Percutaneous coronary intervention(PCI) can effectively restore reperfusion of ischemic myocardium in patients with coronary artery disease.But currently PCI treatment is just available for a small proportion of the patients with coronary artery disease,so there was an insufficiency of PCI in patients with coronary artery disease.From the perspective of ethics,the reasons for the phenomenon and some feasible strategies for the problem are also analyzed in this paper.

The etiology of deep vein thrombosis (DVT) is still not elucidated nowadays. Based on the accordance between DVT incidence and the anemophilous pollen concentration in the air, we proposed the hypothesis that allergic reaction induced by anemophilous pollen may cause "idiopathic" DVT, and proinflammatory factors may play an important role in the thrombosis process.

BACKGROUND: Triggering receptor expressed on myeloid cells-1 (TREM-1) in the intestine was upregulated and correlated with disease activity in inflammatory bowel diseases. Membrane-bound TREM-1 protein is increased in the pancreas, liver and kidneys of patients with severe acute pancreatitis (SAP), suggesting that TREM-1 may act as an important mediator of inflammation and subsequent extra-pancreatic organ injury. This study aimed to investigate the relationship between the expression of TREM-1 in intestinal tissue and intestinal barrier dysfunction in SAP. METHODS: Sixty-four male Wistar rats were randomly divided into a sham operation group (SO group, n=32) and a SAP group (n=32). A SAP model was established by retrograde injection of 5％sodium deoxycholate into the bile-pancreatic duct. Specimens were taken from blood and intestinal tissue 2, 6, 12, and 48 hours after operation respectively. The levels of D-lactate, diamine oxidase (DAO) and endotoxin in serum were measured using an improved spectro-photometric method. The expression levels of TREM-1, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) mRNA in terminal ileum were detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). Specimens of the distal ileum were taken to determine pathological changes by a validated histology score. RESULTS: The serum levels of D-lactate, DAO and endotoxin were significantly increased in each subgroup of SAP compared with the SO group (P<0.01, P<0.05). The expression levels of TREM-1, IL-1β and TNF-α mRNA in the terminal ileum in each subgroup of SAP were significantly higher than those in the SO group (P<0.01, P<0.05). The expression level of TREM-1mRNA was positively correlated with IL-1β and TNF-α mRNA (r=0.956, P=0.044; r=0.986, P=0.015), but the correlation was not found between IL-1β mRNA and TNF-α mRNA (P=0.133). Compared to the SO group, the pathological changes were aggravated significantly in the SAP group. CONCLUSIONS: The expression level of TREM-1 in intestinal tissue of rats with SAP was elevated, leading to the release of inflammatory mediators and intestinal mucosal injury. This finding indicates that TREM-l might play an important role in the development of intestinal barrier dysfunction in rats with SAP.

Objective - - To analyze the prevalence and influencing factors of multi site work related musculoskeletal disorders （ ） Methods WMSDs in surgeons. A total of 102 surgeons from four hospitals were selected as study subjects by convenient sampling method. The Chinese version of Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of ， Results WMSDs in the past one year the related individuals and occupational factors. The total prevalence of WMSDs among （ ）， （ ） （ ） surgeons was 54.9%. The top three sites were neck 48.0% lower back 35.3% and shoulder 32.4% . The prevalence of （ vs ，P ） WMSDs in multiple sites was higher than that in a single site 43.1% 11.8% <0.01 . Multivariate logistic regression ， ， analysis showed that surgeons who smoked were tired at work and had a bent back had a higher risk of developing WMSDs ［ （ - ）， （ - ）， （ - ）， P ］ odds ratios and 95% confidence intervals were 3.66 1.41 9.46 8.33 2.15 32.20 and 18.74 2.14 166.77 all <0.01 Conclusion - after excluding the influence of confounding factors. The prevalence rate of multi site WMSDs among surgeons is ， high and the influencing factors include bad living habits and occupational factors such as working load and working posture.

OBJECTIVETo investigate the mechanism of Hangman's fracture and its clinical manifestation and treatment.

METHODSTen patients with Hangman's fracture treated at our hospital from 1988 to 2001 were analysed.

RESULTPatients were injured by motor vehicle accidents (7 patients), object hitting on the head (1), and fall (1). Injuries were classified as type I (1 patient), type II (5), type IIa (2) and type III (2).

CONCLUSIONSMotor vehicle accident and fall are major causes of Hangman's fracture with neurological deficits but limited motion and neck pain. Hangman's fracture is easily diagnosed using lateral cervical X-ray and CT. Hangman's fractures of types I, II and IIa can be treated conservatively, but those of type III or spinal cord injury require surgical stabilization.

Adolescent ; Adult ; Axis, Cervical Vertebra ; injuries ; Female ; Follow-Up Studies ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fractures ; diagnosis ; surgery ; Spinal Fusion ; Traction ; Young Adult

OBJECTIVETo investigate the character, diagnosis and treatment of multiple-level fractures of the cervical spine.

METHODSForty-three patients (38 male, 5 female) with multiple-level fractures of the cervical spine were retrospectively analysed in our hospital from 1988-2001.

RESULTSAmong 36 patients with multiple contiguous fractures of the cervical spine, 32 cases were injured at low cervical spine; 7 patients were non-contiguous spinal fractures in which there were 5 cases injured at upper and lower cervical spine. The frequently injured sites were vertebral body (31 patients), laminae (25 patients), spinous process (9 patients), vertebral arch (4 patients), transverse process (5 patients), lateral mass (5 patients); level frequently affected were C(4), C(5), C(6) and C(7); 21 patients were treated with anterior vertebrectomy and fusion, 10 patients with posterior laminectomy and fixation, 2 patients with both anterior and posterior decompression and fixation. 60.5% were flexion-compression injury. 10 patients with conservative treatment.

CONCLUSIONSContiguous type was more common than non-contiguous type in multiple level cervical spinal fractures; Injured sites always located at lower cervical spine in contiguous cervical fractures different from that fractures of atlas, axis and lower cervical spine in non-contiguous type; Unstable segments and level of spinal cord injury were at lower cervical spine; Operations must obtain both decompression and stability of spine.

Adolescent ; Adult ; Cervical Vertebrae ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; Male ; Middle Aged ; Multiple Trauma ; diagnosis ; surgery ; therapy ; Retrospective Studies ; Spinal Fusion ; Spinal Injuries ; diagnosis ; surgery ; therapy

Objective To evaluate the clinical results of free vascularized fibular associated with iliac graft in treatment of old femoral neck fracture.Methods From 1994 to 1997,76 cases of old femoral neck fracture were treated with free vascularized fibular associated with iliac graft,they were followed up for observ- ing fracture healing,hip function and femoral head necrosis.Results Sixty-eight of these 76 cases were fol- lowed up with detail data with the main term as 10.5 years.All fractures healed within 4 to 6 months.63 cases got a almost normal hip function with the Harris score was 87.5,in these cases,the structure of femoral head were normal and the grafted fibular and iliac bone healed with the femoral.4 cases got to femoral head necrosis and 1 experienced hip dislocation.Conclusion Free vascularixed fibular associated with iliac graft is a good method to treat these cases with old femoral neck fracture who want reserve their femoral head.

AIMTo investigate the preparation of diclofenac sodium pulsatile release pellets (DS-PRP), the release in vitro and the pharmacokinetics of the drug.

METHODSDiclofenac sodium (DS) core pellets prepared by extrusion-spheronization technology were coated in a mini-fluidized bed spray coater with swelling material as the inner coating swelling layer and ethylcellulose aqueous dispersion as the outer coating controlled layer. The effects of formulation and medium on pulsatile release of DS were investigated under release rate test. Pharmacokinetic and bioavailability study in eight human subjects were performed by HPLC method.

RESULTSThe delayed-release time and release rate of DS from DS-PRP were influenced obviously by the swelling material, the concentration of SDS in medium, the coating level of the inner swelling layer and the outer controlled layer. In vitro, the delayed-release time T0.1 was 3.1 h, and the pulsed-release time T0.1-0.2 was 1.2 h. In vivo, the delayed-release time Tlag was 2.8 h, and the bioavailability was (91 +/- 12)%.

CONCLUSIONThe release of drug from DS-PRP was shown to be in pulsed way both in vitro and in vivo.

Adult ; Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; pharmacokinetics ; Biological Availability ; Cellulose ; analogs & derivatives ; chemistry ; Delayed-Action Preparations ; Diclofenac ; administration & dosage ; pharmacokinetics ; Humans ; Hydrogen-Ion Concentration ; Male ; Random Allocation ; Sodium Dodecyl Sulfate ; chemistry

OBJECTIVETo evaluate the veracity of the C1 lateral mass screw insertion in the atlantoaxial fixation using plate and screw method without A-P fluoroscopic guiding.

METHODSIn the atlantoaxial fixation, without A-P fluoroscopic guiding, we probe lateral mass edge and identify the entrance point of C1 lateral mass screw indirectly. 159 patients treated with atlantoaxial fixation using plate and screw method were studied. Postoperative CT was used for analysis, and the position of the lateral mass screws in atlas was identified by coronary and axial CT scan. Three areas were delimited in and around the lateral mass of atlas in the axial CT scan, so as to analyze the location of screws: area A (inside the joint face), area B (outside the joint face but still in lateral mass), and area C (outside the lateral mass).

RESULTSAmong the 318 screws, 308 (96.9%) were located in area A, 5 in area B (1.6%), and 5 in area C (1.6%). All cases got atlantoaxial union at 4 months after operation.

CONCLUSIONProbing lateral mass edge and identifying the lateral mass indirectly is reliable for identifying the path of screw in atlas.

Adolescent ; Adult ; Aged ; Atlanto-Axial Joint ; surgery ; Bone Screws ; Cervical Atlas ; surgery ; Child ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Joint Instability ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; methods

To study the allele frequencies and their polymorphism characteristics of human platelet antigen (HPA) and human leucocyte antigen-I (HLA-I) in Chinese xi'an population, the types of HPA and HLA-I in 375 Chinese xi'an voluntary platelet donors were detected by PCR-SSP and PCR-SSO as well as flow cytometry with magnetic beads, and were analyzed. The results showed that there was no polymorphism in HPA-7-HPA-14, HPA-16 and HPA-17 which only expressed-aa type, the -bb type was only detected in HPA-3 and HPA-15, 9 out of 16 samples for the HPA-5ab phenotype simultaneously expressed HPA-15ab, the other 7 samples expressed HPA-15bb, no HPA-15aa phenotype was observed. Phenotypes detected in this study were HPA-1aa-17aa, HPA-1ab, -2ab, -3ab, -3bb, -4ab, -5ab, -6ab, -15ab and -15bb. Among 375 cases, HLA-A specificity of 16 species was observed, which accounted for 76% (16/21) of detectable phenotype specificity in this locus, moreover, 11 species showed frequency > 1%; HLA-B specificity of 36 species was observed which accounted for 84% (36/43) of detectable phenotype specificity in this locus, moreover 23 species showed frequency > 1%, these species were covered by common specific HLA-I in northern China, 264 species haplotype HLA-A-B were found in 375 cases, the frequency of 30 species was > 1%. It is concluded that the gene frequency distribution of HPA and HLA-I in Chinese Xi'an population is in accordance with population of northern China on the whole, but it has its own characteristics.
Adolescent ; Adult ; Alleles ; Antigens, Human Platelet ; genetics ; Asian Continental Ancestry Group ; genetics ; Blood Donors ; China ; Female ; Genes, MHC Class I ; Humans ; Male ; Middle Aged ; Phenotype ; Young Adult