ObjectiveTo investigate the effect of ulinastatin on perioperative renal function in patients undergoing orthotopic liver transplantation.MethodsSixty ASA Ⅱ or Ⅲ patients of both sexes aged 35-64 yr weighing 50-75 kg with normal blood urea nitrogen (BUN) and creatinine (Cr) before operation undergoing orthotopic liver transplantation were randomly divided into 2 groups ( n ＝ 30 each):control group (group C) and ulinastatin group ( group U).Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with isoflurane inhalation,propofol TCI,continuous remifentanil infusion and intermittent iv boluses of fentanyl and vecuronium.The patients were tracheally intubated and mechanically ventilated.PET CO2 was maintained at 30-35 mm Hg.Ulinastatin 400 000 IU in normal saline 20 ml was infused iv after induction of anesthesia.Ulinastatin 200 000 IU was then infused every 4 h until 48 h after operation.Urine volume and the amount of furosemide administered were recorded before anhepatic phase,and during anhepatic and neohepatic phase.Venous blood samples and urine were collected before induction of anesthesia (T1),at 15 min of anhepatic phase ( T2 ),at 15min of neohepatic phase (T3),at the end of operation (T4) and 48 h after operation (T5) for determination of serum concentrations of BUN,Cr and creatinine clearance rate and urinary N-acetyl-beta-D-glucosaminidase (NAG)activity and microalbumin concentration.ResultsCompared with group C,ulinastatin significantly decreased the amount of furosemide administered and increased urine volume during anhepatic and neohepatic phase,decreased serum Cr concentration,increased creatinine clearance rate at T2.5,decreased urinary NAG activity and microalbumin concentration at T4.5 and serum BUN concentration at T3-s.ConclusionUlinastatin has protective effect on rehal function during perioperative period in patients undergoing orthotopic liver transplantation.

Objective To investigate the prevalence, clinical features, diagnosis, treatment and the influence on procreation of uterine malformation. Methods Totally 225 women with uterine malformation referred to our hospital from Mar 1990 to Jan 2005 were involved in this retrospective analysis.The constituent ratio, clinical feature, diagnosis, treatment and the influence on procreation were analyzed.Results (1) Among 225 cases of uterine malformation, 125 cases (55.6%) were septate uterus; 122(97.6%, 122/125 ) of these patients became pregnant, but always associated with a high risk of reproductive failure and obstetrical complications, such as abortion, abnormal fetal presentation, premature rupture of membrane. (2) Among 51 cases (22. 2%, 51/225 ) of didelphia, 50 cases (98%, 50/51 )became pregnant without any influence from this malformation. Five cases were combined with urinary system complication. (3) Among 26 cases (9.7%, 26/225 ) of rudimentary horn of uterus, 4 cases (15%, 4/26)became pregnant, and 1 case (4%, 1/26) presented with ipsilateral oviduct ectopic pregnancy; 2 cases (8%, 2/26) were combined with urinary deformities. (4) In 14 cases (6. 2%, 14/225) of bicornuate uterus, 1 case (7%, 1/14) presented with urinary tract abnormalities; gestations were more common, but due to the uterine structural abnormality, recurrent miscarriage and premature delivery were unavoidable.(5) Others: none came up with sterility in 4 cases (1. 8%, 4/225) of saddle shaped uterus. All the three cases ( 1.3% , 3/225) of ametria were with the chief complaint of primary amenorrhea. Two cases of unicornis uterus (0.9%, 2/225) were both complicated with sterility, while neither with urinary system deformities. Conclusions Among uterine malformations, septate uterine is the most common type. Septate uterus, didelphic uterus, bicornuate and rudimentary horn of uterus do not affect pregnancy, but can cause different complications. Unicornis uterus always causes sterility. Uterus malformations often come up with urinary system deformities.