Objective To evaluate the long-term clinical outcome of percutaneous coronary intervention ( PCI) with drug-eluting stents ( DES) for distal unprotected left main coronary artery (ULMCA) lesions. Methods Between Jan 2005 and Dec 2009, 111 patients with distal ULMCA disease who underwent drug-eluting stents implantation were enrolled in this retrospective study. The primary end points were major adverse cardiac and cerebrovascular event (MACCE) at follow-up, including death, non-fatal myocardial infarction, cerebrovascular event and target lesion revascularization ( TLR) . Results Patients were 65. 6 ± 10 years old. 21. 6% were diabetic. 31. 5% of the left main bifurcations were classed as Medina 1, 1, 1. Provisional T stent technique was performed for 79. 3% of the population. 30. 6% of cases underwent angiography follow-up. The median follow-up time was 2. 3 years, the MACCE-free survival was 87. 4% and the estimated freedom from TLR was 94. 6% . Diabetes mellitus was identified as the predictor of TLR. Conclusions PCI with DES for distal ULMCA disease was safe and effective when the strategy was made based on the case-by-case assessment.

The author analyses the chance and challenge of foreign periodicals booking in hospital libraries following China entering WTO and under the network environment,and proposes some effective solutions.

Objective:To investigate characteristics of masticatory movement path in young adults with AngleⅡ1 malocclusion.Meth-ods:1 5 youths with normal occlusion(group Ⅰ)and 1 5 with AngleⅡ1 malocclusion(group Ⅱ)were included.Mandibular movement paths of the incisal point of the incisor during unilateral-sided gum-chewing were recorded by the BioEGN mandibular kinesiography an-alyzer.Both maximal distances and directions (FH-opening/closing angles)in sagittal plane were analyzed.The statistic analyses were performed with SPSS 1 3.0 software.Results:Lateral distances of left masticatory movement path in Group I and Group II were (8.24 ±1 .48)mm and (6.58 ±2.49)mm,those of right(8.05 ±1 .05)mm and (6.42 ±2.47)mm,respectively(P <0.05).The aver-age of FH-opening/closing angle of masticatory movement path in Group I was higher than that in Group II at each level(P <0.05)ex-cept 0.5 mm point in the left masticatory movement path.Conclusion:Maximal lateral distance and FH-opening/closing angle of mas-ticatory path in young adults with AngleⅡ1 malocclusion are less than those with normal occlusion.

Objective To discuss the expressions of NF-κB and Vimentin in bladder urothelium carcinoma and their significance. Methods 60 bladder urothelium carcinomas and 20 controls were evaluated and the presence of NF-κB and Vimentin were examined by inmunohistochemical SP method.Results Both NF-κB and Vimentin in bladder urothelium carcinoma and nomal bladder tissue had significant differences (x2 =21.8,P ＜ 0.01; x2 =10.45,P ＜ 0.01).The positive rates of NF-κB expression in different grade of bladder urothelium carcinoma:grade Ⅰ 32 ％ (5/16),grade Ⅱ 68 ％ (13/19),grade Ⅲ 96 ％(24/25) (x2 =4.8,P ＜ 0.05,x2 =4.24,P ＜ 0.05).The positive rates of NF-κB expression in different stage:Ta-T1 stage 57 ％ (16/28),T2-T4 stage 81％ (26/32) (x2 =4.13,P ＜ 0.05).The positive rates of NF-κB expression in lymph node metastasis or not:87 ％ (21/24) and 58 ％ (21/36) (x2 =5.83,P ＜ 0.05).The positive rates of Vimentin expression in different grade of bladder urothelium carcinoma:grade Ⅰ 19 ％(3/13),grade Ⅱ 53 ％ (10/19),grade Ⅲ 84 ％ (21/25) (x2 =4.25,P ＜ 0.05,x2 =4.94,P ＜ 0.05).The positive rates of Vimentin expression in different stage:Ta-T1 stage 36 ％ (10/28),T2-T4 stage 75 ％(24/32)(x2 =9.38,P ＜ 0.05).The positive rates of NF-κB expression in lymph node metastasis or not:50 ％ (12/24)and 61％ (22/36) (x2 =0.72,P ＞ 0.05).The expression of NF-κB increased was positively correlated with expression of Vimentin (x2 =12.4,P ＜ 0.005,r =0.42).Conclusion Both NF-κB and Vimentin in bladder urothelium carcinoma and normal bladder tissue have significant difference.The expression of NF-κB is positively correlated with tumor grade,clinical stage and lymph node metastasis,but not with age and sex.The expression of Vimentin is positively correlated with tumor grade,and clinical stage,but not with age,sex and lymph node metastasis.The expression of NF-κB is positively correlated with the expression of Vimentin.

Objective To evaluate the efficacy of surgical retrieval of testicular spermatozoa,and to present the preliminary results of the retrieved testicular spermatozoa used in intracytoplasmic sperm injection (ICSI) for treatment of non obstructive azoospermic infertility. Methods Forty nine cases of non obstructive azoospermia underwent open testicular biopsy and diagnostic testicular sperm extraction (TESE).Those who had sperms in diagnostic TESE underwent ICSI at least 3 months later. Results Sperms were detected in diagnostic TESE in 12 cases (24.9%). The testicular volume,FSH level and testicular pathology did not accurately predict the presence or absence of sperm in testes.Seven (87.5%) of 8 cases had sperm in re TESE, which were used in their ICSI cycles,resulting in 3 clinical pregnancies. Conclusions The diagnostic TESE should be performed to determine the presence or absence of testicular spermatozoa in testicular failure before ICSI,and the surgically retrieved testicular spermatozoa can be adopted in ICSI for treatment of non obstructive azoospermic infertility.

Objective To study the effect of quality ciecle on improving nurses application ablitiy in operating monitors. Methods Quality circle group was established in the department of general surgery and the circulation of plan-do-check-action was used in the groups for continuous quality control of ECG monitor application.The satisfaction of nurses with ECG monitor management and consuming time of ECG monitor installation were compared between pre-and post-enforcement of quality control circulation. Results After use of quality control circulation,the nurses were more satisfied with the maintenance of ECG monitoring and they knew better about their right storage and disposition and where the monitors were(all P<0.001).Conclusion The quality circle may effectively regulate ECG monitor management,improve applying proficiency of nurses and effectively improve work efficiency,so it is worth clinically applying.

In order to adapt to the demand of culturing high quality talents and to strengthen student's comprehensive quality,pathophysiology department of medical college of Qinghai University carried on the reform on the pathophysiological experiment examination system.After researches and practices in recent years,we established a set of relatively sound examination system including experiment operating and experiment report in normal study,report for designable experiment and experiment skill and theory exam.Investigation results demonstrated that examination system after reform functioned well in training the students' operation ability,observation ability and ability to analyze and solve questions.

Objective To research the expression change and the sense of histone acetylation and p21WAF1 protein in breast cancer. Methods Pathological morphologic changes of breast cancer were identified by H. E. staining. Immunohistochemical study for p21WAF1 protein expression was performed on 80 breast cancers and 80 normal breast tissues. The expressions of acetylated histone H3, H4 and p21WAF1 protein in 80 breast cancers and 80 normal breast tissues were analyzed by Western blot. Results H.E. staining discovered that the tissue structure and cell morphous of breast cancer had visible atypia, compared with normal breast tissues. The immunohistochemical results displayed that the positive expression of p21 WAF1 in 80 breast cancers and 80 normal breast tissues was 49 cases(61.25 %) or 3 cases (3.75%), respectively. There was significantly difference in the expression level between the 80 breast cancers and 80 normal breast tissues (P ＜ 0. 05). The expression levels of p21WAF1 protein in breast cancer tissues were higher than that in normal breast tissues, 0. 78 ± 0. 095 or 0. 65 ± 0. 055, respectively. The expression levels of acetylated histone H3, H4 protein in normal breast tissues were higher than those in breast cancer tissues. H3 was 2. 35 ± 0. 340 or 1.07 ± 0. 067, respectively, H4 was 3.44 ± 0. 202 or 1.11 ± 0. 086, respectively. There was significantly difference in the expression levels between the 80 breast cancers and 80 normal breast tissues (P ＜0. 01). Conclusions The occurrence and development of breast cancers may be related to the expression change of histone acetylation and p21WAF1 protein.

OBJECTIVE:To investigate the significance of tacrolimus blood concentration monitoring to the therapy of mem-branous nephropathy. METHODS:41 patients with membranous nephropathy received tacrolimus,and the blood concentration of ta-crolimus reached to steady state. The trough concentration of tacrolimus was determined by EMIT. The patients were followed up, and clinical therapeutic efficacies were recorded. The relationship of blood concentration of tacrolimus with clinical efficacy was evaluated by SPSS 16.0 software. RESULTS:The blood concentration of tacrolimus was(7.47±2.74)ng/ml in complete remission (CR)group,(5.72±1.19)ng/ml in partial response(PR)group,and(3.30±1.08)ng/ml in no response(NR)group,with total remission rate of 75.61%. The blood concentration of CR group was the highest,followed by PR group and NR group,there was statistical significance among 3 groups(P<0.05). CONCLUSIONS:The clinical efficacy of tacrolimus in the treatment of nephrot-ic syndrome is correlate to the blood concentration intimately. Trough concentration monitoring of tacrolimus has important signifi-cance to the treatment of membranous nephropathy.

Objective To investigate the misdiagnosed vascular vagovagla reflexes (VVR) and the treat-ments during interventional therapy for peripheral anerial disease (PAD). Methods The clinical data of 5 patients with VVRs from 128 PAD patients undergoing interventional therapy so as to analyse the causes for the misdiag-noses and then render pertinent treatment. Results The VVR in the 5 patients belonged to mixed type and all cas-es occurred after intervention and initially misdiagnosed. All patients were recovered well without adverse reaction. Conclusion Intervention therapy for PAD may be susceptible to VVR. Prompt management may bring in a good prognosis when VVR happens.