Objective To compare the clinical diagnostic value of 320 row four-dimensional CT angiography (4D-CTA)and digital subtraction angiography (DSA)in untreated arteriovenous malformation (AVM)patients.Methods Thirty-six patients with AVM diagnosed by DSA were included in this study.Two independent readers blind to the results of all examinations evaluated the find-ings of DSA and 4D-CTA of each patient.All results were then documented using a standardized scoring sheet.Results The diagno-sis results of 4D-CTA for AVM lesions in all 36 patients were accurately consistent with those of DSA,including the position,size and vascular structure.There were 14 cases with the largest diameter <3 cm,20 cases 3-6 cm,2 cases >6 cm.Lesions involved only the anterior circulation in 13 cases,only the posterior circulation in 13 cases,and both the anterior and posterior circulation in 10 cases.Conclusion 4D CTA has excellent diagnostic accuracy in the detection of AVM lesions,including size,location,feeding ar-teries and draining veins,with similar value as DSA in the clinical diagnose and evaluation of AVM.

Objective To inquire into the curative effects of combination of laproscopic cholecystomy and laparoscopic transcystic duct common bile duct exploration on cholelithiasis, cholecystolithiasis and cho-ledocholith. Methods The clinical data of 19 cases were retrospectively analyzed from Sep. 2006 to Jan.2009. Results All the operations were performed successfully. The operative time was 60～120 min, the drainage time was 3～5 d, and the postoperative hospitalization time 4～7 days. All of the patients were fol-lowed up from 3 to 6 months. No complications occurred. Conclusion Laparnscopic transcystic biliary duct exploration is safe, feasible and worth generalizing.

Objective To identify the efficacy and safety of aspirin in reducing the serum high sensitivity C reactive protein(hsCRP)level and preventing the internal arteriovenous fistulas(AVF)embolism in maintenance hemodialysis patients. Methods One hundred and ten hemodialysis patients using AVF more than 3 months were randomly divided into 2 groups,the intervention group(n=55,received aspirin 100 mg/d)and the control group(n=55).Examinations were performed at baseline and 6-month after treatment.Serum hsCRP level,platelet aggregates ratio(PAR),coagulation and inflammation indicators were measured.AVF embolism and the adverse events were monitored. Results Six months later.PAR and hsCRP level of the intervention group patients aged≤60 years decreased significantly [(68.14±8.45)%vs (82.37±9.12)%;(4.79±4.81)mg/L vs(6.94±10.26)mg/L,all P＜0.05],and were significantly lower as compared to.the control group[(68.14±8.45)%vs(74.7±11.50)%,(4.79±4.81)mg/L vs(5.12±9.25)mg/L,all P＜0.05].There were 2 cases of AVF embolism occured in both groups,which showed no statistical difierence (P=0.676).The incidence of adverse effeets was higher in the intervention group than that in the control group but no statistical significance was found (20.0%vs 7.2%,P=0.052),while the mortality rate had no difference between 2 groups (3.6%vs 0,P=0.495).Conclusion Use of aspirin 100 mg/d for 6 months can significantly reduce the serum hsCRP level and PAR in hemodialysis patients under 60-year-old without serious adverse reactions.

Action Potentials ; Animals ; Atrial Fibrillation ; physiopathology ; Atrial Function, Left ; physiology ; Cardiac Pacing, Artificial ; Pulmonary Veins ; physiology ; Rabbits ; Streptomycin ; pharmacology ; Verapamil ; pharmacology

ObjectiveTo study the effect of consolidated trunk muscle training on balance and motor function in patients with hemiplegia after stroke. Methods96 patients were divided into treatment group (48 cases) and control group (48 cases). All the patients received regularly rehabilitation, and the patients in the treatment group received the control ability training in the trunk muscle in addition. They were assessed with Trunk Control Test (TCT)， Berg Balance Scale (BBS)， Modified Barthel Index (MBI), Functional Ambulation Category (FAC), Fugl-Meyer Assessment (FMA) and walking speed (WS) before and after the treatment. ResultsThe scores of TCT, BBS, FAC, MBI, WS and FMA improved significantly in both groups after treatment (P<0.01)， and improved more in the treatment group than in control group (P<0.05). The scores of TCT correlated with those of BBS, MBI, FAC, FMA, and WS (P<0.05). ConclusionThe consolidated trunk muscle training can obviously improve balance and motor function of stroke patients.

Adenosine ; pharmacology ; Animals ; Cyclic Nucleotide-Gated Cation Channels ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels ; Ion Channels ; physiology ; Isoproterenol ; pharmacology ; Membrane Potentials ; drug effects ; Muscle, Smooth, Vascular ; physiology ; Myocytes, Smooth Muscle ; physiology ; Potassium Channels ; Pulmonary Veins ; physiology ; Rabbits

Objective To investigate the association of genetic polymorphisms of intercellular adhesion molecule 1 (ICAM-1) with diabetic peripheral neuropathy (DPN). Methods A total of 607 type 2 diabetes patients from the Affiliated Hospital of Weifang Medical University were enrolled in this study between June 2013 and December 2014. Rs5498 (A/G K469E) and rs1799969 (G/A R241G) in the ICAM-1 gene were genotyped by using TaqMan allelic discrimination in 295 patients with DPN and 312 subjects without DPN. The distribution of these two SNPs and the genetic influence of ICAM-1 gene polymorphisms on the development of DPN were conducted. Results Genotype distributions of both SNPs were coincided with Hardy-Weinberg equilibrium in the two groups. SNP rs1799969 (G/A R241G) in the ICAM-1 gene showed a high GG genotypic frequency at 96.8%(non DPN) and 99.0%(DPN) respectively. SNP rs5498 (A/G K469E) represented AA and AG genotypes. The values were AA 48.7%/AG 39.4%in non DPN group and AA 51.5%/AG 41.7%in DPN group. There were no significant differences in genotypic distributions and allele frequencies of SNPs rs1799969 (G/A R241G) and rs5498 (A/G K469E) between the patients with DPN group and patients without DPN group (P>0.05). The dominant(AA+AG)/GG and additive (GG/AA) models of rs5498 (A/G K469E) were associated with higher risk of DPN (ORadjusted=1.585, 1.575 respectively, P<0.05). To carry A allele was related to the susceptibility of DPN. There was no such association in genetic models of rs1799969 (G/A R241G) and DPN pathogenesis. Conclusion The present study provides evidence that SNP rs5498 E469K (A/G) in the ICAM-1 gene is associated with susceptibility of DPN, and the carrying A allele appears to be a risk of DPN.

Modern microecology states that there are a lot of commensal bacteria on the surface and inside human body, and most of them reside in the human intestines.The microbiota, which colonize in the gut of the host, the host, and the environment, together constitute a unity of dynamic equilibrium.Intestinal microecology is mainly to explore the structure and function of gut microbiota in the bodies of healthy human beings, to discover the influence of the structural disorder of gut microbiota on human health, and to use its intervention to guide the host to live healthily.Human ’ s constitution in TCM theory is considered as an inherent characteristic, which is formed on the basis of the prenatal and postnatal development of human beings, and affects morphology, physiology and psychology.The human gut microbiota are involved in many physiological and pathological activities, and their changes could reflect the physiological and pathological state of the host, so the research method of using intestinal microecology to study TCM constitution could be of important significance in the individual treatment.The four basic principles and three scientific questions of TCM constitutional theory are strongly interrelated with the basic theory of intestinal microecology, and they could serve as mutual interpretation.Based on the study result of modern intestinal microecology, this paper attempts to combine TCM constitutional theory with intestinal microecology, and offers microscopic interpretation of the four basic principles and the three key scientific questions of TCM constitutional theory.

Objective To study the prevalence,treatment policy and control of hypertension in patients with maintenance hemodialysis, and to analyze the influencing factors of hypertension control.Methods We studied the current status of 1382 patients with maintenance hemodialysis in 11 dialysis centers in Shanghai, among them 809 were male, and 573 were female.Hypertension was defined as systolic blood pressure(SBP) ≥ 140 and/or diastolic blood pressure (DBP) ≥90 mm Hg ( 1 mm Hg = 0.133 kPa).Those who had a history of hypertension and requiring antihypertensive therapy were also diagnosed as hypertension though their blood pressure was within normal range during the survey.Hypertension control was defined as blood pressure ＜ 140/90 mm Hg before each dialysis session.Results The prevalence of hypertension in the hemodialysis patients was 86.3%.The treatment rate and control rate in those patients were 96.8% and 25.5% respectively.More than half (50.4% ) of patients were treated with only one kind of anti-hypertensive drug, and 34.4% with 2 kinds, 14.2% with 3 kinds, 1.0% with 4 kinds or more.Calcium channel blocker (CCB) was the most frequently prescribed drug (61.0%), followed by angiotensin Ⅱ receptor blockers ( 56.4% ), centrally acting anti-hypertensive agent ( 26.4% ), beta blockers and alpha, beta-blockers( 14.0% ).The control rate of hypertension in those hemodialysis people was aggravated by the existence of coronary artery disease.The patients who need more kinds of antihypertensive agents have a poorer control rate of hypertension.The hypertension control rate elevated significantly with the adequate hemodialysis.Conclusions There is a very high prevalence of hypertension in maintenance hemodialysis patients.Although the treatment rate is high, the control rate is unsatisfactory.So the control of hypertension in hemodialysis patient is still a clinical challenge.Appropriate dialysis adequacy, reasonable use of erythropoietin, treatment of heart disease and judicious use of antihypertensive drugs may be helpful to improve the clinical outcome.

BACKGROUNDThe non-operation treatment of intra-abdominal trauma guided contrast enhanced ultrasound (CEUS) is one of the hottest research topic. Gelatin/thrombin/calcium (GTC) was developed as a novel haemostatic agent for non-operable intra-abdominal trauma. We hypothesized that GTC can achieve haemostasis (without the use of pressure) within a short time in a large wound model by percutaneous injection under CEUS guidance.

METHODSForty Wister rats received large liver injuries by haemostatic clamp and were randomly divided into four groups, according to the haemostatic agent used. These included normal saline (NS) group A, lyophilising thrombin powder (LTP) group B, GTC group C, and absorbable α-cyanoacrylate (ACNA) group D. Each injury site was treated with one of the above materials and total bleeding time was recorded. All liver wounds were evaluated using CEUS at three periods: pre-injury, injury and post-treatment. The liver wounds were also evaluated by histology 3, 6, and 9 days after injury and the extents of abdominal adhesions were recorded.

RESULTSThe sensitivity of CEUS (100%) in detecting blunt traumatic liver lesions was significantly higher than conventional ultrasound (42.5%). Bleeding times at the injury site in the GTC group C ((129.3 ± 14.0) seconds) and ACNA group D ((5.2 ± 1.0) seconds) were significantly shorter than those in the NS group A ((369.5 ± 48.8) seconds, P < 0.01) and LTP group B ((324.7 ± 52.22) seconds, P < 0.01). The LTP group B showed no significant difference compared with the NS group A. Gross examination of liver tissue revealed that there were fewer intra-abdominal adhesions in the GTC group C (10%) than in the ACNA group D (100%). Histopathologic examination showed that GTC was completely absorbed after nine days.

CONCLUSIONSGTC, delivered by percutaneous injection under CEUS, may achieve haemostasis (without the use of pressure) within a short time in a large wound model. GTC is absorbable and may prevent intra-abdominal adhesions. Therefore, it may be the optimal choice for first aid treatment of large abdominal wounds in the setting of blunt trauma.

Animals ; Calcium ; administration & dosage ; therapeutic use ; Gelatin ; administration & dosage ; therapeutic use ; Hemorrhage ; diagnostic imaging ; drug therapy ; Hemostatics ; administration & dosage ; therapeutic use ; Injections ; Liver ; diagnostic imaging ; injuries ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Thrombin ; administration & dosage ; therapeutic use ; Ultrasonography