Objective To discuss the relationship between c-reactive protein and prognosis of acute coronary syndrome.Methods C-reactive protein of 60 acute coronary syndrome aged patients was evaluated.The patients were divided into two groups:one group with higher CRP level and another group with normal CRP level.The following-up duration was 6 months.After correct therapy,the morbidity of re-angina,arrbythmia,heart failure,re-infarction and cardiac death was compared.Results The morbidity of re-angina,arrhythmia,heart failure,re-infarction,cardiac death was 46.3%(19/41),43.9%(18/41),9.8%(4/41),22.0%(9/41),7.3%(3/41)respectively in higher Clip levd group;The morbidity of re-angina,arrhythmia,heart failure,re-infarction was 15.8%(3/19),10.5%(2/19),5.3%(1/19),5.3%(1/19)respectively in normal CRP group and there was no cardiac death accident.There was significant difference between the two groups.Conclusion CRP plays an important role in the onset of acute coronary syndrome,and its level is related with the higher morbidity of re-angina,arrbythmia,heart failure,re-infarction and cardiac death.

Objective To quantitatively assess renal hemodynamic changes in hypertensive acute kidney injury in rabbits induced by L-NAME using 64-slice spiral CT functional imaging techniques,and to explore the application of these techniques in evaluation of early kidney functional changes.Methods Fourteen female New Zealand white rabbits were randomly divided into normal control group (n=6)and L-NAME group (n=8).The control group was injected NaCl solution and the L-NAME group was injected the same amount of L-NAME solution to make hypertensive acute kidney injury model.64-slice spiral CT and SPECT were scanned af-ter injection.Blood samples were collected before and after injecting NaCl and L-NAME solution to detect serum creatinine (Cr).Cr level and CT perfusion parameters of the two groups were analyzed and compared with the pathology results.GFRCT detected by con-trast-enhanced CT and GFRSPECT detected by SPECT were analyzed by the rank correlation test.Results Renal blood volume,blood flow,permeability surface,time to peak,and peak value had statistically significant differences between the control and L-NAME group (P <0.05).GFRCT and GFRSPECT had obvious correlation.GFRCT of L-NAME group was obviously lower than that of the con-trol group.The kidneys of L-NAME group showed obviously injured under both light microscope and microscope.Conclusion 64-slice spiral CT functional imaging techniques can dynamically observe and quantitatively assess early hypertensive kidney dysfunc-tion,especially unilateral renal blood flow abnormalities.It is an effective examination in quantitatively assessing kidney function.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) on quantitative analysis of re?nal cortex perfusion in hypertensive rabbits model. Methods Hypertensive rabbit modal (n=10) were established by inject?ing N-nitro-L-arginin methylester (L-NAME). CEUS and Cystatin C (CysC) serum level analysis were performed at differ?ent time points:before and the 2nd, 4th, 6th and 8th week after injecting L-NAME. Time-intensity curve and area under curve (AUC) were analyzed quantatively while correlation of AUC and CysC were also analyzed. Results Serum level of Cys C in?creased significantly at the 6th week after L-NAME administration which is earlier than the increase of serum levels of Scr and BUN. AUC decreased at first then increased after L-NAME administration. Upon addition of L-NAME, rise time (RT) and peak intensity (PI) decreased while mean transit time (MTT), time from peak to one half (HPT) and time to peak (TTP) in?creased. Our study confirmed a positive correlation between AUC and Cys C (r=0.950, P<0.001). Conclusion Setting up rabbits model by L-NAME is convenient and reproducible, which is an useful tool in experimental study of preclinical and clinical phase of hypertensive renal injury. CEUS combining with CysC serum level analysis is considered as an effective technology for evaluating renal function in hypertensive patients.

Objective To evaluate the value of multi-slice spiral computed tomography (MSCT) in diagnosing postoperative intestinal obstruction of rectal cancer.Methods The CT imaging results and clinical manifestation of 50 patients with postoperative intestinal obstruction of rectal cancer confirmed by pathology were reviewed retrospectively.These cases including Miles (24 cases),Dixon (18 cases),Hartmann(8 cases) procedure were collected from Tianjin People's Hospital from 2011 to 2013.Conservative management was done in 10 cases and the remaining 40 patient underwent surgical intervention.Statistical difference between the three kinds of surgical causes of intestinal obstruction was analysed by x2 test.Results Most common cause after Miles and Hartmann postoperative intestinal obstruction was of adhesion,while anastomotic stenosis was the most common reason of intestinal obstruction after Dixon procedure.The difference of incidence of intestinal obstruction caused by hernia and anastomotic stenosis between the three kinds of operation method was statistically significant (x2 =5.382、20.486,P ＜ 0.05).Conclusions MSCT could identify the etiology and site of postoperative intestinal obstruction of rectal cancer,providing favorable imaging evidence for clinical treatment.

Objective To present the experience of laparoscopic extraperitoneal radical prostatectomy and evaluate its safety and efficacy. Methods A total of 91 patients diagnosed with localized prostate carcinoma were admitted from February 2003 to June 2008. The level of serum PSA ranged from 7. 5 - 47. 0 ng/ml(mean 14. 0 ng/ml). The volume of the prostate ranged from 35 - 75 ml(mean 52 ml). Biopsy was performed before the operation and the pathological results revealed prostate carcinoma with Gleason score no more than 8. CT, MR and ECT revealed there was no lymph node or seminal vesicle involvement and there was no bone metastasis. The procedures were performed with an-tegrade techniques and pelvic lymphadenectomies were performed in 32 cases and nerve-sparings were performed in 11 cases. Results The operation duration ranged from 105 - 270 min (mean 173 min). Intraoperative blood loss was 110 - 1200 ml(mean 315 ml). Incontinence occurred in 19 cases in early stage and 18 cases recovered within 3 months. Positive surgical margin occurred in 11 cases. There was no complication of urethra stricture during 3 - 30 months' follow-up. No lymph node was involved in 32 cases with pelvic lymphadectomy. Five of the 11 cases received nerve-sparing prostatectomy had normal erectile function during the follow-up. Conclusions Laparoscopic extraperitoneal radical prostatectomy is a safe, effective and efficient surgical procedure with the minimal invasion, less morbidity and rapid recovery. Laparoscopic radical prostatectomy is emerging as an alternative to open radical prostatectomy.

Objective　To evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy.　Methods　A total of 285 patients received the operation with mean age of 67 years (50-76 years) from January 2008 to April 2012.Mean level of PSA was 15.7 μg/L (1.8 -50.0 μg/L),and mean prostatic volume was 44 ml (26 -74 ml). No lymph node or seminal vesicle involvement was found by CT or MR and radionuclide bone scan revealed no metastasis.271 cases were confirmed diagnosis by prostatic biopsy and 14 were detected through pathological studies of TURP specimens.Gleason score ranged from 6 to 8.14 cases were in clinical stage T1b,29 cases in T1c,214 cases in T2 and 28 cases in T3a.Transperitoneal approach and modified technique involving bladder neck dissection,nervesparing technique and vesicoureteral anastomosis were applied on patients.　Results　Mean operative time was 105 min (55 -150 min).Mean intraoperative estimated blood loss was 240 ml (50-800 ml).Rectal injures occurred in 2 cases and were repaired under laparoscopy.Drainage tube and urinary catheter were removed 48 -72 h and 5 -8 d postoperatively.Postoperative hospital stay was 7 d (5 - 11 d).Positive surgical margin was present in 58 patients.Mean follow-up time was 29 months (3 -50 months).Complete continence were found in 208 patients immediately after catheter removal.68 patient recovered continence within 3 months and 9 patients remained incontinence 3 months after surgery. Normal erection presented in 42 of the 57 cases with nerve-sparing.　Conclusions　Transperitoneal laparoscopic radical prostatectomy is safe and efficient.Higher efficiency and lower complication rate have been achieved through modified laparoscopic technique involving bladder neck dissection,nerve-sparing technique and vesicoureteral anastomosis.

Objective To report the modified liver mobilization technique in management of renal cell carcinoma with intrahepatic inferior vena cava thrombus. Methods 10 cases (7 men and 3 women at the average age of 49 years) of renal cell carcinoma with intrahepatic inferior vena cavs thrombus were reviewed.The operations were carried by using father clamp to control inferior vena cava,combined with hepatic portal blocking. Results There was no postoperative complication.The average blood loss was 800 ml.The mean hospital stay was 13 days.The time of follow-up ranged from 1 to 48 months. Conclusions The technique of using father clamp to control suprahepatic inferior vena cava combined with hepatic portal blocking is feasible for the treatment of the renal cell carcinoma with intrahepatic inferior vena cava thromhosis.

OBJECTIVE: To study the effect of down-regulating miR-488 targeting Jag1 on the injury of hypoxia-reoxygenation myocardial H9c2 cells. METHODS: A hypoxic-reoxygenated myocardial H9c2 cell injury model was constructed. miR-488 inhibitor was used to transfect the cells. CCK-8 method and flow cytometry were used to detect cell proliferation and apoptosis in each group. Lactate dehydrogenase (LDH), superoxide dismutase (SOD), malonaldehyde (MDA), catalase (CAT) levels were detected. Western blotting was used to detect the expression of Bcl-2 associated X Protein (Bax) and B cell lymphoma/lewkmia-2 (Bcl-2). Target genes of miR-488 were predicted, and a luciferase reporter system was used to verify the targeting relationship between the two. Myocardial H9c2 cells were co-transfected with miR-488 inhibitor and Jag1 siRNA, and treated with hypoxia and reoxygenation, cell proliferation, apoptosis, LDH, SOD, MDA, CAT levels, and Bax, Bcl-2 protein expression were detected. RESULTS: The expression of miR-488 in the hypoxia-reoxygenated myocardial H9c2 cells was increased, along with reduced cell proliferation, increased apoptosis, increased Bax protein expression, decreased Bcl-2 protein expression, increased MDA, decreased CAT and SOD, and increased LDH level in the supernatant of cell culture. When myocardial H9c2 cells were transfected with miR-488 inhibitor and treated with hypoxia and reoxygenation, the expression of miR-488 was decreased, along with increased cell proliferation, decreased apoptosis, decreased Bax protein expression, increased Bcl-2 protein expression, decreased MDA, increased CAT and SOD, and decreased LDH level in the supernatant of cell culture. Down-regulation of miR-488 could target and down-regulate Jag1 expression. And Jag1 siRNA could reverse the effect of miR-488 inhibitor on the proliferation, apoptosis, LDH, SOD, MDA, CAT levels and the expression of Bax and Bcl-2 of hypoxic-reoxygenated myocardial H9c2 cells. CONCLUSION Down-regulating miR-488 targeted Jag1 can attenuate hypoxia-reoxygenation induced myocardial H9c2 cell injury.
Apoptosis/genetics* ; Down-Regulation ; Humans ; Hypoxia/genetics* ; Jagged-1 Protein/genetics* ; MicroRNAs/genetics* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac

Objective To explore the perioperative nursing of holmium laser enucleation of the prostate (HoLEP).Methods 45 patients with benign prostatic hyperplasia (BPH)and blad-der outlet obstruction (BOO)underwent holmium laser enucleation of the prostate.The nursing focused on psychological care and preoperative preparation,monitoring postoperative vital signs, the bladder flush unobstructed,preventing of lower limb venous thrombosis,telling patients drink water early according to the bowel sounds,postoperative health guidance and discharge guidance. Results 45 patients who underwent HoLEP had no complications,less postoperative bleeding and discharged from hospital successfully.Conclusion Preoperative psychological nursing for patients with hyperplasia of prostate,preoperative preparation,assisting postoperative bed,monitoring vi-tal signs,guaranteeing the bladder flush unobstructed,taking nursing measures to prevent the vein thrombosis of lower limbs according to DVT score,and skin care,postoperative rehabilitation exer-cise,health guidance and discharge guidance ensure the recovery and discharge from hospital.So it is worthy of promotion.

Objective To explore the perioperative nursing of holmium laser enucleation of the prostate (HoLEP).Methods 45 patients with benign prostatic hyperplasia (BPH)and blad-der outlet obstruction (BOO)underwent holmium laser enucleation of the prostate.The nursing focused on psychological care and preoperative preparation,monitoring postoperative vital signs, the bladder flush unobstructed,preventing of lower limb venous thrombosis,telling patients drink water early according to the bowel sounds,postoperative health guidance and discharge guidance. Results 45 patients who underwent HoLEP had no complications,less postoperative bleeding and discharged from hospital successfully.Conclusion Preoperative psychological nursing for patients with hyperplasia of prostate,preoperative preparation,assisting postoperative bed,monitoring vi-tal signs,guaranteeing the bladder flush unobstructed,taking nursing measures to prevent the vein thrombosis of lower limbs according to DVT score,and skin care,postoperative rehabilitation exer-cise,health guidance and discharge guidance ensure the recovery and discharge from hospital.So it is worthy of promotion.