Objective To evaluate and compare the therapeutic effects among intravenous rt-PA thrombolysis,thrombolysis plus delayed intracoronary stenting for acute myocardial infaction(AMI)using 99Tcm-MIBI myocar dial SPECT imaging.Methods 60 cases of AMI were divided into two groups Which were the thrombolysis group(n=30),thrombolysis plus delayed stenting group(n=30).99Tcm-MIBI myocardial SPECT imaging was performed 3 weeks after thrombolysis therapy.Results The scores of the two groups were(29.5±7.8),(18.4±6.2)(t=7.2,P＜0.01)respectively.Conclusion Thrombolysis plus delayed stenting seems to be more effective than thrombolysis.

Objective To investigate the clinical effect and immunologic function of Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder.Methods 64 cases of Ventilator pneumonia in our hospital were collected and randomly divided into experiment group and control group, 32 cases each.Two groups were given conventional treatment, the control group received Methylprednisolone Sodium Succinate 1 mg/kg qd, the experiment group was given Methylprednisolone Sodium Succinate 1 mg/kg qd, and Moxifloxacin Hydrochloride and Sodium Chloride Injection 400 mg qd.Two groups of patients were continuous treated for 10 days.After treatment,T lymphocyte subsets, NK cells, white blood cell count, C reactive protein, clinical symptoms disappeared time, mechanical ventilation time, ICU length of stay and mortality rate were compared. Results After treatment, the total effective rate in the experiment group 75% was higher than the control group 50%( P <0.05 ).The levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in two groups increased(P<0.05), levels of CD8 +decreased(P<0.05),levels of WBC, CPR and PCT decreased in the two groups(P<0.05), and compared with the control group, the levels CD3 +, CD4 +, CD4 +/CD8 +and NK cell in the experiment group were higher(P<0.05), levels of CD8 + were lower(P<0.05),levels of WBC,CPR and PCT were lower(P <0.05), the rales disappeared time, cough disappeared time, fever disappeared time were significantly shorter than the control group(P <0.05), the duration of mechanical ventilation and the length of hospital stay were significantly shorter(P<0.05).Conclusion Moxifloxacin combined with small dose of hormone in the treatment of Ventilator pneumonia in elder was significantly effective, and it can relieve inflammation, prevention of infection control, enhance immune function.

Objective To observe the clinical effect and side-effect of low molecular weight beparin (LMWH) and simvastatin on patients with acute myocardial infarction(AMI). Methods 80 cases of AMI were randomly divided into simvastatin with low-molecular-weight heparin treatment (joint group) 40 cases and nitrates drug treatment( conventional group) 40 cases Au the patiants were observed before and after treatment for serum inflammatory factor,quantitative gated tomography,Holter and analysis of the effectbefore and after treatment. Results The conventional group and joint group after the treatment of TC, TG, LDL, HDL-C, hs-CRPs, CD40L levels were decreased than before treatment (t=2. 131, t = 2. 211, t = 2. 235, t = 2. 211, t = 2. 115, t = 2. 274, both P＜0. 05 ) ; the joint group after treatment bs-CRP, sCD40L significantly declined than conventional group (t = 2. 231, t = 2. 245, both P＜0. 05 ) ;conventional group of IMT dropped 1.1% lower than the 3.4% of the joint group ( X2 = 4. 01,P＜0. 05 ) ; conventional treatment group plaque score 11.5% higher than the combined group plaque score decreased 16. 9% (X2 =4. 25 ,P＜0. 05) ;joint group after treatment,a few soft spots(7. 7 %) lower than before treatment(28.2%) (X2 = 6. 78,P＜0. 01) ;the joint group of EDV,ESV,EF after treatment decreased significantly than before treatment (t =2. 221 ,t =2. 342 ,t = 2. 245, P＜0. 05) ; conventional treatment group and joint group after the number of ischemic attack, ST above the largest decrease, ST segment depression was significantly lower than the time before treatment(t=2. 731 ,t=2. 781, t=2. 785,t=2. 781, t=2. 815, t=2. 874, both P＜0. 01);joint total effective rate 90. 0% higher than the conventional group 67.4% (X2=4. 25,P＜0. 05 ). Conclusion Simvastatin combined with LMWH have good effect in the treatment of acute myocardial infarction.

To introduce Prof. Jin Yi-cheng’s academic thoughts on pediatric tuina therapy, in order to promote the extensive application of the relevant tuina techniques and the inheritance of famous doctor’s experience, and enhance the clinical effects of tuina in treatment of children’s diseases.

Objective To explore the method and therapeutic principle of transcatheter closure of coronary artery fistula, aortopulmonary collaterals and aortopulmonary window. Methods Interventional occlusion of 4 cases of coronary artery fistulas and 1 case of aortopulmonary collaterals with Cook coils, 1 case of coronary artery fistulas and 1 case of aortopulmonary window with AGA Amplatzer duct occluder. The mean age of 7 children were 8.5 years. Results Transcatheter closure of 7 cases of vascular malformations were successful. During the follow-up period of 1 month to 5 years, no residual shunt and other complications appeared. Conclusion The curative effect of transcatheter closure of vascular malformations was good. But for the occlusions′ success and prevention from complications occurrence, the indications of closure should be obeyed, the time of X-ray exposure should be less than 60 minutes.

Objective To evaluate the therapeutic effect of transcatheter closure of perimenbranous ventricular septal defect (PMVSD) with membranous VSD occluder device and compare the effect of transcatheter closure of VSD with surgery. Methods The therapeutic effect of transcatheter occlusion in 48 children with VSD is compared with that of other 73 cases who had received surgical treatment. Age, height, weight, pulmmary artery pressure, size of the defect, time for hospitalization, success rate as well as complications after operations are compared between the 2 groups. All the data are proccessed either by means of t test or ? 2 test statistically. Results There are no statistical differences between the two groups in age, height, weight, pulmonary systolic pressure and the rate of success. But the size of VSD is smaller and the time for operation and hospitalization is shorter in the group of transcatheter occlusion. There are no significant differences between the two groups in the rate of complications including the second surgery, residual shunt, bleeding, nerve injury, hemolysis, Ⅲ atrioventricular block, pneumothorax, hydrothorax, hydropericardium, aortic valve insufficiency and infection. But left anterior bundle branch block and complete left bundle branch block occur more often in the group of the catheter interventions during or after the occlusion. Conclusion Transcatheter occlusion shows a promising therapeutic effect on VSD. To prevent complications, therapeutic rules and technical criterias should be obeyed and close monitoring after the closure should be carried out.

Objective To analyze the clinical application of monoenergetic technique of dual-energy CT in removing metal artifacts for patients with fractures fixed with metal fixer.Methods Fofly-five patients with fractures fixed with metal fixer underwent dual-energy CT scanning for the fractures.Two different data were collected in one-time scanning using dual-energy scanning sequence.With monoenergetic technique,two different data at 100 and 140 kilovolts were used for subtraction to removing metal artifacts based on different densities.Raw data were reconstructed with monoenergetic technique(group A)and conventional simulation method(group B),respectively.And,all data were reconstructed with multiplanar reconstruction (MPR),volume rendering(VR)and maximum intensity projection(MIP),respectively.Wilcoxon signed rank test was applied for the comparison of imaging quality and artifacts between the two groups.Results There were fewer artifacts on the images due to the application of monoenergetic technique in dual-energy CT scanning.In group A,the rate of high-quality images reached to 91.9%(124/135);and,in group B,it was 59.3%(80/135).There were statistical diference between the two groups(Z=-12.541.P<0.01).The images without artifact reached to 89.6%(121/135)in group A;whereas,it was 45.2%(61/135)in group B.There was statistical difference between the two groups(Z=-11.910,P<0.01).Conclusion Using monoenergetic technique,metal artifacts were removed effectively and the fine structure of fracture was clearly displayed.

Objective To analyze the incidence of complications during and after interventional therapy for common con-genital heart disease (CHD) in children. Methods From January 2011 to December 2013, interventional therapy of common congenital heart disease which include ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA) and pulmonary valve stenosis (PS) were performed in 2356 patients. Among them, 159 patients who developed complications during and post to interventional therapy were retrospectively analyzed. Results The overall complication rate was 6.75%(159/2356) (11.40% post VSD occlusion, 7.50% post ASD occlusion, 3.09% post PDA occlusion, 1.63% post percutaneous balloon pulmonary valvuloplasty (PBPV) ).The rate of arrhythmia was 4.41%(102/2356). The severe complication rate was 2.71%(64/2356) (3.62%post VSD occlusion, 2.21%post ASD occlusion, 2.53%post PDA occlusion, 1.63%post PBPV). The intraoperative severe complication rate was 0.51%(12/2356);the early severe complication rate was 1.99%(47/2356);the late severe complication rate was 0.21%(5/2356). Interventional therapy rate was 0.13%(3/2356); cardiovascular surgery rate was 0.64%(15/2356);conservative treatment rate was 1.95%(46/2356). The mortality rate was 0.08%(2/2356). Conclusions The complications and mortality rate of interventional therapy for CHD in children are relatively low, but cannot be ignored. The complication could be reduced by choosing proper indications, following the operational procedures and careful operative follow-up.

Objective To evaluate the safety and efficacy of percutaneous closure for muscular ventricular septal defect(MVSD).Methods Fifty-one patients diagnosed as MVSD from October 2011 to July 2016 at Guangdong General Hospital were enrolled including 32 males and 19 females,ranging from 1 to 16 (5.12 ±3.52) years in age,weight (20.19 ± 10.55) kg.The diameter of the MVSD was (4.82 ± 2.51) mm which was measured by transthoracic echocardiography (TTE),and multiple defects were found in 10 patients.The choice of plugging device and transport system depended on the size,position and status of MVSD.TTE and left ventricular (LV) angiography were performed before and after release of the device to evaluate the therapeutic effects.Electrocardiogram and TTE were performed during follow-up period at 24 h,1 month,3 months,6 months and 12 months after operation and yearly thereafter.Results Eight cases showed no hemodynamic significance through standard catheter examination then the interventional therapy was stopped.Cardiac arrest was found in 1 case when the long sheath was transported along the track,and the procedure was terminated immediately,and the selective surgical operation was performed after successful rescue.The devices were successfully placed in the rest of 42 patients (97.6％) with operation time (90.68 ± 36.42) min and fluoroscopy time (18.67 ± 10.89) min.The average of follow-up time was (13.82 ± 13.84) months ranging from 1 to 48 months.It was found that mild residual shunts showed in 4 cases during operation,mild tricuspid regurgitation showed in 2 cases and trivial aortic regurgitation showed in 1 case at 6 months after operation,but there was no need to intervene anymore.Conclusions Percutaneous closure of MVSD in children is safe and effective with high successful rate and low incidence of complication.The middle-term follow-up findings were satisfactory.

In experimental teaching of oral histological pathology,we made full use of the heuristic teaching,observing sectioning, practice and CAI teaching effect and meaning and reached the conclusion that the comprehensive teaching is helpful to students’autonomous learning, cultivating their observation analysis ability,deepening their understanding and at the samen timehelping them improve their practical capability,so as to improve greatly both the oral experiment teaching quality and students’comprehensive practice ability.