Objective To observe the relationship between carotid artery elasticity and ultrasonic classification of carotid plaques in elderly patients,and to provide the clinical basis for clinical treatment and prevention of atheroselerosis.Methods 682 elderly patients undergoing health physical examination were randomly selected in our hospital from February 2010 to February 2012.Clinical data were surveyed by using questionnaire method.Carotid artery color Doppler ultrasound detection and brachial-ankle pulse wave velocity (PWV) were measured and analyzed.The relationship between carotid artery elasticity and ultrasonic classification of carotid plaques in elderly patients were evaluated.Results A total of 186 cases with carotid atherosclerotic plaques (CAP) were found in 682 cases,accounting for 27.3％,among whom there were 123 patients (18.0％) with hard plaques and 63 patients (9.2％) with soft plaques.Patients with CAP were divided into hard plaque group and soft plaque group.There were significant differences in carotid intima media thickness (IMT) among carotid plaque grade 1 versus 2 versus 3[(0.8±0.2)mm,(0.88±0.23)mm,(0.97±0.17) mm,respectively,P＜0.05].There was a positive correlation between PWV and carotid plaque grade in the hard plaque group (r＝0.30,P＜0.05),but not in soft plaque group.Conclusions Arterial elasticity is an index for vascular disease,and is closely related to the severity of carotid atherosclerosis,which can be used as one of predictive indexes for carotid atherosclerosis.

Objective To outline the surgical experience of liver transplantation in children receiving left lateral lobe (segments II, III). Methods From March 1 to September. 1, 2004, 11 cases of pediatric liver transplantation were performed in Medical School of Hannover including 10 cases of split liver transplantation and 1 case of living related liver transplantation, and the clinical data of those cases were collected and analyzed. The average age and weight of these patients was 48.6 months (5-82 months) and 14.3 kg (6.9-23.8 kg) respectively, and 8 children had the previous abdominal surgical history. Results The average weight of the left lateral graft procured was 276.2 g (198-373 g), and the average cold ischemia time, anhepatic phase and operation time was 679 min (183-1290 min), 69 min (44-88 min) and 252 min (155-335 min) respectively. Six children received temporal closure of abdominal wall after liver transplantation. One child developed the perforation of stomach 15 days after operation, and compression of hepatic artery due to limited abdominal capacity occurred in 2 children within 24 h postoperatively. No complications including outflow obstruction of hepatic vein, hepatic artery thrombosis, primary graft nonfunction, graft necrosis and bile leakage from the cutting surface happened. Conclusion The left lateral lobe liver transplantation in children has been widely used with promising results. Resection of ill liver under controlling of inferior vena cava, simultaneous reperfusion of hepatic artery and portal vein and application of temporal abdominal wall closure had unique advantage, and thus, would be worth adopting.

Objective To investigate the clinical efficacy of laparoscopic versus open omental patch repair for perforated peptic ulcer. Methods One hundred and twenty-seven patients who underwent omental patch repair for perforated peptic ulcer were analyzed retrospectively. There were 74 cases in the laparoscopic repair group (LR group) and 53 cases in the open repair group (OR group) respectively. Operative time, intraoperative blood loss,postoperative pain at 1 d and 3 d.time to first flatus and resumption of diet, time to drainage removal,surgical site infections (wound infection and intra-abdominal abscess),systemic complications and length of postoperative hospital stay were compared. Results LR group experienced less intraoperative blood loss[(32.7 ±25.6) ml], lower postoperative pain at 3 d[(2.8 ±1.5) scores], earlier time to first flatus [ (25.8 ± 20.1) h] and resumption of diet [ (2.7 ±2.1) d ], shorter time to drainage removal [(2.0±1.5) d], less wound infection (0) and shorter hospital stay[(4.8 ±2.3) d] than those in OR group [(53.2±30.0) ml, (36.9±27.9) h, (3.7±2.0) scores, (3.6±2.3) d,(2.9±2.2) d,9.4%(5/53), (6.6±4.0) d](P< 0.01 or <0.05). There were no significant differences in operative time,postoperative pain at 1 d, incidence of intra-abdominal abscess and systemic complications between the two groups. There were no suture-site leakage, reoperation and death in two groups. Conclusions Laparoscopic omental patch repair for perforated peptic ulcer is safe and efficacious. It has significant advantages over open approach with respects of less postoperative pain,earlier return of bowel function,less wound infection and shorter hospital stay.

Objective To improve scientific research capacity and disciplines development,we performed grading system to specialize and quantize the management in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods With assistance of forum survey related to 20 clinical and technical departments in hospital,we assessed the status of disciplines development,designed assessment criteria,and revised relevant regulations in grading system.Results The implementation of grading system promoted scientific achievements,academic communications and human resource development in hospital as relative to their pre-implemental controls.Conclusions The implementation of grading system facilitates scientific research and improves disciplines development.

Objective: To observe the characteristic changes of specific immunological function of serum endo toxin level,spleen lymphocyte human leukocyte antigen(locus) DR(HLA-DR),limphopolesis and positive expression of caspase-3 in rats with sepsis and the effect of Xuebijing injection(血必净注射液) on their immunological function.Methods: Sepsis model was produced by cecal ligation and puncture(CLP).Seventytwo male SD rats were randomly divided into four groups: sham operation,model,levofloxacin and Xuebijing injection.Blood samples were taken from the vein in the abdominal cavity at 3,24 and 72 hours after the models were established, afterwards the rats were sacrificed and their spleens were taken out.Matrix development process was employed to examine the level of serum endotoxin,FACS flow cytometer was used to examine the expression level of HLA-DR,immunohistochemistry method was applied to examine the positive expression of caspase-3 in spleen,and the method of methyl thiazolyl tetrazolium(MTT) was employed to examine the lymphopoiesis.Results: The levels of serum endotoxin,lymphopoiesis and caspase-3 positive expression index in model group were obviously elevated than those of sham operation group,and percentage of HLA-DR was markedly lowered(all P

Objective To explore the appropriate approach of delivery after cesarean section of Uyghur women in primary hospitals in Xinjiang Uyghur Autonomous Region.Methods A total of 5 154 women delivered in Luopu County People Hospital,Hetian Prefecture,Xinjiang Uyghur Autonomous Region from January 2011 to December 2012.Among them,178 Uyghur women had cesarean section history.The interval between the previous cesarean section and this delivery varied from 1 year to 17 years.The number of cases attempting vaginal labor and the indications of the previous cesarean section were recorded.The indications for the second cesarean section were analyzed.The gestational weeks at delivery,blood loss in 2 hours after delivery,neonatal birth weight,newborn asphyxia,the rate of postpartum fever (≥38 ℃) and hospitalization days were compared between the two approaches of delivery.Results (1) Among the 178 cases,119 cases attempted vaginal labor,the rate of attempting vaginal labor was 66.9％ (119/178).A total of 113 cases succeeded in vaginal delivery (the vaginal delivery group),with the successful rate of attempting vaginal delivery of 95.0％ (113/1 19),and the successful rate of vaginal delivery was 63.5％ (113/178).For those 119 women succeeded in vaginal delivery,the indications of the previous cesarean sections were as following:pregnancy complications (68.1％,81/119),macrosomia(5.0％,6/119),dystocia (14.3％,17/119),pregnancies complicated with other diseases(5.0％,6/119) and cesarean section on maternal request(7.6％,9/119).(2) 15 cases in the cesarean section group had postpartum hemorrhage,with the incidence of 13.3％(15/113).The mean total labor time was (507± 182) minutes.6 cases attempting vaginal delivery failed and turned to cesarean section.(3) 59 cases received the second cesarean section (the cesarean section group).The rate of second cesarean section was 33.1％ (59/178).The indications of the second cesarean section were as following:contracted pelvis (5％,3/59),pregnancy complications (42％,25/59),macrosomia (20％,12/59),short interval between the two cesarean sections(≤2 years); (12％,7/59) and cesarean section on maternal request (20％,12/59).(4) Gestational weeks at delivery,rates of newborn asphyxia in the vaginal delivery and cesarean section groups showed no significant statistical difference (P＞0.05).In the vaginal delivery group,the average blood loss in 2 hours after delivery was (259±213) ml,the rate of postpartum fever was 10.6％,the mean fetal birth weight was (3 272±477)g and the mean hospitalization was (1.8±1.6) d.In the cesarean section group,they were (400±320)ml,54.2％,(3 539±500)g and (8.7±2.2)d,respectively.There was significant statistical difference (P＜0.01) between the two groups.Conclusions Vaginal delivery after cesarean section could be attemped in Uyghur pregnant women in Xinjiang primary hospitals,if doctors could choose the indications strictly and monitor closely.These could increase the success rate and safety of vaginal delivery and therefor reduce the cesarean section rate.

Objective To study the expressions of miRNAlet7 and Ras in non-small cell lung cancer ( NSCLC),and their correlations with clinicopathological features and survival time.Methods In-situ hybridization was used to detect the expression of let7,and SP immunohistochemistry to measure HMGA2 in 68 NSCLC cases ( group A) and 20 cases with normal lungs ( group B).Results The positive rate of let7 in group A was lower than that in group B (39.7％ vs 63.2％ ) ( P ＜0.05).The positive rate of Ras in group A was higher than that in group B (66.2％ vs 25.0％ ) ( P ＜0.01 ).The positive rate of let7 was not related to the age,gender,histological type,cell differentiation,and clinical stages of cancer patients(P ＞0.05).The positive rate of Ras was related to smoking,sex,and histological type of cancer( P ＜0.01 ),and was not related to cell differentiation,lymphatic metastasis,and clinical stages of cancer ( P ＞0.05).There was an obvious negative correlation between let7 and Ras( r =-0.627,P ＜0.01 ).The 2-year survival rate of let7-positive group was higher than that of the let 7-negative group ( x2 =4.84,P ＜0.05).No statistically significant difference was found between Ras-positive and-negative groups ( P ＞0.05 ).Conclusions The lower level of let7 expression,and high level of Ras expression have much to do with the carcinogenesis of NSCLC.The level of let7-positive expression is closely related to prognosis; while Ras may act in cooperativity in the occurrence and development of NSCLC.

Objective To investigate the clinical efficacy of laparoscopy combined with cholangioscopic FREDDY laser lithotripsy for the treatment of difficult central type bile duct calculi.Methods Fifty-five patients with difficuh central type bile duct calculi undergoing laparoscopy combined with cholangioscopy were analyzed retrospectively.There were 31 patients in FREDDY laser lithotripsy group (FREDDY group) and 24 patients in routine instrunent group (routine group).Operative time,intraoperative blood loss,conversion rate,time to first flatus,incidence of postoperative complications (such as pancreatitis,hemobilia and biliary leak),postoperative hospital stay and first session bile duct clearance rate were compared.Results Operative time,intraoperative blood loss,time to first flatus,postoperative hospital stay in FREDDY group [( 106.2 ± 49.4) min,(37.7 ± 28.6) ml,(25.8 ± 19.3 ) h,(5.9 ± 3.3 ) d]were significantly lower than those in routine group[( 142.2 ± 64.8 ) min,(60.3 ± 32.1 ) ml,(37.2 ± 21.6 ) h,(8.4 ±4.9) d] (P＜ 0.05 or ＜0.01 ).There were no statistically significant differences in conversion rate,incidence of postoperative complications and first session bile duct clearance rate between the two groups (P ＞ 0.05).There were no dead in both groups.Seven patients with residual bile duct stones were cured by cholangioscopy through T-tube sinus 6 weeks after prior surgery.Forty-three patients were followed up 6 to 12 months with no recurrent bile duct stones and bile duct stenosis.Conclusions Laparoscopy combined with cholangioscopic FREDDY laser lithotripsy is recommendable to treating difficult central type bile duct calculi with good short-term results and has the advantages of minimal invasiveness,safety,efficiency and rare complications.

ObjectiveTo investigate the etiology, clinical characteristics, diagnosis and treatment of regional portal hypertension caused by left upper abdominal malignant tumors.MethodsFrom January 2006 to December 2009, a total of 8 patients presenting regional portal hypertension were treated at our hospital, whose clinical data were analyzed retrospectively. ResultsPancreatic tumors (5/8) and retroperitoneal tumors(3/8)were the primary etiology,andthe main symptoms included upper gastrointestinal bleeding and irregular left upper abdominal pain.Isolated gastric varices were the most distinct clinical features. All patients underwent multi-visceral resection including pancreatic body and tail and spleen. Tumor involved stomach, left kidney, left adrenal and splenic flexure of colon were also removed en bloc. During the follow-up period there was no recurrent upper gastrointestinal bleeding, one patient died and two patients developed metastasis or tumor local recurrence.ConclusionRegional portal hypertension caused by malignant tumor was relatively rare,aggressive resection of multi-viscera combined with devascularization was an effective therapy.

BACKGROUND: Microcarrier culture technology has become a new and large scale cell culture technology. It has been mainly used in the amplification research of tissue engineering seed cells. Microcarder possesses the advantage of larger surface area and plays an essential role in microcarrier culture technology.OBJECTIVE: To sum up the biomaterials and methods of microcarrier preparation, and provide theoretical foundation for the study of microcarrier culture technology and tissue engineering.METHODS: Articles were retrieved from PubMed, Wanfang, and VIP databases with the key words of "micrecarrier, biomaterials cell culture, tissue englneering" in both English and Chinese between 1967/2009 and 1990/2009, respectively. Inclusion criteria:study addressing microcarrier materials, preparation, and performance; study of microcerrier cell culture; animal experiments and clinical applications. A total of 34 articles were originally retrieved based on their titles and abstracts.RESULTS AND CONCLUSION: Although a lot of studies have reported research and preparation of microcarrier, clinical application remains still difficult. Recently, varying materials will be made into novel compound materials by new technology,which can adjust mechanics and biodegredation of microcarder via surface modification.