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.

Through analysis of the anatomic and physiological characteristics and the pathophysiological changes of 84 obstructive sleep apnea syndrome (OSAS) patients,the risks and key points of nursing care during general anesthesia were summarized,such as careful assessment of the patient situation,preparations of first aid materials and drugs,close observation and cooperation with the procedure of anesthesia,timely detecting and dealing with the abnormal changes during anesthesia.

Objective To explore the efficacy of closed reduction and inter na l fixation of cannulated screws by minimally invasive procedure in management of tibial plateau fractures. Methods From October 1999 to January 2002, 42 patient s with tibial plateau fractures, which were 29 males and 13 females with an aver age age of 41 years ranging from 26 to 67 years, were treated surgically in our hospital. According to Schatzker system, the fractures were diagnosed as type Ⅰ in 9, type Ⅱ in 5, type Ⅲ in 13, type Ⅳ in 3, type Ⅴ in 6 and type Ⅵ in 6. There was open fracture in 5, and closed fracture in 37. The fracture fragments of tibial plateau were reduced with closed manipulation or reduced assisted by minimally invasive procedure. The later by minimally invasive procedure included two kinds of reductions, one of which was reduction assisted by Kirschner pin t hat was introduced percutaneously into the larger fragment; the other was reduct ion assisted by a bone tamper that was introduced through a small incision into the cortical window beneath the depressed articular surface. Fixation was achiev ed using percutaneous 6.5 mm cannulated screws or combination of the cannulated screws and Bastiani external frame in unstable fractures. Results Of 42 patients , 37 were followed up from 6 to 30 months (average, 15 months). All 37 fractures were united within 12 weeks postoperatively. The mechanical axis of affected li mb and the stability of affected knee joint were restored in the patients. Accor ding to Sanders score for functional results of knee joint, 13 patients were rat ed as excellent, 20 good, and 4 fair. Anatomical reduction was identified while the stepping of articular surface after reduction was less than 2 mm. In 21 pati ents with anatomical reduction, the functional results were excellent in 8, good in 11, and fair in 2. However, in 16 patients without anatomical reduction, the functional results were excellent in 5, good in 9, and fair in 2. There was sig nificant difference between the two groups on functional results. There were no postoperative complications such as infections and neurovascular bundle. Conclus ion Closed reduction and fixation through minimally invasive procedure has provi ded satisfied results in tibial plateau fractures such as less complications, ex cellent mechanical axis restoration, and ideal functional recovery.

BACKGROUND: Three-dimensional printing technology is a new technology which can quickly and accurately transform the virtual computer-aided design into the three-dimensional physical prototypes. Three-dimensional printing physical model method can replace the method of traditional preoperative planning and repair surgical simulation, with the characteristic of repeatable, which has been deepened day after day in clinical application of spine surgery. OBJECTIVE: To summarize the application status of three-dimensional printing technology in spine surgery and look forward to its future development directions. METHODS: The articles regarding the application of three-dimensional printing technology on clinical applications in spine surgery were retrieved from PubMed databases, Google Scholar, China National Knowledge Infrastructure and Wanfang Database from January 2000 to July 2015. The key words were 3D printing technology, rapid prototyping technology, spine, vertebra, department of orthopedics, fracture, joint, hand and foot, bone tumor, trauma, cervical vertebrae, thoracic vertebrae, lumbar vertebrae, sacral vertebrae, pedicle of vertebral arch, vertebral body, intervertebral disc, and clinical application. A total of 50 articles with a good representation were selected and discussed after repetitive studies and reviews were excluded. RESULTS AND CONCLUSION: The three-dimensional printing technique has been applied in preoperative diagnosis, individualized orthosis customerization, the communication between doctors and patients, teaching, the formulation of individualized and high-accurate repairing plan, intraoperative navigation and individualized implant customization. These results suggest that with the rapid development of medical imaging, digital medicine and technologies of the cel and tissue culture and new materials, three-dimensional printing technology wil have a wide range of applications in spine surgery.

Objective To explore the characteristic and clinical meaning of myocardial bridge in patients with multi-slice spiral CT(MSCT) coronary angiography.Methods 875 patients with suspected or diagnosed coronary artery disease were studied with MSCT coronary angiography,579 cases were male and 296 cases were female,ranged from 30~87 years old in age with average of 60 years old.The heart was scanned with retrospectively ECG-gated,reconstruction from phase for all original tomographic source images at 30%~40% R-R phase interval according to heart rate ≥75 bpm and at 40%~50% R-R phase interval according to heart rate ≤75 bpm.The images of maximum intensity projection,multiplanar reconstruction and vulume reconstruction were gained to show left and right main coronary artery and their main branchs on mulliple angle.Results The myocardial bridges were detected in 89 cases,the positive rate was 10.2%,36 cases(40.5%)had different grade stenosis(≤50%).The myocardial bridges located at middle segment of anterior descending artery(79.8%),the thickness of myocardial bridge was 0.06~0.55 cm,the atherosclerosis plaques were found in 20 cases,the vascular stenosis was approximate to 50%.39 cases with simple myocardial bridges had angina,21 cases hadn’t angina.23 cases with myocardial bridges accompanied by coronary artery atherosclerosis had angina.Conclusion MSCT coronary angiography may clearly detect the myocardial bridge,which can provide more worthy information for clinical diagnosis and treatment.

Objective To analyze the effect of acromio-humeral interval on the occurrence of subacromial impingement syndrome (SIS) after the clinical application of clavicular hook plate in acromioclavicular joint dislocation (Tossy Ⅲ). Methods From July 2005 to October 2008, 63 cases of acromioclavicular joint dislocation (Tossy Ⅲ) were treated with clavicular hook plate. There were 48 males and 15 females with an average age of 33.6 years (range, 21-53 years). The relationship of the acromio-humeral interval (AHI)were analysed between the two groups by X-ray measurement. The AHI and plate-humeral interval (PHI)were measured on X-ray film to detect difference between the two groups. Results After the operation, all t he 63 cases were divided into two groups according the occurrence of SIS. There were 14 cases in the group of SIS and 49 cases in the group without SIS. The mean follow-up was 12.2 (average, 6-15) months.The average AHI of was (8.5±2.1) mm and (9.7±2.6) mm in the group of SIS and the group without SIS respectively. The difference between the two groups was statistically significant. The average PHI of the group of SIS and the group without SIS was (6.1±2.8) mm and (6.8±2.4) mm respectively. There was no difference between the two groups. After removal of the clavicular hook plate, the clinical sign disappeared in the group of SIS. According the Karlsson scoring system, the excellent and good rate of the shoulder function was 100%. Conclusion The occurrence of SIS after the clinical application of clavicular hook plate has related to the width of the subacromial interval. The syndrome could be treated by the removal of clavicular hook plate.

[Objective]To explore the operative techniques of open reduction and internal fixation of displaced radial head fractures in adults. [Methods]Twenty-six cases of radial head fractures had been treated with open reduction and internal fixation. According to Mason classification, 16 fractures were type II, 6 were type III and 4 were type IV. Operative exposures of radial head were performed through the Kocher approach in 22 cases, and through a midline posterior skin incision in 4 cases in order to repair concomitant fracture of proximal ulna. After being reduced, fractures of radial head were fixed with mini-fragment plate and screw which were placed in "safe zone" not to impinge on the proximal radioulnar joint with forearm rotation.[Results]At a mean follow-up of 32 months, all fractures had united. There was no patient who suffered from wound infection or injury to posterior interosseous nerve. According to the Broberg and Morrey functional elbow index, the outcome were excellent in 17 patients, good in 9.[Conclusion]Open reduction and internal fixation of displaced radial head fractures may get satisfying outcomes, with successful performing of the requirements below: (1) sustaining lateral ulnar collateral ligament; (2) avoiding injury to posterior inerosseous nerve; (3) getting anatomic reduction; (4) stably fixing fractures without impinging on joint.

Objective To explore clinical characteristics,pathology,prognosis and proper treatment of pure mucinous breast carcinoma(PMBC).Methods Retrospective analysis Was carried out on patients with PMBC who were admitted from Jan.2004 to Dec.2010.Results PMBC patients accounted for 2.6%of all the patients with breast cancer treated at the same period.The mean age of PMBC patients was(55.28±15.73)years,ranging from 32 years to 81 years.The tumor diameter was from 1 to 10 cm and axillary lymph node involvement was 0%.Immunohistochemieal detection showed the positive rate of estrogen receptor(ER),progesterone receptor(PR),HER-2 and p53 was 96%,92%,0%and 32%respectively.All patients underwent operation and polychemotherapy(cyclophosphamide+Adriamycin,Paclitaxel+Adriamyein).12 cases received tamoxifen,13 cases received letrozole and 8 cases received postoperative irradiation.All the patients were followed up from 1 month to 6 years and the overall survival rate was 100%.Conclusions PMBC is a favorable histological type of breast carcinoma with good prognosis.Proper surgical and adjuvant therapy is important to improve survival rate and life quality.Molecular biologic parameters should be given enough consideration into prognosis evaluation.

Objective To observe the clinical efficacy of electroacupuncture plus nasal irrigation in treating upper airway cough syndrome (UACS).Method A total of 114 UACS patients were randomized into 3 groups, 38 cases in each group. Group A was treated with acupuncture plus electrical stimulation with sparse-dense wave, group B was intervened by nasal irrigation with Shuang Huang Lian, and group C was treated with the two methods together. The clinical efficacies of the three groups were compared.Result The total effective rates were respectively 84.2%, 73.7% and 94.7% in group A, group B and group C. The total effective rate of group C was significantly different from that of group A and group B (P<0.05).Conclusion Electroacupuncture plus nasal irrigation can produce a more significant therapeutic efficacy compared to electroacupuncture or nasal irrigation alone.

Objective To develop a lower limbs rehabilitative apparatus and explore its effects. Methods From January to September, 2016, 28 children with spastic cerebral palsy were divided into control group (n=14) and observation group (n=14) randomly. The control group received routine rehabilitation, while the observation group received self-made lower limbs rehabilitative apparatus training addition-ally. They were assessed with Gross Motor Function Measure (GMFM)-88 and Berg Balance Scale (BBS) before and three months after treatment. Results There was no significant difference in the scores of GMFM-88 and BBS between two groups before treatment (P>0.05), while they increased after treatment (t>6.124, P<0.001), and were higher in the observation group than in the control group (t>2.329, P<0.05). Conclusion Self-made lower limbs rehabilitative apparatus could help to improve the gross motor function and balance function in children with spastic cerebral palsy.