Objective To explore clinical characteristics of chronic total occlusion(CTO) in population with routine coronary angiography,and to cumulate therapeutic experience.Methods Retrospective analysis was performed on clinical data of 57 cases with CTO selected from 825 patients undergone coronary angiography.Results Among 57 cases,the percentage of male,myocaridial infarction,diabetes mellitus,hyperlipidermia and left ventricular dysfunction was 73.7%,84.2%,22.8%,73.7% and 22.8%,respectively.The types of lesions included single branch(n=11),double branches(n=29) and three branches(n=17).Of 70 branches lesion vessels,44 were TIMI 0 of blood flow classification and 26 were TIMI1.The position of lesions occurred at left anterior descending branch(n=32),left circumflex branch(n=16),right coronary artery(n=22).The occlusion time was less than three months(n=41) and more than three months(n=29).The lengths of lesion was divided into less than 20 mm(n=43) and more than 20 mm(n=27).The shapes of terminal lesion looked like rat-tail(n=42) and blaze knife-edge(n=28).The coronary stents were performed at 57 lesions among 70 branches and the successful rate of operation was 82.9%.Conclusions Timely coronary angiography and selecting suitable treatment on different kinds of lesions for male patients with myocardial infraction,especially complicated with diabetes mellitus,might play important roles in prevention of CTO and in improvement of the successful rate of percutanous coronary intervention for the complex lesion.

Objective To evaluate the significance of laparoscopy in the diagnosis and treatment of unexplained acute right lower abdominal pain in women. Methods Clinical data of 52 women with unexplained acute right lower abdominal pain from April 1999 to April 2004 were retrospectively analyzed. Results Diagnosis was clarified under laparoscope in all the 52 patients, including 28 cases of acute appendicitis, 18 cases of acute pelvic inflammatory disease, 3 cases of ovarian cyst pediculotorsion, 2 cases of right tubal pregnancy, and 1 case of Crohn’s disease with iliac perforation. With exception of a conversion to open surgery in 3 patients, laparoscopic treatment was successfully completed in the remaining 49 patients. No surgical complications occurred. The patients were discharged from the hospital 2~6 days postoperatively. Conclusions Laparoscopy is a timely, safe and effective alternative for the diagnosis and treatment of unexplained acute lower right abdominal pain in women.

BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

Objective To observe cell proliferation and neurogenesis in the pregnant mouse dentate gyrus (DG) and the subventricular zone(SVZ). Methods Injection of the thymidine analog 5 bromo 2 deoxyuridine (BrdU)to determine the extent of cell proliferation combined with single or double immunohistochemistry staining with antibodies BrdU,TuJ1(class Ⅲ ? tubulin,neuron specific early differentiation marker)and GFAP. Results The number of BrdU positive cells in the pregnant mouse dentate gyrus was significantly more than that of unpregnant mouse dendate gyrus but not in the subventricular zone.In dentate gyrus,approximately 80% of these cells were neuronal characteristics (TuJ1 immunoreactive)and 3%～5% of these cells were astrocytic characteristics(GFAP immunoreactive).Conclusion\ These findings suggest that pregnancy significantly increases cell proliferation and neurogenesis in the adult mouse dentate gyrus and present the possibility that these new cells exert an important influence on hippocampal function

Objective To isolate neuroepithelial stem cells from the spinal cord neural tube of the embryonic rat and induce them to differentiate into dopaminergic neurons. Methods Serum free cells suspension culture and single cell cloning technique were used to isolate neuroepithelial stem cells. 5 bromo 2 deoxyuridine(BrdU) to label new cells combined with single or double immunocytochemistry staining to detect nestin antigen before differentiation and neural cell specific antigens after differentiation, such as neurofilament (NFM 160?kD), glial fibrillary acidic protein(GFAP), galactocerebroside(GalC) and tyrosine hydroxylase(TH). Striatal extracts were used to induce neuroepithelial stem cells to differentiate into dopaminergic neurons. Results The cells isolated from the spinal cord neural tube of the embryonic rat expressed nestin antigen. They had the potential to serially passage and differentiate into neurons, astrocytes and oligodendrocytes. Striatal extracts could induce 12% of them to differentiate into dopaminergic neurons compared with 3% in controls.Conclusion The cells, which express nestin antigen, isolated from neural tube are multipotent and have the ability to self renew, therefore, they are neural stem cells. These stem cells can be induced to differentiate into specific neurons in vitro. Which can provide materials for neural transplantation.

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with propofol in patients of Uygur nationality.Methods Thirty-one ASA Ⅰ or Ⅱ Uighurs of both sexes,aged 21-59 yr,with body mass index 18-28 kg/m2,undergoing elective surgery,were enrolled in this study.Anesthesia was induced and maintained with propofol and sufentanil target-controlled infusion and iv injection of cisatracurium 0.2 mg/kg.The target effect-site concentration (Ce) of propofol was set at 3.0 μg/ml.Tracheal intubation was performed after the target Ce and plasma concentrations were balanced.The target Ce was set at 0.8 ng/ml in the first patient.Each time Ce increased/decreased by 10％ in the next patient depending on whether or not the cardiovascular response to tracheal intubation occurred.The positive cardiovascular response was defined as increase in systolic blood pressure by 15％ and/or HR＞ 90 bpm lasting for ＞ 15 s.The EC50(95％ confidence interval) of sufentanil blunting cardiovascular responses to trancheal intubation was calculated by Probit analysis.Results EC50 (95 ％ confidence interval) of sufentanil inhibiting cardiovascular response to tracheal intubation when combined with 3.0 μg/ml propofol was 0.46 (0.43-0.49) ng/ml.Conclusion EC50 of sufentanil inhibiting cardiovascular response to tracheal intubation is 0.46 ng/ml in patients of Uygur nationality when combined with propofol.

Objective To understand the present status of human parasitic infections and their characteristics in rural areas of the southern part of Jiangsu Province, to provide basis of making practical control measures.Methods Four thousand and eighty-two people were examined with stool tests and those people were distributed in 8 slected spots in the southern part of Jiangsu Province,according to the methods of national investigation scheme on human principal parasites. Results The avarage infection rate of parasites was 6.71%. The male and female infection rates of parasites were 4.77% and 8.42%,respectively. There were significant differences (P

Objective To investigate the effects of fasudil hydrochloride on learning and memory, and the autophagy in hippocampal CA1 neurons in subarachnoid hemorrhage (SAH) rats. Methods Fifty-four male Sprague-Dawley rats were randomly divided into sham group (n=18), SAH group (n=18) and drug group (n=18). Subarachnoid hemorrhage model was established with internal carotid artery punc-ture. The drug group was injected fasudil hydrochloride 10 mg/kg intraperitoneally after modeling per 24 hours, while the sham group and SAH group were injected the same volume of saline. They were tested with shuttle box test 6, 24 and 72 hours after intervention, then the hippocampal CA1 area was stained with HE and immunohistochemistry to observe the morphology of cells and the expression of Beclin-1 and microtubule-associated protein 1 light chain 3 II (LC3-II). Results Compared with the sham group, the frequence of avoidance de-creased in SAH group at each time point (P<0.05), while the avoidance reaction time increased (P<0.05);the survival of neurons in hippo-campal CA1 area decreased (P<0.05), and the expression of Beclin-1 and LC3-II increased (P<0.05). Compared with SAH group, the fre-quence of avoidance increased in the drug group at each time point (P<0.05), while the avoidance reaction time decreased (P<0.05);the sur-vival of neurons in hippocampal CA1 area increased (P<0.05) and the expression of Beclin-1 and LC3-II increased further (P<0.05). Con-clusion Fasudil hydrochloride can improve learning and memory ability and protect neurons from damage, which may associate with the ex-cess of autophagy activation in hippocampal CA1 areas in SAH rats.

Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.

Objective To report a newly developed method and procedure to establish a rat model of subarachnoid hemorrhage in detail, and to provide a better model simulating the clinical subarachnoid hemorrhage caused by a ruptured aneurysm for related research.Methods One hundred and twenty healthy SPF 2-3-month old male Sprague-Dawley rats were divided into 4 groups, 30 rats in each group.The three experimental groups were sacrificed at 6, 24 and 72 hours after modeling.Rat models of subarachnoid hemorrhage were established by inserting a fiber core in the internal carotid artery and piercing this artery.Successful establishment of the subarachnoid hemorrhage model was confirmed by observation of breathing, pupil, defecation, urination and inspection at autopsy dissection.The controllability and reproducibility of this model were verified by observation of clinical manifestation and explored by mortality analysis.Results Subarachnoid hemorrhage was successfully induced by fiber core piercing the internal carotid artery at the needed location.Conclusions This method of model preparation is stable and understandable.The operation is nimble, with a good reproducibility.This model can be successfully performed after a short time learning, well simulate the sudden hemorrhage caused by a ruptured aneurysm, and suitable for research on early brain injury and vasospasm after subarachnoid hemorrhage.