Objective To investigate the impact of metoprolol and tongxinluo on the levels of hypersensitivity C -reactive protein (hs -CRP)and NT -proBNP in patients with coronary heart disease.Methods 84 patients with coronary heart disease were randomly divided into the observation group(n =42)and the control group(n =42). The control group was given metoprolol treatment,and the observation group was given metoprolol and tongxinluo treat-ment for 3 months.The echocardiography before and after treatment was inspected.The levels of serum hs -CRP were measured with immune reflection method and the levels of BNP were measured with ELISA.Results The total effective rate,adverse reaction rate of the control group were 95.24%,4.76%,and those of the observation group were 76.19%,23.81%,the differences were statistically significant (P <0.05).The ventricular septal thickness (IVST),left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVDD),left ventricular systolic touch the inside diameter (LVSD)of the observation group were improved than the control group (P <0.05),while the IVST,LVEF,LVDD,LVSD of the observation group after treatment were better than the control group (t =3.996,4.123,3.852,4.256,all P <0.05).The levels of serum hs -CRP and NT -proBNP of the observation group were lower than the control group (t =5.225,7.856,all P <0.05).Conclusion Metoprolol combined with Tongxinluo capsule can improve cardiac function,reduce serum hs -CRP and plasma BNP levels,improve clinical outcomes of patients.

Objective:To explore the principles and elements of ethical review of clinical trials regarding medical apparatus and instruments.Methods:This paper introduced Beijing Anzhen Hospital's requirements on considerations for the vulnerable,acquisition of informed consent,the researchers' qualification and experiment design,during ethical review of clinical trials regarding medical apparatus and instruments.Results:Institution review board of Beijing Anzhen Hospital designed principles and standard operating procedures for ethical review of clinical trials regarding medical apparatus and instruments.Conclusion:Ethical review of clinical trials regarding medical apparatus and instruments now is more scientifically standardized,and has become an important approach for the protection of subjects' rights and interests.

?AIM:To compare the curative effect of conjoint fascial sheath( CSF) suspension and levator muscle resection for moderate or severe congenital ptosis.?METHODS: Forty - three patients ( 74 eyes ) with moderate or severe ptosis were treated by CSF suspension or levator muscle resection randomly, and followed up for 6mo. The normalization rates of the two operations were then compared by statistical method, and the complications of the two operations were analyzed.?RESULTS: The two operations appeared no significant difference on the normalization rate for moderate congenital ptosis (P>0. 05), while the normalization rate of CSF suspension on severe congenital ptosis was significantly higher than that of levator muscle resection (P<0. 05). Less complication was happened in the CSF suspension group than in the levator muscle resection group.?CONCLUSION:CSF suspension is more effective on the treatment of severe congenital ptosis than levator muscle resection, and has advantages such as less trauma, repeatable, and less complication.

Objective To study the causes of misdiagnosis between renal cell carcinoma (RCC) and renal angiomyolipoma (RAML). Methods Since 1990, 228 cases of RCC and 62 RAML were surgically treated.13 of them,4 RCC and 9 RAML were incorrectly treated because the misdiagnosis on imaging examination or intraoperative frozen section study. The causes were analyzed. Results 4 RCC underwent enucleation or simple nephrectomy because of the frozen section diagnosis of RAML.None have developed recurrent RCC with 1～4 years of follow up.Of the 9 RAML cases,6 have been misdiagnosed as RCC on imaging procedures.The other 3 patients that failed to reach a proper diagnosis on imaging examination were submitted to intraoperative frozen section studies.1 was diagnosed as RCC and the other 2 remained uncertain. Radical nephrectomy have been performed for 9 patients. Conclusions Difficult interpretation due to poor quality of frozen sections is a potential cause of diagnosis error.RCC might be confused with RAML when the specimens contained highly vascular tissue. The content and distribution of fat is the main cause of imaging misdiagnosis.

Objective To observe the behavior of Schwann cell migration and wrapping up of fibres during co-culture of Schwann cells with steroframe of PLA and PLGA fibres. Methods Schwann cells were mixed into 30% ECM gel and co-cultured with PLA non-spinning fibre steroframes and seeded on one ends of PLGA fibres which were treated with collagen,polylysine or ECM. The attachment,growth and migration of Schwann cells were observed under phase contrast microscope and laser scan confocus microscope. Results (1)When Schwann cells were co-cultured with PLA steroframes,most of the Schwann cells kept in the fibre holes and attached on PLA fibres to form B?ngner band likd structures. (2)When co-cultured with PLGA fibers,Schwann cells could attach and migrate on PLGA fibres and the number of Schwann cells were obviously increased when PLGA fibres were treated by ECM. Conclusions (1)ECM gel colud promote Schwann cells attachment,growth and migration on PLA steroframes and PLGA fibers. (2)ECM gel is a good integrating substance for constructing tissue engineering bioartificial nerve.

Objective To observe the function changes of right ventricular in chronic obstructive emphysema after lung volume reduction surgery. Methods Twenty-six patients with chronic obstructive emphysema undergoing lung volume reduction surgery were examined by color Doppler echocardiography to determine systolic function and diastolic function of right ventricle in preoperative days and postoperative days of 5～7; 12～14; 1 month and 3 months. Results Contraction of right ventricle: comparing with preoperative parameters, there were significant decrease (P0.05) of those above mentioned in postoperative days 12～14. It recovered at 3 month after operation. Relaxation of right ventricle: the swift filling peak flow-rate in earlier relax period (E) and E flow-rate integra (ETVI) decreased meanwhile swif filling peak flow-rate in late relax period (A) and A flow-rate integra (ATVI) increased in the postoperative days 5～7 (P

Objectives To evaluate the efficacy and safety of h um an hepatocyte transplantation in the treatment of severe hepatitis induced by dr ugs. Methods The primary human hepatocytes were isolated from t he liver of a healthy donor, and they were then cryopreserved. The thawed hepato cytes were transplanted into the patient's spleen via a femoral artery catheter. 2?10~10 hepatocytes were harvested, and 70% of thawed hepatocytes were vi able, and 2?10~9 vital hepatocytes were transplanted. Results One month after the transplantation, clinical symptoms of the recipient were a meliorated obviously, and the levels of BIL, NH3, ALT and AST lowered, while PA elevated. 50 days after discharge from the hospital it was found that biochemica l parameters returned to normal values, and the hepatocyte signal could be detec ted in the spleen with MRI. Conclusion Hepatocyte transplantati on is safe and efficacious.

Objective To investigate the effects and safety of human hepatocytes transplantation in vivo for the treatment of liver failure. Methods The primary human hepatocytes were collected from normal liver tissue donated by healthy volunteers and preserved by cryopreservation technique. After thawing, the hepatocytes were transplanted into the spleen of patients with severe hepatitis through catheterization of the femoral artery. Then the changes in clinical symptoms, serum biochemical indexes and MRI signals of the spleen were observed in the patients. Results A total of 2?10 10 hepatocytes were isolated from normal liver tissue of healthy volunteers and 75% of the hepatocytes were alive after cryopreservation and thawing. The number of transplanted hepatocytes was 2?109. In the recipients, the clinical symptoms were markedly improved, serum levels of bilirubin, NH_3, ALT and AST were significantly reduced, but that of PTA remarkably increased, after hepatocyte transplantation. The follow-up examination was performed 80d and 270d after discharge from the hospital, and it was showed that all the serum biochemical indexes returned to normal and signals of the hepatocytes were found in the spleen. Conclusions Hepatocyte transplantation is a safe and effective therapy for severe hepatitis. The transplanted hepatocytes can proliferate and differentiate in the spleen to replace or partially compensate the liver function of synthesis, detoxication and metabolism. Contrast enhanced MRI can be a new method for follow-up study of transplanted hepatocytes.

Objective:To investigate the role of thoracic echocardiography in diagnosis and differential diagnosis of the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture.Methods:A total of 19 patients with sinus rupture caused by ventricular septal defect in the right ventricular outflow road were reviewed.These patients were diagnosed as aortic right coronary sinus by preoperative transthoracic echocardiography from February 2010 to September 2016 in Xiangya Second Hospital and Xiangya Medical College Affiliated Haikou Hospital.The clinical symptoms,echocardiography and intraoperative lesions were compared and analyzed among the patients.Results:The intraoperative lesions were consistent with the preoperative echocardiographic diagnosis in 16 patients.Among them,11 cases could be heard the continuous sound of the machine with systolic murmur and no tremor in left sternal rib 2-3 auscultation.The color Doppler imaging of right ventricular systolic indicated the based continuous Doppler spectrum.The preoperative echocardiography and intraoperative lesions testified the ventricular septal defect size and the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture.Among them,3 cases were complicated with other heart diseases.Other 3 cases were not accorded with the preoperative diagnosis.There were auscultation smell and noise but no tremor.The preoperative echocardiography and lesions indicated the right ruptured aneurysm of the sinus of big and long mouth,1 case with aortic valve stenosis and regurgitation,congenital aortic valve two valve malformation,1 case with aortic valve-severe reflux,1 case with pulmonary infection,and 3 cases with no intraoperative lesions in the ventricular septal defect.Conclusion:Preoperative transthoracic echocardiography is the preferred preoperative,quick and noninvasive method for ruptured aneurysm.Each stage of observation procedure and method can observe the ruptured aneurysm of aortic sinus,the location,size and adjacent ofventricular septal defect.Meanwhile,the flow spectrum characteristics of the ventricular septal defect in the right outflow tract of the right sinus aneurysm can be found by Doppler ultrasound imaging.

Objective To observe of therapeutic effect of bamboo shoots extract compound on the treatment of hemorrhagic anemia.Method The glucose,total protein,amino acids,trace and macro elements in bamboo shoots extract were determined.Through the performance of angular vein bloodletting,a hemorrhagic anemia rat model was set up.Two therapy groups received the intragastric administration of compound Ⅰ(0.15% iron porphyrin and 10% honey) and compound Ⅱ(70% bamboo shoots extract,0.15% iron porphyrin and 10% honey),respectively.And the control group only received the de-ionized water of the same dose.The blood samples,collected via tail vein in 0,18,42,67 and 90h after the administration,were detected for hemoglobin,red blood cell and hematocrit.And the acute toxicity test was also conducted.Result Compound Ⅱ,which contained the Bamboo shoots extract that was rich in glucose,amino acids,amino,and trace and macro elements,had a better efficacy in treating hemorrhagic anemia of rats than the Compound Ⅰ.And the result of acute toxicity was normal. Conclusion Bamboo shoots extract compound could promote the recovery of hemorrhagic anemia.