Vascular prosthesis can absorb y-globulin or fibrinogen when they are transplanted in vivo, accordingly the cellular components in blood, such as platelet, are easy to attach on surface and become fiat shape to be activated, which then result in an inreversible aggregation and thrombus formation. During the process of transplanting vascular prosthesis at a diameter of more than 6 mm, a high vascular patency rate can be observed, while small-diameter (< 6 mm) vascular prosthesis transplantation is under low blood flow, therefore it produces the thrombosis. It is necessary to conduct surface modification of small-diameter vascular prosthesis and to enhance hemocompatibility. The main methods of modification include the alter of surface structure of vascular prosthesis, the augmentation of endothelial cells attachment on surface of vascular prosthesis, and grafting modification of vascular prosthesis surface.

Colorectal cancer, C RC, is a kind of cancer, which has a high rate of morbidity and mortality.Liver metastasis is the most frequent metastasis way in CRC, and related to the prognosis of the patients.There are many studies on the treatment of colorectal liver metastasis. The resection of the metastasis is one of the major treatments. Other treatments, including chemotherapy, alleviative and immunogenic treatments,are beneficial supplements to the resection. We summariz the indications, contraindications, managements and effects of these treatments.

Objective To analyse the clinical characteristics of primary extra-nodal malignant lymphoma of the ear, nose and pharynx in order to improve the diagnosis of the disease. Methods Clinical characteristics of primary extra-nodal malignant lymphoma of the ear, nose and pharynx were analysed retrospectively in 16 patients. Especially that of the middle ear and paranasal sinuses, which were rare in occurrence. Results There was one patient with lymphoma of the middle ear, presenting otalgia, chronic secretory otitis media (conductive hearing loss) and facial nerve palsy as main symptoms. Seven patients of lymphoma of tonsils showed hypertrophy of the tonsil and foreign body sensation in pharynx as main symptomatology. Two patients of lymphoma in the nose and paranasal sinus complained of bloody rhinorrhea, odorous discharge, and inferior turbinate hypertrophy. The patients suffering from nasopharyx lymphoma always complained of headache and bloody rhinorrhea. Oropharyngeal lymphoma always presented symptoms of pharyngalgia, fever, soft palate ulcer, and ozostomia. Conclusion The keys to make a correct diagnosis of extra-nodal lymphoma of the ear, nose, or pharynx are to become familiar with their clinical characteristics and to perform a prompt biopsy.

Objective To investigate the significance of T‐SPOT .TB and real‐time quantitative Polymerase Chain Reaction (PCR) in the diagnosis of extrapulmonary tuberculosis .Methods Among the 125 cases of extrapulmonary tuberculosis group ,all the 125 cases were performed in accordance with the acid fast bacilli smear ,TB‐PCR and T‐SPOT .TB detection .87 cases of Non‐tuberculosis disease group were detected .Results Among 125 cases of extrapulmonary tuberculosis ,4 cases were positive for acid fast bacilli smear and the positive rate was 3 .2% ;57 cases were positive byTB‐PCR and the positive rate was 45 .6% ;96 cases were positive by T‐SPOT .TB and the positive rate was 76 .8% .wo methods were detected in104 cases of positive patients ,the positive rate was 83 .2% .3 cases were positive by TB‐PCR and the positive rate was 3 .4% in 87 cases with non tuberculosis disease group . 4 cases were positive by T‐SPOT .TB and the positive rate was 4 .6% .Conclusion Here is an important practical value in the diag‐nosis of T‐SPOT .TB detection technology in extra pulmonary tuberculosis ,and TB‐PCR joint detection could further improve the detection rate of pulmonary tuberculosis .

Objective To study the expression and the clinical significance of Wnt signal pathway regulation factor Pygo2 in human renal cell carcinoma.Methods Using RFQ-PCR and immunohistochemical SP methods to detect Pygo2 mRNA and protein expression in 42 cases renal clear cell carcinoma and their own normal kidney tissue specimens.All specimens had a definite diagnosis by pathologic.All were renal clear cell carcinoma.The tumor diameter was 1.2-15.5 cm.The average was 7.2 cm.Among all patients,there were 7 cases with diameter ＜ 4.0 cm,9 cases 4.0-7.0 cm,26 cases ＞ 7.0 cm.Fuhrman classification:grade Ⅰ 6 cases,grade Ⅱ 17 cases,grade Ⅲ 17 cases,grade Ⅳ 2 cases.AJCC TNM stages:stage Ⅰ 16 cases,stage Ⅱ 7 cases,stage Ⅲ 7 cases,stage Ⅳ 12 cases.Statistics was done to analyze the expression difference of pygo2 between normal kidney and renal cell carcinoma,and among renal cell carcinoma within each group.Results There was higher expression of Pygo2 in renal cell carcinoma,and in the adjacent lower expression.The pygo2 mRNA expression were 2.88 ± 1.26 and 1.00 ± 0.00 in respective specimens (P ＜ 0.0001).The pygo2 protein expression were 45.53 + 24.54 and 11.02 + 1.39 in respective specimens (P ＜ 0.0001).Pygo2 expression in grading and staging were statistically significant (P ＜0.0001),but in gender,age was not statistically significant (P ＞ 0.05).Conclusions High expression of Pygo2 was found in Fuhrman high grade,high clinical staging,lympho-metastasized renal clear cell carcinoma.Pygo2 might play an important role in the occurrence and development process in renal clear cell carcinoma.

OBJECTIVE Study the role of mycoplasma infection and expression of Ki67 protein in the pathogenesis, development and prognosis of laryngeal carcinoma. METHODS Immunohistochemistry method was used to study 145 specimens of laryngeal carcinoma tissues, 25 specimens of precarcinoma tissues, 31 specimens of vocal cord polyps and 15 specimens of normal tissues adjacent to laryngeal carcinoma. RESULTS ①The positive rates of PD4 and Ki67 were 45.52%(66/145) and 82.76 % (120/145) in laryngeal carcinoma tissue, 16.00 % (4/25) and 32.00 % (8/25) in precarcinoma tissue, 12.90 % (4/31) and 22.58 % (7/31) in vocal cords polyps, 6.67 % (1/15) and 0 (0/15) in normal tissues adjacent to laryngeal carcinoma. ②The positive rates of PD4 and Ki67 were higher in the advanced laryngeal carcinoma cases than that in the early laryngeal carcinoma cases. The positive rates of PD4 and Ki67 were higher in laryngeal carcinoma cases with cervical metastasis than that laryngeal carcinoma cases without cervical metastasis(P

Objective To evaluate clinical value of utilization of real‐time fluorescence isothermal RNA amplification assay (SAT)for detecting Mycobacterium tuberculosis(MTB) in pleural effusion samples of patients with tuberculous pleurisy .Methods 90 hydrothorax specimens of patients with tuberculous pleurisy and 52 hydrothorax specimens of patients with non‐tuberculous pleurisy were selected ,and MTB was detected by using Roche culturing method ,SAT and TB DNA fluorescence quantitative expan‐sion method respectively .The sensitivity ,specificity and clinical value of SAT for detecting MTB were analysed .Results Taking Roche culturing method as the standard ,the sensitivity ,specificity and Youden index of SAT for detecting MTB were 90 .9% , 72 .1% and 0 .630 respectively .In patients clinically diagnosed with tuberculous pleurisy ,the positive detection rate of hydrothorax specimens detected by using Roche culturing method and SAT were 24 .4% and 43 .3% respectively ,and had statistically significant differences(χ2 =7 .166 3 ,P=0 .001 4) .Conclusion SAT is a rapid ,sensitive and specific method for the detection of MTB in pleu‐ral effusion samples ,which could improve the detection rate of MTB and decrease incidence of missed diagnosis and misdiagnosis .

Objective To observe the clinical efficacy of acupuncture at Xinming points (Extra) plus strong rein-forcing mani- pulation in treating optic atrophy.Methods Forty (56 eyes) optic atrophy patients were randomly allocated to a treatment group of 20 cases (29 eyes) and a control group of 20 cases (27 eyes). The control group received conventional medications, and the treatment group received acupuncture at Xinming points (Extra) plus strong reinforcing manipulation in addition. The visual acuity, the mean visual sensitivity (MS) of visual field and the P100 wave latency of P-VEP were recorded in the two groups before and after the treatment. The clinical therapeutic effects were compared between the two groups.Results The visual acuity, the MS of visual field and the P100 wave latency of P-VEP were significantly changed after treatment in both two groups (P<0.05). After the treatment, there were statistically significant differences in the visual acuity, the MS of visual field and the P100 wave latency of P-VEP between the two groups (P<0.05). The total efficacy rate was 75.0% in the treatment group versus 35.0% in the control group, and the difference was statistically significant (P<0.05).Conclusions Acupuncture at Xinming points (Extra) plus strong reinforcing manipulation is an effective method for optic atrophy.

Objective To investigate the operative techniques of microsurgery treatment of M1 segment of middle cerebral artery (MCA) aneurysms via pterional approach in 132 cases.Methods Retrospectively analyzed the clinical manifestation,angiograms,and surgical operation data of 132 patients with M1 segment of MCA aneurysms who underwent microsurgery through pterional approach.Results Preoperative digital subtraction angiography (DSA) was conducted in 121 cases to identify the size,shape,orientation and relationship with blood vessels around the MCA aneurysms.The other 11 cases underwent emergency operation.Among the 132 cases,72 patients were discharged in good condition according to Glasgow Outcome Scale; 41 patients were in poor condition; 19 cases were dead or in predying state.Postoperative CT showed that49 cases occurred new infarction and 7 cases developed hydrocephalus or enlargement of ventricles.Ventriculoperitoneal shunt was conducted in 2 cases.Intraoperation rupture and bleeding of aneurysms occurred in 17 cases.Conclusion The aneurysms in M1 segment of the middle cerebral artery are mostly located in the bifurcation of M1 segment.Most branches and perforating arteries stem from middle cerebral artery trunk.Patients with Hunt-hess grade Ⅰ-Ⅲ MCA aneurysms or with Hunt-hess grade Ⅳ,Ⅴ should be treated with microsurgery as soon as possible.Inside Sylvian fissure approach is the most frequently adopted in microsurgery via pterional approach.It is key for the success of the operation to preoperatively understand the anatomy surrounding the aneurysms,have good microsurgical skills and employ correct methods of preventing and managing of rupture of aneurysm.It can relieve the secondary cerebral vasospasm to clear up hematocele in the cisterns or to wash the cisterns or use adhesive wound dressing on blood vessels during operation using papaverine.

Objective To investigate the medical assistance to inpatients from low-income families for solving their difficulties in seeing doctors and affordability.Methods Random sampling was made to five ongoing medical assistance projects in the hospital for statistics and analysis of the data so collected.Results Medical expenses of such inpatients are beyond their affordability.Despite the coverage of their basic medical insurance,the reimbursement rate is too low to alleviate their financial burden.Conclusion A“4-party payment”model is recommended,combining the government support for basic medical insurance,social welfare assistance,philanthropic assistance and that paid by the inpatients.This model is expected to effectively alleviate the financial burden of such inpatients.