BACKGROUND:Sirolimus and Paclitaxel-eluting stents are commonly used for clinical application.Sirolimus-eluting stent have been proved safely and effectively to treat acute myocardial infarction.However,the comparison between those two eluting stents has been less reported yet.OBJECTIVE:To compare the security and long-term efficacy between Sirolimus- and Paclitaxel-eluting stents to the treatment of ST-segment acute myocardial infarction via percutaneous transluminal coronary intervention.METHODS:A total of 354 patients with ST-segment acute myocardial infarction,including 259 males and 95 females,were administrated with Sirolimus- and Paclitaxel-eluting stents.All cases were randomly divided into Sirolimus-elutin9 stent group (n=213) and Paclitaxel-eluting stent group (n=141).Major adverse cardiovascular events were compared between the two groups during 1-year following up.RESULTS AND CONCLUSION:One-year following up indicated that there was no significant difference in recurrent myocardial infarction (1.5% vs.1.5%) and cardiac death (2.5% vs.3.0%) between the two groups.Radiography showed that there was no significant difference in restenosis rate (5.0% vs.4.5%) between the two groups.Inner diameter lose was (0.19±0.34) mm in the Sirolimus-eluting stent group and (0.19±0.37) mm in the Paclitaxel-eluting stent group,and there was no significant difference.Additionally,there was also no significant difference in major adverse cardiovascular events between the two groups (8.9% vs.9.1%,P>0.05),suggesting that both Sirolimus-and Paclitaxel-eluting stents were safe and effective to the treatment of ST-segment acute myocardial infarction via percutaneous transluminal coronary intervention.

0.05). The positive rates of CD_ 44v6 expression in the TNM stages I+II and III+IV were 57.1% and 83.3%, respectively, and the difference of which were significant(P

BACKGROUND: Sampling the autogenous bone always needs to develop the second operational area or harvest surrounding the implant, which will increase the risk of trauma and infection. Therefore autogenous bone powder may be taken into consideration to reclaim and use for the treatment of local bone defect.OBJECTIVE: To construct experimental models of repairing bone defect by autogenous bone powder and implant material, and observe the biocompatibility between materials and host.DESIGN: Single sample observation.SETTING: College of Stomatology, Dalian Medical University.MATERIALS: The experiment was performed at the Animal Experimental Center of Dalian Medical University from August 2005 to April 2006. Five healthy hybrid dogs were used in this study. Titanium nail and Bio-Oss bone implant materials were designed and produced by Xi'an Zhonghang Titanium Biological Materials Co., Ltd.METHODS: The first, second and third premolars of dogs were uprooted and received implantation 3 months later. Four implant sockets were prepared at left and right sides respectively of each dog, totally 40 sockets. One titanium nail was implanted into each socket, totally 40 nails. Autogenous bone powder collected when drilling hole, Bio-Oss implant materials and their mixture at 1:1 were implanted in artificial bone defect at bucca side, respectively, while non-implanted bone was served as blank control.MAIN OUTCOME MEASURES: ①At week 9, recovery of bone mass was recorded. Height of alveolar bone, density of bone trabecula and osseointegration were observed by X-ray film.②Histological change was determined by methylene blue-basic fuchsin method.RESULTS: No titanium nail fell off, so five dogs were all involved in the result analysis.①General condition and bone defect: At week 9 of implantation, wound was well healed, and the titanium nail was stable with total reserved rate of 100%. Compared with blank control, the bone defect mass was less in bones implanted with autogenous bone powder (P＜0.01), and the least in bones implanted with mixed powder, which had optimal recovery.②Recovery of bone mass: X-ray film demonstrated that, 40 titanium nails were closely connected with bone, and the healing was well.③Biocompatibility between materials and host: All titanium nails were closely surrounded by erythroic compact bone, no blue soft tissues were seen between implant materials and bone, and direct bone interface appeared under low power lens.CONCLUSION: It is effective to repair bone defect by autogenous bone powder and implant material in dog models,good hiocompatibility is observed between materials and host.

Objective To explore the molecular mechanisms involved in liver regeneration after different cold ischemic (CI) times for the liver graft in 30% volume rat liver transplantation. Methods A model of 30% volume Lewis to lewis rat liver transplantation with hepatic artery reconstruction was established. Rats were grouped as follows: 1 h CI group (n =25), 8 h CI group (n =25) and 16h CI group (n = 25). Survival rate of rats in each group and liver regeneration were observed. Specimen were collected at predetermined intervals from 90 min, 1,4 and 7 d post-reperfusion. TNF-α and IL-6 expression, STAT3 activation were determined in liver grafts. Expression of cyclin D1 and hepatocyte replication with BrdU uptake were studied by immunohiatochemistry. Statistical analysis was used to compare BrdU positively stained hepatoeytes at 1 d post- reperfusion in each group. Results 30% liver transplantation was performed in a total of 75 rats. Compared with rats in 1 h CI group, TNF-α and IL-6 expression in 8 h CI and 16 h CI groups were markedly increased after 30% liver transplantation. STAT3 activity in 8 h CI and 16 h CI groups was significantly increased. Cyclin D1 expression in 8 CI group was demonstrated with cytoplasmic and nuclear staining. Grafts in 16 h CI group showed large areas with no cyclin D1 expression. Number of hepatoeytes with positively stained neclei in 1 h CI group was more than that in 8 h CI group at 1 d after transplantation (t = 6.14, P < 0.05). Conclusion Liver regeneration following 30% liver graft transplantation may be through TNF-α/IL-6/STAT3/ Cyclin D1/DNA synthesis pathways. The reason for 30% liver graft failure with significant cold ischemic injury is that hepatocytes may not respond to initiating signals for liver graft regeneration.

On the basis of Shay's ulcer model, we have studied the effects of food re. striction time on the experimental gastric ulcer in rats. The results indicat that each restricted group forms gastric ulcer after ligation of pylorus 18 hr. There are a postive correlation between the restricted time and the severity of gastric ulcer, and a negative correlation between the severity of gastric ulcer and the amount of gastric acid secretion. We suggested that Shay's ulcer model does not belong to peptic ulcer, but belonges to one of the stress ulcers. The restricted time may play an important role in the mechanism for this ulcer model.

Objective To study the diagnosis of chronic lymphocytic thyroiditis (CLT), and the treatment of CLT companied with other thyroid diseases. Methods Clinical data of 63 cases of CLT were analyzed retrospectively. Results 26 cases were diagnosed by non-operative methods (11 cases by fine needle aspiration biopsy, FNAB). The rest of 37 cases were operated on because of misdiagnosis as other thyroid disease and then comfirmed as CLT by pathology. Of them, 2 were companied with nodular goiter, 6 with Graves' disease, 1 with thyroid adenoma and 2 with carcinoma, respectively. 19 cases were treated by thyroixine, 3 were not treated, 4 treated by operation after thyioxine managment and 37 were treated by operation. Non-operation group had rather satisfied effect in short-term period. 29 cases (78.4%) in operation group were followed up for 1 to 6 years, and 5 cases had hypothyroidism. Conclusions It is necessary to have complete serum immunologic examination and FNAB for suspect patients.They have to be examined carefully in order to avoid omitting complications and incsease the rate of diagnosis.Non-operative treatment is the major therapy of CLT. If CLT is companied with other thyroid disease, operation or non- operation should be adopted according to the pathological type.

Objective To investigate the characteristic, diagnosis and treatment of occult breast carcinoma(OBC). Methods The clinical data of 12 cases of OBC were analyzed retrospectively.Results All patients showed axillary node enlargement as the first sign and were operated on. The operation included axillary node excision (ANE) in 1 patient, axillary node excision plus simple mastectomy in another one, radical mastectomy in 6, and modified radical mastectomy in the other 4,respectively. Eleven patients (91.7%) were followed up for 1-15 years. During the follow up, 1 patient who underwent axillary node resection and 1 who received ANE plus simple mastectomy died of systemic metastasis,18 and 22 months after operation respectively;another case who subjected to radical mastectomy had axillary lymph node metastasis 3 years after the operation,and was re operated on,but the patient died of lung metastasis 4 years after the reoperation. And the others still survived, in which 2 have lived for over 3 years, 2 over 5 years, and 4 over 10 years. Conclusions For axillary mass which causes are uncertain, the possibility of OBC should be considered.Meanwhile excision and pathological examination are necessary. The metastatic histological structure of the axillary nodes usually provide important clue for the source of tumor. Radical or modified mastectomy is the best treatment,and post operative chemotherapy and/or radiotherapy should be done.

The clinical data of 23 cases with emergent hematochezia endoscopically diagnosed as non-ulcerous duodenum diseases were retrospectively analyzed.Majority of cases were misdiagnosed and delayed to transfer to emergency room because of lack of knowledge and experiences of local medical workers.After referral to our emergency department,all 23 cases obtained appropriate management and cured successfully.

Objective To evaluate the clinical values of endogenous creatinine clearance rate(Ccr) ,serum creatinine (SCr) ,urea nitrogen(Urea) ,serum cystatin C(s‐Cys‐C) ,serum retinol binding protein(s‐RBP) ,Urine total protein (u‐Pro) ,urine albumin and creatinine ratio(u‐Alb/Cr) ,urine RBP(u‐RBP) ,urine Cys‐C(u‐Cys‐C) ,u‐NAG and et al in the diagnosis of chronic renal failure (CRF) ,find suitable and effective detection combinations to increase the diagnostic accuracy of CRF .Methods SCr ,Urea ,s‐Cys‐C , s‐RBP ,u‐Pro ,u‐Alb/Cr ,u‐RBP ,u‐Cys‐C ,u‐NAG were detected respectively in 206 hospitalized patients and Ccr values were calcu‐lated at the same time .By using Excel and SPSS19 .0 softwares ,the data were analysed .Combined detections included two and four items combined detections .Results Youden index(YI) of serum Cys‐C was 0 .59 .Area under the curve in the receiver operating characteristic(ROC) of Cys‐C was 0 .872 which was the highest of all the single detection items .Combined detection of SCr and s‐Cys‐C got the highest YI (0 .60) .Combination of four items(Urea ,SCr ,s‐RBP ,s‐Cys‐C) had the highest positive predictive value (100 .00% ) .Combination of u‐RBP and u‐Cys‐C had the highest negative predictive value(100 .00% ) .Conclusion Combined detec‐tion was more favorable for CRF diagnosis .Combination detection of SCr and s‐Cys‐C was the most valuable detection for the diag‐nosis of CRF .Among single item detections ,s‐Cys‐C detection had better sensitivity and specificity ,and diagnostic efficiency than other detection items .U‐RBP and u‐Cys‐C could be used to exclude renal impairment due to its noninvasive sampling .

From 1952 to 1990, 21 cases of malignant tumor of the appendix, including 14 cases of carcinoid tumor of appendix, 4 cases of appendix adenocarcinoma, 2 cases of appendix lymposarcoma and 1 case of appendix cystocarcinoma, were treated in the Affiliated Hospital of Wannan Medical College Among these 21 patients, 16 underwent appendectomy alone, 5 underwent appendectomy first and a right hemicolectomy was performed on later All of the 21 patients were followed up for 5～10 years,the survival rate was 90 5% and 90 5% respectively So if a malignant tumor of the appendix was suspected, a biopsy during operation should be done to determine the pathological type If the diagnosis was clear, the choice of operation mode must be made according to the size and the pathological type of the tumor In selective patient, a right hemicolectomy must be performed on