Objective To evaluate catheter-directed thromlysis (CDT) through three different approaches in combination with intervention for acute deep venous thrombosis (DVT) of the lower extremities. Methods In this study 137 acute DVT cases were enrolled. CDT was performed through small saphenous veins in 107 cases,through the great saphenous veins in 21 and through popliteal veins in 9.Iliac vein balloon dilation was performed in 66 cases,and stents were placed in 60 cases. Results The limb edema reduction rates between small saphenous vein group and great saphenous vein group and popliteal vein group were of no significant difference (82.3％ ±7.6％ vs 81.6％ ±6.0％ vs 83.9％ ±6.1％,P＞0.05).The difference of rates of thrombolysis ( 63.5 ％ ± 7.7％ vs 66.9％ ± 8.4％ vs 66.1％ ± 2.7％ )between the 3 groups was not statistically significant (P ＞ 0.05 ). The mean time required for the cannulation was shorter in great saphenous vein group than the other two groups [ (7.3 ± 0.3 ) min vs (20.8 ± 1.1 ) min and (15.7 ±0.6) min,P ＜ 0.05 ].There were 12 cases complicating incision bleeding during thrombolysis in small saphenous vein group,in this group there were 5 cases complicating phlebitis and 8 complicating saphenous nerve injury.The complication rates in great saphenous vein group was lower (P ＜ 0.05).Follow-up made in 112 cases for 3 -25 months.There were 97 cases without limb edema.While test by venography or color Doppler,89 cases showed venous patency and rethrombosis developed in 8 cases. Conclusions Catheter-directed thrombolysis with iliac venous intervention was an effective method for the treatment of acute deep venous thrombosis.CDT through great saphenous vein is easier with less complications.

Objective To explore influence of noninvasive positive pressure ventilation treatment on the brain natriuretic peptide(BNP) level of patients with pulmonary heart disease.Methods 104 patients with pulmonary heart disease were randomly divided into two groups,control group ( conventional therapy) and study groups ( noninvasive ventilation),each group 52 cases.The BNP level of the two groups before and after treatment were detected and compared.Results After treatment,the BNP level in the two groups were all decreased,and the BNP level of the study group was( 197.8 ± 39.6) ng/L,which was significantly lower than that of the control group[ (320.9 ± 43.0 ) ng/L ]( t =3.22,P ＜ 0.05).Conclusion Noninvasive positive pressure ventilation treatment could effectively reduce BNP level in patients with pulmonary heart disease.

Objective To investigate the curative effect of noninvasive positive pressure ventilation combined with aerosol inhalation of budesonide on patients with severe asthma.Methods One hundred and twenty-one patients with severe asthma were randomly assigned to two groups.Both groups were treated with noninvasive positive pressure ventilation based on routine treatment.In addition,patients in the treatment group were given aerosol inhalation of 2 ml budesonide and 2 ml NS,two times each day,14 days for a course.Clinical symptoms improvement and arterial blood pressure changes of two groups before and after treatment were studied to compare the curative effect of the treatments in the two groups.Results There were no significant differences in pH,PaO2 and PaCO2 between the treatment and the control groups(P ＞ 0.05).After one course of treatment,the treatment group had significantly higher levels of pH(7.43 ± 0.04 vs.7.34 ± 0.02,t =3.423,P ＜ 0.05) and PaO2 ( [77.4 ± 16.7 ] mm Hg vs.[ 62.4 ± 16.5 ] mm Hg,t =3.414,P ＜ 0.05 ) and lower levels of PaCO2 ( [43.4 ±8.9] mm Hg vs.[50.9 ± 9.1 ] mm Hg,t =5.317,P ＜ 0.05 ) than the control group.There were significant differences in the total effective rate between the Budesonide group and the control group (96.7％ vs.88.3％,x2 =4.218,P ＜ 0.05 ).Conclusion Noninvasive positive pressure ventilation combined with aerosol inhalation of budesonide is a simple and effective strategy for patients with severe asthma.Thus it may be worthy to be widely used clinically.

Objective To study the clinical significance of plasma N-teminal pro brain natriuretic peptide (NT-pro-BNP) level in diagnosis and evaluation prognosis of patients with different heart failure.Methods Plasma NT-pro-BNP level was detected and compared in all patients at the first day and a week after the patients' condition turn better.Results The level of plasma NT-pro-BNP for the high blood pressure's heart disease and the chronic heart failure of coronary heart disease and the chronic heart failure of cor pulmonale were significantly higher than normal (t =2.98,t =2.98,t =2.98,P ＜ 0.01).The level of plasma NT-pro-BNP was reduced after treatment (t =2.56,t =2.75,t =2.88,P ＜ 0.05,P ＜ 0.01,P ＜ 0.01).The level of plasma NT-pro-BNP was gradually increased by the increased degree of the heart failure(t =2.78,P ＜ 0.05).Conclusion The levels of plasma NT-pro-BNP at acute stage for the high blood pressure's heart disease and the chronic heart failure of coronary heart disease and the chronic heart failure of cor pulmonale were increased obviously and descend by the patients' condition return.The level of plasma NT-pro-BNP can monitor patients' condition and estimate the heart failure patients' prognosis.

Objective To investigate the features and risk factors associated with lymph node metastasis in colorectal neuroendocrine neoplasm.Methods Clinical and pathological data of 63 patients with colorectal neuroendocrine neoplasm treated in Yinzhou People's Hospital between June 1997 to December 2012,were analyzed retrospectively.Comparisons of categorical data and univariate analysis of risk factors of lymph node metastasis were conducted by x2 test,multivariate analysis was conducted by Logistic regression analysis.Results Of the 63 patients the rate of regional lymph node metastasis was 30％ (19/63) with 58％ limited to para-intestinal lymph nodes in 11 cases,26％ limited to mesenteric lymph nodes in 5 cases,and 16％ limited to mesenteric root central lymph nodes in 3 cases.No metastasis exceeding central lymph nodes was observed.According to univariate analysis,tumor size,depth of invasion,ulceration in mucous membrane,invasion of lymphatic vessel and pathological grading suggested by WHO were related to regional lymph node metastasis (P ＜ 0.01).Multivariate regression analysis revealed that tumor size,invasion of lymphatic vessel and pathological grading were independent risk factors for lymph node metastasis in colorectal neuroendocrine neoplasm (P ＜ 0.05).Conclusions Colorectal neuroendocrine neoplasm with larger tumor size,invasion of lymphatic vessel or higher grade (G2,G3) has high risk of regional lymph node metastasis.

Objective To study the effect of STC2 on invasion and metastasis of breast cancer cells and its mechanism.Methods By 231 HM shRNA interference cell STC2,we observed fiber cells expressing form,number plate cloning experiment statistical analysis.Immune co-precipitation (CO-IP) for testing related protein expression.Results By 231 HM STC2 cells expressing shRNA interference,231 HM presents high transfer characteristics of fiber cell morphology,cell invasion and metastasis ability of increase at the same time;On the contrary,after 231 cells expressing STC2,cell invasion and metastasis ability induced.In addition,after reducing STC2 expression of 231 HM cells,its resistance to radiation-inducled apoptosis and expression of STC2 after 231 reduced,ability to resist radiation induced apoptosis of cells induled too.Conclusion Collectively,these results indicate that STC2 may inhibit EMT at least partially through the PKC/Claudin-1-mediated signaling in human breast cancer cells.

BACKGROUND: Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. METHODS: Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test). RESULTS: We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies. CONCLUSION: The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries. TRIAL REGISTRATION ClinicalTrials.gov, NCT01597232.
Humans ; Adult ; Postoperative Complications ; Erythrocyte Transfusion/adverse effects* ; Blood Transfusion ; Hospitals ; Hemoglobins/analysis*