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.

BACKGROUND:On-pump coronary artery bypass grafting(CABG)is replaced by off-pump coronary artery bypass grafting step by step.Effects of the two operations on liver and renal function deserve further studies.OBJECTIVE:To analyze the postoperative changes in liver and renal function between off-pump and on-pump CABG.DESIGN.TIME AND SETTING:Controlled study.The experiment was conducted at the Department of Cardiovascular Surgery.General Hospital of Chinese PLA.Beijing between June and November 2005.PARTICIPANTS:Fifty patients undergoing elective CABG at General hospital of PLA from June to November 2005 were enrolled in the study.All patients had normal liver and renal function before surgery.None of them developed severe acute liver and renal function.METHODS:All patients were allocated to either off-pump coronary bypass(OPCAB)(n=30)or on-pump conventional CABG (CCABG)(n=20)group according to patient's intention and condition.No significant difference was detected in age,gender,body mass index,preoperative ejection fraction,preoperative liver and renal function and operation risk factors between both groups(P>0.05).MAIN OUTCOME MEASURES:Alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen (BUN)and creatinine(Cr)were respectively measured in patients of both groups before surgery,1 day,1 week and 2 weeks after surgery.RESULTS:A total of 50 patients were involved in the final analysis.Changes in liver function:Serum ALT and AST Ievels in the OPCAB group were significantly lower than those in the CCABG group at 1 day after surgery(P<0.05).The level of two parameters recovered to the baseline at 2 week after surgery in both group.Changes in renal function:Serum BUN and Cr levels in the OPCAB group were significantly lower compared to the CCABG group at the first postoperative day(P<0.05).BUN and Cr levels recovered to the preoperative levels at 2 weeks after surgery in bOth group.CONCLUSl0N:CABG has an adverse effect on liver and renal function.which can recover in the early postoperative period.OPCAB has the less adverse effect on liver and renal function and offers a better liver and renal protection compared to CCABG.

Objective To compare the noxious stimulations induced by insertion of Proseai laryngeal mask airway(PLMA)and classic laryngeal mask airway(CLMA)in children.Methods Forty-seven ASA Ⅰ or Ⅱ children,aged 3-12 yr and undergoing surgery under general anesthesia,were randomly divided into 2 groups:PLMA group(group P,n =23)and CLMA group(group C,n =24).General anesthesia was induced with target-controlled infusion(TCI)of propofol.When the effect-site concentration of propofol was equal to the plasma concentration predetermined.PLMA or CLMA insertion was attempted.The target plasma concentration of propofol was predetermined according to Dixon's up-down method,with 0.2 μg/ml as a step size.The initial target plasma concentration of propofol was 6 μg/ml and 4.4 μg/ml for groups P and C,respectively.The preedetermined target plasma concentration of propofol and the satisfaction of insertion conditions for each child were recorded.Results The 50％ effective concentration(EC50)of propofol to achieve satisfied condition of PLMA and CLMA insertion were 5.87(95％ CI,5.62-6.11)and 4.53(95％ C1,4.38-4.69)μg/nl,respectively,and the difference was significant(P ＜ 0.01).Conclusion The noxious stimulation induced by insertion of PLMA in children aged 3-12 years is stronger than that of CLMA.

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 and analyze the usage of expensive outpatient prescriptions in different hospitals in Longgang area,Shenzhen,and to discuss and provide reference for the rational usage of expensive pre-scriptions.Methods Two primary hospitals,two secondary hospitals and one tertiary hospital in the Longgang area, Shenzhen,were chosen as the research targets.The expensive outpatient prescriptions,defined as the amount of pre-scription was over 150,200 and 300 yuan for primary,secondary and tertiary hospital respectively,were randomly selected and evaluated using international standards for the rational use of drugs.Results The average prescription items for primary,secondary and tertiary hospitals were 2.96,2.61 and 2.61.The largest proportions of prescription costs were 150 to 200 yuan,200 to 250 yuan and 300 to 350 yuan,which were respectively accounted for 49.6%, 56.6% and 37.7%.The frequency of using proprietary Chinese medicine,was 60.08%,68.18% and 41.62%respectively,which was not reasonable.The clinical diagnosis for the prescriptions of primary and secondary hospitals was mainly composed of trauma,bronchitis and vaginitis.The usage of drugs was not reasonable about the use of anti-biotics and infusion.In addition,the clinical diagnosis for the prescription of tertiary hospital was mainly diabetes, hypertension and cerebral infarction,where the abuse of using large dose of adjuvant drug was observed.Conclusion The frequency of using proprietary Chinese medicine is higher at all levels of hospital.In order to reduce the propor-tion of expensive prescription,the medicine institution should establish a sound system for drug use management and strengthen supervision and verification for western medicine physicians using proprietary Chinese medicine in their prescription.Furthermore,we should intervene and restrict the abuse usage of the adjuvant medicine.