Objective:To explore causes of complicated acute lung injury (ALI) after percutaneous coronary interven-tion (PCI) .Methods:According to blood gas analysis and chest imaging examination ,a total of 175 patients under-going PCI were divided into ALI group (n=62) and non-ALI group (n=113) .High performance liquid chromatog-raphy was used to measure plasma concentrations of epinephrine (E) and norepinephrine (NE) during perioperative period .Plasma levels of interleukin-6 (IL-6) and procalcitonin (PCT) and chest CT imaging changes were meas-ured .Fluorescent immunoassay was used to measure plasma level of brain natriuretic peptide (BNP) to assess impact of cardiac function on ALI .Results:Compared with non-ALI group on 1d after PCI ,there were significant rise in plasma levels of NE [ (2.51 ± 0.31) nmol/L vs .(6.91 ± 0.39) nmol/L] and E [ (1.23 ± 0.11) nmol/L vs .(6.03 ± 0.37) nmol/L] ,P<0.01 all;and significant rise in plasma levels of IL-6 [ (119.81 ± 17.23) pg/ml vs .(252.28 ± 34.23) pg/ml] ,PCT [ (0.88 ± 0.01) pg/ml vs .(4.99 ± 0.87) pg/ml] and BNP [ (927.82 ± 89.72) pg/ml vs . (3936.55 ± 131.78) pg/ml] in ALI group (P<0.01 all) .Chest CT indicated that lung tissue inflammation was seri-ous .Conclusion:In patients undergoing percutaneous coronary intervention ,complicated acute lung injury is related to hyperactive sympathetic activity ,postoperative inflammation and heart function status etc .

Objective: To observe the therapeutic effect of peritoneal dialysis on low cardiac output syndrome (LCOS) after surgery in children with congenital heart disease (CHD). Methods: A total of 61 CHD children complicated with LCOS after surgery were selected. Echocardiography was used to measure heart chamber diameter, left ventricular ejection fraction (LVEF) and pulmonary artery pressure etc. before and after peritoneal dialysis; and central venous pressure (CVP), urine volume, blood gas analysis indexes，plasma brain natriuretic peptide (BNP) concentration were measured to evaluate influence of peritoneal dialysis. Results: Compared with before treatment, there were significant increase in urine volume [(203.28±15.81) ml vs. (989.11± 54.72) ml], LVEF [(32.94±2.29)% vs. (51.93±2.79)%]；and significant reduction in pulmonary artery pressure [(46.72±3.84) mmHg vs. (34.82±2.92) mmHg], CVP [(17.27±1.47) cm H2O vs. (10.41±1.01) cm H2O] and plasma BNP level [(5928.71±158.27) ng/ml vs. (3851.83± 128.81) ng/ml], P<0.001 all. Conclusion: Peritoneal dialysis may effectively treat low cardiac output syndrome after surgery in children with congenital heart disease, related with its effect of ultrafiltration and relieve cardiac burden.

Objective To study the symptomatic characteristics distribution of Chinese medicine of patients with pulmonary hypertension.Methods Symptomatic information of 52 patients with pulmonary hypertension was collected to find the symptomatic characteristics of Chinese medicine,and analyse the correlation of symptom and pulmonary hypertension with different types and degrees.Results The proportion of TCM symptom of pulmonary hypertension from high to low were syndrome of strong Qi sinking(96.2%),syndrome of blood stasis(75.0%),syndrome of deficiency of lung Qi(42.3%),syndrome of deficiency of heart Qi(30.8%),syndrome of deficiency of spleen Qi(17.3%).Syndrome of blood stasis was the most closely related to the congenital cardiopathy(CC) with pulmonary hypertension.Syndrome of deficiency of heart Qi was the most closely related to the degree of pulmonary hypertension increased pressure.The next one was syndrome of deficiency of lung Qi.Conclusion Syndrome of strong Qi sinking,syndrome of blood stasis,syndrome of deficiency of heart Qi and syndrome of deficiency of lung Qi are the main syndromes of pulmonary hypertension.Syndrome of strong Qi sinking is the most closely related to the pulmonary hypertension.

Objective To evaluate the clinical value of ultrasonography in diagnosis of benignPHand malignant thyroid nodules by binary Logistic regression model.Methods A retrospective analysis of 240 cases of thyroid nodules confirmed by pathology after operation excision was conducted.173 nodules were benign as control group,67 nodules were malignant as observation group.The ultrasonic features of thyroid nodules were collected.The factor had statistics significance by x2 test between the two groups were analyzed by binary Logistic regression.A logistic regression model was created.The ROC curve was drawn and the area under the curve was calculated.Results There were statistically significant differences among boundary,aspect ratio,shape,internal echo,calcification,acoustic halo,cervical lymphadenectasis between the control group and observation group(x2=45.392,7.590,30.039,24.168,37.406,6.893,16.078,all P<0.01).And after Logistic regression analysis,six variables that entered the regression equation were boundary(P=0.000,OR=8.437),aspect ratio(P=0.000,OR=12.816),microcalcification of the nodules(P=0.000,OR=8.893),shape(P=0.000,OR=8.791),internal echoes(P=0.001,OR=8.313)and cervical lymphadenectasis(P=0.001,OR=6.891).The accuracy of the model was 90.7%(223/246)in predicting malignant nodules in thyroid.The area under the ROC curve was(0.904±0.031).Conclusion The binary Logistic regression can be used to differentiate malignant and benign thyroid nodules,and make a more accurate judgment for the nodules in thyroid.

Objective To construct the RNAi vector targeting survivin gene, in order to observe its effect on lung adenoearcinoma A549 cell radiosensitivity, and explore the possible mechanism. Methods One pair of RNA interference sequence targeting survivin gene was designed according to the eDNA sequence, the recombinant RNAi plasmid pGenesil2-survivin was constructed. After certified by enzyme digestion and sequencing, the pGenesil2-survivin plasmid was transfected into A549 cells. Survivin mRNA and protein was measured by RT-PCR and Western blot, respectively. The apoptosis was analyzed with flow cytometry. The radiosensitivity was measured by clone formation assay. Results The pGenesil2-survivin vector was successfully established. After the pGenesil2-survivin was transfeeted into A549 cells for 48 h, surviving protein and mRNA in pGenesil2 group were not obviously changed compared with that in normal group. They were increased after 5 Gy X-ray irradiation, but obviously inhibited in pGenesil2-survivin group. The cell apoptosis in pGenesil2-survivin and 5 Gy X-ray groups was obviously increased (t1 = 10.63, P < 0.001 ; t2 = 3.75 , P < 0.05), the effect was more manifest in combined group(t = 4.83, P < 0.05). D0 and Dq in normal and pC, enesil2 group were not obviously different, but those in pGenesil2-survivin group were lower. Conclusions RNAi targeting survivin gene could inhibit survivin mRNA and protein expression, enhance the A549 cell apoptosis rate and cell radiosensitivity.

Objective:To observe therapeutic effects of dexmedetomidine combined metoprolol on subarachnoid hemorrhage (SAH) complicated myocardial injury (MI) .Methods:According to random number table , a total of 131 SAH + MI pa‐tients were divided into control group (n=31) ,metoprolol group (n=34) ,dexmedetomidine group (n=32) and combined treatment group (n=34 ,received metoprolol combined dexmedetomidine ) .Plasma levels of norepinephrine (NE) ,epi‐nephrine (E) ,brain natriuretic peptide (BNP) and cardiac troponin I (cTnI ) were measured ,echocardiography etc .were used to assess MI recovery condition before and after treatment in all groups .Results:Compared with before operation , there was significant rise in LVEDd on 1d after operation ,significantly reduced on 3d after operation and recovered to nor‐mal on 7d after operation ( P<0.05 all);significant reduction in LVEF on 1d after operation ,significantly rose on 3d after operation and recovered to normal on 7d after operation ( P<0.05 all);significant rise in levels of cTnI ,BNP ,NE and E on 1d after operation ,started to reduce on 3d after operation and recovered to normal on 7d after operation in metoprolol group ,dexmedetomidine group and combined treatment group , P< 0.05 all;compared with control group ,metoprolol group and dexmedetomidine group on 7d after operation ,there was significant reduction in LVEDd ,and significant rise in LVEF and significant improvement in cardiac function ;significant reductions in plasma levels of NE [ (1.37 ± 0.08) pmol/L ,(1.05 ± 0.09) pmol/L ,(1.19 ± 0.07) pmol/L vs .(1.01 ± 0.06) pmol/L] ,E [ (6.17 ± 0.41) pmol/L ,(6.02 ± 0.34) pmol/L ,(6.06 ± 0.29) pmol/L vs .(5.26 ± 0.26) pmol/L] ,cTnI [ (0.22 ± 0.02)μg/L ,(0.11 ± 0.03)μg/L ,(0.17 ± 0.02)μg/L vs .(0.09 ± 0.01)μg/L] and BNP [ (1126.81 ± 11.27) ng/L ,(1014.09 ± 14.29) ng/L ,(1154.09 ± 16.52) ng/L vs .(954.09 ± 9.31) ng/L] in combined treatment group ,P<0.05 all .Conclusion:Either dexmedetomidine or meto‐prolol ,or their combination can effectively inhibit SAH complicated myocardial injury ,improve cardiac function ,but com‐bined treatment possesses the best effective effect .

BACKGROUND: A skull defect is inevitable after decompression treatment for traumatic brain injury. Titanium mesh as the most recognized skull repair material has good biocompatibility and has been widely used in clinical practice. However, the timing for skull repair after brain injury is still in dispute.OBJECTIVE: To compare the changes of brain perfusion and the recovery of neurological function in patients with skull defects before and after early and late-stage titanium mesh repair based on CT perfusion technique.METHODS: This was a single-center, prospective, observational clinical trial that was completed at the Taihe Hospital,Hubei University of Medicine in Hubei Province, China. Eighty-six patients with craniocerebral injury who had undergone decompression with removal of bone flap from January 2013 to January 2016 were recruited and subjected to skull repair using titanium mesh. All the patients were randomized into two groups: test group (n=40) with early skull repair within 1-3 months after decompression and control group (n=46) with late-stage skull repair within 6-12 months after decompression. CT perfusion technology was used to observe changes of brain perfusion at 3 days operatively and at 10 days postoperatively. The Barthel index was evaluated at 30 days postoperatively. The trial was registered with ClinicalTrial.gov (identifier: NCT03222297) on July 12th, 2017. The study protocol was approved by the Ethics Committee of Taihe Hospital with the approval No. 2012 (08), and performed in accordance with the Declaration of Helsinki,formulated by the World Health Organization and the hospital's ethical requirements for human research. All the patients and their families were voluntary to participate in the trial, were fully informed of the trial process, and then signed the informed consent prior to the initialization of the trial.RESULTS AND CONCLUSION: The postoperative cerebral blood volume and cerebral blood flow at the parietal cortex on the side of skull defect and at the cortex in the defect region were significantly higher in the two group than the baseline (P < 0.05), while the time to peak was lower than the baseline (P < 0.05). Compared with the control group,significantly higher cerebral blood volume and cerebral blood flow as well as shorter time to peak were observed in the test group (P < 0.05). The Barthel index of the test group was also significantly higher than that of the control group at 30 days postoepratively (P < 0.05). Overall, early skull repair with titanium mesh is helpful to improve the cerebral blood perfusion at the affected side and the recovery of neurological function. In addition, CT perfusion technology is a safe and effective method to monitor hemodynamic changes in the brain.

ObjectiveTo investigate the effect of intrathecal injection of TRPV3-siRNA lentivirus on bone cancer pain(BCP) behaviors in rats.Methods40 female SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 4 groups (n=10 in each group):Sham group (S),BCP group (B),negative control lentivirus group (C) and TRPV3-siRNA lentivirus group (T).Group B,C and T were induced bone cancer pain by intra-right-femur inoculation of Wallker 256 cells,while rats in group S were injected of inactivated cell.Rats in group T were intrathecally treated with 5 μl TRPV3-siRNA lentivirus while rats in group C received 5 μl negative lentivirus on 1~6 d after surgery.All the rats received pain behaviors including paw withdrawal thermal latency(PWTL) and paw withdrawal mechanical threshold (PWMT) at 1 d before BCP and 1,3,6,9,12,15,18 and 21 d after BCP.L4~L6 spinal cords were reserved for RT-PCR and Western Blot.ResultsCompared with group S,PWTL and PWMT of group B were decreased (P<0.05).On the 9th day,PWTL of group T was higher than that of group C((17.52±2.15)s vs (14.36±1.67)s,P<0.05).However,there was no significant difference in PWMT between group T and group C((16.89±1.54)g vs (15.53±1.36)g,P>0.05).The results of RT-PCR and Western blot demonstrated that the expression of TPPV3 in group T was decreased compared with that in group C(P<0.05).ConclusionIntrathecal injection of TRPV3-siRNA lentivirus can inhibit the expression of TRPV3 and thus alleviate symptom of PWTL,but not PWMT.

Objective To investigate endplate shape in low lumbar spine in patients with herniated nucleus pulposus, and analyze the relationshipbetween endplate shape and herniation of intervertebral disc, Modic changes. Methods The preoperative MRI of 110 patients wasreviewed. The endplate shape was divided into 3 types. Disc degeneration was classified with the Pfirrmann's way. Results Concave typewas the most common in the lower lumbar spine. Flat was more prevalent in lower than in upper. The L5~S1 segment was flat in most cases.Irregular type was the least and mainly appeared at the L5~S1 segment. Disc degeneration worsened from concave, flat, to irregular. Herniatedintervertebral disc dominated with flat and irregular endplates, and no-herniated ones dominated with concave. Modic changes more associatedwith irregular endplates. Conclusion Endplate shape may respond to the disc degeneration. Modic changes associate with irregularendplate.

Objective To observe the characteristics and treatment of malignant peripheral nerve sheath tumor originated from neurofibromatosis and the outcome of the patients. Methods A case was reported and the related literatures were reviewed. Results and Conclusion Malignant peripheral nerve sheath tumor is a rare soft tissue malignancy, which is with highly invasion. There are some difficulties with the diagnosis and treatment, and the outcome is poor. Early diagnosis is very important for treatment.