Objective To study the effect of implanted stent or selected operation in patients with acute occlusion of right coronary artery during the emergency coronary arteriongraphy. Methods Forty-three patients with acute occlusion of right coronary artery who underwent the emergency coronary arteriongraphy were divided into two groups: the implanted stent group ( n = 23) during the emergency coronary arteriongraphy and the selected operation group (n =20) during the emergency coronary arteriongraphy . Then we observed the general data, the coronary artery pathological changes, preoperative and postoperative thrombus, the blood flow, remained stenosis and the prognosis. Results The implanted stent group was similar to the control group in general condition, but implanted stent group was significantly different from the control group in the near, intermediate and distal coronary artery pathological changes ( <0.05) . The control group was significantly different from the implanted stent group in the thrombus and slowly blood flow ( <0.05) . After three months, we reviewed coronary arteriongraphy and selected operation, The implanted stent group was significantly different from the control in the remained stenosis and slowly blood flow (<0.05) . But the implanted stent group was similar to the control groug in the thrombus and new proceeding cardiovascular events. Conclusion When thrombus appears in acute occlusion of right coronary artery, we can implant stent during the emergency coronary arteriongraphy if the thrombus is little, or we can select operation after PTCA on the contrary.

OBJECTIVE To evaluate the clinical efficacy of piperacillin/tazobactam for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with pulmonary encephalopathy.METHODS Seventy three cases of AECOPD with pulmonary encephalopathy were randomized into piperacillin/tazobactam group and ceftazidime group,and sputum culture was underwent for each case before and after treatment.RESULTS The total efficacy rates and bacterial clean rates in piperacillin/tazobactam group and ceftazidime group were 91.67% and 88.89%,75.68% and 57.89%,respectively,and the differences between the two groups were statistically significant.CONCLUSIONS It suggested that piperacillin/tazobactam be a more effective drug for AECOPD with pulmonary encephalopathy.

ObjectiveTo evaluate the clinical value of the pumping and popliteal vein thrombosis contact thrombolytic treatment of lower extremity deep venous thrombosis(LEDVT).MethodsFor thirty deep venous thrombosis patients with ipsilateral popliteal vein approach through a comprehensive intervention,the line of the inferior vena cava filter was implanted under the premise of first balloon mechanical thrombus fragmentation and thrombus aspiration by 10 F improved the inferior vena cava stents conveying sheath,followed by the line of contact thrombolytic therapy.Four patients underwent iliac vein in the thrombolytic treatment of stent implantation.Vein patency and venous patency score and health and poor limb circumference difference were used to assess efficacy of treatment.Patients were followed up for at least 1 year.ResultsThe technical success rate was 100％.At six months after sugery,the mean lower limb circumference difference of the 30 patients was＜ 1.5 cm.Lower limb venous angiography showed significantly improved vein patency score [ (9.5 ± 2.6) vs.(3.6 ± 2.1 ),Z =1.65,P ＜ 0.01 ].Venous patency rate was ( 69.5 ± 13.2) ％.No serious complications during treatment and the period of follow-up.Conclusion Transpopliteal vein interventional treatment of lower extremity deep venous thrombosis is simple,safe and effective.

Objective To evaluate the effect of autologous bone marrow-derived stem cell (MSCs)transplantation in the treatment of decompensated hepatic cirrhosis.Methods Bone marrow was harvested (150-200 ml) from 25 patients with decompensated cirrhosis and hepatic failure.The MSCs were isolated according to the method reported by Wollert and infused into liver via hepatic artery catheter.At different time points after the transplantation,the patients' liver function and prothrombin time(PT) were evaluated,and the survival rate and symptoms of the patients were recorded.Results All the serum biochemical indexes remained stable 2 weeks after the transplantation,and at 4 weeks after transplantation,levels of albumin was increased significantly in comparison with the preoperative level((30.91 ±4.00) g/L vs (26.65 ±5.30) g/L,t =3.07,P ＜0.05).At 12 weeks,the levels of albumin further increased((32.00 ±6.18) g/L vs (26.65 ±5.30) g/L,t =3.02 P ＜ 0.01).While at 12 weeks after operation,there was significant difference on the total bilirubin ((39.94 ± 21.15) mmol/L vs (125.01 ± 150.05) mmol/L; t =2.63,P ＜ 0.05),tolal bile acid ((41.63 ±33.91) μmol/L vs (78.00 ± 59.80) pmol/L;t =2.53,P ＜ 0.05) when compared with the preoperative level.4weeks after operation,the liver enzyme indicators changed significantly when compared with the preoperative level (P ＜0.05).At 12 weeks after operation,there was significant difference on the PT((14.71 ± 1.59) s vs (21.40 ± 6.07) s,t =5.01,P ＜ 0.01) and the level of fibrinogen ((2.64 ± 0.61) g/L vs (1.66 ± 0.94) g/L,t =4.17,P ＜0.01).1 week after the transplantation,90.67％ patients exhibited improved appetite and 88.5％patients showed better physical strength; at 2 weeks,hepatic face improved in 16 cases (63.5％),and spider telangiectasia was significantly reduced in 1 case;at 12 weeks,the survival rate of the patients was 77.44％,and 3 died or gave up treatment due to chronic liver failure complicated by spontaneous bacterial peritonitis,hepatorenal syndrome,or DIC.No complications associated with the transplantation occurred in these patients.Conclusion MSCs transplantation can significantly improve the liver function of patients with decompensated hepatic cirrhosis with good safety and effectiveness,but the indications should be strictly controlled.

Objective To determine the treatment effect of cesarean scar pregnancy (CSP) and provide theoretical guidance in selecting proper treatment for this disease. Methods Sixty-two patients were randomly divided into 2 groups taken uterine artery embolization combines uterine curettage (combination group,n = 32) and gynaecologic surgery (surgery group, n = 30) respectively. The operation time, blood loss, intraoperative fluid volume, uterine retention rate, hospitalization days and medical expense of two groups were recorded and compared.The complication occurrence of both short-term and long-term was observed, and the results in two groups were compared. Long term and short term occurrence of complications were also observed. Results No significant difference in preoperative indicators was found between two groups, includes average age, menopause time, blood β-HCG value,gestational sac diameter,the amount of vaginal bleeding (P ＞ 0. 05 ). But after the operation,we found significant difference between the combination group and surgical group in uterine retention rates (96.9% (31/32)and 20.0% (6/30) respectively, P ＜ 0. 01 ). The significant differences were also observed in operative time (42. 0 ±13.2) min and ( 120.0 ± 34.5 ) min respectively, P ＜ 0. 001 ); average hospitalization days ( (7.0 ± 1.0)days and ( 15.0 ± 2.0) days respectively, P ＜ 0. 001 ); medical expense ( $ 9143.5 ± 864.3 and $ 11 371.7 ±1621.0 respectively, P ＜ 0. 001 ) between the combination group and surgical group. During hospitalization,complication occurred in 1 case in combination group and in 7 cases in surgery group, of which mild complications were seen in 6 and serious complication in 1 patient. No treatment-related complications occurred in long-term observation in neither of the groups. The complication occurrence in combination group and surgery group were 3.1%(1/32) and 23.3% (7/30) respectively ,with a significant difference between two groups (P ＜ 0.01 ). Conclusions In the treatment of cesarean scar pregnancy, the uterine artery embolization combines uterine curettage therapy is superior to gynaecologic surgery for its shorter operative time, less infusion quantity, higher uterine retention rate,fewer complications, shorter time of hospitalization, less medical expense and better security.

Objective To inVestigate the effect of emodin on hyPertroPhic scar fibroblasts ( HSFs ) and exPlore the underlying mechanism. Methods HSFs were treated by emodin at final concentrations of 0,20,40,and 80 μmol·L-1, resPectiVely,in the cultural media. Forty_eight hours later,the cells were subjected to MTS assay and flow cytometry assay with annexin V and ProPidium iodide as dyeing indicators. Whole cell lysates from the cells of eVery grouP were subjected to Western blotting to measure the Protein exPression leVels of ERK1∕2,Bcl_2,Mcl_1 and RIP1. Results The cell Viability of HSFs was inhibited by emodin in a dose dePendent manner. The mortality rate of HSFs treated with emodin for 48 h at the concentrations of 40 and 80 μmol·L-1 were 28. 6%and 68. 0%,resPectiVely,which was significantly higher than that of the control grouP ( P<0.01).Pretreatmentwith Z_VAD_FMK could Partially reduce the mortality caused by emodin (P<0.05).PhosPhorylation of ERK1∕2 and the exPression of RIP1 and Mcl_1 were inhibited by emodin. Conclusion Down regulation of ERK1∕2,RIP1 and Mcl_1 by emodin may account for the inhibited Proliferation and increased cell death of HSFs.

Objective To observe the efficacy of Mimics finite element analysis software in the gasserian ganglion radiofrequency treatment of trigeminal neuralgia. Methods 180 cases with primary trigeminal neuralgia and VAS score ≥8 were randomly divided into 2 groups (n = 90 each): CT group (group C) and Mimics group (group M). The preoperative skull CT image of the foramen of cranial base could be analyzed in group C. The preoperative cranial CT image could be reconstructed and analyzed by Mimics finite element analysis software in group M. The puncturing success rate, complications rate and the outcomes between two groups were recorded. Results The puncturing success rates were 100% in group M and 92% in group C (P < 0.05). 6 cases with hematoma and 1 case, which were stabbed into the oral cavity were found in group C. No puncture complication was found in group G. There was no statistically significant between the two groups (P < 0.05). The VAS score was 1.6 ± 0.3 in group C and 1.3 ± 0.4 in group G, there was no statistical significance (P > 0.05) between them. Conclusions The Mimics finite element analysis software could improve the success rate of basicranial foramen ovale puncture and reduce the occurrence rate of puncture complications. Therefore , it could be safely applied to the treatment of primary trigeminal neuralgia by gasserian ganglion radio frequency.

Objective To observe the clinical efficacy of bosentan in treatment of severe pulmonary hypertension related to congenital heart disease (CHD-PAH) .Methods 5 patients with severe CHD-PAH patients received bosentan therapy, then pulmonary artery pressure, pulmonary vascular resistance (PVR), 6min walk test,right ventricular end-systolic diameter (RVSD) changes were observed and statistically analyzed after six months medication. Results Pulmonary arterial systolic pressure (sPAP) was significanfly decreased from (96±11) mmHg to (86±10) mmHg, <0.01.pulmonary arterial diastolic pressure (dPAP) was significanfly decreased from (56±10) mmHg to (46±9) mmHg ( <0.01),pulmonary arterial mean pressure (mPAP) was significanfly decreased from (73 ±11) mmHg to (59 ±10) mmHg ( <0.05), pulmonary vascular resistance was significanfly decreased from (17.8±1.9) Wood to (13.1±1.7) Wood (<0.01) . 6min walk test was improved from (136±40) m to (198±55) m, <0.01.right ventricular end-systolic diameter significanfly decreased from (40±5) mm to (36±6) mm after 6 months therapy ( <0.05) . Conclusion Bosentan can decrease pulmonary arterial systolic pressure, improve exercise tolerance, improve right ventricular function in patients with severe CHD-PAH.

OBJECTIVE To investigate the transgenerational effect of neuroendocrine metabolic programmed alteration in adult intrauterine growth retardation (lUGR) offspring rats with prenatal nicotine exposure. METHODS Pregnant Wistar rats were administered daily with nicotine (2 mg.kg-1 ) by sc from gestational day 11 until delivery. F1 offspring was fed with a standard diet before four groups in F2 were set up according to the cross-mating between F1 normal adult rats and nicotine-induced lUGR adult rats. CC group was mated by F1 normal adult rats, CN group by F1 normal adult male rats and lUGR adult female rats, NC group by F1 lUGR adult male rats and normal adult female rats, while NN group was mated by F1 lUGR adult rats. F2 adult rats were subjected to a fortnight ice water swimming stimulus. Blood samples were collected before and after stress and then detected for the levels of adrenocortico-tropic hormone ( ACTH), corticosterone ( CORT), glucose, triglycerides ( TG) and total cholesterol (TCH). RESULTS Before stress, the level of serum CORT in F2 male rats of NN group was decreased to 73.9% of that of the CC group (P<0.05),while the level of serum TG in F2 male rats of CN and NC groups was increased to 1.43 and 1.52 times that of the CC group, respectively ( P<0.05). Meanwhile, the level of serum TG in F2 female rats of CN, NC and NN groups was increased to 1.71, 1.80 and 1.81 times that of the CC group, respectively (P<0.05). After stress, the serum CORT gain rate in F2 male rats of CC group was -1.67%, but was 36.0% in NN group. The serum glucose level in male NC group and in female CN group was increased to 1.61 and 1.62 times that of the corresponded CC groups, respectively (P<0.01). Furthermore, the serum TG gain rate in F2 rats of each nicotine group was decreased markedly in comparison with their corresponding controls (P<0.05), ie, the serum TG gain rates in F2 male rats of CN, NC and NN groups were decreased to 46.4%, 16.7% and 7.7% of the CC group, while the serum TG gain rates in F2 female rats of these groups were decreased to 20.6%, 4.0% and 8.4% of the CC group, respectively. Compared with CC group, TCH level of females and males in NN group was decreased by 40.5% and 21.9%(P<0.01) before stress, respectively, and the TCH gain rate of females in NN group was increased by 49.7%(P<0.05) after stress. CONCLUSION The reproductive and developmental toxicities and the neuroendocrine metabolic programming alterations induced by prenatal nicotine exposure are transgenerated to F2 offspring and these effects exhibit gender and parental differences.

Objective To compare the efficacy and safety of intravenous thrombolysis on cardiogenic cerebral infarction and noncardiac infarction by recombinant tissue plasminogen activator (rt-PA). Methods Comparations of NIHSS, mRS and adverse events before and after treatment were made between the cardiogenic group and the noncardiac group. Results No significant differences in the NIHSS and mRS were found between the two groups. The incidence of brain hernia and dermatorrhagia in the cardiogenic group was higher than that in the noncardiac group. Conclusion Rt-PA therapy in cardiogenic cerebral infarction was effective and safe in spite of higher incidence of hemorrhage and brain hernia.