Objective To compare the treatment effects of minimally invasive exfoliation's point of varicose veins pump-stripping surgery and traditional treatment of varicose veins of lower extremity surgery.Methods 106 cases with lower extremity varicose veins were simple randomly divided into A,B groups.A team exfoliation new minimally invasive devices for minimally invasive varicose veins stripping point-pumping operation,B group is the traditional line of lower extremity venous stripping pump surgery,after the results of comparative assessment.Results Hemorrhage (15.3 ± 5.4) mL,operation time (58.9 ± 14.3) min,hospitalization time (4.8 ± 1.3) d and operation cost (5124.5 ± 524.7) yuan of group A were lower than those of group B [(65.4 ± 25.1) mL,(72.5 ± 18.6) min,(6.8 ±2.4) D and (6 179.6 ± 623.8) yuan] (P =0.023,0.035,0.019,0.027).Conclusion The minimally nvasive exfoliation's saphenous vein high ligation stripping point-pumping operation not only small wounds,easy to operate,and less post-operative complications and rapid recovery,and on the cost of hospitalization is superior to traditional surgery.

Objective To establish a HPLC method for the assay of Dehydroandrographolide in Fufang Kumu Xiaoyan Pian. Methods Standard was Dehydroandrographolide, HPLC was used with Agilent ZORBAX SB-C18 column (4.6 mm?150 mm, 5 ?m). The mobile phrase was consisted of acetonitrile-0.1% Ammonia slution (30∶70). The detection wavelength at 253 nm. The flow rate was 1 mL/min. Results The assay displayed good linearity. The linear range of ephedrine Hydrochloride was 0.049 92~4.992 ?g (r =0.999 9, n =7). The average recovery was 99.70% and RSD was 0.63% (n =9). Conclusion This method is simple, accurate and can be used for the quality control of Fufang Kumu Xiaoyan Pian.

Objective To evaluate the value of flow cytometry ( FCM) for the differential diagnosis between myelodysplasia (MDS) subtype refractory cytopenia with multiple dysplasia (RCMD) and aplastic anemia (AA). Methods The flow cytometric data of bone marrow samples from 168 cases of RCMD and 77 cases of AA were analyzed retrospectively in blind, and its results were compared with gold standard to evaluate its diagnosis values. Results The specificity of abnormal of single immunophenotype in the surface of granulocytes and myeloblasts was high (range 75.3% -100% ) , but the sensitivity was very low (range 5.4%-50% ). In parallel tests, the sensitivity and specificity of the combination of CD+34 cells≥1% , myeloblasts ≥3% , abnormal expression of CD117 in granulocytes and loss of CD13 in myeloblasts or increased intensity of CD33 in granulocytes were higher than other combinations. The sensitivity and specificity of above combination were more than 62% and 92% , respectively. In the scoring method,different score was given to 8 markers according to different diagnostic value, which were CD+34 cells ≥1 % ,myeloblasts≥3% , abnormal expression of CD117 in granulocytes, loss of CD13 in myeloblasts, increased intensity of CD33 in granulocytes, loss of CD13 in granulocytes, loss of CD10 in granulocytes, and decreased SSC in granulocytes. The sensitivity and specificity were both high if we defined that the total score ≥1.5 was RCMD and the score < 1. 5 was AA. Conclusions The value of abnormal of single immunophenotype for differential diagnosis between RCMD and AA is low. Parallel tests can increase the diagnostic sensitivity obviously and not decrease the specificity. CD+34 cells≥1% , myeloblasts≥3% and abnormal expression of CO117 in granulocytes were the most important markers. The scoring method is precise to distinguish RCMD from AA.

AIM: To study the electrophysiological effects of nitric oxide (NO) on the pacemaker cells in guinea-pig left ventricular outflow tract under the condition of ischemia/reperfusion ( I/R) .METHODS:The spontaneous slow action potentials of guinea-pig left ventricular outflow tract were recorded by conventional intracellular microelectrode technique.The effects of NO donor sodium nitroprusside ( SNP) on the spontaneous slow action potentials under normal or I/R condition were investigated.RESULTS:SNP at concentrations of 1, 10 and 100μmol/L but not 1000μmol/L signif-icantly increased velocity of diastolic depolarization ( VDD) and rate of pacemaker firing ( RPF) , SNP at concentrations of 1, 10, 100 and 1 000μmol/L notably increased maximal diastolic potential (MDP), amplitude of action potential (APA) and maximal rate of depolarization ( Vmax ) , shortened 50%and 90%of the duration ( APD50 and APD90 ) .In ischemia 10 min group, VDD and RPF were significantly decreased, APA and Vmax were notably increased, and APD50 and APD90 were markedly lengthened compared with control group.In reperfusion 10 min group, VDD and RPF were significantly in-creased, MDP and APA were notably decreased, and APD50 and APD90 were markedly shortened compared with I 10 min group.In reperfusin 10 min group, the pacemaker activity was always irregular.In reperfusion 10 min group, the parame-ters of spontaneous slow action potentials restored to the levels of control group except for VDD and Vmax .In 1, 10 and 100 μmol/L SNP+R groups, VDD and RPF were significantly increased than in ischemia 10 min group .In 1, 10, 100 and 1 000 μmol/L SNP+R groups, APA, APD50 and APD90 were restored to the levels of control group.CONCLUSION:SNP significantly increases the spontaneous activity of left ventricular outflow tract, and relieves the effects of I/R on the sponta-neous slow action potential markedly.

Objective To investigate the relation between endothelial repairing function and in-stent restenosis in patients with symptomatic middle cerebral arterial (MCA) stenosis after stent implantation.Method Sixty-six patients with symptomatic MCA stenosis underwent percutaneous stent implantation.Cranial CTA revealed that 23 patients had MCA restenosis (restenosis group) 1 year after stenting,including 14 cases with ＞50％ stenosis and 1 case with MCA occlusion,and 43 patients had no restenosis (non-restenosis group).The number of endothelial progenitor cells (EPC) was examined by flow cytometry,the adhesion function of EPC was tested by adhesion assay,the migration ability of EPC was tested by Transwell method and serum vascular endothelial growth factor (VEGF) levels were measured by ELISA.The relationship of endothelial repairing function with restenosis was analyzed.Results The MCA stent implantations were successfully performed in all patients.The EPC number (33.7 ± 4.6 vs.61.6 ± 6.4),adhesion activities (26.1 ± 7.5 vs.56.3-± 9.6),migration activities (12.0 ± 3.9 vs.21.4 ± 6.5) and serum VEGF level [(56.7 ± 14.6) vs.(89.6 ± 17.32) ng/L] in restenosis group were significantly lower than those in non-restenosis group (t =18.48,13.09,6.34 and 7.73,all P ＜ 0.05).Conclusion For patients with MCA stenosis after percutaneous stent implantation the increased risk of in-stent restenosis is associated with low level of EPCs and their migration ability,and low serum VEGF level.

By analyzing the clinical data of 216 cases of acute cerebral infarction (ACI) from 2012 January to 2013 June retrospectively,we found that the serum levels of high sensitive C-reactive protein (hs-CRP) in patients were significantly higher than those in 186 controls (P ＜0.01).The degree of neural function defect in ACI patients was assessed by the National Institutes of Health Stroke Scale (NIHSS) score.The hs-CRP level of the patients with NIHSS score ＞ 8 were higher than that in those with NIHSS score ≤8 (P ＜ 0.05).The hs-CRP level of patients of large artery atherosclerosis were (6.32 ± 4.12) mg/L and the positive rate of hs-CRP was 85.7％ (84/98).All were respectively higher than those in patients of penetrating artery disease [(1.97 ±0.86) mg/L,7/71],cardiogenic stroke [(3.70 ± 2.76) mg/L,14/24],undetermined etiology [(3.43 ± 3.52) mg/L,5/11] and other etiologies [(3.41 ± 3.25) mg/L,5/12] (all P ＜ 0.05).Logistic regression analysis was performed for the risk factors of ACI.The correlative factors of ACI included hypertension,diabetes mellitus,atrial fibrillation,smoking,total cholesterol,homocysteine and high sensitive C-reactive protein (OR =1.56,1.19,1.23,1.17,3.08,1.34,1.25,all P ＜ 0.01).The serum levels of hs-CRP increased significantly in ACI patients and were correlated with the degree of neural function defect.

Objective To investigate the changes of serum high sensitive C-reactive protein(hs-CRP) level in patients with acute cerebral infarction(ACI),and the relationship between serum hs-CRP level and ACI severity as well as subtypes according to Chinese Ischemic Stroke Subclassification(CISS)criteria. Methods The serum hs-CRP level in 256 patients with ACI and 196 normal controls were measured. The degree of nervous function defect in patients with ACI was assessed by the United States National Institutes of Health Stroke Scale ( NIHSS ) score. All patients were classified into five major ischemic stroke subtypes based on CISS criteria. Logistic regression analysis was applied to analyze the risk factors of ACI. Results The serum hs-CRP level in patients with ACI and control group were(4. 69 ± 2. 58)mmol/ L and(2. 13 ± 1. 79)mmol/ L,and the difference between groups was significant(t = 12. 439,P = 0. 000). The hs-CRP in patients with severity ACI (147 cases)were(5. 89 ± 4. 15)mmol/ L,significantly higher than that in patients with mild ACI,and the difference between groups was significant((2. 11 ± 1. 45)mmol/ L,t = 10. 230,P = 0. 000)). As for subtype ACI,the case of the large artery atherosclerosis subtypes was 106( 41. 57% ),highest than any other subtypes. The hs-CRP level of large artery atherosclerosis was(7. 01 ± 3. 12)mmol/ L,higher than that of control group( P = 0. 000). The logistic regression analysis showed that many factors were related to ACI including total cholesterol,homocysteine and high sensitive C-reactive protein( OR = 0. 324,0. 749,0. 809;P< 0. 05). Conclusion The serum hs-CRP level in patients with ACI increase significantly,and relate to the degree of neural function defect. The level of hs-CRP of large artery atherosclerotic stroke is the highest. The change of serum hs-CRP is very valuable to estimate the severity of ACI.

Objective To investigate drug resistance mechanism of aminoglycoside-resistant Acinetobacter baumannii by detecting 16S rRNA methylase gene and three common genes of aminoglycoside-modifying enzymes in Acinetobacter baumannii infected patients at EICU. Methods The 48 Acinetobacter baumannii strains were collected,and antimicrobial susceptibility tests were performed by VITEK automicroscan. The MIC was detected by 2-fold agar dilution method,and genes were analyzed by polymerase chain reaction( PCR) . Results Among 48 strains,28 were highly resistant to aminoglycosides and 20 showed lower resistances. The 16S rRNA armA,APH(3')-I,ANT(3'')-Ia,AAC(6')-Ib genes were detected in 71. 43%,60. 71%,82. 14%, and 53. 57%of the 28 highly resistant strains,but only present in 0. 00%,0. 05%,0. 05%,and 0. 05%of the low-resistant isolates(P<0. 01). Conclusion The aminoglycoside-modifying enzymes and 16S rRNA methylase were frequently found in Acinetobacter baumannii clinical isolates,which is closely related to the high-level resistance to aminoglycoside antibiotics.

Objective:To summarize the age, gender difference, cause, location, time, treatment and prognosis of femoral intertrochanteric fracture complicated with pseudoaneurysm, and analyze the influence of different treatment methods on the occurrence of femoral intertrochanteric fracture complicated with pseudoaneurysm.Methods:Using the method of systematic literature review, a total of 76 literatures were retrieved from multiple databases at home and abroad, and 45 literatures were screened out through the second screening of title, abstract and full text. The patients with intertrochanteric fracture complicated with pseudoaneurysm were selected as the research objects, and the duplicate cases were deleted; the age, gender, onset age, etiology, location, treatment and prognosis of the disease were retrospectively analyzed.Results:A total of 54 cases of femoral intertrochanteric fracture related pseudoaneurysms were selected from 45 literatures, including 25 males and 27 females, and 2 cases had no gender; aged from 43 to 94 years old, and 4 cases were younger than 60 years old, 6 between 61 and 70, 17 between 71 and 80, and 25 between 81 and 90. Forty-five cases occurred in deep femoral artery, 3 cases in superficial femoral artery, 1 case in superior gluteal artery, 1 case of medial circumflex artery, 1 case of lateral circumflex femoral artery, 1 case of femoral artery, and 2 cases of unknown location. The occurrence time of pseudoaneurysm: 17 cases within 1 week after fracture, 8 cases from 1 week to 3 weeks, 19 cases from 3 weeks to 3 months, 2 cases more than 3 months, and 8 cases unknown. The causes of pseudoaneurysm: among the 54 patients, 41 cases had definite causes, including 21 cases of vascular injury caused by fracture block; 20 cases of iatrogenic injury, of which the incidence of direct injury of blood vessels by screw or drill was the highest, accounting for 55% (11/20). Twenty-two cases were treated with vascular embolization, 10 cases with surgical sutures, 8 cases with surgical ligation, 4 cases with resection of pseudoaneurysm, 5 cases with covered stent, and 4 cases with thrombin injection. There were 42 cases who had follow-up data, and no recurrence and other complications were found during the follow-up period.Conclusion:The peak age of femoral intertrochanteric fracture complicated with pseudoaneurysm was 71-90 years old. The incidence of femoral intertrochanteric fracture complicated with pseudoaneurysm was more often within 1 week after fracture and 3 weeks to 3 months after fracture, due to fracture fragments and iatrogenic vascular injury caused by the location of the profundus femoris artery. Treatment options include vascular embolization, surgical ligation, suture or resection of pseudoaneurysm, covered stent and thrombin injection, and the prognosis is generally good.

Objective To evaluate the applied value of septal cartilage combined with perpendicular plate of ethmoid bone graft in short nose plasty in Chinese people with insufficient septal cartilage.Methods From February 2015 to March 2017,thirty-five women with short noses underwent septal extension grafting in our institute.We used perpendicular plate of ethmoid bone to enhance the L-strut structure.An L-strut,comprising 0.6 cm segments of the caudal and dorsal cartilaginous septum,was left altered to harvest more cartilages for septal extension.The harvested septal cartilage was grafted on one side of the caudal septum.Then the alar cartilage was fixed at the end of the septal cartilage graft.Nasal lengths and nasolabial angles were measured pre-and postoperatively.Results The average nasal lengthening was (3.37±1.87) mm (P＜0.001).There was no infection,cerebral spinal fluid leakage,hemorrhage and other complications postoperatively.The average follow-up was 10 months (6 months to 2 years).After operation,33 patients were satisfied with the nasal contour,1 patient complained of high tip projection whereas one patient complained of low tip projection,and the dissatisfactions were corrected by revision surgeries.Conclusions Combining the septal cartilage with perpendicular plate of ethmoid bone graft presents an adequate nose lengthening and a decreased nostril show,even in patients with very little septal cartilage.With minimum complications,this novel technique provides promising clinical outcomes and high patient satisfaction.