The structure and the blood supply of perichondral ring of human being and rabbits in developing period were studied by microangiographic and histological methods. Perichondral ring is situated around the epiphyseal disc and metaphysis and consists of osseous ring, zone of mesenchymal cell, which contains fairly abundant blood vessels derived from the metaphyseal periosteum and perichondrium. The perichondrium is thick and also contains abundant vessels which connect epiphyseal and metaphyseal circulations in the extra-osseous and part of which passes through the zone of mesenchymal cell to supply the epiphyseal disc. Role of perichondral ring in the development period of bones were discussed.

Objective: To explore the efficacy of esmolol on cardiac ischemia in patients with serious coronary lesions who are not candidates for coronary revascularizations. Methods: Fifty seven aged patients (34 male) with serious coronary artery disease not candidates for coronary revascularizations were included. All patients had classical angina involved in cardiac ischemia, and definitely ischemic ST-segment depressions in surface electrocardiogram, however which were not relieved by routine treatment including intravenous nitrate or even morphine. All patients received loading dose injection and continuously intravenous infusion of Esmolol, and the baseline characteristics before treatment and the effects at 4 hours after infusion of Esmolol were carefully recorded. Results: After infusion of Esmolol, the ischemia-related symptoms of 41 patients completely relieved, and their ST depressions recovered to the baseline accompanied with significant reduction in blood pressure and heart rate (P＜0.0001 all) within (66±23) min. Moreover, nine patients were observed that their ischemia-related symptoms were relieved and ST alteration recovered partially (P＜0.0001 both) at four h after continuous infusion of esmolol. Conclusion: Esmolol is effective to relieve the serious cardiac ischemia-related symptoms and ST-T alteration of ECG in patients with serious coronary lesions.

Background Researches determined that the pathogenesis of retinal vein occlusion (RVO) is associated with primary open angle glaucoma (POAG) in Caucasian population.However,the relationship between RVO and POAG in Asian population is unclear.Objective This study was to survey the percentage of POAG in RVO patients in China.Methods A prospective cross-sectional observational study based on hospital was performed.Three hundred and seventy five patients with newly diagnosed RVO by fluorescein fundus angiography (FFA) were consecutively enrolled in Peking University Third Hospital from October 2011 to May 2013,and gonioscopy was carried out in all the patients.Glaucoma was diagnosed according to the criteria of the International Society of Geographical and Epidemiological Ophthalmology (ISGEO).RVO was classified into central retinal vein occlusion (CRVO),hemicentral retinal vein occlusion (HRVO) and branch retinal vein occlusion (BRVO) based on fundus photograph and FFA,or classified into arteriovenous crossing RVO (AV-RVO),optic cup RVO (OC-RVO),optic nerve RVO without optical nerve head swelling (NONHS-RVO) and RVO with optical nerve head swelling (ONHS-RVO) based on the sites of venous occlusion.The percentages of POAG in different types of RVO were calculated.This study was approved by Ethic Committee of Peking University Third Hospital,and written informed consent was obtained from each patient before entering study cohort.Results Three hundred and seventeen RVO patients finished screening of glaucoma,with the response rate 84.5％.The percentage of POAG is 8.2％ in RVO patients,including 7.1％ in the CRVO patients,23.5％ in HRVO patients and 6.2％ in BRVO patients.The percentage of POAG was significantly higher in OC-RVO patients (27.9％) and NONHS-RVO patients (13.2％) than that in AV-RVO patients (4.7％) and ONHS-RVO patients (1.3％) (all at P＜0.05).Conclusions The overall percentage of POAG in RVO patients in China is 3-4 times higher than general population.Higher percentage of POAG is found in OC-RVO patients and NONHS-RVO patients,suggesting that pathogenesis of RVO is probably associated with the glaucomatous anatomic changes of optical nerve head.

ObjectiveTo investigate clinical risk factors and coronary angiographic features in young men with acute myocardial infarction (AMI).MethodsWe retrospectively studied 200 young men with AMI and compared with 104 non-CHD men,89 old men with AMI.All patients were admitted to hospital from January 2009 to December 2010 and undergone coronary angiography,and the clinic and coronary angiographic features were assessed.The relation between body mass index (BMI),smoking history,familial history of early coronary artery disease,essential hypertension,type 2 diabetes mellitus,hyperlipidemia,serum uric acid ( UA),lipids,hemoglobin (Hb),fasting blood glucose (FBG) with coronary artery disease and its severity was observed.The severity of CAD was diagnosed by the number of diseased vessel.Results In young men with AMI group,the factors such as smoking history,obesity,essential hypertension,type 2 diabetes mellitus,familial history of early coronary artery disease were remarkably different ( P ＜ 0.05 ) ; body mass index,fasting blood glucose,total cholesterol,triglyceride,low density lipoprotein cholesterol were higher than the control group ( P ＜ 0.05 ),hemoglobin was lower than the control group ( P ＜ 0.05 ).Applying Logistic regression analysis,obesity ( OR =11.020),type 2 diabetes mellitus ( OR =5.805 ),essential hypertension ( OR =4.428 ),familial history of early coronary artery disease ( OR =2.883 ),smoking history ( OR =2.153 ) and lower concentration hemoglobin ( OR =1.034) are independent risk factors (P ＜ 0.05) for young men with AMI. According to coronary angiography in young men with AMI,there were 14 cases with zero-vessel disease,109 cases with singlevessel disease (54.50％,69 cases involved with left anterior descending artery) and 42 cases with twovessel disease,35 cases with three-vessel disease.The ratio of single vessel disease involved left anterior desending artery in young men was higher than that of old men with AMI ( P ＜ 0.05 ).Conclusions Obesity,type 2 diabetes mellitus,essential hypertension,familial history of early coronary artery disease,smoking history and lower concentration of hemoglobin are risk factors of young men with AMI ; Single vessel coronary disease is seen more frequently in young men with AMI.

Objectives To evaluate the efficacy and safety of administering Ivabradine in the elder patients with chronic heart failure(HF).Methods Totally 52 outpatients with chronic stable HF in Fuwai Hospital and Anzhen Hospital from August 2015 to February 2016,with heart rates (HR)of ＞70 bpmafter optimized medical therapy were selected and administrated Ivabradine for 3 months(Ivabradine group).50 patients who received optimized medical therapy except Ivabradine for economic or other reasons were recruited as control group during the same period.Initial dose of Ivabradine was 2.5 mg two times a day,up to a maximum of 7.5 mg two times a day,adjusting the dose according to HR.Resting HR of the patients was maintained around 60 beats/min and not lower than 55 beats/min.HR,N-terminal pro-brain natriuretic peptide (NT-proBNP),6-minute walk distance,Minnesota heart failure quality of life(MLHFQ),left ventricular ejection fraction(LVEF) and adverse effects were recorded.Results At baseline,no significant differences were found in HR,NT-proBNP,the scores of MLHFQ,6-minute walk distance (all P＞ 0.05) between Ivabradine group and control group.After 3 months of treatment,compared with control group,Ivabradine group showed significantly decreased levels of HR,the scores of MLHFQ and NT-proBNP(allP＜0.01),and significantly increased 6-minute walk distance and LVEF(all P＜0.01).Compared with baseline data,Ivabradine treatment showed the decreased levels of HR [(69.5 ± 10.2)bpm vs.(80.2 ± 7.8)bpm,P＜0.05],the scores of MLHFQ [(14.9±4.3)scores vs.(23.5±6.2)scores(P＜0.05)]and NT-proBNP [1 682 ng/L (212-3 628) vs.2 450 (254-5 344) ng/L,P ＜ 0.05] significantly,and showed the significantly increased levels of 6-minute walk distance [(386.4 ± 101.8)m vs.(282.9 ± 86.3)m,P＜ 0.05]and LVEF [(40.0±6.0)％vs.(31.0±7.0)％ (P＜0.05)].Few adverse effects were recorded.Conclusions In elderly outpatients with stable HF,Ivabradine treatment is effective and safe.

Objective To explore the relationships among post traumatic stress disorder(PTSD),gratitude and posttraumatic growth (PTG) for terminal cancer patients.Methods Totally 119 advanced cancer patients were investigated with the self-demographic questionnaire,posttraumatic growth inventory (PTGI),the PTSD cheeklist-civilian version (PCL-C) and the Gratitude Questionnaire-6 (GQ-6).Results For terminal cancer patients,the total score of PCL-C was 34.02±12.49.The scores on re-experience,avoidance/numbness,hypervigilance were 9.79±3.78,13.85±5.68,10.36±3.80.The total score of gratitude was 29.37±7.48.The total score of PTG was 51.34± 13.57.The scores of life appreciation,personal relationship and self-strength were 8.00± 2.99,21.18± 5.84,22.16± 6.10.The total scores of PTG were significantly statistical significance among different PTSD groups(F=16.267,P＜0.01)and gratitude groups(F=43.674,P＜0.0 1).The total scores of PCL-C (r=-0.694,P＜0.01),re-experience (r=-0.664,P＜0.01),avoidance/numbness (r=-0.671,P＜0.01),hypervigilance (r=0.753,P＜0.01) and gratitude(r=-0.611,P＜0.01) were all correlated with PTG.The total score of PCL-C and gratitude could explain 66.6％ variation of PTG.For the relationship between PTSD and PTG,the moderation effect of gratitude was not significant (P ＞0.05).Conclusion The gratitude and PTSD were important influence factors for terminal cancer patients' PTG,while the moderation effect of gratitude was not significant,so in clinical intervention we should pay more attentions to the actual effects of gratitude,and we should not pursuit gratitude education blindly.

Objective:To explore the curative effect of assisted surgery based on 3D printing technology on complex Pilon fractures.Methods:From June 2017 to June 2018, 52 patients with complex Pilon fracture treated in the General Hospital of Armed Police Navy were selected in the study.The patients were divided into study group ( n=26) and control group ( n=26) according to different operation mode.The control group was treated with traditional open reduction and internal fixation, and the study group was supplemented with 3D printing technology.The differences of treatment effect, operation time, intraoperative hemorrhage, fracture healing time, hospitalization time, incidence of complications, ankle function score and VAS pain score between the two groups were compared. Results:The total effective rate of the study group was 88.5%(23/26), which was higher than 65.4%(17/23) of the control group (χ 2=3.900, P=0.048). The mean operation time ( t=-3.770, P<0.001), mean fracture healing time ( t=-2.206, P=0.032) and mean hospitalization time ( t=-9.542, P<0.001) of the study group were shorter than those of the control group, and the amount of intraoperative bleeding ( t=-20.226, P<0.001) was less than that of the control group, the differences were statistically significant.The total incidence of complications in the study group was 15.4%(4/23), which was lower than 42.3%(11/23) in the control group (χ 2=4.591, P=0.032). With the development of time, the ankle function score of the two groups increased gradually, and the VAS pain score decreased gradually ( P<0.05). One month after operation, the ankle function score of the study group was higher than that of the control group ( t=2.340, P=0.023), but there was no statistically significant difference between the two groups in VAS pain score ( t=-0.278, P=0.782). At the last follow-up, the ankle function score of the study group was higher than that of the control group( t=2.760, P=0.008), and the VAS pain score of the study group was lower than that of the control group( t=-3.633, P<0.001), the differences were statistically significant. Conclusion:3D printing assisted surgery is better than traditional open reduction and internal fixation in the treatment of complex Pilon fracture, with shorter operation time, fracture healing time and hospitalization time, less intraoperative bleeding, lower incidence of complications and better postoperative recovery.

Structure of biliary system is complex as well as various, making troubles for optimal surgical treatment of biliary disease. Remarkable imaging of biliary system helps surgeon evaluating patients and planning surgeries. There are several methods to obtain accurate anatomical information of biliary system, such as X-ray fluoroscopy, MRI and fluorescence-based imaging. Each has its own advantages and disadvantages. Combination of multi-model imaging technologies may improve visual result of anatomical information of biliary tract. More resolvable, legible, and sequential imaging technology of biliary system remains further study. This article reviews various cholangiography methods widely used in the clinical setting.

Background: Voltage-gated sodium channel 1.5 (Nav1.5) potentially promotes the migratory and invasive behaviors of colon cancer cells. Hitherto, the prognostic significance of Nav1.5 expression remains undetermined. The present study aimed to explore the associations of Nav1.5 expression with clinical outcomes and estrogen receptor-β (ER-β) expression in non-metastatic colon cancer patients receiving radical resection. Methods: A total of 269 consecutive patients with pathologically confirmed stages Ⅰ–Ⅲ colon cancer who under-went radical resection were selected. Nav1.5 and ER-β expression was detected by using immunohistochemistry (IHC) on tissue microarray constructed from paraffin-embedded specimens. IHC score was determined according to the percentage and intensity of positively stained cells. Statistical analysis was performed with the X-tile method, k coef-ficient, Chi square test or Fisher's exact test, logistic regression, log-rank test, and Cox proportional hazards models. Results: We found that Nav1.5 was commonly expressed in tumor tissues with higher mean IHC score as compared with matched tumor-adjacent normal tissues (5.1 ± 3.5 vs. 3.5 ± 2.7, P < 0.001). The high expression of Nav1.5 in colon cancer tissues was associated with high preoperative carcinoembryonic antigen level [odds ratio (OR) = 2.980;95% confidential interval (CI) 1.163–7.632; P = 0.023] and high ER-β expression (OR = 2.808; 95% CI 1.243–6.343;P = 0.013). Log-rank test results showed that high Nav1.5 expression contributed to a low 5-year disease-free survival (DFS) rate in colon cancer patients (77.2% vs. 92.1%, P = 0.048), especially in patients with high ER-β expression tumor (76.2% vs. 91.3%, P = 0.032). Analysis with Cox proportional hazards model demonstrated that high Nav1.5 expression [hazard ratio (HR) = 2.738; 95% CI 1.100–6.819; P = 0.030] and lymph node metastasis (HR = 2.633; 95% CI 1.632–4.248; P < 0.001) were prognostic factors for unfavorable DFS in colon cancer patients. Conclusions: High expression of Nav1.5 was associated with high expression of ER-β and indicated unfavorable oncologic prognosis in patients with non-metastatic colon cancer.

OBJECTIVETo determine the mid-term effects of cutting balloon angioplasty (CBA) on in-stent restenosis.

METHODSA total of 69 patients with in-stent restenosis were divided into 2 groups randomly: cutting balloon angioplasty and plain old balloon angioplasty. The mechanisms of restenosis and dilation results were determined by quantitative coronary angiography and intravascular ultrasound. Follow-up was performed.

RESULTSThe procedural success rate was 100% without death and acute closure. One patient experienced dissection at the distal end of the stent and needed another stent. The mean follow-up period was 6.7 +/- 2.3 months. The final re-restenosis rate was 15% and 18% at 3 months and 6 months respectively, markedly lower than after plain old balloon angioplasty (38% and 43%). Acute gain by intravascular ultrasound (IVUS) was 1.72 +/- 0.52 mm after cutting balloon angioplasty, higher than 1.15 +/- 0.54 mm after plain old balloon angioplasty. The lumen diameter late loss in the cutting balloon group was 0.26 +/- 0.05 mm and 0.38 +/- 0.06 mm at 3 months and 6 months respectively, significantly lower than for those in conventional balloon group (0.78 +/- 0.19 mm and 0.89 +/- 0.16 mm, respectively, P < 0.001). As shown by IVUS, the main mechanism of cutting balloon angioplasty was marked reduction of plaque area without significant increase of vessel area (less vessel trauma).

CONCLUSIONCutting balloon angioplasty is feasible and effective for the treatment of in-stent restenosis with less vessel trauma.

Aged ; Angioplasty, Balloon ; methods ; Coronary Angiography ; Coronary Restenosis ; therapy ; Coronary Vessels ; pathology ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Time Factors ; Treatment Outcome