Objective:To explore predictive value of serum high sensitive C reactive protein (hsCRP) for clinical risk of acute cerebral infarction (ACI).Methods: A total of 122 ACI patients diagnosed in our hospital were regarded as cerebral infarction (CI) group, another 122 patients without ACI who received physical examination in our hospital during the same period were selected as non-CI group.Intima-medium thickness (IMT), plaque location and hsCRP level were compared between two groups, and the relationship among different IMT, plaque types and hsCRP level was analyzed.Results: Compared with non-CI group, there were significant rise in percentages of IMT thickening (1.6% vs.19.7%), carotid atherosclerotic plaques (15.6% vs.69.7%) and unstable plaques (8.2% vs.60.7%) in CI group, P=0.001 all;among CI patients, compared with normal IMT patients, there was significant rise in hsCRP level [(4.7±1.6) mg/L vs.(8.5±2.5) mg/L vs.(12.6±3.9) mg/L] in IMT thickening and IMT plaque formation patients, and hsCRP level of plaque formation patients was significantly higher than that of IMT thickening patients, P=0.001 all;hsCRP level of unstable plaque patients was significantly higher than that of stable plaque patients [(13.7±2.7) mg/L vs.(9.1±2.1) mg/L, P=0.001].Conclusion: Compared with normal IMT patients, there was significant rise in hsCRP level in IMT thickening and IMT plaque formation patients, and hsCRP level of unstable plaque patients was significantly higher than that of stable plaque patients in acute cerebral infarction and non-CI patients, so hsCRP can be used as risk predictor for carotid atherosclerosis and acute cerebral infarction

Objective\ To study whether gonadotropin releasing hormone receptor (GnRHR)mRNA exist in rat submaxillary gland and it's gene sequence. Methods\ The total RNA isolated from rat submaxillary gland was amplified by RT\|PCR, the PCR products were identified by sequencing with Sanger's method. Results\ The specific amplified band of GnRHR mRNA was detected through agarose gel electrophoresis and gene sequence is identical to the sequence of GnRHR which has been reported in rat pituitary. Conclusion\ GnRHR can be produced by submaxillary and response for modulating biological function of submaxillary.\;

Objective Through investigating the current situation of scientific research in medicine graduate students, we can provide scientific basis for training postgraduates effectively and reference for graduate education reform. Methods A total of 243 medicine graduate students in Drum Tower Hospital were surveyed and asked to complete the designed questionnaires which included general situation, the objective to study, the situation of participation projects, the management of student, and achievements. Results 33.74％ (82) of students' purpose was confusion, 51.44％ of (125) graduate students engaged in clinical and basic research, the scientific research graduate students and doctoral students participated in the tutor research project more than the professional type graduate students and Postgraduate student (P<0.05). There were significant differences in the number of SCI related papers published by the postgraduates who differ in their ways of training and in different degrees (P<0.05). Conclusion Graduate students are an important part of high-level talents in China. They are the successors of future scientific research. The effectiveness of training postgraduates' scientific research ability will directly affect the future scientific research level of the country. So we should strengthen the cultivation of graduate students' scientific research accomplishment, construct a scientific training model, set up scientific training mode and supervision mech-anism, in order to promote the research level of medical graduate students.

Objective To analyze the succumbed reasons of emergent pereutaneous coronary intervention(EPCI)in treatment of acute myocardial infarction(AMI)during operation and in-hospital period.Method During March 1999 to June 2005,623 AMI patients received EPCI,and 27 patients died.The succumbed reasons and clinical characteristics of the succumbed patients were analyzed.Result Among the 27 succumbed patients,with age 51 to 91(69?18)years old, 16 had three-vessel lesions.10 had two-vessel lesions and l had single vessel lesion.Ten patients were accompanied with old myocardial infarction,9 with diabetes meUitus,19 with hypertensions,4 with impaired renal functions,and 6 with old cerebral infarction.Nine patients died of eardingenic shocks,6 died of no-reflows,2 died of heart ruptures,2 thrombosis, 2 acute left heart failure,2 acute renal failure,2 intracranial hemorrhage,l shock due to hemorrhage of puncture position, and l acute perieardiae tamponade.Conclusion The succumbed reasons of EPCI in treatment of acute myocardial infarction were various.Cardiac shock and no-reflow were primary reasons.Old age,multi-vessel lesion,diabetes mellitus, and old myocardial infarction may serve as predicting factors.

BACKGROUNDThe most appropriate surgical approach for patients with post-infarction left ventricular (LV) aneurysm remains undetermined. We compared the efficacy of the linear versus patch repair techniques, and investigated the mid-term changes of LV geometry and cardiac function, for repair of LV aneurysms.

METHODSWe reviewed the records of 194 patients who had surgery for a post-infarction LV aneurysm between 1998 and 2010. Short-term and mid-term outcomes, including complications, cardiac function and mortality, were assessed. LV end-diastolic and systolic dimensions (LVEDD and LVESD), LV end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) and LV ejection fraction (LVEF) were measured on pre-operative and follow-up echocardiography.

RESULTSOverall in-hospital mortality was 4.12%, and major morbidity showed no significant differences between the two groups. Multivariate analysis identified preoperative left ventricular end diastolic pressure > 20 mmHg, low cardiac output and aortic clamping time > 2 hours as risk factors for early mortality. Follow-up revealed that LVEF improved from 37% pre-operation to 45% 12 months post-operation in the patch group (P = 0.008), and from 44% pre-operation to 40% 12 months postoperation in the linear group (P = 0.032). In contrast, the LVEDVI and LVESVI in the linear group were significantly reduced immediately after the operation, and increased again at follow-up. However, in the patch group, the LVEDVI and LVESVI were significantly reduced at follow-up. And there were significant differences in the correct value changes of LVEF and left ventricular remodeling between linear repair and patch groups.

CONCLUSIONSPersistent reduction of LV dimensions after the patch repair procedure seems to be a procedure-related problem. The choice of the technique should be tailored on an individual basis and surgeon's preference. The patch remodeling technique results in a better LVEF improvement, further significant reductions in LV dimensions and volumes than does the linear repair technique. The results suggest that LV patch remodeling is a better surgical choice for patients with post-infarction LV aneurysm.

Aged ; Female ; Heart Aneurysm ; etiology ; mortality ; surgery ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications ; mortality ; surgery ; Ventricular Remodeling

Objective To study the clinical value of portable echocardiography system in diagnosis for acute paroxysmal dyspnea.Methods Clinical data of 81 patients with acute paroxysmal dyspnea recorded by a portable echocardiography apparatus at their bedside were retrospectively analyzed,and compared to those of 45 patients by conventional echocardiography.Results The 2D images in portable echocardiograph were similar to those of conventional echocardiograph.Diagnosis could be established in 74 (91.4%),corrected in six (7.4%) and not confirmed only in one (1.2%) of 81 patients with acute paroxysmal dyspnea by portable echocardiography system.And,portable echocardiography system could be used to diagnose pericardial effusion and to monitor perieardial puncturing and draining at bedside. Conclusions Portable echocardiography systems can provide rapid,accurate and valuable information on diagnosis and treatment for acute paroxysmal dyspnea,and make its clinical intervention accurate,scientific and effective,bringing echocardiography performed at bedside possible.

In this paper is advanced a new type of collimator-dual sieve-mesh collimator.Its principle is to use scanned electronic beam to attack 400 matrix-arranged wolfram targets of the square holes on the upper side of the main collimator and created 400 small X-ray fields sized by 10mm×10mm.These X-ray fields will leave on its center 400 smaller X-ray fields sized by 5mm×5mm after being further collimated by a sub-collimator. What's more,16 different groups of such X-ray fields can be left on the center of the same field by controlling the all-round movement of the main collimator and sub-collimator in proper order and by scanning it round by round and mesh by mesh with electronic beams.It is these ting fields groups that make up various treatment fields with different energy (Dosage).This type of collimator can replace and simplify all other present collimators on accelerators and conformal-intensity modulation radiotherapy equipments. It has advantage of reducing the costs of radio-therapy equipment and making conformal and intensity modulation radiotherapy easier to perforn.

Causes analysis of death is the most common work in forensic pathology practice. When designing problem-based learning (PBL) teaching objectives, we should take cause analysis of death as the main line and give consideration to other related issues. The selected cases should be typical ones that solve the target problems, which can fully reflect the basic theoretical knowledge of forensic pathology, and have moderate difficulty, delights and clear conclusions. The PBL course is divided into three steps. The first step focuses on providing students with case information to guide them to find out the problems that need to be solved. The second step focuses on discussing the problems and making pathological diagnoses. The third step focuses on answering the question raised at the beginning of the course. Each lesson can also be divided into several sections by which the lesson plans should be prepared. In the teaching process, performing active interaction with students, controlling the direction of classroom development, balancing student opportunities should be done well in order to make the curriculum smoothly and achieve the purpose of teaching.

OBJECTIVETo investigate the effect of Changtong oral liquid (CTOL) on the proliferation of cultured fibroblasts derived from normal peritoneum (NFs) and adhesive peritoneum (AFs) of rats.

METHODSTwenty male SD rats were randomized into 4 groups, including a normal serum group and 3 CTOL groups with CTOL treatment at low, medium or high doses. Serum samples were obtained from the abdominal arteries of the rats after oral treatment with CTOL for 7 days. The fibroblasts were isolated from the peritoneum by means of tissue culture, and the passage 3-8 cells were cultured with the sera of the normal control and CTOL groups for 24, 48, 72 and 96 h. MTT assay was used to observe the proliferation of the fibroblasts.

RESULTSThe dose of CTOL was inversely correlated to the absorbance but positively to the growth inhibition rates. Compared with the NFs cultured in normal control rat serum, the NFs in serum from CTOL groups showed no obviously changes in the absorbance at 24 and 48 h, but displayed significant reduction at 72 and 96 h (P<0.01). Compared with the AFs in normal rat serum, the AFs in the 3 CTOL groups all showed significantly decreased absorbance at 24, 48, 72 and 96 h (P<0.05). At the same time point, the inhibition rate of AFs in low-dose CTOL group showed no significant difference from that in the normal control group, but CTOL at a medium dose resulted in a significantly higher inhibition rate of AFs at 72 h (P<0.05). High-dose CTOL produced significant differences in the inhibition rates of AFs and NFs (P<0.05).

CONCLUSIONCTOL can inhibit the proliferation of AFs and NFs in vitro. AFs appear to be more sensitive to CTOL, which has a dose-dependent inhibitory effect of AF proliferation.

Adhesiveness ; Administration, Oral ; Animals ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Fibroblasts ; cytology ; drug effects ; Male ; Peritoneum ; cytology ; Rats

Objective To compare the clinical outcomes of selective artery (SAC) with main artery (MAC) clamping of robotic partial nephrectomy (RPN) in patients with early-stage (cTiN0M0) renal masses.Methods Between October 2016 and September 2018,a total of 343 cT1 renal mass patients receiving RPN with SAC (n =21) or MAC (n =322) in our center,were retrospectively analyzed.There were 13 males and 8 females in SAC group with a mean age of (53.1 ± 10.6) years old,mean tumor size of (2.5 ±0.7)cm,and mean R.E.N.A.L.score of 6.2 ± 1.5.There were 149 males and 173 females in MAC group,with a mean age of (51.6 ± 12.3) years old,mean tumor size of(3.5 ± 1.4)cm,and mean R.E.N.A.L.score of 7.9 ± 1.6.There was statistical significance between two groups in tumor size and R.E.N.A.L score(P ＜ 0.001).The group covariates were balanced through propensity score matching (PSM) using 1:2 nearest neighbor matching method.After matching,mean age,tumor size,R.E.N.A.L.score and preoperative eGFR in the SAC and MAC groups were (3.1 ± 10.6) vs.(52.7 ± 10.2) years,(2.5 ± 0.7) vs.(2.6±0.7) cm,6.2 ±1.5 vs.6.2 ±0.9,and (101.7 ± 19.8)vs.(101.6 ±20.3) ml/(min · 1.73m2),respectively (P ＞ 0.05).Perioperative outcomes and follow-up data were compared between the two matched groups.Results There was no significant differences resulted regarding operating time [(127.0 ±54.8)min vs.(130.0 ±49.9) min],blood loss[(166.0 ± 173.5)ml vs.(124.0 ± 101.0)ml],ischemia time [(18.9 ± 6.4) vs.(18.1 ± 5.8) min],hospital stay [(8.7 ± 3.4) d vs.(8.5 ± 2.5) d],incidences of complications (28.6％ vs.19.0％),surgical conversions (0 vs.2.4％),transfusions (4.8％ vs.2.4％) or positive surgical margin(0 vs.0) and malignant pathological outcomes(95.2％ vs.92.9％).The follow-up durations ranged from 3 to 24 months with a mean duration of 9.1 and 12.4 months in SAC and MAC,respectively.At the end of follow-up,the two groups had similar decrease in estimated glomerular filtration rate [(7.5 ± 17.2) ％ vs.(12.1 ± 18.2) ％,P =0.466],but the difference was statistically significant with ECT-GFR both of function reduction in the operated kidney [(21.6 ± 14.6) ％ vs.(38.4 ± 20.7)％,P =0.001] and in two kidneys [(2.5 ±16.4)％ vs.(14.8 ±20.0)％,P =0.002].Conclusions Robotic partial nephrectomy with selective vascular control lead to better postoperative renal function compared with main vascular clamped PN techniques and does not lead to a higher surgical risk following a strict patient selection criteria.