BACKGROUND: The inflammatory reaction occurs following implantation of cardiovascular stent with manifestations of the activation of blood coagulation system and dramatically increasing of inflammatory markers serum C-reactive protein. OBJECTIVE: To explore the changes of inflammatory reaction and C-reactive protein in coronary artery disease patients following cardiovascular stent implantation.METHODS: A computer-based online search of CNKI (1990/2009) and PubMed databases (1990/2009) was performed for related articles with the key words "cardiovascular stent, C-reactive protein" in Chinese and "cardiovascular stent on plasma, C-reactive protein" in English.RESULTS AND CONCLUSION: Based on the metal stents, drug-eluting stents can transfer the active drugs to the damaged vessels, release them into the vascular wall and inhibit the in-stent restenosis, Main drugs of anti-inflammatory drug-eluting stent include dexamethasone and methylprednisolone. Main drugs of anti-migratory and anti-proliferative drug-eluting stent includerapamycin, paclitaxel and actinomycin D. Main drugs of supporting intima concrescence stent include estradiol. Coronary artery stents implantation can induce and aggravate local inflammation reaction, which have important infection for vascular endodermis hyperplasia and restenosis occurrence. Some impressible index for inflammation reaction, such as levels of C-reactive protein,have predictive value for vascular events following the coronary artery stents implantation. A significant increase in plasma C-reactive protein after coronary stenting has been observed following stent implantation. Therefore, understanding of inflammatory reaction and C-reactive protein, as well as cytokine changes is important for preventing restenosis, early treatment of restenosis, as well as improving treatment effect.

Anticoagulants ; therapeutic use ; Humans ; Venous Thrombosis ; drug therapy

Endovascular repair has gained worldwide popularity for the treatment of aortic dissection and aortic aneurysm.The non-tapered stents are selected usually.The aortic diameters vary in different level.High incidence of distal stent-induced complications is closely related to the aortic taper angle.According to several published studies,the aortic taper angle could be evaluated by establishing geometric model.Applications of tapered stents can significantly reducing the incidence of distal stent-induced comnplications.This review summaries the latest researches in the studies of the progress and the application of the aortic taper angle and the tapered stents,providing a reference for endovascular stent-graft selecting in the treatment of aortic dissection and aortic aneurysm.

Objective To investigate the crosstalk between Wnt signaling pathway and TGF-? signaling pathway in prostate cancer cell line PC-3. Methods Luciferase report assay and RT-PCR methods were used to explore the crosstalk between two pathways. Results Wnt signaling pathway activated TGF-? responsive CAGA-luciferase reporter activity. ?-catenin(WT), TCF-4(WT), GSK3? (KM) activated while TCF-4(DN) inhibited CAGA reporter activity. ?-catenin(WT), TCF-4(WT) synergized to activate TGF-? signaling while TCF-4(DN) had converse effect.TGF-? signaling pathway activated LEF-1 luciferase activity through a Smad3-dependent manner.Smad7 activated LEF-1 luciferase activity,Smad3 and Smad4 also synergically activated LEF-1 reporter activity.?-catenin(WT),TCF-4(WT) cooperated with each other to the activity of cyclinD1 promoter luciferase while Smad3 inhibited cyclinD1 promoter activity.The inhibitory effect of Smad3 on cyclinD1 promoter could be partially reversed by co-transfecting ?-catenin(WT),TCF-4(WT).TGF-? induced the expression of VEGF in PC-3 cells and this effect was enchanced by LiCl addition. Conclusions Wnt signaling pathway and TGF-? signaling pathway can activate each other in prostate cancer cell line PC-3.Two pathways have crosstalk and this might be important for the development and progression of prostate carcinoma.

· AlM: To explore the correlation of center retinal thickness and axial length in non-proliferative diabetic retinopathy ( DR) .
· METHODS:A total of 80 cases ( 155 eyes ) of non-proliferative DR patients were divided into three groups according to the axial length, 22~24mm of 27 cases (51 eyes) were normal group, 24 ~26mm of 28 cases ( 55 eyes) were long axis group, >26mm of 25 cases ( 49 eyes) were super long axis group.The center retinal thickness and ocular axial length of three groups were measured and the correlation of center retinal thickness and axial length were analyzed.
· RESULTS:Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in normal group, with statistically significant difference ( P<0.05 ); Among the inner ring and outer ring, the center retinal thickness of upper and lower, bitamporal and nasal side of super long axis group was thicker than that in long axis group, with statistically significant difference ( P<0.05); The DR central macular of retinal thickness was no correlation of the axial length ( P >0.05 ), but retinal thickness get thinning with increased of axial length on the inner ring and outer ring area, showed a negative correlation ( rinner ring =-0.63, router ring=-0.67, P<0.05).
·CONCLUSlON:Center retinal thickness and ocular axial length in non -proliferative DR patients, and center retinal thickness of super long axis patients are thinning obviously.

Alveolitis, Extrinsic Allergic ; diagnosis ; therapy ; Humans ; Occupational Diseases ; diagnosis ; therapy

Objective To compare the therapeutic effect of endovascular repair (EVAR) and open surgical repair(OSR) of abdominal aortic aneurysm in high-risk patients. Methods The clinical data of 55 patients from 1998 to 2008 with infrarenal abdominal aortic aneurysm who received surgical treatment were analyzed by using the customized probability index. The perioperative and short term advantages and disadvantages of OSR group (n=20) were compared with EVAR group (n=35). Results All patients in OSR group were followed up, 94% patients in EVAR group were followed up, the mean follow up time were 75 and 70 months respectively. (1) Compared to OSR group, the EVAR group had shorter operation time [(3.1±0.6) h vs (4.9±0.9) h, P<0.05], (2) EVAR group had shorter ICU and hospital stay after operation and less blood loss (P<0.01), (3) Compared to OSR group, the EVAR group had lower mortality within 30 d(2.86% vs 15%), (4)the EVAR group had lower peri-operative complications(17% vs 40%), (5) The main complications of EVAR were endoleak (8.57%), (6) The main complications of OSR was cadiovascular incidence(25%). Conclusions Endovascular treatment, indicated for AAA in high-risk patients, can cut down the perioperative incidence of cadiovascular events, mortality and complications. CPI is useful to estimate the perioperative incidence of cadiovascular events, mortality and complications, and can be used to guide the therapeutic method.

Objective To evaluate effect of en bloc resection of malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina.Methods Between February 2005 and July 2010,16 patients with malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint underwent hemi-sacrectomy and functional reconstruction.The operation achieved en bloc resection of tumor with reservation of contralateral sacral foramina.There were 10 males and 6 females,aged from 17 to 70 years (average,37.9 years).There were 5 cases of chondrosarcoma,3 cases of Ewing's sarcoma,2 cases of malignant schwannoma,2 cases of osteosarcoma,1 case of malignant giant cell tumor of bone,1 case of lymphoma and 2 cases of metastatic tumor.Results The surgical time ranged from 4 to 11.5 hours (average,6.5 hours).The average blood loss was 3600 ml (range,1500 to 5500 ml).Five patients underwent type Ⅰ resection,while 11 patients underwent type Ⅱ resection.All patients were followed up for 21 to 59 months (average,34.4 months).Three months after operation,13 patients had difficulty with ankle plantar flexion,while sphincter function was more or less reserved in 16 patients.Four patients (25％)had wound healing complications,which was cured after debridement and drainage.Local recurrence occurred in 7 patients.There were 5 cases of local recurrence among 6 patients who had intralesional margin;4 recurrence lesions located in the sacrum and 1 in soft tissue.Eight patients (50.0％) survived without tumor,2 patients (12.5％)survived with tumor,and 6 patients (37.5％) died of tumor.Conclusion The en bloc resection of tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina was feasible and had better outcome compared with total sacrectomy.

Objective To evaluate the functional outcomes of different limb salvage procedures in patients with bone and soft tissue sarcomas of the shoulder girdle.Methods From July 2001 to July 2008,16 patients with limb salvage for sarcomas of shoulder girdle were respectively analyzed,including 11 males and 5 females with an average age of 38.4 years (range,17-67).Localizations of the tumors were 8 in the scapula(including 4 chondrosarcomas,1 Ewing sarcoma,and 3 metastases),5 soft tissues of the shoulder girdie(including 2 synoviosarcomas,1 fibrosarcoma,1 hemangioperieytoma,and 1 well-differentiated liposarcoma),and 3 proximal humerus (including 1 osteosarcoma and 2 metastases).Twelve patients were treated with classical Tikhoff-Linberg procedures,and 4 with improved procedures.Results The mean surgical time duration was 3 hours.The mean blood loss was 1600 ml.The mean follow-up time was 40 months.Major complications included 2 cases of delayed wound healing,and 1 ulnar nerve injury.One patient had local recurrence and died of pulmonary metastases 18 months after second operation of interscapulothoracal amputation.The patient with fibrosarcoma also died of pulmonary metastases 23 months later.One patient with synoviosarcoma was alive with pulmonary metastases in 9 months.Four of 5 patients with carcinoma metastases died during 11 to 23 months later.The 5-year cumulative survival rate was 34.6%.Functions were preserved in the whole hand and elbow.The MSTS functional score of the patients receiving classical Tikhoff-Linberg procedures was 14.7,while improved Tikhoff-Linberg procedures was 19.5.Conclusion The Tikhoff-Linberg procedure not only provides a wide resection of tumors in the shoulder girdle but also preserve the whole hand and elbow functions.The shoulder function was poor in patients receiving classical Tikhoff-Linberg procedures.

Background Treatment of corneal ulceration by transplanting drug-loaded amniotic membrane has been used widespreadly abroad,however,seldom study is found in China up to now.Objective This study was to explore the sustained release property and the efficacy of the drug-loaded amniotic membrane.Methods The bacteriostatic area of amniotic membrane fragments immersed with different concentrations (5,20,30 g/L) of levofloxacin for different time points (5,15,30,60 minutes) was evaluated by in vitro test.Bacterial corneal ulceration models were established in 20 rabbits by injected 0.7 MCF staphylococcus aureus suspension (0.1 ml) into the central corneal stroma to form the cloudy area of 4.0-6.0 mm.Then the rabbits were randomized into two groups.Regular amniotic membrane transplantation was performed laterally and 0.5％ levofloxacin drops was topically administered after operation in the amnion+levofloxacin drops group,and drug-loading amnion transplantation was used in the drug-loading amnion group.Aqueous humor of 0.1 ml was collected in 30 minutes,1 hour,2,3.5,5.5 hours after levofloxacin was administered and 1 day,3,7,10,14,21 days after operation for the detect of levofloxacin level with high-performance liquid chromatography.The corneal symptom was scored based on McNeill's criteria in 1 week,2 weeks and 4 weeks and the ulceration area was assessed under the slit lamp in the first week.The pathological examination was carried out in the fourth week after surgery.Results The mean bacteriostatic area was bigger with the increase of levofloxacin concentration,and bacteriostatic area in amnion immersed for 15 minutes was bigger than that of 5 minutes (P＜0.01).The levofloxacin concentration of aqueous humor after transplantation was decreased by extending the time,and that in 30 minutes and 5.5 hours after operation was (0.873±0.264) mg/L and (0.106±0.027) mg/L,respectively,in the amnion+levofloxacin drops group,and that in day 1,3,7 after surgery in the drug-loading amnion group was higher than at 30 minutes in the amnion+levofloxacin drops group,showing all significant differences (all P =0.00).In the first,second and fourth week after operation,the corneal symptom score was 1.7±0.6,1.3±0.5,0.2±0.4 in the drug-loading amnion group and 2.2±0.8,2.0±0.6,1.5±0.8 in the amnion+ levofloxacin drops group,with the significant differences among the different groups and time points (Fgroup =9.49,P =0.01 ;Ftime =22.96,P=0.01).The corneal ulceration area was (1.6±0.6) mm2 in the drug-loading amnion group and (3.2±0.8) mm2 in the amnion+levofloxacin drops group 1 week after operation,showing a significant difference between them (t =3.98,P =0.00).Histopathological revealed that the various layers of cornea tissue appeared irregular arrangement in the amnion + levofloxacin drops group 4 weeks after operation with 1-2 layers of new squamous epithelium.Disorder hypothallus structure,more inflammatory cells and residual vascular cavity were visible.However,new squamous epithelium of 4-5 layers was seen in the drug-loading amnion group,and inflammatory cells and residual vascular cavity were less than the amnion+levofloxacin drops group 4 weeks after operation.Conclusions Levofloxacin-loaded amniotic membrane can sustained release levofloxacin and maintain an effective drug concentration in aqueous humor,which improves the treating efficacy for staphylococcus aureus corneal ulceration.