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 investigate the effect of batroxobin on the plasma levels of endothelin (ET) and calcitonin gene-related peptide(CGRP) in patients with acute cerebral infarction(ACI). Methods 60 patients with ACI were randomly divided into therapy group(n = 30) and control group(n = 30),500 ml of 5% GS plus 1.0g ramme of Troxerutin was intravenously dripped par day and ticlopidine 250mg/day in the control group. Based on the control group therapy,Batroxobin was intravenously dripped with 10U on the 1st day and 5U on the 3rd and 5th day for seven days. The plasma levels of ET and CGRP were detected pre and post treatment by radioimmunoassay. Results Plasma levels of ET and CGRP in batroxobin therapy group post treatment ( 81.25±27.38 ) ; ( 44. 13±13.30) ng/L were significantly different from those pre treatment(109. 83±38.24) ; (24. 73±13.59) ng/L (all P＜0. 01 ) ,and were also significantly different from those post treatment in the control group(98.07±30. 39) ; (37.02±12. 41 )ng/L (all P＜0. 01 ). Conclusion Batroxobin can accommodate the equilibration between ET and CGRP, and protect brain cell and blood vessel endothelial cell.

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.

Objective Explore the relationship of ventricular late potential (VLP) and the heart function of children with viral myocarditis,and provide the evidence for their diagnosis and therapy.Methods The clinical data of 152 cases of epileptic children were collected.The patient group was divided into three groups (severe arrhythmia,heart failure,and cardiogenic shock).The patient group was also divided into two groups (cardiac dilatation,and non-cardiac dilatation) according to UCG.Serum levels of cTnI and VLP in children with viral myocarditis were detected.Results The VLP was negative in the mild and control groups,but the positive rate of VLP is 75.0 ％ in the severe group.The positive rate of VLP was 60.0％ in the severe arrhythmia group,77.78％ in the heart failure group,and 100％ in the shock group.There is one kind of negative rank correlation between LAS,RMS40 and LVFS (P ＜ 0.05),and another negative rank correlation between RMS40 and LVEF (P ＜ 0.05).Conclusions The children with viral myocarditis have a favorable prognosis.The sever patient in the minority must be diagnosed in time and treated because of the critical state of viral myocarditis children.The serum level of cTnI and VLP were increased in children with viral myocarditis,and they were sensitive parameters to reflect patients’ condition.

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 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 quantify Contribution to LE at Birth from Mortality Variation for Some Diseases in Shanghai.Methods Health problem for population was classified into 5 group: infectious group,tumor,cerebrovascular group,injury and others.Cause elimination life table methods was employed to analyze the mortality registry data for Shanghai residents during 1953 to 1999.Chisquare for trend was used to analyze the variation for ASMR and Pearson correlation was used to describe the relationship between the variation of LE at birth and social economic factors.Results During 1953 to 1999,crude mortality rate(CMR),mortality rate by area,age-specific mortality rate(ASMR) from infectious group diseases showed obvious trends of descending.Also CMR and ASMR from injury for urban residents showed obvious trends of ascending.However,for suburb residents,CMR from injury had a trend of decline but ASMR had no significant trend.CMR from tumor and cerebrovascular group for Shanghai residents showed a rising trend but mortality rate by area and ASMR not.After 1979,the proportion of contribution for the rise of LE at birth for Shanghai urban residents from infectious group was about 33%,which was much higher than that of other 3 groups.The proportions of contribution in suburb male group from injury and cerebrovascular were 40.26% and 25.18%,respectively.The variation of mortality risk from tumor for urban male residents gave a negative contribution to respondent rise of LE at birth.Besides,the proportions of contribution in suburb female group from infectious disease(21.60%) and injury(12.55%) were largest.Compared to the mortality in 1996,among infectious group,injuries,tumor and cerebrovascular group,potential decline of mortality from tumor contribute the most to the rise of LE at birth,cerebrovascular group has the second,injury had the third and infectious group has the least.Development of Shanghai medical service resource showed a significant correlation with the rise of LE at birth.Conclusion Shanghai has successfully prevented and controlled the infectious disease group.The future strategy for disease prevention and control ought to focus on tumor,cerebrovascular diseases and injury.Based on the theory of risk competing,cause elimination life table method help greatly to set proper LE aims for public health plan.

A gas chromatographic method was established for determination of cholesterol. The egg yolk was directly saponified with 1ml 40% potassium hydroxide and 20ml ethylene glycol. The unsaponifiable substances were extracted by diethyl ether and then dried with anhydrous sodium sulfate. The extract (2?l) was injected into the gas chromatograph. The average percentage of recovery was 100.0?2.6%. The precision of the method was good, the coefficient of variation was 1.9%. The mean cholesterol content of egg yolk determined by this method was 1247.1?80.1 mg/100g and agreed with the value reported in literature.

Sophocarpine ( SC ) , an alkaloid extracted from sophora alope -curoides L. , was found to have a rapid and significant hypotensive action both in anesthetized dogs and in conscious renal hypertensive rats. On superior cervical ganglia and nictitating membrane preparation ,SC 15mg, administered via lingual artery, briefly relaxes the rigid contraction of nictitating membrane caused by continuous stimulation of sympathetic preganglionic fibers. SC 50, 100, 200?g/kg reduced the vascular resistance index 13.1 ?1.6%, 20.5?4.6%, 27.8?4.1% respectively when perfused into the femoral artery .Measurement of the changes of hemodynamics with constant voltage transthoracic admittance plethysmograph in 5 intact anesthetized dogs showed that SC iv 25mg/ kg enhenced the index of myocardial contractility 18% and heart beat index 40%, shortened Q -Y interval 37%.These results suggest that hypotensive action of SC should be realized by both relaxing the peripheral vascular smooth muscules and blocking the transmission of impulse through the sympathetic ganglia.

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.