Objective:To evaluate the prognosis of acute peripheral arterial embolization.Methods:From Jan 1990 to Jun 2002,117 cases with 149 times of embolization were analyzed retrospectively to determine the distribution,amputation rate and mortality of arterial embolization.Logistic regression was employed to define the role of site,the extent and range of ischemia,ischemic time,treatment modality,with or without atherosclerosis,and recurrent onset on amputation rate of extremities.Results:Approximately 87% of embolization occurred in lower limbs,that occuring in internal organ was about 2% and upper extremities 10%.Among 117 cases,the mortality was 11.9%,amputation rate 7.8% and limb salvage 92.2%.Conclusion:Underlying heart disease and embolization of internal principal organ are the leading causes of death.Single embolectomy and anti-coagulation therapy are the mainstay of treatment for acute embolization.The major prognosis of limbs depended on the extent and range of ischemia and secondary treatment.

Objective To probe the essential aspect and its counter measure in training clinical medical postgraduate students.Methods Based on the review of recently publish papers related and teaching practice for years,the standpoint is put on the need of students in their long-term career after receiving degree.Results Medical ethics and medical information education should be the key point in the teaching plan.Teaching the students in accordance with their apti-tude should be based on their long-term need and the supervisors should be glad for and skilful at education.To put more cost of scientific research to students is in keeping with the China’s na-tional policy of invigorating the country through science and technology.Writing clinical case reports ought to be encouraged.Conclusion The noble medical ethics is the motivation force of gaining consummate medical skill.Up-to-date medical information and skill are the necessary capability in getting new knowledge and bringing forth new ideas.Writing case reports is to keep with the reality of students and may deepen the results of clinical observation and accumulate more data on typical case as well as give the bases to further research.

Based on both domestic and abroad research results concerning the local therapeutic efficacy, influence factors, survival time and prognosis of radiofrequency ablation (RFA) in treating recurrent hepatocellular carcinoma (HCC), this paper aims to make a review of medical literatures about RFA treatment of recurrent HCC that were published in Chinese and in English during the period from 2005 to 2014, and to analyze the related factors that may influence the local therapeutic efficacy and survival rate. The results indicate that the recurrent tumor size, tumor number, recurrence interval, serum alpha fetoprotein (AFP) level, serum prothrombin, etc. are important factors that will affect the therapeutic efficacy of recurrent HCC. At the same time, the results point out that the study of imaging predictors can help suggest the different recurrent types, which is very useful in making individualized follow-up strategy and in monitoring tumor recurrence. Local treatment, with RFA being the main method, together with comprehensive therapies, including other new technologies and new drugs, will improve the current clinical situation in treating recurrent HCC.

Objective: To investigate the effects of immunotherapy on PRA, TGF-β and CD4+CD25+Foxp3+ nTreg cells in women with unexplained recurrent spontaneous abortion. Methods:We detect the level of PRA,TGF-βin serum and the expression of nTreg cells in peripheral blood of pregnant, non pregnant and natural fertility women by enzyme immunoassay and flow cytometry. Results:After immunotherapy,the median level of PRA and TGF-βin non pregnant group was lower than that in pregnant group(27. 5%,107. 7 pg/L vs 68. 75%,189. 9 pg/L,P<0. 01). Compared to pregnant group,the median expression rate of nTreg cells were lower in non pregnant group(5. 05% vs 8. 05%,P<0. 01). Conclusion:The PRA,TGF-βand nTreg cells are critical factors for pregnancy in RSA patients. It is helpful to identify and judge the effect of immunotherapy by detect the level of panel reactive antibodies,TGF-β in serum and the expression rate of nTreg cells in peripheral blood.

Vascular bypass grafting is the most common procedure for ischemic heart disease and peripheral vascular disease. Although synthetic grafts have been developed, replacement of vessels with purely synthetic polymeric conduits often leads to the failure of such graft, especially in the grafts less than 6 mm in diameter, mainly due to the early formation of thrombosis, infection and so on. Tissue engineering is a relatively new discipline that offers the potential to create vascular grafts from autologous cells and biodegradable polymer scaffolds. It has become a promising approach for generating a biocompatible vessel graft and contributing to the long-term patency rate of small-caliber grafts. This review describes the major progress in the tissue engineering vascular grafts, including the seeding cell sources, the biodegradable scaffolds, the construction technologies of tissue-engineered vessels, as well as nanotechnology.

BACKGROUND:White blood cells involved in the inflammatory response play an important role in deep vein thrombosis.E-selectin mediates the initial process of white blood cell and vascular endothelial cell attachment during inflammation.OBJECTIVE:To investigate the relationship between deep venous thrombosis(DVT) and plasma E-selectin.DESIGN,TIME AND SETTING:Completely random design and linear correlation analysis were performed at Department of Vascular Surgery,First Affiliated Hospital of Chongqing Medical University and Clinical Diagnostic Laboratory of Chongqing Medical University from September to December 2007.PARTICIPANTS:Twenty-seven cases of deep vein thrombosis,16 males and 11 females with an average age of(57 ? 15) years,were selected,who attacked within 3 days or with aggregated condition.METHODS:Blood samples were obtained at the admission of the patients.After 72 hours,a second specimen was obtained,defined by thrombolysis and anticoagulant therapy.Determination of plasma E-selectin by ELISA and the blood coagulation abilities and platelet count of the 1st blood samples were performed,including part-time activation thromboplastin,prothrombin time,and plasma fibrinogen.MAIN OUTCOME MEASURES:E-selectin levels before and after treatment,blood coagulation abilities before treatment,platelet determination and E-selectin related analysis.RESULTS:No acute pulmonary embolism occurred in 27 cases of deep vein thrombosis during the treatment.One case underwent routine Forgart of thrombectomy catheter,and of the other 26 cases,15 were significantly improved,and 11 were not improved after 72 hours.Plasma E-selectin levels significantly decreased after thrombolysis,anticoagulant therapy in deep vein thrombosis patients with clinical remission(P = 0.001),but the plasma E-selectin levels were increased in those with no remission(P = 0.003).E-selectin levels and platelet count of deep vein thrombosis in patients before treatment showed no correlation(r =-0.113,P = 0.576),and were not related to fibrinogen content(r =-0.050,P = 0.802),or part-time activation thromboplastin(r=-0.046,P=0.822),and prothrombin time(r=-0.080,P=0.690).CONCLUSION:Plasma E-selectin levels are positively related to deep vein thrombosis severity.

Objective To construct a logistic regression model about the patients' age and transrectal ultrasound characteristics combined with serum PSA level and to predict prostate cancer.Methods 424 clinical data of patients with prostate disease in our hospital from January 2011 to January 2014 were retrospectively analyzed,the patients' age ,transrectal ultrasound pathological findings and biopsy findings in patients were used to establish a logistic regression model.Results Compared to patients with prostate cancer by age segment,>70 years of age or PSA levels in patients was significantly higher than in patients with other age groups;prostate cancer patients and patients with non-cancerous prostate disease were significant differences in the comparison of the various PSA levels (P<0.05);shape of two groups of patients with prostate,prostate boundaries,both inside and outside the boundaries gland,prostate and seminal vesicles separation line clarity,prostate and rectum separation line definition,lymph node metastasis, abnormal blood flow signals and weak echo comparison with a statistically significant difference between two groups(P<0.05 ),whereas no significant difference between nodules and uneven echo two factors (P>0.05 );transrectal ultrasonographic combined age and PSA prostate cancer diagnosis sensitivity of 65.01% and a specificity of 92.73% and accuracy was 83.46%,81.89% positive predictive value,negative predictive value 83.95%. Conclusion Age and characteristics of patients with rectal ultrasound combined with serum PSA level logistic regression model to predict the results of the prostate is better,and should be introduced.

Objective:To provide ideas for the participation of clinical pharmacists in clinical individualized medication.Methods:Clinical pharmacists participated in the clinical consultation for one senior patient with acute cholangitis treated with biapenem.Results:The consultation comments and suggestions proposed by clinical pharmacists were accepted by clinics,which played an important role in assisting doctors in the rational drug use and significantly improved the medical treatment.Conclusion:Clinical pharmacists should participate in individualized medication and help clinicians optimize drug therapy,which can improve the safety and efficacy of medication.

Objective To retrospectively analyze the risk factors of recurrent groin hernia. Methods Data came from all hernia repairs recorded in our hospital between 1991 and 2001. A total of 1 082 cases of groin hernia was analyzed through Cox proportional hazard model to determine the relative risks between recurrence and mode of admission, types of groin hernia, repair methods (traditional/tension free hernioplasty), and post operative complications.Results From 1991 to 2001,1 082 groin hernia operations were performed in our hospital, 88.9% for primary hernia and 11.2% for recurrent hernia. As compared with traditional hernia repair methods, Lichtenstein’s tension free hernioplasty technique had less relative risk for recurrent hernia repair than that for primary hernia repair. Postoperative complications and indirect hernia were linked to an increased relative risk for recurrence. Conclusion There are many factors affecting the recurrence of inguinal hernia, but the use of tension free hernia repair may decrease re recurrence of recurrent hernia.

Objective To review experimental study and clinical application of materials to bile duct repair and reconstruction.Methods Comparison of different materials was made between advantages and disadvantages.Results Synthetic grafts such as vitallium,teflon are easy to handle,but have no flexion,and have foreign body reaction.Although autogenous free tissues such as venous patch and peritonium are resistant to infection,they are likley to lead to bile duct stricture because of lacking adeuqate blood supply.Vascularized neibouring tissues for repearing bile duct defect have satisfactory results.Conclusions To avoid bile duct striccture,vary measures should be taken to repair bile duct defecs;for segmental loss of bile duct,end to end anastomosis or Roux-en-Y biliary jejunal reconstruction should be applied.