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Two cases of pregnant women with lumbar disc herniation causing neurologic deficits are reported. The first case received percutaneous endoscopic discectomy following the cesarean section; and the second case underwent micro-discectomy in the left lateral position under local anesthesia at 23-week gestation. After surgery, satisfactory outcomes were obtained in both cases. The management of these two cases indicates that the disc surgery is a safe procedure for patients during pregnancy.
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The background of abdominal computed tomography (CT) images is complex, and kidney tumors have different shapes, sizes and unclear edges. Consequently, the segmentation methods applying to the whole CT images are often unable to effectively segment the kidney tumors. To solve these problems, this paper proposes a multi-scale network based on cascaded 3D U-Net and DeepLabV3+ for kidney tumor segmentation, which uses atrous convolution feature pyramid to adaptively control receptive field. Through the fusion of high-level and low-level features, the segmented edges of large tumors and the segmentation accuracies of small tumors are effectively improved. A total of 210 CT data published by Kits2019 were used for five-fold cross validation, and 30 CT volume data collected from Suzhou Science and Technology Town Hospital were independently tested by trained segmentation models. The results of five-fold cross validation experiments showed that the Dice coefficient, sensitivity and precision were 0.796 2 ± 0.274 1, 0.824 5 ± 0.276 3, and 0.805 1 ± 0.284 0, respectively. On the external test set, the Dice coefficient, sensitivity and precision were 0.817 2 ± 0.110 0, 0.829 6 ± 0.150 7, and 0.831 8 ± 0.116 8, respectively. The results show a great improvement in the segmentation accuracy compared with other semantic segmentation methods.
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Humans , Kidney Neoplasms/diagnostic imaging , Neural Networks, Computer , Specimen Handling , Tomography, X-Ray ComputedABSTRACT
Current classifications of tibial plateau fractures include three-pillar classification, four-quadrant classification, eight-segment classification, ten-segment classification, and four-column & nine-segment classification. This article reviews the various CT classifications of tibial plateau fractures, their advantages and disadvantages and surgical approaches as well. The essence of the CT classifications is to pay more attention to the coronary fracture line, especially the posterior coronal fracture fragments. A classification which combines the four-quadrant idea of the articular surface of the tibial plateau with the four-column idea of the peripheral cortex of the tibial plateau, and is supplemented by descriptions of non-articular surface structures (intercondylar spine, tibial tubercle and fibula head), may provide a more comprehensive understanding of a specific tibial plateau fracture, but may therefore be too complicated and difficult to use clinically due to too many combinations that need matching.
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Objective@#To systematically evaluate the efficacy and safety of CT-guided percutaneous lung puncture biopsy versus ultrasound-guided percutaneous lung puncture biopsy.@*Methods@#Relevant domestic and foreign related databases such as PubMed, Web of Science, Cochrane Library, OVID, China Biology Medicine, VIP, Wanfang and CNKI databases were searched, the randomized controlled trial about the applications of CT-guided and ultrasound-guided percutaneous lung puncture biopsy were collected. After extracting the relevant data, a Meta-analysis was performed using RevMan 5.2 and Stata softwares.@*Results@#Ten studies met the inclusion criteria, with a total sample size of 1 158 cases, of which 635 were CT-guided puncture biopsy and 523 were ultrasound-guided puncture biopsy. Meta-analysis showed that the difference of the success rate between the CT-guided group and the ultrasound-guided group was not statistically significant [97.48% (619/635) vs. 96.56% (505/523), RR= 1.01, 95% CI 0.99-1.03, P= 0.360]; the puncture diagnosis rate in the CT-guided group was lower than in the ultrasound-guided group, and the difference was statistically significant [92.44% (619/635) vs. 96.56% (505/523), RR= 0.97, 95% CI 0.94-0.99, P= 0.007]. The total incidence of complications after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [14.49% (92/635) vs. 9.56% (50/523), RR= 1.56, 95% CI 1.11-2.19, P= 0.010]; the incidence of pneumothorax after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [11.50%(73/635) vs. 6.31% (33/523), RR= 1.77, 95% CI 1.17-2.68, P= 0.007]; the difference of the incidence of bleeding after puncture between the CT-guided group and the ultrasound-guided group was not statistically significant [2.99% (19/635) vs. 3.25% (17/523), RR= 1.08, 95% CI 0.59-1.98, P= 0.800].@*Conclusions@#Both CT-guided and ultrasound-guided percutaneous lung puncture biopsy have good clinical diagnostic value. However, for the intrapulmonary masses shown by ultrasound, the ultrasound-guided lung puncture biopsy has a shorter operation time, lower cost, and higher safety.
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Objective:To systematically evaluate the efficacy and safety of CT-guided percutaneous lung puncture biopsy versus ultrasound-guided percutaneous lung puncture biopsy.Methods:Relevant domestic and foreign related databases such as PubMed, Web of Science, Cochrane Library, OVID, China Biology Medicine, VIP, Wanfang and CNKI databases were searched, the randomized controlled trial about the applications of CT-guided and ultrasound-guided percutaneous lung puncture biopsy were collected. After extracting the relevant data, a Meta-analysis was performed using RevMan 5.2 and Stata softwares.Results:Ten studies met the inclusion criteria, with a total sample size of 1 158 cases, of which 635 were CT-guided puncture biopsy and 523 were ultrasound-guided puncture biopsy. Meta-analysis showed that the difference of the success rate between the CT-guided group and the ultrasound-guided group was not statistically significant [97.48% (619/635) vs. 96.56% (505/523), RR= 1.01, 95% CI 0.99-1.03, P= 0.360]; the puncture diagnosis rate in the CT-guided group was lower than in the ultrasound-guided group, and the difference was statistically significant [92.44% (619/635) vs. 96.56% (505/523), RR= 0.97, 95% CI 0.94-0.99, P= 0.007]. The total incidence of complications after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [14.49% (92/635) vs. 9.56% (50/523), RR= 1.56, 95% CI 1.11-2.19, P= 0.010]; the incidence of pneumothorax after puncture in the CT-guided group was higher than that in the ultrasound-guided group, and the difference was statistically significant [11.50%(73/635) vs. 6.31% (33/523), RR= 1.77, 95% CI 1.17-2.68, P= 0.007]; the difference of the incidence of bleeding after puncture between the CT-guided group and the ultrasound-guided group was not statistically significant [2.99% (19/635) vs. 3.25% (17/523), RR= 1.08, 95% CI 0.59-1.98, P= 0.800]. Conclusions:Both CT-guided and ultrasound-guided percutaneous lung puncture biopsy have good clinical diagnostic value. However, for the intrapulmonary masses shown by ultrasound, the ultrasound-guided lung puncture biopsy has a shorter operation time, lower cost, and higher safety.
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Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.
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OBJECTIVE:To explore the new mode and new method for the reform of the pharmacy specialty experimental teaching in the cultivation of innovative talents. METHODS:In view of the present situation of pharmacy experimental teaching in China,ideas and measures for the reform of pharmacy experimental teaching were put forward,and a new model of experimental teaching was put forward in combined with the actual situation of our school. RESULTS:The reform of pharmacy experiment should guide students to establish the correct scientific research spirit,increase the comprehensive experiment and design experi-ment,improve the evaluation methods,and pay attention to the process of evaluation. And training mode of tutorial system was put forward based on the actual situation. CONCLUSIONS:Training mode of tutorial system has certain guiding significance for the further deepening of pharmacy specialty experimental course and cultivation of innovative talents.
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Aim To investigate SIRT1 activity and an-ti-inflammatory effects of Chikusetsu oleanane saponin ( COS) on the RAW264. 7 macrophage cells induced by lipopolysaccharide ( LPS ) . Methods The nitric oxide ( NO) release was detected with Griess method. Western blot was used to detect the expression of tumor necrosis factor-α( TNF-α) , interleukin 1β( IL-1β) . Nuclear factor-κB ( NF-κB) and silent information ad-justment factor 1 ( SIRT1 ) were tested by immunofluo-rescence. Results 1 mg · L-1 LPS co-cultured with COS at 25~300 mg·L-1 had no significant effect on the growth of RAW264. 7 cells. Compared with the LPS group, COS effectively inhibited the NO release and suppressed the expression of TNF-α and IL-1β, and also inhibited the translocation of NF-κB and up-regulation of SIRT1 . Conclusion COS has protective effects on RAW264. 7 cells stimulated by LPS, which may be related to up-regulating the expression of SIRT1 and promoting the deacetylation of NF-κB, thereby in-hibiting the translocation of NF-κB and reducing the expression of TNF-α and IL-1β.
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<p><b>OBJECTIVE</b>To evaluate the clinical effectiveness of Onodera prognostic nutrition index (OPNI) in the predictive value of nutrition risk.</p><p><b>METHODS</b>In a prospective cohort study from July 2014 to June 2015 in the Department of General Surgery of the Ninth People's Hospital of Chongqing, NRS2002 and OPNI were conducted in 200 patients undergoing gastrointestinal elective operation. OPNI was calculated with serum albumin (Alb) and peripheral lymphocyte (TLC) [OPNI=Alb(10(9)/L)+5×TLC(10(9)/L)]. By using the results of NRS2002 as the golden standard for diagnosis of nutrition risk (A NRS2002 score≥3 was deemed as nutritional risk and a nutritional care plan should be initiated. A NRS2002 score <3 was deemed as no nutritional risk), the effectiveness of OPNI was evaluated by the receiver operator characteristic(ROC) curve. The sensitivity, specificity, positive and negative predictive values, Youden indexes and area under ROC curve(AUC) of different diagnostic cut-off points of OPNI were analyzed to determine the optimal operating point (OOP). Kappa test was used to estimate the consistency of different cut-off points for OPNI with NRS2002 in defining nutrition risk.</p><p><b>RESULTS</b>A total of 103 patients were of NRS2002 ≥3 group, and 97 of NRS2002 <3 group. The overall OPNI was 45.4±7.4. When OOP was 45.8, the AUC of OPNI was 0.914 (95% CI: 0.873 to 0.954); the sensitivity, specificity, Youden indexes were 85.4%, 85.6%, 0.711; the positive predictive value and negative predictive value were 85.3% and 83.7%, respectively. According to this OOP, the subjects were divided into the OPNI ≥45.8 group(n=102) and OPNI <45.8 group (n=98). Compared with OPNI ≥45.8 group, OPNI <45.8 group were older [(66.5±12.1)years vs. (57.0±15.3) years, t=-4.905, P=0.000], and had lower BMI[(20.4±3.0) kg/m(2) vs. (21.7±3.0) kg/m(2), t=3.069, P=0.002], lower albumin[(34.7±4.7)10(9)/L vs.(43.6±3.4)10(9)/L, t=15.542, P=0.000] and lower TLC[(1.0±0.5)10(9)/L vs.(1.6±0.7)10(9)/L, t=7.254, P=0.000], respectively. Kappa test indicated that when using OPNI=45.8, the diagnostic value of OPNI on nutrition risk was consistence with NRS2002(Kappa=0.691, P=0.000).</p><p><b>CONCLUSIONS</b>OPNI can be used as a relatively simple and reliable method for clinical screening and assessment of nutrition risk.</p>
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Humans , Digestive System Surgical Procedures , Elective Surgical Procedures , Lymphocytes , Malnutrition , Diagnosis , Nutrition Assessment , Nutritional Status , Prospective Studies , ROC Curve , Risk , Sensitivity and Specificity , Serum AlbuminABSTRACT
Objective To study the adjuvant immunoactivity of polysaccharides from Panax japonicus by alcohol of different concentrations;To discuss its part with the strongest adjuvant immunoactivity. Methods Polysaccharides from Panax japonicus was sunk with alcohol of different concentrations, and 30%alcohol compound, 60%and 90%alcohol polysaccharide were obtained. Different segments of polysaccharide and OVA protein were injected to mice once a week for three times for immunity. Five days after the last immunity, the mice were executed to collect blood, and the antibody titer was determined. The three parts of alcohol compound were scanned by infrared spectrum to determine the type of polysaccharide preliminarily. Results Compared with the control group, the antibody titer of different segments of polysaccharide obviously increased, especially the polysaccharide sunk by 60%alcohol. Infrared spectrum analysis showed that polysaccharides from Panax japonicus contained pyranose ring structure. Conclusion Polysaccharides from Panax japonicus has significant adjuvant immunoactivity, and polysaccharide sunk by 60%alcohol has the strongest adjuvant effects.
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Objective To research the protective effects of totalPanax Japonicus extract on learning memory, antioxidation, and anti-apoptosis of aging mice,and explore the mechanism. Methods Male mice were randomly divided into normal group, model group, Vitamin E (VE) group, Panax Japonicus extract low and high dose group. Except for the normal group, the other groups were injected withD-gal on the back of the neck subcutaneously to establish aging model. Normal group and model group were given a gavage with saline and each treatment group was given a gavage with totalPanax Japonicus extract and VE once a day for 7 weeks after the aging model established. All mice were be measured their learning and memory ability in the eighth week. After the test, the morphological changes of CA1 neurons were observed by HE stain. SOD, GSH-Px, MDA levels in brain tissue were measured by biochemical method, the expressions of Bcl-2 and Bax mRNA were evaluated by RT-PCR.Results Mice inPanax Japonicus extract low and high dose group could spend less time in searching for the platform, improve the learning and memory ability. TotalPanax Japonicus extract increased the activity of SOD and GSH-Px, while decreased the content of MDA. In addition, it could increase the expression level of Bcl-2 mRNA and reduce the expression level of Bax mRNA as well.Conclusion TotalPanax Japonicus extract has anti-aging effect.
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Objective To investigate the cut-off point value of 1-hour plasma glucose of oral glucose tolerance test in the diagnosis of the T2DM and IGR.Methods Three hundred and fifty-four subjects (6.0mmol/L≤ FPG ＜ 7.0mmol/L) were participated in the OGTT.To get the cut-off point value of 1-hour plasma glucose in the diagnosis of the T2DM and IGR by applying the receiver operator characteristic curve,and compare it with the WHO diagnostic criteria.Results (1)The cut-off point value of screening T2DM by ROC curve was 12.90mmol / L,whose specificity was 77.1％ and sensitivity was 90％.Meanwhile the cut-off point value of screening IGR was 10.83mmol / L,whose specificity was 73.2％,and the sensitivity was 73.5％.(2)Among the 136 patients with type 2 diabetes mellitus that diagnosed by WHO criteria,115 patients could be diagnosed by 1hPG that more than FPG which could diagnose 81 patients.And the difference was statistically significant (P ＜ 0.05).Meanwhile,It was more than 106 patients that diagnosed by 2hPG,but there was no statistically significant.According to the diagnostic criteria of 2hPG ≥11.1mmol/L,there were 106 cases of T2DM.Among these patients,95 cases and 51 cases could be diagnosed respectively by 1 hPG and FPG,and there was statistically significant (P ＜ 0.01).(3)Application of the cut-off point of 1 hPG,NGT,IFG,CGI and DM re-grouped.FPG,2hPG increased gradually in order to NGT,IGR,DM.(4) No matter the blood glucose levels,1hPG and 2hPG had good correlation,(P =0.000).A significant correlation could be found between FPG and 2hPG only in hyperglycemia.The correlations between 1 hPG and FPG disappeared only in a normal level of blood glucose.Conclusion The cutoff point value of 1hPG is 12.90mmol/L which has advantage to diagnosis of type 2 diabetes mellitus.It is a useful complement to the WHO Diagnostic criteria.
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<p><b>OBJECTIVE</b>Qingkailing injection (QKLI), Jinnaduo injection (JNDI), Shuxuetong injection (SXTI), Shenmai injection (SMI) and Kangai injection (KAI) are widely used in China. To predict the herb-drug interactions in clinical application, they were evaluated for their in vitro inhibition effect on CYP3A in rat liver microsomes.</p><p><b>METHOD</b>The rat liver microsomes were incubated with different doses of 5 kinds of traditional Chinese medicine injections (TCMIs) in the present of testosterone, a specific substrate of CYP3A. 6beta-hydroxytestosterone, the metabolite of testosterone, was monitored by HPLC to compare the inhibition effect of 5 TCMIs on CYP3A in rat liver microsomes. Ketoconazole was used as a positive control.</p><p><b>RESULT</b>10% QKLI reduced the formation of 6beta-hydroxytestosterone by approximately 93.0%, which is more significant than other four TCMIs. The half maximal inhibitory concentration (IC50) and the enzyme-inhibitor constant K(i) were 1.0% and 0.7% respectively.</p><p><b>CONCLUSION</b>QKLI showed much stronger inhibition activity against CYP3A, comparing to other 4 TCMIs. The results revealed that QKLI may be involved in herb-drug interactions by inhibition of CYP3A.</p>
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Animals , Male , Rats , Cytochrome P-450 CYP3A Inhibitors , Injections , Medicine, Chinese Traditional , Microsomes, Liver , Rats, Sprague-DawleyABSTRACT
Objective To verify the traditional serrated pathway by comparing microsatellite instability(MSI) status among traditional serrated adenoma, traditional adenoma, serrated colorectal cancer and non-serrated coloreetal cancer. Methods Seventy-five paraffin-embedded tissue samples, including 15 with serrated adeneearcinoma (Sca), 20 with non-serrated adenocareinoma (N-Sca), 20 with traditional serrated adenoma(TSA) and 20 with villous adenoma(AD) were collected from the pathology department of our hospital. Genomic DNA was extracted from these samples and then amplified with fluorescently-labeled primer specific for BAT25 and BAT26. The MSI status was detected with DNA automatic sequencer. Results Six of 18 samples with TSA harbored MSI-H and twelve MSI-L/MSS; 18 samples with conventional adenoma were exclusively of MSS; 3 of 13 samples of serrated carcinoma harbored MSI-H and ten MSI-L/MSS; 18 of 19 N-Sca samples harbored MSI-L/MSS and only one MSI-H. With Chi-square test, the MSI frequency in AD group and N-Sca group was significantly lower than that in TSA group and Sca group ( P < 0. 05 ) ; but with no statistical difference between the TSA group and Sca groups ( P > 0. 05 ). Conclusion MSI-H frequency in AD group and N-Sca group was obviously lower than that of TSA group and Sca group. It is concluded that there might be a new traditional serrated neoplasia pathway which is different from the conventional adenoma-carcinoma carcinogenesis pathway, but we still need prospective follow-up studies to verify its existence.
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Chickens were infected with chicken anemia virus (CAV) at one-day-old and vaccinated with La Sota vaccine 8 days later. Meanwhile, uninfected chickens were vaccinated as controls. At 7, 14 and 28 days post vaccination, the content of IgG,IgM,IgA and HI titer in serum, the number of T cells, IgG, IgM and IgA antibody producing cells in thymus, bursa and spleen, the proliferative response of T、B cells, the inductive activity of interleukin 2 (IL-2) and interferon (IFN) in thymus and spleen were tested. The results showed that the content of IgG, IgM, IgA and hemoagglutination inhibition (HI) titer in serum, the number of T cells, IgG, IgM and IgA antibody producing cells in thymus, bursa and spleen, the proliferative response of T cells and B cells as well as the inductive activity of IL-2 and IFN in thymus and spleen of infected-vaccinated chickens significantly decreased compared with the control. These results indicated that the immunofunction and immunoregulation were dropped post ND vaccination of CAV-infected chickens.
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AIM: To observe the protective effect of non-wounded ischemic preconditioning on ischemic/reperfusion injury in isolated rat hearts. METHODS: 25 male SD rats, weighting (250?30) g, were randomly divided into three groups: control group (C, n= 8), anoxia/reoxygenation group (A, n= 8) and non-wounded legs ischemic preconditioning group (N-WIP, n= 9).Hearts were isolated from rats and perfused on a Langendorff apparatus with a normal Krebs-Henseleit buffer (saturation 95% O 2+5% CO 2) at a constant pressure (8.33 kPa) and temperature (37 ℃) in C group ; Following 15 min equilibration, hearts were subjected to 15 min of global ischemia and 15 min reperfusion (37℃) in A group ; Rats were subjected to non-wounded leg repeated-brief ischemic preconditioning, and then treated in procedure similar to A group in N-WIP group.The activities of superoxide dismutase (SOD) and Ca 2+ -Mg 2+ -ATPase, malondialdehyde (MDA) content of efflux from coronary vessel and myocardium, myocardium monophasic action potential and contractile force were measured before ischemia, 15 minutes after ischemia and 5, 15 minutes after reperfusion. RESULTS: Compared with A group, non-wounded legs ischemic preconditioning reduced the incidence of reperfusion arrhythmias ( P
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AIM: To observe the effects of herba houttuyniae injection, a chinese medicine, on myocardial injury induced by endotoxin and to explore the possible mechanism. METHODS: 24 male SD rats,weghting (250?30) g, were randomly divided into three groups: normal control group(NC, n=6), endotoxin group (ET, n=6), herba houttuyniae injection puls endotoxin group (HHI+ET, n=6) and herba houttuyniae injection group (HHI, n=6). Heart was isolated from rats and perfused on Langendorff apparatus with Krebs-Henseleit (KH) buffer (Saturation 95%+5%CO_2) at a constant pressure (8.33 kPa) and temperture(37℃). The activities of superoxide dismutase (SOD) and malondialdehyde (MDA) content of efflux from coronary artery were measured at certain time points (0 min, 20 min, 50 min, 80 min). The ventricular function, the concentration of nitric oxide (NO) and the activity of succinate dehydrogenase (SDH) in myocardial tissue were also observed. RESULTS: Compared with ET group, the percentage recovery of the product of left ventricular pressure difference and heart rate [(LVSP-LVEDP)?HR], LVDP,+dp/dt_(max) were all increased apparently in HHI treatment group. The activities of SOD, SDH and the concentration of MDA, NO in HHI treatment group were close to that in normal control group. CONCLUSION: Herba houttuyniae injection protects myocardium against injury induced by endotoxin. It may be related to decrease in the level of NO, the strength of antioxidation, the stability of enzyme activities and the improvement of energy metabolism in myocardium.
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AIM: To detect the role of fibrinogen activity (Fa) in the progress of coronary artery disease (CHD).METHODS:Fa was measured with hemorheology methods in patients with CHD stable phase (n=30) and angina pectoris (n=27).RESULTS: (1) Levels of plasmatic fibrinogen and plasmatic viscosity in patients with CHD were higher than that of control group (P