Objective　To study the effect of the combined use of aminoguanidine (AG) and cyclosporine A (CsA) on acute rejection following cardiac allograft. Methods　Except the control group, all other three groups were respectively treated by AG 600mg/kg every day subcutaneously 0 to 7 days after transplantation, low-dose CsA 2mg/kg every day i.m 0 to 7 days after transplantation, and low-dose CsA plus AG. Inducible nitric oxide synthase (iNOS) expression and nitric oxide (NO) production during acute allograft rejection were detected at 4th day after operation, and the graft survival was observed.Results　Compared with the control group, iNOS expression and NO production were significantly inhibited in the AG-treated group (P＜0.05)，the progression of acute rejection was slightly attenuated and allografted heart survival prolonged. The inhibitory effects of iNOS activity and NO production in the recipients receiving the combined treatment of low-dose CsA plus AG were higher than those receiving low-dose CsA alone. Compared with the low-dose CsA group, low-dose CsA plus AG could significantly reduce the histologic grade of acute rejection (P＜0.01) and prolong the graft survival (P＜0.05). Conclusion　The combined use of low-dose CsA and AG could synergistically suppress iNOS activity and NO production, and significantly prolong allografted heart survival.

The precise surgical treatment for hepatobiliary diseases has been a challenging topic in hepatobiliary surgery for a long time.A perfect preoperative plan can help the surgeon make R0 resection of the lesion and preserve the healthy tissue as much as possible.In addition,all of these depend on the application of different imaging modalities,especially three-dimensional reconstruction technique.But some limitations of 3D reconstruction should be noted:different surgeons may have different views for one object because of different observation points;or it cannot be used for intraoperative re-orientation and so on.3D printed model can overcome some disadvantages of 3D reconstruction.This paper reviewed related literature that reported the usage of 3D printed model in hepatobiliary surgery.

Objective To study the surgical treatment and the related risk factors of cholangioenterostomy anastomotic stenosis.Methods We retrospectively analysed the clinical data of 41 patients who underwent surgical treatment for cholangioenterostomy anastomotic stenosis in the PLA General Hospital from January 1,2008 to November 30,2014.Results All patients' clinical symptoms were alleviated and they were discharged home.No one died perioperatively.Anastomotic restenosis happened in 5 patients.Conclusions Reoperation for cholangioenterostomy anastomotic stenosis was difficult.The surgeon should make the anastomosis as large as possible to decrease the risk of restenosis.A T tube should be used when necessary.

Objectives: To investigate the treatment effect of enteral nutrition rich in diet fiber in diarrhea because of bacteria disorder after severe brain injuries.Methods:20 cases with severe brain injuries were supported with enteral nutrition rich in diet fiber after the occurrance of diarrhea because of bacteria disorder as clinical treatment group.20 cases with the same conditions were treated with traditional methods as control.Results: Diarrhea of all patients in clinical treatment group had been controlled during 7-10 days,and the feeding quantities reached total calories.The nutrition state was improved,and the body internalenvironment was stable during the 20 days. Conclusion: Enteral nutrition rich in fiber can treat diarrhea caused by bacteria disorder after severe brain injuries.

ObjectiveTo determine the possibility of r eal-time perfusion imaging in the quantitative evaluation of myocardial perfusion in various segments of left ventricle. MethodsImages of ten anesthetized dogs were obtained at the mid-papillary muscle short-axis view with a real-time imaging system. Mechanical index (MI) was adjusted to 0.1 , 0.2 and 0.4 respectively, and frame rate was set at 20 Hz. Optison was infused intravenously at a rate of 0.1 , 0.2 and 0.5 ml/min, respectively. Images were recorded for 150 real-time frames commencing immediately after a couple of Doppler bursts. Myocardial opacification was assessed both visually and quantitatively for six segments of left ventricle (antero- and infero-septum, inferior, posterior, lateral and anterior wall). Myocardial signal intensity versus real-time frame curves were made and fitted to an exponential function: Y=A(1-e -?t ). ResultsUsing low MI (MI= 0.1 or 0.2 ) and with continuously infusion of Optison at a rate of 0.2 or 0.5 ml/min, real-time imaging resulted in sufficient myocardial opacification and left ventricular endocardial border definition, and displayed myocardial thickening and wall motion simultaneously. ConclusionsReal-time imaging has a potential in the quantitative assessment of myocardial perfusion, and allows simultaneous assessment of perfusion and myocardial function.

Objective To explore the effect of paraspinal approach and posterior median approach for one -stage decompression recon-struction in the treatment of thoracolumbar spine fracture and dislocation .Methods From January 2012 to January 2014, 60 patients with thoracolumbar spine fracture and dislocation who were admitted and treated in our hospital were selected as the research objects .All patients received one-stage decompression reconstruction for treatment .According to the methods of approach , the patients were divided into the ob-servation group and the control group .The 30 cases in observation group were treated by paraspinal approach while the other 30 cases in con-trol group were treated by posterior median approach .Visual analogue score ( VAS) was applied .The status of surgery , recovery of centrum height, changes of Cobb angle as well as the occurrence rate of postoperative complications in the two groups were recorded .Results In the observation group, the operative time, time in bed and length of stay were (89.16 ±11.63) min, (39.75 ±8.69) h and (3.96 ±1.04) d respectively, which were shorter than those in the control group .The intraoperative blood loss was (89.64 ±13.62) mL which was lower than that in the control group and the difference was significant (P<0.05).One week after operation, the anterior and posterior height of centrum in the observation group increased significantly while Cobb angle significantly reduced .Compared with those before the treatment , the difference was significant (P<0.05).The maximum coronary diameter and maximum sagittal diameter of paraspinal muscles in the ob -servation group after the treatment were (48.96 ±5.34)mm and (18.16 ±6.74)mm respectively, which were significantly higher than those in the control group and the difference was significant (P<0.05).The incidence of lumbar and back pain in the observation group was 3.33%which was lower than 23.33%in the control group and the difference was statistically significant (P<0.05).Conclusion To carry out decompression reconstruction through paraspinal approach can reduce the the pain degree of patients and the incidence of lumbar and back pain after operation .

Objective Although graded nursing has been implemented in nursing homes since 2001 in China, it is not popu-lar.This research aimed to investigate factors of graded nursing implementation in nursing homes by subject analysis in order to provide a reference for the construction of graded nursing system in nursing homes . Methods We performed an analysis of data retrievals for grading nursing system in nursing homes from 2005 to 2015 based on five large databases: CNKI, Wanfang, VIP, CBM, and PubMed.Subject analysis was applied in the conclusion of retrieved literature . Results There were 993 related documents by pre-liminary selection and 21 documents were concluded for subject analysis .By document acquisition , code design , subject code search , integrated subject search and subject definition , five factors including policy , professional quality , institutional management , resource supply and individual were summarized . Conclusion These five factors give a correct and overall view of the facilitators and barriers to the implementation of graded nursing in nursing homes in China , which will contribute to its improvement .

Objective To study the clinical effect of transpedicular vertebral osteotomy spine shortening in treating spinal kyphosis com-plicated with spinal cord nerve dysfunction. Methods A total of 80 patients with spinal kyphosis complicated with spinal cord nerve dys-function in our hospital from May 2013 to June 2014 were enrolled and randomly divided into observation group(n=40) and control group (n=40). The observation group received transpedicular vertebral osteotomy,and the control group received lamina and facet osteotomy. The situation of surgery,vertebral healing and spinal cord function condition,treatment effect between two groups were compared. Results The operation time and postoperative ambulation time of observation group were shorter than those of control group [(76. 52 ± 9. 1) vs (113. 46 ± 13. 44) min,(3. 28 ± 0. 43) vs (5. 67 ± 0. 68) d]. The postoperative bleeding volume,postoperative drainage volume of observation group were less than those of control group [(36. 14 ± 4. 28) vs (55. 23 ± 7. 15) mL,(17. 92 ± 2. 12) vs (29. 64 ± 4. 28) mL]. The Cobb angle and residual urine volume,initial and strong urinary bladder capacity,maximum urinary output of observation group were significantly less than those of control group [(6. 12 ± 0. 68) vs(9. 78 ± 1. 21) mL,(241. 45 ± 28. 56) vs(335. 54 ± 36. 86) mL,(456. 56 ± 51. 78) vs (586. 35 ± 63. 12) mL,(63. 78 ± 7. 24) vs (96. 32 ± 10. 22) mL]. The intervertebral height of observation group was higher than that of control group [(12. 62 ± 2. 81) vs (8. 41 ± 1. 32) mm]. The excellent rate of observation group was significantly higher than that of control group(97. 50%vs 82. 50%). Conclusion Transpedicular vertebral osteotomy spine shortening is helpful to reduce operation wound, pro-mote postoperative recovery,correct kyphotic deformity and improve neurological functionin,improve therapeutic effect.

Objective To evaluate the efficacy of TCM Bufei Yishen method combined with conventional western medicine for patients with stable chronic obstructive pulmonary disease (COPD) presenting lung-kidney deficiency.Methods Sixty six COPD patients with lung-kidney deficiency admitted from January 2014 to December 2015 were randomly divided into Bufei Yishen (BY) group (n=34) and control group (n=32).Patients in control group treated with conventional western medicine and those in BY group were treated with TCM Bufei Yishen recipe combined with conventional western medicine.The pulmonary function and COPD Assessment Test (CAT) score were evaluated before and after treatment,and after 3 month-following up.Results In BY group the pulmonary function parameters FEV1 and FEV1/FVC after treatment were significantly higher than those before treatment (69.91±8.15 vs.51.56 ± 8.33,t=4.435,P< 0.01;57.33 ± 9.86 vs.49.89 ± 8.89,t=3.526,P<0.05,respectively);the FEV1 and FEV1/FVC after 3-momth follow up were significantly higher than those before treatment (65.68±9.54 vs.51.56±8.33,t=3.993,P<0.05;59.08±8.49 vs.49.89±8.89,t=3.668,P<0.05,respectively).In control group the FEV1 and FEV1/FVC after 3-momth follow up were significantly higher than those before treatment (63.94±8.76 vs.50.98±8.08,t=4.475,P<0.05;59.12±9.55 vs.50.35±9.06,t=3.614,P<0.05,respectively).The pulmonary function parameters FEV1 of BY group was significantly better than that of control group (69.91±8.15 vs.62.02±8.91,t=3.745,P<0.05) after 3-months of follow-up.After treatment,the CAT score in both group was decreased (BY group: 27.35±2.93 vs.30.36±3.19,t=3.548,P<0.05;control group: 29.06±2.67 vs.30.51±2.99,t=1.832,P<0.05);however,the CAT score was decreased more markedly in BY group than that in control group (t=2.658,P<0.05).Conclusion TCM Bufei Yishen method combined with conventional western medicine can improve the pulmonary function and quality of life of patients with stable COPD presenting lung-kidney deficiency.

Objective To study the effects of angiogenesis inhibitor SU5416 on the growth and metastasis of pancreatic cancer in SD rat model. Methods Dimethylbenzanthracine (9 mg) (DMBA),was implanted into the parenchyma of Sprague Dawley rat pancreas to induce pancreatic cancer. Rats with established pancreatic carcinoma were randomly divided into 4 groups (15 rats each) to receive every the other day for consecutive 13 weeks before sacrifice peritoneal cavity injection of: Normal saline (control),5-fluorouracil 30 mg?kg -1 (5-Fu group),SU5416 16 mg?kg -1 (SU5416 group),and both 5-Fu and SU5416(combined treatment group). Tumor weight,inhibition rates,intratumoral microvessel density (MVD),apoptotic index (AI) and metastasis were evaluated. Results Tumor weight was (1.15?0.21) g,(0.68?0.42) g,(0.31?0.11) g,(0.19?0.06) g respectively;the inhibition rate was 0,48%,80%,85% respectively;the intratumoral microvessel density (MVD) was (12.3?3.2),(11.4?3.8),(2.1?1.5),(1.8?1.1) respectively;The apoptotic index (AI) was (2.64?1.86)%,(5.71?3.14)%,(13.21?4.26)%,(21.12?7.15)% respectively. Peritoneal metastasis was significantly less severe in 5-Fu group,SU5416 group and combined group than that in control group(83% versus 46%,25% and 0) ( P