One hundred and fifty patients with 70 percent or more of carotid steno-ocelusion confirmed by digital subtraction angiography were selected to analyze risk factors for its clinical symptoms.Results of analysis showed that risk for clinical symptom increased with severity of unilateral carotid stenosis (OR = 3.546,95% CI 1.515-8.300,P = 0.004).Whereas presence of "functional complete circle of Willis" was a protective factor for it (OR = 0.208,95 % CI 0.045-0.962,P = 0.045).

Objective To develop an HPLC method for determination of content of ergosterol in cultured Cordyceps militaris and natural Cordyceps sinensis. Methods Diamonsil C18(2) column (150 mm×4.6 mm, 5 μm) was used, with methanol-water (98∶2) as mobile phase, column temperature of 25 ℃ , flow rate of 1.0 mL/min, and detection wavelength of 280 nm. Results The linear range of ergosterol was 0.197 7-3.954 9 μg (r=1.000), and avarage recovery rate was 99.51%, RSD was 0.56% (n=9). Conclusion This method is effective, sensitive and accurate with high repeatability and stability, which is helpful for the determination of ergosterol in the cultured Cordyceps and natural Cordyceps.

Objective To study the clinical features and prognosis in patients with severe basilar artery disease.Methods The clinical features and damaged location in 48 patients with serious stenosis or occlusion in basilar artery were assessed and followed-up 3 months later.The correlation between the clinical features and poor outcome was analysed.Results 19 patients had poor outcome and 4 patients died during 3 months.The most patients suffered from vertigo attack.12 patients presented conscious disturbance within 72 h after onset,and most of them had poor outcome(P<0.05).Conclusion The prognosis of basilar artery stenosis or occlusive disease is not as grave as previously thought.Vertigo occurs frequently,but dose not relate with poor outcome significantly.Consciousness in the initial stage maybe relate to outcome significantly.

Objective To investigate short-term hemodynamic changes in selected patients with middle cerebral artery(MCA) stenting by transcranial Doppler sonography(TCD).Methods Stenting was given to 29 cases (31 MCAs) of patients with moderate and severe MCA stenosis if they had recurred symptoms during the standard antiplatelet therapy.TCD was applied to assess the hemodynamic changes in the stenosis segment and stenotic distal segment before stenting, 1 h and 3 d after stenting. Results Angiography showed that the rate of post-procedure residual stenoses of MCA were less than 20%.Compared with the pre-stentinng peak systolic velocity [PSV, (273±77)cm/s], the post-stenting PSV significantly decreased,which was (162±38) cm/s (P＜0.01) at 1 hour and (168±45)cm/s ( P＜0.01)at 3 days, respectively.Three cases (3 MCA) experienced recurrent stenosis-like spectra at stenosis segments 3 d after stenting and brain CT showed that 2 out of 3 cases suffered intracranial hemorrhage,which was potentially induced by hyperperfusion; PSV doubled in the stenotic distal segment in at least 28.6% patients.There was no statistic difference between pre- and post-stenting in the contralateral MCA (P＞0.05).Conclusions Stenting can dramatically improve the hemodynamic compromise of stenosis segments and their distal segments in selected patients with symptomatic MCA stenosis, however, potential hyperperfusion risk might he taken into consideration after MCA stenting.

Objective To systematically evaluate the effect of preoperative transarterial chemoembolization (TACE) on perioperative safety of patients with resectable hepatocellular carcinoma (HCC).Methods Literatures were researched using Chinese Journal Full-text Database,Wanfang database,VIP database,PubMed,Medline from December 1,1994 to May 30,2016 with the key words including “肝细胞癌,肝切除,术前化疗栓塞,经动脉化疗栓塞,liver cancer,hepatocellular carcinoma,liver resection,hepatectomy,transcatheter arterial chemoembolization,transarterial chemoembolization,preoperative” Manual retrieval was also conducted simultaneously.The randomized controlled trials (RCTs) about TACE on perioperative safety of patients with resectable HCC were received and enrolled.Patients undergoing surgery after preoperative TACE were allocated into the case group and patients undergoing first-stage resection were allocated into the control group.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as relative risk (RR) and 95％ confidence interval (CI).Measurement data were represented as standardized mean difference (SMD) and 95％CI.The heterogeneity of the studies was analyzed using the I2 test.Results Five RCTs were enrolled in the Meta analysis,and the total sample size was 430 cases including 212 in the case group and 218 in the control group.Results of Meta analysis showed that there was no statistically significant difference in the hemihepatic resection rate between the 2 groups (RR=0.99,95％CI:0.81～ 1.20,P＞0.05).The combined resection rate of perihepatic organs in the case group was significantly higher than that in the control group (RR=3.42,95％CI:1.91-6.12,P＜0.05).Results of subgroup analysis showed that operation time and incidence of postoperative complications of patients with an average tumor diameter ＞5 cm in the case group were respectively longer and higher than these in the control group (SMD=0.31,RR=1.65,95％CI:0.06-0.57,1.01-2.69,P＜0.05).Conclusion There is no obvious effect of preoperative TACE on resectable HCC,and it can evaluated combined resection rate of perihepatic organs,operation time and incidence of postoperative complications of patients with resectable HCC and an average tumor diameter ＞ 5 cm,and also reduce the perioperative safety.

Objective To evaluate the role of spiral CT in initial diagnosis and following up detection for patients with thoracic sarcoidosis.Methods 25 patients with thoracic sarcoidosis which had complete data were analyzed retrospectively.Radiography and CT were performed in all cases.The diagnostic accuracy of two methods were statistically compared.Results The diagnostic accuracy of CT in initial detection of thoracic sarcoidosis was 64%.Among the misdiagnosed patients,5 cases were misdiagnosed as lymphoma(n=5) and the else were misdiagnosed as thoracic tuberculosis(n=1) and metastatic tumors(n=3).Conclusion As well as it's significance in following up period,the advantage of CT in determining the diagnosis of thoracic sarcoidosis is conspicuous.CT also can be used to evaluate the therapeutic efficacy.

Objective To observe the clinical efficacy and related complications of modified suture method in treating perimembranous ventricular septal defect(VSD). Methods The clinical data of 110 children with perimembranous VSD were retrospectively analyzed. Among them, 51 cases were treated with conventional suture method (conventional suture group), and 59 cases were treated with modified suture method(modified suture group).The extracorporeal circulation time,intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and related complications were recorded. The transthoracic echocardiography was performed 1, 6 and 12 months after operation. Results The children successfully completed the operation,and no intraoperative death occurred.The extracorporeal circulation time, intraoperative blood transfusion volume, postoperative drainage volume, total hospital stay and rate of related complications in modified suture group were significantly lower than those in conventional suture group: (41.2 ± 9.6) min vs. (52.1 ± 10.6) min, (182.2 ± 42.9) ml vs. (255.3 ± 56.7) ml, (73.2 ± 18.7) ml vs. (102.3 ± 23.5) ml, (12.8 ± 2.5) d vs. (16.1 ± 3.6) d and 13.6% (8/59) vs. 29.4% (15/51), and there were statistical differences (P<0.01 or <0.05). The blood flow velocity of pulmonary valve and blood flow velocity of aortic valve 1,6 and 12 months after operation in modified suture group were significantly better than those in conventional suture group, blood flow velocity of pulmonary valve: (113.8 ± 21.4) cm/s vs. (126.5 ± 22.6) cm/s, (104.6 ± 18.2) cm/s vs. (112.3 ± 18.5) cm/s, (102.3 ± 15.8) cm/s vs. (113.8 ± 16.5) cm/s; blood flow velocity of aortic valve:(141.9 ± 24.6)cm/s vs.(136.0 ± 25.7)cm/s,(148.3 ± 18.7)cm/s vs.(142.3 ± 20.3)cm/s,(148.8 ± 18.1) cm/s vs. (141.6 ± 18.1) cm/s, and there were statistical differences (P<0.05). Conclusions The modified suture method has the characteristic of short operating time, less blood transfusion and postoperative drainage,and swift recovery.It also can reduce postoperative arrhythmia and residual reflux.

OBJECTIVE:To establish HPLC fingerprints of Miao medicine Ardisia crenata.METHODS:HPLC method was adopted.The determination was performed on Diamonsil C18 column with mobile phase consiste of methanol-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was 220 nm,and column temperature was maintained at 30 ℃.The sample size was 10 μL.Using 11-O-(3',4',5'-three-o-galloylhyperin)-bergeninum as reference,HPLC fingerprints of 16 batches of samples were determined.Common identification and similarity evaluation were performed by using TCM Chromatographic Fingerprint Similarity Evaluation Software (2012 edition).Cluster analysis of fmgerprrints was conducted.RESULTS:There were 6 common peaks in HPLC fingerprints of 16 batches of samples.The similarity among 8 batches was more than 0.9.The 16 batches of samples could be clustered into 4 categories.CONCLUSIONS:Established fingerprints can provide reference for identification and quality evaluation ofA.crenata.

Objective: To investigate the preparation of bioactive denatured acellular dermal matrix (DADM) from burn mice riched in mice bone marrow mesenchymal stem cells. Methods: Twelve BALB/c mice were collected and 20% total body surface area scalds (hereinafter referred to as burns) with deep partial thickness were inflicted on the back skin of each mouse. After removing epidermis, the burned skin were collected and divided into Triton X-100 group and elhylene diamine tetraacetic acid (EDTA) group according to the random number table, with 15 samples in each group. Samples in Triton X-100 group and EDTA group were respectively placed in mixture of 2.5 g/L Triton X-100 and 2.5 g/L trypsin solution and mixture of 0.2 g/L EDTA and 2.5 g/L trypsin solution for sustained vibration and elution for 24 hours to make mice DADM. The general appearance of DADM was observed. The structure and arrangement of collagen fibers of DADM were observed by scanning electron microscope and tissue structure of DADM were observed by fluorescence microscope. Bone marrow mesenchymal stem cells (BMSCs) from mice were transplanted in mice DADM in the two groups with concentration of 2×105 cells per well to prepare bioactive mice DADM. After cultured for 3 days, tissue structure of bioactive mice DADM was observed by hematoxylin and eosin staining, distribution and number of BMSCs of bioactive mice DADM were observed by immunofluorescence staining. Proliferation of BMSCs of bioactive mice DADM after cultured for 2 h, 1 d, 3 d, and 5 d was detected by cell count kit-8. Data were processed with analysis of variance for repeated measurement and t test. Results: (1) Mice DADM in the two groups were white in appearance with certain tenacity and elasticity. Mice DADM in the two groups maintained good three-dimensional porous network structure. Collagen fibers of mice DADM in EDTA group were with good continuity, and collagen fibers of mice DADM in Triton X-100 group were fractured in varying degrees. Mice DADM in the two groups were decellularized completely, and the collagen fibers were loose and arranged disorderly. The continuity of tissue structure of mice DADM in EDTA group was better than that of mice DADM in Triton X-100 group. (2) After cultured for 3 days, the BMSCs in bioactive mice DADM in the two groups were evenly distributed. The number of bioactive BMSCs in mice DADM in EDTA group was 37±7, which was significantly more than that of mice DADM in Triton X-100 group (25±8, t=0.128, P<0.05). The proliferation of bioactive BMSCs in mice DADM in Triton X-100 group and EDTA group was similar at 2 hours and on day 1 after cultured (t=1.292, 0.656, P>0.05). On 3, 5 days after cultured, the proliferation of bioactive BMSCs in mice DADM in EDTA group was significantly higher than that of mice DADM in Triton X-100 group (t=2.309, 14.128, P<0.05 or P<0.01). Conclusions Mice DADM prepared by decellularization of EDTA has better three-dimensional porous network structure and good continuity of collagen fiber. The BMSCs in bioactive DADM from burn mice prepared by transplanting BMSCs are evenly distributed with large quantity and strong proliferative capacity, which has the potential to be good autologous dermal substitute.

Objective To explore the influence of preoperative transarterial chemoembolization on short-term prognosis in patients with hepatocellular carcinoma after liver transplantation Methods From Jan 2006 to Sep 2016 in Ruijin Hospital 21 patients received preoperative hepatic transarterial chemoembolization (TACE) before liver transplantation,the other 30 patients undergoing upfront liver transplantation served as control group.Results No statistical difference was found in the total operation time (401 ± 72) min vs.(377 ± 100) min,blood loss (2 785 ± 25 56) ml vs.(4 199 ± 3 748) ml and length of hospital stay (32-± 16) d vs.(28 ± 17) d between two groups,and the occurrence rate of vascular complications (14.3％ vs.0) or biliary complications (9.5％ vs.6.7％) also showed no difference (P ＞ 0.05).Although more patients were diagnosed with postoperative infection in the observation group (81％ vs.40％) (P ＜ 0.05),there was no statistically significant difference in complication grade and perioperative mortality between two groups (P ＞ 0.05).There's no remarkable difference in the liver function recovery level between two groups in terms of postoperative indexs of liver function such as TBL,ALT,AST,and there was also no statistical difference between two groups in 1-year,2-year and 3-year overall survival (P ＞ 0.05).The waiting time in the study group was significantly longer than that in the control group (P ＜ 0.05),and the incidence of postoperative immune dysfunction was lower than that of the control group (P ＜ 0.05).Conclusion Preoperative TACE does not affect liver function recovery and perioperative safety after liver transplantation.