Objective To explore the clinical features diagnosis and treatment of left main coronary artery (LM) disease. Methods According to the results of coronary angiography,significant stenosis was defined as ≥50% stenosis. Isolated LM group had 9 patients (4.62%),one-vessel stenosis LM group 15 patients (7.69%),two-vessel stenosis LM group 53 patients (27.18%) and three-vessel stenosis LM group 118 patients (60.51%). Results 195 cases (6.74%) of LM stenosis were found. The incidence rate was low. 164 patients (84.1%) had unstable angina,and 125 patients (64.1%) had myocardial infarction. Coronary artery bypass surgery was performed in 57 patients (29.2%) and the angina disappeared in most of them (84.2%). Five patients received unprotected LM stenosis and angina disappeared in all. Conclusion LM stenosis has sever symptoms. Coronary angiography is the only way for diagnosis and CABG the best treatment. Unprotected LM stenosis is valuable for some patients.

Objective To compare the survival rates from two conservative strategies in the treatment of malignant pleural mesothelioma (pemetrexed plus cisplatin or pemetrexed plus carboplatin ).Methods Seventeen cases diagnosed of malignant pleural mesothelioma at clinical stages of or over Butchart Ⅲ in our hospital during 2005 -2009 were treated with pemetrexed plus cisplatin (10 cases,Group A)or pemetrexed plus carboplatin (7 cases,Group B ).The difference in the survival rates between these two groups was compared.Results The early survival rate (0 -3 months)in pemetrexed plus cisplatin (group A)-treated group was more than that of pemetrexed plus carboplatin group (group B),but the difference was not statistically significant (x2 =0,1.52,1.52,respectively,P ＞ 0.05 ).For the medium-term survival rate (4 - 9 months),group A was better than group B,and the difference was statistically significant( x2 =5.21,4.41,4.41,4.50,4.50,4.55,respectively,P ＜ 0.05 ).The two groups produced comparable long-term survival rate s (10 -12months) ( x2 =1.31,0.09,0.09,respectively,P ＞ 0.05 ).Conclusion To increase the medium-term survival rate (4 -9 months)of patients with MPM,we prefer to using pemetrexed plus cisplatin regime.For the patients with more severe side effects which can be relieved by folic acid and VitB12,this regime is also recommended.Otherwise,for the patients with unrelievable side effects,especially for those with poor physical condition or a short survival expectation,pemetrexed plus carboplatin is suggested.

Objective To compare nursing students' adaptation in clinical practice who are under two different curriculum systems in order to guide our college's curriculum reform. Methods ROY adaptation model was used as the theoretical basis to design the questionnaire. 48 students in the reform class and 80 students in the parallel class were surveyed by questionnaire. Results The reform class and the parallel class of students were both unadaptable in clinical practice, but the reform class's adaptation was better than the parallel class. Conclusions Curriculum reform has some positive effect in clinical practice, nursing educators should take appropriate approaches to promote students to adapt the clinical practice.

Objective To analyze and explore the value of the mutislice spiral CT (MSCT) scanning,its reconstructive technology and MRI scanning for applying to the identifying diagnosis of new and old vertebral compresion fracture.Methods One hundred and sixty-seven cases with the new and old vertebral compresion fracture who have 189 vertebrae in total were examined using the MSCT scanning,their imaging information were postprocessed with 2D and 3D reconstruction at the work station.Thirty-four patients with overall 43 vertebrae were carried out by MRI scanning and their images were compared with those of MSCT.Results They had the highest proportion of vertebrae in L1 with accounting for 27.68% (31/112) and 35.06% (27/77) among the patients with new and old vertebral compresion fracture,respectively.The next was T12,L2 and T11.There were statistically significant differences between new and old cases in such appearance as fracture line clear and sharp(102 and 21),contusion and hemorrhage of spinal cord(15 and 0),parenchyma shadow beside vertebrae(103 and 11),appendant fracture(26 and 5),organ's lacerated wound around vertebral body(30 and 0),discus intervertebrales vacuum(10 and 36),derangement and hardening of vertebral bone trabecularism(29 and 51) (P＜0.01).Twenty-six vertebrae with the uneven low T1 WI signal,27 vertebrae with the T2 WI fat-suppresion irregular high signal were demonstrated in MRI scanning among 27 vertebrae of 21 cases with new vertebral compresion fracture.While 16 vertebrae with the T1WI and T2WI signals were the same as those of the normal vertebrae,16 vertebrae were the T2WI fat-suppresion low signal among 13 cases with old vertebral compresion fracture.Conclusions The MSCT plays an important role in identifying diagnosis for the most of the patients with the new and old vertebral compresion fracture, while MRI scanning may reflect the pathophysiological characteristics in diagnosis of the spinal cord and the ligament lesion.Therefore,the MSCT and MRI scanning should be integrated to be used to enhance remarkably the accurate rate of the diagnosis.

Objective To compare the long-term efficacies of anterior cervical decompression and fusion (ACDF)and conservative therapy in treatment of unisegmental cervical disc herniation and to analyze the degree of the long-term adjacent segment disc degeneration in ACDF.Methods 120 patients treated in our hospital from January 2006 to January 2009 were selected,60 patients underwent ACDF as operation group and 60 patients underwent physical therapy and drug (conservative therapy)as non-operation group. All the patients were recorded when they were diagnosed with cervical unisegmental cervical disc herniation, and followed-up for 60 months, and they were evaluated with American Spinal Injury Association (ASIA)score,Visual Analogue Scale (VAS),Japanese Orthopedics Association (JOA) score and imaging (Miyazaki grading system). Results 107 patients were followed up,55 patients treated by operation were followed up for an average 59.7 months (59.7±0.4),while 52 patients treated by conservative therapy were followed up for an average 58.8 months (58.8±1.5).Compared with before treatment, the ASIA, JOA, and VAS scores of the patients in two group after treatment were improved (P<0.05),and the scores of ASIA,VAS,and JOA in operation group were superior to that in non-operation group (P<0.05),and adjacent segment disc degeneration occurred more frequently in the upper adjacent segment than the lower adjacent segment (P<0.05).Conclusion ACDF is superior to conservative therapy in alleviating symptoms and improving prognosis of unisegmental cervical disc herniation. Long-term postoperative disc degeneration mainly occurrs in the upper segment.

Objective To compare the efficacy of thrombus aspiration catheter combined with intracoronary tirofiban and nitroglycerol injection through the aspiration catheter versus the guiding catheter during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods Thirty-four patients with STEMI undergoing primary PCI and receiving thrombus aspiration catheter combined with intracoronary tirofiban and nitroglyeerol injection through the aspiration catheter were enrolled as the aspiration group (n =34),and those who had similar coronary angiography results and basic characteristics but receiving thrombus aspiration catheter combined with intracoronary tirofiban and nitroglycerol injection through the guiding catheter were served as the guiding group ( n =33 ).The outcomes of the two groups were observed and compared.Results There was no significant change of blood pressure between before and after injection in the aspiration group ( P ＞ 0.05 ),but the change of blood pressure was significant after injection compared with before injection in the guiding group ( P ＜ 0.01 ).The cTn-I,BNP,peak-value of CK-MB,peak-time of CK-MB,TIMI grade 3 flow,slow-reflow in IRA after PCI in the aspiration group were superior to those in the guiding group ( t =3.92,P ＜ 0.01 ;t =4.70,P ＜ 0.01 ; t =3.39,P ＜ 0.01 ; t =7.17,P ＜0.01 ; x2 =3.877,P ＜ 0.05 ; x2 =3.876,P ＜ 0.05 ).LVEF,LVEDd and LVESd after 1 month in the aspiration group were superior to those in the guiding group (t =5.99,P ＜ 0.01 ;t =4.53,P ＜ 0.01 ;t =8.12,P ＜ 0.01 ),but no significant differences of LVEF,LVEDd,LVESd were found after 1 week resolution of sum of ST-segment elevation and the MACE rates after PCI were found between the two group ( P ＞ 0.05 ).Conclusion Application of thrombus aspiration catheter combined with intracoronary tirofiban injection through the aspiration catheter is more effective than through the guiding catheter in patients with Acute ST-segment elevation myocardial infarction,which could decrease slow-reflow phenomenon and improve re-perfusion and left ventricular function with better clinical outcomes.

Objective To explore the therapeutic efficacy of nanometer high-frequency square pulse light technology targeting kidney cancer.Methods Fifty BALB/c nude mice were vaccinated with human ACHN cell line and randomly divided into 1 control group and 4 therapeutic groups.The 4 therapeutic groups were cured with high-frequency square pulse light and nanometer high-frequency square pulse light.The treatment cycle was 4 weeks.The tumor growth condition and tumor-repres-sion change were observed and compared.Results The tumor volumes of the control group in-creased obviously,whereas the tumor volumes of the therapeutic groups decreased obviously or in-creased gently.The mean tumor volume and the tumor growth curve of the therapeutic groups were significantly lower than those of the control group(P＜0.05),but there was no significant difference between the therapeutic efficacy of the kidney cancer using high-frequency square pulse light and nanometer high-frequency square pulse light(P＞0.05).Synteresis of kidney carcinogenesis experiments results indicated that using high-frequency square pulse light and nanometer high-frequency square Dulse light could prevent the production and development of the kidney cancer(P＜0.05),but the svnteresis efficacy of the 2 methods had no obvious difference(P＞0.05).Conclusion Using highfrequency square pulse light and nanometer high-frequency square pulse light can cure the kidney cancer and,to some extent,prevent the production and development of kidney cancer.

OBJECTIVE To investigate the knowledge of Helicobacter pylori infection among outpatients,analyzing the data and providing useful information and measures for H.pylori infected and uninfected patients. METHODS Questionnaires about the knowledge of H.pylori were operated on 286 patients randomly selected from patients taking gastrointestinal endoscopy in October,2005. RESULTS Among 286 patients investigated,177 cases(61.9%) took the examination for diagnosis,while 157 cases(54.9%) had upper abdominal symptom more than 12 months.There were 60% patients investigated who knew only 2 items from total(7 items) about H.pylori in the questionnaires,while 46.7% patients wanted to obtain the knowledge of the disease and instructions on health care from medical professionals.In addition,it showed that there was no close relation between education level and knowledge of the disease. CONCLUSIONS Investigating the knowledge of special disease,which mastered by the patients,will help to identify patients blind to the disease they have,and patients who are in need of health-care instructions.

Objective To assess the val ue of 18-fluorodeoxy glucose (~18F-FDG) positron emission tomography( PE T)-CT in the detection of malignant bone metastases. Methods Thirty-five out of 332 patients, 89 lesions were detected on ~18 F-FDG PET-CT and were interpreted separately on PET, combined CT, and fused PE T-CT images. Results Of the 89 lesions detected on PET- CT images, 68 were malignant and 21 were benign lesions. PET alone identified 62 malignant lesions and 17 benign lesions. The diagnostic sensitivity, specificit y, and accuracy of PET alone for diagnosis of bone metastases were 91.2% (62/68) , 81.0% (17/21), and 88.8% (79/89), respectively. The combined CT alone identifi ed 55 malignant lesions and 16 benign lesions. The diagnostic sensitivity, s pecificity, and accuracy of combined CT alone were 80.9% (55/68), 76.2% (16/21), and 79.8% (71/89), respectively. The fused PET-CT images identified 64 maligna nt and 19 benign lesions. The diagnostic sensitivity, specificity, and accuracy of the fused PET-CT were 94.1% (64/68), 90.5% (19/21), and 93.2% (83/89), respe ctively. Conclusion In the diagnosis of bone metastases, ~18F-FDG PET-CT imaging reduces the false positive rate and increases the specificity. ~18F-FDG PET-CT imaging is helpful in the differentiation o f bone metastases from benign lesions.

Objective To observe the safety and efficiency of DIVER thrombus aspiration catheter application during percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI)and to evaluate its impacts on the myocardial reperfusion,cardiac function and in-stent restenosis after 9months.Methods A total of 86 cases of ST-segment elevation patients of AMI treated with PCI and confirmed complete occlusion lesion by angiography from November 2008 to December 2010 were randomly divided into two groups:aspiration group(n =43)with DIVER thrombus aspiration cathetcrs were used,and non-aspiration group (n =43).ST-segment recovery within two hours,TIMI grade,the in-hospital adverse major cardiac events,the levels of Pro-BNP,coronary function determined by ultrasound heartbeat graph and the results of coronary angiography after PCI for 9 months were compared between two groups.Results There was significant difference on ST-segment recovery within two hours between these two groups[95.35％(41/43)vs 79.02％(34/43),x2 =11.862,P =0.0006].The incidence of TIMI 3 grade flow was significantly higher,the incidence of TIMI 2(slow flow)and TIMI 0-1(no-reflow)grade flow were much lower in aspiration group than those in non-aspiration group immediately after PCI[TIMI 3:93.02％(40/43) vs 81.40％(35/43),x2 =6.06,P =0.0335 ; TIMI 2:6.98％(3/43) vs 13.95 ％(6/43),x2 =3.12,P =0.0495 ; TIMI 0-1:0 vs 6.98 ％(3/43),x2 =5.29,P =0.0352].There was no difference on LVEF[(0.420±0.054) ％ vs(0.408±0.052)％,t =1.0496,P =0.766and LVEDD(56.5±4.5)mm vs(57.6±4.4)mm,t =1.0419,P =0.7832]between these two groups one day after PCL LVEF was significandy higher in aspiration group than that in non-aspiration group one and nine months after PCI[(0.452±0.050) ％ vs(0.432±0.049) ％,t =3.3957,P =0.0482 ;(0.469±0.053) ％ vs (0.413±0.052)％,t =4.9457,P =0.0336].LVEDD was significantly smaller in aspiration group than that in non-aspiration group one and nine months after PCI[(49.6±5.1) mm vs(53.4±4.6) mm,t =3.4548,P =0.0473 ;(46.5±4.4) mm vs(50.2±4.8) mm,t =3.7260,P =0.0421].There were no cardiovascular events (angina,myocardial infarction,heart failure,cardiac death)in both groups during 9 months follow-up.The coronary angiography results showed that the occurrence rate of in-stent restenosis in aspiration group was significantly lower than that in non-aspiration group(2.33％ vs 6.98％,x2 =4.4351,P =0.0463).Conclusion The application of DIVER thrombus aspiration catheters during PCI in all patients with AMI was safe and effective,it can improve the myocardial tissue perfusion and the post-operative cardiac function and can lower the occurrence rate of in-stent restenosis.