Objective To evaluate the Cys-C、β~2-MG、RBP as marker三of early diagnosis in patients with diabetic nephropathy Ⅱ(DN).Methods ninety patients with DN were divided into three groups according to urinary albumin excretion rate (UAER),that is normal,micro and mass group.Serum Cys-C、β~2-MG、RBP、BUN,Crea were detected and parallelly contrasted in the three groups and control group with thirty healthy people.Results compared with the control group,the serum Cys-C、β~2-MG、RBP of micro and mass group both significantly increased and the normal group had no significant difference.The positive rate of Cys-C、β~2-MG,RBP in mass group was respectively 100%、100%、96.1%;the positive rate in micro group as follows:Cys C (92.3%)＞B2-MG(84.6%)＞RBP(66.6%)＞Crea(46.1%)＞BUN(28.2%).Conclusion serum Cys-C、β~2-MG、RBP have high positive rates in patients with diabetic nephropathy Ⅱ(DN).They can be used as early diagnostic marker of diabetic nephropathy Ⅱespecially Cys-C.

Objective: To review the pathological characteristics of the lungs in mitral stenosis with pulmonary hypertension, and provide evidence for clinical treatment. Methods: Pulmonary pathological changes in 37 patients with rheumatic mitral stenosis and secondary pulmonary hypertension received mitral valve replacement. Six patients of aortic valve disease without pulmonary hypertension received aortic valve replacement and were taken as control. The lung biopsies were obtained from the middle lobe of the right lung in operation. Pulmonary muscular arteries were studied quantitatively and qualitatively. Results: All patients with mitral stenosis showed various degrees of vascular and other associated parenchymal changes. The structural changes in the muscular arteries was graded according to the degree of MT/R. There was 81% of patients with mitral stenosis in mild to moderate degree. Conclusion: The pulmonary vascular pathological changes of patients who have rheumatic mitral stenosis with pulmonary hypertension are related to the level of preoperative pulmonary artery pressure. And in most of them the pulmonary vascular pathological changes are in mild to moderate degree.

Objective To investigate the drug-resistant status of Acinetobacter baumannii in clinical strains isolated from our hospital,and get to know the distribution of integrons carried by Acinetobacter baumannii,analyze the correlation between integron and drug-resistant of Acinetobacter baumannii..Methods Collected 85 Acinetobacter baumannii isolated in our lab,the drug-sensitivity tests were completed by the method of KB,the integrase genes were amplified by polymerase chain reaction(PCR),and identified the type of integron..Analyzed the correlation between the drug-resistant and integron in Acinetobacter baumannii..The open reading frame of integron were amplified by PCR,the polymorphism of integron was identified,and sequenced the PCR products.Results Except for Imipenem and Cefoperazone/ sulbactam(drug resistant rate less than 10%),the drug resistant rate of other 15 antibacterial was no more than 30% among the 85 Acinetobacter baumannii isolated in our lab..66.1 %(57/85) stains carried the integrons I,we didn't find out the integron Ⅱ and Ⅲ.The drug-resistant rates of Acinetobacter baumannii with integron were higher than that of Acinetobacter baumannii without integron.The length of amplified products in variable region of open reading frame of integron varied from 03 to 25kb,.The sequencing results confirmed the integron included multidrug resistant gene code.Conclusion In our hospital,the drug-resistant rate of Acinetobacter baumannii was high,and the majority were multidrug resistant strains.The drug-resistant rate of Acinetobacter baumannii was enhanced with integron,The multidrug resistant of Acinetobacter baumannii was associated with integrons.

Objective To investigate the surgical diagnosis and treatment of chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction,so as to deepen our knowledge on chronic stenosis of mechanical prosthetic valve.Methods The clinical data of 5 patients with chronic stenosis of mechanical prosthetic valve complicated with acute dysfunction were retrospectively analyzed,and the relevant literatures were reviewed.Results Re-operation(mechanical prosthetic valve replacement) was performed once the diagnoses were confirmed.The patients recovered well;the cardiac function was obviously improved;and there were no early complications.Conclusion Chronic stenosis of mechanical prosthetic valve should be strongly suspected when they have symptoms indicating valvular stenosis.Complication of acute mechanical prosthetic valve dysfunction is not difficult to diagnose,and prompt operation is important to save the life of patients.

Objective To assess the deep inferior epigastric perforator (DIEP) vessels in patients with breast reconstruction flaps by contrast-enhanced ultrasound (CEUS) and three-dimensional ultrasound (3DUS) reconstruction techniques.Methods Conventional ultrasound,CEUS and 3DUS were used to evaluate DIEP vessels of breast reconstruction flaps in 43 patients before surgical procedures.The identification,localization and spatial relationship of DIEP vessels were analyzed with conventional ultrasound,CEUS and 3DUS methods.The findings of CEUS and 3DUS were compared to conventional ultrasound and surgical outcome.Results Compared to CDFI,40 cases (93％) were observed more clearly with CEUS,and were showed more accurately than conventional ultrasound.41 cases (95％) could be displayed wonderfully in 3D ultrasound.Perforators which were detected by ultrasound were confirmed in the surgery and the transferred flaps survived completely.Conclusions Perforators can be displayed more clearly and located more accurately by CEUS and 3DUS.CEUS and 3DUS could play a very important role in the preoperative navigation of the DIEP than conventional ultrasound.

Objective To evaluate and demonstrate ultrasonographic characteristics of mandibular ameloblastoma with active proliferation. Methods Nineteen subjects with ameloblastomas in the mandibles were examined with ultrasonography. In addition to sizes,internal echoes,the research was focused on blood flow of the tumors and destruction of mandibles. Ultrasonographic appearances of the tumors were compared with histopathological findings. Sensitivity and specificity of Doppler flow signals and destruction of mandibles for prediction of active tumor proliferations were calculated. Results Fifteen cases (79%)showed no or minimal flow signals on color Doppler flow imaging(CDFI), whereas the remaining 4 lesions demonstrated abundant flow signals,in which 3 cases were confirmed histopathologically with active tumor proliferations. The sensitivity and specificity of the Doppler flow signals for prediction of active tumor proliferations were 100% and 94%, respectively. Fourteen cases (74%) showed the mandibular cortices were thin but continuous,among the remaining 5 lesions showed local cortices destruction,3 of them were confirmed histopathologically with active proliferations. The sensitivity and specificity of the destruction of cortical bone for prediction of active tumor proliferations were 100% and 88 %, respectively. Conclusions Ultrasonography can be used as a new effective supplementary diagnostic method for mandibular ameloblastomas. CDFI of tumor vascularity and destruction of cortical bone could be used to predict active tumor proliferations and invasiveness.

OBJECTIVE To investigate the drug-resistant rates of clinical Acinetobacter baumannii strains isolated from our hospital and to understand the integrons distribution carried by A.baumannii.To identify the type of the integrons and analyze the correlation between integron and drug resistance in A.baumannii clinical isolates. METHODS Collected clinical isolates and the drug-sensitivity tests were completed by the method of KB.Amplified integrase were tested by PCR and identified the integron category.Correlation between integron in A.baumannii and drug resistance was analyzed.The open reading frame(ORF) of integron were amplified and observed the polymorphism of integron,Part of amplified products were sequenced. RESULTS Apart from imipenem and cefoperazone /sulbactam,the drug-resistant rate of 85 A.baumannii clinical isolates to else 15 kinds of antibacterials surpassed 30.0%.67.1% A.baumannii clinical isolates carried the integrons,and confirmed all of them belonged to integron Ⅰ after identification,but integrons Ⅱ and Ⅲ were not found.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterials were higher than those of A.baumannii without integron.The length of amplified products in variable region of ORF of integron varied from 0.15 to 2.5 kb.The sequencing results confirmed the integron carried multidrug-resistant gene code. CONCLUSIONS Drug-resistant rate of A.baumannii clinical isolates in our hospital is higher and the majority of them are multidrug-resistant strains.The drug-resistant rates of A.baumannii with integron to 14 kinds of antibacterial are higher.The multidrug-resistant A.baumannii is associated with integrons.

Objective The results of Aortic valve replacement (AVR). Combined with ascending aortic replacement(group A) or aortoplasty (group B) in patients with aortic valve disease and ascending aortic dilatation were analysed to assess the clinical outcomes and respective indications. Methods Among the two groups, the age, gender, NYHA class, types of aortic valve lesions and left ventricular ejection fraction were not different statically. The ascending aortic diameters in group A[(50.41 ±3.71) mm] and group B [(48.29±2.18) mm] were not statically different. Ascending aortic replacement was performed in Group A. A Dacron tube(diameter 28 ～ 30mm) was routinely wrapped around the ascending aorta after aortoplasty in group B. Results There was 1 postoperative death in group B, blood transfusion volume and postoperative complications were not stasticaly different in the two groups. Cardiopulmonary bypass time [(110.52 ± 27.51) min] and aortic across clumping time [(71.70 ± 17.13)min] in group A were significantly longer than that of group B [(97.31 ± 19.46) min,P=0. 004; (57.13 ±19.46) min, respectively. P=0.025]. Conclusion Aortic valve disease, especially bicuspid valve disease often combines with ascending aortic dilatation or aneurysm. In younger patients, ascending aorta should be actively treated surgically when the diameter is equal or more than 40mm. Aortoplasty with external reinforcement of a Dacron tube is simpler and safer than aortic replacement in patient without aortic atherosclerosis or ulceration, and large aneurysm.

Objective To summary the methods and results of first and second operations on patients with aortic valve disease and non-specific aortitis.Methods The total 34 patients including 23 cases with aortitis and 11 cases with Behcet disease were studied from Jan 2000 to Dec 2010.The first operation was Bentall procedure in 18 cases and AVR in 16 cases.Fourteen of 16 cases who had AVR developed severe paravalvular leakage,and undewent the second operation including 10 aortic root replacement (8 valve-conduit and 2 homograft) and 4 non-anatomic AVR.Results Eighteen patients who had first operation of Bentall procedure all survive without aortic pseudoaneurysm after the follow-up of 6 months to 11 years.Fourteen redo cases all survive except for one case died of repture of aortic pseudoaneurysm 1.2 years postoperatively.Conclusion Preoperative diagnosis in these patients is very difficulty.The first operation of root replacement is of choice.The second operation is very difficulty to handle,root replacement can achieve satisfactory results.Non-anatomic AVR is easy to perform,and good hemo stasis intraoperatively,and is a satisfied alternative method with good results.

Objective To determine the feasibility and safety of radiofrequeney(RF)ablation of entire prostate guided and monitored by contrast-enhanced transrectal ultrasound(CE-TRUS)in canine model.Methods Contrast ultrasound-guided RF ablation of entire prostate was preformed transrectally using Cool-tiptm electrodes in 7 normal canines under general anesthesia.The urethra/bladder and rectum were protected by infusion of cold distilled water through a Foley catheter and injection of cold distilled water into the prostate-rectum space,respectively.CE-TRUS findings were compared with TTC-stained pathologic results.Results All the 7 canines tolerated the ablation procedures.CE-TRUS clearly demonstrated hypoechoic thermal lesions as avascular/nonperfusion areas.The average number acquired for entire prostate ablation was 4.3(3 to 6).The average ablation volume achieved on pathology was 96.55%.There was no statistically significant difference when compared average ablative volumes between CE-TRUS and TTC-stained pathology[(9.16±5.20)cm3 vs(8.62±3.13)cm3,P=0.583].The coefficient correlation was 0.94(P=0.002).No thermal related injuries were found in anv of the bladder and rectum.The thermal related inj uries of the urethra were less than 1/4 quadrant.Conclusions It is feasible to ablate the entire prostate using RF thermal energy under CE-TRUS guidance.CE-TRUS plays a key role for achieving entire prostate ablation.The urethra and rectum can be protected by cooling of these structures during the procedure.