Objective To investigate the relationship between the level of serum brain natriuretic peptide(BNP) and the severity of coronary artery disease in elderly patients with coronary heart disease(CHD).Methods We recruited 498 elderly CHD patients undergoing coronary angiography(CAG) from our hospital.Based on CAG results,patients were divided into two groups:406 patients with lesion of vessel(s)and ≥50％ vessel stenosis as the CHD group,and the other 92 patients with ＜ 50％ vessel stenosis as the negative control group.Their clinical data such as left ventricular ejection fraction(LVEF) and serum BNP was recorded.The patients was further divided into 177 single-,129 double-,100 triple-,and 92 negative vessel disease groups according to the number of vessels with significant stenosis.The patients with CHD were divided into three different age groups:(1) A group:60-69 years old,254 patients ;(2) B group:70-79 years old,112patients;(3)C group:equal or greater than 80 years old,40 patients.Serum levels of BNP were measured before CAG.The relationship between BNP and the severity of coronary disease was analyzed.Results The level of BNP was significantly elevated in the CHD group[(387.5±132.3)ng/L]than the negative control group [(58.6±22.1) ng/L](t =23.83,P ＜ 0.01).The level of BNP was significantly enhanced(F =87.42,P ＜0.01) along with the increasing number of coronary artery Stenosis,with single vessel disease group(202.2±116.6)ng/L,double vessel disease group(487.5±152.3)ng/L and triple vessel disease group(768.7±264.3) ng/L; the level of BNP significantly increased(F =57.33,P ＜ 0.01) along with increasing age,with A group(182.6±93.1)ng/L,B group(352.2±121.2)ng/L and C group(491.2±158.7) ng/L.The level ofLVEF did not change in the procedure(P ＞ 0.05).Conclusion The levels of BNP were closely associated with the severity of coronary artery disease and were a strong clinical predictor for myocardial ischemia.

C-fos,one of the immediate-early genes,encodes Fos,which appears to modulate the express of more “downstream” genes and attribute to long-term changes in cellular function.Recently,c-fos has been researched on extensively and progress has been acquired greatly.This article summarizes c-fos on structure,function and the relationship to epilepsy.

BACKGROUND:Endovascular embolization materials have been produced and used clinicaly, but new problems constantly occur in the clinical application and new demands are also developed for embolic materials. OBJECTIVE:To retrospectively analyze the advantages and disadvantages of various types of embolic materials and to investigate the relationship between application fields and selection of embolic materials, thereby providing a reference for clinical treatment. METHODS:CNKI and PubMed databases were retrieved for relevant literature, and then embolic materials were systemicaly reviewed based on relevant clinical application and basic research literature in the folowing aspects: embolism mechanisms, clinical applications, advantages and disadvantages of various embolic materials. In this review, the existing problems in the current study were pointed out, and the development direction of relevant research and clinical application were also prospected. RESULTS AND CONCLUSION:Embolic materials should have biodegradability and biocompatibility. Current embolic materials include absorbable gelatin sponge, Polyvinylalcohol embolic agent, micro-coils and liquid embolic materials. Gelatin embolic material has no antigenicity and good histocompatibility, as wel as has excelent compressibility and water re-expansibility. Polyvinylalcohol particles are a polymer material that is insoluble in water, has high expansion coefficient, mechanical embolization, non-alergenic reaction, no acute systemic toxicity, no intracutaneous irritation, and can be used safely and effectively. Adhesive liquid embolic material has no vascular toxicity and has been widely used. Endovascular embolization materials have been produced in succession, and meanwhile, new problems in clinical applications have been found and new demands for embolic materials have been put forward continuously. Thus, a variety of embolic materials have their own advantages and disadvantages, and none of embolic materials can be applied to al diseases. To select an appropriate embolic material is very important for safe and effective treatment.

BACKGROUND:Researchers suggest that thermal damage happens when the temperature of biological tissues is over 44℃. Accurate analysis of burn range wil facilitate diagnosis and therapy of skin burns. OBJECTIVE: To establish the mathematical model of the skin tissues subjected to high temperature and to analyze heat transfer process, and then to predict the burn range of the skin. METHODS:A finite element method was used to simulate the temperature field when the skin tissue was burned. And the relevant animal experiment was conducted to identify the mathematical model. RESULTS AND CONCLUSION:The temperature field was obtained by using the finite element method and the variation tendency between the theoretical data and the experimental data were agreed, but they did not fuly coincide. The scope of skin burn can be predicted by the present finite element method, and help to research the process of heat transfer.

Objective To investigate the possibility of DCs transfected with CTLA4Ig cDNA by retrovirus vector to induce antigen specific hyporesponsiveness.Methods The modified DCs(CTLA4Ig-DCs) were prepared by transferring the DCs from cultured rat BM cells with the constructed retro-virus CTLA4Ig vector.The CTLA4Ig gene expression was detected on the prepared DCs by RT-PCR and Dot-ELISA methods.The influence of the modified DCs on mixed lymphocyte reaction(MLR) intensity was determined by T cell proliferation.Results The CTLA4Ig gene could be transferred successfully to DCs by retrovirus vector,which was confirmed by RT-PCR and Dot-ELISA methods.As compared with control group,DCsRev could significantly and antigen-specifically inhibit MLR in vitro in a dose-and time-dependent manner.The number of DCRev from 10~(3) to 10~(4) could reach the maximal inhibition by(69.12 %).On the other hand,the inhibition capacity of DCsRev was increased from(48 h) to 12 h prior to adding stimulating cells and the maximal inhibition was(98.3 %) at(12 h).Analysis of T cell proliferation revealed that donor-specific inhibition could be induced by DCsRev in an ex-vivo model.But this kind of inhibition was not lifetime.Conclusions The CTLA4Ig gene could be transferred successfully to DCs by retrovirus vector.This kind of DCs lost capacity of stimulating MLR,and could inhibit T cell proliferation,which might be responsible for the antigen-specific suppression induced by DCsRev.

ObjectiveTo investigate the effects of pre-infusion of hypertonic sodium chloride hydroxyethyl starch 40(HH40)injection in prevention for transurethral electroresection of the prostate syndrome(Tuns).MethodsSixty patients with benign prostate hyperplasia(ASA)grades Ⅱ toⅢwere recruited in the study and randomly divided into two groups,one injected intravenously with HH40 at dose of 5 ml/kg by drip after sursical operation a8 experiment and the other injcoted with the same volume of Ringer's solution as control Mcan arterial pressure,heart rate,saturation of blood oxygen(SaO2)and central venous pressure were monitored for all the patients.In addition.serum concentrations of sodium,potassium,chloride and serum osmolality were determined before(T0)and 30 min(T30)and 60 min(T60) after operation,respectively,as well as pH valRe and partial pressure of carbon dioxide(PgCO2)in the gastric mucosa were determined by a Tonocap monitor.Occurrence of TURS and use of atropine,ephedrine and rinse solution were documented.Resuits TURS occurred in four patients in the eontrol group during surgical operation,whereas uo TUns occurred in experimental group.Serum sodium concentration was (126.5±13.3)mmoL/L at T60 in control group,significantly lower than that in experimental group(P＜0.05),while intragastric pH value and PgC02 level were(7.26±0.04)and(54±9)mm Hg[(7.2±1.2)kPa],respectively in controls,significantly higher than those in experimental group(P＜0.05).ConclusionsPre-infusion with HH 40 can improve tissue perfusion and prevent effectively from TURS in patients with transurethral electroresection of the prostate.

Objective To quantitatively assess the geometry configuration of mitral valve and annulus in the ischemic mitral regurgitation(IMR) and non-ischemic mitral regurgitation(NIMR) by real-time threedimensional transesophageal echocardiography (RT-3D-TEE),and provide a basis for surgical cardiac surgery.Methods 98 patients undergone RT-3D-TEE examination were enrolled in this study,and were divided into three groups:IMR group (n =43),NIMR group (n =33),and no mitral regurgitation group (control group,n =22).Full-volume 3D dynamic images of mitral annulus and valve were obtained.The images were off-line analyzed using Qlab 7.0 MVQ workstation,and the geometry indexes:area of leaflets (A3DE),area of anterior leaflet (A3DE Ant),area of posterior leaflet (A3DE Post),perimeter of annulus (C3D),anterolateral to posteromedial diameter of annulus (DAlPm),anterior to posterior diameter of annulus (DAP),annulus height (H),maximal prolapse height (HProl),maximal tenting height (HTent),volume of leaflet prolapse (Vprol),volume of the leaflets tent (Vtent),Aortic orifice to mitral plane angle (θ),angle of anterior leaflet (θAnt),non-planar angle of leaflets (θNPA),angle of posterior leaflet (θPost)and other mitral valve leaflets and annulus,were derived and statistically analyzed.Results Compared with the control group,significant increases of A3DE,A3DE Ant,DAP and θPost,and decreases of θ and θNPA were demonstrated in IMR group,the differences were statistically significant (P ＜ 0.05).Significant increases of A3DE,A3DE Ant,DAP,HProl,Vprol and θNPA,and decreases of θ,θAnt and θPost were explored in NIMR group,the differences were statistically significant (P ＜0.05).Compared with NIMR group,a reduction of A3DE,A3DE Ant,DAP,HProl and θNPA,and increases of θAnt and θPost were found in IMR group and the differences were statistically significant (P ＜0.05).Conclusions Both IMR group and NIMR group could lead to mitral annulus dilatation,leaflets area increase,and mitral annulus geometry change,the overall mitral annulus tends to flatten were more obvious in the NIMR group than those in IMR group.The prolapse is more prominent in NIMR group than those in IMR Group.The difference of mitral annulus geometry between IMR group and NIMR group indicates that the damage of the mitral leaflets and annulus might be more serious in NIMR group.

Objective To explore the surgical treatments through anterior and posterior approaches for anterior and posterior compression of cervical spinal cord. Methods The clinical data of 25 cases of anterior and posterior compression of cervical spinal cord from June 1999 to November 2003 were summarized retrospectively. There were 18 males and seven females with age range of 28-56 years (average 36.4 years). Of all,18 cases were with tricolumnae fractures of cervical spine caused by traffic injury,five with cervical herniation and two with malignant macrophage tumor in vertebral body and annex and vertebral lamina. Results All 25 cases underwent internal fixation decompression with I-stage combination operation of anterior and posterior approaches. Of 18 cases with tricolumnae fractures,one died and 17 recovered in various degrees. In five cases with cervical herniation,the positive sign disappeared basically. Two cases of malignant giant-cell tumor appeared metastatic carcinoma in the lungs 10 months after operation. Conclusions The I-stage combination operation of anterior and posterior approaches is an ideal way for the patients suffering from anteropsterospinal compression in cervical spinal cord. It can not only decompress completely the cervical spinal cord,stabilize the wounded cervical vertebra,but also facilitate nursing and function training and be beneficial to the recovery of spinal cord function.

Objective To study the effect of berberine on extracellular release of high mobility group box 1 (HMGB1) and its mechanism. Methods After LPS was activated by different concentration of berberine, the release of HMGB 1 and TNF-a, and expression of HMGB 1 mRNA in cultured mouse peritoneal macrophages was investigated. Results Berberine markedly suppressed the release of HMGB 1 and expression of HMGB 1 mRNA from LPS-stimulated macrophages (P<0.05). While the release ofTNF-a was't significantly affected. Conclusion Berberine suppressed extracellular release of HMGB 1 by decreasing expression of HMGB 1 mRNA.

Objective To investigate the accuracy of image registration with computed tomograpby (CT) and magnetic resonance imaging(MRI) and to determine gross tumor volume(GTV) of hepatocellular carcinoma(HCC).Methods Thirteen patients were enrolled in this study.CT image was taken in inhala tion phase,and MRIT2 image at the time of peak exhalation.Additional MRIT2 image was taken by fast scanning(MRIT2F) in peak inhalation phase in 6 patients.After mutual information method to CT/MRI im age registration,manual adjustment was made to optimize the accuracy of image fusion.The GTV and liver of each patient was independently contoured by two observers on CT,MRIT2 and MRIT2F images.The accura oy of image fusion was assessed by the ratio of liver overlap(P-LIVERCT-MRIAT2 ,P-LIVERCT-MRIT2F) ,and the dis tance between bone markers(DCT-MRIT2,DCT-MRIT2F) of CT and MRI on the fused image.The volumes of GTV contoured on CT (V-GTVCT),MRIT2 (V-GTVMRIT2),MRIT2F (V-GTVMRIT2F) and their overlap (V GTVCT-MRIT2,V-GTVCT-MRIT2F) and composite volumes (V-GTVCT+MRIT2,V-GTVCT+MRIT2F)were measured.The percentage of V-GTVCT and V-GTVMRIT2 on V-GTVCT+MRIT2,V-GTVCT and V-GTVMRIT2F on V-GTVCT+MRIT2F,V GTVCTMRIT2 and V-GTVCT-MRIT2F on V-GTVCT was also calculated,respectively.Results The mean DCT-MRIT2 and DCT-MRIT2F were 2.7±0.8 mm and 2.1Q±0.9mm.The mean P-LIVERCT-MRIT2 and P-LIVERCT-MRIT2F were 85.9% ± 4.1% and 92.7%± 1.5%.Interobserver difference was significant for GIN defined by CT,but not by MRIT2.V-GTVCT,V-GTVMRIT2 and V-GTVMRIT2F were 387±396 cm3 ,488 ±461 cm3 and 597 ±541 cm3 ,respectively.The percentage of V-GTVCT and V-GTVMRIT2 on V-GTVCT+MRIT2 was 66.2%±13.5% and 88.7% ± 10.2% ,while V-GTVCT and V-GTVMRIT2F on V-GTVCT-MRIT2F was 71.3%±12.7% and 93.5%± 4.8%,respectively.Conclusions CT and MRI for image fusion should be obtained in the same respirato ry phase and in the same treatment position.Automatic registration using mutual information method by auto matic registration software is useful.CT and MRI image should be integrated for HCC GTV delineation.GTV used for planning should be the sum of CT-defined GTV and MRl-defined GTV.