Stent fracture has been implicated as a cause of drug-eluting stent failure. The authors report here 2 cases with stent fractures which were diagnosed by coronary artery angiography and intravascular ultrasound (IVUS). Both of them received multiple-stent-implantation. Five stent fractures altogether were detected in two patients. All the involved stents were sirolimus-eluting ones. Angiographic study showed that three stent fractures were complete transverse linear fracture with stent displacement. IVUS demonstrated that three stent fractures were complete break and two were partial break. One fracture was located close to the overlapping site of two stents and another fracture was accompanied by the formation of a coronary aneurysm. Angiography and IVUS are helpful to identify stent fracture. In addition, IVUS is more likely to clarify the cause of stent failure as well as the mechanism of stent fracture.

Objective To investigate the application value of plasma D-dimer(D-D )in the diagnosis of spontaneous bacterial per-itonitis(SBP)in patients with liver cirrhosis .Methods 137 cases of cirrhotic patients with ascites were selected and divided into SBP group and non SBP(NSBP) group .30 cases of patients with chronic liver disease and 30 healthy individuals were selected as chronic liver disease group and normal control group ,respectively .The levels of D-D and C-reactive protein(CRP) were measured in specimens from all the groups .Results The D-D levels of SBP group ,NSBP group ,chronic liver disease group and normal control group were (7 .82 ± 5 .68) ,(5 .55 ± 4 .55) ,(0 .45 ± 0 .26) and (0 .06 ± 0 .04) mg/L ,respectively .And the serum CRP levels were (30 .0 ± 29 .6) ,(16 .4 ± 20 .5) ,(5 .3 ± 1 .8) and (2 .1 ± 0 .9)mg/L ,respectively .The levels of D-D and CRP were both higher in SBP group and NSBP group than in chronic liver disease group and normal control group(P<0 .01) .The D-D and CRP levels of SBP group were both significantly higher than those of NSBP group (P<0 .05) .The ROC curve showed that the AUC ,sensitivity and specificity of D-D were 0 .650 ,0 .604 and 0 .709 ,respectively ,and those of CRP were 0 .705 ,0 .792 and 0 .582 ,respectively .Conclu-sion Plasma D-D detection was beneficial to the early diagnosis of SBP in cirrhotic patients with ascites .

Objective To identify the causes of coronary angiographic hazy lesions by intravascular ultrasound (IVUS) to avoid inappropriate stenting. Methods Twenty-five cases with hazy regions on coronary angiogram were consecutively identified from July 2009 to March 2010. Hazy regions were defined by coronary arteriongraphy as reduced contrast density without a clearly defined intimal tear, dissection,thrombus,or stenosis ( ＞ 50% ). This cohort of patients were subsequently underwent IVUS examinations and treated according to the results of IVUS. Results The lumen CSAs were settled as ＞ 4. 0 mm2 in all examinations. Among all 25 cases,hazy lesions were located in left anterior descending in 12 patients, right coronary artery in 6 patients, left circumflex in 5 patients, and left main artery in 2 patients. According to the IVUS findings, 2 cases showed absolutely normal or near-normal arterial wall structure image, 10 cases showed calcified plaque,5 cases showed plaque rupture,3 cases showed eccentric plaque ,2 cases showed thrombosis formation,2cases showed dissection,1 case showed subintimal hematoma. Seven patients received stent implantation, and the rest accepted medical therapy. There were no in-hospital MACEs reported among all patients. Conclusion Nearly half of the coronary arteriongraphic hazy lesions were caused by calcified plaque. IVUS can distinguish calcified plaques from intimal tears, thrombus and other underlying etiologies,and help to avoid unnecessary stenting.

Objective To investigate the application of lymphocyte parameters in screening the lymphocyte proliferation and re-active hyperplasia disease.Methods 128 cases as the healthy control,100 cases of lymphoma,35 cases of multiple myeloma(MM), 34 cases of lymphocytes reactive hyperplasia(RL)and 5 cases of chronic lymphocytic leukemia(CLL)were selected and performed the peripheral blood cells analysis by the Sysmex XE-2100 hematology analyzer.The relevant lymphocyte parameter values were re-corded and the comparative analysis in the difference between the disease groups and the control group was performed.The role of each lymphocyte parameter in screening the lymphocyte proliferation and reactive hyperplasia diseases was evaluated by the receiver operating characteristic curve(ROC curve).Results The high fluorescence lymphocytes(HFL),in the control group was 0.008 ± 0.008,in the lymphoma group was 0.016±0.058,in the MM group was 0.019 ±0.063,in the RL group was 0.040 ±0.070,and CLL group was 0.388±0.158.Compared with control group,the difference of RL and CLL group was statistically significant(P <0.05).The percentage of lymphocytes(LY%,:the control group:34.4%±5.9%,the lymphoma group:26.6%±13.1%,the MM group:31.0%±13.1%,the RL group:29.2%±15.4% and the CLL group:44.5%±38.5%.The difference between the lympho-ma group and the control group was statistically significant(P <0.001).The lymphocytes structural parameters X(LY-X),the con-trol group:833.5 ± 22.7,the lymphoma group:867.9 ± 28.5,the MM group:867.9 ± 26.6,the RL group:859.2 ± 27.8 and the CLL group:894.0 ± 65.4.Except for the CLL group,the differences between other groups and control group were statistically significant(P <0.001).The lymphocytes structural parameters Y(LY-Y),the control group:659.6 ± 23.0,the lymphoma group:669.4 ± 43.5,the MM group:665.9 ± 37.1,the RL group:665.9 ± 40.0 and the CLL group:778.4 ± 152.1.Compared with the control group,the difference of the lymphoma group was statistically significant(P <0.05).AUC of the ROC curve in the pa-tients with lymphocyte proliferation and reactive hyperplasia disease by LY-X screening was 0.819,with the sensitivity of 80.5%and the specificity of 60.1% when cutoff value was 842.5.Conclusion The lymphocyte parameters,especially LY-X can reveal the
morphological changes of lymphocytes sensitively and contribute to screening the patients with lymphocyte proliferation and reactive hyperplasia disease.

Objective:To investigate the intracellular localization and association of chicken major histocompatibility complex class Ⅰsubunits with invariant chain.Methods:At first,the sequences of MHCⅠ ? and ?2m subunits were amplified with RT-PCR.Secondly,we constructed the eukaryotic expression plasmids of MHCⅠ ? and MHCⅠ?2m that was fused with red or enhanced green fluorescent protein,respectively.The recombinant plasmids of MHC Ⅰsubunits and pEGFP-C1-Ii that could express enhanced green fluorescent protein were transiently transfected into COS-7 cells with Lipofectamine 2000.Immunofluorescence microscopy was carried out to detect the expression and intracellular localization of Ii and MHC Ⅰsubunits,and immunoprecipitation was used for analyzing their association.Results:The colocalization was found in endocytic compartments when GFP-Ii,MHCⅠ?-RFP and MHCⅠ?2m-RFP were co-expressed in COS-7 cells.Immunoprecipitation of Ii showed that GFP-Ii co-isolated with MHCⅠ?-GFP and MHCⅠ?2m-GFP subunits when COS-7 cells were transiently transfected with pEGFP-C1-Ii,pEGFP-N1-MHCⅠ? and pEGFP-N1-MHCⅠ?2m.Conclusion:Chicken Ii can not effectively associate with single ? or ?2m subunits from chicken MHC Ⅰmolecules,but Ii and the integrated MHC Ⅰmolecule can form the complexes that are colocalized in endomembrane system of COS-7 cells.

HRP solution was injected into the right side of the thoracic spinal cord of the rat with a micropipette to observe the neurons which give rise to the descending propiospinal tract. Labeled neurons were distributed throughout the bilateral Rexed's laminae Ⅰ-Ⅹ of the spinal cord in the segments rostral to the site of HRP application. The greatest number of the labeled cells were consistently found in lamina Ⅶ (including the intermediolateral nucleus), and then in laminae Ⅷ and Ⅳ. Our results verified the existence of the nucleus of the dorsolateral funiculus and its intraspinal connections in the spinal cord of the rat. This nucleus gives rise to the descending projections to the lower spinal segments.

0.05).There were no statistical difference between the 50 mg IM group and the 75 mg NM group in secondary end-point.Conclusion Maintenance therapy with 50 mg domestic clopidogrel did not increase the 1-year incidence of major adverse cardiac events when compared with standard 75 mg of Plavix therapy.

Objective To explore the clinical efficacy of atorvastatin calcium in the treatment of chronic congestive heart failure(CHF).Methods According to the order of admission with single and double,132 CHF patients were randomly divided into control group and study group,66 cases in each group.The control group was given routine treatment,and the study group was treated with atorvastatin calcium on the basis of routine treatment.The clinical efficacy was assessed.Before and after treatment,the serum TC level was measured,the left ventricular ejection fraction(LVEF) and heart left ventricular end diastolic diameter(LVDD),heart index(CI) were assessed by echocardiography.The adverse reactions during treatment were observed.Results The total effective rate of the study group was 92.42%,which was higher than 83.33% of the control group,the difference was statistically significant(x2=9.35,P<0.05).The serum TC of the study group after treatment was (3.24±0.75)mmol/L,which was lower than (4.70±0.86)mmol/L of the control group,the difference was statistically significant(t=8.96,P<0.05).The level of LVEF of the study group after treatment was (46.39±6.35)%,which was higher than (44.60±5.82)% of the control group,the difference was statistically significant(t=9.47,P<0.05).The levels of LVDD and CI were (47.06±5.39)mm and (2.60±0.62)L·min-1·m-1 respectively,which were lower than (49.53±6.17)mm and (2.97±0.69)L·min-1·m-1 of the control group,the differences were statistically significant(t=10.31,9.40,all P<0.05).There was no significant difference in adverse reactions between the two groups(x2=2.04,P>0.05).Conclusion Atorvastatin calcium in the treatment of CHF patients on the basis of routine treatment has better clinical effect.It can significantly reduce TC and significantly improve cardiac function,and has high safety.

Objective ToanalyzethedistributionanddrugresistancesituationofKlebsiellapneumoniae(KPN)isolatedfromour hospital during 2014 .Methods The drug susceptibility test was carried out by the Siemens fully automatic bacterial identification /drug susceptibility test analyzer .The drug susceptibility test results were judged according to the (CLSI) M100‐S22 document (2012) .Results A total of 291 strains of KPN were detected from 8 486 submitted specimens ,in which 20 strains were multi‐drug resistant Klebsiella pneumoniae(MDR‐KPN)isolates were 213 strains ,48 strains were extended‐spectrum beta‐lactamases producing Klebsiella pneumoniae (ESBLs‐KPN) and 10 strains were carbapenem‐resistant Klebsiella pneumoniae(CR‐KPN) .The KPN detec‐tion rate had statistical difference among different specimens (P= 0 .000) .The constituent ratio of KPN isolation in the sputum specimen was highest(P=0 .000) .The KPN detection rate had statistical difference among different departments (P=0 .000) ,the constituent ratio of KPN isolation in the respiration department was highest (P=0 .000) .The resistance and sensitivity of KPN to different antibacterial drugs had statistical difference(P=0 .000) ,carbapenems had the lowest resistance rate .Conclusion KPN has relatively low resistance rate to commonly used antibacterial drugs ,its multi‐drug resistant strains are in the higher level ,which should arouse clinic and hospital infection management department must to pay attention to and adopt corresponding supervision measures .

Objective To evaluate the value of immature granulocytes count in diagnosing and monitoring the systemic inflam-matory response for patients with systemic inflammatory response syndrome,and to provide a new indicator of systemic inflammato-ry response.Methods 207 patients suspected of systemic inflammatory response syndrome were enrolled.The dynamic changes of immature granulocytes counts and the disease situation were recorded for all subjects.The blood samples were collected in vacuum tubes with EDTA-K2 anticoagulant.Blood cell count and immature granulocytes count were performed in Sysmex XE-2100 hema-tology analyzer.The determination of C-reactive protein and procalcitonin were also completed.The performance of immature granu-locytes in diagnosing systemic inflammatory response syndrome was evaluated by receiver operating characteristic curve analysis. Results The area under the curve of immature granulocyte count (IG #)was 0.78 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 62.2 % and a specificity of 73 % at IG #> 0.1 65.The area under the curve of immature granulo-cyte percent (IG%)was 0.771 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 54.1 % and a specifici-ty of 94.6 % at IG%>2.55 %.The area under the curve of C-reactive protein was 0.71 6 in diagnosing systemic inflammatory re-sponse syndrome,with a sensitivity of 67.6% and a specificity of 75.7 % at C-reactive protein> 64.15 mg/L.The area under the curve of procalcitonin was 0.772 in diagnosing systemic inflammatory response syndrome,with a sensitivity of 75.7 % and a speci-ficity of 70.3 % at procalcitonin> 0.33 mg/L.Conclusion Immature granulocyte count is beneficial for the diagnosis and the as-sessment of prognosis of systemic inflammatory response syndrome.