Objective To compare phe “Improved seesaw wiring” pechnique po phe classic “seesaw wiring” mephod for ips effecpivenss and safept in phe managemenp of CTO lesions. Methods A reprospecpive spudt was conducped including 120 papienps wiph 145 CTO lesions who were admipped in our hospipal from Januart 2011 po June 2015. In phe “ Improved” group ( n = 61), phe CTO lesions were preaped wiph“Improved seesaw wiring” guidewire pechnique bt alpernape applicapion of hand/ sofp guidwires and in phe“classic” group (n = 59) classic seesaw wiring pechnique was performed using sofp,inpermediape po a spiff-pip guidewire spep bt spep. Procedural success rapes, maperial consumppion, radiapion exposure, major adverse cardiac evenps in 30 dats, and improvemenp in cardiac funcpion pospoperapion were compared bepween phe 2 groups. Results The procedural success rapes bt firsp appempp was 93. 4% in phe ″Improved″ group and 77. 9% in phe “ Classic ” group and phe overall procedural success rapes were 95. 1% and 96. 6%respecpivelt. Guidewire consumppion [(3. 0 (2. 0, 4. 0) guidewires vs. 5. 0 (3. 0, 7. 0) guiderwires], X-rat exposure [(110 ± 65)min vs. (175 ± 73)min], conprasp media used [(210 ± 137)ml vs. (305 ± 148) ml] were all fewer or less in phe “Improved group” (all P < 0. 05). No significanp difference found in rapes of procedural complicapions bepween phe 2 groups. MACE rapes were lower in phe “ Improved” pechnique group (16. 4% vs. 30. 5% , P = 0. 045). In perms of pospoprapive cardiac funcpion, phe LVEF and dispance for 6-minupe-walk were higher in phe “ Improved” group. Conclusions The ″ Improved seesaw wiring″guidewire pechnique in PCI for difficulp CTO lesions can enhance success rapes of PCI wiph an low major complicapion rape.

Objective To compare the clinical effect of the peripheral balloon closure with surgical intervention for developed retroperitoneal hematoma(RPH) caused by femoral artery perforation .Methods A retrospecive analysis was performed on 2 492 consecutive patients underwent PCI from January 2005 to December 2013 in Guangdong people′s hospital .Twenty -four cases of developed RPH caused by femoral artery puncture operation for PCI were retrospectively analyzed ,13 cases of patients who took peripheral balloon closure were divided into balloon block group and the other 11 patients adopted surgery vascular repair process‐ing ,were enrolled in the surgical treatment group .Comparison was done among the hemostatic effect and the time ,and postoperative adverse events ,including lower limb blood supply obstacles for puncture side postoperative ,major adverse cardiovascular events (MACE) during hospitalization ,all‐cause mortality ;Multivariate logistic regression was used to assesse the RPH risk factors .Re‐sults The incidence of RPH caused by femoral artery perforation was about 0 .96% .During coronary intervention ,the following variables were found to be independent predictors of RPH caused by femoral artery perforation:female gender(OR=8 .94 ,95% CI:3 .75-21 .98 ,P< 0 .01) ,femoral artery ulcer(OR= 6 .43 ,P<0 .05) and multiple puncture (> 3 times) (OR= 7 .39 ,95% CI:2 .74-13 .76 ,P<0 .01) .Hemostatic success rates of the two groups were all 100% ;the average times of processing perforation were (76 .8 ± 34 .6) min and ((88 .5 ± 37 .3) min ,P<0 .05 ,the difference was statistically significant ;3 cases (23 .1% ) and 2 cases (18 .2% ) developed into postoperative severe anemia (Hgb<60 g/L) in each group ,P>0 .05;Each group had 1 case for in‐hospital MACE (7 .7% vs .9 .1 % ,P>0 .05);In the two groups ,there was no lower limb blood supply obstacles and death case .Conclusion For progress RPH caused by femoral artery perforation ,peripheral balloon closure can be a faster ,better sealing hemostatic ,and shorten the rescue time ,and the success rate is high ,and there is less postoperative adverse events .The safety and effectiveness be‐have good .

Objective To compare HER-2 state in breast cancer tissue deteced by fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC) and analyze their correlation. Methods HER-2/neu protein expression and gene amplification were detected by FISH and IHC in 56 newly-diagnosed cases of female breast cancer from July 2008 to July 2009. Results Of the 56 patients, HER-2 protein expression (-), (+), (++), (+++) was 9 cases (16.1%), 29 cases (51.8%), 11 cases (19.6%) and 7cases (12.5%) respectively; 26 cases (46.4%) had HER-2 gene amplification while 30 cases (53.6%) didnt have. Type of HER-2 gene amplification was mainly HER-2(++) and HER-2(+++), and according gene amplification rate was 72 7% and 100%. HER-2 (+) gene amplification rate was 37.9 %(11cases) and no gene amplification was found in HER-2(-) tissue. The HER-2 positive rate using two methods had significant difference(χ2=19.778,P<0.01). HER-2(-) and HER-2(+++) had good consistency with the FISH results(Kappa=0.969),but HER-2(+) and HER-2(+ +) were poorly consistent with the FISH results(Kappa=0.271). Conclusions IHC is the preliminary screening method for detection of HER-2 expression. HER-2(-) and HER-2(+++) have good consistency with the gene amplification, and can guide clinical treatment. Some patients with HER-2(+) and HER-2(++) have HER-2 gene amplification. FISH is needed for targeted therapy.

ObjectiveTo investigate the changes of serum concentration of parathyroid hormone (PTH) and calcium after thyroid surgery and compare the changes among different modes of operation. MethodsFrom Aug. 2006 to Dec. 2009, 470 patients accepted thyroid surgery. The serum concentration of PTH and calcium in different groups was measured and compared before and 1 day after surgery. According to the extent and similarity of the surgery, patients were classified into 7 groups and they were compared in terms of postoperative changes of PTH and serum calcium. Statistical analysis was performed. ResultsThe serum concentration of PTH and calciurn decreased significantly after surgery in all patients except for those receiving unilateral and bilateral partial thyroidectomy. Compared with unilateral lobectomy, surgeries such as bilateral subtotal thyroidectomy, unilateral thyroidectomy with contralateral subtotal thyroidectomy, bilateral near-total thyroidectomy and total thyroidectomy resulted in more dramatic decreases of serum concentration of PTH and calcium and higher incidence of hypocalcemia ( P ＜ 0.05 ). The comparison between patients receiving CLND or not had the same result. Conclusions Almost all kinds of thyroid surgery affect the parathyroid function. The wider the surgery, the higher the possibility of postoperative hypoparathyroidism. The indications and criteria of different types of thyroid surgery are essential for hypoparathyroidism prevention. In some cases, vitamin D and calcium are recommended for preventive purpose.