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 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 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

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.

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.

Objective To investigate the clinicopathological features of thymic neuroendocrine carcinoma and its differential diagnosis. Methods Clinicopathologic analysis and immunohistochemical staining were performed in 5 cases of TNC. Results For 5 cases TNC, 3 cases occurred in men, 2 cases occurred in women. The average age was 46.8 years. They were with chest symptoms before operation. 3 cases were Ⅱ and 2 cases were Ⅲ by clinic stages. Grossly , the tumors were gray in color with areas of hemorrhage and necrosis. Histopathology of well differentiated 2 cases and poorly differentiated 3 cases. Immunohistochemically, the tumor cells were positive for CK, NSE, SyN and CgA. 3 cases were positive for PCNA, Ki67, p53. Conclusions TNC has a pleomorphic appearance of histological features with well, moderate and poorly-differentiated areas. Immunohistochemical staining is helpful in the differential diagnosis of TNC from other tumors derived from the thymus. Neither grading as neuroendocrine carcinomas nor any individual histologic parameter showed a significant association with prognosis. Initial aggressive treatment, including complete surgical excision and adjuvant radiotherapy, appears to offer the best hope for prolonged survival. Adjuvant chemotherapy also should be considered, because the incidence of distant relapse is high.

1. The diameters, lengths and course of the posterior primary rami, posterior medial and posterior lateral branches of lumbar nerves were studied. The form, inner diameters and position of the osseous fibrous foramina, osseous fibrous canals and lumbdorsal fascia foramina on the upper margin of iliac crest through which the nerves pass were also studied.2. Basing on the observation of 174 sides of the specimens the composition and types of the superior clunial nerve of the Chinese were observed, and their positions and courses on the upper margin of the iliac crest, were described in detail.3. The method and theoretical basis of locating the superior clunial nerve on the upper margin of the iliac crest were proposed.4. Basing on the anatomical character of the posterior rami of the lumbar nerve, the cause of lumbar and lumbocraral pain and their operative approach were discussed.

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.

Objective To find out the differences of sleep posture between normal children and those with obstructive sleep apnea hypopnea syndrome(OSAHS),and assess the effects of sleep posture on the children with OSAHS.Methods The results of polysomnography(PSG) of 385 children diagnosed as OSAHS by polysomnography were compared with that of 161 children who matched the former in age and gender(Controls).The effects of different sleep posture on obstructive apnea,hypopnea index(AHI) and apnea index(AI) were analyzed.Results For the children with OSAHS when sleeping,the percentages of sleep time in different posture were 45.4%+36.3% in supine posture,39.5%+34.5% in side posture and 15.1%+32.6% in prone posture,respectively;while in control group,the correspond percentages were 32.8%+24.5%,54.7%+23.9% and 12.5%+17.2%,respectively.Comparing the two groups,significant differences existed on the sleep time in both supine and side posture(P0.05).Children with OSAHS spent more time in supine posture and less time in side posture than those children in control group(P0.05).For the children with OSAHS,the average AHI and obstructive AI in three sleep-related postures were 14.5 and 3.80,respectively.The values of both AHI and AI in supine posture were significantly greater than that in side or prone posture(P