Adrenomedullin (AM) is a new peptidergic regulator of vascular function. AM serves as a hormone, which has many biological properties, plays an important role in the many pathophysiological processes, especially shock. This review will highlight the structure, biological properties of AM and the relationship between AM and shock.

To observe the changes in plasma adrenomedullin (AM) and its possible mechanism of pathogenesis of traumatic shock, 30 Sprague Dawley rats were randomly divided into control group, traumatic shock without resuscitation group, and traumatic shock with resuscitation group. Ten control rats were intubated after anesthesia only. Traumatic shock was reproduced in 20 rats by fracturing shafts of both femurs and bleeding to a mean arterial pressure of 35～45mmHg via femoral artery. Hypotension of rats with traumatic shock with resuscitation group was maintained 30min, and then the bled blood was returned, followed by an infusion with same volume of Ringer's solution. Plasma levels of adrenomedullin(AM) were assayed before and after shock. The data showed that plasma levels of AM were significantly increased after shock, and they were higher in the early period than late period. They were also higher in rats without resuscitation than that in rats of the resuscitation group. The results suggested that plasma levels of AM were significantly increased at an early in rats with traumatic shock, implicating that it might play an important role in the development of traumatic shock. Measures taken to decrease the levels of AM at this period might be helpful to improve the result of resuscitation of traumatic shock in rats

Objective:To study the dynamic changes of serum AFP before and after cryosurgery for liver cancer.Methods:The dynamic changes of serum AFP in 46 cases of liver cancer before and after cryosurgery were analyzed.Results:In those with a negative AFP before operation,the value of AFP increased rapidly 3 days after operation,kept positive for half a month,and was difficult to be turned negative.In those with a positive AFP before operation,there were no evident changes 3 days after operation,and the value of AFP decreased to normal half a month after operation.Conclusion:The change of AFP had some characteristic in the cryosurgery of liver cancer.Detection on the changes of AFP value is helpful in judging the curative effect and prognosis of cryosurgery for liver cancer patients.

Objective To investigate the changes of plasma adrenomedulin(AM) and nitric oxide(NO) and their correlation in rats with traumatic shock. Methods 40 Sprague-Dawley rats were randomly divided into control group(n=10), traumatic shock without resuscitation group (n=10), traumatic shock with resuscitation group (n=10) and aminoguanidine group (n=10). 10 rats of control group only received intubation after anesthesia. The other 30 rats were made animal models of traumatic shock by crashing both femur shafts and doing bloodletting to mean arterial pressure of 35～45mmHg via femoral artery. Hypotention of rats in traumatic shock with resuscitation group were maintained 30min, and then the lost blood was returned, followed by an infusion of equal volume of Ringer's solutions. Rats of aminoguanidine group were given aminoguanidine 60mg/kg body weight during resuscitation. The changes of Plasma levels of AM and NO in every group of rats were observed before and after shock. Results The plasma level of both AM and NO in the rats of traumatic shock was higher than that in the rats of control group, and reached the highest 30min after resuscitation. The level changes of plasma AM and NO in the rats of aminoguanidine group were not significant. The level change of plasma AM was positive correlation with the level change of plasma NO. Conclusions AM and NO may play an important role in the pathological process of traumatic shock. AM develops its role probably by NO.

Objective To investigate the clinical effect of gastric bypass operation on treating type 2diabetes,and analyze the management status.Methods Fifty-seven patients wiith type 2 diabetes treated by gastric bypass operation were divided by different body mass index(BMI) into 4 groups:group A( BMI ＜ 20kg/m2) with 8 cases,group B (20 kg/m2≤BMI ＜24 kg/m2) with 21 cases,group C (24 kg/m2≤BMI ＜27kg/m2) with 17 cases and group D (BMI ≥27 kg/m2) with 11 cases.The control of blood glucose and glycosylated hemoglobin,changes of diets and body weight,diabetes complications,adverse reactions after operation and postoperative management were followed up or reviewed.The clinical data were analyzed comprehensively.Results The cure rate of group C was the highest [ 70.6％( 12/17 ) ],while the cure rate of group A was the lowest (0).The overall cure rate was 43.9％(25/57) and the overall improvement rate was 28.1％(16/57).The overall efficient rate was 71.9％(41/57) and the overall inefficient rate was 28.1％(16/57).Apart from a few patients had malnutrition,amenorrhea,bad stomach,diarrhea and poor diet after leaving the hospital,other patients had no surgery complications and no patients died.There was no clinician to follow up and did education to these patients after operation.Conchusions Gastric bypass operation is safe and effective for obese and non-obese patients with type 2 diabetes.It is a new method to weat type 2diabetes at present,but the indications should be grasped and operation enlargement must he prevented.The management of teams of physicians,surgeons,dietitians,nurses should be established afler operation.