Objective To evaluate the clinical application value of intravascular ultrasound(IVUS) in the treatment of left main coronary stenosis. Methods Sixty-three patients with left main coronary stenosis were identified by IVUS to evaluate the plaque characteristics and the severity of the stenosis. According to the severity of the stenosis,the patients were divided into percutaneous coronary intervention ( PCI) group (IVUS=50% ) (n = 33 ) and control group (IVUS < 50% ) (n = 30). The group of PCI was treated by PCI. The control group was treated by routine therapeutic agents. The profiles of plaques and stenosis were described. The complications were recorded by follow-up visits. Results More soft and eccentric plaques were found in PCI group. After one year follow up,cardiac events (angina) occurred in 4 cases (12. 1% ) in PCI group. In control group, cardiac events ocurred in 18 patients (60. 0%), including 6 cases of angina, 5 case of paroxysmal ventricular tachycardia,3 cases of myocardial infarction (confirmed by IVUS,showing that the left main coronary artery was responsible for the event), 3 cases of frequent premature ventricular contraction and 1 case of sudden death. There was a significant difference in the occurrence rate of cardiac events between PCI group and non-PCI group (x2 = 13. 81 ,P <0.01). Conclusion IVUS is useful for the identification and treatment guidance. Intervention therapy produces good prognosis in patients with IVUS-identified left main coronary stenosis by more than 50% of the area.

Objective To explore the relationship of angiotensin Ⅱ (Ang Ⅱ) and atrial natriuretic peptide(ANP) with the chronic heart failure syndrome in newborn infant with congenital heart disease.Methods One hundred newborn infant with congenital heart disease(30 patients in cardiac function grade Ⅰ group;40patients in cardiac function grade Ⅱ group;30 patients in cardiac function grade Ⅲ and Ⅳ group) were enrolled and 30 cases of normal physical examination newborns with matched age and sex were selected as the control group.Concentrations of Ang Ⅱ and ANP were determined in these groups.Results Ang Ⅱ in newborn infant with congenital heart disease were significantly higher than that in normal controls,the activated Ang Ⅱ were more and more as disease severity worsen in the NYHA functional classification subgroup,among them,Ang Ⅱ increased most in grade Ⅲ and Ⅳ group ((119.19 ± 5.54) ng/L and (30.72 ± 1.34) ng/L,P ＜ 0.01).Ang Ⅱ was significantly correlated with cardiac function classification (r =0.85,P ＜0.01).ANP in newborn infant with congenital heart disease were higher than that in normal controls,and ANP also increased more and more obviously as disease severity worsen in the NYHA functional classification subgroup,it increased most in grade Ⅲ and Ⅳ groups ((9.00 ± 2.37) pmol/L and (1.15 ± 0.09) pmol/L,P ＜ 0.01).ANP was significantly correlated with cardiac function classification (r =0.79,P ＜ 0.01).Conclusion Ang Ⅱ and ANP are activated in newborn infant with congenital heart disease,they are closely related to the severity of the disease.So the children's cardiac function can be speculated by detecting Ang Ⅱ and ANP concentration.

Objective To investigate the role of atrial natriuretic peptide(ANP) and endothelin 1 (ET-1) of newborns with congenital heart failure and its clinical significance.Methods One hundred newborns with congenital heart disease were selected as our subjects.They were divided into 3 groups according to cardiac function grading criteria and that were grade Ⅰ group(30 cases),grade Ⅱ group(40 cases) and grade Ⅲ-Ⅳ group(30 cases).Another 30 normal newborns were served as control group matched with age,gender.ET-1,ANP were detected.Results The levels of ET-1 and ANP in newborns of grade Ⅲ-Ⅳ were (132.35 ±5.26) ng/L and (9.25 ± 2.37) pmol/L,significant higher than that in control group((53.62 ± 3.81) ng/L and (1.15 ±0.09) pmol/L;P ＜0.01).As the severity of the disease in newborns with congenital heart failure,the level of ET-1,ANP were activated more.There was a positive correlation between ET-1 and grade of cardiac function (r =0.35,P ＜ 0.01).Meanwhile,it also showed a positive correlation between ANP and cardiac function (r =0.72,P ＜ 0.01).Conclusion ET-1,ANP in newborns with congenital heart disease are activated with characterized of chronic heart failure,and related to severity of the disease.

[Objective]To observe changes of skin reinnervation during burn wound healing and determine remodeling of nerve fibers.[Method]Wound tissue and scars were harvested.Collagen was determined with modified Masson trichrome staining and nerve fibers were labeled with neuro filament protein by immunofluorescent technique.Three dimension reconstruction of nerve fibers regenerated was observed under laser scanning confocal microscope.[Result]The CVF(collagen volume fraction) increased during the process of wound healing.The regenerated nerve fibers were sparse,short and small,which was significant lower the normal control.The skin reinnervation improved during the wound healing process and came to peak NVF(nerve fiber volume fraction) in proliferative stage.Disintegration and fragmentation were observed frequently in samples from proliferative stage,which seldom occurred during mature stage.[Conclusion]The remodeling of skin nerve fibers comprises a sequential process of increasing number,shape distortion during wound healing and then disintegration,number decrease and normal shape.

BACKGROUND: Previous studies have found that nerve growth factors play an important role in the process of wound healing, but there is less research for the low-affinity nerve growth factor receptor p75 and sortilin in fibroblasts, and no reports on whether there are differences in expression of p75 and sortilin in the scar fibroblasts and normal skin fibroblasts. OBJECTIVE: To study the expression of low-affility nerve growth factor receptor p75 and sortilin in the normal human skin fibroblasts and the human keloid fibroblasts. METHODS: The keloid fibroblasts and normal hunman skin fibroblasts were cultured in vitro, and the immortalized epithelial cells HaCaT were used as the positive control. The real-time PCR was used to detect the mRNA expression of the p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts, and western blot and immunocytochemical staining were used to detect the protein expression of p75 and sortilin. RESULTS AND CONCLUSION: The real-time PCR and western blot results showed that in the protein and mRNA levels, p75 and sortilin showed positive expression in the keloid fibroblasts and normal human skin fibroblasts, and there was no significant difference in the expression of p75 between keloid fibroblasts and normal human skin fibroblasts, and the expressions of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were significantly lower than those in HaCaT. There was no significant difference of p75 expression between keloid fibroblasts and normal human skin fibroblasts, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts (P < 0.05). Immunocytochemical staining result showed that the expression of p75 and sortilin in the keloid fibroblasts and normal human skin fibroblasts were distributed in the membrane and cytoplasm. Precursor nerve growth factor combined with high-affinity p75 receptor could promote the apoptosis of the cells with the help of sortilin, and the expression of sortilin in the keloid fibroblasts was significantly lower than that in the normal human skin fibroblasts, which may associated with the high proliferation of the keloid fibroblasts. The results provide a new target for the prevention and treatment of pathological scars.

Objective To study community morbidity of gastroesophageal reflux cough (GERC),and then establish its procedure of diagnosis. Methods For the patients with chronic cough, on the basis of inquiring medical history and physical examination, chest radiograph, induced sputum, pulmonary ventilation function and airway hyperresponsiveness, blood eosinophilic, IgE,allergens skin test, nose, throat examination,sinus X-ray or pharyngoscope etc was managed. On the basis of the results,patients suspecting GERC was screened out, and then RDQ was performed, extra-esophageal symptoms related performance was inquired and scores were recorded. The patients with scores ≥ 12 were diagnosed as GERC; the patients with scores ＜ 12 were performed diagnosing treatment with proton pump inhibitor (PPI),and patients with positive results were diagnosed as GERC. The materials was analyzed statistically. Results The patients with chronic cough were 430 cases,and the community morbidity of GERC was 22.79%(98/430). RDQ ≥12 scores was 68.37%(67/98),and RDQ ＜ 12 scores was 31.63%(31/98).There was significant difference in extra-esophagus manifestation (P ＜0.01);26 cases with RDQ ＜12 scores were diagnosed as GERC (83.87%),and the rate of GERC in chronic cough was 21.63% (93/430). Conclusions RDQ is a favourable screening test in diagnosing GERC. PPI diagnosing treatment has high sensibility in GERC. It is necessary to establish community diagnosis procedure.

Objective To investigate the clinical efficacy of percutaneous kyphoplasty(PKP) in treatment of elderly osteoporotic vertebral compression fractures(OVCF).Methods 122 elderly OVCF patients from Oct.2009 to Oct.2013 in Lihuili Hospital of Ningbo Medical Center were selected,and were randomly divided into group A,and group B.There were 61 cases in each group.Group A received percutaneous kyphoplasty(PKP),and group B were treated with percutaneous vertebroplasty(PVP).The two groups were observed in terms of pain,activity,vertebral compression rate and Cobb angles after treatment.The two groups were followed up at least for 3 months.The postoperative side effects were recorded and analyzed.Results After the treatment,the two groups significantly improved in VAS score and activity(P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After the treatment,vertebral compression rate and Cobb angle got better than before in the two groups,but group A recovered more obviously than group B,and the difference had statistical significance (P ＜ 0.05).The postoperative recurrence rate was 18.03 ％ (11/61) in the observation group and 9.84 ％ (6/61) in the control group,and the difference had statistical significance (P ＜ 0.05).Conclusion PKP and PVP can significantly relieve pain,but PKP had better effect than PVP in vertebral body and spinal kyphosis improvement,which is worth of clinical application.

Objective To evaluate the clinical significance of telomerase in the diagnosis of lung cancerusing SROC curve method.Methods Looking“telomerase”and“lung cancer”as keywords,retrieving journalspublished within past 20 years in order to incorporate into literatures and to collect data .To conduct the SROC analysisusing Meta -DiSc 1.4 software.Results 1.Twenty -two documents were sampled as tissue specimensand the heterogeneity was relatively large (P =0.017).To analyze the data with random effective models ,thecombined sensitivity and specificity were 0.788(0.761 -0.814)and 0.955(0.936 -0.969),respectively.TheSROC AUC area under the curve was 0.9515,SE(AUC) =0.0145.2.There was no heterogeneity(P =0.633)amongthe 10 lavaged literatures.By use of fixed effects model for data analysis ,the combined sensitivity and specificitywere 0.777(0.734 -0.816) and 0.922(0.888 -0.948),and SROC AUC area under the curve was0.9369,SE(AUC) =0.0141.Conclusion Telomerase is a ideal tumor marker,and the detection of telomeraseactivity in lavage fluid is stable and accurate in clinical diagnosis .

Objective To know the establishment of the flap pedicle blood supply and the right moment of the cutting off of pedicle by means of laser Doppler blood perfusion imaging instrument on the random flap blood flow changes.Methods 20 adult healthy rabbits were divided in to four groups and each 5 have unilateral flaps.1,3,5,7,9,12,14,18 days after operation,the pedicle blood perfusion values (PU) measurement of the distal pedicle on the flap and midpoint of both ends of the pedicle were performed,and PU values were analyzed.Results Pedicle of the PU values at the different time points changed little (P＞0.05).The PU value in the distal flap reached the minimum 1 day after operation and then increased gradually [3 d (1.24±0.07),5 d (1.57±0.15),7 d (1.79±0.08),9 d(1.89±0.13),12 d(2.01±0.16),14 d(2.18±0.09) and 18 d(2.40±0.18),P＜0.05].When distal PU values/pedicle PU value≥1.2,the flap survival rate reached 99%.Conclusions The establishment of random skin flap blood circulation,as well as the ratio of PU values of distal to the pedicle flap pedicle can be used as the timing of an important indicators.

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.