Objective To investigate the feasibility of exposing cephalic vein with horizontal incision on the chest and the successful rate of implanting pacing leads using guide wire and split sheath. Methods Right cephalic vein was separated with horizontal incision on the right lateral upper part of chest in 220 patients with permanent pacing indication. The pacing lead was advanced through the cephalic vein directly or by using a guidewire and a split sheath if the direct approach was unsuccessful. The subclavian venous puncture through the incision was used finally to implant the endocardial lead when the cephalic approach failed. All pacemakers were placed in the subcutaneous package at the inner part of the incision. Results Cephalic vein was well exposed with horizontal incision. Additionally, it is safe and convenient to puncture the subclavian vein through this incision. The successful rate of implanting pacing leads directly through cephalic vein was only 71% with single lead and 58% with dual pacing leads, respectively. However, it increased to 94% with single lead and 88% ( P

Objective To study the efficacy of complete hemihepatic vascular exclusion (CHVE) in the prevention of tumour dissemination during liver resection for hepatocellular carcinoma (HCC).MethodsA case-control study was carried out on 281 patients who underwent liver resection for HCC between February 2006 and April 2010.89 patients underwent hepatic resection using CHVE (group A) and 192 using Pringle maneuver (group B).The postoperative 1-,2-,3 year rates of intrahepatic recurrence and lung metastasis,and the overall disease-free survivals were compared between the two groups.ResultsThe incidence of lung metastasis at 1 year after operation was significantly lower in group A than group B (6.7％ vs.15.1％,P=0.048).There were no signilicant differences in the incidences of lung metastasis at postoperative year 2 and 3 between the two groups (15.7％ vs.25.0％ and 32.6％ vs.30.7％ ; P＞0.05).The differences in the postoperative 1-,2-,3- year intrahepatic recurrence rates were not significant between the two groups (20.2％ vs.31.8％,51.7％ vs.60.3％,68.5％ vs.79.2％,respectively; P＞0.05).The median survivals of the two groups were 25.9 months and 21.7 months,respectively.Patients in group A had a significantly higher overall disease-free survival rate than patients in group B (P=0.035).ConclusionsCHVE was efficacious in reducing the incidence of lung metastasis and in improving the overall disease-free survival in patients after liver resection for HCC.CHVE contributed in preventing intraoperative tumour dissemination and in improving prognosis.

Objective To evaluate the effect of case management model on the stable patients with chronic obstructive pulmonary disease (COPD),containing health knowledge level,the number of acute exacerbation and the quality of life.Methods Fifty patients were divided into the experimental group and the control group with 25 cases each by random digits table method.The experimental group received the case management model for 3 months.The control group received routine care for 3 months.The COPD health Knowledge Questionnaire(CKQ) scores and St George's Respiratory Questionnaire(SGRQ) scores were measured for 4 times (the beginning of the intervention and 1 months,2 months,3 months later),and the numbers of acute exacerbation were measured at 3 months later.Results The CKQ scores at 1,2,3 months after intervention were (28.04±1.43),(28.20±1.00),(28.40±1.04) points in the experimental group,and (18.08±2.30),(18.50±1.87),(18.33±1.66) points in the control group,and there were significant differences (t=18.109,22.556,5.320,all P ＜ 0.01).The scores of SGRQ and symptom at 2 months and 3 months after intervention were (50.56±8.68),(49.40±8.05),(41.52±10.86),(37.16±8.90) points in the experimental group,and (57.42±10.22),(59.46±9.06),(54.50±8.67),(56.71 ±10.03) points in the control group,and there were significant differences (t=-7.222-2.536,P ＜ 0.05 or 0.01).The influence scores at 1,2,3 months after intervention were (46.28±8.74),(44.40±8.11),(42.04±8.22) points in the experimental group,and (51.50±7.77),(51.79±8.06),(54.08±6.96) points in the control group,and there were significant differences(t=-2.206,-3.197,-5.523,P ＜ 0.05 or 0.01).There was no statistically significant difference about activity scores between two groups before and after intervention (P ＞ 0.05).The numbers of acute exacerbation during 3 months with 3,22 cases in 1 and 0 time in the experimental group and 9,15 cases in the control group,and there was statistically difference between two groups(x2=4.306,P＜ 0.05).Conclusions The case management model can promote the stable COPD patients to know more disease-related health knowledge,and improve the health knowledge level.The case management model can reduce the symptoms of the stable COPD patients,reduce the frequency of acute exacerbation,reduce the influence of disease on daily life,prevent further decline in activity endurance,and improve the quality of life.

Colorectal cancer is a common malignant tumor of digestive tract, and the risk of inflammatory bowel disease developing into colorectal cancer is significantly increased. Immune signaling pathways NF-κB, IL-6/STAT3, COX-2/PGE2, IL-23/Th17 and TLRs have been confirmed to promote the transformation from colitis to colorectal cancer. NOD2 and intestinal microbes also participate in the regulation of inflammation mediated carcinogenesis. Chronic inflammation is a potential risk for colorectal cancer, and anti-inflammatory drugs may play a chemical preventive role. In this review, we summarize the signaling pathways involved in inflammation-associated colon carcinogenesis and evaluate the chemoprophylaxis of colon cancer.

[Summary] The genomic DNA was extracted from peripheral blood leukocyte of the patient with thyroid hormone resistance syndrome and 14 members of his family.The exons 1-10 of thyroid hormone receptor β (TRβ) gene were amplified by PCR.The products of PCR were sequenced directly to detect the gene mutation.The results showed that 3 members of this family were confirmed to have the C→T transition mutation at nucleotide 1 303 site within exon 10 of TRβ gene,and the missense mutation results in the substitution of histidine to tyrosine (H435Y).The heterozygous mutation may lead to the occurrence of thyroid hormone resistance syndrome.

Objective To study the effects of Xinshuai mixture on mitochondrial function of hypertrophy cardiomyocyte cell in vitro.Methods The primary neonatal rat myocardial cells were cultured to establish hypertrophic myocardial model by AngII.The levels of superoxide dismutase(SOD), methane dicarboxylic aldehyde (MDA), monoamine oxidase(MAO) and cyclooxygenase (COX) were detected by ELISA, as the mitochondrial function and oxidative stress damage.The expression level of caspase-3 mRNA was detected by Real-time PCR.Results Compared with control group, the SOD level in model group reduced markedly, MDA level increased significantly, the activities of MAO increased, the activities of COX decreased, the expression of caspase-3 level increased significantly(P<0.01).Compared with the model group, the SOD level increased and MDA level decreased in Xinshuai mixture group and blank serum group.But the SOD level and activities of MAO, COX in Xinshuai mixture group and blank serum group had significant difference(P<0.05,P<0.01).The expression of caspase-3 mRNA level in Xinshuai mixture was significantly higher than the blank serum group(P<0.01).Conclusion Xinshuai mixture could significantly improve the fuction of mitochondrial in hypertrophy cardiomyocyte cell, reduce the energy metabolism and oxidative stress injury, and protect cardiac myocyte through lower the expression of caspase-3.

Objective To investigate the significance of cyclooxygenase-2 (COX-2),vascular endothelial growth factor(VEGF) protein expression and angiogenesis in hepatocellular carcinoma(HCC).Methods Tissue sec- tions from 40 HCC patients were examined immunohistochemically for protein expression of COX-2 and VEGF.Mi- crovessel density(MVD) was counted by endothelial cells immunostained by anti-CD34 antibody.Results The ex- pression of COX-2 protein in well differentiated HCC was stronger than that in moderately differentiated HCC and poorly differentiated HCC(P

Objective To evaluate medium-term results in critical limb ischemia (CLI) patients undergoing endovascularly revascularization based on concepts of angiosomes.Methods Clinical data were reviewed on 612 CLI patients who had isolated below-the-knee (BTK)lesions and were treated by endovascular technology from June 2006 to May 2012.Following the angiosome model of perfusion,286 patients (357 limbs)were treated by directly revascularizing the feeding artery.326 patients (455 limbs)were treated by revascularizing non-feeding artery to improve perfusion to ulcer indirectly.Primary endpoints included ulce-healing rate as of 3 months,amputation-free survival( AFS),freedom from major amputation (FFMA) and recurrence rate of CLI.Results During follow-up(mean,24 ± 18 months),ulce-healing rate during 3 months of direct treatment group was obviously higher than that of indirect group (82.4％ vs.66.4％,X2 =26.16,P ＜0.05).The fourth year AFS was 48％ ±5％ vs.37％ ±6％,t =3.44,P ＜0.05,and the fourth year FFMA was 73％ ±4％ vs.58％ ±3％,t =4.61,P ＜0.05.In recurrence rate of CLI,there wasn't significant difference between direct group and indirect group(42％ ±5％ vs.45％ ±6％,t =- 0.64,P ＞ 0.05 ).Conclusions Following the angiosome model of perfusion,direct revascularizing the feeding artery of CLI patients can obviously improve ulcer-healing rate during 3 months,medium-term AFS and FFMA.

Neonatal nerves exist in tumor tissues,and tumor cells can invade nerve by neurogenesis.Current research shows that cancer cells can secrete cytokines to promote the differentiation and growth of nerve cells,in turn,the differentiation and growth of nerve cells can stimulate tumor development and metastasis.Neurogenesis is one way of interaction bettween tumor cells and microenvironment similar to angiogenesis and lymphangiogcnesis,which has a major impact on biological behavior of tumor cells and prognosis.