0.05).Conclusion Early pre-interventional tirofiban therapy for patients with acute STEMI who undergo primary PCI improves patency of infarct-related artery and tissue reperfusion,but its effects on short-term clinical outcomes are similar to routine tirofiban administration in catheter laboratory.

Objective To perform Low dose dynamic MSCT( multi-slice CT) in sleeping obstructive sleep apnea syndrome ( OSAS) patients correcting the imprecise measure values in waking state, and to exactly analyse the location and extension of the dynamic changes about the condition. Methods Sixteen OSAS patients were scanned both in waking and naturally sleeping period ( end phase of inspiration and expiration). Measured at the narrowest part of the retropalatal ( RP) and retroglossal ( RG) and 5 mm under the tip of epiglottis at the epiglottal ( EPG) at the end period of inspiration in sleeping, respectively, and compared the accurate pos(?)on of the narrowest or occlusive level in 3 phases. All patients were also scanned using cine mode at the narrowest level at the end period of inspiration in sleeping to show the pharyngeal cavity changes during sleep. Results The smallest XSA of RP region (Mw = 47. 50 mm2 ,Me =73. 00 mm2 , Mi =2. 00 mm2 ;Zwe =2. 897,Pwe =0. 003 ;Zwi =4. 192,Pwi

Objective To study the best parameters of low dose MSCT in examining the pharyngeal disease.Methods 20 volunteers were scanned by MSCT using 10 mm collimation,10 mm interval,120 kV,200 mA,100 mA,50 mA,25 mA parameters,respectively.All of the data was reformed(collimation 2.5 mm,interval 1.3 mm) on ADW 4.0 workstation.The image quality in different dose were scored respectively by 4 experienced radiolagists. Results The best appropriate parameter was 10 mm collimation,10 mm interval,120 kV,50 mA.Conclusion In examining the pharyngeal disease,the application of low dose(120 kV,50 mA) scan mode not only can assure the image quality but can decrease the exposure to patients.

Objective To define the characteristic values of the pharyngeal cavity by comparing the values of measures and ratios between the patients with obstructive sheep apnea-hypopnea syndrome(OSAS) and controls.Methods Sixty-eight OSAS patients who were diagnosed using polysomnography,and 56 healthy people were scanned by MSCT(multiple slices computed tomography)in the awake state.Then, the values were measured on the reformated images and were compared between two groups.Results Of the 63 values,49 values were different between the two groups,and among those,4 values were entered into the Discriminant Functions.These were the left-right diameter(LR)[OSAS:LR=(9.4?3.7)mm,controls: LR=(20.1?5.0)mm,t=-13.820,P=0.000)and the cross-sectional area(XSA)[OSAS:XSA= (54?27)mm~2,controls:XSA=(164?77)mm~2,t=-10.944,P=0.000]of RP,the heights of tongue [OSAS:(75.4?8.3)mm,controls:(58.4?9.8)mm,t=10.476,P=0.000],the lengths of uvula/the lengths of airway(OSAS:0.139?0.039,controls:0.154?0.048,t=-1.983,P=0.050).Conclusions Many measures and ratios were different between the two groups,but there were overlaps between them. Measures using the Discriminant Functions can help the diagnosis of OSAS.

Objective To investigate the clinical features,diagnosis and therapy of adrenal incidentalomas. Methods The data of 66 cases of adrenal incidentalomas were retrospectively analyzed. Results The accuracy rates of localization detected by B-Ultrasound,CT scan and MRI were 84.3%,100% and 100% respectively. The accuracy rates of qualitative diagnosis by B-Ultrasound, CT scan and MRI were 30.0%,75.5% and 79.2% respectively. There were 60 cases underwent operation and the postoperative pathological examination confirmed that there were 31 cases of adrenal cortical adenoma, 6 cases adrenal cyst, 5 myelolipoma, 5 pheochromocytoma, 3 adrenal cortical carcinoma, 3 metastatic carcinoma, 3 ganglioneuroma, 1 adrenal neurilemmoma, 1 adrenal hematoma, and 1 nodular hyperplasia of adrenal cortex. Conclusions Ultrasonography is the first choice of scanning adrenal incidentaloma. However the CT scan and MRI are satisfactory in localization of the tumour. The qualitative diagnosis of adrenal incidentaloma will depend on the diameter, imaging features of tumors, the age of patients, and endocrine examination.

Objective To investigate the difference of amplitude of low-frequency fluctuation (ALFF) and fraction of amplitude of low-frequency fluctuation(fALFF) between Alzheimer's disease (AD)patients and normal aging (NA) controls by voxel-based analysis.Methods Thirty-one AD patients and 44 NA controls were enrolled in the study.Blood oxygen level dependent functional (BOLD) EPI data were obtained during resting-state by using 32-channel head coil.Data were realigned,normalized and then smoothed with 8 mm FWHM kernel.Resting-state fMRI toolkit(version 1.6) was used to generate ALFF and fALFF images.Independent two sample t-test was performed with SPM5 to compare ALFF and fALFF of AD and NA controls.Pearson correlation analysis was performed to examine the relationship between MMSE score and ALFF,fALFF parameters.The significance level was set to be uncorrected O.001 on the voxel level and 0.05 on the cluster level.Results AD patients showed increased ALFF in left temporal lobe (0.492 ±0.119) and right cingulated cortex (0.434 ± 0.093) of AD patients,which were 0.443 ± 0.068 and 0.380 ±0.081 in NA controls (t =2.658,2.227,P ＜ 0.05).Decreased fALFF was found in bilateral posterior cingulate cortices (1.167 ± 0.203) and increased fALFF was found in bilateral temporal lobes (left 1.226 ±0.127,right 1.146 ±0.214) with left side dominance,which were 1.453 ±0.269,1.134 ±0.088,1.014 ± O.132 in NA controls (t =5.001,3.695,3.285,P ＜ 0.05).Bilateral temporal ALFF and fALFF correlated with MMSE positively (r =0.768—0.909,P ＜ 0.05) with left dominance.Conclusion AD patients showed increased resting-state functional MRI changes correlated with MMSE score in the temporal lobes with left dominance,which indicated left temporal lobe may be the best location for the observation of disease progression in AD patients.

Objective To compare the clinical efficacy between continuous and intermittent androgen deprivation in high risk prostate cancer.Methods Sixty-four patients with high risk prostate cancer were treated from January 2008 to April 2009,36 cases who accepted goserelin and bicalutamide were taken as intermittent hormonal therapy (intermittent treatment group),while 28 cases who accepted bilateral orchiectomy in addition to flutamide were regarded as continuous hormonal therapy (continuous treatment group).The comparison of tumor specific mortality,time of prostate specific antigen (PSA) to nadir,tine to PSA recurrence,serum testerone and quality of life score were assessed between the two groups.Results In continuous treatment group and intermittent treatment group,follow-up period was (26.4 ± 10.3) and (28.1 ± 8.7) months,the time of PSA to nadir was (3.8 ± 2.1 ) and (4.0 ± 3.6) months,the time to PSA recurrence was (20.1 ± 12.3) and (24.5 ± 14.6) months,respectively.There was no significant difference between the two groups.At the time of 18,24 and 30 months after therapy,serum testerone was 0.85,0.88,0.89 μg/L in continuous treatment group,while 1.21,1.36,1.48 μg/L in intermittent treatment group,respectively (P ＜ 0.05 ).Similarly,quality of life score was 38.7,40.5,39.8 scores in continuous treatment group,while 49.2,51.4,52.3 scores in intermittent treatment group at the time of 12,18 and 30 months after therapy,respectively (P ＜ 0.05 ).Conclusions Clinical efficacy could not been found between continuous and intermittent endocrinic therapy of prostate cancer.During intermittent,quality of life seems to be better and increases in accordance with serum testerone recurrence at given time.

The ideal treatment and recovery of osteoarticular injury remain to be resolved. Small intestinal submucosa (SIS), a naturally-occurring decellularized extracellular matrix, has been recognized as an ideal scaffold for tissue engineering and widely used in repairing various tissues and organs. Nowadays its application has also been gradually increased in the field of orthopedics. We reviewed laboratorial studies and clinical trails about the application of SIS in bone and joint repair, aiming to evaluate its effects on the repair of bone, cartilage, meniscus, ligament and tendon. SIS has showed promising results in repairing bone, meniscus, ligament or tendon. However, additional studies will be required to further evaluate its effects on articular cartilage and tendon-bone healing. How to optimize SIS material,is also a focused problem concerned with making SIS a potential therapeutic option with high value for orthopedic tissue repair.
Animals ; Cell- and Tissue-Based Therapy ; Humans ; Intestinal Mucosa ; cytology ; Intestine, Small ; cytology ; Joint Diseases ; physiopathology ; surgery ; therapy ; Tissue Engineering ; instrumentation ; methods ; Tissue Scaffolds ; chemistry

Objective To explore the effects of astrocytes in cervical spinal cord posterior horn on allodynia in rat models of migraine.Methods Fifty-four male SD rats were randomly divided into 9 groups (each group n =6): blank group,sham surgery group,new inflammatory soup 3 d group (IS 3 d group),new inflammatory soup 7 d group(IS 7 d group),saline group,fluorocitrate (FCA)prevention group,FCA prevention control group,FCA treatment group,FCA treatment control group.Following the IS stimulation in the rat dual matter,Von-Frey hair was used to monitor the pain threshold of periorbital skin.Immunofluorescence technique was used to observe the expression of specific marker of astrocyte,glial fibrilary acidic protein (GFAP),and neuron activation marker,C-fos.Results ①Von-Frey hair study showed the thresholds of IS 3 d group and IS 7 d group were significantly decreased compared with the control group(3 d:5.3 ±0.3 vs 6.4 ±0.3,F =40.15;7 d:3.0 ±0.3 vs 6.3 ±0.2,F =382.5,both P ＜0.01).The pain thresholds of FCA prevention group and FCA treatment group both began to significantly increase at the day 4 (FCA prevention:5.5 ± 5.1 vs 5.1 ± 0.2,F =16.00 ;FCA treatment:4.3 ± 0.2 vs 3.0 ± 0.2,F =138.0,both P ＜ 0.01).②GFAP immunofluorescence showed that the mean optical density (A) values of IS 3 d group and IS 7 d group were significantly increased compared with the control group(3 d:24.5 ±4.4 vs 14.8 ± 2.5,F =32.54;7 d:38.9 ± 7.1 vs 14.6 ± 1.8,F =63.56,both P ＜ 0.01).()C-fosimmunofluorescence showed that mean A value of IS 3 d group was significantly increased compared with the control group (20.4 ± 2.3 vs 8.4 ± 1.1,F =129.0,P ＜ 0.01).The difference was not significant between the IS 7 d group and the control group.Conclusions Activated astrocytes contribute to the facial allodynia induced by chronic dural inflammation.Its inhibitor FCA could both prevent and treat the allodynia behaviour.All of these suggest that astrocytes may not only contribute to the initiation of mechanical allodynia but also the maintenance.

OBJECTIVEThis prospective registered study was conducted to investigate the impact of statins (pravastatin, fluvastatin, atorvastatin) on clopidogrel platelet inhibition in patients with acute coronary syndrome (ACS) or stable angina.

METHODSA total of 1015 consecutive patients with ACS or stable angina underwent coronary angiography/percutaneous coronary intervention (PCI) were allocated to pravastatin group (n = 228), fluvastatin group (n = 179), atorvastatin group (n = 481) or placebo control group (n = 127). Baseline characteristics, coronary angiography/PCI features and acute stent thrombosis, platelet aggregation induced by 2, 5, 10 and 20 micromol adenosine diphosphate (ADP) at 1 minute (ADP-1), 5 minutes (ADP-5) and maximal platelet aggregation (ADP-M) were compared among groups.

RESULTSBaseline and procedural characteristics were comparable among the four groups. Acute stent thrombosis (pravastatin group 0.9%, fluvastatin group 1.1%, atorvastatin group 1.0% and control group 0.8%, all P > 0.05), ADP-1, ADP-5, and ADP-M (all P > 0.05) were also similar among groups. Multivariate liner and ordinal logistic analysis revealed that age (B = 0.21, P = 0.001), dose of clopidogrel (B = 7.30, P = 0.002) and use of low-molecular heparin (OR = 6.71, P = 0.01) were independent factors for platelet aggregation inhibition efficacy by clopidogrel.

CONCLUSIONInhibition of platelet aggregation with clopidogrel was influenced by age, clopidogrel dose and low-molecular heparin but not by various statin treatments.

Acute Coronary Syndrome ; drug therapy ; Adenosine Diphosphate ; Aged ; Angina Pectoris ; drug therapy ; Atorvastatin Calcium ; Drug Interactions ; Fatty Acids, Monounsaturated ; therapeutic use ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Indoles ; therapeutic use ; Male ; Middle Aged ; Platelet Aggregation ; drug effects ; Platelet Aggregation Inhibitors ; therapeutic use ; Platelet Count ; Platelet Function Tests ; Pravastatin ; therapeutic use ; Prospective Studies ; Pyrroles ; therapeutic use ; Ticlopidine ; analogs & derivatives ; therapeutic use