Objective:This study compares titanium ring-pin stapler and hand-sutures in the end-to-end anastomosis between renal artery and internal iliac artery in clinical kidney transplant. Methods:In 75 renal allograft recipients, the arterial reconstruction were randomly assigned to anastomoses with either 6/0 interrupted nylon sutures(39 patients) or titanium ring-pin stapler(36 cases). Results:Arterial anastomosis with ring-pin stapler was significantly faster(17.8 versus 28.1 min). In 2 cases, a lower pole artery was successfully anastomosed to the epigastric artery with 2 mm ring. All 75 renal arteries were patented without episodes of postoperative bleeding, or need for revision of the anastomosis in both groups. Mechanical anastomosis resulted in slightly but not statistically significantly less artery stenosis during 2-5-year follow-up.Conclusion:Renal artery anastomosis with ring-pin stapler is as safe and effective as hand-suture. The time required for mechanical anastomosis is only about 1/2 that required for suture anastomosis.

Objective To explore the clinical significance of DSA and MRA detection in cerebrovascular desease of patients with diabetes mellitus.Methods 142 diabetic patients were selected in the study. The vascular structure was detected by digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) . Results There was 1123 (56.5%) branches of artery atherosclerotic stenosis in a total of 1988 detecting artery and there was no significant difference between the DSA and MRA (χ2=0.36、0.47、0.53,P>0.05) . The results showed that the DSA and MRA methods had no significant difference on display average count in detecting bilateral ACA,MCA,PCA 284 vessels (t=0.27、0.56、0.89,P>0.05) . There were 656 arteries stenosis in checking the Willis ring vascular by DSA evaluation of the Willis ring and the sensitivity and specificity by MRA were more than 90%. Conclusion MRA and DSA can be applied in diagnosis of in cerebrovascular disease of patients with diabetes mellitus.The noninvasive advantages of MRA are worth to be concerned by clinician.

Objective The aim of this study is to elucidate the current status of hilar cholangiocarcinoma with regard to its epidemiology,clinical features,diagnosis,Bismuth-Corlette typing,pathologic categories,treatment,complication and prognosis in China.Methods Original articles published form January 1991 to August 2008 were searched in the CBM disc,VIP information and CNKI.Clinical appraisal and data extraction were conducted independently by 2 reviewers.The outcomes of 2280 procedures from 22 retrospective studies were analyzed.Results When radical resection was compared with palliative resection,the 1-yr survival rate (84.0％ vs.46.8％,OR=5.71,95％CI 3.99～8.17,P＜0.01) and 3-yr survival rate (31.5％ vs.13.5％,OR=4.43,95％CI 2.07～9.47,P＜0.01) were significantly higher.For the palliative resection group,the 1-yr survival rate of the drainage group (27.2％ vs.38.7％,OR=0.47,95％CI 0.31～0.72,P＜0.01) was significantly higher than the palliative resection group.The rate of tumor resection rose after 2002 (x2=35.9588,P＜0.01),but the rate of radical resection did not significantly rise ((2 =2.1052,P=0.1468).Conclusions Radical resection is still the optimal treatment for hilar cholangiocarcinoma.If radical resection is technically not possible,palliative drainage is a reasonable treatment.Palliative resection do not improve survival and it is not recommended.

Objective To observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

Objective To evaluate the therapeutic effect of Buqi-Huoxue decoction on cervical spondylotic arteriopathy(CSA). Methods 182 patients were diagnosed with CSA in our hospital during the period of March 2009 to November 2013. Among which 92 cases were assigned to a test group(outpatients) and 90 cases to a control group. The test group was treated with traditional Chinese medicine Buqi-Huoxue decoction, while the control group was treated with flunarizine and nimodipine. The level of seriousness of the symptoms, abilities and physical signs were recorded by clinical assessment scale for cervical spondylosis(CASCS), and velocity of blood flow at systolic peak(Vs)and mean blood flow velocity(Vm) of vertebral arteries(VA)and basilar artery(BA)were measured by transcranial doppler(TCD) monitoring to evaluate the blood supply before and after the treatment. After 30 days of treatment, CASCS and the TCD were recorded again to observe the clinical symptoms and the degree of blood supply improvement, and then the data were analyzed to value the curative effect. Results CASCS score of the two groups was 88.82±5.19, and 83.46±5.72 respectively, with P<0.05. The TCD results showed that, the patients less than 60 years old in the test group had Vs values of LVA, RVA and BA at(50.52±6.86)cm/s,(49.14±5.81)cm/s,(57.20± 5.37)cm/s after the treatment, and these values of the control group were(53.70±8.14)cm/s, (51.67±7.45)cm/s, (59.76±5.11)cm/s respectively;while patients over 60 years old in the test group had Vs values of LVA, RVA and BA at(40.37±2.24)cm/s, (40.78±1.85)cm/s, (51.04±3.81)cm/s after the treatment, these values of the control group were(37.58±2.86)cm/s, (37.58±2.72)cm/s, (46.92±5.26)cm/s respectively. The effective rate of the test group was 97.83%, while the value was 88.89%of the control group, which also showed a significant difference(χ2=13.743, P=0.01). Conclusion More significant effects of Buqi-Huoxue decoction for treating disease of CSA was achieved compared with the treatment of flunarizine and nimodipine.

OBJECTIVE:To investigate clinical efficacy and safety of Xuebijing injection in the treatment of chronic ob-structive pulmonary disease (COPD) complicated with community-acquired pneumonia (CAP). METHODS:A total of 88 COPD patients with CAP selected from our hospital during Feb. 2013-Jan. 2015 were divided into control group and observa-tion group according to random number table,with 44 cases in each group. Control group received routine treatment as an-ti-infection,reducing phlegm,fluid replacement,nutritional support,etc. Based on control group,observation group was ad-ditionally given Xuebijing injection 50 mL added into 0.9% Sodium chloride injection 100 mL,ivgtt,for 30-40 min,bid, for consecutive 10 d. Clinical efficacy,application time of antibiotics,pulmonary function indexes [FEV1,FVC,FEV1/FVC,VC] were observed in 2 groups. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was 88.64%,which was significantly higher than 70.45% of control group,with statistical significance(P<0.05). The application time of antibiotics in observation group was significantly shorter than control group,with statistical significance (P<0.05). There was no statistical significance in FEV1,FVC,FEV1/FVC,VC between 2 groups before treatment (P>0.05). After treatment,FEV1 and VC of 2 groups were improved significantly,and the observation group was better than the control group,with statistical significance(P<0.05). There was no statistical significance in FVC,FEV1/EVC before and af-ter treatment and betwean the two groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Xuebijing injection has significant therapeutic efficacy for COPD complicated with CAP and can significantly shorten the use time of an-tibiotics,improve pulmonary function with good safety.

Gastrointestinal bleeding in children is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach.The causes of hemorrhage are numerous and varies with age.The clinical presentation of gastrointestinal bleeding in children ranges from asymptomatic microcytic anemia to hypovolemic shock.Therefore,the primary focus in a child with gastrointestinal bleeding is rapid assessment,stabilization,and resuscitation followed by a diagnostic modalities.

Objective:To compare the social adaptability of Chinese and Japanese children Method:306 preschool children in Xi'an and 215 Japanese children were sampled The research instrument was the Infant-Junior Middle School Social Adaptive Capacity Scale Result:In the six fields of social adaptability, Chinese children had lower scores than Japanese children, except for that of sports Conclusion:Chinese preschool children have lower social adaptive capacity, which may be due to the overprotective attitude of Chinese parents or grandparents

Target therapy is a major progress in treatment of advanced colorectal cancer. Cetuximab and bevacizumab are the most widely used target agents in colorectal cancer, which target against EGFR and VEGF respectively. The addition of target agent to chemotherapy improve efficacy and prolong survival in the first line setting, as well as in the second line setting. The increased respectability of liver metastases from colorectal cancer is of great importance, k-ras gene mutation is a definite predictor of cetuximab, however, there is no clear predictor for bevacizumab.

Purpose:Our study is to find out the inhibitory action of recombinant human TNF-related apoptosis-inducing ligand(TRAIL) on ovarian cancer cell line cultured in vitro. Methods:MTT was applied to assay the inhibiting action of various concentration of TRAIL on two ovarian cancer cell lines of 3AO and HO-8910.The apoptosis rates were measured by flow cytometry. Results:The growth of human ovarian cancer cells was effectively inhibited by TRAIL. A clear dose- and time-dependent correlation between TRAIL concentration and the degree of apoptosis induction was observed with up to 43.20% apoptotic cells after 24 h of incubation with 50 ng/ml TRAIL. The cells assumed typical cell apoptosis configuration. Conclusions:TRAIL can effectively inhibit the growth of ovarian cancer cells and induce apoptosis of the cells.