Objective:To explore the correlation between lipid metabolism and coronary atherosclerosis in advanced aged patients with coronary heart disease (CHD) .Methods:A total of 95 advanced aged patients ,who were suspec-ted CHD and received coronary angiography (CAG) in our hospital from Dec 2010 to Dec 2013 ,were selected .Ac-cording to CAG results ,the 95 patients were divided into CHD group (n=43) and non-CHD group (n=52) .Their clinical data were retrospectively analyzed ,and the correlations between blood lipids and coronary atherosclerosis were analyzed .Results:Compared with non-CHD group , the ratio of low density lipoprotein cholesterol to high density lipoprotein cholesterol (LDL-C/HDL-C) [ (2.01 ± 0.65) vs .(2.38 ± 0.92) , P=0.024] significantly rose in CHD group .In CHD group ,number of diseased coronary vessel was positively correlated with triglyceride (TG) level ,LDL-C/HDL-C ,TG/HDL-C and atherogenic index of plasma (AIP) , r=0.183~0.256 (P<0.05 all) ,and inversely correlated with HDL-C level (r= -0.243 ,P<0.05);coronary stenosis degree was positively correlated with LDL-C/HDL-C ,TG/HDL-C and AIP (r=0.225~0.331 ,P<0.05) ,and inversely correlated with HDL-C level (r= -0.261 ,P<0.05) .In CHD group ,total Gensini score was positively correlated with blood lipid indexes (r=0.068~0.201 ,P<0.05 or <0.01) and inversely correlated with HDL-C level (r= -0.138 ,P<0.01) .Con-clusion:Elevated plasma HDL-C level can delay progression of coronary heart disease in advanced aged patients with coronary heart disease .LDL-C/HDL-C and AIP are indexes evaluating severity and risk of coronary atherosclerosis in patients with coronary heart disease .

AIM: To investigate the effects of tripchlorolide (TP) on proliferation and autophagy of human lung cancer A549 cells, and explore its mechanism.METHODS: MTT assay was performed to analyze the effect of TP on the viability of human lung cancer A549 cells.The A549 cells were treated with TP, and their autophagy was observed un-der the fluorescence microscope through acridine orange staining.Green fluorescence spots were observed by fluorescence microscopy through GFP-LC3 plasmid transfection experiment.The levels of LC3 and p-ERK in the A549 cells after TP treatment were determined by Western blot.RESULTS: The viability of human lung cancer A549 cells was significantly inhibited by TP in a dose-time dependent manner (P <0.05).The number of the intracellular acidic follicles dyed with bright red fluorescence was significantly increased after TP treatment in A549 cells.The number of green dot-like con-gregate autophagosomes in cell cytoplasm was significantly increased after TP treatment in the A549 cells transfected with GFP-LC3 plasmid, while the normal treatment only induced a few cells with autophagosome formation.At the same time, we did not observe the dot-like congregate autophagosomes after TP treatment in the A549 cells transfected with GFP-control plasmid.Compared with control group, the expression of LC3-II protein was up-regulated in A549 cells after TP treatment (P <0.01).Furthermore, treatment with TP in A549 cells for 48 h also led to a significant upregulation of phosphorylated form of ERK (P <0.01).In contrast, no significant change in the levels of total ERK protein was observed.Compared with 100 nmol/L TP group, TP +3-MA group down-regulated the protein levels of LC3-II (P <0.01) and p-ERK (P <0.01) in the A549 cells.CONCLUSION: TP significantly inhibits the growth of A549 lung cancer cells and induces the
autophagy, which may be correlated with upregulation of p-ERK protein.

We should foster the students'service idea of human centered, make them to be skillful and have morals. Thus they could serve patients with enthusiasm, win the praise of patients by reasonable charge and smallest wound.

Bronchiolitis Obliterans ; Child ; Humans

AIM: To investigate clinical efficacy of two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin) for acute retinal necrosis syndrome.
METHODS: Thirty patients (40 eyes) with acute retinal necrosis syndrome in our hospital were randomly divided into group A and B. Group A was treated with acyclovir with prednisone acetate tablets, and group B was given ganciclovir with prednisone acetate tablets and aspirin. Clinical effects in the two groups were observed and compared.
RESULTS: After treatment, the overall response rate in group B (90%) was obviously higher than that in group A (70%), both of two regimens were effective, without significant difference (P>0. 05). There was no significant difference on the pre - treatment visual acuity between the two groups (P>0. 05). After different treatments, the visual acuity in group B was ≥0. 5 in 12 eyes, 0. 1≤and<0. 5 in 4 eyes, 0. 02 ≤ and < 0. 1 in 3 eyes, and no photosensitive in 1 eye. The visual acuity in group A was≥0. 5 in 9 eyes, 0. 1≤and<0. 5 in 3 eyes, 0. 02≤and<0. 1 in 6 eyes, and no photosensitive in 2 eyes. The recovery of visual acuity in group B was obviously better than that in A group ( P < 0. 05). The incidence of complications such as retinal tear, herpes, mouth ulcers, chickenpox, viral encephalitis and central nervous system diseases in group B (10%) was significantly lower than that in A group (35%,P<0. 05).
CONCLUSION: Two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin ) both have positive therapeutic effect, but the latter can better restore visual acuity and decrease the complications.

AIM:To observe the rehabilitation effect of oral Calcium Dobesilate Tablets and Epalrestat Tablets on the proliferative diabetic retinopathy ( PDR ) patients after vitrectomy.
METHODS:After vitrectomy patients informed consent, they were randomly divided into intervention group and control group, and their vision and fundus were followed up and compared at 2d;3, 6, 9, 12mo after operation.
RESULTS: The recovery and sustainment of visual acuity, and subsiding of macular edema of patients in drug intervention group were significantly better than that in control group.
CONCLUSION: PDR patients after vitrectomy actively orally take medicine to protect retina, which can improve vision and fundus rehabilitation.

Objective To investigate the effect of patient-controlled intravenous analgesia (PCIA) with dexmedetomidine mixed with sufentanil on the sleep quality after spinal surgery.Methods Eighty patients of both sexes, aged 21-72 yr, weighing 48-100 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective spinal surgery, were randomly assigned into sufentanil group (group S) and dexmedetomidine mixed with sufentanil group (group DS) with 40 cases in each group.In group S, PCIA solution contained sufentanil 2 μg/kg and tropisetron 6 mg in 100 ml of normal saline.In group DS, PCIA solution contained sufentanil 2 μg/kg, dexmedetomidine 3 μg/kg and tropisetron 6 mg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose, a 15 min lockout interval and background infusion at a rate of 2 ml/h.Sufentanil 5 μg injected intravenously and celecoxib 200 mg given orally were used as rescue analgesics, and numeric rating scale (NRS) score at rest was maintained ≤4 within 48 h after surgery.Ramsay sedation scores were recorded at 1, 2, 6, 12, 24 and 48 h after surgery.Sleep quality was evaluated using the Medical Outcomes Study Sleep Scale (MOS-SS), and the average time of daily sleep and Sleep Problems Index (SPI) were recorded at week 1 before and after surgery.Patient's satisfaction with sleep was assessed on the night of surgery and 1st day after surgery.The requirement for rescue analgesics was recorded.Results There was no significant difference in the requirement for rescue analgesics between group S and group DS (P＞0.05).Compared with the value before surgery, the average time of daily sleep was significantly shortened, and SPI was increased at week 1 after surgery in group S (P＜0.05 or 0.01), and no significant change was found in group DS (P＞0.05).Compared with group S, the Ramsay sedation scores were significantly increased at 1, 2, and 6 h after surgery, the average time of daily sleep was prolonged at week 1 after surgery, the SPI was decreased at week 1 after surgery, and the degree of satisfaction with sleep was increased on 1st day after surgery in group DS (P＜0.05 or 0.01).Conclusion PCIA with dexmedetomidine mixed with sufentanil is helpful in improving the sleep quality after spinal surgery in the patients.

Objective To evaluate the results of surgical treatment for duodenal gastrointestinal stromal tumor (GIST).Methods Between January 2000 and January 2013,33 patients underwent surgical resection of duodenal GIST in Peking University Cancer Hospital,including local resection and pancreatoduodenectomy.Clinical data,surgical outcome and prognosis were reviewed.Results The median survival time is 94 months (range:55-132 months).The 1,3,5-year survival rates are 97％,89％ and 80％,respectively.The 5 year survival rate of patients after pancreatoduodenectomy and local resection is 78％ and 83％,respectively (P =0.091).It shows that tumor size and mitotic count and Fletcher classification influence overall survival.Conclusions When fulfiling proper safe margins,local resection is a reliable and curative option for most duodenal GISTs.

15 mm,10～15 mm,

Objective To develop a protocol for ultrasound-guided percutaneous radiofrequency ablation (RFA) on hepatic tumors larger than 3.5 cm in diameter, and to evaluate its role in ablation treatment. Methods Mathematical analysis was performed to generate the preoperative protocol which included the least ablation (sphere) number and the optimal overlapping mode and procedure for adequately ablating a large and spherical target lesion. The target ablation volume consisted of a tumor plus a 0.5- 1.0 cm tumor-free margin. The operation method for electrode placement was also described. Based on this mathematical protocol, 113 patients with 124 hepatic tumors [( 4.75? 0.92)cm in diameter, ranging from 3.6- 7.0 cm] were enrolled and treated. Seventy-one patients had 76 primary and 42 had 48 metastatic hepatic tumors. Results Totally 554 ablations (electrode placements) were performed in 124 tumors. The tumor complete necrosis rate was 87.9% (109/124), the local recurrence rate 24.2% (30/124), the estimated mean time to local recurrence 17.3 months. Twenty-five patients had received 38 retreatments for the local recurrence (17 received one time, and 8 received two or three times). Major complications were found in 7 patients (6.2 %). Of them, only one patient who suffered from colon perforation one week after RFA treatment required surgical intervention. Conclusions A theoretic basis and clinical guidance in RFA of hepatic tumors larger than 3.5 cm might be provided. Treatment results indicated that the protocol might probably be used to improve complete necrosis rate and reduce local recurrence rate in ablation therapy. The protocol was firmed effective and feasible.