Kawasaki disease,which is an acute multisystem vasculitis of unknown cause,leads to pathognomonic feature of coronary artery lesion.Recent studies show that genetic polymorphism,neutrophils,monocytes,cytokines and other factors are involved in the development of coronary artery disease.Long-term use of anticoagulant drugs may reduce coronary artery damage.

A systematic review is based on randomized controlled trials (RCTs), and the reliability of its conclusion is closely related to the quality of original literature. The low quality of existing RCTs in China leads to the failure of conclusive findings in systematic reviews when evaluating the effectiveness of interventions. It is almost universal for systematic reviews to draw the conclusion that "further well-designed multicenter and large-scale RCTs are still required to confirm the beneficial effects of interventions". This paper analyzed the current status of RCTs in China, discussed the influence of including trials of low quality in a systematic review and assessed how a systematic review should be carried out under such circumstances. Furthermore, the methods to evaluate the quality of RCTs were introduced and evaluated. Finally, several strategies were proposed to improve the quality of RCTs in China: foster an honest academic and social environment, enhance the training of doctors on clinical research methodology, promote the implementation of clinical registration systems and strengthen the quality control of clinical research and the medical journals regulations on the quality of submitted papers.

Objective To study the efficacy and safety of methylcarboprost suppository in preventing postpartum hemorrhage of cesarean section.Methods Two hundred and nine puerperants with cesarean section were randomly divided into two groups: test group(n=103),1mg methylcarboprost suppository was given sublingually after peritoneotomy,and control group(n=106),20IU oxytocin intravenous drip immediately after neonate delivery. 20IU oxytocin were injected into uterine muscularis in the both groups after neonate delivery.The amount of bleeding in perioperation and 24 hours after delivery were measured.Results The blood loss volumes in perioperation and 24hour after delivery in test group were 191 2ml and 317 2ml respectively, and in control group were 216 6ml and 350 5ml respectively,and there was significant difference in the blood loss volume between the two groups(P

Recurrent miscarriage is a common disease in clinical obstetrics and gynecology. There is no curative treatment for recurrent miscarriage in conventional medicine. Traditional Chinese medicine (TCM) has been widely used in the treatment of recurrent miscarriage in China for thousands of years. However, randomized controlled trials (RCTs) with high quality evaluating the effectiveness and safety of Chinese herbal medicine (CHM) still lack. This study was conducted in order to identify methodological problems in published or unpublished RCTs of CHM in the treatment of recurrent miscarriage, and provide suggestions for TCM researchers to conduct high-quality clinical research.

Objective To study the clinical features of traumatic mitral regurgitation and its surgical treatment methods and outcomes. Methods Clinical data of 16 patients with traumatic mitral regurgitation surgically treated from December 2000 to November 2008 were retrospectively analyzed. The cardiac thoracic ratio was 0.55 ±0.07 and the left ventricular ejection fraction (LVEF) was (51.2% ±23.2)%. According to the New York Heart Association (NYHA) functional classification, 10 patients were at grade Ⅰ - Ⅱ before operation. The surgical procedures consisted of mitral valvuloplasty in 14 patients and mitral replacement in two, when correction of other cardiac injuries was made at the same time.Of all, 14 patients obtained follow-up for (35.2 ± 25.7 ) months. Results The interval between trauma and appearance of mitral regurgitation was (23.3 ±50.90) months. Of 13 patients with echocardiography during follow-up, there were four patients with normal tricuspid hemodynamics, seven with trace tricuspid regurgitation and two with mild regurgitation. The value of LVEF was (66.8 ± 9.0)% at followup, significantly higher than preoperation (P ＜ 0. 05 ). There were 13 patients at grade Ⅰ - Ⅱ of NYHA,with a significant increase compared with preoperation ( P ＜ 0. 01 ). Conclusions Mitral regurgitation may emerge either immediately or several years after trauma. Traumatic mitral regurgitation patients can get satisfactory outcomes when comprehensive mitral valvuloplasty or mitral replacement is performed promptly.

Objective To explore the feasibility of laparoscopy-assisted total mesorectal excision(TME) for anterior resection of rectal cancer.Methods The clinical records of 42 patients with rectal cancer who underwentlaparoscopic TME from April 2006 to July 2008 were analyzed retrospectively.Results All the laparoscopic TME with anal sphincter preservation operations were successful;no case was converted to open procedure.The distal end of rectum was anastomosed by a reusable linear stapler.The average operative time was 195 min(170-230 min) and the operative blood loss 15 mL(10-30 mL).The time for bowel functionrecovery was 32 hours.One patient had postoperative dysuria,and one had intraoperative subcutaneousemphysema.No anastomotic leakage or infection of incisional wound occurred.Conclusions Laparoscopy-assisted anterior resection for rectal cancer is safe and feasible.

0.05). Conclusion Clopidogrel resistance may influence long-term prognosis in patients implanted with DES, and it may contribute to recurrence of ischemic events.

Objective To compare the therapeutic efficacy and safety of ultrasound-guided thrombin injection (UGTI) combined with saline injection and ultrasound-guided compression repair (UGCR) for upper limb pseudoaneurysm (PSA). Methods The clinical features and therapeutic efficacy of UGCR and UGTI for PSA of the upper extremities were retrospectively assessed after catheterization through radial artery. When UGCR was conducted, PSA, its communicating emissaries with other arteries were first identified with color Doppler, and then direct manual compression over the aneurysm for 30 minutes until complete thrombosis was observed. When UGCR failed, a 20-22G needle was inserted into PSA and saline was injected with continuous color Doppler guidance to confirm that the tip of the needle was in the aneurysm. Then thrombin was injected into the aneurysmal sac. All the patients were followed-up clinically and with ultrasound 24h or 14-30 days after the treatments. Results For the 14 patients with upper limb PSA who received UGCR for the first time, 5 were cured with a success rate of 35.7%. Nine cases underwent repeated UGCR treatment, and it was successful in four patients. The overall success rate for UGCR was 64.3% (9/14). All the five patients in whom UGCR failed were successfully cured when UGTI was conducted. In four cases it was successful after the first UGTI, and only one patient received repeated UGTI treatment. The total success rate for UGTI was 100% (5/5). No obvious adverse effect and recurrence were found after follow-up for 14-30 days in all patients. Conclusions Both UGCR and UGTI are safe, effective, and expedient treatment for patients with PSA in the upper extremity. UGTI is the preferred method for its simplicity, high success rate and avoidance of possible distal arterial embolism.

In order to elucidate the mechanism of liver damage due to acute biliary sepsis,the changes of hepatocyte mitochondria were observed during biliary sepsis in the rat.The accompanied liver function changes were also studied.Mitochondrial calcium content,and lysosome fragility of the hepatocytes,lipid peroxide (LPO) level of liver tissue,ornithine carbamoytransferase (OCT),mitochondrial glulamicoxloacetic transaminase (m-GOT),and hepa-toplastin were determined.It was found that there were overloading of calcium in mitochondria,increase of lysosome fragility,and accumulation of LPO in the liver.These events would result in adverse effects on mitochondrial function.The activity of serum OCT and m-GOT was significantly increased,which suggests that mitochondria are seriously damaged since the 2 enzymes mainly come from hepatocyte mitochondria.And the liver reserving function declined progressively.Our study indicates that mitochondrial damage does exist during acute biliary sepsis,which might play an important role in liver damage.

The phagocytic function of Kupffer cells (KC) during acute obstructive cholangitis was observed in 244 Wistar rats.The rats were killed in the 6th,12th,24th,and 48th hour after operation,and the uptake of colloidal carbon by KC,plasma endotoxin and fibronectin(Fn)were determined and the morphology of KC was observed.It was found that in the rats with acute obstructive cholangitis,the phagocytic function of KC and plasma Fn significantly elevated in the 6th hour and markedly reduced in the 48th hour after operation as compared with those of the control (P