Objective: This paper focuses on the most commonly used Guiding Catheter and conduct study on material selection, push force, torque and twist controllability. Methods:In contrast to the method used in our clinical surgery three foreign manufacturers of medical guidelines for catheter materials, testing foreign manufacturers’ products. Conclusions analyzing t foreign products their own characteristics, provide the technical basis for better medical research and clinical guidelines for catheter performance. Results: Three foreign guiding catheter manufacturers selected the same materials, after testing, the guiding catheter has the best maximum pushing force, can quickly reach the site of disease. Conclusion: The guiding catheter has the best torque control, can better use in distorted vessel;the guiding catheter has the best twist controllability, can deal with complex vascular anatomy.

ObjectiveTo investigate the association between a new identified Gly82Ser polymorphism of RAGE gene and diabetic microangiopathy,a case control study of 260 Chinese subjects (including 156 type 2 diabetics with or without nephropathy or retinopathy and 104 non diabetic control) was performed.MethodsGenotype frequencies of Gly82Ser polymorphism were studied by PCR RFLP analysis with AluI digestion.ResultsThe most frequent genotype and allele of Gly82Ser polymorphism of RAGE gene in Chinese were genotype GG and allele G.Their frequency distribution showed significant difference between Chinese and Caucasian.There was no difference in genotype frequencies or allele frequencies between type 2 diabetic patients (DN 0) and the control subjects.Genotype and allele frequencies did not differ in type 2 diabetic subjects with nephropathy or without nephropathy.Moreover,there were no associations between diabetic patients with or without retinopathy in genotype and allele frequencies as well (two tailed Fisher’s exactP >0.05).ConclusionOur results showed that Gly82Ser polymorphism in RAGE gene was not associated with diabetic microangiopathy,which suggests that these genetic variants may not be involved in the mechanism of diabetic microangiopathy in Chinese type 2 diabetics.

Objective To summarize the strategies of nutritional support for patients with hyperlipidemic acute pancreatitis (HLAP). Methods The clinical data of six HLAP patients who were treated in our department from January 1998 to December 2009 were retrospectively reviewed. Results The disease conditions of all patients were improved after fasting and early nutritional support and lipid-lowering treatment. Three cases with severe HLAP received enteral nutrition via a nasojejunal tube. Another three patients with milder HLAP obtained low-fat diet and orally administered lipid-lowering drugs. The plasma triglyceride levels decreased from (25.30 ± 20. 48 ) mmol/L to (5.41 ±4.55) mmol/L. No relapse was noted during follow-up (range: 3 -24 months). Conclusions The approaches of nutritional support for HLAP patients should be customized based on the specific disease conditions,and the enteral nutrition and lipid-lowering drugs should be reasonably and carefully designed and applied. For severe HLAP, nasojejunal tube should be maintained in the early stage to ensure the application of enteral nutrition and lipid-lowering drugs, protect the integrity of gut mucosal barrier, and decrease the fluctuation of blood glucose.

Objective To summarize and analyse the clinical data of death cases in the department of emergency internal medicine. Methods The clinical data of patients presenting at the department of emergency internal medicine from January 2005 to July 2010 were analyzed retrospectively. Results Among 13 211 patients of department of emergency internal medicine, 145 died. More cases died in winter( 32.0% , 39/122 ).More than half of deaths occurred within 6 hours after admission( 54.5% ,79/145 ). The top six death causes were sudden death, pulmonary infection, cerebrovascular accident, advanced cancer, gastrointestinal bleeding,cardiovascular diseases and the occurrence rates were 18. 6%, 13.8%, 13.8%, 10.3%, 9. 7% and 9.0%respectively. Conclusion The first three death causes in department of emergency internal medicine were sudden death, cerebrovascular accident, pulmonary infection. Prevention of these diseases, cooperation between emergency department and other departments and special training on standardized treatment of critically ill patients should be enhanced.

Objective To investigate influence of hohstic nursing intervention on psychological state and gastrointestinal function of patients after abdominal operation. Methods 48 patients undergoing abdominal surgery with epidural anesthesia were divided into the intervention group and the control group. Holistic nursing intervention and routine nursing were given to the two groups respectively. Self-rating anxiety scale (SAS) and serf-rating depression scale (SDS) were used to evaluate the psychological state of all patients and gastrointestinal tract function were also measured. The result underwent t test. Results SAS and SDS scores were lower on the fifth day after operation and the time of borborygmus recovery, anal exsufflation and defecation was shorter in the intervention group when compared with those of the control group. Conclusions Hohstic nursing to patients after abdominal surgery can eliminate anxiety and depression and improve recovery of gastrointestinal tract function.

AIM: The aim of the present study was to clarify the mechanism of intracellular signal transduction in Ang Ⅱ- induced proliferation of vascular smooth muscular cells (VSMC) by observing the effect of c- Src on Ang Ⅱ- mediated mitogen- activated protein kinase (MAPK) activation and c- Fos protein expression in cultured VSMC of rats. METHODS: Cultured aortic VSMCs from SD rats were transfected with anti-sense c-Src oligodeoxynucleotides (ODNs) wrapt with lipofectin to inhibit c- Src activity and protein production. Untransfected VSMCs were used as control. We observed the role of Ang Ⅱ stimulation in MAPK activation and c- Fos protein expression. c- Src kinase activity was measured by protein immunoprecipitation and kinase autophosphorylation. The phosphorylation rate of the substrate myelin basic protein (MBP) was employed to assess MAPK activity.Western immunoblot was used to detect protein expression of c- Src and c-Fos. RESULTS: c-Src protein expression in VSMC transfected with different concentrations of anti- sense ODNs significantly decreased in a negative dose- effect manner. c- Src kinase activity was also markedly inhibited. Following the stimulation of Ang Ⅱ on transfected VSMCs with anti-sense ODNs, the increase rate of c- Src activity was 8.7% of that in control, the activity of MAPK was 1.6% compared with control and c- Fos protein expression was as 30.0% as that of control. CONCLUSION: Ang Ⅱ induces c- Src activation. MAPK activation and c - Fos protein expression by Ang Ⅱ is dependent on c- Src activation. These findings indicate that c- Src is an important signal factor in Ang Ⅱ-induced VSMC proliferation.

Objective　To observe the effects of epithelial growth factor (EGF) and basic fibroblast growth factor (bFGF) on wound healing of the penetration keratoplasty (PKP) with autograft in rabbits. Methods　After the establishment of penetrating keratic autograft model on 24 rabbits, they were equally divided into EGF-, bFGF-, EGF+bFGF-treated and control groups. The wound healing of all the animals were observed with healing intensity, liquid scintillation counter, AgNORs staining, VG staining and transmission electron microscopy. Results　①EGF, bFGF, and EGF+bFGF increased the limiting pressure of the wounds and the 3H-TdR incorporation. ②The fibroblast cells and its secreting proliferative collagen in both the bFGF group and EGF+bFGF group were more well-arranged. Conclusion　①EGF, bFGF, EGF+bFGF can obviously elevate the intensity of wound healing after PKP and enhance the synthesis of DNA. ②The effect of this agent combination is just as the same as bFGF applied alone 14 d after the operation. ③bFGF can improve the quality of wound healing after PKP.

Objective:To analyse pros and cons of Shikani laryngoscope anatomically during nasal intubation.Methods:60 pa-tients,with ASAⅠ -Ⅱ,aged 1 9 to 29 years old,undergoing titanium plate and titanium screw removal surgery after orthognathia, were randomly divided into Shikani group (S group,n =30)and HC video laryngoscope group (V group,n =30).Successful intuba-tion rate of the first attempt,total time cost,nasal bleeding rate and the incidence of postoperative airway complications were compared. Results:Compared with group V,the time cost of group S was significantly lower(P <0.05).But the rate of successful intubation for the first attempt,nasal bleeding rate and incidence of complications were the same in both groups(P >0.05).Conclusion:Shikani la-ryngoscope is faster,less invasive with easy maintenance in nasal intubation.

Objective To investigate the risk factors of pneumonia in patients with non ST segment elevation-acute cononary syndromes (NSTE-ACS).Methods A total of 183 cases with NSTE-ACS was divided into pneumonia and non-pneumonia groups.The possible risk factors were screened firstly,then nonconditional logistic model multivariate analysis was used to investigate risk factors including age,sex,weight,smoking,chronic obstructive pulmonary disease (COPD),hypertention,diabetes,left ventricular failure,renal failure,low serum albumin,early revascularization and early rehabilitation exercise on the occurrence of pneumonia in NSTE-ACS.Results The differences were statistically significant in factors including age,smoking,COPD,diabetes,left ventricular failure,renal failure,low serum albumin,early revascularization,and early rehabilitation exercise between two groups (P ＜ 0.05).By analysis of logistic,risk factors on the occurrence of pneumonia in NSTE-ACS were age,smoking,COPD,diabetes,left ventricular failure,renal failure,and low serum albumin(P ＜0.05).Early revascularization and early rehabilitation exercise were the protective factors to avoid pneumonia.Conclusions Left ventricular failure,age,smoking,COPD,diabetes,renal failure,and low serum albumin were the risk factors of pneumonia occurred in NSTE-ACS,but early revascularization and early rehabilitation exercise were the protective factors to avoid pneumonia.Actively treating the risk factors and early initiating the protective factors can effectively reduce the incidence of pneumonia.

Objective To investigate the significance of peroxisome proliferator-activated receptor (PPAR)γexpression in the lung tissue of rats with chronic hypoxic pulmonary hypertension (HPAH). Methods Forty male Sprague-Dawley rats were randomly divided into four groups (n=10 for each group):normal control group (NC), hypoxia control group-one-week (HC-1w), hypoxia control group-two-week (HC-2w) and hypoxia control group-three-week (HC-3w). Normal control group was raised under normal oxygen condition in ventilated animal cage for three weeks. The other HC groups were placed in a low oxygen chamber (O2 concentration of 10%) from 9:00 AM-5:00 PM (8 h/d) everyday by one week, two weeks and three weeks. The mean pulmonary arterial pressure (mPAP), right ventricular systolic pressure (RVSP) were detected. The index of right ventricular hypertrophy RV/(LV+S) was measured by dissecting rat heart. The morphological changes of the small pul-monary arteries were observed by HE staining, and the percentage of vascular wall thickness (WT%) was calculated. The ex-pression level of PPARγprotein was detected by Westren blot assay. Results The mPAP, RVSP and RV/(LV+S) were sig-nificantly higher in HC groups than those of NC group (P<0.05). The morphology of pulmonary arteries showed vessel wall thickening and vessel lumina stenosis in HC groups compared with that of NC group. The PPARγexpression in lung tissue was significantly lower in HC groups than that of NC group, and the downward trend was more obvious with the extension of time. Conclusion PPARγplays an important role in the occurrence and development of chronic hypoxic pulmonary hyper-tension.