0.05 ). Conclusions The non-mended injury does not affect the therapeutic effect of the Madigan prostatectomy with the urethral injuries due to the operation.

Objective:To make clear the present situation of treating chronic renal failure(CRF) by TCM in our hospital. Methods: Adopting a retrospective survey of medical records in a row. Results: In total of 76 cases of patients,74 cases took herbal decoction. 19 prescriptions were used which focused on Shenqidihuang Decoction 37 cases (50.00%), Huanglianwendan Decoction 9 cases (12.16%) and Dangguishaoyao Powder 7 cases (9.46%). Herbs such as Radix Salviae Miltiorrhizae,Radix et Rhizoma Rhei,Radix Achyranthis Bidentatae and Rhizoma Coptidis were the main medicines. Herbal medicine accompanied with Shenqidihuang Decoction were Cortex Eucommiae, Radix Acanthopanacis Bidentatae(62.16%), Pericarpium Citri Reticulatae, Fructrs Amomi,Radix Aucklandiae, folium perillae, caulis perillae (59.46%) and Rhizoma Coptidis, Caulis Bambusae in Taeniam, fortune eupatorium herb (48.57%) respectively. With the main methods of tonifying qi and enriching yin, activating blood and detoxifing and regulating the middle energizer. The herbal decoction had a good effect on CRF patients in the near future. Conlusion: The prescriptions used in our hospital had the characteristics of giving consideration to deficiency and excess, takes both deficiency and excess, tonification and discharge, and paying attention to spleen. The prescriptions had some effect on CRF in the near future, but the long-term effect need further observation.

Objective To explore the spatio-temporal regularity of cerebral edema in the early stage of severe burn (50% TBSA Grade Ⅲ) with four-dimensional (4D) mathematic model. Methods Twenty-six dogs were randomly divided into control group and 6, 12, 18 and 24 hours post-burn groups. The dogs in the postburn groups suffered severe burn of 50% TBSA GradeⅢ. Six hours after burn, 50 g/L glucose was injected according to Parkland formula. MRI manifestation, histopathological changes, brain water content and intracranial pressure were observed in each group. A 4D mathematic model was established based on the results of MRI scanning. Results Two turning points ( 6 and 18 hours postburn) and three phases of pathologic changes were displayed by 4D mathematic model of cerebral edema in the early stage of severe burn. The first phase (6 hours postburn) was in the subclinical period,when an effective treatment should be taken as quickly as possible so as to prevent deterioration of postburn cerebral edema. The second phase ( 6-18 hours postburn) was in the apostatic period with pathologic characteristic of vasogenic and cytotoxic brain edema. The third stage (18-24 hours postburn) was the critical period of cerebral edema. Intracerebral pressure (ICP) increased rapidly due to limitation of cranial cavity, when cerebral hernia easily happened. Conclusions The 4D model indicates that there is a feature of type S curve in the pathologic process of cerebral edema in the early stage after severe burn.

Objective To discuss the clinical value of subintimal angioplasty (SIA) in treating long segment occlusion of superficial femoral artery (SFA) in the elderly,and to observe the follow-up results.Methods Subintimal angioplasty was performed in 66 elderly patients with stage Ⅱ-Ⅳ long segment occlusion of SFA.The improvement of ankle-brachial index (ABI) and the long-term patency rates were observed and analyzed before and after treatment.Results Of 66 elderly patients,the surgery was successfully performed in 64 cases (97 ％).Skin temperature was improved,the claudication disappeared or a claudication distance was prolonged,the rest pain disappeared or relieved,foot infection was under control and turned into the dry gangrene in these patients.SIA was given up in 1 case because the wire failed to return to the true lumen and the distal outflow segment was occluded.One patient underwent bypass grafting instead of SIA because the wire failed to get into the subintimal.The ABI got obvious improvement before and after treatment (0.59±0.16 vs.0.84± 0.21,P＜0.01).The patency rates in 62 patients undergoing SIA at 6,12,24,36 months were 85.5％ (53/62),69.4％ (43/62),54.8％ (34/62) and 48.4％ (30/62) after surgery,and the 3-years limb salvage rate in 62 cases was 96.6％ (60/62).Conclusions Subintimal angioplasty is an effective method for treating long segment occlusion of superficial femoral in elderly patients,and it has the satisfactory long-term follow-up results.

Stage assessment is an important part of standardized resident training.After two years of practice and exploration,Liaoning had established the complete examination and evaluation system including the theory test and skill test and this system was future improved through analyzing two years' results and summing up the experiences making it more suitable for residency training in the future.

Objective:To assess the ability of axillary reverse mapping (ARM) to identify and preserve the arm lymphatics drainage as well as determine its ability to reduce lymphedema. Methods:A total of 300 breast cancer patients who underwent axillary lymph node dissection (ALND) from June 2009 to May 2011 were enrolled in this study. Methylene blue dye (2 mL to 3 mL) was injected into the ipsilateral upper inner arm along the medial intramuscular groove to map the upper extremity lymphatic drainage system prior to ALND. The blue lymphatic and lymph nodes were identified and preserved during the operation. The change in the arm circumference was the selected method of measurement. The difference in the bilateral upper arm circumference was recorded after 2 months (difference≥2 cm is defined as lymphedema). Results:The ARM was performed successfully in 195 (65%) of 300 patients. The incidence of lymphedema was significantly lower in the successfully mapped patients than in the failing mapping patients, with statistically significant difference during follow-up at 6, 12, 18, and 24 months post operation. Conclusion:The ARM technique can identify and preserve the arm lymphatics drainage and prevent upper extremity lymphedema after breast cancer axillary lymphadenectomy.

Objective To evaluate the role of real-time three-dimensional transesophageal echocardiography(RT3D-TEE) in non-valvular atrial fibrillation with left atrial appendage(LAA) stunning after catheter ablation.Methods Clinical and echocardiographic variables were analyzed by univariate regression in order to investigate the relationship between the group of LAA stunning and others in 28 patients after catheter ablation.Results Univariate analysis revealed difference in persisting time of atrial fibrillation[(16.4 ± 11.6)weeks vs (21.3 ± 18.6) weeks,P ＜0.05],left atrial diameter[(43.4 ± 8.3) mm vs (47.6 ± 5.9) mm,P ＜0.05 ],left atrial emptying fraction (0.38 ± 0.04 vs 0.30 ± 0.09,P ＜0.05).LAA emptying fraction based on three-dimensional volume measurements had significant difference (0.20 ± 0.03 vs 0.12 ± 0.02,P ＜ 0.001) between the group of LAA stunning and other cases.Conclusions LAA ejection fraction calculation by RT3D-TEE is feasible and more accurate than by clinical and other echocardiographic in LAA stunning after ablaton of atrial fibrillation.

BACKGROUND: Foreign and domestic scholars have made some studies on local anatomy and imageology of osseous pterygopalatine fossa, but studies on anatomy of section of osseous pterygopalatine fossa are few.OBJECTIVE: To measure hole-hole distance and aperture of pterygopalatine fossa from adult cranial bone at coronary and horizontal planes, and to observe the morphology of pterygopalatine fossa at corresponding sections.DESIGN: Repeated measurement design.SETTING: Scientific Research Office, Chengdu Medical College.MATERIALS: This experiment was carried out in the Laboratory for Local Anatomy, Department of Human Anatomy,Chengdu Medical College from March to November 2006. Sixty sides of complete dry cranial bone samples from 30 Chinese adult cases, who were of either gender and regardless of age, were involved in this study.METHODS: Bilateral pterygopalatine fossa of 30 dry cranial bone samples (60 sides) were sliced, 15 for slicing at coronary plane, and 15 for slicing at horizontal plane. Morphology of pterygopalatine fossa at the corresponding layers was observed, and related hole-hole distance and aperture were measured. Outcome was performed statistical analysis.MAIN OUTCOME MEASURES: Measurement at coronary plane: [1]orbit-rotundum distance (distance from the lowest point of inferior orbotal fissure to the center of rotundum); ② rotundum- pterygoid canal distance Ⅰ (vertical distance from the center of rotundum to the center of pterygoid canal); ③ rotundum- pterygoid canal distance Ⅱ (Distance from the area where rotundum appeared to the area where pterygoid canal appeared). Measurement at horizontal plane: [1]anterior-posterior dimension ( the largest distance between anterior and posterior walls which paralleled to perpendicular plate of palatine bone in each layer); ② lateral dimension (distance from midpoint of perpendicular plate of palatine bone to midpoint of line, which was between outermost sphenoidal process in the anterior wall of pterygopalatine fossa and foremost evagination in the posterior wall of pterygopalatine fossa). Morphology of pterygopalatine fossa in each layer was observed at coronary and horizontal planes, separately.RESULTS: ①At the coronary plane, the 1st to 6th layers of bilateral pterygopalatine fossa presented with inclined inverted trapezoid (70%, 21 sides), and inclined quadrilateral (30%, 9 sides), and the 7th to 10th layers of bilateral pterygopalatine fossa presented with canal-shape (100%). Themean value of right orbit-rotundum distance was (5.0±2.7) mm, andthat of left orbit-rotundum distance was (5.3±2.1) mm; The mean value of right rotundum- pterygoid canal distance Ⅰ was (6.4±3.9) mm, and that of left rotundum- pterygoid canal distance Ⅰ was (6.1±4.3) mm; The mean value of right rotundum- pterygoid canal distance Ⅱ was (7.3±2.6) mm, and that of left rotundum- pterygoid canal distance Ⅱ was (7.5±2.1) mm. ② At horizontal plane: The anterior and posterior walls of the 1st and 2nd layers of bilateral pterygopalatine fossa mainly presented with double curves with palinal convex surfaces (80%, 24 sides); the 3rd and 4th layers mainly presented with opposing convex surfaces (66.7%, 20 sides); The 5th to 6th layers mainly presented with canal shape (60%, 18 sides);And the 7th to 10th layers presented with canal shape (100%). At horizontal plane, for the pterygopalatine fossa in the 1st to 6th layers, its lateral dimension was larger than its anteroposterior dimension, and for the pterygopalatine fossa in the 7th to 10th layers, its lateral dimension was equal to its anteroposterior dimension. There were no significant differences of aperture in each layer of pterygopalatine fossa between bilateral samples (P＞ 0.05).CONCLUSION: Anatomical studies on the section of osseous pterygopalatine fossa retrieve the limitation in local anatomy,and provide reliable anatomical evidence for imageology of pterygopalatine fossa and related surgical operation.

The association of the serum phospholipid fatty acid components with lipid profiles in patients with newly-diagnosed type 2 diabetes mellitus was investigated.Saturated fatty acid in patients with newly diagnosed type 2 diabetes mellitus was increased(48.79±1.55 vs 42.58±1.96,P<0.01),whereas monounsaturated fatty acid and polyunsaturated fatty acid were decreased(10.72±1.53 vs 12.09±1.32,33.41±2. 16 vs 35.79±2.41.6.08±1.66 vs 9.54±1.54,all P

Induction of immune tolerance is characterized by high efficiency,low toxicity and economic advantages,and immune tolerance has very important significance in organ transplantation.In the establishment of immune tolerance,dendritic cells (DCs) play the key roles such as clonal deletion or clonal anerge,expressing t-cell inhibiting factors,activating helper T cells electively and inducing regulatory T cells,especially CD4 + CD25 + regulatory T cells,etc.Similarly,CD4 + CD25 + regulatory T cells whose primary target point is dendritic cell also have various functions such as affecting dendritic cells'maturing,restraining dendritic cells'antigen presentation to T cells,inhibiting the activation of T cells in non-specific ways and inducing immune tolerance.Current research shows,dendritic cells and CD4 + CD25 + regulatory T cells regard each other as target point and work synergetically.Here we mainly discuss the function and interaction of dendritic cells and CD4 + CD25 + regulatory T cells in the immune tolerance.