Objective To analyze the causes of misdiagnosis of acute myocardial infarction(AMI)with non -specific clinical symptoms.Methods Clinical data of 32 cases of nonspecific clinical symptoms of AMI misdi-agnosis were collected retrospectively,and analyzed misdiagnosis reasons of nonspecific clinical symptoms of AMI. Results Of 32 AMI patients,10 cases were misdiagnosed as digestive system disease,6 cases of cardiovascular system diseases,respiratory diseases in 5 cases,otolaryngology disease in 1 case,4 cases of cerebrovascular disease, immune system disease in 4 cases,endocrine system disease 1 case,1 case of periarthritis of shoulder.Conclusion The diagnosis of atypical AMI patients should follow evidence -based medicine,it can get the correct diagnosis and the best treatment plan and treatment effect in the shortest time,and to reduce mortality and improve prognosis is par-ticularly important.

Objective To compare the clinical efficiency between laparoscopic and open complete mesocolic excision for right-sided colon cancer.Methods Between January 2011 and August 2012,a total of 134 patients with right-sided colon cancer who underwent CME at Fuzhou General Hospital of Nanjing Military Command were divided into laparoscopic (71) and open (63) groups.The intraoperative parameters,pathology,postoperative course and short-term outcomes were compared between groups.The chi-test and the student t test were used for statistics.Result There were no significant differences in the length of distal (P=0.427) and proximal margin (P=0.515),tumor diameter (P =0.440) and number of lymph nodes dissected (P =0.377).Postoperatively patients were followed for up to 12 months,no significant differences were found in local regional recurrence rates (4.2％ vs 1.6％) (P =0.622) and distal metastasis rates (5.6％ vs 3.2％) (P =0.684) between the two groups.The mean operative time (P =0.134) and postoperative complication rate (P =0.977) were similar.The mean intraoperative blood loss was less (P =0.000),bowel flatus passed earlier (P =0.000) and hospital stay shorter (P =0.000) in laparoscopic than that in open group.Conclusions Laparoscopic CME has the same oncologic clearance effects and short-term follow-up result compared with open CME for right-sided colon cancer,and laparoscopic CME is minimally invasive,less bleeding,less pain and quick recovery.

Objective To evaluate the clinical significance of low ligation and high ligation of inferior mesenteric artery (IMA) and lymph nodes dissection on radical resection for rectal cancer.Methods One hundred and fifty-six patients who were diagnosed rectal cancer in our hospital between May 2007 and May 2008 were divided into low ligation group (80 cases)and high ligation group (76 cases).The low ligation group was treated with low ligation of IMA and lymph nodes dissection,the high ligation group was cured by high ligation of IMA and lymph nodes dissection.cases.The IMA lymph nodes metastasis,number of lymph nodes,cancer recurernce rate,5-year survival rate,complication rate were compared and analyzed.Results The rate of lymph nodes metastasis around the origin of inferior mesenteric artery was 15.0％ in the low ligation group,the rate of lymph nodes metastasis around the origin of inferior mesenteric artery was 14.5％ in the high ligation group,and the difference was not statistically significant (P ＞ 0.05).Compared two groups of postoperative recurrence rate,5-year survival rate,anastomotic leakage rate,sexual dysfunction rate and urinary retention rate,there was no significant differences (P ＞ 0.05).The intestinal function recovery time and low anterior resection syndrome incidence of the low ligation group were lower than the high ligation group,there were significant differences (P ＜ 0.05).Conclusions Low ligation of inferior mesenteric artery and lymph nodes dissection can achieve radical resection for rectal cancer.Compared with traditional high ligation of inferior mesenteric artery,there were no differences for patients on recurrence rate,5-year survival rate and complication rate.

Purpose　The aim is to investigate the hemostatic and protective effect of fibrin sealant(FS) on liver trauma in rats.Methods　On the surface of cracked wound(type Ⅰ) and resected wound(type Ⅱ)，spraying of FS or thrombin or direct suturation, was used receptively. Natural hemostasis was used as control.During postoperation the hemostatic time and the state of wound healing on 1st, 4th, 7th,14th, 50th day were observed.Results　Compared with the natural hemostasis,the hemostatical time of the FS group was shorter 86.0%(P＜0.01)in liver trauma type Ⅰ and 79.0%(P＜0.01)in liver trauma type Ⅱ.Compared with the thrombin group,the hemostatical time of the FS group was shorten 45.0%(P＜0.01)in liver trauma type Ⅰ and 84.0%(P＜0.05) in liver trauma type Ⅱ.The wound surface of FS group was healed faster than that of other groups.Conclusion　FS was an effective hemostatic and healing-promoter on liver trauma of rats.

OBJECTIVE:To determine content of paeoniflorin in shaofuzhuyu superfine powder granules by HPLC. METHODS: The separation was performed on C18 chromatographic column, the mobile phase was methanol -0.05mol/L KH2PO4(40∶65)with a flow speed at 1ml/min, detection wavelength at 230nm and column temperature at 30℃. RESULTS:The linear range of paeoniflorin was 15.04～752.00?g/ml(r=0.9 998,n=6),the mean recovery rate was 103.3%(RSD=1.53%,n=3).CONCLUSION:This method was simple, accurate, good in recurrence and high in precision, and which can be used for the contents determination and the quality control of the shaofuzhuyu superfine powder granules.

ObjectiveTo investigate effects of anisodamine on myocardial caspase-1 and interleukin-18 expression following overtraining-induced acute myocardial injury in rats.Methods Forty-eight male Wistar rats weighing 200-220 g were randomly divided into 3 groups:group control (group C,n =8) ; group exhausting swim (group ES,n =24) and group anisodamine (group AD,n =16).The animal model of overtraining-induced acute myocardial injury was developed by exhausting swim The animals were forced to swim until they were exhausted.The animals sank to the bottom and no righting reflex or escape response was elicited when they were taken out of water in groups ES and AD.In group AD anisodamine 10 mg/kg was given intraperitoneally 20 min before overtraining.Blood samples were taken from inferior vena cava immediately (T1) and at 6 and 24 h after overtraining (T2,T3 ) in group ES and at T2,T3 in group AD for determination of serum cardiac troponin 1 (cTnI) concentration (by ELISA).The animals were sacrificed after blood sampling and myocardial specimens were obtained for microscopic examination and determination of caspase-1 and interleukin-18 expression (by immuno-histochemistry).ResultsOvertraining significantly increased serum cTnI concentration and up-regulated myocardial caspase-1 and interleukin-18 expression in group ES as compared with group C.Anisodamine significantly attenuated overtraining-induced increase in serum cTnI concentration and myocardial caspase-1 and interleukin-18 expression in group AD as compared with group ES.ConclusionAnisodamine can reduce overtraining-induced acute myocardial injury by down-regulating caspase-1 and interleukin-18 expression.

Objective To analyze the correlations between the CT features and pathological classifications of gastroentric neuroendocrineneoplasm(GE-NEN) and to evaluate the association between prognostic value and CT features.Methods 45 cases pathologically and immunohistochemically proved GE-NEN were studied retrospectively.The correlation between the CT features (tumor's volume,shape,enhancement patterns and TNM stage) and pathological classifications was analyzed.Meanwhile,the association between the CT features and patients' overall survival was evaluated by Kaplan Meier method using Log-rank test and multivariate analysis in Cox proportional hazard model.Results The CT features were proved to be associated statistically with pathological classifications including the tumor's volume,shape,with or without areas of cystic change,necrosis or ulceration,T stage and lymphadenopathy (P ＜ 0.05).On the other side,the patients' overall survivals were associated with age,pathological classifications,volume of tumors,with or without areas of cystic change,necrosis or ulceration and TNM stage.Age,areas of cystic change,necrosis or ulceration and metastases were the independent prognostic factors.Conclusion Contrast-enhanced CT can be useful in the classification of GE-NEN and predicting the patient's survival.

Objective:To established a modified implanting model of VX2 liver tumor in rabbit on the base of the classic implanting method, and compared the results within the two methods. Methods:30 rabbits with the mean weight of (2.65?0.29)kg were divided randomly into two groups with 15 rabbits each. The rabbits in Group A received classic implantation for induction of the liver tumor model, and Group B were inducted by injecting a piece of tumor tissue into the left anterior lobes of liver. Implanting time of each group was recorded and compared, and spiral CT scan was performed at 8th day, 15th day, 22nd day, 29th day postoperatively. The manifestation of tumors in CT scan was observed and tumor volume was calculated simultaneously with formula V=1/2ab2 (a=the shortest diameter and b=the longest diameter).Each tumor was confirmed through pathology. Results:The implanting time of Group A and Group B were (9.47?2.85)min and (5.85?1.62)min, respectively, with significant difference between them. Besides, there was statistical difference of the achievement ratio between two groups, as it was 53.3% for Group A and 86.7% for Group B. No significant difference was found for the tumor growth between two groups. Conclusion:Modified implanting method for induction of the rabbit liver tumor model was superior to the classic implanting method.

Objective To investigate the clinical efficacy of RevoLix 2 μm continuous wave laser treatment on bladder neck contracture after benign prostatic hyperplasia operation. Methods A total of 21 cases were enrolled in current research and they all accepted 2 μm continuous wave laser treatment of bladder neck contracture after benign prostatic hyperplasia operation in the 252th Hospital of the Chinese People's Liberation Army. The clinical efficacy was recorded. Results The operation of the 2 μm continuous wave laser vaporesections were successfully performed on 21 cases. The maximum urine flow rate was increased from(6. 86 ± 1. 97)ml/ s to(16. 31 ± 1. 61)ml/ s,and the difference was significant(t = 15. 49,P < 0. 01). After 3 to 23 months(median 14 months)follow-up,20 cases were cured and 1 case was combined with bladder residual urine 110 ml. Conclusion The therapy of 2 μm continuous wave laser is a superior micro-invasive surgery method for patients with Bladder neck contracture,which shows little blood loss,high level safety,convenient operation and infrequent complications.

Objective:To explore the role and mechanism of Talin-1 in mouse aortic dissection.Methods:Sixty male FVB mice were evenly divided into groups of blank, model, Talin-1 up-regulation, Talin-1 up-regulation control, Talin-1 down-regulation, and Talin-1 down-regulation control. Except mice in the blank group, mice were treated with β-aminopropionitrile (BAPN) combined with angiotensin to construct a mouse aortic dissection model. Hematoxylin-eosin and vascular elastic fiber staining (EVG) were used to observe the aorta and elastic fiber morphology and structure. Western blot was used to detect the phosphorylation levels of FAK and ERK1 / 2 in mouse aortic tissue.Results:The success rate of aortic dissection in model mice was 70%, and there was no aortic dissection appeared in the blank group.No mice died during the experiment. The incidence of aortic dissection in the Talin-1 down-regulated group was 100%, which was significantly higher than that in the Talin-1 down-regulated control group( P<0.05). The incidence of aortic dissection in the Talin-1 up-regulated group was 20%, significantly lower than that in the Talin-1 up-regulated control group. The wall thickness of the aorta of mice in the Talin-1 down-regulated group was accompanied by hematoma or pseudocavity formation. The median elastic fiber content was higher than that in the Talin-1 downregulation control group( P<0.05). The content of elastic fibers in the blood vessel wall of mice in the Talin-1 up-regulation group was significantly higher than that in the Talin-1 up-regulation control group.The down-regulation of Talin-1 significantly inhibited FAK phosphorylation, and instead promoted ERK1/2 phosphorylation( P<0.05). Conclusions:Down-regulation of Talin-1 may reduce the elastic fiber content in the aorta of mice by activating the ERK1/2 signaling pathway, leading to vascular remodeling of the aortic wall and promoting the occurrence of aortic dissection.