In this study, the effects of blood glucose and blood pressure on the compliance of large and small arteries were investigated. The results showed that arterial compliances of both large and small arteries were decreased in patients with diabetes mellitus. In non-diabetic patients with well controlled blood pressure, the compliance of small arteries was markedly improved. These results suggested that both blood glucose and blood pressure affected arterial compliance.

Objective To investigate the diagnosis and treatment of mutinous cystadenoma of the pancreas.Method The clinical data of 12 cases with pancreatic mutinous cystadenoma was confirmed by pathology from May 2000 to May 2009 was retrospectively analysed.Results The accuracy rates of ultrasound,CT and MRCP were 50.0%(5/10),66.7%(6/9)and 83.3%(5/6)respectively.Pancreaticoduodenectomy,duodenum-preserving pancreatic head resection,distal pancreatic resection,distal pancreaticresection and splenectomy,segment pancreatic resection were performed according to the site of tumors.Completed resectable rate was 91.7%(11/12),palliative resection in 1 case,postoperative pancreatic leakage in 3 cases.2 cases cured;1 case died of intra-abdominal infection caused by pancake fistula 1 month later;1 case died of tumor recurrence and metastasis 25 months later.Conclusions Pancreatic cystic neoplasms is lack of specific clinical manifestations.Combined with application of imaging methods,can improve the diagnosis rate.Operation is the most effective therapy.The feasible procedures for mucinous cystadenoma of the pancmas should be choiced according to the site of tumors.

Objective: To assess trends of β-blocker use within 24h of admission in ideal candidates with acute myocardial infarction (AMI) in eastern urban China from 2001 to 2011. Method: A 2-stage random sampling design was performed. In the first stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select cases from the participating hospitals. Data was obtained by central medical record abstraction. 10-year trend and predictors of early β-blocker application were assessed with weighted calculation for each year to represent the overall situation of eastern urban China. Results: 35 hospitals were sampled and 32 of them were finally participated. With necessary exclusion, 1399 ideal candidates were included in this analysis. The early weighted β-blocker application rates in 2001, 2006 and 2011 were 64.7%, 69.7%, and 60.9% respectively, P=0.0447 for trend. Patients with chest pain at admission (OR=2.22, 95% CI 1.19-4.13), higher systolic blood pressure (OR=1.40, 95% CI 1.11-1.77) or faster heart rate (OR=2.01, 95% CI 1.58-2.55) were more likely to use β-blocker; in contrast, compared with NSTEMI patients, STEMI patients seemed less likely to receive such treatment (OR=0.55, 95% CI 0.37-0.81). Conclusion: The early β-blocker therapy in eastern urban China is suboptimal for ideal AMI patients who could benefit from it. The application pattern has not been changed from 2001 to 2011 which might be related to physicians' misunderstanding of relevant evidence or guidelines. Our study may help to create an important target to improve the quality of AMI care.

Objective To evaluate the surgical techniques and clinical applications of single-port transumlilical laparoscopic dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction (UPJO). Methods From August 2009 to March 2010, 15 patients were treated with single-port transumbilical laparoscopic dismembered pyeloplasty. There were 12 males and 3 females,aged 12 to 55 years with an average age of 20 years, who were diagnosed by diuretic renography,IVU, and MRU et al. A single umbilical incision of 3. 5cm was made for single-port trocar and a flexible-tip 0°digital video-laparoscope was used in all cases. The procedures were performed according to the methods used in classical laparoscopic dismembered pyeloplasty with general instruments. ResultsAll operations were performed successfully without conversion to open surgery. The mean operative time was 90 (75-145) min, and the mean hospital stay length was 6 days. No organs injury occurred during operation, and no urine leakage was found afer operation. The symptoms of low back pain disappeared and hydronephrosis reduced apparently or dispeared without any anastomotic stenosis after follow-up of 4-6 months. Conclusions Single-port transumbilical laparoscopic dismembered pyeloplasty is feasible, effective and safe for the treatment of UPJO.

According to the practical problems including uneven distribution of medical resources in border areas , the difficulty of medical treatment for grass-roots unit, the low efficiency of referral between hospitals , and untimely mastery of health conditions of offi-ciers and soldiers , we constructed and developed a telemedicine information system based on hospital medical database with the backig of military integrated information network platform .A joint regional service platform among hospitals was constructed to realize high efficien -cy of medical referrals for officers and soldiers , computerization of personal medical information transmission , digitalization of health re-cords management , and paperless medical audit .The system provides convenient and high quality health care services , improves the level and efficiency of medical service , and enhances the ability of medical support to the troops by informationization .

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.

Objective: To assess the trend of statin application for in-hospital acute myocardial infarction (AMI) patients with its impact factors in eastern urban China from 2001 to 2011. Methods: A 2-stage random sampling design was performed to extract representative AMI sample patients. In the ifrst stage, a simple random-sampling was used to identify participating hospitals. In the second stage, a systematic sampling was conducted in 2001, 2006 and 2011 to select the cases from participating hospitals, to take medical records and clinical information for calculating the in-hospital statin application rate. The impact factors for statin application was assessed by multi Logistic regression model with generalized estimating equations. Results: A total of 5940 AMI records from 32 hospitals were enrolled. From 2001 to 2011, the in-hospital statin use rate increased from 46.0% in 2001 to 82.2% in 2006 and to 93.7% in 2011,P<0.001 for trend. Multi Logistic regression analysis indicated that the patients with LDL-C>3.37 mmol/L were more likely to receive statin therapy than those with LDL-C<1.81 mmol/L (OR=1.59, 95% CI 1.10-2.30,P=0.013); the patients with chest pain at admission (OR=1.82, 95% CI 1.14-2.91, P=0.012), combining hypertension (OR=1.44, 95% CI 1.02-2.03,P=0.038), with in-hospital PCI (OR=2.99, 95% CI 1.71-5.23, P<0.001) were also more likely to receive statin therapy. The application rate of statin was reduced by reduced LDL-C level accordingly and the patients without LDL-C examination, accounting for 21.3%, had the lowest statin application rate. Conclusion: Statin therapy for in-hospital AMI patients was dramatically increased from 2001 to 2011 in eastern urban China and the guideline was rapidly popularized in clinical practice. However, the improvement has been needed especially in patients without LDL-C examination or with low LDL-C levels; we emphasize that AMI patients should receive statin therapy regardless their LDL-C levels.

Objective To discuss the semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008, 36 patients (20 males and 16 females with mean age of 43 years) underwent retroperitoneoscopic adrenalectomy in 60° -70° semilateral supine position. There were adrenal cortex adenomas in 18 cases, pheochromocytoma in 6 cases, adrenal cysts in 3 cases, myelolipoma in 2 cases, gangliocytoma in 1 case, lymphangioma in 1 case, metastatic tumor in 1 case and corticohyporplasia in 4 cases. The mean diameter of the tumors was 2.6 cm( 0.5 - 7.7 cm ). The tumors were superior to the renal pole in 5 cases, anteromedial in 10 cases and superomedial in 17 cases. The three ports that were usually used in lateral position and were placed anteriorly to create retroperitoneal place: the first port was placed 2 -4 cm superior to the iliac crest along the anterior axillary line, the other two were placed just below the costal margin along the midaxillary line and at the same level along the midclavicular line, and dissected along the anterior surface of kidney to its superomedial aspect, so as to avoid the hampering of the kidney in the exposing of the diseased adrenal gland. Results The procedure was completed successfully in all of the cases with the operating time of 37 - 145 min ( mean 69 min) and intraoperative blood loss of 30 - 100 ml (mean 48 ml). Six cases had rupture of peritoneum, which were sutured and the procedure was continued to completion. The postoperative hospital stay was 3 -8 d (mean 5 d ). Thirty-five patients were available for follow-up of 3 - 28 months ( mean 14 months). The case of metastatic tumor died of the primary diseases in the 12th month postoperatively. No other complication was found. Conclusion With this alternative position and ports' location, the procedure of retroperitoneoscopic adrenalectomy could be easier and safer than the conventional position.

Objective: To explore the application and affecting factors of clopidogrel loading therapy in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in china in 2006 and 2011. Methods: Based on “China patient-centered evaluative assessment of cardiac events retrospective study of acute myocardial infarction”, we collected clinical information of STEMI patients with PCI in 2006, 2011 and analyzed clopidogrel loading therapy status in different years and different hospitals. According to clopidogrel doses, the patients were divided into 2 groups: Clopidogrel 300mg group, the patients received a single dose of clopidogrel ≥300mg while <450mg and Clopidogrel 600mg group, the patients received a single dose of clopidogrel ≥450mg while ≤600mg. The relevant factors affecting clopidogrel loading therapy status were identiifed by binary Logistic regression analysis. Results: A total of 2481 eligible patients were enrolled and their mean age was (60.9 ± 12.0) years including 21.4%female. From 2006 to 2011, the overall application of clopidogrel loading was (51.0% vs 47.4%), the ratio for patients in Clopidogrel 300mg group was (43.1% vs 39.2%), in Clopidogrel 600mg group was (7.8% vs 8.2%), allP>0.05. In 2006, the hospital median rate of clopidogerl application was 44.4% (IQR 21.8% to 69.0%) and in 2011, it was 48.1% (IQR 25.0% to 70.8%),P=0.940. Binary logistic regression analysis showed that the patients were admitted within 12 hours of onset, with primary PCI and treated in central region had the higher rates of clopidogrel loading therapy. Conclusion: Clopidogrel loading therapy was seriously inadequate in STEMI patients with PCI, variation was across hospitals and the status was similar between 2006 and 2011. Clopidogrel loading therapy should be improved.

non-myeloablative BuCy+fludarabine conditioning regimen,and another one was treated with TBI+VP-1 6 +CTX+CCNU conditioning regimen.Only one case received short-term MTX,cyclosporin A and ATG regimen for prevention of graft-versus-host disease (GVHD).The GVHD prevention regimens of the other patients were based on short-term MTX,cyclosporin A,ATG and mycophenolate mofetil regimen.The hematopoietic reconstitution, complications and prognosis were observed.Results One patient died of intracranial hemorrhage,and hematopoi-etic reconstitution was achieved in the other 20 patients.The median time for hematopoietic reconstitution shortened by one day in large-dose group compared with that in low-dose group.Adverse reactions included high fever, shivering,gastrointestinal tract adverse reaction,liver injury,oral mucositis and other rare side effects.GVHD occurred more frequently in patients with HLA mismatched transplantation.Nine patients with aGVHD and 9 patients with cGVHD recovered after effective treatment.Within 100 days after transplantation,18 patients had bacterial or fungal infection,mainly upper respiratory tract infection;7 patients had cytomegalovirus infection;2 had EB viremia,and one had urinary BK virus infection.Only one patient died of VOD.Hemorrhagic cystitis occurred in 5 patients and improved after treatment.The median survival time was 24 months (ranging from 136 days to 9 years).One-year and 3-year overall survival rates were 85.2% and 63.9%,the disease free survival rates were 81% and 23.8%,recurrence free survival rates were 71.4% and 14.3%,respectively.Conclusion URD-HSCT was an effective method to treat leukemia.Conditioning regimen of BuCy and modified BuCy2 were safe and effective,the adverse reactions were reversible and well tolerated.Hematopoietic reconstitution time shortened in large-dose MNC and CD34 + cell number groups compared with that in low-dose group.The occurrence rate of GVHD with HLA mismatched transplantation was more than that of HLA matched transplantation.Low-dose heparin,prostaglandin E1 and Danshen injection can effectively prevent VOD.