Objective To investigate the hemostatic effect of the radial hemostatic compression device(TR Band hemostatic gasbag)after transradial coronary intervention and discuss the optimal hemostasis time.Methods 266 patients who received transradial coronary angiography and used TR Band hemostatic gasbag for hemostasis were divided into group A,B and C,according to the compression time,the compression time in group A (90 cases)was 8 h,10 h in group B (87cases),12 h in group C (89 cases).The condition of bleeding,changes in blood oxygen saturation,and hand swelling in each group were compared.Results The bleeding rates of group A,B and C were respectively 16.7％,3.4％ and 9.0％,the difference was statistically significant.The incidence of hand swelling after operation in group A,B and C were respectively 27.8％,12.6％ and 21.3％,the difference was statistically significant.No significant difference was seen in blood oxygen saturation between three groups.Conclusions Application of radial hemostatic compression device after transradial coronary intervention proved good hemostasis effect,compression time for 10 h has the best effect and less adverse effect.

BACKGROUND: Relapse of acute leukemia is possibly correlated with abnormal expression of cellular adhesion molecule-1 (VCAM-1).OBJECTIVE: To observe the level of VCAM-1 in serum and bone marrow stromal cell (MSC) supernatant of patients with relapsed acute leukemia. METHODS: Samples of serum and MSC supernatant were collected from 17 patients with remission-phase and relapse-phase acute leukemia hospitalized in the Department of Hematology, the Fifth Affiliated Hospital of Sun Yat-sen University between June 2006 and March 2008. The levels of VCAM-1 were measured with ELISA in remission and relapse phases.RESULTS AND CONCLUSION: Compared with the remission phase, the VCAM-1 level of serum was significantly increased in the relapse phase (P < 0.05). At 1 and 3 weeks after in vitro culture, the VCAM-1 level in the MSC supernatant was not changed (P > 0.05), but it was significantly increased on the fourth week (P < 0.05). The results demonstrated that VCAM-1 expression of serum and MSC supernatant in the relapse phase was greater than that in the remission phase, suggesting that abnormal expression of VCAM-1 was possibly correlated with relapse of acute leukemia.

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To investigate the effects of antisense oligonucleotides directed at TNF-? on the intracranial pressure following craniocerebral explosive injury. Eighteen dogs were randomly divided into artificial cerebrospinal fluid (ACSF) group, sense group and antisense group. Using the model of craniocerebral explosive injury, ACSF, the sense oligonucleotides to TNF-? and the antisense oligonucleotides to TNF-? were administered into cerebellomedullar cisterna before injury respectively in three groups, and then the intracranial pressure and contents of brain H 2 O in the bilateral hemispheres in three groups were compared. As compared with the ACSF groups and the sense groups, the contents of brain H 2 O in the antisense groups were significantly reduced( P

Objective To investigate the role of sonic hedgehog (Shh) signal transduction pathway in the expression of vascular endothelial growth factor (VEGF) under hypoxia in cultured human retinal pigment epithelial (hRPE) cells.Methods ARPE-19 were cultured and divided into normal ARPE-19 (Cont) and hypoxia group (100 μmol/L CoCl2 Cobalt Chloride +-ARPE-19);hypoxia group was further divided into CoCl2 group,cyclopamine group (CYA) and dimethyl sulfoxide (DMSO) group.20 μmol/L cyclopamine was added to the CYA group 1 hour before hypoxia,1‰ DMSO was added into DMSO group at the same time.The hRPE cells were cultured under hypoxia for 4,8,12,24 hours.The expression of Shh and VEGF were determined by Real-time fluorescent quantitate PCR (RT-PCR).The amount of VEGF in the hRPE-conditioned supernatant was measured using enzyme linked immunosorbent assay (ELISA) at 4,8,12,24 hours,respectively.Results RT-PCR tests showed that the level of Shh and VEGF of hRPE was time dependently increased (Shh:F=45.260,P=0.001;VEGF:F=264.938,P=0.001).The level of Shh and VEGF of hRPE in the group treated with cyclopamine was decreased (P＜0.01).ELISA tests showed that the amount of VEGF in hRPE supernatant was significantly increased in time-dependent manner (F =3 156.676,P =0.001),and it was down-regulated by cyclopamine under hypoxia (P＜0.01).Conclusion Shh signal transduction pathway could play a role in the VEGF expression induced by hypoxia in hRPE cells.

BACKGROUND:Core decompression and autogenous bone grafts are widely used in treatment of early avascular necrosis of femoral head. According to the report, the success rate of this therapy has obvious difference;the reasons may be related to inaccurate puncture location and secondary damnification of repeated puncture. OBJECTIVE:To reconstruct three-dimensional model of femoral head necrosis by Mimics software for reappearance of lesions in the necrotic area to realize measurement of necrotic area of the femoral head and estimation of its volume. METHODS:We restructured images by using multi-slice spiral CT Syngommvvp VE23A workstation, Inspace software and NeuroDSA software. Hip CT data in DICOM format were imported into Mimics 13.0 software systems. Necrotic area of the femoral head was reconstructed with Mimics SimuIation software to truly reproduce the integrated form, scope and stereochemical structure of the necrotic area so as to achieve the measurement of the necrotic area of the femoral head and the volume estimation. We designed the best core decompression channel, simulated core decompression surgery, so that the patients could refer to the best simulated decompression path in the operation of core decompression. RESULTS AND CONCLUSION:(1) Among 36 patients (48 hips) with avascular necrosis of femoral head, there were phase I in 8 hips, accounting for 17%, phase II in 28 hips, accounting for 58%, and phase III in 12 hips, accounting for 25%. (2) The volume of necrotic area was (1 475.48±647.342) mm3 in the phase I, (4 571.77±2 344.55) mm3 in the phase II, and (4 836.46±2 969.33) mm3 in the phase III. (3) We simulated the core decompression based on the radius of the sphere of the necrotic area as parameter in the Mimics Simulation software module, and then completely cleared the necrotic area. (4) Surgery can more clearly understand information and stereochemical structure of the necrotic area with Mimics software to simulate the core decompression. It is the theoretical basis of operation.

Objective To explore the chronergy of fibrinolysin and its influence on fibrinogen ( FIB ) and thrombus precursor protein (TpP) in treatment of acute cerebral infarction (ACI). Methods The clinical trial adopted the randomized single-blind placebo-controlled design.Totally, 150 patients with ACI (onset time≤12 h) were chosen and randomly divided into experimental group A ( group A receiving treatment of fibrinolysin after 12 h onset of ACI ) , experimental group B ( group B receiving treatment of fibrinolysin after 24 h onset of ACI) and control group ( group C without fibrinolysin treatment) , 50 cases in each group.The patients in experimental group A and B received basic treatment for ACI and fibrinolysin treatment.Patients in group C were given the basic treatment for ACI and placebo.The level of FIB and TpP before and after 7 days treatment, NIHSS scores before and after 14 days treatment, BI scores before and after 90 days treatment, incidence rate of progressive cerebral infarction ( PCI ) , stroke recurrence and mortality rate of the three groups were analyzed to evaluate the clinical effect of fibrinolysin.Hepatic and renal function before and after 7 days treatment, incidence rates of haemorrhage and hypersensitiveness were analyzed to evaluate the security of fibrinolysin. Results The NIHSS score of patients in group A, B and C (4.0±1.6, 6.5±2.2 and 8.0±4.7) was declined significantly after treatment (P<0.05).Group A and B declined more than group C (P<0.05).Group A declined even more than group B (P<0.05).The BI score of patients in group A, B and C after treatment was 68.5±30.6, 55.6±29.2 and 49.7±28.9.The BI score of all groups increased significantly after treatment (P<0.05).Compared with group B and C, group A increased more significantly (P<0.05).The incidence rate of progressive stroke in group A, B and C was 4%, 20% and 30%, respectively.The incidence rate of progressive stroke in group A was lower than that in group B and C (P<0.05).The recurrence rate of stroke after 90 days treatment in group A, B and C was 6.3%, 8.3% and 25.5%, respectively.The recurrence rate of stroke after 1 year treatment in group A, B and C was 10.4%, 12.5% and 31.9%, respectively.The recurrence rates of stroke in group A and B 90 days and 1 year after treatment were significantly lower than those in group C (P<0.05). There was no significant difference in the mortality between the three groups (P>0.05).The FIB in group A, B and C after treatment was (2.74±0.75) g?L-1,(2.82±0.83) and (3.67±1.35) g?L-1, respectively.The level of FIB in the three groups did not decrease significantly after treatment (P>0.05).However, the level of FIB in group A and B declined significantly as compared with that in group C.The TpP in group A, B and C after treatment was (3.56±1.26) mg?L-1, (3.43±1.22) and (13.21±6.54) mg?L-1, respectively.The level of TpP in group A and group B decreased significantly after treatment (P<0.05). The level of TpP in group A and B declined even more significantly than that in group C.Fibrinolysin did neither obviously injure liver and kidney nor increase the risk of bleeding, and had low hypersensitiveness incidence rate. Conclusion Treatment with fibrinolysin within 24 h after onset of cerebra infarction benefits the patients. However, dosing after 12 h onset of ACI benefits more than dosing after 24 h.Fibrinolysin plays a role of anti-thrombosis primarily by lowering the TpP level, and its influence on fibrinogen is limited.

Objective To investigate the effects of breviscapine on the expression of urine Kim‐1 and NGAL in the patients with septic shock complicating renal injury .Methods A total of 66 cases patients with septic shock complicating acute kidney inju‐ry(AKI) in our hospital from May 2013 to May 2015 were selected and randomly divided into the intervention group and control group according to the random number table ,33 cases in each group .All cases were given the standardized therapy of septic shock . On this basis the intervention group was given the intravenous drip of breviscapine .The clinical curative effects were compared be‐tween the two groups .Results The level of Kim‐1 and NAGL were risen after 1 d of treatment ,but began to gradually drop on 3 d of treatment ,the levels of Kim‐1 and NAGL on 3 ,5 ,7 ,9 d had statistical differences between the two groups (P<0 .05);in the in‐tervention group ,5 cases died ,while 6 cases in the control group died .The ICU stay time ,cases number needing dialysis ,dialysis times and dialysis curative time in the control group were more than those in the intervention group ,the differences were statistical‐ly significant(P< 0 .05) .Conclusion Breviscapine could reduce the expression of Kim‐1 and NGAL in the patients with septic shock complicating AKI and promote the recovery of renal function .

Objective To determine the incidence of lung infection and associated factors in patients with traumatic brain injury for the sake of improving the clinical outcomes.Methods A retrospective analysis was made on records of 325 patients who hospitalized between January 2014 and June 2014.There were 198 male and 127 female patients,aged 11-78 years [(38.4 ±8.3) years].A total of 172 patients were injured in traffic accidents,80 in high falls,56 in blow accidents,and 17 in others.Lung infection status was documented and related risk factors were analyzed.Results Thirty-two patients (9.8％) had lung infection.Pseudomonas aeruginosa amounting to 12 strains was the most common pathogenic bacteria.Univariate analysis showed mechanical ventilation,airway open,and aspiration were significantly related to lung infection.Logistic regression identified aspiration (OR =2.891,P ＜ 0.05) and mechanical ventilation (OR =1.323,P ＜ 0.05) as the independent risk factors for lung infection.Conclusions Lung infection is a serious complication of traumatic brain injury,affected largely by aspiration and mechanical ventilation.Active preventions,reductions of risk factors,and early treatments should be done to get the best efficacy.

Objective To compare the eficacy and safety of flexible laryngeal mask (FLMA) and endotracheal tube (ETT) in children undergoing adenoidectomy and tonsillectomy. Methods Forty children with snoring disease scheduled for selective adenoidectomy and tonsillectomy surgery under intravenous compound inhalation general an-esthesia were divided randomly into either FLMA group or ETT group. MAP,HR and SpO2 were recorded before an-esthesia induction(T0 ), 1 (T1 ),3 (T2 ),5 (T3 ) min after intubation,1(T4 ),3 (T5 ) min after extubation. Param-eters for respiratory mechanics included peak airway pressure (Ppeak ), mean airway pressure (Pmean ), end tidal CO2 (PetCO2 ),and airway sealing pressure. All of the above indicators were recorded 5 min (T6 ) after intubation, 10 (T7 ),20 (T8 ) min after put in mouth gag,5 (T9 ) min after removing mouth gag. Meanwhile,chievement ratio of first time insertion,incidence of regurgitation aspiration,bucking,laryngospasm,wheezing when extubation and af-ter extubation,anesthesia time,surgery time,extubation time were recorded. Complications such as nausea and vomi-ting,pharyngeal pain,hoarseness were followed up 24 hours after surgery. Results MAP, HR during T1 , T2 , T3 , T4 ,T5 were significantly higher in group T than T0 , and those in group FLMA (P<0.05). MAP, HR were not sig-nificantly changed in group FLMA during each time. Ppeak , Pmean was significantly lower in group FLMA than that in group ETT. The extubation time was shorter and the incidence of coughing and pharyngalgia after operation was low-er in group FLMA than that in group ETT. Conclusion Compared with endotracheal intubation, on the basis of not affecting surgical operation, FLMA is an effective, safe anesthesia for adenoidectomy and tonsillectomy surgery in children, with the advantages of hemodynamic stability, mild airway trauma,and is a easy handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory me-chanics and low incidence of postoperative upper airway complications.