OBJECTIVETo observe thee efficacy of different ways of percutaneous coronary intervention (PCI) for treating elderly coronary heart disease (CHD) patients.

METHODSTotally 470 elderly CHD patients were classified to three age brackets (equal to or more than 85 years old, 60 to 74 years old, 75 to 84 years old). They were assigned to the transradial intervention (TRI) group (236 cases) and the transfemoral intervention (TFI) group (234 cases) according to different intervention pathways. Correlated indices and postoperative clinical efficacy were compared between the two groups.

RESULTSA higher successful rate of surgery was obviously got in patients 85 years old or older than 85 than in those 60 to 74 years old and 75 to 84 years old (P <0. 05). The incidence of major cardiovascular events (MACE) was reduced at post-operative 12 and 24 months in patients 85 years old or older than 85 (P <0. 05). The case number for changing intervention pathway were increased in the TRI group with statistical difference (P <0. 05). Compared with the TFI group, the case number for changing intervention pathway was increased; the time for arteriopuncture, the time for catheterization, and the time for X-ray exposure were prolonged; the time for postoperative bedding were obviously shortened; the incidence of vascular complications at the puncture site were lowered. The incidence of postoperative 12-month MACE was lowered, all with statistical difference (all P <0. 05). The incidence of MACE within postoperative 24-month MACE decreased in patients 60 to 74 years old and 75 to 84 years old (P <0. 05). The incidence of MACE within postoperative 24 months increased in patients 85 years old or older than 85 of the TRI group with statistical difference (P <0. 05).

CONCLUSIONTRI can be preferably chosen for PC in treating elderly CHD patients.

Aged ; Aged, 80 and over ; Coronary Artery Disease ; surgery ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Infarction ; Percutaneous Coronary Intervention ; methods ; Radial Artery ; Treatment Outcome

Objective To investigate the effective predictors of response in HBeAg-positive patients treated with adefovir dipivoxil(ADV)and to provide evidence for individualized treatment.Methods Patients administered with ADV for 48 weeks in a randomized,placebo-controlled,multicenter trial were studied.Statistical analyses,such as Backward stepwise logistic regression and 2?2 method were used for predictors analysis at week 48.Results The baseline serum ALT levels,HBV DNA levels,and undetectable serum HBV DNA by PCR at week 24 were predictors for HBV DNA negativity at week 48.The median of serum ALT levels and HBV DNA levels prior to treatment were 134.5 U/L and 6.57 lg copies/mL,respectively.Patients with baseline ALT levels higher than the median,HBV DNA levels lower than the median,and serum HBV DNA undectectable by PCR at week 24 had greater rate of HBV DNA negativity(93.3%),HBeAg loss(60%)and HBeAg seroconversion(40%)at week 48 than the others.47.8% of patients whose HBV DNA levels were positive at week 24 also achieved HBV DNA negativity at week 48,and 8.6% achieved HBeAg seroconversion.Conclusion Better response at week 48 has significantly higher serum ALT levels and lower HBV DNA levels prior to treatment and HBV DNA negativity at week 24 compared with non-response.Patients whose HBV DNA levels ware still positive at week 24 should continue therapy.

Objective To investigate the relationship of serum cholinesterase(CHE) level with the severity and prognosis in patients with acute cerebral infarction. Methods A total of 325 patients with acute cerebral infarction were recruited as patients group,and another 101 healthy sub?jects were selected as control group. Velocity method was employed to detect the level of serum CHE. Patients with acute cerebral infarction were then divided into different groups according to the infarcts diameter and the modified Rankin scale(mRS)at 1 year post stroke. The collected data were analyzed statistically. Results The level of serum CHE in small and medium area infarction group was higher than control group(P<0.01);the level of serum CHE in large area infarction group was lower than control group(P<0.01);the level of serum CHE was negatively correlated with infarct size,NIHSS and the mRS score(r=-0.302,-0.232,-0.455,P<0.001). The level of CHE,age,NIHSS and infarcts diameter was identified as independent influence factors for prognosis of acute cerebral infarction. Conclusion Early phase of serum CHE level is closely related with the infarct size and illness severity index in patients with acute cerebral infarction,which could be an independent factor affecting the prognosis of cere?bral infarction.

Public relationship has an outstanding effect on virtue education. Public relationship can regulate behavior, culture noble ethics, coordinate interpersonal relations and improve the ability of society adaptation for medical students. Public relationship can also build up good image of medical students, and improve their comprehensive qualities.

AIM To study the effect of rutoside (Ru) on blood rheology in murine acute pancreatitis (AP). METHODS Blood rheology, enzymatic levels and pathology of the pancreas were evaluated in all Wistar rats. The pancreatic sections were scored and compared. RESULTS In AP group, the whole blood viscosity, the plasma viscosity, the eryrocyte sedimentation, the hematocrit, the agglutinatin index of red blood cell, and the rigidity index were significantly elevated. The pancreatitis injury was described as evident pancreatic acinar necrosis and infiltration of inflammatory cells. Ru 120, 60, 30 mg?kg -1 (sc) ameliorated the abovementioned adverse pathophysiological changes seen in the control group. CONCLUSION During the course of AP, rutoside ameliorated the blood rheology abnormality and showed a protective effect on pancreatic tissue.

AIM:To compare the two techniques of pre-chop and non-pre-chop, and discuss the technical advantages of the capsulorhexis forceps assisted pre-chop.METHODS:Totally 149 cases of age-related cataract were randomly divided into using pre-chop (Group A) and non-pre-chop (Group B) techniques groups, for Group A patients received phacoemulsification after pre-chop by using capsulorhexis forceps.The ultrasonic energy, average phacoemulsification time, intraoperative complications, 1d, 1wk uncorrected visual acuity (UCVA) and 1d, 3d,1wk postoperative corneal edema were recorded and compared.RESULTS:The subgroups of the same group of nuclei were compared in the two groups.The ultrasonic time in Group A was lower than that of Group B, and the difference was significant(P<0.01).Also the corneal edema in the former was lighter than that of the latter(P<0.05).There was difference in uncorrected visual acuity(UCVA) between groups(P<0.05).CONCLUSION:Compared with non-pre-chop, the time of ultrasound in pre-chop group was shorter, the degree of corneal edema was lighter and early postoperative UCVA was better.

AIM: To observe the influence of lentiviral vectors expressing siRNA for survivin gene knockdown in A549 cells,sequentially as tools to explore the molecule pathogenesis and new gene therapy of lung adenocarcinoma.METHODS: The lentiviral vectors,which express survivin siRNA,were constructed and transfected into A549 cell strain.The titers of the lentiviruses were determined by 293T cells.The expressions of survivin and caspase-3 were detected by Western blotting and RT-PCR.The cell cycle and cell growth of A549 cells were examined by MTT and FCM.RESULTS: The expression of survivin was suppressed effectively by siRNA targeting survivin.The expression of survivin mRNA decreased by 97%.The expression of survivin protein decreased by 94%.The rate of cell growth was decreased.The G1 phase cells were increased,whereas S phase cells were decreased.CONCLUSION: The lentivirus vectors expressing siRNA for survivin can significantly inhibit gene expression and the cell growth,and markedly induce the apoptosis.It is hopeful to be a new gene therapy of lung adenocarcinoma.

Objective To investigate the influence of flufenamic acid (FFA) on gap junction intercellular communication in vascu-lar smooth muscle cells(VSMC) in situ of acutely isolated arteriole segments .Methods Whole-cell patch clamp recordings were used to study the effects of FFA on membrane input capacitance (Cinput ) ,membrane input conductance(Ginput ) or membrane input re-sistance(Rinput ) of VSMCs embedded in arteriole segments .Results FFA concentration-dependently and reversibly suppressed Ginput or increased Rinput ,with an IC50 of 56 and 33μmol/L in acutely isolated mesenteric artery(MA) and brain artery(BA) segments re-spectively .There was not significant difference between MA and BA (P> 0 .05) .After application of FFA (≥ 300 μmol/L) ,the Cinput ,Ginput and Rinput of the in situ cells were very close to the respective dispersed cell in MA and BA .Conclusion FFA is a reversi-ble gap junction blocker ,achieving a complete electrical isolation of the recorded VSMC at ≥300 μmol/L .FFA suggesting a homo-geneous property of the gap junctions between MA and BA .

‘Student-centered’ teaching model is the needs of higher medical education.In the process of education,we carried out comprehensive and systematic reforms by satisfying students' needs and improving students' ability as the main line.These reforms included change of teaching methods (the basic theory combined with clinical knowledge),increase of innovative experiments and change of evaluation system.These results showed that students were interested in these reforms,the innovation abilities of students were improved and students could pay more attention to the process of learning.

Objective To study the feasibility of testing three disease-causing genes for Alport syndrome,COL4A3,COL4A4 and COL4AS,in diagnosing patients with sporadic Alport syndrome by using targeted capture and next generation sequencing.Methods The clinical data of a 9-year-old boy suspected with Alport syndrome were collected.Genomic DNA was extracted using standard procedures from the peripheral blood leukocytes of the patient and his parents,respectively.Targeted capture and next generation sequencing and Sanger sequencing were applied to analyze the mutations in the 3 disease-causing genes.Clinical data of cases reported already with autosomal recessive Alport syndrome caused by the mutations in the COL4A4 gene were summarized.Results The patient was presented with neither family history of hematuria nor chronic renal failure.Haematuria and proteinuria were found at the age of 1 year.The patient presented with episodes of macrohaematuria and gradually developed nephrotic-level proteinuria.At the age of 8 years 7 months,bilateral sensorineural hearing loss was diagnosed.So a probable diagnosis of Alport syndrome was postulated.A compound heterozygous pathogenic mutations of 3578-1G ＞ A and 3967 C ＞ T(Q1323X) were identified in the COL4A4 gene in the patient.The mutation of 3578-1G ＞ A was inherited from his father,and the mutation of Q1323X from his mother.The patient was decisively diagnosed with autosomal recessive Alport syndrome.Conclusions The test of COL4A3,COL4A4 and COL4A5 genes can help diagnose patients with sporadic Alport syndrome by using targeted capture and next generation sequencing.