Objective To explore the methods to reduce the occlusion of perforating arteries after intracranial stenting of the vertebral artery. Methods Clinical data of 32 cases of Gateway-Wingspan stent implantation for intracranial branch of vertebral artery were retrospectively analyzed. The postoperative stricture and perfusion improvement situation were evaluated, the reason of perforating artery occlusion was analyzed. Results Thirty-two patients were implanted with 33 pieces of Wingspan stent and 1 piece of Apollo bracket. The operation success rate were 100%, and the stenosis rate reduced from (76.6±6.1)%to (27.9±5.2)%. After three months, the transcranial doppler sonography (TCD) and CT angiography were checked, showing no in-stent restenosis in all patients. Two patients occurred the perforating artery occlusion within 24 hours after operation. The possible reason was the change of stability of atherosclerotic plaque at the stenosis and the plaque displacement caused by the mechanical action of the balloon or stent, which may lead to medulla oblongata artery block. After drug and rehabilitation treatment, the symptoms in patients were improved significantly. Conclusion The perforating artery occlusion after stent implantation in intracranial branch of vertebral artery can be prevented by strict evaluation and preoperative preparation, the right selection of intraoperative balloon and stent, which still needs larger sample data to prove.

Objective:To study the treatment effect of zoledronic acid and letrozole on life quality of postmenopausal women with breast cancer operation. Methods:Totally 26 patients were in the control group,and given letrozole,and 23 patients were in the treat-ment group with zoledronic and letrozole. The patients in the two groups were assessed bone mineral density ( BMD) of hip and lumbar vertebrate before the treatment and the 6th and 12th month after the treatment. BALP, CTX, VAS, FACT-B and adverse reactions were also assessed at the 6th and 12th month after the treatment. Results:Improvement of BMD and FACT-B in the treatment group was sig-nificantly better than that in the control group. BALP, CTX and VAS in the treatment group were all decreased more significantly than those in the control group (P<0. 05 or P<0. 01). There was no significant difference in the metastasis between the two groups (P>0. 05). Conclusion:By preventing bone loss and increasing BMD, the combination of zoledronic acid and letrozole can effectively im-prove the life quality of postmenopausal women with breast cancer operation.

ObjectiveTo elucidate the clinical characteristics and the outcome of SARS in elderly pat ients. Methods Clinical data of 66 elderly patients(≥60 years) with SARS were analysed and compared with that of 238 younger adult SARS patients(18-59 years) in the sa me period. Results Sixty-six out of 304 patients(21 7%) with SARS were more than 60 years. Th e mortality rate of SARS in elderly patients was 22 7%. Underlying disease,lon ger course of disease,dyspneic respiration,severe type of SARS,and higher mor tality were more prevalent in elderly patients than those in the younger adult S ARS patients(P

Objective To study the expression of PIM-1 in prostate cancer (PCa) and its clinical significance. Methods Reverse transcription polymerase chain reaction ( RT-PCR) analysis was used to determine the expression level of PIM-1 mRNA in 2 cases of benign prostatic hyperplasia ( BPH) samples and 5 cases of PCa samples, and immunohistochemical analysis was used to investigate PIM-1 protein expression in 20 cases of BPH, 20 cases of high grade-prostatic intraepithelial neoplasia ( HGPIN) and 42 cases of PCa tissues. The immunohistochemical staining intensity was scored as negative, weak, moderate and strong positive. Results The expression level of PIM-1 mRNA in 5 cases of PCa was 0. 63 , 0. 55 , 0. 42, 0. 91 and 0. 76 ; the level in 2 cases of BPH was 0. 26 and 0. 27 , respectively. The negative rates of expression of PIM-1 protein in BPH, HGPIN and PCa tissues were 60% ( 12/20) , 20% (4/20) and 2% (1/42) ,the weak positive rates of the expression were 40% (8/12) , 20% (4/20) and 12% (5/42) , while the moderate to strong positive rates of the expression of PIM-1 protein was 0 (0/20) , 60% ( 12/20) and 86% (36/42) , respectively. Immunohistochemical analysis showed PIM-1 protein expression in PCa was higher than those in HGPIN and BPH(all P

Objectives To investigate the methods of protecting external branch of the superior laryngeal nerve (EBSLN)in carotid endarterectomy and to observe the effect of using these methods in clinical surgery. Methods EBSLN (20 sides)of 10 heads of corpse were studied by using microanatomy from January 2013 to December 2013. The occurrence probability of EBSLN on the lower edge of posterior belly of digastric muscle,medial edge of external carotid artery and upper edge of superior thyroid artery in anatomy triangle was analyzed. The distances from the midpoint of the EBSLN to carotid bifurcation, mandibular angle and mastoid tip were measured. Sixty-five patients with carotid endarterectomy in Tianjin Huanhu Hospital from December 2013 to November 2014 were treated with the protective methods of the relevant EBSLN by using anatomy triangle as a mark. Whether the patients had injury symptoms of EBSLN were followed up after procedure. Results (1)The occurrence probability of 20-side EBSLN in anatomy triangle was 95%(19 sides). The midpoint of EBSLN in the anatomy triangle at the posterior mandibular angle was median 0. 34 (-1. 62 to 2. 43)cm,at the inferior mandibular angle was 1. 28 (-1. 33 to 3. 42) cm,at anterior mastoid tip was 2. 84 (0. 51 to 5. 14)cm,at inferior was 4. 51 (2. 82 to 6. 39)cm,and at anterior superior of the carotid bifurcation was 1. 64 (0. 57 to 3. 78)cm. (2)65 patients who underwent carotid endarterectomy used the protective methods of intraoperative EBSLN. There was no manifestation of EBSLN injury at 3 weeks to 9 months after procedure. Conclusion In carotid endarterectomy,taking an anatomic triangle as a symbol,it is no more than 2 cm of the anterior superior of carotid bifurcation during the separation process. As for the patients with higher or lower position of carotid bifurcation,in the range of crossing rear mandibular angle 0. 50 cm or below the mastoid tip 4. 50 cm for arterial separation should be avoided,and this can effectively protect EBSLN.

Objective To analyze the high risk factors of blood infection in Chinese citizens' organ donation,provide the basic evidence for early protection,increase the success rate of donor distribution,and expand the Chinese organ donation pool.Methods A retrospective study was performed on 70 cases of donation recruited during October 2014 to January 2016.The incidence of blood infection in these donors was analyzed.The univariate analysis and multivariate logistic regression analysis were used to find out the high risk factors influencing the donor blood infection.Finally,the donor blood infection assessment model and the receiver operating characteristic (ROC) curve were established to assess the sensitivity and specificity.Results The overall infection rate was 64.3％ (45/70).The pulmonary,blood,and urinary tract infection rate was 42.9％,31.4％ and 1.4％ respectively.The total length of hospital stay (＞10 days) (P =0.017),oxygenation index (＜ 233.5 ± 107.0) (P =0.046),aspartate aminotransferase (＞196.9 ± 329.1 U/L) (P =0.044),and valley alanine aminotransferase (＞95.0 ± 78.1 U/L) (P =0.026) were four risk factors for predicting the donor blood infection.The multivariate logistic regression analysis revealed that the total length of stay ＞10 days along with the donors' oxygenation index (＜233.5 ± 107.0) was independent risk factor for predicting the blood infection.The donor blood infection model was:0.193 + 1.753 hospital stay (＞10 days)-0.007 oxygenation index.The sensitivity and specificity were 0.682 and 0.75 (P ＜0.001) respectively.Conclusion For a long-term stay in ICU,the rate of blood infection for donors was much higher,at this time,the most effective antibiotics should be chosen.Besides,improving donor oxygenation index and liver function can reduce the incidence of infection.

Objective To investigate whether myeloid-derived suppressor cells (MDSCs) have a protective effect in septic mice. Methods The model of caecal ligation and puncture (CLP) was performed to induce polymicrobial sepsis in mice. The changes of MDSCs in spleens at different times after operation were studied. In order to observe the influence of MDSCs on the inflammatory factors and survival of septic mice, MDSCs were injected into the peritoneal cavities of mice after CLP. Results MDSCs accumulated in spleens of septic mice progressively. MDSCs could increase anti-inflammatory cytokine production, decrease the level of inflammatory factors, and improve the survival rate of mice with sepsis. Conclusion MDSCs can attenuate the inflammation and improve the survival rate of mice with sepsis, suggesting that intraperitoneal injection of MDSCs may provide a new direction for the treatment of sepsis.

Objective To observe the effect of Bingdouting capsule(BC)on rabbit model of sick sinus syndrome.Methods Rabbit models of sick sinus syndrome were established by external application of 20 % methanal on the region of sinoatrial node.The effect of BC on heart rate and electrophysicological parameters of sinoatrial node was observed.Results BC markedly increased the heart rate,shortened the sinoatrial conduction time(SACT)and corrected sinoatrial node recovery time(CSNRT).Conclusion BC has an obvious effect for the treatment of sick sinus syndrome in rabbits.

Objective To determine whether pulmonary arterial hypertension(PAH) and pulmonary venous hypertension (PVH) can be differentiated noninvasively by echocardiography. Methods Fifty-six patients with pulmonary arterial systolic pressure(PASP) ≥40 mmHg by echocardiography were involved,and cardiac catheterization performed within 7 days of each other. Based on left ventricular end-diastolic pressure or pulmonary capillary wedge pressure(PCWP) ,30 patients were classified as PAH group and 26 patients as PVH group. The early(E) and late(A) diastolic mitral inflow velocities,E/A ratios,deceleration time(DT),early dastlic mitrial annular velocity(E') and E/E' ratios were measured by conventional and Doppler tissue imaging echocardiography in the two groups. Results Compared with PVH group,the PAH group had significantly higher A,DT,PASP and E',and significantly lower E,E/A ratio and E/E' ratio (P < 0. 01 or P <0. 001). E/E' and E/A ratio was optimal indexes for differentiation of PAH and PVH,the area under receiver operating characteristic curve was 97% and 91 %, respectively. Optimal cutoff for diagnosing PVH was E/E'>9.2 (sensitivity 95%, specificity 97%) and E/A> 1. 7 (sensitivity 75%,specificity 92%). Conclusions PAH and PVH imaging can be reliably differentiated by echocardiography.

Objective To investigate the relationship between the sensitivity of gastric cancer cells to arsenic trioxide（As2O3）and the level of reactive oxygen species（ROS）production.Methods The viability of gastric cancer cell lines MGC803,BGC823 and SGC7901 treated with As2O3 was determined by MTT assay.ROS levels of the gastric cancer cells before and after the treatment of As2O3 were detected by flow cytometry.Results Cell growth was significantly inhibited by As2O3 in time-and dose-dependent manner in three gastric cancer cell lines.The IC50（72 h）of As2O3 for MGC803,BGC823 and SGC7901 was about 2.8,3.1 and 10.2 μmol/L,respectively.IC50（72 h）of MGC803 and BGC823 was lower than that of SGC7901（P 0.01）,gastric cancer cell line SGC7901 was less sensitive than the others.The inherent ROS level of MGC803,BGC823 and SGC7901 was 20.3±2.0,64.2±3.3 and 57.7±2.0.After treatment with As2O3 5 μmol/L for 24 h,the peak level of ROS in MGC803 and BGC823 cells increased to 100.8±3.8 and 103.5±2.3,compared with inherent ROS level,the difference had statistical significance（P 0.001,P 0.01）,but the inherent ROS level in SGC7901 cells was 56.5±2.4（P 0.05）.Conclusion The sensitivity of gastric cancer cells to arsenic trioxide is associated with the increase of reactive oxygen species level.