Abstract:Objective To evaluate the frequencies and risk of HBV mutations in basic core promoter (BCP) region in HBV-related liver diseases. Methods This case-control study enrolled a total of 2,093 cases, including asymptomatic HBV carriers (ASC), chronic hepatitis B (CHB) patients, liver cirrhosis (LC) patients and hepatocellular carcinoma (HCC) patients. HBV mutations were detected by DNA sequencing method. The association of HBV mutations with the risks of CHB, LC, and HCC was evaluated by non-conditional Logistic regression model adjusted for age and sex as compared to ASCs. Results The frequencies of all the HBV mutations, except for T1768A mutation, in the HCC patients were higher than 30%; while all the HBV mutations frequencies were lower than 30% in ASCs. The frequencies of all the 7 HBV mutations gradually increased in ASCs, CHB, LC, and HCC groups in order (P_trend<0.001). The adjusted odds ratios (AOR) of all the HBV mutations, except for T1768A, were gradually increased in the CHB patients, LC patients, and HCC patients in order compared to ASCs. It was found that A1762T/G1764A was associated with HCC (AOR=13.91; 95%CI=9.66-20.03). The cumulative frequency of HBV mutations in the BCP region gradually increased with progression of hepatitis B-related diseases (P_trend<0.001). Conclusion HBV mutation frequencies in the BCP region gradually accumulate during the progression HBV-related liver diseases, which finally leads to end-stage liver diseases. These HBV mutations can be used for early prediction of HBV-related end-stage liver disease.

Abstract:Objective To study the effect of primary cilia-mediated sonic hedgehog (Shh) signaling on differentiation of rat bone marrow stromal cells (MSCs) into neuron-like cells. Methods Rat MSCs were isolated and cultured. The study was divided into normal resveratrol-cultured group, resveratrol-induced group, SAG (Smoothened \[Smo\]agonist) group, and cyclopamine (Smo inhibitor) group. Cell morphology was observed under inverted microscope; the expressions of Ac-Tu, Ptc, Smo, and Gli1 were examined by immunofluorescence method. Western blotting analysis was used to detect the protein expressions of Smo and Gli, and RT-PCR was applied to detect mRNA expressions of Smo and Gli1. Results No expression of primary cilia was found in the normally cultured MSCs. After pre-induction or 24 h starvation, MSCs expressed primary cilia, Ptc, Smo and Gli1 proteins, with Ptc protein in the primary cilia and Smo, Gli1 in the cytoplasm. In normal cultivation, resveratrol did not promote the translocation of Smo or induce differentiation of MSCs into neuronal-like cells. When MSCs expressed primary cilia, resveratrol and SAG led to translocation of Smo from the cytoplasm into primary cilia, accompanied by MSCs differentiation into neuronal-like cells and significantly increased expression of Smo and Gli1 mRNA and protein (P＜0.05). When cyclopamine was added, Smo remained expressed in the cytoplasm, the expression of Smo and Gli1 mRNA and protein was significantly decreased (P＜0.05), and MSCs differentiation into neuronal-like cells was inhibited. Conclusion MSCs express primary cilia and have Shh signaling. Primary cilia-mediated Shh signaling participates in MSCs differentiation into neuronal-like cells.

Abstract:Objective To observe the expression of autophagy and microtubule-associated protein 1 light chain 3 (LC3) in hippocampus CA1 area of vascular dementia rats, so as to explore the role of autophagy in the pathogenesis of vascular dementia. Methods The rats were randomly divided into sham operation group, vascular dementia model group (VD group) and Wortmannin autophagy inhibitor group (WM group). Each group was further divided into 1, 2, 4, 8 and 12 week subgroups after the successful model preparation (n=6). Vascular dementia rat models were established by blocking four vessels. The learning and memory abilities were examined by Morris water maze, autophagy was observed by transmission electron microscope, and the ratio of autophagy-associated protein LC3Ⅱ/LC3Ⅰ was obtained by Western blotting analysis. Results Compared with the sham operation group, the escape latency was signficantly increased in the VD group（P<0.05 or P<0.01）, and the times of traversing terrace were significantly decreased (P<0.05 or P<0.01). Compared with the VD group, the escape latency was significantly decreased and the times of traversing terrace was significantly increased in WM group (P<0.05 or P<0.01). In the hippocampus CA1 area of VD group, the nuclear membrane of neurons was sagged, the nuclei was condensed, mitochondria were swollen, and autophagosomes and lysosomes were observed in week 1; the autophagosomes and lysosomes were increased in week 4, and they could still be found in week 12. The neuronal damage was slighter and the autophagosomes were reduced in WM group compared with VD group. In CA1 area of hippocampus of VD group, the LC3Ⅱ/LC3Ⅰ ratio was increased in week 1, peaked in week 4, began to decline in week 8, and still kept at a high level in week 12. Compared with the VD group, the LC3Ⅱ/LC3Ⅰ ratio was significantly decreased in WM group at all time points (P<0.05 or P<0.01).Conclusion Autophagy is activated in CA1 area of hippocampus of VD rats, and may play an important role in the pathogenesis of VD.

Abstract:Objective To explore the expressions of Beclin1 and microtubule-associated protein 1 light chain 3(LC3) in type A aortic dissection (AD) tissue and to discuss the relevance. Methods Twenty surgical AD specimens were used in this study, and 10 normal control specimens were obtained from autopsy. Immuno-histochemical staining and Western blotting analysis were performed to evaluate the locations and expressions of Beclin1 and LC3 proteins. Results It was found that Beclin1 and LC3 proteins were mainly located in the vascular smooth muscle cells of the AD tissues, and the expressions in the AD tissues were signicantly higher than those in the control group (P<0.05). Conclusion Autophagy is activated in the vascular smooth muscle cells of AD tissues, which may play an important role in the development and progression of thoracic aortic dissection.

Abstract:Objective To investigate the effects of glycine on neuron injury induced by oxygen glucose deprivation (OGD) and the underlying mechanisms. Methods In vitro OGD model was established with cultured rat primary neurons. The study was randomly divided into normal control group, OGD group and glycine treatment group. The influences of glycine on cell activity and survival rate were detected by MTT, and cell apoptosis was detected by flow cytometry. Western blotting analysis was used to examine the effect of glycine on expression of apoptotic proteins Bcl-2, Bcl-xL, Bad, and Bax. Results Glycine could improve the activity and survival of primary neurons of rats and decrease neuron apoptosis. Glycine also significantly increased anti-apoptotic proteins Bcl-2 expression and significantly decreased pro-apoptotic proteins Bax expression (P<0.05 or P<0.01). Conclusion Glycine can notably alleviate neuron injury induced by OGD, which is probably through up-regulation of anti-apoptotic factors and down-regulation of pro-apoptotic factors.

Abstract:Objective To explore the possible cytokine mechanism of delayed skin wound healing in mice exposed to ionizing radiation(IR), so as to provide evidence for further research. Methods Totally 68 female Kunming mice were randomly divided into two groups. Back skin defect was made in mice of the experimental group (n=34) immediately after exposure to 6 Gy^{60n=34) had skin defect but with no radiation exposure. Wound areas were continuously measured and wound healing rates were monitored on day 2, 4, 6, 8, 10, 12, and 14 after damage (n=10). Mice were sacrificed on day 1, 3, 5, and 7 (each time point 6 mice), the skin and thin layer of muscle tissues around the wound were obtained, and H E staining was used for evaluating wound healing. Platelet derived growth factor BB （PDGF-BB） and tumor necrosis factor alpha (TNF-α) expression levels in the dermal defects were examined by immunohistochemical methods and real time PCR. Results The wound healing rate in the experimental group was significantly lower than that in the control group within 14 days after damage(P<0.01). On day 14 the wound healing rate in the experimental group was significantly lower than that in the control group (61.61% and 90.13%, P<0.01). H E staining showed more severe inflammatory cell infiltration, disarranged collagen fibers and less proliferation of fibroblasts in the wound of experimental group compared with that of the control group. Immunohistochemical and real time PCR results demonstrated that PDGF BB expression in experimental group was significantly less than that in the control group from day 3 to day 7 (P<0.05). PDGF-BB gene expression in experimental group was less than that in the control group from day 3 (P<0.01). The expression of TNF α protein and gene was up regulated in both groups and reached the peak on day 5, then began to decrease. On day 7, TNF α protein and gene expression in the experimental group was significantly higher than that in the control group (P<0.01). Conclusion PDGF-BB and TNF-α participate in delayed wound healing in ionizing radiation mice with dermal defects.}

Abstract:Objective To modify the establishment of intramedullary spinal cord glioma model in rats and to evaluate the established model. Methods Fischer rats were injected with 9L glioma cell suspension into the spinal cord. The optimal amount of implanted tumor cells, implantation sites, and depth were selected for establishment. Basso, Beattie, and Bresnahan (BBB) scale were used to evaluate the neuronal function of lower limbs of the rats; high resolution MRI and immunohistochemistry method were used to examine the tumor forming, so as to evaluate the established model. Results Our optimization parameters for establishing rat intramedullary spinal cord glioma models included: the amount of implanted 9L glioma cells was 6 μL (1.0×10⁵/mL); the implantation site was at T₁₀ level and the depth was 3 mm under the dural. The rats developed obvious lower limb neuronal dysfunction 2 weeks after implantation of 9L glioma cells. Pathological and MRI examination confirmed growth of intramedullary tumor cells. Conclusion Intramedullary spinal cord glioma models can be successfully established by implanting 9L glioma cells into the spinal cord of Fischer rats, which paving a way for future studys.

Abstract:Objective To establish a neonatal rat model of thoracic aortic dissection by treating pregnant rats with semicarbazide. Methods Implantable capsule osmotic pump with different concentrations of semicarbazide (5, 10, 15, 20, 25, 30, 35, 40 mg/\[kg·d\])or normal saline were implanted into the abdomen of rats on day 14 of pregnancy. The thoracic aortas of 21 day fetus and neonatal rats were collected. H-E staining was applied to examine the pathological changes under microscope, and the formation of thoracic aortic dissection was analyzed. Results Various degrees of thoracic aortic dissections were observed in neonatal rats after the mother rats were given different concentrations of semicarbazide. At a lowest semicarbazide release rate of 25 mg/kg per day, all the neonatal rats survived and had a high incidence of thoracic aortic dissection. Conclusion A neonatal rat model of thoracic aortic dissection has been successfully established, paving a way for further researches.

Abstract:Objective To investigate the resting-state abnormalities of heroin addiction by analyzing resting-state functional connectivity of the caudate nucleus. Methods Fifteen male chronic heroin users and 15 age-, gender- and nicotine dependence-matched healthy subjects participated in the present resting-state functional connectivity analysis. All the participants undertook a resting-state fMRI scan with GE 3.0 T scanner and the obtained data were analyzed by Statistical Parametric Mapping (SPM) software. Functional connectivity was analyzed based on resting-state fMRI data to identify the correlation between the caudate and the other regions on the whole brain scale by SPM. Finally, t-test was applied to determine the functional connectivity of the caudate between the two groups. The relationship between the connectivity of specific regions and heroin-dependence period was investigated. Results Compared with the healthy control group, the caudate of heroin-dependent group had significantly enhanced functional connectivities with the lentiform nucleus, amygdala, hippocampus (t=2.8, P<0.005；voxel>5) and significantly decreased functional connectivity with the dorsal anterior cingulate cortex (t=2.8, P<0.005). Besides, the functional connectivity between the caudate and left amygdala (r=0.68, P<0.05) and right hippocampus (r=0.59, P<0.05) was positively correlated with the duration of heroin use. Conclusion The resting functional connectivities of the brain regions for rewarding, memory and motivation/drive are increased after heroin dependence, and those of the cognitive control region are decreased, which might be related to heroin dependence.

Abstract:Objective To explore the values of CT enhancement scanning and diffusion-weighted magnetic resonance imaging (DWI) in differential diagnosis between chronic mass-forming pancreatitis and pancreatic carcinoma. Methods The clinical data of 101 patients with pancreatic lesions (Jan. 2008 to Oct. 2012) were retrospectively analyzed. The results of abdominal CT enhancement scanning were compared with the postoperative pathological findings, and the sensitivity, specificity, accurate rate, positive predictive value, and negative predictive value of CT enhancement scanning were calculated. The CT findings of mass-forming pancreatitis and pancreatic carcinoma were compared. The size, site, shape (reinforcement levels after enhancement, calcification, pseudocyst, and dilated pancreatic duct) of the lesions, the perirenal fascia thickening, peripancreatic vessel invasion, and metastasis status were analyzed and the key diagnostic points were identified. Pancreatic DWI imaging characteristics of all the patients using b value 800 s/mm² was analyzed and the apparent diffusion coefficient(ADC) values of the two groups were compared with normal pancreatic tissues. Results Of the 101 pancreatic lesions, 59 were pathologically diagnosed as pancreatic cancer and 42 as mass-forming pancreatitis. The sensitivity, specificity, accurate, positive predictive value, and negative predictive value of CT findings were 94.9%, 88.1%, 92.1%, 91.8%, and 92.5%, respectively. CT values before and after enhancement, calcification of pancreas and pancreatic duct, pseudocyst, dilated pancreatic duct and bile capillary, peripancreatic vessel invasion, and metastasis were of significant values for differential diagnosis between chronic mass-forming pancreatitis and pancreatic carcinoma(P<0.05). No significant difference in ADC values was found between chronic mass-forming pancreatitis and pancreatic carcinoma, but ADC values of chronic mass-forming pancreatitis and pancreatic carcinoma were significantly different from that of normal pancreatic parenchyma(P<0.01). Conclusion CT enhancement scanning can contribute to differential diagnoses between pancreatic cancer and chronic mass-forming pancreatitis, while DWI is of limited value for the differential diagnosis of the two diseases.

Abstract:Objective To investigate the variation of the monthly incidence of smear-positive tuberculosis with time in Chongqing, so to provide a scientific evidence for the control and prevention of tuberculosis. Methods Using the SPSS 13.0 software, we established an ARIMA model with the monthly incidence data of smear-positive tuberculosis (2005-2009), and the model was used to forecast the monthly incidence of Jan. 2010 to Dec. 2010. The short-term forecasting efficacy was evaluated. Results The established ARIMA (1,1,0)×(0,1,1)₁₂ model was suitable for forecasting the monthly incidence of smear-positive tuberculosis in Chongqing. The observed values of 2005-2009 were in the 95% confidence interval of the fitted values, and the average relative error of the predictive value was 6.31% for 2010. Conclusion ARIMA (1,1,0)×(0,1,1)₁₂ model can satisfactorily forecast the monthly incidence of smear-positive tuberculosis in Chongqing, which provides a reliable evidence for control and prevention of tuberculosis.

Abstract:Objective To conduct a comparative study on the middle- and long-term efficacies of individualized titanium stick angular designs for treating thoracolumbar vertebrate fractures. Methods A total of 96 patients were divided into two groups,with 50 in the treatment group and 46 in the control group. The titanium stick in the treatment group was folded based on the numerical value which had been obtained by measuring and calculating the standard lateral projection of thoracolumbar vertebrate before the operation; the numerical value on sagittal plane was the sum of the average angle of its upper and subtus athletic segment, the angulation of subtus athletic segment and the angle of subtus vertebral body. The titanium stick in the control group was folded based on experience during the operation, with other treatments being the same. The patients were followed-up for at least 6 months, with an average of (18±5) months. All the patients received radiography examination pre- and post-operatively. And 42 patients received CT examination before and at the last follow-up; another 30 patients received MRI examination at last follow-up. Results At the final follow-up, the anterior, posterior vertebral heights were (1.06±0.46) mm and (0.42±0.26) mm for the treatment group and (2.37±0.86) mm (P<0.05) and (0.79±0.46) mm for the control group, respectively. The average loss of Cobb angle was (1.57±0.51)° in the treatment group and (2.49±0.89)° in the control group at final follow-up (P<0.05). The treatment group had 21 cases with fish tail and the control group had 25. The failure rate of internal fixation was 6% in the treatment group and 13% in the control group. The eggshell phenomenon on CT findings was found in 10 of the 22 patients in the treatment group and in 9 of the 20 cases in the control group at final follow-up. The neurological status was improved at least by 1 Frankel grade in the patients who had preoperative incomplete paraplegia. The scores of Oswestry Disability Questionnaire for the treatment group were: 0 in 17 cases, 2 in 15 cases, 4 in 11 cases, 6 in 2 cases, 8 in 2 cases, 56 in 1 case ,80 in 1 case, and 88 in 1 case; for the control group were 0 in 10 cases, 4 in 15 cases, 6 in 11 cases, 8 in 2 cases, 10 in 2 cases ,18 in 2 cases, 50 in 2 cases, and 80 in 2 cases. There were significant differente between the two groups （34% vs 21.74%, P<0.05）. Conclusion When transpedicle vertebral arch internal fixation system is used for treatment of thoracolumbar vertebrae fractures via posterior approach, individualized titanium stick angular design can accurately regain the physiologic curve of the fixed thoracolumbar segment,reducing operational time,loss of vertebral height correction, failure rate of internal fixation, incidence of backache, and degeneration of adjacent segment.

Abstract:Objective To evaluate the possible influence of zoledronic acid on intra-operative bleeding and recurrence of spinal giant cell tumor. Methods A prospective, observational clinical control study was conducted. The zoledronic acid group: patients received zoledronic acid 1 week before (4 mg) and 3 weeks after (4 mg) the surgery; after then 4 mg zoledronic acid was given every 4 weeks for 3 years after surgery or till the patients could not tolerate. The control group: patients received no zoledronic acid or bisphosphonate before and after operation. The intraoperative blood loss was recorded for all the patients and the patients were given an imaging follow-up every 6 months postoperatively to detect recurrence. Results A total of 53 patients were eligible for this study, including 28 for zoledronic acid group and 25 for control group. The average amount of bleeding was (1 594±847) mL (400-3 200 mL) for zoledronic acid group and (2 476±769) mL (800-4 000 mL) for the control group, showing significant difference between the two groups (P<0.05). No patients in the zoledronic acid group had recurrence or severe adverse reactions within 3 years after surgery. Four patients (16%) in the control group had local recurrence within 3 years after surgery (2 patients occurred after 24 months, 2 patients occurred after 36 months). The Chi-square tests result showed significant difference in recurrence rates between the two groups (χ2=4.846,P=0.028). Conclusion Preoperative use of zoledronic acid can effectively inhibit the bleeding during the operation for spinal giant cell tumor, and long-term postoperative use of zoledronic acid can help to prevent recurrence, which needs large sample study for further verification.

Abstract:Objective To use ultrasound-guided percutaneous microwave for simultaneous ablation of a nodule in submandibular gland and another in the ipsilateral thyroid gland. Methods A 57-year old man presented non-painful nodules in his right submandibular gland and right thyroid lobe simultaneously, with the sizes being 10 mm×10 mm×9 mm and 13 mm×11 mm×10 mm separately. Percutaneous microwave ablation and biopsy were conducted for both nodules simultaneously under ultrasound guidance. The short-term effects were documented both clinically and ultrasonographically. Results The ablation therapy was completed uneventfully and took a total of 20 min. The ablation time was 185 seconds for the submandibular nodule and 72 seconds for the thyroid nodule. No intra-operative complications such as bleeding, edema or nerve injury were observed. No symptoms of injuries to the facial nerve, glossal nerve or recurrent laryngeal nerve were observed during a 2-month follow-up. Ultrasound examination revealed that the ablated area was shrank and kept unenhanced on CEUS. Conclusion Microwave ablation therapy is suitable for the conjoint treatment of concomitant nodular lesions in multiple neck organs. The method is economical, efficient, minimally invasive, and is worth of more clinical practices.

Abstract:Objective To evaluate the value of flexible ureteroscopy (F-URS) in managing asymptomatic calyceal calculi for flight attendants. Methods We retrospectively analyzed the clinical data of 8 flight attendants who were surgically treated for asymptomatic calyceal calculi at our hospital from January 2008 to May 2012. The demographic information, disease characteristics, and perioperative information were collected. Results Eight patients had a total of 37 intrarenal calculi, with bilateral renal stones found in 2 patients. The mean number of stones per kidney in our patients was 3.7±0.7 (range 3-5). The mean size of individual stone was (4.5±1.5) mm (range 2-8 mm). The mean stone size per kidney was (16.8±4.7) mm (range 6-20 mm). The mean operation time was (45.0±7.6) min (range 30-56 min) and the average postoperative hospital stay was (1.8±0.5) d (range 1-2 d). Mean time lost from work due to F-URS was (13.0±1.1) d (range 12-15 d). No severe complications occurred during the operation. Stone free rate was 100% at 2 weeks after treatment as showed by a follow-up CT scan. Conclusion F-URS with holmium laser is a safe, effective and minimally invasive procedure, and may serve as a first-line therapy for asymptomatic calyceal calculi for flight attendants.

Abstract:Sudden cardiac death (SCD) refers to death within 1 hour after onset of cardiovascular disease or death within 24 hours from the last stable status. SCD has a high incidence and mortality rate. The relationship between heart autonomic nerves, especially sympathetic nerve and SCD, is the focus of study. The increase and/or heterogeneity of sympathetic activity and the remodeling of sympathetic innervation can lead to arrhythmogenic substrate in the heart or even SCD. Medicine treatment, implanted cardioverter defibrillator, left cardiac sympathetic denervation, renal sympathtic nerves ablation and spine stimulation have obtained encouraging outcomes. Therefore the present paper reviews the autonomic system, especially sympathetic nerves, and its relationship with cardiac arrhythmia.

Abstract:Objective To create a canine model of premature ventricular contraction-induced tachycardia-mediated cardiomyopathy, and to explore the effect of frequent premature ventricular contraction on the function of the left ventricular function. Methods Sixteen mongrel dogs were randomly divided into sham operation group and paced group. Animals in the paced group underwent the implantation of a dual-chamber pacemaker through right thoracotomy, and the pacemaker was connected to two epicardial right ventricular leads, with one creviced in the cardiac apex and the other one in the outflow tract of the right ventricle, with an atrioventricular delay adjusted to ensure the presence of coupled pacing to simulate ventricular bigeminy. Dogs in the control group were not connected to the leads. Echocardiographic measurements were obtained before and 4 weeks after operation. Results One dog in the paced group died of infection after 4 weeks. In the paced group (n=7), LV end-diastolic diameter (LV-EDD) increased from (2.86±0.10) cm before operation to (3.35±0.27) cm after operation (P<0.05) and LV end-systolic diameter (LV-ESD) increased from (2.07±0.20) cm before operation to (2.72±0.21) cm after operation (P<0.05). In addition, the left ventricular ejection fraction (LVEF) decreased from (67.57±4.49)% before operation to (43.66±3.88) % after operation (P<0.05). No significant changes in LV dimensions or function were noted before and after operation in the control group. Conclusion It is feasible to simulate ventricular bigeminy with coupled pacing in canines. Premature ventricular contraction-induced cardiomyopathy can lead to increased LV dimensions and decreased LV function.

Abstract:Objective To evaluate the diagnostic and therapeutic values of capsule endoscopy (CE) for small bowel tumors (SBTs). Methods Totally 773 patients with suspected SBTs disease underwent CE during October, 2006 to December, 2011. Further examination was done for patients with suspected SBTs, and the final diagnosis was made by CE and pathological confirmation. Results SBTs were detected in 21 patients (14 males, and 7 females, mean age \[53.9±15.7\] years), with a detection rate of 2.7%. Nineteen patients had obscure gastrointestinal bleeding and two had abdominal pain. Four events of capsule retention occurred at the lesion sites. Nineteen patients underwent surgical treatment and two received chemotherapy; the patients were followed up for a mean of (19±14) (range 5-32) months; and there were two death cases due to metastasis (one at 5 months of follow-up and the other at 17 months). Conclusion CE is an effective choice for diagnosis of suspected SBTs, which is of guidance value for the treatment and prognosis of SBTs.

Abstract:Objective To use thromboelastograph (TEG) technique for examining the platelet inhibition effect by aspirin and clopidogrel before percutaneous transluminal angioplasty and stenting (PTAS), so as to search for the optimal timing, dosage for clinical practice. Methods The clinical data of 93 patients were divided into 4 groups according to the aspirin history and different doses of aspirin before PTAS; the 4 groups were: non-medication history with aspirin+lower dose aspirin (aspirin 100 mg+clopidogrel 75 mg, Group 1), non-medication history with aspirin+higher dose aspirin(aspirin 300 mg+clopidogrel 75 mg, Group 2), medication history with aspirin+lower dose aspirin(Group 3), and medication history with aspirin+higher dose aspirin(Group 4). The blood samples were collected on day 1, 3 after anti-platelet aggregation drugs; TEG technique was used to detect arachidonic acid (AA)-induced inhibition rate of platelet aggregation and adenosine diphosphate (ADP) receptor-induced inhibition rate of platelet aggregation. Results For different time points: in group 1, the inhibition rates of platelet aggregation of aspirin and clopidogrel were significantly higher on day 3 (AA: \[89.09±17.42\]%, ADP: \[57.02±23.97\]%) as compared with those on day 1 (AA: \[ 82.24±22.25\]%, ADP: \[49.62±25.44\]%; P<0.05); in group 3, the inhibition rates of platelet aggregation were also significantly higher on day 3 (AA: \[95.06±8.05\]%, ADP: \[47.76±24.95\]%) than those on day 1 (AA: \[88.88±14.66\]%, ADP: \[36.17±22.71)%\]%; P<0.05). For different doses: the AA-induced inhibition rates were not significantly different between group 1 and group 2 or between group 3 and group 4 on day 1 and 3. Conclusion Without aspirin history, the inhibitory effect of platelet aggregation of aspirin before PTAS for 3 d is better than that for 1 d, and there is no difference between those of lower and higher doses.

Abstract:Objective To explore the surgical procedure and prognosis for elderly patients with early stage non-small-cell lung carcinoma (NSCLC). Methods The clinical data of 113 elderly patients with early stage NSCLC, who were treated in Changhai Hospital between January 2010 and December 2012, were retrospectively analyzed. The clinical features, treatments, surgical approaches, surgical procedures, and surgical outcomes were analyzed. Results Sixty-four patients received surgical treatment and others were transferred to internal treatment. There were significant differences in performance status (PS) and lung function (FEV1% and VC%) between the surgical patients and non-surgical patients (P=0.001, P=0.046, P=0.038). Of the 64 patients undergoing surgical treatment, 47 (73.4%) received video-assisted thoracic surgery (VATS) and 17 (26.6%) received open thoractomy. Fifty-six patients underwent lobectomy, 8 underwent limited resection, and none had pneumonectomy. Among VATS patients, two (4.0%) of the 47 patients were converted to thoractomy. The overall complication rate was 18.8% (12/64), the complication rate of the VATS group was significantly different from that of thoractomy group (6.0% vs 41.0%, P<0.05). Univariate and multivariate logistic regression analysis revealed that conventional open chest surgery was the independent risk factor for post-surgical complications in elderly NSCLC patients (P=0.01,P=0.03). Only one patient died after surgery. Conclusion Elderly NSCLC patients should not be denied for pulmonary resection if their performance status and lung function allow. VATS approach lobectomy can effectively reduce post-operation complications and decrease perioperative risks. Conversion to an open procedure should be considered in case of lymph node adhesions. Pneumonectomy should be avoided for elderly NSCLC patients.

Abstract:Objective To evaluate the safety and efficacy of ultrasound-guided one supracostal upper-calyx percutaneous access nephrolithotomy for staghorn stone. Methods A total of 581 patients with staghorn stone were treated with one supracostal upper-calyx access percutaneous nephrolithotomy from October 2004 to October 2011. The maximal diameters of stone measured by plain abdominal radiography were 3.6-6.5 cm, with a mean of (5.10±0.82) cm. Target calyx was posterior upper-calyx,puncture point was selected in tenth or eleventh intercostal space as guided by ultrasound, and the F22-24 upper-calyx percutaneous access was established. 17F nephroscope and 70 W holmium laser were employed to crush the stones. The operation time, perioperative complications, and stone-free rate were recorded. Results The upper-calyx percutaneous access was established successfully in all patients. The mean operation time was (82.07±16.25) min (range 54 to 140 min). The stone-free rate was 85.4% (496/581) after first-stage procedure. Fourteen patients (2.4%) had postoperative high fever, and 3 of them (0.5%) had infectious shock. Four patients received blood transfusion, and 2 of them underwent digital subtraction angiography to control bleeding. Four patients (0.7%) underwent thoracic drainage. There were no injuries to the lung, spleen, colon, or liver. The overall postoperative complication rate was 3.8%. The mean postoperative hospital stay was (5.55±1.35) days (ranging 4-15 days). Conclusion One supracostal upper-calyx percutaneous access can achieve high stone-free rate in treating staghorn stone, but with relatively high risk of complications. Ultrasound-guided technique can greatly reduce complication, making the procedure safer.

Abstract:Objective To evaluate the clinical outcomes of three different sealers for one-visit root canal therapy. Methods A total of 362 patients/425 teeth diagnosed as pulpitis were randomly divided into three groups: group A, including 120 patients/121 teeth, treated with zinc oxide engenol(ZOE); group B, including 121 patients/151 teeth, treated with Cortisomol; and group C, including 121 patients/153 teeth, treated with 2Seal easymiX. All the teeth were filled with gutta percha by cold lateral condensation. The post-treatment pain and the one-year successful rate were observed. Results The incidence rate of post-treatment pain in group A (15.7%\[19/121\]) were significantly higher than those in group B (5.3%\[8/151\] , P<0.01) and group C (6.5%\[10/153\], P<0.05); and there was no significant difference between group B and C. The one-year successful rates were not significantly different between group A (94.0%\[110/117\]), B (96.5%\[137/142\]) and C (97.9%\[142/145\]). Conclusion The three kinds of root canal sealers can all achieve satisfactory one-year successful rate in one-visit root canal therapy; moreover, Cortisomol and 2Seal easymiX can also reduce post-treatment pain, making them ideal root canal sealers.

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