Objective Our purpose was to report Initial clinical application experience and assess the immediate and short-term effect of transcatheter closure secundum atrial septal defects (ASD) using Amplatzer atrial septal ocluder.Methods Procedures were perfomed under fluoroscopy and transesophageal echocardiography monitoring. Nine patients (3 male, 6 female) underwent attempted transcatheter closure of a ASD using the Amplatzer atrial septal ocluder device with 10F, 11F or 12F long sheath at a mediant age of 33.0?5.2 years (range 8 to 52 years) and weighed 22 kg or more. Other congenital cardiac anomanies which require surgery were excluded. The mediant diameter of ASD at its narrowest segement were mensureted with the balloon catheters was 23.3?6.2 mm (ranger 11 to 30 mm). Systolic pressures of pulmonary arteries were 24.4?5.5 mm Hg (24-46 mm Hg) with catheterization mensuration. After the procedure, TEE were perfomed immediately to find whether there any residual shunt retained. Follow-up evaluation was color flow mapping at 24 h, 1, 3 and 6-months after closure. Results Nine patients had successful device placement. Transesophageal echocardiography showed that 8 patients had complete immediate closure and one had a small residual shunt after the operation, and could get up in the next day. The complication of cerebral throumbus embolism occurred in one woman patient during the procedure. She accepted immediately thrombolysis therapy with urokinase and recovered after several days. Conclusion Transcatheter closure of secondum ASD using Amplatzer atrial septal occluder device is an effctive nonsurgical therapy method. The operation has specialities of simple, safe with a high succes rate of placement and a fine occlusion effect. Further clinical trias are underway.

Objective To evaluate the primary result of proximal femoral nail anti-rotation(PF-NA)in treating osteoporotic intertrochanterie fractures. Methods Between March 2006 and August 2007.PFNA or Gamma nail intemal fixation were performed in 31 patients with osteoporotic intertrochan-tefie fractures.of whom were 19 males and 12 females at a mean age of 75.6 years(45-89 years).Ac-cording to AO classification,there were 8 type A1 fractures,16 type A2 fractures and 7 type A3 fractures.Aeearding to Evans-Jensen classification.18 cases were rated as Evans Ⅱ and 13 as Evans II.AIl frac-tares were closed ones and 6 patients were combined with internal diseases.PFNA was implanted throush a mini-incision without exposure of the fracture section during operation in 12 patients. Results Of all.6 patients received emergency operation,19 did operation within 3 days and 6 waited for selective op-eration(5-7 days)after controlling internal diseases.PFNA had shorter operation time,less hlool loss and shorter union time compared with Gamma nail(P＜0.05).No complications such as infection,non-union or loosening of nails were found.According to HarriS hip rate scale system,the excellence rate of PFNA was 83.4%and that of Gamma nail 73.7%. Conclusion PFNA is a good choice to treat osteo-perotie intertrochanteric fractures.owing to its advantages of stable fixation,minor trauma,eaSy opera-tion.short operation time,little bleeding,minor lOSS of selerotin and early exercise.

Objective To analyze the risk factors for perioperative acute cerebral vascular accident (PACVA) and put forward the corresponding preventive measures.Methods The clinical data of elderly patients in our hospital who suffered from PACVA in recent 5 years were retrospectively studied.The correlation between risk factors and the occurrence of PACVA was analyzed.Results One hundred and fifty cases were enrolled in the study.Seventy eight cases of them suffered from PACVA with the average age of 70 years ranging from 60 to 98 years.Fifty six cases(71.8%)were found PACVA in one week after operation.Multiple regression analysis showed that hypertension, history of cerebrovascular disease, unstable blood pressure and obesity were independent risk factors for PACVA.The newly diagnosed perioperative atrial fibrillation and carotid atheroselerosis were the high risk factors for PACVA.Conclusions PACVA is one of the common perioperative complications.Necessary check, monitor and treat measures should be taken in the perioperative period, especially for patients with risk factors.

Objective To investigate the clinical significance of prenatal ultrasound examination in the diagnosis of fe?tal digestive tract development. Methods Twenty-nine cases of congenital digestive tract malformation were examined in according to the different characteristics of their different fetal ultrasound images. Results There were 11 cases with non-magenblase or less magenblase (37.93%), 4 cases with combination of multiple malformations, and 9 cases with combination of amniotic fluid in the 29 cases. There were 7 cases (24.14%) with dilatation of intestine and intestinal vesicles, in which 3 with multiple malformations and 3 with polyhydramnios. There were 8 cases (27.58%) with double bubbles, in which 1 case with multiple malformations and 7 cases with amniotic fluid. Conclusion The prenatal ultrasound examination in 30 to 32 weeks of pregnancy is very valuable in diagnosis of fetal digestive tract development, which is worthy of clinical application.

BACKGROUND:Morphological characteristics of the rabbit lumbar vertebrae are of great significance for animal experiments about lumbar spine, but there is a lack of study on the lumbar morphology in rabbits. OBJECTIVE:To establish a three-dimensional model of rabbit lumbar vertebrae, and to observe its morphological characteristics, thereby providing anatomical basis for the animal experiments about lumbar spine.METHODS:Twenty New Zealand rabbits were subjected to 64-row multi-detector CT (Siemens) scan, and the three-dimensional models were constructed based on the CT data from 140 lumbar vertebrae. The morphological parameters of L1-7 were measured, and the internal and external structures of lumbar vertebrae and changes of different segments were observed. RESULTS AND CONCLUSION:(1) Changes of the morphological parameters of each lumbar vertebra:the L1-7 height first increased and then decreased, and the shortest height was in the L7, which was (1.12±0.18) cm. L1 vertebral body exhibited the shortest transverse diameter, (1.03±0.15) cm, and the longitudinal diameter did not differ significantly among vertebrae. The transverse and longitudinal diameters of L1-6 spinal canals were on a rise, but decreased abruptly at L7. The pedicle width of L1-7 increased gradually;the pedicle height of L1-5 increased gradually, and then began to decrease markedly, and the shortest at L7, (0.58±0.11) cm. The width and length of L1-6 spinous process increased steadily, but decreased at L7. The length of L1-3 transverse process increased gradually, tended to be steady at L3-6, and increased notably at L6-7;there were significant differences in the transverse process angle at L1-6, but the angle increased markedly to (58±2)° at L7, (2) These results indicate that the internal and external structures of lumbar vertebrae and changes of different segments are obtained through morphological measurement of lumbar vertebrae in New Zealand white rabbit, which provides a detailed anatomical data for relative animal experiments.

Objective Analysis of the etiological factors and the diagnostic methods of fever of unknown origin(FUO)in order to avoid misdiagnosis and missed diagnosis.Methods One hundred and twenty-eight patients with FUO were collected from our hospital.Results A final diagnosis was established in 118(92.2%)patients by using serological methods,bacteriological methods,body fluid test,bone marrow examination,tissue biopsy and diagnositic therapy.Infection(62.5%),connective tissue diseases(16.1%),malignancies(11.0%)were found to be the common causes of the fever in these patients while infection was the main cause of FUO in our research.The major pathogens responsible for the infec tion was bacteria,followed by virus and tuberculosis.Adult Still's disease was the most common connective tissue diseases in these patients.Lymphoma,malignant histocytosis and leukemia were the main forms of malignancy.Conclusion Infectious diseases was the most common cause of FUO while connective tissue disease and malignant tumors are also important in the pathogenesis of FUO.

Ataxia Telangiectasia Mutated Proteins ; Breast ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Carcinoma, Intraductal, Noninfiltrating ; metabolism ; pathology ; Cell Cycle Proteins ; metabolism ; Checkpoint Kinase 2 ; DNA-Binding Proteins ; metabolism ; Female ; Humans ; Lymphatic Metastasis ; Neoplasm Grading ; Protein-Serine-Threonine Kinases ; metabolism ; Tumor Burden ; Tumor Suppressor Protein p53 ; metabolism ; Tumor Suppressor Proteins ; metabolism

Inflammation plays an essential role in the pathophysiology of atherosclerosis. Our study was aimed to investigate whether salvianolate, a novel water-soluble phenolic compound of Danshen, alleviates atherosclerosis via regulating the inflammation in rats. High fat diet feeding plus vitamin D3 injection was used to induce atherosclerosis in rats. Salvianolate (60, 120 or 240 mg/kg) or placebo was given to atherosclerotic rats. The plasma lipids, interleukin 6 (IL-6) and C reactive protein (CRP) were measured by ELISA. CD4+CD25+Foxp3+ cells were determined by flow cytometry. Histological changes were examined by hematoxylin and eosin staining. The results showed that the levels of plasma IL-6 and CRP were elevated in the rats fed on high fat diet, and the histological analysis demonstrated the successful establishment of atherosclerosis models. Treatment with salvianolate alleviated the atherosclerotic process and decreased the levels of plasma IL-6 and CRP. Also the number of CD4+CD25+Foxp3+ cells was increased in salvianolate-treated rats. It was concluded that salvianolate could treat atherosclerosis via modulating the inflammation at cytokine and cell levels.

Objective To observe the changes of immunological parameters and the effects of intravenous immunoglobulin (IVIG) in children with idiopathic thrombocytopenic purpura (ITP),schonlein-Henoch purpura(HSP) and mucocutaneoas lymph node syn-drome(kawasaki disease, KD).Methods T cell subsets and serum immunoglobulins and complements were measured with the flow cytometry and enhanced trubidimetric immunoassay. Routine therapy combined with IVIG. Results CD3+ CD4+ T cells were de-creased in children with ITP accompanied by increased serum IgG;Serum IgA and CD3+ T cells were increased in children with HSP; CD3+ CD8+ T cells were decreased in children with KD. Clinical features were markedly improved after treatment with IVIG. It was noted that the incidence of damage to coronary artery decreased after the use of IVIG. Conclusions T cell subsets, serum immunoglobulins should undergo the clinical routine examinations in ITP,HSP and KD. Early administration of IVIG might be important to improve disease prognosis and shorten its course of treatment in children with three kinds of immunology related diseases.

ObjectiveTo observe the effects of bone marrow stromal cells (BMSCs) on vessel endothelial cells proliferation and microvessel formation in vitro.MethodsBMSCs and brain vessel endothelial cells were separated from adult and divided into co-culture group of BMSCs and endothelial cells, medium group of BMSCs, comparison group. Endothelial cells proliferation and microvessel formation were observed. ResultsEndothelial cells were promoted to proliferate and formate the microvessel in medium group and co-culture group. And the effect was prominence in co-culture group.ConclusionBMSCs can promote the proliferation and microvessel formation of endothelial cells.