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 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 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 screen for the differentially expressed genes in peripheral blood mononuclear cells(PBMCs) from type 2 diabetes patients with distal symmetric polyneuropathy(DSPN) by gene microarray.Methods: A 5 075 gene cDNA microarray was used to examine gene expression in PBMCs of 2 type 2 diabetes patients with DSPN(group 1),2 type 2 diabetes patients without DSPN(group 2),and 2 age-and sex-matched controls(control group).The differentially expressed genes were identified and subjected to real-time RT-PCR analysis.Results: Twenty-two genes were found to be differentially expressed,including cell metabolism and signal transduction genes,oncogenes and anti-oncogenes,DNA synthesis and repair genes,ion channel and transport protein genes,DNA-binding,transcription and transcription factor genes,and cytoskeleton genes.There were 4 genes up-regulated and 18 down-regulated.Real-time RT-PCR results of AK1 and FBXO7 were consistent with that of microarray analysis.Conclusion: Microarray expression profile of PBMC in type 2 diabetes patients with DSPN is differential.DSPN may be involved in cell metabolism,signal transduction,DNA synthesis,etc.

Objective To investigate papillary muscle function and construction in myocardial infarction(MI) patients by two-dimensional speckles tracking imaging(2D-STI),and to analyze the influence factors of ischemic mitral regurgitation.Methods Fifty myocardial infarction with ischemic mitral regurgitation(IMR) patients were brought into case group.The patients were divided into two groups:Ant MI group and Inf-Pos-MI group.Forty-five health volunteers were involved as control group.Anterior,posterior papillary muscle longitudinal strain (ALS,PLS),delay time(DT),fractional shortening (FS),length between the posterior or anterior papillary muscle tips and the contralateral anterior mitral annualr (APM AMA,PPM AMA),mitral leaflet closure (MLC),inter distance papillary muscle (IPMD) were aquired respectively.Papillary muscle function and construction among the groups were compared,and the effective factors of IMR were evaluated.Results Between the control group and Ant-MI group,the left ventricular end-diastolic diameter(LVEDD),left ventricular end-diastolic and end-systolic volume(LVEDV,LVESV),left ventricular ejection fraction(LVEF),ALS,delay time(DT),A FS,IPMD,MLC,APM-AMA,PPM-AMA were significantly different(all P ＜0.05).Between the control group and Inf-Pos-MI group the LVEDD,LVEDV,LVESV,EF,DT,PPM-AMA,MLC,PLS,P-FS were significantly different(P ＜0.05).Between the Ant-MI group and Inf-Pos-MI group,the LVEDD,LVEDV,LVESV,EF,MLC,ALS,PPM-AMA,PLS were significantly different (all P ＜ 0.05).In the Ant-MI group,LVEDV,ALS,MLC were significantly correated with Gensini score(r =0.71,-0.65,0.56;P ＜0.05).In the Inf-Pos-MI group,PPM AMA,PLS were significantly correated with Gensini score(r =0.65,-0.76;P ＜0.05).In the Ant MI group and Inf-Pos-MI group,the ALS,PLS,PPM-AMA were significantly different (P ＜ 0.05).Its correlates in Logistic analysis of Ant-MI group included LVEDV,MLC,DT with OR 1.48,1.72,1.54(P ＜0.05),respectively.Its correlates in logistic analysis of Inf Pos-MI group included PLS,PPM-AMA,DT with OR 1.78,1.57,1.56 (P ＜0.05),respectively.Conclusions There are different extent of damage of papillary muscle function and construction in Ant-MI group and Inf-Pos-MI group.The increases of LVEDV and MLC and desynchronization of PMs are risk factors of IMR in Ant-MI group.The increases of PMP-AMA,decrease PLS and desynchronization of PMs are risk factors of IMR inInf-Pos-MI group.

Isocitrate dehydrogenases(IDHs)are considered as key enzymes in the tricarboxylic acid cycle. Recurrent mutations in the IDH1 and IDH2 genes are recently found in several human cancers. Those point mutations specifically affect IDH1 and IDH2 active site arginine residues and confer a neomorphic enzyme function of directly catalyzing α-ketoglutarate(α-KG)to R-2-hydroxyglutarate(R-2-HG). R-2-HG can com-petitively inhibits α-KG-dependent enzymes and may therefore contribute to the occurrence and development of tumor. In addition,Mutation status of IDH1 and IDH2 are closely relative to the progress and prognosis of cer-tain tumor. Thus IDH1 and IDH2 are considered to be promising biomarkers for early diagnosis and prognosis and targeted therapy.

Objective To investigate the relationships between serum inflammatory mediators and myocardial injury in rats with sepsis.Methods Thirty male Sprague Dawley (SD) rats were randomly divided into normal control group and sepsis (0,24,48,72 h) groups.The rats subjected to sepsis were induced with cecum ligation perforation (CLP).Tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),cardiac troponin Ⅰ (cTnI) and B-type natriuretic peptide precursor (NT-proBNP) in the venous blood were measured at 0 h,24 h,48 h,and 72 h after CLP.The lactic acid (Lac) of the arterial blood,cardiac index (CI),acute physiology and chronic health evaluation (APACHE) Ⅱ score were also determined simultaneously.Results The levels of TNF-α,IL-6,cTnI,NT-proBNP,and Lac in sepsis (24 h,48 h,and 72 h) groups were significantly elevated compared to normal control and sepsis (0 h) group.In addition,the number of sepsis (24 h,48 h,and 72 h) groups progressively increased (P ＜0.05).Conclusions It existed a close relationship between serum inflammatory mediators and myocardial injury,and made myocardium damage after CLP.

Allergic rhinitis (AR)and bronchial asthma often coexist in the same individual,in which they influence development and severity of each other.Both domestic and foreign research has showed that Syn-ergistic treatment to children with AR and asthma could be achieved by inhaled corticosteroids(ICS),oral leu-kotriene receptor antagonist and subcutaneous /sublingual allergen specific immunotherapy;collaborative manage-ment will be realized by doctors'Comprehensive clinical assessment,children and caregivers'self-assessment and chronic disease management tools.Collaborative treatment and management is significant to children with both allergic rhinitis and asthma.In addition,it has an edge in improving compliance of children and their parents during the treatment,the quality of childrens'life,and reducing burden of the diseases.

BACKGROUND:Thinking from ovarian cancer stem cel theory shows that: in the tumor cels, there are a fraction of stem cels with self-renewing ability and multipotent differentiation, which are the root causes of ovarian cancer recurrence and drug resistance. Studies have shown that CD90 can be used as a surface marker of mesenchymal stem cels and stem cels of other cancers.
OBJECTIVE:To explore the biological features of CD90+ tumor cels from ovarian cancer tissues.
METHODS: Primary ovarian cancer cels were isolated from the abdominal dropsy of ovarian cancer patients to sort CD90+ and CD90- cels using flow cytometry. RT-PCR was used to detect expressions of stem cel-related genes and epithelial to mesenchymal transition-related genes. Cel invasion was observed by Transwel invasion assay, cel proliferation and differentiation observed by clone formation assay, stem cel potential observed by suspension sphere-forming assay, and tumor formation rate observed byin vivo tumorigenicity experiment.
RESULTS AND CONCLUSION:Compared with the CD90- cels, the expressions of CD44, CD133, ALDH1, N-cad and Vimentine were significantly higher in the CD90+cels (P < 0.05), but the expression of E-cad was significantly decreased in the CD90+ cels (P < 0.05). Tumor formation rates of CD90- and CD90+ cels were increased significantly with the increase of seeded cel number, which was more obvious in CD90+ cels. The number of transmembrane cels, the number of cel clones and the number of suspended spheres were significantly higher in the CD90+ cels than the CD90- cels (P < 0.05). Experimental findings from this study show that CD90+ cels highly express epithelial to mesenchymal transition-related genes and stem cel-related genes, with higher invasion, proliferation and differentiation, in vivo tumorigenicity and potential of stem cels. CD90+ cel separation may be a new method to separate ovarian cancer stem cels.