ABSTRACT Atherosclerosis (AS) is the principle cause of cardiovascular disease. For many years, AS was regarded as irreversible. However, recent accumulated evidence suggests that AS can regress with proper manipulation. Studies from animal models show that low cholesterol diet can induce obvious regression of AS plaques; Drugs, such as probucol, clolestyramine, lovastatin, isradipine, fosinopril, etc, can reverse the AS respectively by manipulating plasma lipoprotein, scavenging free radicals, blocking calcium channel or inhibiting an-giotensin converting enzyme. Clinical trials furthersubstantiate that good lifestyle and effective control of plasma lipoprotein can reduce clinical events and cause AS plaques regression. Although, AS plaques can regress is no longer in doubt, the mechanism is still unknown. The HDL-mediated reverse cholesterol transport system, apoptosis of the plaque cells may play an important role.

Objective To evaluate the clinical value of application of mesh plug tension-free repair of ingui-nal hernia in grass-roots hospital .Methods A total of 32 patients with inguinal hernia treated by benison-free ingui-nal herniorrhaphy with mesh plug and 28 patients treated with the traditional herniorrhaphy were retrospectively ana-lysed.Results The mean operation time and the postoperative hospital stay of group A were 56.94min and 5.25d, and those of group B were 69.61min and 5.96d,the mean operation time and the postoperative hospital stay of group A were significantly shorter than those of group B (t=-2.891、-3.284,all P<0.05).Patients needed postoperative analgesic therapy (10 cases) and patients suffered from urine retation ( 2 cases ) of group A were less than group B(χ2 =8.014,5.357,all P<0.05).There were 3 cases with postoperative scrotum hematoma in each group and they had no statistical difference for that(P>0.05).All cases received follow-up for 20-40 months,there were no recur-rence in group A during the follow-up period,but 2 cases recurrence in group B .Conclusion Mesh plug tension-free repair of inguinal hernia has the advantages of shorter operation time ,more rapid recovery ,less complications and low-er recurrence rate ,so it is suitable for popularization and application in grass-roots hospital .

Objective To explore the characteristics of childhood tuberculosis and recent advances in the diagnosis and treatment of this disease in order to improve its diagnosis and treatment. Methods Key words“child”“tuberculosis”“diagno-sis” and “treatment” were used to retrieve relevant literatures from Pubmed,Web of Science,CNKI and Wanfang databases.The literatures were reviewed and clinical experience summarized. Results Disseminated tuberculosis and extrapulmonary tubercu-losis were common in children with tuberculosis. It was difficult to collect with samples of diagnostic value for detection. There counterparts were no systematic diagnosis and treatment programs available for children with drug-resistant tuberculosis,and phar-maceutical dosage forms tailored for children were lacking. Conclusion Tuberculosis in children is more complex to diagnose and treat than in adult counterpart.Diagnosis of this disease relies on a variety of diagnostic methods.It's still challenging to control childhood tuberculosis.

[Objective]To assess the efficacy of one-stage anterior radical debridement,decompression,and fusion with anterior and/or posterior spinal instrumentation in the treatment of multisegments spinal tuberculosis.[Method]From 2001 and 2005,a total of 15 patients included thoracic,thoracolumbar and lumbar spinal tuberculosis underwent anterior debridement,allograft bone fusion,and stabilization with anterior and posterior instrumentation.The mini-invasive technique including thoracoscope and X-tube were applied in the later 8 cases.[Result]An average of 2.1 years' follow-up was achieved in 16 patients.The overall fusion rate was 100% in the dynamic lateral views.There was no graft problems.The kyphosis angles that were corrected postoperatively averaged 19.9?.All patients' neurological function were improved except that there was no change in 1 patient with Frankel grade B preoperatively.[Conclusion]Reconstructing the stability of spine is very important for the treatment of spinal tuberculosis.The application of internal instrument and allograft,choosing appropriate surgery can greatly improve the clinical results.Mini-invasive technique reduced blood lost and made the operation easier.

Objective To analyze the level and change trends of cancer mortality in the media focused area,Yingcheng of Hubei Province,to further support the authenticity and reliability of the information from media report.Methods Use the data of the first national retrospective death survey and the third national retrospective sampling death survey to describe cancer mortality and change trends in Yingcheng of Hubei Province.Results Crude cancer mortality in Yingcheng was 148.26/100 000.In the past 30 years,cancer mortality significantly increased by 9.27 times.Among 100 000 people in the county,each year 43 cases of malignant tumor death occurred more than the national average level.A variety of malignant tumors' mortality change in the county is significantly different from those of the country,such as esophageal cancer,stomach cancer did not fall but rise;liver cancer,lung cancer,leukaemia and colorectal cancer increased 5.84 times,5.61 times,5.07 times and 17.91 times more than the national average,respectively.The excess mortality rate of stomach cancer,liver cancer,lung cancer and colorectal cancer were 15.32/100 000,16.78/100 000,8.32/100 000 and 3.98/100 000 respectively.Negative binomial distribution fitting results suggest that death of stomach cancer exists village aggregation.Conclusions The level of historical cancer mortality in Yingcheng was low,but increase quickly,presently it is on the national high-incidence level.It presents the phenomenon that a variety of malignant tumors is generally on high-incidence level and stomach cancer exists village aggregation.

Lymphocyte-activation gene 3 (LAG-3), also known as CD223, is a 498-amino-acid type I transmembrane protein encoded by LAG-3 gene, which consists of extracellular, transmembrane and intracellular regions.LAG-3 negatively regulates T lymphocyte by binding extracellular domain to ligand, thus avoiding autoimmunitycaused by T cell over-activation. Like programmed cell death 1 (PD-1) and cytotoxic T lymphocyte antigen 4 (CTLA-4), LAG-3 is an important immune checkpoint in vivo and plays a balanced regulatory role in human immune system.Tumor cells escape the surveillance of the immune system by over-expressing LAG-3 ligand. With the development in research of immune checkpoints, LAG-3 has become a new generation of immunotherapy targets after PD-1 and CTLA-4. This article reviews the structure and function of LAG-3 and the application of its inhibitors in tumor immunotherapy, in order to provide reference for the further study of LAG-3.

Objective To compare the diagnostic efficiency in showing the responsible blood vessels for neurovascular compression in patients with trigeminal neuralgia by 3D‐FIESTA‐C and 3D‐TOF‐MRA sequences .Methods The imaging data of 60 patients with primary trigeminal neuralgia were analyzed retrospectively .After MRI examination ,all of the patients underwent micro‐vascular de‐compression (MVD) .3D‐TOF‐MRA and 3D‐FIESTA‐C sequences were performed to evaluate the three‐dimensional relationship be‐tween trigeminal nerve and blood vessels through the original and reconstructed image .The intraoperative endoscopic findings were set as the gold standard comparing to the manifestations of 3D‐TOF‐MRA and 3D‐FIESTA‐C .Results The sensitivities of 3D‐TOF‐MRA and 3D‐FIESTA‐C for the diagnosis of the existence of responsible vessels were 85 .7% ,89 .3% ,the specificities were 75 .0% , 100% ,and the accuracies were 85 .0% ,90 .0% ,respectively (P=1 .000) .Furthermore ,the sensitivities of 3D‐TOF‐MRA and 3D‐FIESTA‐C for the diagnosis of the existence of responsible arteries were 94 .1% ,88 .2% (P=0 .244) ,while the sensitivities of the responsible veins were 0 .00% and 88 .2% (P=0 .009) .Conclusion Both the 3D‐FIESTA‐C and 3D‐TOF‐MRA sequences can accurately deter‐mine the existence of responsible vessels in trigeminal neuralgia before surgery .3D‐FIESTA‐C sequence is superior to 3D‐TOF‐MRA for presenting the responsible veins ,which can be used as a supplemental diagnostic tool before operation .

Objective To investigate the correlation between regional cerebral oxygen saturation (rSO2) value and the prognosis of comatose patients in the intensive care unit (ICU).Methods From January 2013 to September 2014, a total of 64 comatose patients admitted in the department of ICU were enrolled.The patients were divided into two groups : consciousness group (n =25) and coma group (n =39).The level of the Glasgow coma scale (GCS), APACHE Ⅱ score and Full Outline of UnResponsiveness score (FOUR) of patients were monitored.The rSO2 was measured by Somanetics INVOS 5100 monitor.Results The differences in levels of FOUR and GCS at admission and GCS at discharge between the two groups were statistically significant (P ＜ 0.05).In the consciousness group, the levels of GCS、 FOUR and rSO2 were higher compared with the coma group (P ＜ 0.05).ROC curve analysis revealed that the areas under the curve of GCS, FOUR and rSO2 for predicting prognosis were 0.823 (0.718-0.928), 0.820 (0.728-0.912) and 0.924 (0.863-0.985) respectively.Conclusions The rSO2 was useful for estimating the prognosis of comatose patients in general ICU.

BACKGROUND:The carotid siphon has a complex structure, which is difficult for two-dimensional imaging observation due to shelter from the basicranial bone. Digital subtraction angiography is conducive to display the course of carotid siphon, but there is a lack of anatomical landmarks. Three-dimensional CT imaging is beneficial to show the structure of carotid siphon and have its measurement, which provides a new and effective means in relevant studies.
OBJECTIVE:To clarify the morphology and calcification distribution of the carotid siphon, thereby providing an objective basis for relevant clinical and basic research.
METHODS: A total of 206 patients, over 50 years old, with no lesions or variation under head and neck CT angiography were selected and divided into non-calcification group (n=70) and calcification group (n=136). The carotid siphon was reconstructed on the imaging workstation to observe the classification (“U”, “V”, “C” and “S” types) and calcification distribution, the bending angles of C4 and C5 segments as wel as lumen diameter were measured.
RESULTS AND CONCLUSION:The 70 patients in the non-calcification group were at a mean age of (59.17±10.27) years, and the “U” type accounted for 35.7%, “V” type for 30.7%, “C” type for 27.2%, and “S” type for 6.4%; Among them, 33.3% patients (25/70) had the same type at both sides; the lumen diameter was (4.92±0.63) mm, and the blending angles of C4 and C5 were (87.23±16.66)° and (49.21±16.01)°. In the calcification group, the mean age was (67.39±9.32) years, and there were 41.5% of “U” type, 33.1% of “V” type, 24.3% of “C” type, 1.1% of 24.3%, and among the 136 patients, 43.4% (59/136) showed the same type at both sides; the lumen diameter was (4.90±0.44) mm, and the blending angles of C4 and C5 segments were (84.44±17.20)° and (52.57±14.16)°. There were significant differences in age and “S” type between the two groups (P < 0.05), but no statistical difference in the lumen diameter and blending angles of C4 and C5 (P > 0.05). In the calcification group, the calcification percentage of inwardly and outwardly curved regions was 13.60% and 19.01% for C4, 27.34% and 16.52% for C5, 9.94% and 13.60% for C6. The morphology of the carotid siphon is mostly seen as “U”, “V”, “C” types, and over 50% types are different at both sides. Calcification of the lumen wal is seen most in the inwardly curved region of C5 segment, folowed by the outwardly curved region of C4 segment. The incidence of calcification is increased with age, which is lower in the S-type carotid siphon. The lumen diameter and blending angle of the carotid siphon show no correlation with calcifications.

Objective To explore the clinical and coronary angiographic characteristics in acute myocardial infarction (AMI) patients with new-onset atrial ifbrillation in early or later stages. Methods From Jun. 2010 to Jun. 2013, 1358 cases of AMI were hospitalized in which 88 were proved to have AMI complicated with new-onset atrial ifbrillation. Eligible patients were divided into early onset group (group1, n=40 cases) and the later onset group (group2, n=48 cases) according to the occurrence of atrial ifbrillation within or after 24 hours of admission. The clinical characteristics and the pathological changes of coronary arteries of the two groups were compared respectively. Results The incidence of inferior wall AMI was signiifcantly higher in group 1. The incidence of anterior wall AMI was signiifcantly higher in group 2 (P<0.05). The incidence of congestive heart failure, the incidence of three-vessel lesions and the in-hospital mortality in group 2 were higher than which in group 1 (P < 0.05). Conclusions The new-onset atrial ifbrillation in different stages may be regarded as a useful indicator for evaluating the clinical characteristic and the infarct-related coronary artery lesions and prognosis of patients with AMI.