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.

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 the clinical efficiency and security of Fe(OH) 3-sncrose-compond combined with erythropoietin on renal anemia.Methods 30 cases of oral iron combined with erythropoietin in the unsatisfactory uremia patients undergoing maintenance hemodialysis,the cases were randomly divided into two groups:the treatment group(n =16) using intravenous sucrose iron 100mg,twice a week,after a total of 1000mg,then l00mg,once 1 -2 weeks;the control group(n =14) continue to oral:ferrous succinate 0.2g,three times everyday,erythropoietin dose was the same in lothgroups for g weeks.Results Hemoglobin was significantly higher(P ＜ 0.01) and hematocrit was significantly higher(P ＜0.01),and serum ferritin significant increased(P ＜0.0l) in sucrose iron treatment group than these of the control group;the patients of treatment group have obviously improved in spirit,appetite,physical and life quality and so on.Sometimes,nausea,vomiting,skin itching were complained lut without significant side effects.While in the control group limited increase in the level of hemoglobin was seen,the majority had nausea,abdominal discomfort,poor appetite.Conclusion The efficiency of intravenous sucmfer combined with erythropoietin in treatment of renal anemia was effective than conventional oral iron combined with erythropoietin and with fewe adverse reactions.

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 build new management model for diabetic foot disease,and to observe the therapeutic effect of diabetic foot ulcers under the new model.Methods 52 patients with newly diagnosed diabetic foot disease were recruited and randomly divided into the experimental group (n=26) and the control group (n=26).While the experimental group adopted the interdisciplinary collaboration model (nurse-doctor jointed diabetes care management model),the control group were treated by the single department pattern.The foot ulcer healing rate,average length of stay (ALOS),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PBG),glycosylated hemoglobin (HbA1c),and the patient awareness of the knowledge about diabetes self-management were respectively compared at 3 and 6 months.Results After receiving a multidisciplinary joint diagnosis and treatment,FPG and 2 h PBG of the patients from the experimental group [(6.44±2.93)mmol/L,(8.52± 2.09)mmol/L] were significantly decreased than those of the patients from the control group [(8.17±3.19)mmol/L,(10.77±3.27)mmol/L].HbA1c at 3 and 6 months (7.2％,7.7％) and ulcer recurrence rate (3.8％) after 6 months of patients of the experimental group were significantly reduced than those of the control group(8.9％,9.1％ and 15.4％).When compared with patients of the control group,patients of varying severity in the experimental group showed significantly shortened ulcer healing time and hospital stay.Moreover,patients from the experimental group showed statistically higher knowledge level and self management ability (P＜0.05).Conclusion Through interdisciplinary collaboration,podiatric medical joint management model can significantly improve cure rate,shorten ALOS,improve blood sugar control and patient satisfaction.

Objective To evaluate the risk factors of pediatric indirect inguinal hernia. Methods A hospital-based case-control study was performed. One hundred and three indirect inguinal hernia cases with two -fold controls (206 cases) were enrolled. Parents were interviewed for their charateristics before and during conception. Unconditional logistic regression model was used for single factor and multivariate analysis to estimate odds ratios and their 95% confidence intervals by SAS 6.12 computer software. Results There were more males than females in the overall identified indirect inguinal hernia(Ratio=93.20%, P

Objective To investigate the relationship between Alloiococcus otitidis (A. otitidis) and Secretory Otitis Media (SOM) in adults.Methods The study included 39 adult patients suffering from SOM and 42 samples (middle ear effusion, MEE)were collected. We detected the four organisms(A. otitidis ,S. pneumoniae, H.influenzae and M. catarrhalis) by mutiplex PCR, for comparing the bacterial findings in the patients with or without cold history, with or without antibiotic treatment, with effusion of different characters and durations by chi-square test. Results The DNA of A. otitidis was detected from 5 MEEs(11.9%).To acute SOM, only 1 sample was PCR-positive for A. otitidis; and to chronic SOM,4 samples were positive. There was a significant difference between them. There were 3 serous MEEs and 2 mucous MEEs, which were PCR-positive for A. otitidis, and there was a significant difference between them. Antibiotic therapy didn't contribute to PCR-positive for A.otitidis. Conclusion There is A. otitidis in the MEEs of adult SOM and it may be a pathogenic factor in SOM. A. otitidis may play an important role in chronic SOM.

AIM: The aim of the present study was to clar ify the mechanism of intracellular signal transduction in Ang II-induced prolife ration 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 wit h 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 protei n expression. c-Src kinase activity was measured by protein immunoprecipitation and kinase autophosphorylation. The phosphorylation rate of the substrate myeli n basic protein (MBP) was employed to assess MAPK activity. Western immunoblot w as used to detect protein expression of c-Src and c-Fos. RESULTS: c-Src protein expression in VSMC transfected with diffe rent concentrations of anti-sense ODNs significantly decreased in a negative dos e-effect manner. c-Src kinase activity was also markedly inhibited . Following t he 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 find ings indicate that c-Src is an important signal factor in Ang II -induced VSMC proliferati on.

As China witnesses constant development of its market economy and gradual deepening of reform in its medical and health cause,the ability of domestic hospitals to adjust their operational management strategies in due course is crucially related to their survival and development amidst market competition.Hospital managers,while stressing quality and economic control,should attach special importance to the brand effect of their hospital and step up hospital brand building,the focus of which lies in patient satisfaction and loyalty and hospital popularity and reputation.Only in this way can they constantly create advantages,enhance core competitiveness and put their hospital in an invincible position amidst market competition.