Objective To evaluate the influence of tirofiban on myocardial perfusion through percutaneous coronary intervention (PCI) and platelet activation in patients with acute myocardial infarction (AMI). Methods Eighty patients with acute myocardial infarction who underwent emergency PCI within 12 hours were randomly divided into 2 groups due to the random number table method: tirofiban group (40 patients) and control group (40 patients). The control group received conventional anticoagulant therapy (aspirin + low molecular weight heparin + clopidogrel). The tirofiban group additionally received intracoronary tirofiban hydrochloride injection of 10 μg/kg PCI during PCI, intravenous maintenance dose of 0. 15 after PCI 15 mins, the changes of platelet activation before and after treatment 7 days,the bleeding complications and major adverse cardiac events (MACE) within 30 days after PCI. Results The TMPG 3 perfusion percentage of tirofiban group (97.5% ,39/40) after PCI 15 minutes was significantly higher than that (80. 0%,32/40) of the control group( x2 = 4. 507,P ＜ 0. 05 ) ;The expression positive rate of platelet activation CD62P,CD63, MPA of the tirofiban group after treatment of 7 days were ( 1.7 ± 0. 7 ) %, ( 1.5 ± 0. 7 ) % and ( 11.7 ±3.8)% ,respectively,which were significantly lower than those of before treatment ([7.2 ± 2. 5]%, [6. 9 ±1.8]% and [22. 0 ± 7. 8] %, respectivley) and those of the control group after treatment of 7 days ( [2. 9 ±1.2]% ,[3.9 ±0.6]% and [16.2 ±4.2]% ,respectivley)(t =5.463,16. 468 and 5.025, Ps ＜0.01 );The incidence of cardiovascular events of the tirofiban group (0) was significantly lower than that of the control group ( 15.0%, 12/40 ) after treatment of 30 days ( x2 = 4. 504, P ＜ 0. 05 ); The incidence of bleeding complications was not significant between the 2 groups ( x2 = 0. 180, P ＞ 0. 05 ). Conclusion The application of tirofiban hydrochloride in intervention in acute myocardial infarction can improve myocardial perfusion, and further inhibiting platelet activation and reduce the incidence of major adverse cardiac events after PCI while does not increase the incidence of severe bleeding.

The Longhua Zhang's internal medicine,the famous clinical inheritance of Chinese medical schools in Shanghai,was well-known by their expert skills and high medical ethics during 370 years.This paper introduces the family origin and its academic characteristic.By studying the Shanghai local chronicles and the Longhua Zhang's genealogy,we learn how they innovating and improving the school.

BACKGROUND:Compared with mesenchymal stem cells from bone marrow and fat, human umbilical cord-derived mesenchymal stem cells, as one of the most potential cellsources to repair the central nervous system, are easy-based, more primitive, and not limited by ethical and legal.
OBJECTIVE:To explore differentiation of human umbilical cord-derived mesenchymal stem cells into neural stem cells induced by the recombinant human basic fibroblast growth factor and recombinant human epidermal growth factor.
METHODS:The human umbilical cord-derived mesenchymal stem cells were induced by basic fibroblast growth factor and epidermal growth factor in vitro. The cellmorphology was observed by invert microscope. The differentiation status was detected by immunofluorescence. The Nestin expression in mRNA level before and after induction was detected by real-time PCR.
RESULTS AND CONCLUSION:The neural stem cellbal s were observed after induction. And the Nestin was detected by immunofluorescence and real-time PCR. Nestin could further differentiate to the neuronal markproteins neuron-specific enolase, microtubule-associated protein 2 protein and glial fibril ary acidic protein. Results from this study show that basic fibroblast growth factor and epidermal growth factor can induce human umbilical cord-derived mesenchymal stem cells to differentiate to neural stem cells, neurons and glial cells.

Objective To estimate the effect of berberine on the proliferation of and expressions of apoptosisrelated factors Bax and Bcl-2 in a human skin squamous cell carcinoma cell line A431.Methods A431 cells were cultured in vitro,and classified into various groups to be treated with berberine at different concentrations (12.5,25,5,100 mg/L) or cisplatin at 250 mg/L (positive control group) for different durations (12,24,48 and 72 hours).The A431 cells remaining untreated served as the negative control group.Subsequently,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate cell growth,and inverted microscopy to observe cell morphology.Real time quantitative reverse transcription-PCR and an immunofluorescence assay were conducted to measure the mRNA and protein expressions of Bax and Bcl-2 respectively.Statistical analysis was done by multi-way analysis of variance (ANOVA) using the software SPSS 13.0.Results MTr assay showed that berberine inhibited the growth of A431 cells,and the inhibitory effect increased with the increase in concentration (F =1118.312,P ＜ 0.001) and treatment duration (F =510.927,P ＜ 0.001) of berberine.Moreover,there was a significant interaction between the concentration and treatment duration of berberine (F =70.239,P ＜ 0.001).Inverted microscopy revealed that when the concentration of berberine increased,cell density was reduced,and cell morphology changed from polygonal to round with cell body shrinkage.The ratio of bax to Bcl-2 mRNA was elevated with the increase in treatment duration and concentration of berberine,and there were significant differences in the mRNA ratio among cells treated with berberine for different time durations at same concentrations (F =226.231,1300.636,4325.139 for berberine at 25,50 and 100 mg/L respectively,all P＜ 0.001).Immunofluorescence staining indicated that the fluorescence intensity of Bax was enhanced,while that of Bcl-2 was weakened after berberine treatment.Conclusions Berberine inhibits the growth of A431 cells in a dose-and timedependent manner,and may induce the apoptosis of A431 cells via regulating the expressions of Bax and Bcl-2.

Objective: To investigate thoracic endovascular aortic repair (TEVAR) and “Chimney” technique for treating the involved left common carotid artery (LCCA) or left subclavian artery (LSA) in Standford B patients with aortic lesion and in-sufficient proximal anchoring area. Meanwhile, to explore the relationship between endoleaking condition and the location of lesion with the prognosis. Methods: A total of 32 relevant patients treated by TEVAR + “Chimney” technique in our hospital from 2011-09 to 2015-07 were retrospectively analyzed. Immediate post-operative image development of LCCA or LSA was observed; cerebral complications, severe upper limb ischemic symptoms and endoleaking conditions were recorded. The patients were followed-up for (3-46) months. Results: Thoracic aortic stent-graft placement was successfully carried out in all 32 patients. Immediate post-operative image development of LCCAor LSAwas favorable, no cerebral complications and no severe upper limb ischemic symptoms were observed. There were 7 patients suffered from endoleak at aortic arch including 6 with the lesion located at the greater curvature side and 1 at the small curvature side. During follow-up period, aortic stent-graft remained in a stable condition and the blood flow in “Chimney” stent was unobstructed. Endoleking condition was gradually reduced and disappeared in 5 patients, it was persisted in 2 patients. Conclusion: “Chimney” technique may prolong anchoring area and keep LCCA or LSA unobstructed, therefore expand the indication of TEVAR in a mini-invasive, safe and effective way. When aortic lesion located at the greater curvature side, the endoleaking probability could be increased.

Objective Shunaoxin Dropping Pills (SDPs), a Chinese patent medicine, has been used widely in China for the treatment of headache, amnesia, and insomnia. The aim of the present study is to observe the effect of SDPs on inducing angiogenesis and neurogenesis in vitro. Methods The present testing system using the serum obtained from animals ig treated with SDPs and a co-culture system in vitro was used to investigate if SDPs promotes brain microvascular endothelial cells (BMECs) tube formation and neural differentiation of neural stem/progenitor cells (NSPCs), which plays important roles in angiogenesis and neurogenesis. Results The SDPs serum sampled from rats ig treated with SDPs for 3 d dose-dependently promoted the tube like structure formation of cultured BMECs, and enhanced the fraction of MAP-2 positive cells of NSPCs, which co-cultured with the BMECs and astrocyte. In addition, there was no significant change in the percentage of glial fibrillary acidic protein positive cells. Conclusion Our results show that SDPs serum can induce neural differentiation and BMECs tube formation in vitro.

BACKGROUND:Restenosis after angioplasty severely limited the application and long-period therapeutic effects of percutaneous coronary intervention. Changes in smooth muscle cel phenotype and their proliferation are important mechanisms of restenosis after angioplasty.
OBJECTIVE:To use bal oon in vivo transduction of osteopontin short hairpin RNA (OPN-shRNA), to inhibit osteopontin expression at the injured blood vessels of a rabbit model of experimental atherosclerosis, and to prevent restenosis after angioplasty.
METHODS:A total of 20 rabbit models of atherosclerosis were established and randomly equal y assigned to empty plasmid group and OPN-shRNA plasmid group. The plasmid recombinant OPN-shRNA and empty plasmid were transferred to the ventral aorta by bal oon.
RESULTS AND CONCLUSION:After bal oon dilatation, specific green fluorescence was detected in the layer of vascular smooth muscle in the two groups. Moreover, with prolonged time of transfection, fluorescence intensity gradual y decreased. Compared with the empty plasmid group, the expanded artery lumen area obviously increased in the OPN-shRNA plasmid group, and plaque burden evidently reduced. Results indicated that bal oon catheter used in regional blood vessels in rabbit models of atherosclerosis could successful y transduce OPN-shRNA plasmid. The restenosis of the expanded blood vessels lessened, and thrombus burden relieved. It is of great importance to prevent the occurrence of restenosis after angioplasty in rabbit models.

BACKGROUND: Iliac bones are common habitant parts in metastatic tumor of bone, and the affiliate cortex is easy to be penetrated into soft tissue blots. The irregular iliac shape and its complex surrounding tissues create the difficulties in puncture operations and cement perfusion.OBJECTIVE: To investigate the clinical outcomes of CT-guided versus DSA-guided puncture combined with bone cement perfusion for metastatic tumor to the ilium.METHODS: Sixty-four patients with metastatic tumor to the ilium udergoing bone cement perfusion were enrolled, and then divided into control and experimental groups (n=32 per group), followed by treated with DSA-guided percutaneous injection of bone cement, and CT-guided puncture, respectively. Subsequently, the diffuse distribution of bone cement was observed using CT. The success rate, leakage rate, Visual Analogue Scale scores and Oswestry Disability Index were compared between two groups.RESULTS AND CONCLUSION: (1) All patients received the surgery successfully, and bone cement leakage happened in two cases of control group and one case of experimental group. (1) The Visual Analog Scale and Oswestry Disability Index scores in the two groups were significantly better than those before treatment (P < 0.05), and the scores showed no significant differences between two groups (P > 0.05). (3) No difference was found in the pain relief and functional recovery between two groups. (4) To conclude, CT-guided treatment can achieve satisfactory outcomes for metastatic tumor to the ilium by bone cement infusion in appropriate time.

Objective: To explore the effect and safety of pre-operative loading ticagrelor on myocardium reperfusion in patients with acute ST-elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (PCI). Methods: A total of 105 acute STEMI patients received PCI within 12-hour of onset were studied and they were divided into 2 groups: Ticagrelor group, the patients received pre-operative oral chewing ticagrelor 180 mg,n=58 and Clopidogrel group, the patients received pre-operative oral chewing clopidogrel 600 mg,n=47. The baseline feathers, operative TIMI and corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG), no-relfow/slow lfow conditions were compared between 2 groups. Results: The baseline feathers and pre-operative TIMI were similar between 2 groups, bothP>0.05. Compared with Clopidogrel group, Ticagrelor group showed increased ratios of TIMI 3 lfow (94.8% vs 80.9%) and TMPG (89.7% vs 72.3%), bothP<0.05, improved CTFC (20.0 ± 4.9) vs (31.8 ± 3.9),P<0.001; decreased rates of no-relfow/slow lfow,P=0.016 and less MACE occurrence,P<0.05; while the post-operative bleeding events were similar between 2 groups,P>0.05. Conclusion: Prior PCI loading ticagrelor may reduce no-relfow/slow lfow incidence, improve myocardium reperfusion safely and therefore, decrease MACE occurrence in acute STEMI patients.

Objective To explore the application value of Carbon Nanoparticles followed by microscale Methylthioninum Chloride in sentinel lymph node biopsy for breast cancer.Methods Two hundred and eight breast cancer patients were selected in the First Affiliated Hospital of Zhengzhou University during recent two years who performed sentinel lymph node biopsy.They were randomly divided into five groups according to different lymphatic tracer injected:Sequential group (A group,128 patients),Carbon Nanoparticles group (B group,44 patients) and Methylthioninum Chloride group (C group,36 patients).According to different Methylthioninum Chloride doses,sequential groups were randomly divided into low dose group (A1 group,48 patients),middle dose group (A2 group,42 patients),high dose group (A3 group,38 patients),If sentinel lymph nodes were negative no longer performed axillary lymph nodes dissection.Receive the five groups statistics of detection rate,the condition of lymphatic tracer,the incidence of local skin irritation and so on.Results (1) The detection rate of A,B and C three groups had no obvious difference.The incidence of lymphatic tracer dyed not ideal in B group was higher than A and B two groups,the incidence of local skin stimulation in C group was higher than A and B two groups.(2) A1,A2,A3,three groups had no difference of the detection rate and lymphatic tracer,but the incidence of local skin stimulation in A3 group is higher than A1,A2 two groups.3.5 groups of SLN detection rate had no relationship with patients' age,BMI,tumor size,tumor location,tumor molecular classification factors (P ＞ 0.05).Conclusions Carbon Nanoparticles followed by microscale Methyhhioninum Chloride detection rate was similar with two separate application,but can reduce the lymphatic vessels not developing situation when used Carbon Nanoparticles alone and reduce the local irritation caused by large dose of Methylthioninum Chloride,so it can be a good choice of SLNB in clinical.