Objective To investigate the feasibility, safety and efficacy of the stent-assisted coil embolization for the treatment of wide-necked anterior communicating artery (ACoA) aneurysms. Methods From November 2011 to November 2014, the clinical data of the patients with wide-necked ACoA aneurysms treated by using the stent-assisted coil embolization were analyzed retrospectively. The clinical and radiographic effects were summarized. The perioperative complications were focused on. Results The ACoA wide-neck aneurysms of 29 patients were treated with stent-assisted coil embolization. Two of them abandoned the interventional treatment because of stents could not be in place and release. The immediate results of interventional treatment showed that 21 were embolized completely (78% ), 5 were near totaly embolized (19% ), and 1 was partialy embolized (3% ). Three patients had intraoperative thrombosis (recanalization achieved after thrombosis, one of them died of cerebral hemorrhage after thrombolysis). One patient suffered cerebral angiospasm, one had aneurysm rupture, and one had distal rupture of the anterior cerebral artery. Twenty-seven patients received clinical folow-up, and the folow-up time ranged from 2 to 36 months (mean 17 months). None of the patients had hemorrhagic or ischemic complications. Sixteen patients received imaging folow-up, and the folow-up ranged from 6 to 12 months (mean 7 months). None of the aneurysms had recurrence. Conclusions Stent-assisted coil embolization of wide-necked ACoA aneurysm is overal feasible, safe, and effective although there are certain risks.

Objective To explore the surgical skill, safety, and cosmetic outcomes of complete endoscopic subcutaneous mastectomy and immediate reconstruction with implants for breast cancer. Methods From August 2004 to September 2007, 31 women with breast cancer received complete endoscopic subcutaneous mastectomy and immediate reconstruction with implants in our hospital after neoadjuvant chemotherapy. The operation spaces were established by insufflating carbon dioxide after lipolysis and liposuction in the subcutaneous stratum and retromammary space. Subcutaneous mastectomy was carried out under a complete endoscope, sentinel lymph node biopsy or axillary lymph node dissection, and immediate reconstruction with implants were carried out via axillary small incision. Results The operations were completed in all of the 31 cases. Sentinel lymph node biopsy was performed on 15 cases (including supplemental axillary lymph node dissection in 8), and immediate axillary lymph node dissection was done in 16 cases. No cancer infiltration on tumor surface or into the nipple basement was observed in frozen sections during the operation. In one patient, the nipple was partly necrotic. No other complications were found in this series. Three months after the operation, cosmetic results were good in 22 cases (71.0%), average in 7 (22.6%), and poor in 2 (6.4%). The patients were followed for 3 months to 3 years (over 1 year in 15 patients), during which no one had metastasis or recurrence of the tumor. Conclusions Complete endoscopic subcutaneous mastectomy combined with immediate reconstruction with implants is less traumatic and safe with few complications and good cosmetic result. The method is a good choice for patients with early-stage breast cancer.

Objective To investigate the influence of central aortic pressure and pulse pressure in coronary Artery. Methods The research involed 173 patients who were suspected coronary heart disease (CHD) in the Fifth People′s Hospital of Chengdu city. The patients were divided into non-coronary disease and coronary disease groups. Patients were divided into one- vessel, two- vessels and three-vessels in coronary disease groups. The data were analyzed by using spass 17.0 software. Results SBP-C,DBP-C and PP-C had statistical significance compared with non-coronary disease (P < 0.05).SBP-C and PP-C had significant difference between single-branch and multiple-branch group(P < 0.05).Logistic multivariate analysis indicated that SBP-C [P = 0.019,OR = 1.207, 95%CI(1.032,1.412)]and PP-C [P = 0.023, OR = 1.166,95%CI (1.021,1.332)] had significant correlation. Conclusion Compared with non-coronary, SBP-C and PP-C were higher, while DBP-C was lower. The higher SBP-C and PP-C are,the worse coronary artery is. SBP-C and PP-C are predispose risk factors for multiple-vessels coronary disease.

Objective To investigate the value of intraoperative neuromonitoring(IONM) for preventing recurrent laryngeal nerve(RLN) injury in thyroid surgery.Methods 1087 consecutive patients undergoing thyroid surgery at Wuhan Central Hospital from Oct 2010 to Dec 2012 were evaluated.277 cases(the study group) underwent thyroidectomy with RLN identification by naked eye plus IONM.810 cases(the control group)underwent thyroidectomy with RLN identification by naked eye only.Results In the control group,733 RLNs (90.49％,733/810)were successfully identified and 77 RLNs were failed to be identified.In the study group,all the 277 RLNs(100％,277/277)were successfully identified.28 cases had postoperative temporal RLN injury,among whom 26 cases were in the control group and 2 cases were in the study group.18 cases in the control group and 2 cases in the study group recovered in 2 weeks after surgery.The rest recovered in 2 months after surgery.RLN injury rate was significantly lower in the study group than in the control group.There was no significant difference in RLN injury for low-risk surgical patients between the 2 groups; however,the study group had advantages in RLN injury than the control group for high-risk patients.Conclusions IONM in thyroid surgery can improve the recognition rate of RLN during thyroidectomy.IONM can significantly reduce the incidence of RLN injury,especially in high-risk surgery.

Objective To analyze related factors for pacemaker pocket infection in elderly patients after implantation of permanent pacemakers and to provide a theoretical basis for preventing pacemaker pocket infection.Methods Pacemaker pocket infection and related factors were analyzed for 412 patients who received implantation of permanent pacemakers from Apr.2010 to Jun.2013 in the Department of Cardiology.Results With 5 cases of pacemaker pocket infection,the rate of infection was 1.2％.The infected patients were older than the uninfected patients [(74.5±4.2) years vs.(60.3±6.6) years,t=4.781,P＜0.01].The rate of infection was higher in patients who had undergone operations twice or more than in patients who had undergone one operation [10.0％ (3/300) vs.0.5％ (2/382),x2=10.583,P＜0.01].The rate of infection was higher in patients with the operation lasting 2 hours or longer than in patients with the operation time shorter than 2 hours [(3.8％ (4/106) vs.0.3％ (1/306),x2=7.802,P＜0.01].The rate of infection was higher in patients with pocket hematoma than in patients without pocket hematoma [16.7％ (3/18) vs.0.5％(2/394),x2=37.492,P＜0.01].Independent risk factors for pacemaker pocket infection included pocket hematoma (OR=6.193),number of operations≥2 (OR=2.594),operating time≥2 hours (OR=2.265) and age of 75 years or older (OR =2.193).Conclusions Pocket infection after implantation of permanent pacemakers is related to pocket hematoma,number of operations,operating time and age.

Objective To establish an effective post-operative oral care procedure for patients with oral cavity cancer.Methods Eighty five post-operational patients with oral cavity cancer admitted to Sichuan Cancer Hospital during March 2011 and March 2013 were randomly divided into control group (42cases) and study group (43 cases).Patients in control group were given routine oral care,and those in study group received a special care procedure:normal saline washing + dioxogen cleaning + normal saline washing + normal saline gargle.Oral cleanliness,oral and lung infections were observed in both groups,and SPSS 17.0 was used for statistical analysis.Results Oral cleanliness,rates of oral infection and lung infection at d3 after operation,time of infections,the delayed wound healing and operating comfort were improved in the study group (Z/t/x2 =-2.48,4.57,4.64,2.36,2.25,-2.51,4.18,respectively; all P ＜ 0.05).Conclusion The oral care procedure containing normal saline washing + dioxogen cleaning +normal saline washing + normal saline gargle can improve oral cleanliness early after operation,reduce complications and increase the operating comfort.

Hepatectomy is the treatment of choice for huge ( ＞ 10 cm) hepatocellular carcinoma.However,the resection is more difficult and risky due to a huge space occupied by the tumor and vascular invasion.Precise hepatectomy is a new concept of liver surgery in the 21st century.The goal of which is the least invasive,most parenchymal preserving and optimal recovery.A male patient with a huge hepatocellular carcinoma (diameter =22.5 cm) received precise hepatectomy in the Department of Hepatobiliary Surgery of Fuzhou General Hospital of Nanjing Military Area.By using the digital medical technology and procedure of liver surgery planning system,the tumor and the whole structure of the liver were three dimensionally reconstructed,and the planning of resection was made.During surgery,the right liver artery and the right.porta hepatis were ligated and the right hemihepatic vessels were occluded.We accomplished right hepatectomy by accurate resection according the precisely planned preoperation,with less bleeding or no bleeding surgical field and rapid recovery.

Objective To analyze the protein expression profile of human glomerular mesangial cells (HMCs) under high glucose and to characterize molecular functions and biological processes. Methods HMCs were divided into high glucose cultured group (30 mmol/L) and normal glucose cultured group (5 mmol/L). The total proteins were extracted after culture for 48 hours. The total proteins of the two groups were separated using two-dimensional fluorescence difference in gel electrophoresis (2-D DIGE) and analyzed using DeCyder 2-D difference analysis software. The differentially expressed proteins were further identified using in-gel digestion with trypsin, of which peptide extracts were prepared for MALDI-TOF-MS analysis. Protein identifications were searched in the NCBI protein database using the Mascot search engine. Results One hundred and forty-seven protein spots whose expression levels were significantly increased or decreased more than 1.5 folds under high glucose were identified. Ninety-six differentially expression protein spots were analyzed by peptide mass fingerprinting and 37 kinds of proteins were identified. The protein spots of phosphatidylethanolamine binding protein 1 (PEBP-1), granulysin,ATP synthase H + transporting mitochondrial FO complex subunit F2 were observed only in high glucose group. The expression of 24 proteins was up-regulated by high glucose, including eosinophil cationic protein, RGS membrane-interacting proteins 16 (MIR16), peptidyl-prolyl cis-trans isomerase, disks large homolog DLG2, breast cancer 2, early onset (BRCA2), Catechol-O-methyltransferase etc. The expression of 5 proteins was down-regulated by high glucose, including O-GlcNAc transferase-interacting protein 106 000 isoform 1, proteasome beta 6 subunit precursor,NEFA-interacting nuclear protein NIP30 etc. Conclusions Expression of 147 proteins in HMCs alters under high glucose. These proteins are involved in the regulation of cytoskeleton, glucose metabolism, cell division, gene transcription, signal transduction, phosphorylation, cell proliferation,apoptosis etc. In-depth analysis of these differentially expressed proteins' function and crosstalk is expected to provide an important experimental basis for clarifying the pathogenesis of diabetic nephropathy.

Background and purpose: Recent literature has high lighted an important role of inflammation in promoting cancer. CRP (C reactive protein) is a way of building the bridge between inflammation and cancer. We aimed to explore correlations between CRP levels and clinical stages of nasopharyngeal carcinoma(NPC). Methods: We analyzed 108 cases, among which 68 cases were NPC, 20 cases were benign inflammatory diseases of nasopharynx, and another 20 were healthy volunteers as control. We detected the level of CRP using immunoturbidimetry (ITM), q test was calculated by SPSS. Results: The mean concentrations of CRP in NPC[(19.8±4.7) mg/L] were significantly increased compared to those in the control group[(6.2±1.8) mg/L], while they were significantly lower than those in benign inflammatory group[(45.6±7.9) mg/L]. In NPC, The mean concentrations of CRP in T4[(25.6±3.9) mg/L] were higher than those in T1[(17.4±5.8) mg/L], T2[(18.6±8.5) mg/L] and T3[(15.6±1.8) mg/L] respectively. The mean concentrations of CRP in N3[(28.0±7.1) mg/L] were higher than those in N0[(17.6±6.8) mg/L], N1[(21.3±5.1) mg/L] and N2[(18.6±5.6) mg/L] respectively. The mean concentrations of CRP in 1V[(25.7±5.5) mg/L] were higher than those in Ⅰ[(14.2±1.9) mg/L], Ⅱ[(16.1±3.9) mg/L] and Ⅲ[(23.0±7.7) mg/L] respectively (P<0.05). There were no statistic differences between the other groups. Conclusion: The serum CRP level is associated with the occurrence of NPC and benign inflammatory disease of nasopharynx. In NPC, the higher the CRP level is, the more advanced the TNM stage will be.

Objective To investigate the changes of bone density,bone microstructure,bone BMP-2 expression in rats at early period of diabetes.Methods Thirty SPF 4-month-old male Wistar rats were randomly divided into 3 groups(n=10 in each group):A(fed with common forage as normal control group),B(fed with high-lipid forage and intraperitoneally injected with STZ to establish type 2 diabetes with insulin resistance),C(fed with common forage and intraperitoneally injected with STZ to establish type 2 diabetes with insulin secretion defaulting).The bone histomorphology,bone histomorphometry,bone BMP-2 expression were investigated 12 weeks later.Results As compared with group A,bone microstructure was of no obvious changes and bone BMP-2 expression was higher in group B(P