Objective To observe the efficacy and safety of tirofiban combined with lowmolecular-weight heparin in treatment of acute coronary syndrome.Methods 138 patients with acute coronary syndrome were divided into two groups(observation group and control group).In observation group,80 cases were treated with tirofiban combined with low-molecular-weight heparin on the basis of conventional therapy.In control group,58 cases were treated with low-molecularweight heparin on the basis of conventional therapy.The efficacy and safety were compared between the two groups.Results The total efficacy was higher in observation group than in control group (x2=8.589,P＜ 0.01).The improvement of 24 h anginal attacks,decrease in values of ECG ST segment and cardiac troponin T value were better in observation group than in control group(all P＜ 0.05).The blood platelet count and adverse reactions were not different between the two groups(t=0.294,x2 =0.747,both P ＞ 0.05).Conclusions Tirofiban combined with low-molecular-weight heparin is effective and safe in the treatment of acute coronary syndrome.It can increase the clinical effect,improve clinical symptoms and signs in the patients,and is worthy of clinical application.

Objective To investigate the influence of albumin on the expression of angiotensin-eonverting enzyme (ACE) in cultured human proximal tubular ceils (HK-2). Methods HK-2 cells were exposed to 2.5, 5, 10 g/L bovine serum albumin (BSA) for 6 h and 12 h respectively. The expression of ACE in HK-2 cells was detected by real-time RT-PCR and Western blot. Results Compared to the control group, the expression of HK-2 cells ACE mRNA treated for 12 h with different concentrations of BSA (2.5, 5, 10 g/L) significantly increased (P

Objective To investigate the influence of Cordyceps polysaceharide (Cp) on epithelial-to-mesenchymal transition (EMT) induced by transforming growth factor-β1 (TGF-β1)in proximal tubular epithelial cells (PTEC). Methods HK-2 cell proliferation was determined by MTT assay. After incubation of HK2 cells with increasing concentrations of TGF-β1 (0, 0.1, 0.5, 1, 5, 10 μg/L) at 48 h and with TGF-β1 (5 μ/L) at different time points, E-cadherin, α-SMA, FN expression at transcriptional and protein levels were detected by real-time PCR and Western blotting respectively. The cells were pretreated with 1,5, 10 g/L Cp respectively for 24 h before adding TGF-β1 (5μg/L), then the cells were incubated for additional 48 h, mRNA and proteinexpression of above 3 cytokines was examined by real-time PCR and Western blotting as well. Results CP alone (0.01, 0.1, 1,5, 10 g/L) induced HK-2 cell proliferation in a dose-dependent manner. TGF-β1 enhanced α-SMA, FN expression while inhibited E-cedherin expression at both transcriptional and" protein level in HK-2 cell. At transcriptional level, compared to single TGF-β1 (5 μg/L) stimulating group, after Cp (1,5, 10 g/L) pretreatment for 24 h, the inhibition rate of a-SMA mRNA was 37.98%, 68.08% and 84.36%, respectively; FN mRNA was 46.97%, 63.82% and 81.85%, respectively; E-cadherin was up-regulated by 0.67 fold, 2.69 folds and 5.43 folds, respectively (P＜0.05). At protein level, the inhibition rate of α-SMA was 33.40%, 47.75% and 68.50%, respectively; FN was 16.26%, 65.92% and 80.30%, respectively; E-cadherin was up-regulated by 1.33 folds, 3.19 folds and 4.29 folds, respectively (all P＜0.05). Under Light microscopy, the Cp reversed cell shape from spindle-shape induced by TGF-β1 to nearly normal shape. Conclusion Cp may exert its inhibitive effects on TGF-β1-induced EMT.

Objective To study the efficacy of tirofiban coronary injection combined with atorvastatin in the treatment of patients with acute coronary syndrome (ACS) and arrhythmia. Methods Ninety-two patients with ACS and arrhythmia admitted to Yiwu Central Hospital from January 2017 to May 2018 were enrolled, and they were divided into a control group and a study group by reference to random number table method, with 46 cases in each group. The patients in the control group received routine treatment; the patients in the study group were treated with tirofiban coronary injection combined with atorvastatin on the basis of the treatment in the control group. The changes of myocardial injury markers, blood lipid levels, inflammatory factors, apoptosis indicators and incidence of adverse reactions were observed before and after treatment in the two groups. Results After treatment the levels of serum cardiac troponin T (cTnT), creatine kinase (CK), CK isoenzyme (CK-MB), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP) and C-myc were significantly lower than those before treatment in the two groups, and all the levels in the study group were lower than those in the control group [cTnT (mg/L):1.5±0.5 vs. 3.2±1.0, CK (U/L): 158.6±17.2 vs. 224.1±20.3, CK-MB (U/L): 30.5±11.4 vs. 44.3±9.7, TC (mmol/L):5.0±0.8 vs. 5.6±0.5, LDL-C (mmol/L): 2.0±1.0 vs. 2.7±1.3, IL-6 (mg/L): 86.5±15.2 vs. 131.4±16.3, hs-CRP (mg/L): 4.7±3.3 vs. 7.3±3.6, C-myc: (18.2±8.1)% vs. (23.4±10.3)%], and all the above differences were statistically significant (all P < 0.05). After treatment, the levels of Bcl-2 in the two groups were significantly higher than those before treatment, and the level in the study group was obviously higher than that of the control group [(78.4±12.2)% vs. (69.3±9.7)%, P < 0.05]. The adverse reactions were found in 6 patients in each group, and the incidence of adverse reactions was the same in the two groups [13.0% (6/46) vs. 13.0% (6/46), P > 0.05]. Conclusions Tirofiban coronary injection combined with atorvastatin is markedly effective in the treatment of patients with ACS and arrhythmia, as it can reduce myocardial cell damage, regulate blood lipid levels, inhibit inflammatory response and antagonize cardiomyocyte apoptosis.

BACKGROUND:Calcaneus is a kind of irregular bone, with complicated three-dimensional structure. Calcaneus is often measured with X-ray plain film, while spiral CT three-dimensional imaging is a potent technology for anatomic measurement and has good application prospect. However, little is known about it. OBJECTIVE:To measure calcaneal anatomic data in Chinese peoples with spiral CT three-dimensional reconstruction and to explore its clinical significance.
METHODS:Calcaneal spiral CT three-dimensional reconstruction in 100 Chinese adults (including 50 males and 50 females) were performed. The length, width, height of calcaneus, and Bohler’s and Gissane’s angles were measured after reconstruction, and compared with the data of westerners.
RESULTS AND CONCLUSION:The mean length, width and height of the Chinese calcaneus were respectively (74.60±5.06) mm, (29.71±2.93) mm and (45.23±4.46) mm in male group, and (71.48±5.36) mm, (26.65±3.01) mm and (42.23±4.49) mm in female group. There were no significant differences between male group and female group in al the above parameters (P>0.05). There was no significant difference in the Gissane’s angle between the two groups (123.3±8.5° versus 122.7±8.9°;P>0.05). The Bohler’s angle in male group (35.98±4.34)° was significantly lower than that in female group (38.81±4.43)° (P<0.05). The length, width and height of Chinese calcaneus were significantly lower than those of westerners (P<0.05). The Bohler’s angle and Gissane’s angle in Chinese adults showed no statistical significance compared with the westerners (P>0.05). Experimental findings indicate that, the length, width and height of Chinese calcaneus in female were lower than that in male, but Bohler’s angle is significantly higher than that in male, there was no significant difference in Gissane’s angle between males and females. Compared with the data of westerners, the length, width and height of Chinese adult calcaneus are significantly decreased, and no difference is found in Bohler’s angle and Gissane’s angle.

Objective: The expression of WNT5A is associated with aggressive tumor biology and poor clinical outcomes of various types of cancer. However, its function in the cell migration of small cell lung cancer (SCLC) should be elucidated. Methods:The expres-sion of WNT5A in SCLC and normal lung tissues was detected by immunohistochemisty. The correlation between the expression and clinical characteristics of WNT5A was analyzed. The function of WNT5A in regulating cell migration was studied in DMS153 cell line in vitro. Small interfering RNA (SiRNA) was used to knock down WNT5A. Wound healing and Transwell tests were used to determine the migration rate of DMS153. The phosphorylated JNK expression was detected by Western blot analysis. Results:The WNT5A expression was higher in SCLC tissues than that of normal lung tissues. WNT5A was correlated with clinical stages, lymph nodes, and distance me-tastasis in SCLC. The high expression of WNT5A was accompanied by abnormal levels of NSE and Pro-GRP. The WNT5A phosphoryla-tion of JNK promoted cell migration in vitro. Conclusion:The expression of WNT5A in SCLC is high and correlated with tumor metasta-sis. The influence of WNT5A/JNK on the cell migration property of DMS153 supports the concept that WNT5A can initiate the cell mi-gration of SCLC, which suggested that WNT5A may be a marker and can be potentially used as an effective therapeutic target for the SCLC metastasis.

BACKGROUND:Crowe type-IV developmental dysplasia of the hip presented complete dislocation of the femoral head, significantly shortening lower limb, serious adverse development of upper segment of acetabulum and femur, and even deformity. At present, there are no reports concerning its therapeutic strategy.
OBJECTIVE:To explore the therapeutic strategy of adult bilateral Crowe type-IV developmental dysplasia of the hip.
METHODA total of 12 cases of adult bilateral Crowe type-IV developmental dysplasia of the hip, who were treated in the Department of Orthopedics, The First People’s Hospital of Changzhou from January 2000 to January 2013, were col ected. There were 5 males and 7 females, at the age of 19-47 years old, averagely 33.5 years old. After two or three weeks of skeletal traction, they received bilateral total hip arthroplasty. Hip rotation center was reconstituted at the level of the“true”acetabulum. The subtrochanteric osteotomy was performed for patients with reduction difficulty. For patients with femoral neck anteversion>40°, subtrochanteric rotary osteotomy was performed.
RESULTS AND CONCLUSION:Disappearance of hip pain, satisfied move function and normal gait were gained after operation. Lower limbs recovered to be isometric. The average leg lengthening was 3.1 cm (range, 2.5 to 4.8 cm). One patient affected sciatic nerve irritation. The average fol owed-up time was 3.5 years. No fracture, dislocation or loosening of the prosthesis appeared. The post-operative Harris Hip Score averaged 86.3. By reconstruction of the hip rotation center in the“true”acetabular level, correction of femoral neck anteversion, reconstruction of function of the abduction muscle and proper selection of prosthesis, total hip arthroplasty for adult bilateral Crowe type-IV developmental dysplasia of the hip could obtain good curative effects.

Objective:To explore the feasibility and safety of CT-guided hookwire localization of small lung nodule in video-as-sisted thoracic surgery. Methods: Preoperative localization of small lung nodule was performed using the CT-guided hookwire tech-nique, followed by video-assisted thoracic surgery in the wedge resection. The next mode of operation depends on the results of frozen biopsy. Results:Preoperative localization with CT-guided hookwire was performed in 34 patients between February 2012 and March 2014. The diameter of lung nodule ranged from 5 mm to 22 mm. CT-guided hookwire localization was successful in all patients, with a median positioning time of 23 min. Puncture needles were detached from two of the total patients during the surgery, and three other pa-tients showed pneumothorax by CT scan after localization. Conclusion:Preoperative hookwire localization of small lung nodule is an accurate and safe approach to improve the rate of wedge resection in video-assisted thoracic surgery.

Objective To compare the curative effect of open and minimally invasive treatment of acute closed achilles tendon rupture with 5 years followed-up study.Methods From September,2010 to January,2012,28 patients with acute closed Achilles tendon rupture in our hospital were followed up for 5 years.There were 21 males and 7 females.Minimally invasive percutaneous suture in 11 cases;open suture in the treatment of 17 cases.The patients were followed up at 6 months,1 year,2 years,3 years,4 years,and 5 years after AOFAS and ATRS score.Results The follow-up time ranged from 60 to 72 months.All incisions healed by first intention and no incision related complications occurred.2 groups of patients with ATRS score at 6 months after operation:the open group was 81.23±3.99,minimally invasive percutaneous group of 88.27±4.27,the difference between the two groups was statistically significantly.After 1 year,there was no significant difference in the scores between the two groups.Two groups of patients with AOFAS score at 6 months after operation:the open group was 69.00±6.23,minimally invasive percutaneous group of 79.27±4.83,the difference between the two groups was statistically significantly.At one year after operation,the open group was 85.53±3.38,and the minimally invasive group was more than 89.90±3.38.The difference between the two groups was statistically significantly.After 2 years,there was no significant difference in the scores between the two groups.Conclusion There is no significant difference between the 2 years after surgery in the treatment of acute closed Achilles tendon rupture or open surger.

Objective To investigate the feasibility of computer-aided pancreas segmentation based on three-dimensional (3D) Dixon MRI at 3.0-T.Methods Five volunteers with health pancreas underwent upper abdominal 3D Dixon MRI at 3.0T with the same scan parameters while holding breath.The automatic segmentation of pancreas is based on the Medical Imaging Interaction ToolKit (MITK) with homemade software.A experienced radiologist performed manual segmentation and computer aided segmentation of the pancreas on the opposed phase and water phase images twice.Similarity was analyzed and compared for the manual and automated segmentations for the two group images.Similarity was presented as Dice coefficients.Results Both of the oppose phase and water phase images of Dixon MRI showed that the signal intensity of pancreas was higher than that of the surrounding tissue,the similarity of water phase was obviously higher than that of oppose phase and the differences were statistically significant.Based on Dixon MRI water phase and oppose phase images,the mean dice coefficients for the manual segmentations were 0.81 ± 0.01 and 0.85 ±0.03,respectively,for both the oppose phase and water phase images (P=0.013).For the automated segmentations,the dice coefficients were 0.69 ± 0.08 and 0.75 ± 0.03 for water phase images and the oppose images,respectively,and the difference was not statistically significant (P =0.155).Conclusions 3.0T oppose phase and water phase of Dixon images could clearly show the pancreas,and automated pancreas segmentation based on water phase Dixon MRI obtained higher similarity,which was feasible.