Objective To compare the effect of direct stenting (DS) and conventional post-dilation stenting (CS) on no-reflow phenomena in coronary artery disease (CAD) patients. Methods Demographic characters, final baloon dilation pressure instant angiographic results, and long term outcomes were compared between patients receiving DS (n=127) and patients receiving CS (n=127). Results Patients in DS group had less degree of stenosis (82%?6% vs 87%?11%,P

BACKGROUNDIntramedullary nails have been widely used in treating femoral shaft fractures. However, end caps falling into soft tissue intraoperatively may cause trouble to surgeons, prolong operative time and increase radiation exposure. Additionally, difficulties may be encountered when removing nails because of callus formation over the nail tip. We performed a prospective study to compare two types of nails in managing femoral shaft fractures.

METHODSGroup I consisted of seventy-four patients with unilateral femoral shaft fractures treated with cannulated interlocking anatomical femoral intramedullary nails. Group II consisted of seventy-eight patients treated with cannulated interlocking anatomical femoral intramedullary nails with tail wires. The patients' ages, fracture severity, duration of operation, fluoroscopy time, blood loss and falls of end caps into soft tissue were recorded. Nails were removed after fracture healing. The duration of operation and blood loss during nail removal were recorded.

RESULTSThere were no significant differences between groups with respect to age and fracture severity (P > 0.05). End caps fell into soft tissue 17 times in 15 cases in group I and 21 times in 16 cases in group II. An average of seven minutes was spent recovering a lost cap in group I. In group II, all lost caps were recovered immediately. The duration of operation and fluoroscopy time in group II was significantly less than in group I (P < 0.05). Asymptomatic palpable nodules were detected in 4 cases in group II. Nail removals were performed on 58 patients in group I and 69 patients in group II. The duration of operation, blood loss and complications in group II were less than in group I (P < 0.05).

CONCLUSIONIntramedullary nails with tail wires facilitate both fracture fixation and nail removal, which can be used to treat femoral shaft fractures with less radiation exposure, shorter surgical time and fewer complications.

Adult ; Aged ; Bone Nails ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Intramedullary ; methods ; Humans ; Internal Fixators ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult

BACKGROUNDRoutine anteroposterior radiographs of the acromioclavicular (AC) joint with or without weight bearing have limitations in demonstrating the AC joint. Transarticular fixation with Kirschner wire is a treatment choice for AC dislocations. However, percutaneous fixation of the AC joint is technically demanding. The C-arm fluoroscopy can be used as routine intraoperative guidance to facilitate this procedure. The current study aims to introduce new projections, the axial and tangential views of AC joint, to help evaluate the severity of the injury and facilitate the percutaneous procedure.

METHODSThree shoulder specimens were used to find the projection directions of the axial and tangential views of the AC joint by using the digital radiography (DR) unit. The axial and tangential views were taken of 20 adult volunteers by referencing the projection directions determined in the shoulder specimens. The angles showed on the DR system and the angles between the coronal plane of the body and the vertical plane of the flat panel detector (FPD) during taking these radiographs were recorded. The C-arm fluoroscopy unit was used to take the axial and tangential views referencing the angles measured on the DR system. Routine anteroposterior radiographs of the AC joint were taken on the volunteers. The minimal distances from the distal clavicle to the acromion were measured on both tangential and anteroposterior radiographs. The data was statistically analyzed.

RESULTSThe clear axial and tangential radiographs of AC joints of the volunteers were obtained using both DR and C-arm fluoroscopy units. The angles demonstrated on the DR window are (20.8 ± 2.4)° for male and (18.3 ± 2.3)° for female. During taking the axial views, the angles between the coronal plane of the body and vertical plane of FPD are (23.3 ± 3.2)° for male and (20.1 ± 2.4)° for female. During taking tangential views, the corresponding angles are (117.5 ± 3.7)° for male and (113.1 ± 3.3)° for female. On the tangential radiographs, the minimal distance from the distal clavicle to the acromion is (6.1 ± 1.2) mm, wider than the same measurement on the anteroposterior radiographs (P < 0.05). Statistical analyses showed no significant differences in the above-mentioned angles and the minimal distances between the left and right AC joints (P > 0.05). There were no significant differences in the above-mentioned angles between DR and C-arm fluoroscopy units (P > 0.05).

CONCLUSIONSThe axial and tangential radiographs of the AC joint can demonstrate the joint clearly and they can be easily obtained with both DR system and C-arm fluoroscopy unit in similar projection directions.

Acromioclavicular Joint ; diagnostic imaging ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Radiographic Image Enhancement

Objective To investigate the correlation between levels of Annexin A1,Bax and lipoprotein-associated phospholipase A2 (Lp-PLA2) and both formation and stability of human carotid atherosclerotic plaques.Methods Forty-five specimens from patients with carotid atherosclerotic plaques (test group,group A),admitted to our hospital from May 2010 to June 2011 and performed carotid endarterectomy (CEA),and 20 specimens from patients with mesenteric artery and 20 healthy subjects (control groups,group B and group C,respectively) were collected in our study.The carotid atherosclerotic plaque specimens were divided into soft plaque group A1 (n=15),mixed plaque group A2 (n=15) and hard plaque group A3 (n=15) according to the results of carotid artery ultrasound.The Lp-PLA2 level in group A and group C was measured by enzyme linked immunosorbent assay (ELISA),and the mRNA and protein expressions of Annexin A1 and Bax in group A and group B were determined by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Results The level of Lp-PLA2 in all patients with carotid atherosclerotic plaques was significantly increased as compared with that in group C (P＜0.05); that in group A1 was significantly higher than that in group A3 (P＜0.05).The mRNA and protein expressions of Annexin A1 and Bax in all patients with carotid atherosclerotic plaques were significantly increased as compared with those in group B (P＜0.05); group A1 exhibited lower mRNA and protein expressions of Annexin A1 than group A3 (P＜0.05),while group A1 exhibited higher mRNA and protein expressions of Bax than group A3 (P＜0.05).Conclusion Annexin A1,Lp-PLA2 and Bax participate in the formation and stability of human carotid atherosclerotic plaques.

At present,China has issued a series of standards relating to traditional Chinese medicine(TCM). The standard system has already taken shape,but there are still some problems,such as incomplete standard system,low standard quality,inadequate application,insufficient study strength and lack of talent. This paper makes a detailed analysis of current management and development of standardization of traditional Chinese medicine in the aspects of " management mechanism and system construction" and " standards".The problems existing in the standardization of TCM are analyzed in three aspects: quality and popularization,standard research and talent reserve. At the same time,some suggestions are put forward to solve the problems. First,we shall strengthen the management of top-level design; second,we shall guide the transformation of high-quality scientific and technological achievements to standards;third,we shall consolidate the basic research of standardization of TCM; fourth,we shall focus on cultivating standardized technical talents; and fifth,we shall strengthen the standard research and development work in key fields.
China ; Drug Delivery Systems ; Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; Reference Standards