Aim To study the receptor mechanism of carvedilol(CAR) on heart failure.Methods Established rat model of heart failure was induced by abdominal aortic coarctation.With modified Langendorff model of rat,isoproterenol(ISO),carvedilol,propranolol(PRL) and the specific ?3 adrenergic receptor(?3AR) blocker SR59230A were given perfusion on heart failure and normal rats' hearts.Then the cardiac function was investigated.At the same time,plasma norepinephrine in normal and heart failure group was measured.Results ① The ?dp/dtmax of heart failure group were significantly reduced compared with those of the normal group,and the norepinephrine level was remarkably higher than that of the normal group.② In heart failure group,perfused PRL on the basis of ISO,the maximum rate of left ventricular pressure rise(+dp/dtmax) decreased by 40.37%? 2.52%,the maximum rate of left ventricular pressure decrease(-dp/dtmax) reduced by 41.36%?1.10%;perfused CAR on the basis of ISO,+dp/dtmax decreased by 24.73%? 3.60%,-dp/dtmax reduced by 22.05%?1.27%.There were differences between these two groups,and the cardiac function perfused CAR was better than PRL.③ Perfused CAR in heart failure group,+dp/dtmax increased by 41.57%?14.98%,-dp/dtmax increased by 33.39%?6.41%;perfused ?3AR specific blocker SR59230A,+dp/dtmax increase by 45.75% ?2.64%,-dp/dtmax increased by 42.81% ?9.62%.There were no differences between these two groups.Conclusion Another receptor mechanism of CAR in heart failure model was probably blocked by ?3AR.

Effects of Sini decoctiou (SD ) on ischemic (anoxic ) electrocardiogram (ECG ) and possible action mechanism of SD were studied.Results indicate that SD significantly improves the pituitrin induced ischemic ECG of rabbits, significantly prevents S-T scgment from desconding and suppresses the elevation of T wave; SD can also lengthen significantly cardioe lectric activity time of anoxic mice. The protective cffects of SD on ischemic (anoxic ) myocardium may be related to the significant increase of myocardial nutritional blood flow induced by administrating SD.

Objective To explore the surgical techniques of keyhole approach craniotomy in the treatment of hypertensive intracerebral hemorrhage in old patients. Methods CT-guided keyhole approach craniotomy was performed to treat 50 old patients with hypertensive hematomas from January 2000 to August 2003. Results CT scans within 12 postoperative hours showed over 90% hematomas were removed. The activity of daily living (ADL) classification results 6 months after the surgery were: grade Ⅰin 10 cases (20.0%), grade Ⅱ in 21 cases (42.0%), grade Ⅲ in 9 cases (18%), grade Ⅳ in 3 cases (6.0%), grade Ⅴ in 2 cases (4.0%), and grade Ⅵ in 5 cases (10.0%). Conclusions Senility is by no means a contraindication for surgery in the treatment of hypertensive hematomas and keyhole approach minimally invasive craniotomy can give a satisfactory effect.

Objective To study chromatography fingerprints of Zanthoxylum echinocarpum by HPLC.Methods Diamonsil C18 column(250 mm?4.6 mm,5 ?m) was used with acetonitrile-water gradient elution,at flow-rate of 1.0 mL/min,detection wavelength at 278 nm.Results HPLC was used to establish fingerprint chromatograph of water extraction from ten batches of Z.echinocarpum,which had been harvested from the same area in Zhangjiajie at the same time.The result showed that 11 peaks were common.Conclusion The method could be used for the quality control of Z.echinocarpum.

Objective To explore the effectiveness of sandplay therapy combined with family counseling in children with school phobia and its influence of child′ self-consciousness. Methods Integrative sandplay therary with family consulting were used to treat 28 patients with school phobia regularly for 2 months. Sandplay and family consulting therapy were given once a week for 45 minutes . Clinical outcomes were assessed using CGI-GI and Piers-Harris children′s self-consciousness scale before and after treatment as well as 3 months posttreatment. Results Overall response rate was 85%. In addition, the physical appearance and characteristic factor before and after treatment were no significant difference (P>0.05). The rest of the various factors and total score compared with pre-treatment significantly improved (P<0.05). After treatment for 3 months, every factor in self-consciousness of children and total score were no significant difference (P>0.05). Conclusion Integrative sandplay therapy with family counseling has better and long-lasting treatment effect to self-consciousness of children with school refusal.

Objective To investigate the imaging features of malignant invasion of major intrahepatic ductal structures (the portal and hepatic venous vasculature, the bilie duct) by primary hepatocellular carcinoma (HCC) using multi-detector-row spiral CT (MDCT). Methods We retrospectively analyzed 68 documented HCC patients with tumorous invasion of the major intrahepatic ductal structures who had undergone contrast-enhanced dual-phase MDCT scanning of the upper abdomen.The morphological changes of the portal and hepatic venous vasculature, the bile duct, and the liver parenchyma at both the hepatic arterial phase and portal venous phase images were carefully observed and recorded. Results Among the 68 patients, 47 patients had malignant invasion of the intrahepatic portal venous vessels with secondary tumor thrombus formation; 12 patients had tumor involvement of the hepatic veins and intraheptic segment of the inferior vena cava; Tumor invasion of the bile duct was seen in 9 patents. The direct CT signs of tumor invasion of intrahepatic venous vessels included: ①dilatation or enlargement of the involved vein with intraluminal soft-tissue “filling defect”; ②enhancement of the tumor thrombus at hepatic arterial phase, the so-called “venous arterialization” phenomenon. The indirect CT signs included: ①arterial-venous shunt, ②early and heterogeneous enhancement of the hepatic parenchyma adjacent to HCC focus, ③cavernous transformation of the portal vein. The CT signs suggesting tumor invasion of the bile duct included: ①dilation of the bile ducts near or proximal to HCC lesion, ②soft-tissue nodule or mass inside the bile ducts. Conclusion Invasion of major intrahepatic ductal structures by HCC will present corresponding CT imaging features. Contrast-enhanced MDCT dual-phase scanning combined with appropriate image post-processing techniques can better evaluate the malignant invasion of major intrahepatic ductal structures.

Objective To compare the curative effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) with that of simple TACE in treating large liver cancers.Methods A computer-based search assisted by manual searching for TACE+MWA vs simple TACE clinical control trials for large liver cancers was conducted.The patient survival,tumor response and complications were enrolled in the scope of analysis.Results A total of 16 papers met the inclusion criteria,which included 1199 patients in total.Meta-analysis indicated that one-,2-and 3-year survival rates of TACE+MWA group were better than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The complete response (CR) rate and partial response (PR) rate of TACE+MWA group were higher than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The stable disease (SD) rate and progressive disease (PD) rate of TACE+MWA group were lower than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).Conclusion For the treatment of large liver cancers,TACE +MWA is superior to simple TACE.(J Intervent Radiol,2017,26:225-231)

Objective To evaluate the value of virtual touch tissue imaging quantification (VTIQ),which was combined with ultrasound Breast Imaging Reporting and Data System (BI-RADS),for differentiating benign from malignant breast lesions.Methods Totally 190 patients with 214 breast lesions were enrolled in this study.All lesions were classified according to the BI-RADS for sonography.The maximum,minimum and mean shear wave velocity (SWV) values on VTIQ in the lesions were obtained.The SWV between benign and malignant lesions were analyzed.Receiver operating characteristic(ROC) curves were plotted to determine the cut off value of VTIQ for differential diagnosis of breast lesions. Results Pathology confirmed 166 benign lesions and 48 malignant lesions.The SWVmax,SWVmin,SWVmean of malignant lesions were significantly higher than those of benign lesions (all P<0.001).The SWVmean 3.67 m/s as the best value in the diagnosis of benign and malignant lesions.The sensitivity,specificity,positive predictive value and negative predictive value of the combination of the SWVmean and BI-RADS classification standard in the diagnosis of benign and malignant breast lesions were 77.6%,97.5%,92.7%,91.3%,respectively.Conclusions The combination of VTIQ and ultrasonic BI-RADS can improve the ability of differential diagnosis of benign and malignant breast lesions.

Several biological characteristics of stem cell such as self-renewal and multi-direc tional differentiation,makes stem cell therapy obtain better clinical efficacy in the treatment of many refractory diseases,Even some of the incurable disease in the treatment of the disease.Stem cell therapy showes a good prospect,brings the clinicians and patients in despair with confidence and hopesometimes.This article introduced the stem cell treatment policy,the management system and the present situation in domestic and foreign,pointed out the main problems of stem cell therapy in china and discussed on the dispute of stem cell therapy in scientific research management and clinical application in China.

Objective To explore the correlation between wide QRS of transesophageal atrial pacing (TEAP) and implicit ventricular pre-excitation.Methods 77 patients tested by TEAP were divided into two groups according to the ECG results .45 patients in group Ⅰhad normal electrocardiogram .32 patients in group Ⅱhad ven-tricular pre-excitation.In group Ⅰ,TEAP results showed that electric pulse wave (S wave) was followed by intermit-tent or continuous wide QRS complex .At the same time , the results of group Ⅰ were compared with the results of groupⅡ.Results (1)The patients of group Ⅰwere excluded the presence of concealed accessory pathway by intra-cavitary electrocardiographic test,among them 20 patients (group ⅠA) were ventricular pacing,the test results dis-played that S wave was followed by wide QRS complex exhibiting a pattern of right bundle branch block ( RBBB) ,SR interval was 0 s;SR intervals of 25 patients (groupⅠB) were not fixed,SR interval was (0.07 ±0.01)s,S wave had no concern with QRS wave ,the wide QRS complex was premature ventricular contraction ,QRS wave shapes were dif-ferent according to the different sites of pacing origin .(2)In groupⅡ,the test results displayed that S wave was close-ly followed by the atrial depolarization wave P ,and there was a wide QRS complex with pre-excitation wave at the be-ginning after a atrioventricular conduction time shorter than normal ,SR interval was fixed ,SR interval was (0.08 ±0. 03)s,at the same time,different parts of accessory pathway QRS complex had different morphological characteristics . (3) SR interval of ⅠA group compared with groupⅠB and groupⅡ,the differences were statistically significant ( t=2.97,3.02,all P<0.05);SR interval had no statistically significant difference between group ⅠB and groupⅡ(t=2.66,P>0.05).Conclusion When TEAP displaying pacing wide QRS complex ,in order to avoid bringing misdiag-nosis,TEAP results should be analyzed comprehensively rather than blindly believing that the reason was concealed accessory pathway .