Purpose To evaluate the application value of rapid exchange method in transnasal intestinal obstruction catheterization. Materials and Methods Fifty-eight patients with adhesive intestinal obstruction underwent transnasal catheterization under X-ray fluoroscopy, of which 31 cases were treated with rapid exchange catheterization method (group A) and the other 27 cases with traditional catheterization method (group B), success rate, operation time and complications were compared between the two groups. Results Catheterization success rate of group A and group B were 96.77%(30/31) and 77.78%(21/27) respectively, which was significantly higher in group A than in group B (χ2=4.907, P<0.05);operation time of group A and group B were (28.2±12.3) min and (25.4±15.7) min respectively, and the difference between them was not statistically significant (t=1.219, P>0.05); no operation associated injury occurred in group A and only one case in group B (3.70%) resulted in bilateral nasal edema with a small amount of bleeding because the operating time was too long, complication rate between the two groups was also not statistically significant (P>0.05). Conclusion Rapid exchange method can improve the success rate of transnasal intestinal obstruction catheterization, but the operation time and complications are comparative to those of the conventional method.

Objective To investigate the association of the gene polymorphism of endothelial nitric-oxide synthase(eNOS) with pregnancy induced hypertension(PIH). Methods Sixty-six gravidas with PIH and 91 normal pregnant women(control) in the third trimester were investigated. The G894T mutation at exon 7 of the endothelial nitric-oxide synthase gene was studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The frequencies of eNOS GG, GT and TT genotypes were 62.1%, 34.8% and 3.1% in PIH group and (79.1%,) 20.9% and 0.0% in control group, respectively (P0.05). Conclusions The variant (G-T) of 894 polymorphism site of eNOS is associated with the genesis of PIH, but not related to the severity of PIH. T allele may be a susceptible gene to PIH.

Objective To evaluate superselective external carotid artery embolization before transnasal endoscopic resection in treating nasopharyngeal angiofibroma.Methods Superselective external carotid artery embolization was performed in 20 patients with nasopharyngeal angiofibroma one to three days before transnasal endoscopic resection was carried out.The clinical data,including the volume of blood loss during the surgery,the operative time and the complications,were retrospectively analyzed.Results Superselective external carotid artery embolization was successfully preformed in all 20 patients,which was followed by the transnasal endoscopic resection within 3 days.The average volume of blood loss during the surgery was 155 ml and the total time of operation was 75 minutes.Mild complications occurred in 6 patients after embolization,which were subsided after symptomatic management.No serious complications occurred after surgical resection.The mean hospitalization days of the patients were 3.5 days.Conclusion Preoperative superselective external carotid artery embolization of nasopharyngeal angiofibroma can markedly reduce the blood loss during surgical resection,apparently shorten the operative time and effectively lower the occurrence of complication after the operation.Superselective external carotid artery embolization combined with transnasal endoscopic resection should be regarded as an ideal therapy for nasopharyngeal angiofibroma.

BACKGROUND:The microcosmic and submicroscopic organizations of tissue engineering scaffold matedals’superficial structure have all important effect on the eell adhesion and growth.By means of nano.Technique and three-dimensional porous technique,the resultant nano-hydroxyapatite/collagen(n-HAC)call imitate the component and microstructure of natural bone.OBJECTIVE:To observe the biocompatibility of human bone m arrow mesenchymal stem cells(MSCs)cultured in vitro with nHAC.DESIGN,TIME AND SETTING :Single samples observation was performed in the Experimental Center of School ofMedical Technology,Jiangsu University from September 2005 to December 2006. MATERIALD:nHAc was provided by the Material Science and Engineering Department of Tsinghua University.Humanbone marrow mesenchymal stem cells were derived from healthy adult volunteers.All the subiects signed the informedconsents. METHODS:Whole bone marrow culture and successive adherence method was used to culture MSCs in vitro,and the cells were then induced to differentiate into the phenotype of osteoblasts by the revulsants(methylprednisolone,vitamin C,β-glycerophosphate and basic fibroblast growth factor).MSCs at passage 3 were co-cultured with nHACfor 14 days.MAIN OUTCOME MEASURES:The cytological characteristics of the osteoblast were identified throue,alkalinephosphatase immunohistochemistry method and Von Kossa stain.The growth condition with or without nHAC wasevaluated through invert microscope and scanning electron microscope,respectively.RESULTS:The cultured MSCs proliferated into uniform fibroblast-like cells rapidly.MSCs reached confluence and started to form multilayers averaging from 10 to 12 days,passaged stably as well.Then the MSCs passaged from 7 to 9 days.Cytochemistry evaluation showed that MSCs in induced culture were positive for alkaline phosphatase and Von Kossa stain,and deposited calcified matrix.It showed a typical ostcoblast feature in morphology and biology.In coculture model ofMSCs with nHAC,cells would attach to the inner surface of nHAC.At 8 days,the osteoblasts proliferated in the nHAC and the secretion of the matrix was observed.Lots ofcells adheredon the surfaceand pores of nHAC at 14 days.There wereextensive prominent connections among cells. CONCLUSION:THE nHAC is suitable for MSCs to adhere,grow and proliferate,with a good compatibility.

Objective To evaluate the safety and effectiveness of treating the endovascular stents placement for spontaneous isolated dissection of splanchnic artery ( SIDSA).Methods Sixteen consecutive patients with diagnosis of SIDSA through CTA and DSA were retrospectively analyzed .All patients had acute persistent abdominal pain and treated by endovascular stents placement.The serious complications and symptoms improvement were reviewed after the operation.The symptoms recurrence and repeated color doppler ultrasonography and CTA were also reviewed in the follow up.Results Twelve superior mesenteric artery ( SMA) dissection and four celiac artery ( CA) dissection were diagnosed among sixteen patients.The dissection length was 1.07 to 11.87 cm and the median length was 3.93 cm.The distance from the original dissection to the orifice of superior mesenteric artery or celiac artery was 0.50 to 6.44 cm and the median was 1.98 cm.Eight stent-grafts and 3 bare stents were successfully implanted in 11 patients.One case with celiac dissection was failed to treat because of the severe compression of true lumen and the guide wire cann′t cannulate to the distal true lumen.Four patients with superior mesenteric artery dissection gave up interventional therapy , Among these 4 patients , 2 patients had small tear site and small false lumen , 1 patient had extremely long dissection , and one case had blood supply of target organs from both true and false lumen.No severe complications such as hemorrhage , intestinal necrosis , hepatic failure and splenic necrosis occurred during the eleven successful endovascular interventions.The abdominal pain in 10 cases was disappeared or significantly relieved , 1 case with superior mesenteric vein thrombosis and severe intestinal ischemia before intervention underwent intestinal resection for necrosis.The follow up period was 1 to 74 months in eleven successful cases , and the median follow-up period was 16 months.One patient with SMA dissection after endovascular treatment was died of sudden stroke three months later .Others had satisfactory outcome and the repeated color doppler ultrasonography and CTA were normal .Conclusions Endovascular stents placement is a safe and effective therapy for symptomatic spontaneous isolated dissection of splanchnic artery.

Objective To evaluate the technique and result of endovascular treatment for right subclavian artery stenosis or occlusion.Methods Seventeen patients [13 males,4 females ; (56 ± 11)years old] with right subclavian artery stenosis or occlusion were treated with endovascular surgery which included recanalization,balloon angioplasty and stenting via femoral or brachial artery route.Cerebral protection devices were used in 6 cases to avoid cerebral embolism.Results Sixteen of the seventeen patients acquired successful recanalization in 8 cases with subclavian artery stenosis (100％ technical success rate) and in other 8 cases with subclavian artery occlusion (88.9％ technical success rate).Five cases were treated with balloon angioplasty,and 11 cases were treated with balloon angioplasty combined with stenting.Good patency was seen in the 16 cases immediately after the procedure.The cerebral protection devices prevented all the cases from cerebral embolism and were retrieved suceessfully.Sixteen cases were followed up from 1 to 66 months [mean (24 ± 18) months].Restenosis was found in one case 10 months later and was successfully treated with re-PTA.One case with aortoarteritis died of cerebral infarction 18 months later.No symptom recurrence was found in other cases and ultrasound or CTA of followup showed excellent patency.Conclusions Balloon angioplasty and stenting are safe and effective for the treatment of right subclavian artery occlusion.

Objective:To investigate the effect of CCN1 on the chemosensitivity of colon cancer cells to 5-FU .Methods:Colon cancer and adjacent tissues, colon cancer cells and normal colon epithelial cells, HCT-116 and HCT-116/5/FU cells were collected, and the SCD1 mRNA expression levels were detected by RT-qPCR; HCT-116 cells were cultured and transfected with pcDNA3.1 and CCN1 expression vectors, or infected with shNC and shCCN1 lentivirus, CCK-8 assay was used to detect cell sensitivity to 5-FU, Western blot and RT-qPCR were used to detect SCD1 mRNA expression, and oil red O staining was used to detect the lipid content. Western blot was used to detect the distribution of transcription factor FoxO1 in the nucleus and cytoplasm. The effect of CCN1 and FoxO1 on the transcriptional activity of SCD1 promoter was detected by luciferase assay.Results:Compared with control group, the expression of SCD1 was up-regulated in colon cancer tissues, cell lines and HCT-116/5-FU cells (all P<0.05); overexpression of CCN1 reduced the sensitivity to 5-FU, increased intracellular lipid deposition, and up-regulated the expression of SCD1 ( P<0.05); Knockdown of CCN1 increased the sensitivity to 5-FU, reduced intracellular lipid content and down-regulate the expression level of SCD1 ( P<0.05); CCN1 can promote FoxO1 nuclear distribution, activation or inhibition of FoxO1 activity can promote or up-regulate SCD1 expression level and promoter activity ( P<0.05). Conclusion:CCN1 may up-regulate the expression of SCD1 by activating FoxO1 activity and inhibit the sensitivity of colon cancer cells to 5-FU.

Objective To compare the clinical efficacy between covered stent and uncovered stent in transjuglar in-trahepatic portosystemic shunt (TIPS) .Methods Thirty patients with liver cirrhosis (portal hypertension), who received TIPS, were retrospectively studied.All patients were divided into two groups covered-stent group(n =20) and uncovered-stent group (n=10).For each patient, portal pressure was measured before and after operation, and the patency of shunt was evaluated by color Doppler ultrasound after operation.The mortality, recurrent bleeding rate and incidence of hepatic encephalopathy were analyzed by Fisher exact probability test.Results The TIPS treatment was successful in all patients, the portal pressure in the covered-stent group reduced from (3.78±0.50) kPa before operation to (2.21±0.44) kPa and that of the uncovered-stent group reduced from (3.67±0.48) kPa to (2.13±0.35) kPa.Twenty-six cases were postoperatively followed-up (17 cases in covered-stent group, 9 cases in uncovered-stent group).The follow-up period varied from 7 days to 62 months (median follow-up period was 23 months).Thirteen patients died of upper gastrointestinal bleeding and hepatic failure.The difference of mortality between covered-stent group (8/17) and uncovered-stent group (5/9) did not reach significant (P>0.05).The recurrent bleeding rate between the covered-stent group (5/17) and the uncovered-stent group (3/9) was not different too (P>0.05).The incidence of hepatic encephalopathy in the covered-stent group (4/17) was not different from that of the uncovered-stent group (2/9) (P> 0.05).The patency rates of 6 months and 12 months reached 100% in the covered-stent group, which were higher than those in the uncovered- stent group 77.8% (7/9) and 55.6% (5/9) (P<0.05) .Conclusions The patency rate of shunt at 12 months after TIPS was higher in the covered-stent group than the uncovered-stent group, while the mortality, recurrent bleeding rate and incidence of hepatic encephalopathy were not significantly different between the two groups.

Objective To investigate the effects of kidney-deficiency on auditory cortex metabolism in the elderly by using the proton magnetic resonance spectroscopy(1H-MRS).Methods 50 volunteers,including 20 young subjects and 30 older subjects matched for gender,were measured by pure tone audiometry、“kidney-deficiency”-related test and were executed 3.0 T multi-voxel 1H-MRS tests,The ratios of N-acetylaspartate (NAA),choline (Cho) and lactate (Lac) to creatine (Cr) were measured and were compared between the two groups.The t-test analysis were used for statistic process.The relationship between auditory cortex metabolism and the symptom of kidney-deficiency was also analyzed.Resnlts The result of kidney-deficiency-related test and pure tone audiometry revealed that there was significant difference between the two groups and the older subjects had the more severity kidney-deficiency and high-frequency hearing loss (t=6.335、19.558,P＜0.05).The NAA/Cho ratio in the auditory cortex in the older group was significantly lower than that in the younger group (t=2.90,P＜0.05).There were no significant differences between two groups for the ratios of NAA/Cr and Cho/Cr (t=1.415、0.927,P＞0.05).Decrease of the ratio of NAA/Cho in the older group is significantly related with kidneT-deficiency(r=- 0.773,P=0.025).Conclusion kidney-deficiency play a very important role in the hearing loss and reduction of the number of neurons in auditory cortex of older healthy subjects.It suggests one possible underlying mechanism for the speech perception difficulties exhibited by aging adults.

With development of medical imaging,especial the wide application of CT,MRI and so on,traditional education method can not meet the needs of the intern-clinical students.Fairly satisfying teaching effects has been achieved for the effective combination of traditional teaching methods with net-work educational method.