is critical for improving the prognosis. Therefore,it is of great importance to explore new endoscopic techniques for increasing the detection rate of early esophageal cancer. Aims:To assess the diagnostic accuracy of targeted biopsy guided by magnifying endoscopy combined with narrow-band imaging(ME-NBI)for suspected superficial lesions in esophagus. Methods:In a prospective cross-over designed trial,65 patients with suspected superficial lesions in esophagus detected by conventional gastroscopy were randomly assigned to group A and group B. Patients in group A received primary white light imaging(WLI)with Lugol’s staining followed by ME-NBI 4-6 weeks later,and patients in group B received primary ME-NBI followed by WLI with Lugol’s staining 4-6 weeks later. Random biopsy was performed in WLI with Lugol’s staining,while targeted biopsy was performed in ME-NBI based on Inoue’s intraepithelial papillary capillary loop (IPCL)classification. Results:A total of 58 patients completed the study and 68 lesions were eligible for statistical analysis. More biopsies were taken in WLI with Lugol’s staining than in ME-NBI(3. 7 vs. 2. 2 per lesion,P < 0. 05). The overall agreement of IPCL classification with definite pathological diagnosis was 89. 7% . The overall agreement of targeted biopsy by ME-NBI and random biopsy by WLI with Lugol’s staining was 85. 3% ;the specificity and positive predictive value of both ME-NBI and WLI with Lugol’s staining for neoplastic lesions were 100% ,but the sensitivity of ME-NBI was superior to that of WLI with Lugol’s staining(90. 0% vs. 70. 0% ,P < 0. 05). The agreement of ME-NBI-guided targeted biopsy with definite pathological diagnosis was slightly higher than that of random biopsy by WLI with Lugol’s staining(89. 7% vs. 86. 8% ,P > 0. 05). Conclusions:ME-NBI-guided targeted biopsy is superior to random biopsy by WLI with Lugol’s staining for detection of superficial neoplastic lesions in esophagus with higher sensitivity and less number of biopsy. It might benefit the follow-up endoscopic treatment.

Objective To observe hepatocellular apoptosis and inflammatory cytokines expression and their mechanisms after paraquat poisoning in rat.Methods Forty Wistar rats were divided into control group (n =8) and model group (n =32) by random number table.Rats in model group were intraperitoneally injected with 30 mg/kg 20％ paraquat concentrate,while those in control group were injected with normal saline.0.5,1,3,7 days after reproduction of the model,8 rats were sacrificed,and blood was collected from inferior vena cava and hepatic tissue was harvested.The serum levels of interleukin-1β (IL-1 β) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay (ELISA).The mRNA expressions of IL-1β,TNF-α,inducible nitric oxide synthase (iNOS) and p53 were determined by reverse transcription-polymerase chain reaction (RT-PCR).Cysteine-containing aspartate-specific proteases (caspase-3,-8,-9,-12) activity in hepatic tissue was determined on the 3rd day with chromogenic substrate method.The liver histopathological changes were observed after hematoxylin-eosin (HE) staining.Results In model group,hepatic tissue showed extensive necrosis with inflammatory cell infiltration in time dependant manner.Serum IL-1β and TNF-α levels were significantly higher in model group half a day after reproduction than those in control group [IL-1β (ng/L):220.13 ± 69.74 vs.0.14 ± 0.03,TNF-α (ng/L):102.66 ± 26.43 vs.0.16 ± 0.02,P＜ 0.01 and P＜0.05],and peaked on the 3rd day and 1st day [IL-1β:(423.72 ± 153.11) ng/L,TNF-α:(690.35 ± 229.64) ng/L].They then decreased gradually,but were still significantly higher than those in control group on the 7th day [IL-1 β:(357.47 ± 87.28) ng/L,TNF-α:(12.39 ± 5.06) ng/L,both P＜0.05].The contents of IL-1β,TNF-α and iNOS mRNA expressions in hepatic tissue were significantly higher than those in control group,and the highest values were seen on the 1st day,the 1st day,and the 3rd day [IL-1β mRNA (gray value):1.569 ± 0.057 vs.0.123 ± 0.016,TNF-α mRNA (gray value):0.683 ± 0.077 vs.0.261 ± 0.025,iNOS mRNA (gray value):3.259 ± 0.135 vs.0.002 ±0.001,P＜0.05 or P＜0.01].There was no difference in p53 mRNA expression between model group and control group at early stage,and both of them showed low expression,and p53 mRNA expression was significantly higher in model group on the 7th day (gray value:2.959 ± 0.086 vs.0.263 ± 0.032,P＜0.01).In model group,caspase activity (pmol/mg) in liver tissue were significantly higher on the 3rd day than those in control group (caspase-3:857.25 ± 309.26 vs.169.73 ± 48.21,caspase-8:199.18 ± 61.41 vs.32.26 ± 11.09,caspase-9:321.62 ± 80.73 vs.90.38 ± 29.76,caspase-12:413.13 ± 89.77 vs.26.73 ± 9.86,all P＜0.01).Conclusion Paraquat can cause acute liver injury in rats,with caspase-3,-8,-9,-12 activities markedly enhanced,and liver injury may be associated with an early high expression of TNF-α,iNOS and p53 gene.

Objective To evaluate the effect of hyperlipidemia on pulmonary uptake in the patients inhaling sevoflurane for anesthesia.Methods A total of 103 patients of both sexes,aged 20-50 yr,with body mass index of 18-25 kg/m2,of American.Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation under general anesthesia,were enrolled in the study.Anesthesia was induced with iv midazolam 0.1 mg/kg,vecuronium 0.1 mg/kg,fentanyl 0.l mg/kg and etomidate 0.3 mg/kg.Patients were mechanically ventilated after endotracheal intubation.Patients inhaled 2％ sevoflurane for 30 min at an oxygen flow rate of 2 L/min.The inspired concentrations (Fi) and expired concentrations (Fe,Fe≈alveolar concentration [Fa]) of sevoflurane were recorded at 1,3,5,7,10,15,20 and 30 min of inhalation (T0-7).Patients were divided into either control group group C) or hyperlipidemia group (group H) according to the results of blood lipid levels after the end of observation.The ratio of Fa/Fi and time spent in reaching the titration value (Fa/Fi =0.8) were calculated in each group.Results There were 67 cases in group C and 36 cases in group H.Compared with group C,the Fa/Fi ratio was significantly decreased at 5,7 and 10 min of inhalation,and the time spent in reaching the titration value was prolonged in group H (P ＜ 0.05).Conclusion The pulmonary uptake of sevoflurane is increased,which may be associated with increased blood/gas partition coefficient.