Objective To investigate attendance of DSCTCA (dual-slice spiral CT coronary angiography). Methods Data from 463 patients undergoing DSCTCA were obtained and anylyzed. Results 451 cases are successfully examined at one time and 12 are failed. 8 in these 12 cases cannot hold their breath and the other 4 patients are due to unsatisfying heart rate. Better images are obtained when the 12 patients are examined again. All of the patients do not have harmful reactions and unexpected complications. Conclusion Excellent images can be obtained with DSCTCA at any heart rate without beta-receptors blocks before examination. The trunk and brunch of coronary artery can be displayed clear. Good attendence is important and guarantee the examination.

Objective To assess the safety and effectiveness of robotic-assisted laparoscopic radical cystcctomy and urinary diversion in the treatment of bladder cancer.Methods We collected the clinical data of one patient with bladder cancer who underwent RCRA with ileal neobladder from the Second Artillery General Hospital in Beijing on March,2010.Literature on this topic was analyzed.Results ( 1 ) Tbc operation duration of this procedure was 540 mins.The intra-operative blood loss was 200 ml,and no blood transfusion was needed.Postoperative pathologic examination indicated low-grade infiltrative urothelial carcinoma.The patient exhausted on the 3th post-operative day,had off-bed activities on the 4th post-operative day,and was discharged on the 28th post-operative day.(2) There were more than 400 patients underwent RARC worldwide.The RARC group had marginally lower complications rate (31％ vs.28％ ) and numbers of lymph node dissection ( 18.2 vs.13.0) than the LCR group.There were significant differences in the duration of operation (285.7 mins vs.372.0 mins),intraoperatie blood loss ( 286 ml vs.556.0 ml) and mean days of hospitalization ( 8.6 d vs.13.0 d) between the RARCA and the LCR groups.Conclusion RARC is a novel and effective procedure for the treatment of bladder cancer.As there is only a relatively small sample around the world and little experience on this procedure can be referred,more clinical practice with RARC and high quality research with long-term follow-up are needed to update the database and evaluate its effectiveness and safety.

Objective To investigate the effects of exogenous nitric oxide (NO) on gaseous transmitter molecule of the hippocampus in rats with global cerebral ischemic-reperfusion(I-R) injury.Methods Twenty-four Wistar male rates were randomly divided into 4 groups of sham operation (group S),I-R control(group I-R),I-R plus sodium nitroproside(SNP) 2 mg/kg(LSNP) or plus SNP 4 mg/kg(group HSNP) with 6 rats each.Global cerebral I-R model was established by 4-vessel occlusion.SNP was injected at 30 min before clamping the bilateral carotid arteries in groups of LSNP and HSNP.The carotid arteries were clasped for 20 min.The rats were killed after cerebral reperfusion for 6 h.The concentrations of hydrogen sulfide(H_2S),NO and CO,the activity of cystathionine beta synthase(CBS),HO and inducible nitric oxide synthase(iNOS),as well as the expression levels of CBS mRNA,iNOS mRNA and hemeoxygenase-1 (HO-1) mRNA in the hippocampus were measured.Results Compared to group S,the concentrations of H_2S,NO and CO,the activities of CBS,HO and iNOS and the expressions of CBS mRNA,iNOS mRNA and HO-1 mRNA in group I-R were increased(P<0.05 or P<0.01) ,which were all higher in groups of LSNP and HSNP than those in group I-R(P<0.05 or P<0.01).Conclusion Exogenous NO can induce the expressions of CBS mRNA and HO-1 mRNA,activate CBS and HO in rats with global cerebral I-R injury,indicating that NO has a modulation effect on the CBS/ H_2S and iNOS/NO systemes.

This review focus on the progress of the treatment of obstructive sleep apnea-hypopnea syndrome by using positive airway pressure and upper airway multilevel surgeries. OSAHS is a disease caused by multiple etiologies. We should consider upper airway anatomical abnormalities and the severity of OSAHS before reasonable treatment plans were formulated. "PAP-surgery-PAP" is the classic procedure for treating moderate OSAHS and severe OSAHS. Preoperative use of PAP could reduce the hypoxic condition of patients and decrease surgical risk. Surgery can effectively reduce the optimal PAP pressure value, and increase the tolerance of patient. Postoperative use of PAP can improve surgical efficacy, shorten patient recovery time. However, the influence of different surgical methods on optimal PAP pressure value is lacking in large samples. More related studies need to be per formed in the future.
Continuous Positive Airway Pressure ; Humans ; Respiratory System ; surgery ; Sleep Apnea, Obstructive ; surgery ; therapy ; Treatment Outcome

Objective To compare the effects of mild hypothermia or normothermia on inflammatory cytokines (IL-2 and IL-10) in elderly patients undergoing surgery for rectal cancer, and determine whether the elevation of IL-2 and IL-10 levels and early postoperative cognitive dysfunction has the relevant. Methods Forty ASA classification Ⅰ or Ⅱ patients aged 65-83 yr undergoing surgery for rectal cancer were randomly divided into 2 groups (n=20 each):normal body temperature group (GroupⅠ) and mild hypothermia group (GroupⅡ) . The venous blood samples were taken at 3 points which were at 1 h before anesthesia (T1), the end of operation (T2) and the 24h after operation (T3) to measure the levels of plasma IL-2 and IL-10. The cognitive function test (MMSE) were performed at one day before operation (N1), one day after operation (N2) and 3th days after operation (N3) . Results The level of plasma IL-2 was significantly lower in the GroupⅡthan that in the GroupⅠat T2 and T3 ( < 0.01), and those was significantly lower at T3 than that at T2 ( <0.01) . The level of plasma IL-10 was significantly higher in the GroupⅡat T3 than that at T1 and T2 ( <0.01) . To compare with N1, the score of both groups were decreased at N2 ( <0.05), and it was lower in GroupⅡthan that in GroupⅠ( <0.05), with a significant difference. The score of both groups were increased significantly at N3 (<0.05), and there was significant difference with N2 ( <0.05);Positive correlation was found between IL-2 at T2 and T3 and the score of MMSE in the GroupⅡat N2 ( =0.459, <0.01) ( =0.550, <0.01) . Conclusion Positive correlations were found between the elevation of IL-2 levels under mild hypothermia and the decline of postoperative early cognitive function in elderly undergoing rectal cancer surgery.

Objective To observe the effect and side effects of concurrent chemoradiotherapy for stage ⅡB～ⅢB cervical cancer. Methods 126 patients with stage ⅡB～ⅢB cervical cancer were randomly allocated into 2 groups. Concurrent chemoradiotherapy group: radiotherapy carried out same as the neoadjuvant chemotherapy group, i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 4 cycle; the neoadjuvant chemotherapy group i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 2 cycle, after chemotherapy received routine radiotherapy 2 Gy per day, 5 times a week to a total dose of 30 Gy with 192Ir brachytherapy, 7 Gy per week. When total dose reached 46 Gy, the middle field was shielded by plumbum, then continuous radiotherapy, total dose reach A point 65-70 Gy, B point 50-56 Gy. Results All patients were followed-up for more than five years. The follow-up rate was 94.4 %. In concurrent chemoradiotherapy group the 3 year survival rate and the 5 year survival rate were 82.8 %, 65.6 %, In neoadjuvant chemotherapy group the 3 year survival rate and the 5 year survival rate were 67.7 %, 46.8 %. There was a significant difference in two groups (X2=3.86, P＜0.05; X2=5.01, P＜0.05), no significant difference in toxicity-side effect. Conclusion Concurrent chemoradiotherapy for advanced cervical cancer can significantly improve the 3-year and 5-year survival rate and has little increase in toxicity-side effect.

Objective To investigate the effect of the activity of CR1, the expression of CD_ 58 , the level of soluble interleukin-2R (SIL-2R) and interleukin-6(IL-6) level in serum on obstructive sleep apnea syndrome (OSAS). Methods Select 20 OSAS cases in hospital and 15 healthy controls of the same age. Use flow cytometry and enzyme-linked immunosorbent assay(ELISA) to detect the activity of CR1, the expression of CD_ 58 and the level of SIL-2R, IL-6 in serum. Results (1)The erythrocytes cancer cell rosette(ECR1CaRR)of the OSAS group was lower than that of control group(P0.05). There were significant positive dependability between the level of SIL-2R,IL-6 in serum and SIT90(P0.05). Conclusions There are relations between the level of SIL-2R,IL-6 in serum and the condition of OSAS cases, which can be used to evaluate and define in clinical work,there is a accommodative role between erythrocyte immune function and some cytokines.

Objective To investigate the change in expression of hippocampal neuronal 5-hyroxytryptamine1A(5-HT1A) receptor in a mouse model of chronic restraint stress.Methods Forty BALB/c male mice aged 6-9 months weighing 25-35 g were randomly divided into 2 groups ( n =20 each): normal control group (group C) and chronic restraint stress group( group S).In group S,the model of chronic restraint stress was established described by Wood et al.Tail suspension test,light-dark test and Morris water maze test were performed respectively at 1 d after successful establishment of the model.Immobility time,staying time in light compartment,and escape latency and frequency of crossing the original platform were recorded respectively in tail suspension test,light-dark test and Morris water maze test.Then the animals were sacrificed,hippocampi were removed for determination of the expression of 5-HT1A receptor in CA1 and CA3 regions of hippocampal neurons by immuno-histochemistry.ResultsCompared with group C,immobility time and escape latency were significantly prolonged,staying time in light compartment was shortened,frequency of crossing the original platform was decreased,and the expression of 5-HT1A receptor in hippocampal neurons was down-regulated in group S ( P ＜ 0.05 or 0.01 ).ConclusionChronic restraint stress can induce cognitive impairment in mice by down-regulating the expression of 5-HT1A receptor in hippocampal neurons.

With the development of modern technology and clinical practice,the classic randomized controlled trial nowadays cannot meet the researchers' needs for evidence with more reliable external validity,especially in the field of TCM.Meanwhile,real-world study (RWS) has been attracting more attention and at the forefront of clinical research all over the world for providing evidence in conformity with the real world condition.In this paper,we firstly described the basic concept of RWS,and then found that it was characterized by large representative samples,loose inclusion or exclusion criteria,allocation of interventions according to patients conditions and willingness,long-term follow-up,and clinically relevant endpoints.By analyzing the existing examples of RWS,we noted and discussed the promising future of RWS in TCM clinical research.Finally,we hope this paper will provide some inspiration for TCM researchers.

Objective To make a genetic diagnosis of sporadic neurofibromatosis type 1 with café-au-lait spots as the only presentation in a child.Methods Blood samples were collected from an 8-year-old child patient,his parents,and 100 healthy human controls.The mutation of NF1 gene was detected by PCR and direct sequencing.Results No mutation was detected in the NF1 gene of the parents or the healthy controls.There was a de novo nonsense mutation c.3520C ＞ T (p.Q1174X) in the NF1 gene of the patient,which leaded to a premature termination codon.Conclusions The child with café-au-lait spots as the only manifestation is diagnosed with sporadic neurofibromatosis type 1 by genetic testing.The mutation c.3520C ＞ T (p.Q1174X) may be an underlying cause of neurofibromatosis type 1.