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 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.

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 .

Background The retina microglia play a eliminating effect on apoptotie cells in the neural retinal layer of normal rats during postnatal development.Milk fat globule epidermal growth factor 8(MFG.E8)can combine specifically with phosphatidylinositol serine of the surface of apoptotie cells and enhance macrophage phagoeytosis of apoptotic cells.Objective Present study was to evaluate the localization and expression of MFG-E8 and its relevant cytokines in the neural retinal layer of normal rats during postnatal development Methods Normal royal college of surgeon(RCS)rats were divided into P0,P3,P7,Pi4,P30,P45 groups according to their postnatal days,and the 30-day-old RCS rats(2 rats)served as controls.Double stain of M FG.E8 and microglial cells marker(CD11b)was performed by immunofluorescence.Expressions of MFG-E8,integrin β5,CD11b and interleukin-6(IL-6)mRNA in the neural retina were analyzed by real-time quantitative reverse transcription polymerase chain reaction(RT-PCR).The utilization of animals complied with the Regulation for the Administration of Affair Concerning Experimental Animals by State and Science and Technology Commission.Results MFG-E8 and CD11b were positively co-expressed in retinal ganglion cell layer and external plexiform layer with the green fluorescence for FITC-labeled IgG and red fluorescence for cy3-labeled lgG respectively in normal adult rats.RT-PCR showed that the mRNA of MFG-E8,integrin 85,CD11b and IL-6 was detectable at P0 rats.The expression level of these eytokines began to rise fterward and reached peak value at P14 rats and then declined gradually,showing significant differences among different ages groups in various cytokines mRNA expression(all P<0.05).Conclusion MFG-E8 can be specifically expressed in the neural layer of retina microglia in RCS rat.

Objective To investigate the prevalence of tumor necrosis factor-?(TNF-?)promoter polymorphisms(at position-308 or-238)in patients with nonalcoholic fatty liver disease(NAFLD),and to explore the relationship between TNF-? promoter polymorphisms and obesity and the insulin resis tance(IR)in those patients.Methods Metabolic variables were measured in 117 patients with NAFLD, among them 60 were obesity and 57 were non-obesity.Genotype of TNF-? promoter were determined by PCR-RFLP.Plasma TNF-? level was measured by ELISA.Indexes of IR and insulin secretion were determined using the homeostasis model assessment method.One hundred and twenty normal subjects who were matched for age and sex served as control.Results The G→A mutation of the-238 TNF-? polymorphism was significantly higher in patients with NAFLD versus controls(29.9% vs.15.8%, P

Objective To observe the curative effectiveness of kidney transplantation on uremic patients complicated with Thalassemia.Methods Forty-six cases of uremic patients complicated with Thalassemia(26 cases of alpha-thalassemia,20 cases of beta-thalassemia)subject to kidney transplan- tation were retrospectively studied as the anemia group.Incidence of delayed graft function restoration, rejection(hyperacute rejection,accelerated rejection and acute rejection)and anemia correction were observed.Time needed for renal function restoration was recorded and creatinine value(Cr)was mea- sured in those patients whose kidney function restored after kidney transplantation.Control group in- cluded 131 cases of kidney transplantation performed concurrently that accompanied with different con- tent of anemia other than thalassemia.Results Incidence of DGF was 26.1% and 23.7% in thalasse- mia group and control group,respectively.Six months after transplantation,39 cases in thalassemia group and 109 cases in control group with follow-up were host and kidney alive.In 6 months,rejection ratio was 30.8% in thalassemia group and 32.1% in control group respectively.Cr value was(121?20)?mol/L and(128?33)?mol/L in thalassemia group and control group,respectively.Ratio of anemia correction in thalassmia and control groups was 79.5% and 76.1%,respectively.No indexes above were found to be statically significantly different between these two groups.Conclusion Uremic patients complicated with thalassemia is suitable for kidney transplantation,with clinical effectiveness similar to those without thalassemia.