Objective To study the influence of body mass index on ambulatory venous pressure of chronic venous insufficiency of lower extremity.Methods One hundred and two consecutive patients with chronic venous insufficiency of lower extremity were enrolled in this study.Ambulatory venous pressure and body mass index were assessed and compared.Normal body weight group had 28 cases,over weight group had 43 cases,obesity group had 31 cases.Resets The complication of pigmentation,eczema,skin sclerosis and ulcer were more in obesity group and over weight group than those in normal body weight group.The resting pressure (P0) in obesity group,over weight group and normal body weight group were (118.0 ± 11.5),(113.0 ± 9.7),(101.0 ± 10.6) mm Hg (1 mm Hg =0.133 kPa),the pressure after unclamp 4 s (4SP)were (75.00 ± 2.99),(71.00 ± 3.01),(65.00 ± 2.17) mm Hg,the percentage of decreased pressure(pd)were (35.0 ± 5.4)％,(39.0 ± 4.3)％,(43.0 ± 5.1)％,the time of P0 recovered 50％ (RT50) were(7 ± 1),(9 ± 2),(12 ± 3) s.The P0 and 4SP in obesity group,over weight group were significantly higher than those in normal body weight group (P ＜0.05).The Pd,RT50 in obesity group,over weight group were significantly lower than those in normal body weight group (P＜0.05).Conclusion With the increasing of body mass index,the chronic venous insufficiency of lower extremity is more severity.

Objective To evaluate the preliminary mechanisms of endovenous laser treatment (EVLT) for lower extremity varicose vein.Methods Laser energy was endovenously administered to observe its biological effects on greater saphenous vein (GSV) segments with different conditions.Some great saphenous vein that was surgically removed after EVLT was examined by means of histopathology.Cruor status was tested after EVLT.Results Histopathologic examination found the vein wall treated by EVLT showed reddening,carbonization,or even perforation,denudation of the intima,loss of cellular contours,and fibrin deposition.Additionally,some areas showed marked vacuolization of cells or even spongiosis,swelling and waxy homogenization of collagen,focal coagulation necrosis within the intima.In saline-filled veins,EVLT-induced vessel wall injury was confined to the site of direct laser impact.In contrast,blood-filled veins exhibited thermal damage in more remote areas including the vein wall opposite to the laser impact.D-dimer was significantly changed after EVLT.Conclusions EVLT laser induced indirect local heat injury of the inner vein wall by steam bubbles originating from boiling blood is proposed as the pathophysiological mechanism of action of EVLT.Intravascular blood plays a key role for homogeneously distributed thermal damage of the inner vein wall during EVLT.No significant difference could be detected between the two laser wavelengths.Continuous emission mode is better than pulse emission mode.

Retrievable vena cava filters can be used to prevent pulmonary embolism. The advantage of the retrievable vena cava filters is that they can either be removed or be remained in the vena cava permanently if needed. This article describes the current status of retrievable vena cava filters including indications, outcomes, patient management, time of filter removal, and the management of thrombus in the filter.

Objective To assess the level of soluble Fas (sFas) and soluble Fas ligand (sFasL) in the sera of patients with systemic lupus erythematosus (SLE),rheumatoid arthritis (RA),multiple sclerosis (MS)and insulin dependent diabetes mellitus (IDDM).Method The level of sFas and sFasL was determined by a sandwich enzyme linked immunosorbent assay.Anti ssDNA (single stranded DNA) was detected by indirect enzyme linked immunosorbent assay.Results The level of sFas in patients with SLE,RA,IDDM and MS was significantly higher than that in healthy individuals.It was interesting that among these autoimmune diseases,the level of sFas in the sera of patients with SLE was dramatically higher than that of the other diseases.The high level of sFasL accompanied by sFas was found in the sera of SLE and RA patients.In the sera of patients with SLE,the anti ssDNA antibody always accompanied by high concentration of sFas and,by contrast,no anti ssDNA antibody was found in all the patients in whose sera no sFas was found.In patients with IDDM,the sFasL level of the serum was significantly lower than that of the serum of healthy donors.Conclusion Serum sFas level of patients with SLE,RA,MS and IDDM is higher than that of healthy individuals.These results indicate that the sFas level can be used as a marker of disease progress and relaxing after treatment with the medicine.It is also demonstrated that there is relationship between the level of anti ssDNA antibody and sFas.The level and significance of serum sFas and sFasL in these autoimmune disease patients are under investigation.

Background and purpose:Life expectancy has continuously improved in recently years with the development of medical level. In 2012, the amount of people who were above 60 years old has reached 810 million and account for 11% of worldwide population. The worldwide population shift towards older ages will inevitably lead to more elderly patients being diagnosed with non-small cell lung cancer (NSCLC). It still remains controversial whether sublobar resection is effective in such cases. In order to solve this question, we need to understand the clinical characteristics of these tumors. Methods:From 2006 to 2012, a total of 310 patients with NSCLC who were above 65 years old underwent surgical resection in Department of Thoracic Surgery, the First Afifliated Hospital of China Medical University and the Second Department of Thoracic Surgical Oncology, Jilin Province Tumor Hospital. The clinical data were retrospectively analyzed in sex, stage, histology, smoking status, smoking amount, drinking status, surgical approaches, multimodality therapy and overall survival. Survival was analyzed by Kaplan–Meier method and log-rank test. Results:There were 256 (82.6%) elderly patients who underwent standard lobectomies and 54 (17.4%) patients who underwent sublobar resections. The overall 5-year survival rate was 52.9%. Patients with different surgical approaches (lobectomy and sublobar resection) had nearly the same 5-year survival rates (60.5%vs 60.8%, P=0.381). The prognosis were signiifcantly inlfuenced by gender (P=0.024), stage of disease (P=0.028), smoking status (P=0.034) and smoking amount (P=0.028). The multivariate Cox proportional hazards analysis revealed that the smoking status was associated with the hazard ratio of 1.660 (1.058-2.606;P=0.028). Conclusion:In elderly NSCLC patients, sublobar resection is considered to be an appropriate treatment in comparison with lobectomy, as this procedure provides an equivalent long-term survival. The survival of elderly patients with lung cancer is closely related to the smoking status.

Objective To investigate the antimicrobial resistance of Haemophilus influenzae in Peking Union Medical College Hospital for rational clinical treatment.Methods A total of 223 strains of H .influenzae were collected from patients from Jan-uary 2008 to December 2011.The antimicrobial susceptibility was tested by Kirby-Bauer method.Production of beta-lactamase was detected using nitrocefin disks.WHONET 5.6 software was used to analyze the data of susceptibility testing.Results Tri-methoprim-sulfamethoxazole and tetracycline were the two antimicrobial agents to which the H .influenzae strains were most resistant.Theβ-lactamase positive ampicillin resistant strains accounted for 15.9 %,andβ-lactamase negative ampicillin resist-ant strains accounted for 8.9%.Conclusions H .influenzae is mainly isolated from respiratory specimens.Majority of the anti-microbial agents still show good antibacterial activity against H .influenzae strains.However,H .influenzae isolates are highly resistant to trimethoprim-sulfamethoxazole and tetracycline.

Objective To explore the clinical diagnosis and treatment of multiple organ failure(MOF)in obstetrics.Methods 17 cases of MOF in obstetrics were studied retrospectively.Results Postpartum hemorrhage,severe regnancy-induced hypertension syndrome(PIH),amniotic fluid embolism,and placental abruption were the major factors leading to MOF from the 17 cases.The blood coagulation dysfunction and the renal failure were the most common organ dysfunction.8 cases died and the fatality rate was 47.06%.Conclusion The key to lowering the fatality rate of MOF is to prevent and treat the primary diseases,diagnose and treat blood coagulation dysfunction and renal failure early.

Objective To study the role of serum chemokines and their receptors in the pathogenesis of atopic dermatitis(AD).Methods Serum levels of interferon ?-inducible protein-10(IP-10),stromal cell-derived factor-1? (SDF-1?),eotaxin,thymus and activation-regulated chemokine(TARC) as well as macrophage-derived chemokine (MDC) were detected by enzyme-linked immunosor bent assay(ELISA) in 39 patients with AD and 39 normal controls.Meanwhile,chem okine receptors CXCR3,CXCR4,CCR3,CCR4 and CCR5 on peripheral blood CD4+T-lymp hocytes were analyzed by flow cytometry with a two-color immunofluorescent sta ining in 39 patients with AD.Results Serum levels of SDF-1?,TARC and MDC we re significantly higher(P 0.05) between the patients[(123.6 ? 110.4) pg/mL a nd (68.7 ? 26.2) pg/mL,respectively]and controls [(100.7 ? 73.7) pg/mL and(66.8 ? 20.5) pg/mL,respectively].The expression of CXCR3,CCR3,CCR4 and CCR5 o n CD4+T cells was increased (P

[Objective] To screen an optimal method for the extraction of volatile oil from Naokangling Capsule (NC) and processing techniques of ?-cyclodextrin (?-CD) inclusion compound of NC. [Methods] The study was carried out with orthogonal design . Oil-extraction ratio, oil-bearing rate and inclusion rate of ?-CD inclusion compound of NC were used as indexes. [Results] The optimal process for oil extraction was adding 10-fold water in medicinal materials and then soaking for one hour and distilling for 5 hours. The optimal processing conditions for ?-CD inclusion compound of NC were: the proportion of ?-CD and volatile oil being 6:1, the inclusion compound being stirred for 2 hours at 40℃ . [Conclusion] This method is simple and practical and can increase the stability of preprations. It can be used for the production of ?-CD inclusion compound in a large scale.

OBJECTIVE To investigate the characteristics and antibiotics resistance of nosocomial infection caused by Stenotrophomonas maltophilia after open-heart operation.METHODS The clinical data of 324 patients with microbiologically documented nosocomial infection from Jan 2004 to Dec 2006 were retrospectively analyzed.RESULTS There were 34 infected cases caused by S.maltophilia,and accounted for 10.5% of all infections during the same period.All infected patients had serious original heart diseases,and received previous glucocorticoids and broad-spectrum antibiotic therapy.Thirty patients prolonged mechanical ventilation time for over 2 weeks.Results of susceptibility test showed that trimethoprim-sulfamethoxazole,ticarcillin-clavulanic acid and levofloxacin were the most active antibiotics,followed by ceftazidime and ciprofloxacin.S.maltophilia presented high resistantce to carbopenems and aminoglycoside antibiotics.CONCLUSIONS Nosocomial S.maltophilia infection is associated with the severity of preoperative underlying heart diseases,prolonged mechanical ventilation and longer period of broad-spectrum antibiotic therapy,especially carbopenems antibiotics.