Objective To evaluate the clinical safety and efficacy of Cheatham-Platinum(CP)covered stent in treatment of aortic coarctation.Methods The therapeutic efficacy was retrospectively analyzed in 15 patients with aortic coarctation who were treated by BIB balloon dilation and CP covered stent implantation.Results All patients were well recovered,the stent did not appear displaced,folded,aorta dissection and rupture.The pressure difference was 5-10 mm Hg(1 mm Hg=0.133 kPa)between proximal part and distal end after operation.Following up(20±12)months,the therapy efficacy of all the patients was stable and there was no fracture,removal,aortic stenosis or dysarteriotony.Heart ultrasounds demonstrated good close of the cases with patent ductus arteriosus.Conclusion CP covered stent is a safe and available clinical therapy,featured by minimum aorta injuries.

OBJECTIVE To investigate the effect of nuclear factor-kappa B ligand-receptor activator of nuclear factor-kappa B-osteoprotegerin(RANKRANKL-OPG)system on bone resorption in middle ear cholesteatoma,and the reasons why middle ear cholesteatoma in children were more aggressive. METHODS The expression of RANKL and OPG in 21 adults cholesteatoma,17 children cholesteatoma and 18 normal external meatal skin was studied with immunohistochemistry. Semiquantitative analysis was used for comparison and statistical analysis. RESULTS RANKL-positive cells and the ratio of RANKL/OPG in cholesteatoma were significantly higher than that in external meatal skin(P

AIM: To investigate the postoperative changes of binocular visual function in patients with congenital superior oblique palsy.METHODS: Eye position and binocular visual function were examined in 28 patients with congenital superior oblique palsy pre- and post-operatively. The results were statistically analyzed.RESULTS: The normal eye position rate after operation was 89.3%. There were 9 patients who gained simultaneous perception after operation, while 13 patients gained fusion as many as that gained stereoacuity. There was statistically significant difference between postoperative and preoperative eyes (P<0.05). Near stereoacuity was improved after operation. Patients who had better visual acuity and low strabismus degrees as well as fusion had a better recovery.CONCLUSION: The operation could improve the eye position and rebuild the binocular visual function of the congenital superior oblique palsy. The recovery of binocular visual function was related to visual acuity and strabismus degrees of the patients and whether they had fusion function.

In order to explore the effects of Panax notoginoside (PNS) on the expression of transforming growth factor β1 (TGF-β1) and Smad-7 in renal tissues of diabetes, a rat model of diabetic nephropathy was set up by intravenous injection of streptozotocin (STZ). Wistar rats were randomly divided into normal group, diabetic control group, group treated by PNS at low-dosage (PL), group treated by PNS at high-dosage (PH) and group treated by catopril (C), respectively. Fasting blood glucose (FBG), renal index, endogenous creatinine clearance rate (C(Cr)) and urinary albumin (UAlb) in 24 h were examined after 6 weeks. Meanwhile, the expressions of TGF-β1 and Smad7 in renal tissues were immunohistochemically dectected. At the end of the sixth week, FBG, renal index, C(cr), UAlb were all elevated significantly in control group (P<0.01). The expression of TGF-β1 protein was increased while Smad7 protein decreased in renal tissue (P<0.01). However, the treatment with PNS reversed the aforementioned changes in renal tissues of diabetic rats. These results indicate that PNS possess a protective effect on the kidney of diabetic rats and it might protect kidney by inhibiting the expression of TGF-β1 protein and enhancing the expression of Smad7 protein.

Objective To investigate the effect of individual nostalgia therapy on positive feelings and sadness of the spouses of postoperative patients with esophageal cancer. Method From June 2014 to June 2015, 60 hospitalized patients and their 60 spouses were set as control group. Routine health education and guidance were conducted once or two times a week for 7 weeks. Another 60 cases of hospitalized patients and their 60 spouses during July 2015 and June 2016 were set up as observation group. The patients were treated with the same nursing intervention as in the control group, and their spouses were subjected to individual nostalgia treatment once a week for 7 weeks. Before the intervention (postoperative day 2) and 7 weeks after the intervention, the positive aspects of caregiving (PAC) and the Margit-Meuser caregiver grief ineventary short form (MM-CGI-SF) were used to investigate their positive feelings and sadness. Result The score on spouse's positive feelings in the observation group after intervention was significantly higher than those of the control group and that of the observation before intervention (P < 0.01). Conclusion Individual nostalgia can effectively improve the feelings of the spouses of esophageal cancer patients and reduce their grief.

Objective To analyze the impact of medical insurance reimbursement mechanism on the income of urban community health centers run by various entities. Methods The data of the baseline survey of community health centers in 28 cities made in 2007 were called into play. These data were used to compare the percentage of the annual medical insurance income from outpatient clinics of three types of community health centers in their gross annual income and their annual outpatient clinic income. Results For 929 community health centers with income from medical insurance reimbursement, the average percentage of their annual income from outpatient clinic accounts for 24% of their gross annual income and 26. 09% of their annual outpatient income;In respect of the reimbursement rates of medical insurance at outpatient clinics, the highest come from those run by enterprises, secondly those by the government,and the least those run by social organizations or individuals. Conclusion The mechanism of medical insurance reimbursement has already affected the income of the third type of community health centers. It is recommended to raise the coverage rate of medical insurance of such type of centers and their reimbursement rates of medical insurance. This may further consolidate the policies of medical insurance reimbursement.

Objective To investigate the diagnosis and treatment of vertigo associated with changes of head position.Methods 112 patients of vertigo associated with changes of head position were analyzed from June 2006 to December 2007 through the positional tests and imaging examination.Results 45 men and 67 women from ages 12 to 75 (median 50) were included with a total of 112 patients.88 patients were diagnosed as benign paroxysmal positional vertigo(BPPV),76 patients as posterior semicircular canals BPPV,9 patients as horizontal semicircular canal BPPV,3 patients as anterior semicircular canals BPPV,9 patients as suspicious BPPV.They were treated by canalith repositioning procedure,the total improvement rate was 96.9% after 1 week.15 cases of cervical vertigo were treated by physical therapy and medication,the vertigo of 4 patients disappeared and of 11 patients was improved significantly after 2 weeks.Conclusion The positional tests and cervical plain x-ray are the simplest ways to diagnose vertigo associated with changes of head position.Physical therapy and medication are effective.It is suitable to promote in the grass-roots hospitals.

Objective To investigate the clinical value of contrast-enhanced ultrasonography(CEUS) in evaluating treatment response of hepatocellular carcinoma after interventional therapy. Methods One hundred and three patients with 136 lesions of hepatocellular carcinoma confirmed by pathology were examined by common color ultrasound (US), contrast-enhanced CT, CEUS and DSA pre- and post-interventional treatment respectively. Results The sensitivity,specificity and accuracy of CEUS for focus judgment after interventional therapy were 95.8%, 95.6% and 98. 5% respectively. The sensitivity, specificity and accuracy of US in detecting tumor deactivation and residue were 92.3% ,77.4% and 83.1% respectively. CEUS were highly consistent with the results of enhanced CT/DSA (Kappa = 0.93) and significantly higher than those of US (Kappa = 0.66). Conclusions CEUS is useful to monitor the efficacy and guide treatment after interventional therapy.

Objective:To investigate the diagnostic value of high resolution CT for temporal bone traumatic facial nerve paralysis and the guidance significance for surgery.Method:Twenty-nine patients of traumatic facial nerve paralysis were investigated.The predictive diagnosis was made according to the clinical data and the image features of HRCT,then a comparative analysis of the preoperative image features and the surgical findings were carried out.Result:The trend of temporal bone fracture displayed on the CT scan was basically consisted with the surgical findings.The direct CT signs of facial nerve injury include the bone fracture line went through the tube,bone tube rupture or continuity interruption,while the indirect CT signs include local incrassation of the facial nerve,lower bone density of the tube,geniculate fossa expansion,oppressed facial nerve,et al.The predictive diagnostic accordance rates of all the image features were above 90%as to the surgical findings.Conclusion:High resolution CT could localize the trend of temporal bone fracture,and is helpful to estimate the extent of facial nerve injury and other complications.High resolution CT could provide reliable basis for clinical diagnosis and trotment.

Objective: To study the impact of ticagrelor on inlfammatory factors in patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI).
Methods: Based on conventional medication, a total of 100 UAP patients after PCI were randomly divided into 2 groups for anti-platelet therapy:Treatment group, the patients received aspirin+ticagrelor and Control group, the patients received aspirin+clopidogrel. n=50 in each group, all patients were treated for 12 months. Plasma levels of inlfammatory factors were examined before treatment and 24h, 7d, 28d after the operation. The patients were followed-up for 12 months for ischemic events, bleeding events and adverse drug reactions.
Results: Before treatment, plasma levels of IL-6, IL-18, TNF-α, PDGF were similar between 2 groups (t=0.1356, 0.1668, 0.2473, 0.5780, all P>0.05). At 24h post-operation, the above inlfammatory factors were signiifcantly increased by peaks in both groups and decreased thereafter. At 24h, 7d and 28d post-operation, the levels of IL-6, IL-18, TNF-a, PDGF in Treatment group were all lower than Control group at each corresponding time point (at 24 post-operation, t=2.0856, 2.4399, 2.2217, 2.2053, all P<0.05), (at 7d post-operation, t=6.0978, 5.9705, 4.4631, 4.3963, all P<0.01) and (at 28d post-operation, t=9.3779, 9.7724, 5.5855, 6.1700, all P<0.01). The follow-up study presented that at 12 months post-operation, the ischemic events in Treatment group was lower than Control group (χ2=4.3956, P<0.05);there were no small hemorrhage or major bleeding events occurred;the slight adverse drug reaction was similar between 2 groups (χ2=0.1773, P>0.05).
Conclusion: Compared to clopidogrel, ticagrelor could better decrease plasma levels of inlfammatory factors, it may reduce ischemic events without elevate bleeding events.