Objective To understand the level of tulnor necrosis factor-α(TNF-α)and asymmetric dimethylarginine (ADMA) in serum of healthy adults and primary hypertension patients with different left ventricle,and to explore the role of TNF-α and ADMA in the pathophysiological mechanism of heart damage due to hypertension.Methods Thirty health adults were recruited as control.Based on the left ventricular mass index(LVMI)and relative wall thickness(RWT),66 patients of hypertension were divided into 4 groups:normal left ventricle group with normal LVMI and RWT,concentric remolding group with normal LVMI and incremental RWT,typical concentric hypertrophy group with incremental LVMI and RWT,eccentric left ventricular group incremental LVMI and normal RWT.TNF-α was measured by radioimmunoassay and ADMA was measured through reversed phase high-performance liquid chromatography.Resuits TNF-α and ADMA increased with the severity of the left ventricle.Each left ventricle group was significantly higher than control group (P<0.01).The differences between left ventricle groups were statistically significant (P<0.01).Conclusions TNF-α and ADMA may participate in the development of left ventricle.

Objective To evaluate the protective effect of prior ?-adrenergic blocker therapy to patients who have PCI therapy.Methods We analyzed 210 consecutive patients undergoing ?-adrenergic blocker,of whom 105 did ?-adrenergic blocker therapy,105 had not.CK-MB、E、NE were tested before PCI,and 6~8 h,16~24 h after PCI.Procedural complications in hospital and 1-year outside outcomes were evaluated.Results (1)There was no significant difference between the two groups on CK-MB、E、NE.(2)Both the in-hospital(2.1% vs 4.1%)and one year (5.5% vs 7.1%)mortality was lower in ?-group than in no-? group.Conclusion Prior ?-adrenergic blocker therapy can reduce the incidence of cardic events.

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0.05).Conclusion DTI can noninvasive detect the potential disorder of corpus eallosum in vivo,thus providing useful information to differentiate the cerebral ischemia disease from multiple sclerosis.

Objective To evaluate the technique of laparoscopic pyeloplasty. Methods 11 cases with ureteropelvic junction (UPJ) obstruction underwent laparoscopic pyeloplasty via post abdominal cavity approach. Results All the operations have been successful,the operating time being 2 to 4 h and the blood loss 40 to 90 ml. Ultrasound B investigation 3 to 24 months after the procedure showed no hydronephrosis in all and IVU analysis in 6 cases one year after the operation disclosed good outcome with less morbidity. Conclusions Laparoscopic pyeloplasty is an effective way to treat UPJ obstruction with minimal trauma to the patient.

Objective To evaluate laparoscopic radical prostatectomy for prostate cancer. Methods 8 patients presented clinical stages pT 1b to pT 2 prostate cancer.Laparoscopic radical prostatecomy was carried out transperitoneally with combining posterior and anterior approachs to the prostate,transecting the bladder neck,lateral dissection of the prostate and urethrovesical anastomosis. Results The operation time was 5 to 11 h with an average of 7.3 h and the blood loss 200 to 1 100 ml,averaged 620 ml.All the patients recovered well and uneventful with no complications such as urethral stricture or incontinence. Conclusions Laparoscopic radical prostatectomy is a better approach and least invasive.The procedure provides clear anatomic vision that facilitates operative performance and quicker recovery.

Objective To describe the ureteroplasty of congenital obstructive megaureter by laparoscopy and to evaluate the efficacy and feasibility of laparoscopic intervention for congenital obstructive megaureter. Methods Six patients with congenital obstructive megaureter were prepared for the laparoscopic surgery.The surgical procedure was briefly described as follows.The dilated ureter was dissected and cut off near the ureter orifice to the bladder by laparoscopy.Next,the free ureter was pulled out through the skin trocar site and was tailored as open surgery.After that,the ureter was placed back to the abdominal cavity and reimplanted laparoscopically into the bladder. Results The operation duration was 2 to 4 h (mean 2.4 h) and blood loss was very little (20～35 ml).No complication developed.The double J stent was removed at 3 months after the operation.Follow-up for half to 2 years showed that all the ureter drainage in the 6 cases was well without any infection. Conclusions Our preliminary result shows that laparoscopic surgery is a safe and effective method for treatment of megaureter.

Objective To evaluate the therapeutic effects of functional reconstructive technique of laparoscopic radical prostatectomy (LRP) for organ confined prostate cancer. Methods From October 2000 to September 2004,54 patients with organ confined prostate cancer (TNM stage of T 1b-T 2) underwent LRP.After completion of the first group of 15 consecutive cases (group A) by Monstouris techniques, the functional reconstructive surgical technique, which is basically composed of anatomical radical prostatectomy,was introduced to LRP in the second group of 39 consecutive cases (group B).These techniques mainly consisted of preservation of urethral and bladder outlet sphincter muscles,reconstruction of bladder neck,and fine anastomosis between urethra and bladder neck with fixation of anterior wall of anastomotic stoma and retropubic vascular complex.The operative time, bleeding volume,complications,continence recovery time and PSA level were comparatively analyzed between the 2 groups. Results All the operations were successful in 54 patients.In group A and group B,the mean operative time was 390 min(range,270-660 min)vs 240 min(range,180-360 min);the mean bleeding volume was 430 ml(range,200-1100 ml) vs 160 ml(100-400 ml);the complication rate was 40% (6/15) vs 13% (5/39) and the continence recovery time was on average 6 months vs 3 months,respectively. There were statistically significant differences in these parameters between the 2 groups (P

[Objective]To investigate the feasibility of the placement of pedicle screws in the thoracolumbar vertebrae under X-ray fluoroscopy step by step.[Method]Eight human cadaveric thoracolumbar spines(T9~L5) were selected and classified into group A and group B randomly,each having 4 specimens.Pedicle screws in group A were placed under X-ray fluoroscopy step by step.CT scanned the specimens of group A and measured the half pedicle length,full pedicle length and the pedicle screw passage length.The "e" angle and "f" angle of pedicle were measured on CT images.When the guide wire was pricked to the half of pedicle length,the wire tip was located at the middle line of the pedicle projection in the standard posterior-anterior image.When the wire was pricked to the full pedicle length in lumbar vertebrae,its tip was located at 3/4 line of the pedicle projection in the standard posterior-anterior image.When the wire was pricked to the full pedicle length in thoracic vertebrae,its tip was located at between 1/2 line and 3/4 line of the pedicle projection.When the wire was pricked into vertebrae,the depth of the wire and the "e" angle were noted in standard lateral image.Pedicle screws were placed by the track of the guide wire.Pedicle screws in group B were placed by traditional technique.The accuracy and feasibility of the method under X-ray fluoroscopy step by step were evaluated by observation of the position of the pedicle screws in group A and group B.[Result] Four of 72(5.56%) pedicle screws were found to have perforated the pedicle wall in group A,and 19 of 72(26.38%) pedicle screws perforated the pedicle wall in group B.The result of group A was superior to that of group B(P

Objective To investigate the effects of eardiopulmonary bypass(CPB)on plasma nitric oxide (NO)and asymmetric dimethyl arginine(ADMA)concentrations in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.Methods Eighteen ASA Ⅱ or Ⅲ patients aged 11-40 yr weighing 26-59 kg undergoing open heart surgery under CPB were divided into 3 groups according to pulmonary arterial systolic pressure(PASP)(n=6 each):group Ⅰ PASP<30 mm Hg;group Ⅱ PASP 30-50 mm Hg and group Ⅲ PASP>50 mm Hg.Arterial blood samples were taken before induction of anesthesia (To,baseline),at the start and termination of CPB(T1,2)and 3,6,24 h after CPB(T3-5)for determination of plasma NO and ADMA concentrations.Results The three groups were comparable with respect to M/F sex ratio,age,body weight and CPB time.The plasma ADMA concentrations were significantly increased while NO concentrations were significantly decreased at termination of CPB(T2)and 3 and 6 h after CPB(T3,4)as compared with the baseline at T0 in group Ⅱ and Ⅲ.The plasma ADMA concentration were significantly higher and No concentrations were significantly lower at all time points in groupⅡand Ⅲthan in group Ⅰ.Conclusion CPB can increase plasma ADMA concentration and decrease plasma NO concentration in patients with congenital heart disease complicated with pulmonary hypertension undergoing open heart surgery.