Using a spectral analysis of heart rate variability (SAHRV) in supine and standing positions were performed in a group of 65 patients with migraine and in a control group of 50 healthy volunteers in order to quantitative evaluate the function of autonomic nervous system(ANS). The result revealed that the integrals of middle frequency bands of amplitude spectra of standing patients were smaller than that of controls (P

Objective To investigate the etiology, pathology, pathogenesy and treatment in patient with rhabdomyolysis (RM) complicated with acute renal failure(ARF). Methods Analysis of clinical and muscle pathological data combined with literatures were made for a patient with RM-ARF.Results The patient who had experienced exercise induced RM for 5 years. Alcohol drinking and infection were led to RM with ARF for this time. There was non-special inflammatory feature in light microscope by biopsy. The principle of RM management was prevention of hypovolemia and acidification of urine. Hemodialysis (HD)was chosen for treatment of ARF and basic recovery was obtained.Conclusions The etiology of this patient may be the alcohol drinking, particularly the infection which developed on the basis of recurrent RM. Muscle biopsy is useful not only for observing the pathological features of RM, but also for differentiation of etiological factors. The HD therapy used in time may be the key to get favorable effect for this case.

Objective The experiences of peri-operative management in senile acute abdominal patients were summarized in order to raise the successful rate.Method We analysed retrospectively 575 cases who were senile acute abdominal patients from 1990 to 2000.Results Among 575 cases,540 cases(93.9%)were cured.423 cases(73.5%) were with other chronic diseases and dysfunctions before operation.Various complications occurred in 168 cases(29.2%)and 35 cases(6.1%) died.The death causes mainly were correlated with accompanied chronic diseases.Conclusion Strengthen peri operative care,active management of other chronic diseases and adequate operation time are important significantly for senile acute abdomen to get satisfied outcome.

Objective To study the cause of misdiagnosis of pancreatic carcinoma(PC) in order to obtain the final diagnosis as early as possible,and increase the rates of early diagnosis and resection of PC.Mothods We petrospectively reviewed 102 cases of PC from 1991 to 1997,and analyzed the diagnostic accuracy of prehospitalized and admitted for PC.Results The average time from initial symptoms and jaundices to admision was 197 days and 60 days,respectively.The misdiagnostic rates of the first consult and multicosult or hospitalized in other hospitals were 100% and 85%,respectively.The most frequently misdiagnostic disease was peptic ulcer(25 cases),the rest were cholelithiasis(14 cases),hepatitis(11 cases),biliary tract ascarides(5 cases).Osteophyte proliferation(3 cases),colilis(3 cases) and others(3 cases).8 cases underwent surgery in other hospitals while 7 cases of them misdiagnosis in operation.The diagnostic rates of B-U and CT after admison were 85% and 95%,respectively.According to operative findings,60% cases had wide-ranging celiac metastasis in which 40% had hepatic metastasis simultaneously,alse 75% had local invasion and lymphatic metastasis.Only 10% and 2% patients underwent radical resection and palliative surgery respectively, while 10% patients had conservative treatment.Conclusion We demonstrated that there are high misdiagnositic rate,low radical rate and delaying final diagnosis for PC.It is urgent to increase its initial diagnostic rate and apply for CT in early stage would be the best device.

Objective To investigate the clinical and pathological features of distal myopathy with rimmed vacuoles(DMRV). Methods Clinical manifestations and pathological features of biopsied muscle specimens were summarized and analysed retrospectively. Muscle specimens were collected from biceps brachii (3 cases), tibialis anterior (2 cases), quadriceps femoris (1 case)and gastrocnemius (3 cases) respectively. 6 cases were observed by electronic microscope. Results The onset of disease was ranged in age from 15 to 33 years, averaging 25 years. It is more common in women than in men in a ratio of 2∶1. Distal muscle weakness and atrophy of the lower extremities was predominant in early stage. Varied involvement of proximal and trunk muscles, with sparing of the facial, extraocular, bulbar, intercostal and diaphragm muscles was recognized in the advanced stage. The striking and common pathologic finding was the presence of rimmed vacuoles in muscle fibers with little evidence of necrotic or regenerative processes. Electronic microscopic study showed an accumulation of myeloid structure in 5 cases, cytoplasmic inclusion bodies in 4 cases and intranuclear filamentous inclusions in 2 cases. A perforated nuclear envelope and extrusion of filaments in adjacent cytoplasm were found in an enlarged nucleus filled with tubulofilementous inclusion.Conclusion The clinical and pathological findings of DMRV occurred in China is basically similar to those reported by Japanese. Ultrastructural study suggested that sarcoplasmic filamentous inclusions might originate from perforated nuclei with inclusion body, which predicts that the rimmed vacuoles are likely to be the end products of nuclear disintegration and focal myofibrillar degeneration.

Objective 　To investigate the features of clinical symptoms and pathological changes of mitochondrial encephalomyopathy. Methods　16 cases of mitochondrial encephalomyopathies were analyzed on clinical features, histochemical changes and ultrastructure observations of muscles.Results　The average proportion of RRFs was 5.9% in 16 cases and central nuclears were present in 11 cases. There were blue fibers on SDH/CCO double stain sections in 12 out of 13 cases. The distribution of blue fibers was concordent with that of RRFs. There were crystal include body in mitochondria of 4 cases. Conclusions　The diagnosis of mitochondrial encephalomyopathy could be made accoding to the presence of blue fibers on SDH/CCO double stain sections and the mitochondria encephalomyopathy could be distinguished from other myopathies.

To investigate whether changes of amino acid neurotransmitter releases in the rostral ventrolateral medulla (rVLM) were related to acupuncture and to the antihypertensive effect of melatonin (Mel) microinjected into the anterior hypothalamic area (AHA) of rats with stress-induced hypertension (SIH), as well as to compare and analyze the relationship between the both antihypertensive mechanisms of acupuncture and of Mel in the AHA. Methods: Animal model of SIHR was made by electric foot shocks combined with noises. Electroacupuncture (EA) was used and Zusanli acupoint of both side was selected. The technique of drug microinjection into the brain was used to observe the change of blood pressure (BP), and synchronously, brain microdialysis was performed for collecting dialysate samples, and then the concentration of amino acid neurotransmitters in the dialysate samples was determined by high performance liquid chromatography combined with fluorescent detection (HPLC-FD). Results: After the animal received stress treatment, the BP elevated, synchronously, the release of glutamate (Glu) in the rVLM increased, and when EA was performed, the elevated BP of the rats with SIH decreased,simultaneously, the release of Glu in the rVLM decreased also. After Mel was microinjected of into the AHA of the SIHR, the elevated BP attenuated, meanwhile, the release of Glu decreased,and those of γ-aminobutyric acid (GABA) and taurine (Tau) increased in the rVLM.Administration ofbicuculline, an antagonist of GABAA receptor, into the rVLM prior to microinjection of Mel into the AHA could partially block the depressor effect of Mel in the AHA. Conclusion: The decrease in the release of Glu in the rVLM contributes to the antihypertensive effect of both acupuncture and Mel in the AHA in the rats with SIH, and the increase in the release of GABA and Tau in the rVLM is also important to Mel in the AHA.

Objective To investigate the nutritional risk,malnutrition rate,and nutritional support in elderly inpafients with hepatobiliary diseases.Methods Totally 156 eldedy inpatients(≥65 years)with hepatobiliary diseases were consecutively enrolled.Nutritional Risk Screening 2002(NRS 2002)was applied to screen nutritional risks on the next morning after admission and two weeks after admission or on the discharge day.Results Of 156 enrolled patients,151 patients(96.8%)completed the NRS 2002 screening.The nutrition risk and malnutrition rate were 36.9%(57/156)and 26.2%(41/156),respectively.The nutrition risk and malnutrition rate were significantly higher in patients with a hospital stay longer than 2 weeks than those with a hospital stay less than 2 weeks(49.6%and 36.7% vs.37.3%and 21.4%,respectively)(both P<0.05).In addition,100 patients(64.1%)with nutrition risk received nutrition support and 27 patients(17.3%)without nutrition risk received nutrition support.Among patients who had undergone major abdominal surgeries,137 patients(87.9%)with nutrition risk received nutrition support while 57 patients(36.8%)without nutrition risk received nutrition support.Conclusions NRS 2002 is a feasible nutritional risk screening tool for elderly inpatients with hepatobiliary diseases.A hospital stay more than 2 weeks the morbidity of the nutritional risk and malnutrition rate increased.Seems the value of nutritional support has not been well recognized in the department of hepatobiliary surgery,inappropriate application of nutritional support still exists.

Objective To study the mechanism of SW480 cell line death caused by transfection of retroviral vector-G1CEACDNa.Methods Plasmid G1CEACDNa was transferred into the SW480 cell line using liposomes method. RT-PCR was performed to examin the expression of CD gene indrectly.The cell growth curve was measured by means of cell counting. When the CD+SW480 cells were exposed to 5-FC (1mmol/L), the growth inhibition rate and the "bystander effect" were detected by MTT method.The ultrastructure was observed by electron microscope.Apoptosis was verified by flow cytometer .Results The product of RT-PCR showed a band at 1.5kb on the photo of electrophoresis. The growth of CD+ SW480 cells was inhibited 24h after administrating 5-FC,and the inhibition rates at 72h,96h,120h were 30.0%,50.0% and 80.0%,respectively.Apoptosis cells in different phases and apoptotic bodies in the field of electron microscope were observed. Meanwhile ,a few cells showed necrosis.Flow cytometer verified that a few cells appearred apoptosis 48h after exposed to 5-FC (1mmol/L), the apoptosis rate and the necrosis rate at 72h,96h were 20.2%,30.7% and 19.6%,21.1% respectively.Conclusions The death mechanism of SW480 cells transfected with G1CEACDNa followed by 5-FC treatment includes both necrosis and apoptosis.Apoptosis is possibly the bystander effect.

Objective To investigate the effect of thermochemotherapy with 5 fluorocytosine(5 FC) on human colorectal carcinoma cell lines SW480 transfected with carcinoembryonic antigen (CEA) tissue specific cytosine deaminase (CD) in vitro.Methods Recombinant retroviral vector G1CEACDNa, in which CD gene was controlled under the CEA promoter, was introduced through liposome technique to the human colorectal carcinoma cell line SW480, and then the cells were selectively cultured in G418. The proliferated colonies were treated with the combined therapy of 5 FC and hyperthermia at a 43℃ over 30 min for 3 times. RT PCR was performed to analyze the expression of CD gene in target cells after thermochemotherapy. Results The CD gene expressed steadily in the target cells after 3 times of hyperthermic treatment. After the transfection of CD gene, SW480 CEACD cells were more sensitive to 5 FC than their parental cells (P