Objective To describe the technique and characteristics of simple hand-assisted laparoscopic resection of renal and adrenal. Methods A total of 37 patients (22 males and 15 females) underwent simple hand-assisted laparoscopic resection of renal and adrenal from June 1999 to April 2004.Their mean age was 52 years (range,25～65 years).Renal resection group included 29 cases,including 13 of renal carcinoma and 2 of renal pelvic carcinoma.All these 15 cases were staged as T 1N 0M 0.The average tumor volume of the renal resection group was 3 cm?3 cm?2 cm.8 of hydronephrosis,2 of renal tuberculosis,4 of renal atrophied.Adrenal tumor resection group included 8 cases;the average tumor volume was 4 cm?5 cm?6 cm. Results Simple hand-assisted laparoscopic resection of the tumors was performed successfully in 36 cases without any complication such as injury of intestines and other important abdominal viscera except 1 case who underwent open surgery.The mean operative time of nephrectomy was 145 min,and that of adrenal giant tumor resection was 125 min.The mean blood loss was 110 ml.The patients recovered well and were discharged 7 to 8 days after operation.Follow-up lasted 3 months to 5 years after operation.Of the 37 cases,35 survived healthily;2 with renal carcinoma died (1 died of cerebrovascular accident 2 years after operation and the other died of brain and pulmonary metastasis 3 years after operation). Conclusions Simple hand-assisted laparoscopic resection of renal and adrenal giant tumor has the advantages of easier performance,shortened operative time and faster recovery from operation.Thus,this technique is worthy of popularization.

OBJECTIVE:To explore the characteristics and clinical application of alginate dressing to provide better biological dressing for clinical wound healing.METHODS:A computer-based online search of CNKI,Medline,Wanfang,Science Direct,and Ei databases was performed for related articles published between January 1960 and October 2009,with the key words "alginate,dressing,clinical application"in Chinese and English.Studies regarding characteristics and clinical application of alginate dressing were included.Repetitive and Meta analysis were excluded.In addition,related books were manually searched.RESULTS:A total of 65 articles were collected,17 were included,and 48 repetitive or Meta analyses were excluded.Alginate is natural polysaccharide carbohydrate extracted from sea tangle,and alginate dressing is soft non-textile fiber refined from seaweed.It contains 85% natural alginate fiber and 15% sodium tvlose.It can absorb effusion,form gelate,and exchange Na+/Ca2+ with effusion.Alginate dressing has been widely used in bedsore treatment,anal fistula nursing,stoma nursing,and diabetic foot nursing.Compared with traditional dressing,infection rate of alginate dressing is lower due to good impermeability,promotion of regional vessel proliferation and blood supply,as well as moist and slightly acidic environment which benefits neutrophil function enhances disinfection.Moreover,it can be used in wound healing following abdominal region operation and abscess incision drainage.CONCLUSION:Alginate dressing provides appropriate environment for wound growth,retains active materials in diffusion,promotes active material release,benefit necrotic tissue solution and cell proliferation and differentiation,as well as epithelial cell migration.Moreover,it maintains hypoxia state of wound,stimulates newly generated capillary growth,and promotes granulation tissue growth.

OBJECTIVE: To explore the characteristics and clinical application of alginate dressing to provide better biological dressing for clinical wound healing. METHODS: A computer-based online search of CNKI, Medline, Wanfang, Science Direct, and Ei databases was performed for related articles published between January 1960 and October 2009, with the key words "alginate, dressing, clinical application" in Chinese and English. Studies regarding characteristics and clinical application of alginate dressing were included. Repetitive and Meta analysis were excluded. In addition, related books were manually searched. RESULTS: A total of 65 articles were collected, 17 were included, and 48 repetitive or Meta analyses were excluded. Alginate is natural polysaccharide carbohydrate extracted from sea tangle, and alginate dressing is soft non-textile fiber refined from seaweed. It contains 85% natural alginate fiber and 15% sodium tvIose. It can absorb effusion, form gelate, and exchange Na~+/Ca~(2+) with effusion. Alginate dressing has been widely used in bedsore treatment, anal fistula nursing, stoma nursing, and diabetic foot nursing. Compared with traditional dressing, infection rate of alginate dressing is lower due to good impermeability, promotion of regional vessel proliferation and blood supply, as well as moist and slightly acidic environment which benefits neutrophil function enhances disinfection. Moreover, it can be used in wound healing following abdominal region operation and abscess incision drainage.CONCLUSION: Alginate dressing provides appropriate environment for wound growth, retains active materials in diffusion, promotes active material release, benefit necrotic tissue solution and cell proliferation and differentiation, as well as epithelial cell migration. Moreover, it maintains hypoxia state of wound, stimulates newly generated capillary growth, and promotes granulation tissue growth.

Eighty-two patients with unresectable primary hepatic carcinoma were divided randomly into 4 groups. Twenty patients (group A) were treated with hepatic artery ligation and embolization. Twenty-three patients (group B) were treated with whole liver moving strip irradiation. Eighteen (group C) were treated with hepatic artery ligation and embolization and portal vein perfusion chemotherapy. Twenty-one (group D) were treated with the therapy as the group C and the whole liver moving strip irradiation. All were followed-up to 12～37 months. The 1-year survival rates of these four groups were 25.0%(5/20), 13.0%(3/23), 33.3%(6/18) and 61.9%(13/21), respectively. The authors believe that combined treatment of group D is recommended for advanced and unresectable primary hepatic carcinoma.

砄bjective: To study the complications of interventional therapy in maxillofacial region. Methods : Retrospective analysis was conducted in 73 cases(96 times) treated with interventional therapy in maxillofacial region. Intraarterial angiography, drug infusion and embolization were conducted in 71 cases of maxillofacial tumor and 2 cases of injury by Seldinger method. Results: Complications with clinical significance occurred were observed in 6 cases (6.2%): allergic reaction to angiographic agent in 2 cases, necrosis of skin in 1, local pain in 1, facial paralysis in 1 and death because of brain damage in 1. 5 cases were cured. Conclusion: The most serious complication in maxillofacial interventional therapy is nerve injury, which may result in death . Certain measures should taken to prevent or reduce the reaction.

Objective: To systematically evaluate the effect of colostrum on immunoglobulin A (IgA) levels among premature infants, so as to provide the evidence for improving premature infants' health with colostrum feeding. Methods: Randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs) pertaining to the effect of colostrum and IgA levels among premature infants were retrieved in national and international databases from inception to September 30, 2022, including CNKI, Wanfang Data, PubMed and Web of Science. Standardized mean difference (SMD) was used as an effect index for meta-analysis. The robustness of the results was evaluated using sensitivity analysis, and the publication bias was evaluated using Begg's test, Egger's test and funnel plot. Results : A total of 650 publications were retrieved initially, and 10 studies were finally included, including 9 RCTs and one1 CCT, with 677 participants. Meta-analysis showed higher secretory salivary secretory IgA levels among premature infants with colostrum feeding than among controls (SMD=0.49, 95%CI: 0.08-0.89), and there were no significant differences between groups in terms of urinary secretory IgA levels (SMD=0.19, 95%CI: -0.39-0.77) or blood IgA levels (SMD=0.29, 95%CI: -0.01-0.59). Sensitivity analysis showed robustness of meta-analysis results, and no publication bias was examined. Conclusion Colostrum feeding may increase salivary secretory IgA levels among premature infants; however, it has no effect on urine salivary secretory IgA levels or blood IgA levels.

ObjectiveThe present study was designed evaluate the aspirin effectiveness in the inhibition of platelet aggregation in patients after OPCAB.Methods290 patients were recruited.145 patients underwent first time OPCAB (surgery group).Arachidonic acid induced platelet aggregation and urine 11-dehydro thromboxane B2 (11-dehydroTxB2) were measured before operation and on aspirin re-administered days 1,4, 10, and 6 months after surgery.The same tests were also detected in 145 patients from the cardiology department (non-surgery group) received medicine therapy as controls.Results Ninety-nine patients were defined as aspirin sensitive after OPCAB (AS Group).Postoperative aspirin resistance was identified in 46 (32％) patients at the first day after aspirin treatment started (AR Group).19 (13％) and 5 (3％) patients remained as AR at day 4 and 10 after aspirin re-administration, respectively.Patients in the AR group had higher 11-dehydroTxB2 levels than those in the AS group (P = 0.049).Six months follow-up showed ARA-induced platelet aggregation was (11.5 ± 3.4) ％.Urine level of 11-dehydroTxB2 was (50.3 ± 15.4) ng/L.No resistance was found.All cardiologic patients were identified as aspirin sensitive, the change of platelet aggregation and 11-dehydroTxB2 were similar as those in the AS group.Weight ＞75 kg and postoperative drainage ＞500 ml were risk factors of aspirin resistance after OPCAB.ConclusionAnti-platelet effect of aspirin was reduced during the early postoperative period in certain patients undergoing OPCAB.In case of resistance,antiplatelet treatment strategy should be intensified or modified.

Objective To understand causes of death of diabetic inpatients and provide evidence for diabetic prevention and control. Methods Analysis of the death causes was carried out in the dead cases of diabetic inpatients in the First and Second Affiliated Hospital of Medical School,Xi'an Jiaotong University from 1991 to 2003.Results Numbers of dead diabetic inpatients of the two hospitals were 254,which accounted for 3.2% of the total dead inpatients;the main death causes of diabetic inpatients were diabetic chronic complications,taking up to 42.5% of all the causes(28.3% of cerebro-cardiovascular and 14.2% of diabetic renalfailure),tumor((20.1%)),infection(11.4%),acute complications(6.7%) amd hepaticcirrhosis(6.3%);in vascular complications,72 cases with hypertension(66.7%).Conclusion The chronic complications have been the main death cause of diabetes,and cerebro-cardiovascular diseases are most important death cause;Hypertension is the main risk factor which increases the mortality of diabetic vascular diseases.Therefore,strict control of both blood sugar and blood pressure is very important in decreasing the mortality of diabetic cerebro-cardiovascular diseases.

Objective: To study the effects of zinc on transport function of erythrocyte membrane. Methods: This study was conducted both in vivo and in vitro. In vivo, weanling rats were divided into three groups and fed with different zinc diets (2.2, 28 and 128 mg Zn/kg diet) for four weeks, the transport function of Na +/K + pump, COTS-1, COTS-2, Gardos and RF channels were determined. In vitro, different concentration of zinc (0,5,10,50,100 and 500 ?mol Zn 2+ /L) were added into fresh human blood and the activities of the five transport channels were detected. Results: Proper zinc could keep the highest activities of Na +/K + pump, COTS-2 and Gardos channel. Too low or too high zinc decreased the transport function of these three channels and the activities of COTS-1 and RF channel were increased with the increase of zinc concentration, indicating the competitive function of these two channels. Conclusion: Zinc plays an important role in maintaining the transport function of erythrocyte membrane.

Objective To study the variation characteristics of plasma von Willebrand factor antigen (vWF Ag) after the off-pump coronary artery bypass graft (OPCAB) and its predictive value on the assessment of cardiovascular ischemia events in the postoperative patients.Methods A total of 338 patients with non-ST-segment elevation myocardial infarction were selected from 2010 to 2012 in this retrospective cohort study,with 249 males and 89 females and a mean age of (69.2 ± 4.5) years.The level of vWF Ag was assayed by the IL ACL-TOP 700 blood coagulation instrument.Receiver-operator curve (ROC) analysis of vWF Ag levels in the prediction of risk of ischemic events was performed.x2 test and Logistic regression were conducted to analyze the relevance between vWF Ag and clinical pathological factors.Cox regression analysis model were used to evaluate the effect on prognosis.Results There was significant difference in vWF Ag level at different time point between the poor recovery group and the stable disease group (x2 =129.53 and 101.48 respectively,both P＜0.01).And the vWF Ag level was higher in the poor recovery group on the 14th,30th,60th,90th day after OPCAB than in the stable disease group at the same time points respectively (all P＜0.05).The optimum cut-off point of vWF Ag (the 30th day after OPCAB) for prediction of ischemic events was 251 ％ within the 31-90th day after OPCAB,the area under ROC curve was 0.839 (95％ confidence interval:0.776-0.902).The Logistic regression analysis showed that the vWF Ag level on 30th day after OPCAB was affected by age,left ventricular ejection fraction,left main artery disease,serum creatinine level,vascular number of bypass grafts,history of myocardial infarction and hypertension (all P＜0.01).The Cox analysis showed that the cut-off value of vWF Ag (on the 30th day after OPCAB) was the independent prognostic assessment parameter for ischemic events in patients with cardiovascular diseases within one year.Conclusions The variation of serum vWF Ag level can reflect the integrated influence of multiple pathological factors on vascular endothelial function after the OPCAB,it can become the effective predictor for disease progression within 90 days and the long-term prognosis after OPCAB.