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 .

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 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.

[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.

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 observe blood plasma matrix metalloproteinase-9 (MMP-9) of the patients with different types of carotid plaque and investigate the relationship between MMP-9 and carotid plaque vulnerability. Methods Totally 64 patients were examined by CDI, TCD, cranium CT, MRI, DSA and nerves function score (NIHSS) to judge their types of carotid plaque. Their plasma levels of MMP-9 and C-reactive protein (CRP) were detected. Results Plasma MMP-9 had direct correlation with plaque vulnerability(r=0.92,P

Objective To observe the effect of different conserve time in ultra deep cryopreservation (-196 ℃)on physiological characteristics of allograft nerve transplantation .Methods A total of 80 female Wistar rats were divide into three groups by random principle:derived group which 20 rats were sacrificed to get both sides of femoral nerves ;control groups which each group had 10 rats include group A for fresh autologous nerve transplantation ,group B for fresh allograft nerve transplantation ;experiment groups which each group had 10 rats including groups C ,D ,E ,F that transplanted after femoral nerves conserve in the -196 ℃ for 3 ,6 ,9 , 12 weeks respectively ,and the results of exterior appearance ,light microscope ,electron microscope were observed and electrophysi-ological test was conducted after transplantation .Results After 9 weeks transplantation :the physiological characteristics of group B was most affected ,followed by group C ,D ,E ,F ,group A was with minimal impact ;the result of electrophysiological test showed that groups A&B ,A&E ,A&F had significant difference(P<0 .05) .Conclusion The physiological characteristics of allograft nerve transplantation relate to the freezing time .

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.

Objective To investigate the clinical pathological characteristics and pattern changes of gastric polyps in the past 15 years.Methods From 1998 to 2012,the cases of gastric polyps diagnosed by gastroscopy were collected.Data of gender,age,location,number,size,Yamata type,pathological type,Helicobacter pylori (H.pylori) infection were retrospectively analyzed.The data were analyzed by Chi square test.Results Among 62 975 cases received gastroscopy,gastric polyps were detected in 2 643 patients and the gastric polyps detection rate was 4.20％,which of female (5.91％,1 790/30 269) was higher than that of male (2.61％,853/32 706).And patients aged ≥60 years old has a high prevalence of gastric polyps; the detection rate was 6.39％(1 124/17 590).The positive rate of H.pylori infection in patients detected with gastric polyp was 12.70％ (321/2 527).Gastric body (40.41％,1 068/2 643) and fundus (26.79％,708/2 643) were two predilection sites of gastric polyps.About 69.05％(1 825/2 643) patients' polyps were solitary,74.76％(1 976/2 643) patients' polyps were less than 0.5 cm in diameter and mainly were Yamata type Ⅰ (30.68％,811/2 643) or type Ⅱ (54.41％,1 438/2 643).The common pathological types were hyperplastic polyps (43.80％,1 109/2 532),inflammatory polyps (34.24％,867/2 532),fundic-gland polyps (19.55％,495/2 532) and adenomatous polyps (2.41％,61/2 532).The detection rate of polyps gradually increased in the past 15 years.Between 1998 to 2002,2003 to 2007,2008 to 2012,the average of 5-year detection rates were 1.11％,2.50％ and 6.49％,respectively.However,the proportion of pathological types didn't change significantly.Conclusions The detection rate of gastric polyps gradually increased year by year,and elderly woman is at high risk.Hyperplastic and inflammatory polyps ware the most common types.

This study was aimed to evaluate the efficacy and safety of Y ixin Tongmai Decoction in prevention and treatment of diabetes mellitus complicated with coronary heart disease ( CHD ) after coronary stenting restenosis . Sixty cases were randomly divided into the conventional western medicine treatment plus Y ixin Tongmai Decoction group ( treatment group ) and conventional treatment of western medicine group ( control group ) . Observation was given on the in-stent restenosis before treatment and one-year after treatment . And the traditional Chinese medicine ( TCM ) Syndrome Scale , changes of single symptom in TCM syndrome , effect of Y ixin Tongmai Decoction on blood glucose and other adverse reactions were also observed before and one-year after treatment . The results showed that in the curative effect evaluation , the restenosis rate of treatment group was 6 . 90%, and the restenosis rate of control group was 17 . 24%. There was significant difference be-tween two groups ( P < 0 . 05 ) . According to the standard of TCM syndrome curative effect , the total effective-ness in the treatment group was 86 . 21%, and that of the control group was 31 . 03%. And there was signifi-cant difference between two groups ( P < 0 . 05 ) . In the safety evaluation , there were no obvious abnormalities during safety detection in the clinical study of two groups. There was no influence on blood sugar levels. And no drug related adverse reactions occurred . It was concluded that Y ixin Tongmai Decoction can reduce coro-nary stent restenosis rate in diabetes complicated with CHD (chest pain) with the syndrome of qi deficiency and blood stasis , phlegm-turbid stasis . It can significantly improve the TCM syndrome and single symptom of patients with good safety .