70%) were involved in this study. Patients were assigned as intracoronary ?-radiation (Beta Cath 30 mm or 40 mm system, Novoste) with CBA group (n=112) and control group (n=183). Pullback radiation was performed for long ISR lesions. In the control group, the patients received intracoronary ?-radiation or CBA alone. In both groups, quantitative coronary angiography was performed, and target vessel revascularization (TVR) and major adverse cardiovascular events (MACE) were documented. Results Clinical follow-up (6.3?1.6 months) was conducted in 106 patients (95%) in the intracoronary ?-radiation with CBA group and 172 patients (94%) in the control group. In the follow-up, in the intracoronary ?-radiation with CBA group, MLD was larger and DS was lower than that in the comparison group. Both TVR and MACE occurred significantly less in the intracoronary ?-radiation with CBA group than in the control group (5% vs 16% for TVR, and 10% vs 25% for MACE; P

To explore novel antifatigue agents targeting with AMPA receptor, 10 compounds were synthesized and their structures were confirmed by 1H NMR, ESI-MS and elemental analysis. 1-BCP was treated as the leading compound. The antifatigue activities were evaluated by weight-loaded forced swimming test, and the AMPA receptor binding affinities were tested with radioligand receptor binding assays. The results unveiled that 5b appeared to possess potent antifatigue activities and high affinity with AMPA receptor, which deserved further studies.

Nowadays,in order to cultivate a great number of high-quality clinicians,on students it is essential for medical university to strengthen education of humanities,excite aspiration for innovating,cultivate innovation ability and teach the modern medical knowledge with science and rational method.The author has given his reasons and made suggestions for the opinion in the article.

Triptolide, a diterpenoid triepoxide from the traditional Chinese medicinal herb Tripterygium wilfordii Hook. f., is a potential treatment for autoimmune diseases as well a possible anti-tumor agent. It inhibits proliferation of coloretal cancer cells in vitro and in vivo. In this study, its ability to block progress of colitis to colon cancer, and its molecular mechanism of action are investigated. A mouse model for colitis-induced colorectal cancer was used to test the effect of triptolide on cancer progression. Treatment of mice with triptolide decreased the incidence of colon cancer formation, and increased survival rate. Moreover, triptolide decreased the incidence of tumors in nude mice inoculated with cultured colon cancer cells dose-dependently. In vitro, triptolide inhibited the proliferation, migration and colony formation of colon cancer cells. Secretion of IL6 and levels of JAK1, IL6R and phosphorylated STAT3 were all reduced by triptolide treatment. Triptolide prohibited Rac1 activity and blocked cyclin D1 and CDK4 expression, leading to G1 arrest. Triptolide interrupted the IL6R-JAK/STAT pathway that is crucial for cell proliferation, survival, and inflammation. This suggests that triptolide might be a candidate for prevention of colitis induced colon cancer because it reduces inflammation and prevents tumor formation and development.
Animals ; Cell Transformation, Neoplastic/*drug effects ; Colitis/complications ; Colonic Neoplasms/chemically induced/*drug therapy/metabolism/pathology ; Dextran Sulfate/toxicity ; Dimethylhydrazines/toxicity ; Diterpenes/*administration & dosage ; Epoxy Compounds/administration & dosage ; Humans ; Interleukin-6/biosynthesis ; Janus Kinases/metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred ICR ; Mice, Nude ; Neoplasm Transplantation ; Phenanthrenes/*administration & dosage ; STAT3 Transcription Factor/metabolism ; Signal Transduction/*drug effects ; Tumor Burden/drug effects ; rac1 GTP-Binding Protein/*biosynthesis

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

Objective:To explore the efficacy difference of two different routes of intracoronary verapamil on no-reflow phe-nomenon during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial in-farction (STEMI) .Methods :From January 2009 to December 2012 ,141 STEMI patients with no-reflow phenomenon during e-mergency PCI who received the manual intracoronary bolus infusion of verapamil were selected .According to the routes of in-tracoronary verapamil ,patients were divided into guiding catheter group (n=67) and selective catheter group (n=74) .The coronary perfusion level ,the ECG ST-segment resolution ,left ventricular ejection fraction (LVEF) and major adverse cardiac events in 30 days post-PCI were compared .Results:There were no statistically significant differences in general datum of the two groups and the average dose of intracoronary infusion verapamil (P>0 .05) .The level of cTFC in the the selective catheter group was significantly lower than that in the guiding catheter group (P<0 .05) .More patients restored the TIMI-3 flow after drug infusion in selective catheter group than guiding catheter group (P<0 .05) .The proportion of complete ST-segment reso-lution after PCI in the selective catheter group was significantly higher than that in guiding catheter group (P<0 .05) .No sta-tistically significant differences were found in LVEF and incidence of major adverse cardiac events during 30 days between the two groups (both P>0 .05) .Conclusions :The intracoronary verapamil through selective catheter can reverse no-reflow phe-nomenon more effectively than through guiding catheter during emegency PCI for STEMI .

Objective:The goal of this study was to analyze the clinical significance of relationship between myocardial collateral and the levels of hypoxia‐inducible factor 1‐alpha (HIF‐1α) and vascular endothelial growth factor A (VEGF‐A) in patients with coronary chronic total occlusion lesion .Methods:89 patients with coronary chronic total occlusion lesion confirmed by clin‐ical data and coronary angiography were identified .The levels of HIF‐1αand VEGF‐A were measured by ELISA ,and the rela‐tive expression of VEGF‐A of peripheral blood mononuclear cell (PBMC) were measured by real‐time PCR .The results were statistically analyzed by the statistical programme for social sciences (SPSS version 18 .0) and software SAS JMP 9 .0 .Results:Compared to Rentrop 0‐1 grade group (18/38 ,47 .4% ) ,Rentrop 2 (11/31 ,35 .5% ) and Rentrop 3 (3/20 ,15 .0% ) grade group had fewer diabetes mellitus .Rentrop 2 [(6 .67 ± 1 .41) mmol/L] and Rentrop 3 [(5 .48 ± 1 .26) mmol/L] grade group had low‐er fasting blood glucose than Rentrop 0‐1 grade group [(7 .24 ± 1 .39) mmol/L] .Rentrop 2 (12/31 ,38 .7% ) and Rentrop 3 (3/20 ,15 .0% ) grade group had fewer clinical heart failure (NYHA Ⅱ ~ Ⅳ grade) than Rentrop 0‐1 grade group (20/38 , 52 .6% ) .Rentrop 2 [(85 .5 ± 27 .7) pg/mL ,(139 .5 ± 42 .1) pg/mL] and Rentrop 3 [(103 .3 ± 30 .2) pg/mL ,(162 .6 ± 43 .3) pg/mL] grade group had higher levels of HIF‐1αand VEGF‐A than Rentrop 0‐1 grade group [(42 .0 ± 16 .1) pg/mL ,(76 .5 ± 32 .2) pg/mL] .Rentrop 2 (1 .31 ± 0 .46) and Rentrop 3 (1 .38 ± 0 .44) grade group had higher level of relative expression of VEGF‐A in PBMC than Rentrop 0‐1 grade group (1 .00 ± 0 .28) .Conclusions:Chronic and consistent ischemia and hypoxia in‐duced the increase of expression of HIF‐1αand VEGF‐A is important for establishment of coronary collateral ,increasing blood supply and improving the heart function and prognosis .

Objective:To analyze the clinical characteristics of patients with immediate severe coronary artery spasm(CAS) af‐ter stent implantation .Methods:The clinical data of 6918 patients who received percutaneous coronary intervention(PCI) from Jan 2012 to Dec 2013 in Zhongshan Hospital ,Fudan University were retrospectively analyzed .And 102 patients with immediate severe CAS after stent implantation were identified and 204 age‐and gender‐matched patients without immediate severe CAS af‐ter stent implantation were selected as control subjects .The general information ,blood indexes ,number and length of stents in the two groups were compared .Results:Compared with the control group ,the ratios of males ,smoking and dyslipidemia were higher in CAS group (P<0 .05) .Patients with CAS had higher neutrophil count and higher level of high sensitive C‐reactive protein(P<0 .05) and received more and longer stents implantation than the control group(P<0 .05 or 0 .01) .Conclusions:Male patients and patients with history of smoking are prone to have immediate severe CAS after stent implantation .Moreover , patients with more and longer stents implantation are prone to have immediate severe CAS .Inflammation may play an important role in the development of CAS after stent implantation .

Objective To compare the efficacy of MRI-transrectal ultrasound(TRUS)software fusion-guided biopsy and cognitive fusion-guided biopsy for detecting prostate cancer(PC).Methods Data of 120 patients with suspected PC(127 lesions)who underwent transperineal prostate biopsy with 2-3 times of target biopsy(TB)and 10 times of system biopsy were retrospectively analyzed.According to TB guidance methods,73 cases(78 lesions)received MRI-TRUS software fusion-guided biopsy were classified into group A,and 47 cases(49 lesions)received cognitive fusion-guided biopsy were classified into group B.The positive rate of PC,clinic significant PC(csPC)and PC in different sized lesions by TB were compared between groups,and the positive rate of PC between 2 or 3 times TB was also compared within each group.Results The positive rate of PC and csPC detected by TB was 55.13%(43/78)and 39.74%(31/78)in group A,53.06%(26/49)and 34.69%(17/49)in group B,respectively,no significant difference was found(all P＞0.05).The positive rate of PC in lesions with the maximum diameter≤10 mm detected by TB in group A was higher than that in group B(P＜0.05),but no significant difference of lesions with the maximum diameter＞10 mm and＜15 mm nor≥15 mm was found between groups(all P＞0.05).No significant difference of positive rate of PC was found between 2 and 3 times TB in group A(P＞0.05),while positive rate of PC of 3 times TB was significantly higher than that of 2 times TB in group B(P＜0.05).Conclusion MRI-TRUS software fusion-guided biopsy had positive rate of PC and csPC similar to that of cognitive fusion-guided biopsy,but was helpful for reducing times of TB and increasing detecting rate for lesions with the maximum diameter≤10 mm.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.