Objective: To study clinical application value of 320-slice spiral computed tomography (SCTCA) for diagnosing coronary artery disease. Methods: A total of 85 patients underwent 320-slice spiral CT and selective coronary angiography (CAG). With CAG as gold standard for diagnosing coronary heart disease (CHD), sensitivity, specificity, positive predictive value, negative predictive value and accuracy were compared between 320- SCTCA and CAG. Results: Sensitivity was 95.65%, specificity was 74.36%, positive predictive value was 81.48%, negative predictive value was 93.55% and accuracy was 85.9% diagnosing coronary artery disease by 320-slice spiral CT. Conclusion: 320-slice spiral computed tomography is a simple, safe, reliable non-invasive measurement, may be used for screening coronary heart disease and reviewing after operation.

Objective To observe histologic changes of human cytomegalovirus(hCMV)-infected explants of first trimester human placenta and expression of hCMV gene in the hCMV-infected explants, and investigate the mechanism of intrauterine transmission of hCMV from mother to fetus.Methods The first trimester placenta explants cultures were carried out, and they were infected with hCMV for 10 days. The expression of hCMV immediate early protein(IEP) 72-IEP86 were determined using indirect-immuno fluorescent assay, and in situ hybridization method was used to examine the hCMV late gene (LG)mRNA. For histologic evaluation of morphological changes in villi, transmission electron microscope was used.Results (1) Typical hCMV-induced lesions bearing hCMV IEP72-IEP86 were consistently localized in the trophoblast of covering placenta villi, interstitial cell and vascular endothelia cell 12 hours after infection, and were predominant in cytotrophoblast. (2) Replication of hCMV in placenta explants culture occurred from 12 hours to 24 hours and disappeared since 48 hours after infection with different concentrations of hCMV when examined by in situ hybridization. (3) Tissue integrity and viability of first trimester placenta explants were obtained in culture for 10 days and then explants were infected with different concentrations of hCMV 100 tissue culture infectious doses(TCID_ 50 ),200 TCID_ 50 and 300 TCID_ 50 , the progression of the infection was observed in the tissue that maintained its normal cellular organization under light microscope. But typical inflammation of cellular organization was observed under transmission electron microscope. Conclusions (1) A flash replication of hCMV in placental explants culture occurs; IEP72-IEP86 may be in intrauterine infection of hCMV for a long time. (2) There are pathological ultrastructure changes in hCMV-infected explants.

[Objective]To investigate the efficacy of early Chinese biotype total hip arthroplasty(THA) in clinical application.[Methods]From October 1997 to March 2004,THA was done in 46 patients(49 hips) with early Chinese biotype.The efficacy was evaluated according to the clinical score and X-ray photographs.[Results]Forty-six patients were followed up for 5~11.5 years(average 8.5 year).The mean Harris hip score improved from 38(35~50) points preoperatively to 82(70~90) points at final follow-up.The imaging observation showed that prothesis loosening occurred in 9 cases.There were hip dislocation in 3 cases.One dislocation occurred on the way to the ward after operation,and the other 4 events occurred after the patients were discharged.Close reduction was all successful.There was 1 case of ectopic ossification,Brooker classification was GradeⅠ.One patient had hip pain and limping.The X-ray photographs showed that there was obvious osteoporosis,but no prothesis loosening occurred.No infection was found.The total good to excellent result was 73.9%.[Conclusion]The early Chinese biotype total hip arthroplasty can relieve the pain.However,the design and the moding parts of the domestic prosthesis need to be modified in order to improve the prosthetic efficacy.

Objective To discuss the application of Apofix interlaminar clamp for the treatment of atlantoaxial instability. Methods From April 2000 to July 2004, 30 patients with atlantoaxial instability were treated with posterior atlantoaxial fusion and Apofix fixation. There were 24 males and 6 females. The mean age of the patients was 41 years (range, 19 to 67 years). The patients included 5 with atlantoaxial dislocation, 25 with odontoid fracture (including fresh fracture for 21, old fracture and nonunion for 4; Anderson Ⅱ for 23 and Anderson Ⅲ for 2). After reducted by skull traction, atlanto-occipital space, arcus posterior atlantis and axial laminar were exposed during operation, upper and lower hooks were inserted. The iliac bone graft was inserted into the space of C1 and C2, the connecting rod of the clamp was compressed and fixed. Results The follow-up of all cases ranged from 8 months to 3 years and 10 months (with the mean of 27 months). There were 28 cases with complete reduction of fracture and dislocation, 2 cases in incomplete reduction. The operation time was 70 to 150 minutes, and the average blood loss was 65 ml. Patients could sit up 3 days (2 to 6 days) after surgery with soft collar. The mean off-bed time was 7 days (2 to 10 days) after operation in the patients without or less spinal cord injury. All cases obtained solid bony fusion 3 months postoperatively. No severe complications such as injuries of vertebral artery, nerve root and spinal cord or aggravation of spinal cord injury occurred. Conclusion Apofix interlaminar clamp has advantages of convenience in operation, provided reliable and safe stability for atlatoaxial segment. The results suggested that this technique is an efficient, reliable segmental posterior fixation.

The application of fetal echocardiography in clinical is increasing , more and more patients need de-tailed consulting services .The following suggestions are made:Echocardiographic doctors should set up the consulting service consciousness , provide consulting with patience , popularity and carefulness; the doctors should understand the patients and their family′s emotions and also pay attention to the psychological care;environmental requirements for patients′echocardiographic examination and counseling service;encouraging multidisciplinary join the participa-tion of consulting services .

Objective To investigate the expression of Skp2 and Cx43 in cervical carcinoma and to study their relationships and clinical significance. Methods The expression of Skp2 and Cx43 was examined by immunohistochemical method in 48 cases of cervical carcinoma tissue, 84 cases of cervical intraepithelial neoplasia (CINⅠ - Ⅱ 45 cases, CINⅢ 39 cases), 28 cases of chronic cervicitis. Results Skp2 expression in cervical carcinoma was higher than that in the CINⅠ - Ⅱ and chronic cervicitis (P <0.05), Cx43 expression was lower in cervical carcinoma than that in the CINⅢ, CINⅠ - Ⅱ and chronic cervicitis (P <0.05). The expression of Skp2 was correlated with histological differentiation and lymph node metastasis (P <0.05). The expression of Cx43 was correlated with the lymph node metastasis (P <0.05). Besides, the expression of Skp2had a negative correlation with that of Cx43. Conclusion Skp2 and Cx43 may play an important role in the genesis and development of cervical carcinoma.

There are a large amount of neural stem cells in the olfactory system which have an active proliferation, ongoing and direc-tional differentiation and migration in order to adapt to the changing environment. The clinical findings showed that the early stages of some neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease all presented dysosmia. In recent years, the relationship be-tween air pollution and dysosmia attracts public concerns. This article introduced some research progresses in this field.

Background and purpose:Pancreatic cancer is one of the most deadly human malignant neoplasms. Resistance to chemotherapeutic drugs is a major reason responsible for poor prognosis in the treatment of pancreatic cancer patients. MicroRNA (miRNA, miR) is a family of small non-coding RNA molecules, dysregulated miRNA is associated with various tumor biological function. miR-33a has been widely reported as a metabolism-related miRNA, while its relationship with drug resistance has little understand. This study was focused on the effect of miR-33a on gemcitabine chemoresistance in pancreatic cancer to bring the novel theoretical basis to chemotherapy for pancreatic cancer.Methods:In situ hybridization and Real-time PCR were used to analyze the miR-33a expressions in pancreatic cancer tissue sample and cell lines, respectively. Cell counting kit 8 (CCK-8) assay was used to calculate the IC50 value of different pancreatic cancer cells.Results:miR-33a was down-regulated in pancreatic cancer tissue and cell lines compared with para-cancerous tissues and normal HEK293T cells. Moreover, miR-33a over expression not only could enhance the chemosensitivity to gemcitabine in pancreatic cancer cells, but also rescue the gemcitabine resistance in pancreatic cancer cells.Conclusion:Down regulation of miR-33a in pancreatic cancer decreases the chemosensitivity to gemcitabine, resulting in development of acquired gemcitabine chemoresistance. It provides the theoretical basis to develop a new molecular targeted drug to combine with chemotherapy for pancreatic cancer.

Objective To evaluate the effect of dexamethasone on lumbar plexus combined sciatic nerve block (CLPSNB). Methods Sixty patients were randomly allocated into three groups with 20 cases each. Guided by a nerve stimulator,CLPSNB was performed with 0. 5% ropivacaine 45 ml plus dexametbasone 10 mg in group A,0. 5% ropivacaine 45 ml plus normal saline(NS) 2 ml and dexametbasone 10 rng Ⅳ. in group B,or 0. 5% ropivacaine 45 ml plus NS 2 ml in group C. ResultsThe durations of sensory and motor blockade in group A were [(15. 2 ± 3. 3)h and (12. 6 ± 2. 8)h], respectively, which were significantly longer than [(10. 1 ± 2. 1)h and (7. 9 ± 1.6)h]in group B and [(10. 4±2. 5)h and (7. 6±2. 3)hi in group C(P<0. 05). Conclusion Dexarnetbasone added to 0. 5% ropivacaine significantly prolonges CLPSNB.