Objective To investigate the influence of patients suffered from acute lower wall cardiac infarct appeared Ⅲ atrio-ventricular block tneatment with thrombolytic recanalization for the early recovery of sinus rhythm.Methods From October 01 till October 06, a total of 25 hospitalized patients in our hospital with acute lower cardiac infarct, chest pain persist over thirty minutes, but less than one hour, immediately treatment with urokinase thrombolytic therapy after hospitalization, among them 17 cases reinfusion therapy success ful and 8 cases failed. Divided into reinfusion therapy success group and failed group, observate thromholytic therapy 6 hours recanalization success and fail group the situation of sinus rhythm recovore. Results Among 17 cases recanalization success patients and 14 cases recover sinus rhythm within 6 hours ,and 8 case fail in recanalization 2 cases recover sinus rhythm in 6 hours(25%)compared these two groups statistical are meaningful ( P＜0. 01 ). Conclusion Acute lower cardiac infarct patients with Ⅲ atrio-ventricular block must use thrombolytic therapy as soon as possible in order to let oclusive coronary artery recanalize, help to recover sinus rhythm as soon as possible and decrease mortality rate.

Objective To investigate the clinical distribution and drug resistance of stenotrophomonas maltophilia and to provide reference for the clinical application of drugs and to control the nosocomial infection. Methods MicroScan autoSCAN4 and Kirby -Bauer (K -B)method were used to assess the bacteria and test the drug sensitivity.The data were analyzed with software WHONET5.6.Results The isolation rate was the highest in respiratory specimens.There was a highest isolation rate of 90.2%.Drug sensitive test showed that stenotrophomonas maltophilia was most sensitive to minocyline,and the resistance rate was 3.6%.The resistance rates of trimethoprim -sulfamethoxazole,levofloxacin and cefoperazone -sulbactam were12.2%,13.4% and 26.8%.Conclusion Drug resistance monitoring of stenotrophomonas maltophilia should be enhanced.Treatment based on drug susceptibility test should be adapted as soon as possible.

Objective To investigate the mechanism of radioulnar dissociation, an uncommon special injury, and its clinical diagnosis and treatment. Methods From 1990 to 1998, 4 patients with concurrent injuries of the proximal and distal radio ulnar joints were treated in my department. Of the 3 cases diagnosed early, 2 were treated with open reduction and internal fixation and 1 with closed reduction. The remaining one patient, whose radio ulnar dissociation was diagnosed 2 months later, had to be treated by secondary operation. Results The 4 patients were followed up for 16 months to 8 years (averaging 46 months). All had excellent results. Conclusion The early accurate diagnosis and early treatment of concurrent injuries of the elbow and the distal radio ulnar joint produce satisfactory results.

Purpose：To determine the treatments and prognostic predictors of malignant melanoma of the head and neck. Methods：Surgical treatment and outcome was analyzed for 28 patients with malignant melanoma of the head and neck at department of the head and neck of our hospital (1984-1994). Results：23 patients underwent local excised as the first treatment, and local recurrence was demonstrated in 8 (34.8%). Margin of resection of primary melanoma was divided into narrow excision (≤2 cm) and wide excision (＞2 cm), and 5-year survival was 58% and 40%(P＜0.01). According to surgical methods, 5-year survival of WE, WE/END and WE/TLND were 80%, 80% and 39%. Conclusions：An excision with 2 cm margin is safe procedure for primary tumor of malignant melanoma of the head and neck. Neck dissection may not be practiced until neck lymph node is positive. Neck dissections differ from the positions of the primary tumors, and the flaps must be raised preferably superficial to the platysma.

Objective:To research expression and function of c-myc gene in hyperacute r ejection of xenotransplantation. 　　Method:Through the model of hyperacute rejection of xenotransplantation wit h isolated rat heart perfused with human plasma,we detected c-myc mRNA expressi on and cell localization with in situ hybridization in hyperacute rejection. 　　Result:c-myc mRNA increased expression in the endothelium cell of heart.Th e value of signal is 450.09±409.99.The value of signal of group of control is 1 74.40±51.50(p＜0.05)。 　　Conclusion:From these study findings,it would appear that hyperacute rejecti on is associated with the elevation of c-myc mRNA expression.

Objective To investigate the effect of parental presence on the anxiety of children during induction of anesthesia with sevoflurane. Methods One hundred and twenty children (ASA Ⅰ or Ⅱ ) aged 2-12 yr weighing 12-32 kg were assigned to one of 2 groups using a random number table ( n = 60 each): control group (group C) and parental presence group (group P). Preoperatiave visit was made the day before surgery in both groups. In group P a parent played with toys with the children for 15 min before induction of anesthesia, while in group C a nurse played with them. Anesthesia was induced with 8% sevoflurane in O2 delivered at 6 L/min through a scented face mask held by the parent or anesthesiologist talking with them in soft words. Modified Yale preoperative anxiety scale (mYPAS) was used to measure anxiety of the children during preoperative visit, before and during induction of anesthesia. Induction compliance checklist (ICC) was used to measure behavioral compliance during induction. ICC score ＞ 5 implied failure of induction of anesthesia with sevoflurane. Adverse events were recorded. Results The mYPAS scores were significantly lower before and during induction of anesthesia in group P than in group C (P ＜ 0.05), but there was no significant difference in ICC scores between the 2 groups ( P ＞0.05). There was no failure of induction in group P while in group C there were 3 failures. Cough occurred in 2 patients in group P but in 3 patients in group C. One patient vomited during induction of anesthesia in group C.Conclusion Parental presence is effective in reducing anxiety of children during induction of anesthesia.

Tumor suppressor CYLD is a deubiquitination enzyme that could regulate NF-?B and JNK signal pathways by deubiquitinating TRAFs,NEMO,Bcl-3 and p53,and in turn regulating the cell cycle and apoptosis.Loss or deficiency of CYLD would lead to the development of skin tumor,including multiple familial trichoepithelioma(MFT),familial cylindromatosis(FC),Brooke-Spiegler syndrome(BSS).Cancers like uterine cervix,kidney,and colon and hepatocellular carcinoma are related to the down-regulation of CYLD.

Objective　To investigate the biological significance of p185 and p16 in breast cancer. Methods　Immunohistochemical S-P method was used to detect the expression of p185 and p16 proteins in 59 breast carcinomas，and their relations to clinicopathologic features were analyzed. Results　The positive rates of p185 and p16 were 47% and 34% respectively. No significant association was evident between the two proteins. There was also no significant relation between p16 expression and clinicopathologic features. p185 positive rate was 64% in the group of lymph-node involvement that was higher than that being 32% lymph-node negative one (P<0.05). Conclusion　p185 and p16 may play important roles independently in the development of breast cancer through different pathways. p185 detection is of important value in breast cancer.

Objective To investigate the possibility and accuracy of idenfication of the sentinel lymph node(SLN) in breast cancer(BC) by using methylene blue intra operatively.Methods 4～6ml methylene blue dye was injected around the breast mass intra operatively. 5～10 minutes after injection,the operation for BC was performed. All blue stained lymph nodes found during operation were considered as SLN, and removed for pathological examination. All patients had axillary lymphadenectomy(ALDN),and the acquired nonsentinel lymph nodes(NSLN)from them were also examined. Results The SLN were identified in 45 of 50 patients(90.0%).There were all 117 SLNs in this series. Of 117 SLNs,111 were located in stage I lymph nodes in axilla(95.0%),and 6 SLNs in stage II(5.0%). Of the 5 cases of the unidentified SLN,the primary tumor was located in the inferior quadrant in 4 cases,and in the uper quadrant in 1 case (P0.05). Histologic status of the SLNs accurately predicted axillary nodes status with an accuracy rate of 91.0%. 4 cases or SLN examination were negative while their NSLN were positive with false negative rate 8.9%. Conclusions This technique can identify SLN accurately;the histology of SLN can predict axillary status correctly. Sentinel lymph node has correlation with the location of the primary tumor but has no correlation with the size of the tumor or breast operation before.

Objective To Study the clinical characteristics of the :sick sinus syndrome,(SSS) in elderly patients.Methods The disease onset age and causes, natural course and symptoms,dynamic electrocardiography(DCG) and cardiac pacing occasion were reviewed and analyzed. in 50 elderly patients had the diagnosis of SSS.Results The morbidity of SSS had increased significantly in elderly men over 70 years. The ordinary causes were coronary heart disease (CHD),specific SSS and the hypertensive heart disease,cardiomyopathy; and degenerative valvular heart disease etc.The mean natural course were about 10 years.The course of DCG type III was the longest one and the type IV was the shortest. The early symptoms were palpitation, dizzy and weakness,and the late symptoms were transient amaurosis, syncope and the worse cardiac angina and heart failure .The cardiac pacing was predicated by the clinical symptom's severity, which was determinated by both of the severity of bradycardia or sinus arrest and the patient's ability of compensation and adaptation.DCG was the commonly used diagnostic method for SSS in elderly patients.Conclusions The SSS has high incidence in elderly men over 70 and is caused by kinds of deasese,such as CHD and specific SSS,etc.The course is frequently intermittent,hide and very long the disease course. The early symptoms and DCG are atypical. The late symptoms commonly are transient amaurosis and syncope .and the late DCG has four types.The cardiac pacing was predicated by the clinical symptom's severity and DCG was the commonly used to diagnose SSS in elderly patients.