Objective To evaluate the association of fetal total bile acid (TBA) concentration with fetal adrenocortical dysfunction in intrahepatic cholestasis of pregnancy(ICP). Methods The concentration of TBA, cortisol and DHEA-S in the cord blood were measured in 20 fetuses with maternal ICP (ICP group) and 22 fetuses of normogravidas (control group) after elective cesarean section. The cord blood TBA concentration was investigated by enzyme method and the cord concentration of cortisol and DHEA-S by radioimmunoassay. Results The cord TBA concentration in ICP group was significantly higher than that of controls [(8.93?3.16)mmol/L vs (4.33?1.51)mmol/L, P0.05)]. The cord blood level of cortisol,DHEA-S and the ratio of DHEA-S over cortisol were correlated with the cord blood TBA concentration (r 1= 0.87,r 2=-0.88,r 3=-0.84,P

Objective To summarize the experience of liver retransplantation, as well as the factors i nfluencing the surgical effects. Methods The clinical data of 8 patients who received liver retransplantation in our cent er were analyzed retrospectively. Results Among 8 cases, complications of biliary tract occurred in 5 cases, chronic rejec tions in 2 cases, embolism in hepatic artery in one case. Infections occurred in 7 cases before engraftment. Case 1 had develope d renal function failure before the surgery, and he died of severe infections an d multi-organ failure after transplantation. Case 4 had massive hemorrhage duri ng the operation and also died of multi-organ failure after transplantation. Case 7 developed in tracanial hemorrhage and abdominal infection and died early after transplantatio n. Other 5 cases has recovered and left hospital. Conclusions Liver retransplantation is the only measure that can be taken to save the lives of patients whose liver allograft fails to function. It's very important that the indications and time of retransplantation should be carefully selected. Factors that may lead to harmful effects on liver retranspl antation include bad preoperative condition of the recipient, tough and long ope ration, massive hemorrhage during the operation, and severe complications after the surgery.

The study of glomerular mesangial cells of normal rats showed that angiotensin Ⅱ (ATⅡ) down-regulated the expression of MMP-2 mRNA, did not have significant effect on TIMP-2 mRNA. And in consequence, ATⅡ down-regulated the ratio of MMP-2 mRNA to TIMP-2 mRNA.

This paper analyzed the 15-year exploration and practice in Zhenjiang City on the reforms of the healthcare reform From the perspectives of the role and impact exerted by medical insurance in hospitals,as well as main challenges and countermeasures or recommendatioas of this regard,the paper discussed the development relationship among public hospitals,healthcare system reform and medical insurance.Main points include the following:orchestrated development between hospitals and medical insurance;establishment of an equal negotiation mechanism between hospitals and medical insurance;establishment of a beneficary system adaptable to medical insurance capacity;establishment of a scientific and feasible pattern of fees settlement and payment;hospitals are expected to deepen the reform and better management,playing the role of providing quality medical services and reasonably controlling medical costs.

Objective To investigate essentiality of bone scintigraphy in patients with renal cellcarcinoma.Methods The clinical data of 152 patients with confirmed renal cell carcinoma from Jan uary 1999 to June 2007 were retrospectively analyzed.There were 106 men and 46 women with a meanage of 56 years (range 11-86 years).The tumor size was 1.5-20.0 cm (mean 6.0 cm).Accordingto the TNM and AJCC staging classification,88 patients had stage I,included of T1a in 47 cases,T1bin 41; 38 had stage Ⅱ; 16 had stage Ⅲ,included of T3a,in 10 cases,T3b in 6; and 10 had stage Ⅳ.Histological grade was well differentiated in 90 cases,moderately in 43,poor in 19.Ten clinical pa thology factors were evaluated by Logistic analysis to present the significant factors related to osseousmetastatic lesions.Results Overall osseous metastatic lesions were present in 22 of the 152 patients(14.5%).Of the 126 patients with clinically localized,11 cases (8.7%) had osseous metastatic le sions.Of the 16 patients with clinically advanced,5 eases (31.2%) had osseous metastatic lesions.Ofthe 10 patients with metastasis,6 cases(60%) had osseous metastatic lesions.Clinical stage was re lated to osseous metastatic lesions by Logistic analysis.The incidence of osseous metastatic lesionswas 40.9% in localized renal cell carcinoma patients with bone pain.Conclusions Bone seintigraphymay be omitted in patients with clinically localized renal ceil carcinoma(stage Ⅰ,Ⅱ) unless bone pain is pres ent.Bone scintigraphy should be performed in patients with stage Ⅲ or Ⅳ regardless of symptoms.

Objective Through studying change of serum level of IL-10 in patients of severe trauma with haemorrhagic shock,to investigate effect of severe trauma with haemorrhagic shock bypass on anti-infiammatory reaction in patients.Methods Menbers of experimental group are 43 patients of Severe trauma(ISS scope≥16).43 patients scheduled for attending with haemorrhagic shock are divided into simple severe trauma group(group B)and severe trauma with haemorrhagic shock(group C);and healthy control group(group A)is made up of randomly seleeted 20 healthy people of medical examination.Blood samples for cytokines and organ function were collected from the vetn of menbers of experimental group(B and C)with limosis at the following time:that day of injury,(T1),3th (T2),5th(T3),and 14th(T4)day after injury;blood samples of healthy control group(A)with limosis were collected at that day of examination;serum level of IL-10 was measured by radioimmunoassay.Results In experimental group(B and C),the serum peak level of IL-10 emerged on T3 and then stepped down;the serum peak level of them increased abviously compared with group A(P＜0.05 or P＜0.01).Furthermore,the serum level of them in C group was usually higher than that on the same time in group B.Conclusion It was longer and severer in time and degree that effects of severe trauma with haemorrhagic shock bypass on IL-10 of body compared with that of simple severe trauma.

OBJECTIVE Exploration of project is to introduce a cochlear organotypic culture technique and the histological evaluation of cochlear hair cells, auditory nerve fibers, and spiral ganglion neurons from rat on post-natal day 3. METHODS The cochlear basilar membrane was placed on the surface of rattail collagen gel in culture medium. The cochlear specimens were double-labeled with FITC-conjugated phalloidin for showing the stereocilia and cuticular plate of the hair cells plus a monoclonal antibody against neurofilament 200 for showing the spiral ganglion neurons and their auditory nerve fibers. Specimens were observed under a Confocal Laser Scanning Microscope with appropriate filters. RESULTS Following the culturing period of 1 to 3 days, cochlear inner and outer hair cells presented normal without any contabescence or missing. The auditory nerve fibers were in an orderly arrangement and the morphology of spiral ganglion neurons were also in good shape. CONCLUSION The cochlear organotypic culture technique and the histological examinations will be helpful to evaluate the cochlear hair cells and the spiral ganglion neurons in various experimental models in vitro.

Objective To study the relationship between large multifunctional proteasome (LMP) 7 gene polymorphism and susceptibility of type 1 diabetes mellitus (DM). Methods The genotyping of LMP7 gene was determined by polymerase chain reaction restriction fragment length polymorphism (PCR RFLP) in 71 type 1 DM patients and 86 healthy persons (as controls). Furthermore, the type 1 DM patients were divided into 3 groups according to the age of diabetic onset. Group A was ≤14 years, group B 15～30 years, group C≥31 years.Results The frequency of LMP7 B/B was decreased significantly (39% vs 58%, P

0.05); ② Significant correlation was found between natural head posture and angle SNA, SNB, SN/MP, N S PNS, NSU, NSGn, ANS PNS Gn, NSH( P

Objective To evaluate the surgical treatment of pheochromocytoma. Methods A total of 151 cases of pheochromocytoma were studied in regard to the preoperative preparation,anesthetic management,operative technique and postoperative treatment. Results Of the 151 cases 132 underwent total tumor excision,12 cases intracapsular excavation and 7 cases partial cystectomy.Only 1 patient died during the course of operation.Pathological examination showed that 137 cases were of benign pheochromocytoma and 14 cases of malignant.After operation 136 cases had normal blood pressure and 15 cases were treated with hypotensor to maintain normal blood pressure.Of the 137 cases of benign pheochromocytoma 9 experienced relapse.Of the 14 cases of malignancy 10 died of metastasis within 5 years. Conclusions Surgical excision is the fundamental approach for cure,and correct preoperative diagnosis and proper perioperative management are extremely important.