20 IU/ml) as predictor was 40.0% and 75.4% respectively. Conclusions The incidence of malignant neoplasm among postmenopausal bleeding women aged 60 and over is 24.2%,ultrasonographic evaluation and CA125 value are reliable and important for diagnosis accurately. Large operation is safe and feasible in aged women.

Objective To observe the clinical efficacy of deep needling at Tianshu (ST 25) and Fujie (SP 14) plus electroacupuncture in treating severe functional constipation (FC).Method Sixty-three patients with severe FC were randomized into a treatment group of 33 cases and a control group of 30 cases. The treatment group was intervened by deep needling at Tianshu (ST 25) and Fujie (SP 14) plus electroacupuncture, while the control group was by sham electroacupuncture. The Complete Spontaneous Bowel Movement (CSBM), Bristol Stool Scale (BSS), and Patient Assessment of Constipation Quality of Life (PAC-QOL) were evaluated before and after intervention.Result In the treatment group, the CSBM after 2-week, 4-week, and 8-week treatments and CSBM of the 4-week and 12-week follow-up study were significantly different from that before intervention (P<0.05). In the control group, the CSBM after 8-week treatments was significantly different from that before intervention (P<0.05). The CSBM after 2-week, 4-week, and 8-week treatments and CSBM of the 4-week and 12-week follow-up study in the treatment group were significantly different from that in the control group (P<0.05). The BSS scores were significantly changed after 2-week, 4-week, and 8-week treatments in both groups compared to that before intervention (P<0.01,P<0.05). The BSS scores after 2-week, 4-week, and 8-week treatments in the treatment group were significantly different from that in the control group (P<0.01,P<0.05). The item scores of PAC-QOL (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction scores and global score) were significantly changed after intervention in the treatment group (P<0.05). The item scores of PAC-QOLA including physical discomfort, worries and concerns, and satisfaction and global score were significantly changed after intervention in the control group (P<0.05). After intervention, the PAC-QOL scores of the treatment group were significant different from that of the control group (P<0.05).Conclusion Deep needling at Tianshu (ST 25) and Fujie (SP 14) plus electroacupuncture is an effective method in treating severe FC.

Objective To explore the value of bedside ultrasound used by ICU doctor in the rapid diagnosis of traumatic abdominal,and to evaluate the advantage of bedside ultrasound in the treatment decision.Methods 60 patients with traumatic abdominal blood in our hospital admitted to the ICU were selected.All patients were checked through bedside ultrasonography by physicians with professional training of ICU,bedside ultrasound and abdominal CT and abdominal flat piece of traumatic hematocelia,and compared the diagnosis of the time of the bedside ultrasound,abdominal CT and abdominal X -ray and ultrasound physician ultrasound examination.Results The difference of abdominal blood detection rate between bedside ultrasonography and abdominal computed tomo-graphy (CT)had no statistical significance (P >0.05);bedside ultrasonography of abdominal blood detection rate was higher than plain film of the abdomen,the difference was statistically significant (χ2 =73.346,P <0.01);bed-side ultrasound received a preliminary diagnosis of time -consuming (4.37 ±2.1)min was significantly lower than that of the examination of ultrasound physicians (13.86 ±5.6)min,abdominal CT (22.13 ±6.9)min and abdominal plain film (28.19 ±7.32)min,the differences were statistically significant (t =3.947,14.607,21.139,26.338,all P <0.01 ).Conclusion By the professional training of ICU physicians for bedside ultrasound traumatic blood abdominal patients can make a more accurate diagnosis,time -shorten,more accord with the requirement of treating critically ill patients in ICU,which has important clinical value for trauma abdominal blood in early rapid diagnosis and treatment.

AIM: To investigate the effect of ischemic preconditioning(IPC) on expression of nitric oxide synthase(NOS) in rat smallfor-size liver graft and its significance.METHODS: Sixty SD rats were randomly divided into 3 groups(n=10 pairs/group): nonwarm ischemia group(NWI);warm ischemic group(WI);and ischemic preconditioning group(IPC).The models of rat small-for-size liver transplantation were set up by two-cuff technique.Expression of eNOS mRNA and iNOS mRNA in hepatic tissue were detected by fluorescence-quantitating-PCR.RESULTS: Heptic expression of eNOS mRNA post-IPC was higher than that pre-IPC(P0.05).It was higher in IPC group than that in NWI and WI group(P

Objective To evaluate clinical significance of ischemia grade to predict severe arrhythmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 225 patients with STEMI admitting to emergency department were enrolled.All enrolled patients were divided into two groups based on the QRS complex electrocardiogram on admission:grade 1Ⅱ ischemia group(135 cases) and grade Ⅲ ischemia group (90 cases).All patients received thrombolytic therapy.The incidence rate of ST segment resolution (STR) and severe arrhythmia in hospital stay was observed.Results The ST segment elevation (Σ.ST) on admission and 2 h after thrombolysis in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(0.84 ± 0.57) mV vs.(0.44 ± 0.35) mV,(0.50 ± 0.23) mV vs.(0.11 ± 0.06) mV] (P ＜ 0.01).The backing rate of ST segment ≥ 50％ 2 h after thrombolysis in grade Ⅲ ischemia group was significantly lower than that in grade Ⅱ ischemia group [56.7％ (51/90) vs.83.7％ (113/135)] (P ＜0.01).The creatine kinase MB (CK-MB) peak value in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(363 ± 105) U/L vs.(212 ± 97) U/L] (P ＜ 0.01).There was no significant difference in the incidence of severe arrhythmia between two groups (P ＞ 0.05).Multiple Logistic regression analysis demonstrated that the independent predictors of severe arrhythmia were duration from symptom to thrombolysis and initial ΣST,whereas grade Ⅲ ischemia remained a strong predictor of severe arrhythmia.Conclusion Grade m ischemia on admission is associated with lower incidence of STR in patients with STEMI after thrombolysis and a strong predictor of severe arrhythmia.

AIM: To investigate the antiproliferation effects of oridonin on hepatocellular carcinoma BEL-7402 cells and its mechanisms of action. METHODS: BEL-7402 cells in culture medium were treated with different concentrations of oridonin. The inhibitory rate of the cells was measured by MTT assay. Cell apoptotic rate was detected by flow cytometry (FCM). Morphology of cell apoptosis was observed by Hoechst 33258 stain. Reverse transcriptase polymerase chain reaction (RT-PCR) and PCR-enzyme-linked immunosorbent assay (ELISA) were used to detect hTERT mRNA expression and telomerase activity before and after apoptosis. RESULTS: Oridonin could inhibit the growth of BEL-7402 cells and cause apoptosis significantly. The suppression was in both time-dependent and dose-dependent manner. Marked morphological changes in cell apoptosis including condensation of chromatin and nuclear fragmentation were observed clearly by Hoechst 33258 stain especially after the cells were treated 48-60 h by oridonin. The expression of hTERT mRNA as well as activity of telomerase decreased concurrently by treatment with oridonin in BEL-7402 cells. CONCLUSION: Oridonin has apparent antiproliferation and apoptosis-inducing effects on BEL-7402 cells in vitro, downregulation of the hTERT mRNA expression and decreasing the telomerase activity of BEL-7402 cells may be one of its important anti-hepatocellular carcinoma mechanisms.

Objective To investigate mRNA and protein expression of aproliferation-inducing ligand (APRIL) in peripheral blood mononuclear cell and plasma of patients with B cells non-Hodgkin lymphoma (B-NHL) pre- or post- chemotherapy and to explore the role of APRIL in the B-NHL. Methods The mRNA and protein expression of APRIL were detected by real-time fluorescence quantitative polymerase chain reaction (RFQ-PCR) and enzyme-linked immunosorbent assay(ELISA), respectively. According to the standard curves,the quantitative levels of target mRNA and protein were determined. Results The detection linear range of targeted mRNA by RFQ-PCR was 101-109 pg/ml, and the coefficient of variation values for both intra- and inter-experimental reproducibility ranged 1.69 %-5.99 % and 6.35 %-10.12 %, respectively. To detect expression of APRIL protein by ELISA, the correlation coefficient of standard curves reached 0.9922. Before or after chemical treatment, the expression levels of APRIL mRNA and protein in patients with B-NHL were significantly higher than those in normal control (P ＜0.01), while the expression levels in post-treatment patients with Ⅲ and Ⅳ stage were lower than those of pre-treatment patients with corresponding stage (P ＜0.05, respectively), but those of pre- and post-treatment patients with Ⅰ / Ⅱ stage were not different (P ＞0.05).Conclusion The expression level of APRIL mRNA is similar to that of APRIL protein. APRIL may be involved in pathogenesis and development of B-NHL. Moreover, APRIL may be related to the burden of B-NHL and it may be considered as a targeted molecule for B-NHL.

Objective To investigate the risk factors associated to malnutrition in elderly inpatients for supplying clinical evidences for the prevention and therapy of malnutrition. Methods A one-to-one matched case-control study was used to investigate the risk factors associated to malnutrition in elderly inpatients over 60 years old. Results Eight-five pairs were included. Single factor analysis suggested that serum total protein. hemoglobin, serum total cholesterol, non auto -selective food, anorexia, dysphasia, confinement in the bed and infectious diseases might be associated with malnutrition in elderly inpaticnts (all P＜ 0.05 ). Logistic regression analysis demonstrated that serum total protein, hemoglobin, anorexia, dysphasia and confinement in the bed were the major risk factors (P＜0.05). Hosmer-Lemeshow test showed the predicable results and practical results had better similarity (x2 =4. 957, P= 0. 762). Receiver operation characteristic curve ( ROC curve) also revealed the area under curve of serum total protein and hemoglobin were 0 760 and 0.621(P=0.000 and P=0.006 respectiuely), therefore, 56.8 g/L of serum total protein and 108 g/L of hemoglobin might be appropriate reference points for evaluating the malnutrition. Conclusions Serum total protein, hemoglobin, anorexia, dysphasia and confinement in the bed may play crucial roles for malnutrition in elderly inpatients, the status of malnutrition will be improved if the reversible risk factors are amendable.

Objective To investigate the prevention of gram-positive cocci infection by oral administration of vaBeomvcin after liver transplantation. Methods Eighty patients who underwent liver transplantation from September 2005 to September 2006 were divided into vaneomycin group and control group.All the patients were intravenously infused with piperacillin + tazobatam to prevent infection after liver transplantation.Patients in vancomycin group were given vancomycin orally in the first 7 days after liver transplantation and vancomycin concentration in the blood were measured at the same time.Infection and stool cocci and bacilli ratio of the patients in the 2 groups were observed.Results Seven patients in vancomycin group and 15 patients in control group(including 3 and 10 patients infected with methicillin resistant staphylococcus aureus in each group)were infected with grampositive cocci,respectively,with statistical difference(x2=4.501,P＜0.05).Three patients in vancomycin group and 10 patients in control group presented with imbalance of gastrointestinal flora,with statistical difference (x2=4.501,P＜0.05).No statistical difference was found in the patients infected with gram-negative bacilli or fungi between the 2 groups(x2=0.065,0.251,P＞0.05).The vancomycin concentration was 0 in the blood of patients who simply took vancomycin.Conclusions It is safe and effective to take vancomycin orally to prevent gram-positive cocci infection and imbalance of gastrointestinal flora after liver transplantation.

Objective To summarize our experience in hepatic artery reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT).Methods A retrospective analysis was made for 17 cases undergoing LDLT in our center from May 2007 to Oct 2008.Results All the 17 right lobe graft of the liver was supplied by single right hepatic artery and the mean diameter of right hepatic artery was 3.1 mm.The hepatic artery for segment 4 was mainly originated from left hepatic artery(12/17,70.1%).The recipient right or left hepatic artery was used in 14 cases of reconstruction,proper hepatic artery was used in 2 cases,and gastroduodenal artery was used in one case.Anastomosis was performed with interrupted 8-0 prolene and 12-16 stitches were made on the posterior wall first and then the anterior wall to avoid turning over the vessel.The mean anastomosis time was(51±26) minutes and all hepatic arteries were patent immediately after anastomosis.Hepatic arterial complications including hepatic artery thrombosis (HAT)did not occur after LDLT.Conclusions Detailed evaluation and careful protection of the hepatic artery of segment 4 are the key to successful reconstruction of hepatic artery in LDLT.Anastomosis was performed without flipping the artery wall helped to reduce the difficulty of operation remarkably and with a good result.