Objective To observe the changes of postoperative blood high sensitive C-reactive protein (hs-CRP), tumor necrosis factor(TNF)-o, P-selectin levels in patients with acute coronary syndrome (ACS) who had an atorvastatin intensive treatment before operation, and investigate its clinical significance.Methods Seventy-eight cases of ACS patients who intended to undergo percutaneous coronary intervention were divided into two groups by random digits table:39 patients comprising the standard treatment group (given atorvaatatin 20 mg/d, conventional treatment), 39 patients comprising the enhanced group (given atorvastatin 40 mg, 20 mg separately at preoperative 12 h, 2 h on the basis of conventional treatment).Among them, 28 cases of the standard treatment group and 29 cases of the enhanced group finally underwent the test. The hs-CRP,TNF-α ,P-selectin levels at preoperative 1 day,postoperative 6 h,postoperative 12 h were detected and then the changes of three factors were analyzed. Results There was no significant difference in hs-CRP,TNF- α, P-selectin between the two groups at preoperative 1 day. The values of the two groups markedly increased at postoperative 6 h, 12 h and the difference was statistically significant (P ＜0.05). The values of the standard treatment group were markedly higher at postoperative 12 h than those at postoperative 6 h,and the difference was statistically significant [hs-CRP: (10.29 ± 0.77) mg/L vs. (6.34 ±1.23) mg/L;TNF-α: (58.15±5.19) ng/L vs. (36.12 ± 3.89) ng/L;P-selectin: (49.58 ±4.92) μg/L vs.(31.47 ± 3.71) μ g/L] (P ＜ 0.05). However, the values of the enhanced group were higher at postoperative 12 h than those at postoperative 6 h but the difference was no statistically significant [hs-CRP: (6.83 ± 1.46)mg/L vs. (5.95 ± 1.17) mg/L; TNF- o: (42.18 ± 7.79) ng/L vs. (34.07 ± 8.79) ng/L; P-selectin: (33.57 ±4.63) μ g/L vs. (29.78 ± 5.61) μ g/L] (P ＞ 0.05). Three factors in standard treatment group were elevating significantly at postoperative 6 h, 12 h compared with those in the enhanced group, but the difference was no statistically significant (P ＞ 0.05). Conclusion Short-term intensive therapy of atorvastatin in ACS patients who intend to do PCI, can reduce the hs-CRP, TNF-α, P-selectin levels effectively.

Objective By taking cardiopulmonary resuscitation (CPR) resident standardization training skills practice as an example,to explore how to improve the ability of resident operating on the clinical skills.Methods 58 resident physicians in the hospital standardized training were selected,and through training and assessment of cardiopulmonary resuscitation skill training,the result was compared,and statistical analysis was made on the overall pass rate,the performance after the training,and the pass rate of operation.Result Comparison of the data was done by the t test,and pass rate by chi square result 48 people passed the training and examination,and the pass rate was 82.76％.The operation scores before and after training were:General (78.5 ± 6.44) vs.(89.2 ± 6.12),Department of gynecology and Obstetrics (74.3 ± 6.54) vs.(87.0 ± 6.34) of (70.6 ± 6.78) vs.(87.3 ± 6.31),rehabilitation medicine (70.2 ± 6.81) vs.(85.6 ± 6.77),Department of Stomatology (69.80 ± 7.07) vs.(82.80 ± 6.89),psychiatric (69.4 ± 7.19) vs.(80.4 ± 6.91),Department of medical imaging (69.30 ± 7.20) vs.(78.80 ± 6.94),(64.00 ± 7.25 test vs.) (76.5 ± 6.99),and the differences were statistically significant.After the training,the average score of the general professional training was 89.2,the highest score,while the average score of students trained in professional inspection department was 76.5 points,the lowest score.Chest compressions and artificial respiration,electrode plate installation project operation were the worst.Students pressed 80 times/min before but now increased to 90 seconds;as for artificial respiration,students often extended more than 30 seconds;the electrode plate installation project operation,extended more than 25 seconds.Conclusion The pass rate of different professional training and the performance before and after professional training have differences,so theory and practice need to be combined to carry out scientific and reasonable training so as to improve the train-ing residents' clinical skills.

Objective To quantitatively assess the neovascularization within human carotid atheroclerltic soft plaque in patients with cerebral infarction using real-time contrast-enhanced uhrasonography. Methods One hundred and forty-two patients with carotid athemselerotic soft plaque were divided into two groups: cerebral infarction group (n = 44)and control group (n = 98).Real-time contrast-enhanced ultrasonography was examined. Acoustics quantitative analysis was made by auto-tracking contrast quantification (ACQ)technology. Results The enhanced intensity (EI)in cerebral infarction group was significandy higher than that in control group[(14.58±4.19)dB vs (11.26±3.77)dB, P< 0.01]. The difference of arrival time (DAT)and the difference of time to peak (DTrP)in cerebral infarction group was significantly shorter than those in control group [(2.21±0.42)s vs (2.46±0.51)s,(2.13 + 0.37)s vs (2.43±0.48)s, P all < 0.01]. Conclusions The real-time contrast-enhanced uhrasonography can provide a new non-invasire and quantitative tool to assess the neovascularizafion within carotid atheroselerofic soft plaque. EI is re-garded as an independent risk factor correhtes strongly with cerebral infarction.

Objective To study prospectively the values of basal and dynamic measurement of inhibin B(INHB), estrodiol (E_2)following gonadotrophin therapy in vitro fertilization(IVF)cycles in predicting ovarian response to stimulation in young women. Methods A total of 57 patients younger than 40 years of age undergoing their first cycle of long protocol IVF treatment were studied and serum INHB, E_2 levels were detected on day 3 of the menstrual cycle, before the first administration of gonadotrophin (day 0), on days 1 and 5 after gonadotrophin therapy(day 1, day 5 ). Ovarian response was presented by: number of oocytes/total rFSH dose and square root of (number of follicles/total rFSH dose). According to number of follicles, number of oocytes and presence or absence of ovarian hyperstimulation syndrome(OHSS), we categorized the results into three different groups: poor response, normal response and OHSS. Results (1) Hormone levels on days 1,5 of rFSH stimulation: There were positive correlation between INHB (r_S:0.69-0.73), E_2 (r_S:0.60-0.73) and ovarian response (P=0.000). (2) INHB, and E_2 levels on day 5 of rFSH stimulation were significantly different between poor response, normal response and OHSS groups(P

Bronchial asthma is a chronic inflammatory disease of the airways, which is characterized by airway hyperresponsiveness(AHR), eosinophilia, elevated IgE, goblet cell metaplasia, airway remodeling and so on.Changes in airway epithelial structure and function are prominent features of asthma.Asthma airway epithelium has abnormal sensitivity to oxidative damage and apoptosis, and is more susceptible to reactive oxygen species(ROS)produced by infiltrating inflammatory cells.The effects of ROS accumulation and oxidative stress are the key links in the pathogenesis of asthma.Oxidants such as ROS can interfere with the structure of epithelial cells and cause tracheal remodeling.Conversely, tracheal remodeling can release inflammatory mediators and aggravate asthma.The main function of mitochondria is oxidative phosphorylation to synthesize ATP, and it is also an important source of ROS.Mitochondrial dysfunction includes energy metabolism conversion dysfunction, mitochondrial biological dysfunction, mitochondrial autophagy and kinetic abnormalities, and mitochondrial-dependent signaling pathway disorders.Mitochondrial dysfunction and cellular hypoxia play an extremely important role in the occurrence and development of bronchial asthma.This article reviews the changes in mitochondrial function of airway epithelial cells in asthma airways in recent years, in order to provide theoretical basis for mitochondria-targeted asthma treatment.

Objective To discuss the effect of the bedside shielding protection on the first and second operators against position radiation in percutaneous coronary intervention.Methods The surface entrance dosage rate for the first and second operators at 125 cm height with and without radiation protection shielding (provided separately) were measured.The t-test was used for statistical analysis of arithmetic mean values of dosage rates.And the effect of bedside shielding protection was calculated.Results The position radiation dosage rate at which the first operator exposed was significantly higher than that for the second in the case of no bedside protection (t =97.1-2 263.0,P ＜ 0.05),whereas the dosage rate at which the first operator (except for the left foot position) exposed was significantly lower than that for the second in the case of no bedside protection (t =-80.9-275.1,P ＜ 0.05).The shielding effect of bedside protection on the first and second operators was in the range of 92.26％-99.36％ and 27.83％-97.90％,respectively.Conclusions The bedside protection may effectively reduce position radiation dose to patients and the use of bedside protection changed the trends in the dose distribution in operators' standing region.Attention should be focused on the radiation protection of the second operators in daily work by making full use of bedside protection.

The blood vessels supplying the anterior part of the iliac crest of 126 (84 males, 42 females) Chinese adult cadavers were observed. The findings are as following:1. The superficial circumflex iliac artery has an average external diameter of 1.45?0.41 mm and supplies mainly the skin and the superficial structures of the groin region and the region adjacent to the anterior superior iliac spine.2. The ascending branch of the lateral circumflex femoral artery has an average external diameter of 2.62?0.51 mm and supplies the tensor fasciae latae and the outer border of the anterior superior iliac spine.3. The deep upper branch of the superior gluteal artery has an average external diameter of 2.87?0.56 mm and supplies the glutei medius et minimus and the outer border of the anterior part of the iliac crest.4. The deep circumflex iliac artery has an average external diameter of 2.77?0.47 mm and may originate from above (18.0％), behind (41.5％), or below (40.5％) the inguinal ligament. It supplies the abdominal muscles adjacent to iliac crest and the inner border of the anterior part of the iliac crest.In this study particular attention was paid to investigating the course, branches, anastomosis of the deep circumflex iliac artery and its relationship to the anterior part of the iliac crest.5. The findings suggest that the deep circumflex iliac vessel may be used as a nutritive pedicle in free microvascular transplantation of the iliac bone.

Objective To explore the influential factors of hospital management teaching and to apply new plans to improve quality of teaching. Methods Questionnaire survey was conducted among 94 students majored in health management in Xuzhou Medical College to investigate student' learning behavior as well as contents, applying value, procedures, and teaching effects of the course. Data was put in by Epidata 3.02, described and analyzed by SPSS 18.0. Continous variables were ana-lyzed by t test and classified variables were analyzed by X2 test. Results 25.6%(24/94) students were not interested in this course. 61.7%(58/94) students thought that the course was highly correlated with profession. 56.4%(53/94) students thought that the course was valuable. 35.1%(33/94) students thought that the course was not good in combining theory with practice in teaching. 19.1%(18/94) stu-dents thought that the course was deficient in interactive teaching and teaching methods. 62.8%(59/94) students were satisfied with the teaching effect. Conclusions Main influential factors of hospital man-agement teaching are learning interest, curriculum evaluation and teaching evaluation. To improve quality of hospital management teaching, it is necessary to communicate the importance of the course and to apply new teaching plans to arouse the interests of students.

Morphology and relationships of piriformis and its tendon,and their relations withsciatic nerve in 100 cases have been observed in order to analyse the cause of sciatica.Piriformis was divided into four types and piriformis tendon into five types.In79% of piriformis there were additional origins.In 5% of cases synovial bursa waspresent below the end of piriformis tendon.The relation between piriformis andsciatic nerve was anomalous in 38%.Sciatic nerves and their branches in 16%passed between the two tendons of piriformis,and along the anterior or posteriorsurface of a tendon.It is concluded that various anomalous relationship between piriformis tendonand sciatic nerve is an important factor giving rise to sciatic pain.

Objective To evaluate the efficiency of inhaling penehyelidine hydyoehloride(PHC)in reducing pulmonary arterial pressure and improving lung funetion in patients with acute exaeerbation of ehronie obstruetive pulmonary disease(AECOPD).Methods Sixty patients with AECOPD were randomly divided into the control group(30 patients) and the treatment group(30 patients).The patients in treatment group inhaled PHC,and patients in control group inhaled diprophylline.The pulmonary arterial pressure was measured before and after inhalation.The peak expiratory flow(PEF) and forced expiratory volume in one second(FEV1)was measured at different time points before and after inhalation. Arterial blood gas and,symptoms were also observed.Results The pulmonary arterial pressure in treatment group was reduced by 20% and reduced by 5% in the control group.FEV1 and PEF were improved after inhalation,the average increase of FEV1 was 350 ml(P＜0.01),and PEF was improved by 37 L/min(P＜0.05).Arterial blood gas analysis was improved,and PaO_2 increased by 18 mmHg(P＜0.01).The respiratory rate and the symptoms of cough and sputum were also improved.Conclusion PHC improved the lung function of patients with AECOPD by reducing the pulmonary arterial pressure.