Ostial lesions present many challenges for percutaneous coronary intervention (PCI). Coronary anomaly will further increase difficulties in performing PCI for the patient. We present such a case as ostial occlusion of an right coronary artery with high takeoff. A 77-year-old male was referred to our institution with a diagnosis of non-ST elevated acute myocardial infarction. Selective coronary angiography and nonselective ascending aortography could not identify the origin of the right coronary artery. Multi-slices computed tomography showed RCA ostial totally occluded. A successful PCI was performed and a perfect final result was achieved utilized with many tips and tricks, including buddy wire technique and focused-force angioplasty.

Vaspin,a serine protease inhibitor derived from visceral adipose tissue,has been identified as an adipokine with insulin-sensitizing effects in a rat model of type 2 diabetes.Recent studies showed that the administration of recombinant human vaspin significantly improved insulin sensitivity and glucose tolerance,and reversed the expression of genes that may promote insulin resistance in diet-induced obese mice.However,the regulation of serum vaspin concentration in individuals with insulin resistance,and the association of vaspin with obesity,type 2 diabetes,and insulin resistance related disorders remain unclear.

Objective To explore the effect of developed operating instrument set for cesarean section. Methods Toally 216 parturients to undergo cesarean section in our hospital during May to December 2014 , were divided into observation group and control group, 108 cases in each group:in the observation group the developed operating instrument set was used and in the control one, the routine operating instrument set was used. The two groups were compared in terms of contamination rate and the time for postoperative operating room preparation. Results The contamination rate of the observation group was significantly lower than that of the control group (P<0.01). The time for postoperative operating room preparation of the observation group was significantly shorter than that of the control group (P < 0.01). Conclusion The developed operating instrument set can reduce the rate of contamination at the operated area during cesarean section and shortned the time for postoperative operating room preparation , thus enhancing the work efficiency.

Brain-derived neurotrophic factor (BDNF)is both a neurotrophic substance and a neurotransmitter.BDNF and its receptors are highly expressed in enteric nervous system,intestinal mucosal epithelium and intestinal muscularis, which play an important role in regulating intestinal sensitivity and motility.This article reviewed the expression and role of BDNF in intestinal tract.

Objective To investigate the effect of interleukin-17 (IL-17) in the gastric cancer cell migration and invasion via regulating epithelial-mesenchymal transition (EMT) and its potential function.Methods (1) Human gastric cancer cell MGC-803 lines in the logarithmic growth phase were stimulated by 0, 1 ng/mL, 10 ng/mL,100 ng/mL and 1μg/mL of IL-17 for 48 hours, and the phenotypic changes were observed.The concentration of IL-17 was selected for follow-on experiments based on the most obvious phenotypic changes.Gastric cancer cell MGC-803 which were stimulated by 100 ng/mL of IL-17 and PBS for 48 hours were allocated into the experimental group and control group, respectively.(2) The expressions of E-cadherin and Vimentin mRNA in gastric cancer cells were assayed through real-time PCR (RT-PCR).(3) The relative expressions of E-cadherin and Vimentin proteins in gastric cancer cells were assayed by the Western blot.(4) The scratch test and Transwell detection were also utilized to study the migration and invasion of gastric cancer cell MGC-803 in vitro.Measurement data with normal distribution were presented as-x ± s and comparison between groups was analyzed using the t test.Results (1) There were significant phenotypic changes in the gastric cancer cell after the different concentration of IL-17 stimulated gastric cancer cell MGC-803 for 48 hours.Cells were changed from polygonal and tight junction to spindle and loosely junction with a deterioration of cell adhesion.Cell phenotypes were gradually changed as the concentration of IL-17 was changed from 0 to 100 ng/mL.Phenotypic changes were the most obvious when 100 ng/mL of IL-17 was used, but these were non-significant as the concentration of IL-17 increased to 1 μg/mL with the death and floating of some cells.(2) The relative expressions of E-cadherin mRNA and Vimentin mRNA in RT-PCR were 0.45 ±0.13 and 1.06 ±0.23 in the experimental group and 2.39 ±0.55 and 1.23±0.41 in the control group, respectively, with significant differences (t =3.811, 2.923, P ＜0.05).(3) The results of Western blot showed the relative expressions of E-cadherin and Vimentin proteins were 0.86 ± 0.17 and 1.56 ± 0.29 in the experimental group and 1.01 ± 0.12 and 0.56 ± 0.17 in the control group, respectively, with significant differences (t =3.551, 3.601, P ＜ 0.05).(4) Cell migration in the 2 groups were detected by the scratch test at 36 hours after scratch test, and the width of scratch in the experimental and control groups were (0.76 ± 0.13) mm and (0.40 ± 0.15) mm, showing a significant difference (t =3.095, P ＜ 0.05).Transwell detection showed number of transmembrane cell in the experimental and control groups were 159 ±28 and 94 ± 18, respectively, with a significant difference (t =3.307, P ＜ 0.05).Conclusion IL-17 can promote the migration and invasion of gastric cancer cells via stimulating alteration of EMT.

Objective To investigate the clinical effect of tension-free hernia repair in the treatment of inguinal hernia combined with ascites.Methods The retrospective cross-sectional study was conducted.The clinical data of 81 inguinal hernia patients with ascites who were admitted to the West China Hospital of Sichuan University from June 2008 to June 2014 were collected.Patients with peritoneal effusion received restriction of sodium in take and diuretic therapy,and patients with severe hypoproteinemia received intravenous injection of albumin.All the patients underwent tension-free hernia repair (Gilbert way).Observation indicators:(1) surgical and postoperative situations:operation time,diameter of hernia ring,defect area of hernia,postoperative plasma drainage,removal time of plasma drainage-tube,postoperative complications and duration of hospital stay;(2) follow-up situation:recurrence and long-term complications of inguinal hernia.Follow-up using telephone interview,outpatient examination and inpatient examination was performed to detect the hernia recurrence and long-term complications for 24 months up to June 2016.Measurement data with normal distribution were represented as (x)±s.Results (1) Surgical and postoperative situations:81 inguinal hernia patients with ascites underwent successful tension-free hernia repair.The operation time,diameter of hernia ring and defect area of hernia were respectively (46± 19) minutes,(3.1-± 0.7) cm and (25 ± 13) cm2.Sixty-five patients received indwelling plasma drainage-tube after repair,volume of light bloodstained fluid was respectively ≥ 100 mL in 39 patients and ＜ 100 mL in 26 patients at 24 hours postoperatively,with a removal time of plasma drainage-tube of (3.2± 1.0)days.Sixteen patients didn't receive indwelling plasma drainage-tube.Of 81 patients,9 and 4 were respectively complicated with mild seroma of incision and scrotal swelling,they were improved and then out of hospital after adequate drainage,with a duration of hospital stay (6.7-± 1.7)days.(2) Follow-up situation:of 81 patients,76 were followed up for 24 months,without recurrence and related complications of inguinal hernia.Conclusion The tension-free hernia repair in the treatment of inguinal hernia combined with ascites is safe and feasible,with good clinical effects.

Objective To assess the diagnostic value of 99Tcm-ECD SPECT for hyperacute cerebral ischemia using rats models.Methods A stable and permanent acute cerebral ischemia model using unilateral middle cerebral occlusion was tested in 24 healthy SD rats.The rats were randomly divided into 6 groups according to the time duration between imaging and induced-ischemia (1,2,3,4,5 and 6 h,respectively).The rats were sacrificed immediately after 99Tcm-ECD SPECT/CT imaging and then the brain tissue was dissected for triphenyl tetrazolium chloride (TTC) and HE staining.The count ratio of affected cortex to the contralateral cortex of ＜ 50％ was defined as ischemia on micro SPECT/CT.The volume of the ischemic area was calculated on both SPECT/CT and TTC images.Paired t test was used to determine the statistical difference between the volumes on SPECT/CT and TTC staining.Results The ischemia volume evaluated by TTC staining at 1,2,3,4,5 and 6 h after occlusion was (73.98 ± 27.76),(90.75 ±29.00),(135.00±40.83),(136.25±22.51),(158.50±32.72) and (168.00±32.75) mm3,respectively.The corresponding ischemia volume evaluated by micro SPECT/CT was (98.50 ± 27.77),(110.40±26.80),(157.00±36.82),(165.50±26.54),(175.75±31.16) and (177.25 ±34.33) mm3,respectively,which was concordant with that by TTC staining at each time point (t:-1.681 to-0.390,all P ＞0.05).The ischemic area on micro SPECT/CT imaging was consistent with the pink area by TTC staining.The volume evaluated by micro SPECT/CT tended to be constant 3 h after the occlusion.The ischemia volume showed no significant difference among 3,4,5 and 6 h (all P ＞ 0.05).Conclusions Micro SPECT/CT may have an haemodynamic value for evaluating in vivo cerebral ischemia applied in a rat model.It might have clinical value for the evaluation and decision-making of ultra acute cerebral infarctions.

Objective To discuss the influence of new weapons in the high-tech war on eye wounds in order to develop the new time-effect treatment strategy. Methods The data of wounds in recent wars were investigated, the causes of eye wounds in high-tech war were analyzed, and the new concept of time effect treatment strategy for eye wounds was proposed. Results The weapons in high-tech war have developed into mass destruction and precisely guided munitions. The main cause of eye wounds is the shrapnel and some new wounds will occur such as eye wounds caused by laser or chemical toxin, radiation cataract. Conclusion In the future high-tech war, the major type of eye-wounds may still be the explosion injury and some new types of eye wounds should be paid more attention. The time-effect treatment strategy should be implemented to meet the demand of improving eye wound therapy and promoting the development of ophthalmology.

The atherosclerotic plaque vulnerability may be related to inflammation,immunity,metabolism and blood clotting.One of the key factors affecting plaque stability is inflammatory reaction.This study was to investigate the relationship between vulnerability of coronary artery plaque evaluated with coronary angiography (CAG),intravascular ultrasound (IVUS) and the levels of plasma inflammatory markers.Methods Fifty-eight consecutive patients with acute coronary syndrome who had coronary lesion of a single vessel were divided into 3 groups based on angiographic morphology of the lesions:type Ⅰ lesion group (n =16),type Ⅱ lesion group (n =25) and type Ⅲ lesion group (n =17).The control group consisted of 17 patients with stable angina.Plasma levels of high sensitivity C reaction protein (hs-CRP),matrix metalloproteinase (MMP,including MMP-2 and MMP-9),CD40 ligand (CD40L) and pregnancy associated plasma protein-A (PAPP-A) were measured by ELISA.A subgroup of 28 patients (including 18 ACS patients and 10 stable angina control patients) who underwent IVUS study,were analyzed.Results The plasma levels of MMP-2,MMP-9 and PAPP-A in type Ⅱ lesion group were significantly higher than those in other groups (all P＜0.05).In type Ⅱ lesion group,linear correlation analyses showed significant positive correlation between levels of hs-CRP and MMP-2 (r=0.508);MMP-2 and MMP-9,CD40L,PAPP-A (r=0.647,0.704 and 0.751,respectively);MMP-9 and CD40L,PAPP-A (r=0.491 and 0.639,respectively);CD40L and PAPP-A (r=0.896).IVUS subgroup analysis showed that the area of plaques and plaque burden in culprit lesion,the incidence of high-risk plaques,remodeling index (RI) and positive remodeling percentage in ACS patients were significantly greater than those in control subgroup (P=0.000,0.037,0.028,0.015 and 0.040,respectively).Compared with control subgroup,the plasma levels of hs-CRP,MMP-2,MMP-9 and PAPP-A were markedly elevated (P=0.033,0.000,0.000 and 0.027,respectively).Conclusions CAG and IVUS combined with study on plasma levels of inflammation mediators are helpful in judging the vulnerability of coronary artery plaques.(J Geriatr Cardiol 2008;5:207-211)

Objective To study the changes of muscle being injected with botulinum toxin A in different period of time,helping for chemically denervated muscle transplantation.Methods Sixteen rabbits were divided into 4 groups.The extensor carpi radialis muscle in one side was chosen for experimental group with the opposite muscle for control group.Morphological changes,histological changes and electron microscopic changes of muscle being injected with botulinum toxin A were observed from the first week to the fouth week.Results The quantity of glycogen and mitochondria in the muscles reduced in the first week.But it was obvious in the third week.We also found some necrotic areas in the fouth week with the muscles restoring.Conclusions The effect of metabolism slowing down and the volume of muscle reducing after botulinum toxin A injection is obvious in third weeks.It could help us choose the best time of chemically denervated muscle transplantation.