In recent years , along with the continuous accumulation of clinical experiences and the improvement of surgical devices, the percutaneous coronary intervention (PCI) has become a perfect treatment method and been widely used in the clinic . Hence , the coronary heart disease ( CHD ) patients have received better treat-ment results. However, the in-stent restenosis is still a big problem after PCI. The combination of Chinese and modern medicine in the prevention of restenosis has become a focused hotspot . In order to further under-stand this issue , this article discussed the Chinese and modern medicine mechanism in order to provide more thoughts for clinical practice .

Objective: To observe influence of hypotension induced with diethylamine(DEA)on oxygen delivery (DO_2), oxygen consumption (VO_2)and the concentration of lactate. Method: Twelve healthy adult dogs were randomly assigned into one of the two groups. 0.001% DEA or 0.0l% sodium nitroprusside (SNP) was infused to induce mean arterial pressure(MAP) to decrease to 60% of baseline and maintaine for 30 min. During hypotension, MAP and HR were recorded. Arterial and mixed venous blood gas, and blood lactate level were measured. Result: There were no sig nificant changes in DO_2. VO_2, oxygen extraction ratio and blood lactate level in both groups. The concentration of lac tate was not increased in either group. Conclusion. The oxygen metabolism may not be affected during DEA-induced hypotention

[Objective]To evaluate the validity and feasibility of somatosensory evoked potentials(SEP) and transcranial magnetic stimulation motor evoked potential(TMS-MEP) in early decompression of spinal cord injury(SCI). [Method]Thirty-two rabbits fell into four groups randomly. The static load model were used to simulate human SCI. According to the compression time, the animals were divided into 4 groups (control,5min, 15min,30min). In this study, somatosensory evoked potentials (SEP) and transcranial magnetic stimulation motor evoked potential (TMS-MEP) were used to assess neurologic function. The EPs were recorded at 5min, 15min, 30min, 60min, 6 hours, 24 hours, 3 days, 7 days post-decompression and before spinal cord injury in injury groups. Latency and amplitude were measured for each wave. Tarlov behaviour score was performed before surgery and after surgery at 1,3,7 days. Histologic studies were performed on part of animals. [Result]Spinal cord compression resulted in a gradual increment in the peak latency and significant decrement in the peak amplitude. After decompression, the recovery of the latency was more obvious than the amplitude in all injury groups, EPs recovered earlier than Tarlov score. [Conclusion]EPs may evaluate the neurologic function of SCI models sensitively and impartially. Dcompression early may promote SCI recovery.

OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

[Objective] To observe the clinical effect of Bryan cervical prosthetic disc in treating ossification of posterior longitudinal ligament(OPLL)of cervical spine.[Method]From October 2005 to June 2007,15 localized OPLL patients were treated surgically by cervical arthroplasty using Bryan disc prosthesis.JOA score and radiological study were performed before and after operation.The range of movement(ROM)of replaced level were investigated postoperatively.[Result]Neurological deficit was alleviated in all patients.All patients were followed up at least 6 months,JOA score increased from an average of 8.5 to 15.8.Replaced segment restored the normal ROM in flexion and extension.[Conclusion]Cervical arthroplasty using Bryan disc prosthesis can achieve good clinical outcome in treating localized OPLL of cervical spine;and the normal ROM can be retained in the replaced level.

Hospital entrustment will incur cultural conflicts,which calls for cultural integration as the best means to ease such frictions and conflicts between two hospitals of cultural difference.Renmin Hospital of Wuhan University (Hubei general hospital)directly hosted Hanchuan people's hospital,and implemented the president responsibility system under the leadership of the management committee.By means of cultural integration to reshape Hanchuan hospital culture,Hubei general hospital has rebuilt the latter's culture.Such reshaping features the following:development as the core,scientific management as the breakthrough,employees as the center,technology upgrade as the basis,and patients service as the direction.Cultural integration has furthered development of the hospital entrusted,and turned frictions and conflicts into infiltration and integration.As a result,Hanchuan hospital is upgraded in general in terms of management and service quality.

Objective To investigate the effect-site concentration for 50% of maximal effect (EC50 )of propofol required for loss of consciousness and onset of burst suppression and to assess the effect of target-control infusion(TCI)of remifentanil on these EC50 of propofol.Methods Sixty patients undergoning general anesthesia for scheduled surgery were randomly divided into 2 groups (n=30):group R received TCI of remifentanil with a target concentraton of 4 ng/ml 10 minutes before TCI of propofol,which started at a target plasma concentration of 1μg/ml and then increased by 1μg/ml step every 1 minute until the burst suppression ratio reach to 15%.Group N received a mock TCI of saline instead of remifentanil and the other procedures were as same as group R.During this,all patients were assessed by modified Observ-er’s Assessment of Alertness/Sedation (OAA/S)scale,the loss of consciousness was definited by modified OAA/S values less than 2,the onset of burst suppression was definited by 15% of burst suppression ratio. Results The EC50 of effect-site concentration of propofol required for loss of consciousness and onset of burst suppression were 2.35 (95%CI 2.29-2.41)and 6.31 (95%CI 6.13-6.47)μg/ml respectively.The EC50 of propofol required for loss of consciousness was decreased to 1.73μg/ml by TCI of remifentanil,but the EC50 of propofol required for onset of burst suppression did not changed by TCI of remifentanil. Conclusion TCI of remifentanil could decrease the EC50 of propofol effect-site concentration required for loss of consciousness but has no effect on the EC50 of propofol required for onset of burst suppression.

Aim Bupivacaine is a kind of long-acting amide local anesthetics.This paper aims to explore the effects of bupivacaine on the short-circuit currents in human alveolar epithelial monolayers and study the possible mechanisms.Methods Short-circuit currents were recorded by ussing-chamber setup.Amiloride-sensitive currents were defined as the difference be-tween the total current and the amiloride-resistant cur-rent.ERK1 /2 phosphorylation protein levels were ana-lyzed by Western blot at 0,1 5,30 and 60 min after administration of 1 00 μmol·L -1 bupivacaine.Results Bupivacaine could inhibit the short-circuit currents in H441 monolayers dose-dependently,which could be inhibited by amiloride.Western blot analysis showed that bupivacaine increased the level of ERK1 /2 phos-phorylation.Conclusion These data demonstrate that bupivacaine can reduce the alveolar ion transport by in-hibiting the amiloride-sensitive currents,possibly by the enhancement of ERK1 /2 phosphorylation. The effects of alveolar fluid clearance following application of bupivacaine should be considered clinically when the patient is complicated with lung injury.

Objective To investigate the prognosis of patients with nasal NK/T cell lymphoma receiving different treatment modalities. Methods From 1990 to 2004, 85 patients with stage ⅠE and ⅡE primary nasal NK/T cell lymphomas were retrospectively studied. Twenty patients received chemotherapy of CHOP regimen alone, 11 patients received radiotherapy only, 6 patients received radiotherapy followed by more than 2 cycles of chemotherapy, and 48 patients received more than 2 cycles of chemotherapy followed by radiotherapy. Survival analysis was performed by the Kaplan-Meier method, the difference between groups was evaluated by the Log-rank test, and the Cox regression model was used for multivariate analysis. Results The 5-year overall survival rate (OS) was 40%. The 5-year OS was 57% and 28% for limited stage ⅠE and extended stage ⅠE(X2 =8. 87, P =0. 003), and 23% for stage ⅡE, which was similar to extended stage ⅠE (X2 =0. 19, P-0. 664). The 5-year OS was 13%, 54% and 47% for chemotherapy alone, radiotherapy followed with or without chemotherapy, and chemotherapy followed by radiotherapy, respectively. The last two groups had better OS than chemotherapy alone (P = 0. 030 and 0.049). The 5-year OS was 58% and 12% for patients achieving complete response (CR) and uncomplete response (X2 = 30.68, P = 0. 000).The CR rate was 56% and 86% for radiotherapy of ≤50 Gy and >50 Gy (X2 =6.11, P=0. 013). The corresponding 5-year relapse-free survival rate was 89% and 84% (X2 =0.36, P=0.551). Of 68 patients receiving initial chemotherapy, the CR rate of those who received ≤2, 3-4 and ≥5 cycles was 0, 20%and 3 3 % , respectively (X2 = 7.65 , P = 0. 022) . For 5 0 patients who received ≥ 3 cycles of initial chemotherapy and 17 patients who received initial radiotherapy of ≥40 Gy, the CR rate was 28% and 88%(χ2= 18. 75, P= 0. 000). In patients with pathological nodular and ulcer type, the CR rates with radiotherapy were higher than with chemotherapy (100%: 38%, χ2 = 7.92, P = 0. 005; and 100%: 11%,χ2 = 14.40, P = 0. 000). Multivariate analysis showed that stage and recent effect were the independent prognostic factors. Conclusions The initial radiotherapy with 50 Gy is appropriate for early stage nasal NK/T cell lymphomas. Combined chemotherapy could be used for extended stage ⅠE and ⅡE, but the outcome of CHOP regimen is poor.

Objective To observe the anti-atherosclerosis (AS) mechanisms of Shuxinwenban granules by observing its effects on the serum level of MMP-9, the expression of VEGF and the formation of the plaques in rabbits. Methods Totally 40 healthy female and male rabbits were divided into control group, model group, Shuxinwenban granules group and Simvastatin group. Control group was treated with basic diet, and other groups were treated with high cholesterol diet for 12 weeks to make AS rabbit models. The treatment groups were given corresponding drugs by gavage for 4 weeks. The serum levels of MMP-9 in rabbits were detected by double antibody sandwich enzyme-linked immunosorbent method and the surface density of VEGF in the atherosclerotic plaques by immunohistochemical staining, at the same time, the pathological changes of the aorta and atheroclerotic plaques were observed. Results Compared with the model group, Shuxinwenban granules significantly decreased the serum levels of MMP-9, and the difference was statistically significant (P <0.01). Similarly, Shuxinwenban granules could significantly decrease the surface density of VEGF in atherosclerotic plaques, the difference was also statistically significant (P<0.01). Pathology showed that the intervention of Shuxinwenban granules decreased the area of atherosclerotic plaque, caused the plaque to smaller and thinner. Conclusion Shuxinwenban granules blocked the inflammatory response by inhibiting the expression of VEGF in atherosclerotic plaque and decreasing the levels of MMP-9 in serum, which lessened the formation of the atherosclerotic plaques.