Objective:To evaluate the clinical value of 64-slice spiral coronary CT angiography(CTA)in diagnosis of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary artery disease.Methods:CTA was used to reconstruct and analyze the 345 segments(each stent was divided into three segments:proximal,middle and distal)of 115 stents in 60 patients with coronary heart disease after PCI.The results of selective coronary angiography(SCA)were taken as the golden standard to evaluate the sensitivity and specificity of CTA in diagnosis of ISR after PCI.Results:CTA clearly showed the location and length of the stents,the stenosis at stent and the characteristics of restenosis plaques.Thirty-nine in-stent restenosis lesions were found by CTA,including 8 calcified lesions and 31 non-calcified lesions.There were 25 lesions at the proximal end of the stent,7 at the middle and 7 at the distal end.Forty-two lesions were found by CTA,including 9 calcified lesions and 33 non-calcified lesions,with 26 at the proximal end,8 at the middle and 8 at the distal end.CTA correctly diagnosed 36 segments,missed 6,and misdiagnosed 3.The sensitivity,specificity,PPV,NPV and accuracy of CTA were 85.71%,99.01%,92.31%,98.04% and 97.39%,respectively.CTA had the highest sensitivity and specificity for diagnosis of the proximal ISR,being 96.15% and 100%,respectively.Proximal stent restenosis accounted for 64.10% of the total.Conclusion:CTA can clearly demonstrate the in-stent restenosis and has a high accuracy in diagnosing restenosis after PCI.CTA is a safe,simple and reliable noninvasive diagnostic method for diagnosis of in-stent restenosis after PCI.

Objective To investigate the image quality and diagnostic accuracy using 64-slice spiral computed tomography (64-CTA) scanner in patients with suspected coronary artery disease. Methods Sixty eight patients with chest pain or post PTCA underwent CT coronary angiography (CTA) and selected coronary angiography (SCA). The SCA results were served as "gold standard" to evaluate the diagnostic accuracy of CTA, while the sensitivity, positive predictive value (PPV) and negative predictive value (NPV) were calculated, respectively. Results 64-slice spiral CT could clearly demonstrate the coronary arterial trunk and branchs with stenosis, calcifications abnormal orifise origination and bridge vascular disease; especially with high accuracy in revealing calcification and even with quantification. The sensitivity, specificity, PPV and NPV of the degree of stenosis more than 75% for coronary artery segments evaluated by CTA were significantly higher than those of the degree of stenosis less than 50% for coronary artery segments(P

Objective To investigate the differences in clinical characteristics between children and adults with systemic lupus erythematosus (SLE).Methods A retrospective cohort study was performed to investigate the differences in clinical data from 89 children and 120 adults with SLE.Clinical manifestations,laboratory results,renal pathological changes and disease activities of patients from the 2 groups were evaluated.Results The most common clinical manifestations including fever,rash,arthritis,renal damage and anemia were found in both groups.However,the incidences of symptoms such as fever,lymphadenectasis,anemia,renal damage,damage of digestive system and nerve system were higher in children with SLE than those in adult patients,and there were statistical significances (x2 =5.085,P=0.024;x2 =6.027,P =0.014;X2 =4.261,P =0.039;x2 =4.221,P =0.040;x2 =4.566,P =0.033;,x2 =4.346,P =0.037,respectively).The positive rate of antibodies against double stranded DNA in serum of children with SLE was higher than that in adults (x2 =1.895,P =0.169).However,the positive rate of antibodies against cardiolipin in serum of children with SLE was lower than that in adults,and there was statistical significance (x2 =4.823,P =0.028).Complement C3 and C4 levels in serum of children with SLE were lower than those in group of adults,and there were statistical significance (x2 =4.221,P =0.040;x2 =7.977,P =0.004,respectively).Class Ⅲ and Ⅳ were commonly observed in classification of renal pathological examinations in both groups.But it was shown that the prevalence of renal damage in children with SLE was higher than that in adult patients,and there was statistical significance (x2 =4.128,P =0.042).The most common SLE disease activity was identified as moderate in the both groups.However,the score of SLE Disease Activity Index was higher in children with SLE than that in adults,there was statistical significance (t =2.192,P =0.031).Conclusions Differences in clinical characteristics of SLE were found in children and adults.Compared with adults with SLE,children patients were found to show higher prevalence of disease activities,damage of multisystem and renal damage.Therefore,children with SLE need to be diagnosed as early as possible and treated aggressively.

Objective To compare internet addiction disorders' family cohesion and their family educa-tion style, and to help prevent internet addiction disorder and interference treatment in families with internet addic-tion disorder. Methods Ninety adolescents with internet addiction disorder were investigated as the experimental group and one hundred normal adolescents as the control group. Questionnaire and in-depth interview was used to collect data,and the data was analyzed with SPSS 10.0. Results Average scores of control group were significant higher than those of experimental group in family cohesion ((51.75±8.86) vs (38.89±12.17), P<0.01). Av-erage scores of control group were significant higher than these of experimental group in family education style ((50.65±7.66) vs (41.44±10.84), P < 0.01). Average scores of experimental group were significant higher than those of control group in dissatisfaction of family cohesion and family education style ((20.87±4.66) vs (12.33±7.88); (23.30±11.06) vs (14.28±7.29), P < 0.01). Conclusion The adolescents with internet addiction disorder have low family cohesion and high dissatisfaction of family education style,wherefore during in-ternet addiction family intervention and prevention, it should pay particular attention to cultivating close and harmo-nious relations among families members. In aspect of family education, parents should pay special attention to chil-dren's healthy personality development, and guide their children to actively take part in social practice and train-ing.

Objective To study the effects of nuclear factor E2-related factor 2 (Nrf2) in delayed encephalopathy in rats after acute carbon monoxide poisoning. Methods One hundred and sixty-eight rats were randomly divided into three groups: forty-eight rats in the blank control group (BC group), sixty rats in the air control group (AC group) as well as in the carbon monoxide poisoning group (CO group). The DEACMP model was established by improved intraperitoneal injections. The animals were valuated at 1st ,3rd, 7th, 14th, 21th, 28th day after acute carbon monoxide poisoning. Tunnel method was used to test the pyramidal cell apoptosis in the hippocampal CA1 area. The expression of Nrf2 was tested by immunohistochemical method and Western Blot method. Result In the CO group, the apoptosis index (AI) started to increase from first day and achieved it's peak at the 7th day (20.20 ± 1.78), then began to decrease slowly. The apoptosis index was still higher than that in the other groups at 28th day. And the apoptosis index of the CO group was markedly higher than the other two groups at each time point. The Nrf2 protein started to increase from 1st day in the CO group , reached its peak at 3rd day (8.20 ± 1.08), reduced later, maintained at a high level at 28th day, and expressed significantly higher than other groups at each time point. Conclusions The Nrf2 has a linear correlation with apoptosis , and plays a dual role in DEACMP because it rapidly increased in first three days to against apoptosis. But it continuously has been excessive expressed from 7th to 28th day in promoting the apoptosis of hippocampus pyramidal cells and may be a positive factor in DEACMP.

Objective:To investigate the levels of AP-1 in hippocampus of rats at different time points after carbon monoxide poisoning.Methods: Carbon monoxide poisoning delayed encephalopathy model by using intraperitoneal injection of carbon monoxide.Uesd HE observed the pathological changes in hippocampus of rats.The levels of AP-1 was observed by immunohistochemistry and Western blot analysis.TUNEL was used to detect apoptotic neurons in hippocampal CA1 area.Results: HE dyeing conditions,the hippocampus cell of air group (AC) and blank group (BC) were normal at each time point.Pathological changes occurred in the hippocampus cell of Carbon monoxide group (CO),reduction in the number of cells,disorder of cells,intercellular space expansion,nuclear fragmentation,anachromasis and pyknotic.Immunohistochemical results,the AP-1 expression level at each time point in group CO were higher than group AC and BC.On 3th day it reached a peak.The comparison at all time points among the groups in the first three days were significantly different in statistics(P<0.05).Western blot results,the expression of AP-1 was consistented with the immunohistochemical results on the time distribution trend.TUNEL results,AI in group CO was higher than those in group AC and BC at all time points,there were significant differences(P<0.05) and 7th reached the peak of apopotsis.Conclusion: Inside the hippocampus of rats,there are increasing in AP-1 . Maybe it is one of the important pathogenesis of DEACMP .

Objective To investigate clinical and pathological features of idiopathic membranous nephropathy (IMN) accompanied by mesangial dense deposit.Methods Clinical data of 46 patients who were diagnosed as IMN accompanied by mesangial dense deposit admitted to Zhejiang Provincial People's Hospital from January 2013 to December 2014 were retrospectively analyzed.They were compared with those of 29 patients who were diagnosed as IMN without mesangial dense deposit during the same period in the hospital.Analysis of their clinical and pathological features was conducted.Results The IMN accompanied by mesangial dense deposit accounted for IMN 61.3％,and had more hyaline changes of arteriole (43.5％ vs 6.9％,P=0.001) and more obvious arteriolar wall thickening (78.2％ vs 51.7％,P=0.016) than IMN without mesangial dense deposit.Furthermore,the positive rate of IgA deposition in IMN accompanied by mesangial dense deposit was greatly higher than that in IMN without mesangial dense deposit (21.7％ vs 0,P=0.007).In other index,such as serum biochemical parameters,urine protein,glomerular lesion,tubulointerstitium pathological damage and other immunopathologic changes,no statistically significant differences were found between these two groups.Conclusions IMN patients accompanied by mesangial dense deposit have severe intrarenal artery lesions,and high positive rate of IgA deposition.

Objective To investigate the clinical and pathological features of idiopathic membranous nephropathy (IMN) in young patients.Methods Clinical data of 20 young patients, 16 to 44 years, who were diagnosed as IMN admitted to the Zhejiang Provincial People's Hospital from January 2013 to December 2014 were retrospectively analyzed, comparing to 55 mid-aged patients who were diagnosed as IMN during the same period in the hospital.Clinical and pathological features of above mentioned patients were analyzed.Results Young patients with IMN accounted for 26.7％ of IMN patients.Compared to mid-aged patients, young patients with IMN had lower proportion of hypertension (P=0.003), lower blood glucose level (P=0.010), higher estimated glomerular filtration rate (eGFR) and low-density lipoprotein (LDL) (P=0.012, P=0.038), and lower levels of T3 and T4 (P=0.030, P=0.034).Furthermore, there were less sclerosis glomeruli (P＜ 0.001), hyaline change of arteriole (P=0.040) and arteriolar wall thickening (P ＜ 0.0001), lower positive ratios of IgA (P=0.008),and more without renal tubulointerstitial lesions (P=0.018) in young patients.There were no statistically significant differences between these two groups in other index.Conclusions Compared to mid-aged patients, young patients with IMN have better blood pressure and blood glucose level, higher glomerular filtration rate and LDL.Moreover, thyroid function is significantly affected, meanwhile the lesions of glomerular, interstitial and vascular are mild in young patients.

Previous studies have demonstrated that the Chinese medicine paeoniflorin, derived from the Ranunculaceae plant peony, peony, purple peony root, was able to have anti-inflammatory, anti-ulcer, anti-hypersusceptibility and anti-oxidation activity. In order to elucidate the pesticide effect and the mechanisms by which paeoniflorin exerts its effect of anti-inflammation and immunoregulation on oxazolone-induced colitic mice, disease activity index (DAI) and histological grading of colitis (HGC) were evaluated in animal model. Moreover, the expressions of HBD-2, IL-6 and IL-10 of mice with experimental colitis were observed with immunohistochemistry and RT-PCR in this study. Results showed that DAI and HGC of oxazolone control group was significantly higher than that of normal control group, and that paeoniflorin groups and 5-ASA group, compared with oxazolone control group, could alleviate the symptoms and histological damages of colitic mice (P < 0.05, P < 0.01). The expression of HBD-2 and IL-6 cytokine on the colon of colitic mice was higher than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01), but the expression of IL-10 is lower than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01). The positive correlations were demonstrated between the expression of (HBD-2 and IL-6) and DAI (Pearson r = 0.728, Pearson r = 0.758, P < 0.01, respectively), (HBD-2 and IL-6) and HGC (Pearson r = 0.819, Pearson r = 0.825, P < 0.01, respectively), whereas, the negative correlations were demonstrated between the expression of IL-10 and DAI (Pearson r = -0.789, P < 0.01), IL-10 and HGC (Pearson r = -0.725, P < 0.01). It can be concluded that to some extent paeoniflorin effectively alleviate the symptoms of oxazolone-induced colitis through regulating the expression of HBD-2, IL-6 and IL-10.

Objective To evaluate the efficiency of levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment. Methods Twenty-three patients with recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment were treated by LNG-IUS. All patients rejected further operation and had no desire of fertility. The visual analogue scale (VAS) scores of pain, menstrual model, weight and serum CA125 level and the volume of ovarian endometriotic cysts before and after 3, 6, 12, 24 and 36 months of treatment were recorded and compared. Results ( 1 ) VAS score:after 12 months of using LNG-IUS, dysmenorrheal, chronic pelvic pain or dyspareunia were relieved significantly. VAS score were dropped from 5.9 ± 2. 3,4. 3 ± 2.0 to 1.0 ± 0. 7,1.4 ± 1. 1 ( P ＜ 0. 01 ). ( 2 )Volum of cysts :after 6 months of using LNG-IUS, the volume of recurrent ovarian endometriotic cysts in 11 patients were reduced from ( 11.4 ± 6. 1 ) em3 to ( 5. 5 ± 3.4 ) em3 significantly ( P ＜ 0. 01 ). At 12 months of follow-up, it suggested that 2 patients' ovarian endometriotic cysts disappeared. At 24 months follow-up,9 patients ovarian endometriotic cysts disappeared ( 3 ) CA125: serum CA125 decreased from ( 65.5 ± 19. 6 )kU/L to (42. 1 ± 13.6) kU/L at 6 months after treatment remarkably (P ＜ 0. 01 ). Continued to decrease after 12 months and then become steady. Irregular bleeding and spotting was the main side effects, weight gain was also observed in few patients. Conclusions LNG-IUS could be used in treatment of recurrent endometriosis after conservative surgery or conservative surgery combined with medical treatment effectively. It could relieve pain, reduce the level of CA125 and decrease the size of ovarian endometriotic cysts. LNG-IUS seems to be an effective, safe, and long term treatment for endometriosis with fewer side effects and better compliance.