OBJECTIVE: To observe the effect of Wenxin granules on heart function of patients with chronic congestive heart failure (CHF). METHODS: 82 CHF patients were randomly divided into treatment group and control group (n=41). Both groups were given routine treatment(alternative use digitalis,diuretic,vasodilator, ACEI, Beta-blockers according to patient’s condition). Treatment group were additionally administered with Wenxin granules for four weeks. The symptom and improvement of heart function of two groups were compared. RESULTS: The symptom and heart function of patients in both groups were improved remarkably. Treatment group was significantly superior to control group in curative effect (P

A total of 114 cases of femoral hernia undergoing 3D Prolene patching via femoral approach were examined for duration of surgery , length of stay , recurrence , postoperative pain and complications.Among them, 53 cases received both pre-and post-operative Doppler ultrasonic examinations.The vein thrombus ,diameter and flow rate of femoral vein were observed to compare with the pre-operative data to learn whether it had difference or not.The operative duration was 13.3 minutes.There was no event of recurrence ,compression,stricture or thrombosis of femoral vein.

Objective To research the association between the prognosis of Acinetobacter baumannii infection and drug resistance among patients in the intensive care unit( ICU). Methods Eighty-four patients with Acine tobacter baumannii infection from February 2003 to April 2009 in Peking University Shenzhen Hospital ICU were retrospectively analyzed and divided into alive group(59 patients) and dead group(25 patients) by using 30-day mortality. The impact of drug resistant Acinetobacter baumannii on mortality was assessed by binary logistic regression. Results The mortality of patients with Acinetobacter baumannii infection was related to age, haematological malignancy, the Chanson Comorbidity Index, APACHEII score, multidrug-resistant Acinetobacter baumannii ( MDRAB) , carbapenem-resistant Acinetobacter baumannii (CRAB ) , septic shock and antimicrobial inappropriate therapy by univariate analysis( P < 0.05). Binary logistic regression revealed that CRAB( OR = 3. 360,95%CI: 1. 563 ～7.223,P< 0.05)and the Charison Comorbidity Index( OR = 1. 633,95% CI: 1. 201 ～2. 221 ,P <0.05) were independent risk factors. Conclusions The prognosis of Acinetobacter baumannii infection was closely correlated with drug resistance. The patients with CRAB infection had a higher mortality.

As multidrug resistance related genes and cell factors are discovered one after another,people have a more thorough understanding to the oncological mechanisms of cancer metastasis.Many evidences of the inherent link between the two tips have been found.These researches provide new ideas to further clarify the regulation mechanisms between them.It is revealed that the inherent link maybe occur on the gene expression and transcription,and with complicated regulative factors.Indepth study of the relations between cancer multidrug resistance and metastasis will help to guide the clinical treatment of tumor.

ObjectiveTo analyze the risk factors of complications after laparoscopic gastrectomy.Methods The clinical data of 76 patients who received laparoscopic gastrectomy at the Tenth Hospital of Tangji University from April 2009 to July 2011 were retrospectively analyzed.All patients were divided into complication group (13patients) and non-complication group (63 patients).Seventeen variables,including gender,age,abdominal surgery history,comorbidities (cardiovascular disease,chronic obstructive pulmonary disease,diabetes mellitus,anemia,hypoproteinemia,pyloric obstruction),palliative operation,operative data ( operation time,blood loss,method of alimentary tract reconstruction),postoperative TNM staging,vascular or nerve invasion and number of lymph nodes dissected were analyzed by using the univariate and Logistic regression analysis to screen out the risk factors of postoperative complications.All data were analyzed using the t test or chi-square test.ResultsThere were 67 patients received laparoscopic curative gastrectomy and 9 received laparoscopic palliative gastrectomy.Sixty-three patients received distal gastrectomy ( including 49 received BillrothⅠgastrectomy and 14 received Billroth Ⅱ gastrectomy) and 13 patients received total gastrectomy + Roux-en-Y esophagojejunostomy).The mean operation time,blood loss,number of lymph nodes dissected were ( 263 ± 72) minutes,( 200 ± 191 ) ml and 17 ±8,respectively.There were 25 patients in TNM stage Ⅰ,18 in stage Ⅱ,27 in stage Ⅲ and 6 in stage Ⅳ.The incidence of complications was high in the old patients,but there was no effect of gender and age on the incidence of complications ( x2 =0.68,2.32,P ＞ 0.05 ).The operation time of the complication group was longer than that of non-complication group,but no significant difference was observed ( t =1.44,P ＞ 0.05 ).Preoperative comobidities (cardiovascular disease,chronic obstructive pulmonary disease,diabetes mellitus,anemia,hypoproteinemia,pyloric obstruction),blood loss and number of lymph node disseeted were not the risk factors of postoperative complications ( x2 =3.20,0.58,0.13,0.26,0.01,0.19,t =0.15,0.83,P ＞ 0.05).The results of multivariate Logistic regression analysis showed that Billroth Ⅱ alimentary tract reconstruction,more comorbidites,and advanced TNM stage were correlated with postoperative complications ( OR =5.54,7.02,2.33,P ＜0.05 ).The accuracy rate of multivariate Logistic regression analysis was 8 i.6％.Conclusion Billroth Ⅱ alimentary tract reconstruction,more comorbidities,and advanced TNM stage are the independent risk factors of complicatioas after laparoscopic gastrectomy.

Objective To assess endothelial function before and after pharmacological cardioversion for acute onset of atrial fibrillation(AF)in the patients with hypertension.Methods 37 consecutive hypertensive patients with acute AF were investigated,in whom sinus rhythm was restored by pharmacological cardioversion within 48 hours of arrhythmia onset without anticoagulant treatment.Of these 37 patients,17 cases treated with ACEI/ARB drugs were assigned to acute AF group 1,20 cases without using ACEI/ARB drugs were assigned to acute AF group 2.20 hypertensive patients with sinus rhythm were included as control group.Plasma markers of endothelial damage/dysfunction [von Willebrand factor(vWF),endothelin(ET)and nitric oxide(NO)] and E-selectin(E-sel,an index of endothelial activation)were measured in acute AF at baseline(pre-cardioversion)and on days 1,7,14,and 30 after cardioversion.The detected results were compared with the levels of controls.Results Plasma concentrations of ET,vWF and E-sel in acute AF group were significantly higher than those of control group;plasma level of NO in acute AF group was significantly lower compared to that of control group.After cardioversion,the plasma levels of ET decreased gradually to the levels of controls by the 7th day of sustaining sinus rhythm in acute AF group 1 and 30th day in acute AF group 2,and the plasma levels of vWF decreased to approach that of controls by the 14th day post-cardioversion in acute AF group 1 and 30th day in acute AF group 2.The NO level gradually increased to that of controls by the 14th day of sustaining sinus rhythm in acute AF group 1 and 30th day in acute AF group 2.Plasma level of E-sel returned to normal by the 7th day in the both groups of acute AF.Conclusion There were evidences of endothelial damage or dysfunction at acute onset of AF among the patients with hypertension,which persisted up to 30 days after cardioversion,and the use of ACEI/ARB might improve the normalization of endothelial function after cardioversion.

Objective To observe the morphologic protection effect of intra-articular injection of osteoprotegerin (OPG)on articular cartilage in a rabbit model of osteoarthritis (OA).Methods Sixty male New Zealand rabbits were randomly divided into 3 groups:OPG group (n=20),sham-operated group (n=20) and PBS group (n=20).In OPG group and PBS group,each rabbit underwent anterior cruciate ligament transection (ACLT) in left knee joint,then 0.1 ml OPG solution or PBS were injected into the left knee for 8 weeks (5 times a week) in OPG group and PBS group,respectively.In sham-operated group,the anterior cruciate ligament was just exposed without transection,and then the incision was closed.All rabbits were sacrificed 12 weeks after operation,and the left knee joints were obtained.The Pelletier score and Mankin score were used to evaluate the macroscopic and microscopic cartilage morphology.Results The score of femoral condyle cartilage and tibial plateau cartilage was 1.80±0.89 and 1.80±0.77 in OPG group,respectively,and 3.10±0.97 and 3.20±0.77 in PBS group.However,there was no statistical difference in Pelletier score between the sham-operated group and the OPG group.Consistent with the macroscopic data,the OPG group has a significantly lower Mankin score involving cartilage structure (2.65±0.88),chondrocyte (1.35±0.71),Safranin O staining (1.83±0.83),tidemark integrity (0.30±0.47) and total score (6.13±1.97) compared with the PBS group (4.52±1.09,1.85±0.63,2.80±0.75,0.65±0.49,and 9.83±1.98,respectively).The OPG group has a significantly higher total Mankin score compared with the sham-operated group (4.80±1.25),however,there were no statistical differences in four subitem scores between the two groups.Moreover,the cartilage thickness in OPG group was 371.84±38.94 μm,255.09±74.82 μm in PBS group,and 404.68±15.97 μm in the sham-operated group,and the differences were statistically significant between three groups.Conclusion OPG has a protective effect on articular cartilage and can slow the progression of OA by reducing the grade of synovitis,decreasing the volume of osteophytes,and suppressing the loss of cartilage thickness.

Objective To compare the recent clinical efficacy between ileal neobladder and orthotopic ileal neobladder.Methods The clinical data of 62 patients with bladder cancer who were performed with cystectomy plus urinary diversion were retrospectively analyzed.Among them,32 patients were performed with orthotopic ileal neobladder(orthotopic ileal neobladder group)and 30 patients were performed with ileal neobladder(ileal neobladder group).The operation time,intraoperative bleeding,intestinal function recovery time,hospital stay,early postoperative complications were compared between two groups.Results All the patients were successful,and there was no operative deaths occurred.There was no significant difference in the postoperative intestinal function recovery time between two groups(P ＞ 0.05).The operation time,intraoperative bleeding,hospital stay in orthotopic ileal neobladder group was higher than that in ileal neobladder group [(463.59 ± 50.24)min vs.(436.07 ± 44.91)min,(1081.16 ± 320.49)ml vs.(867.53 ± 224.61)ml,(46.88 ± 4.67)d vs.(20.37 ± 5.24)d],but the incidence of early postoperative complications in orthotopic ileal neobladder group was lower than that in ileal neobladder group [25.0％(8/32)vs.53.3％(16/30)],and there were significant differences between two groups(P ＜0.05).Conclusions Two kinds of urinary diversion surgical urinary diversion are clinically more mature manner,in clinical practice.Clinicians should be based on the patient's comprehensive situation,combined with the clinical experience to select the most appropriate surgical procedures.

Objective To design and formulate a electronic preoperative preparation checklist for applying in the preoperative preparation,to reduce missing rate in preoperative preparation and transfer,to improve patient satisfaction,to avoid operation delay and medical accident caused by inappropriate preparation.Methods A total of 145 patients with surgery from March 2013 to February 2013 were as experimental group,and 158 patients with surgery from March 2012 to February 2012 were as control group.The experimental group was used electronic preoperative preparation checklist for preoperative preparation and transition,and the control group was used conventional methods.The incidence of mistake for preoperative preparation and transfer and both surgeon's and patient's satisfactory were compared between two groups.Results After applying the electronic preoperative preparation checklist,the incidence of mistake for preoperative preparation and transfer in experimental group reduced significandy to 1.37％(2/145) and 4.83％ (7/145),compared with the incidence of control group 6.33％(10/158),11.39％(18/158),and the differences between two groups were statistically different (x2=4.870,4.305,P ＜ 0.05).Both surgeon's and patient's satisfactory were improved dramatically,the satisfactory in experimental group improved to 100.00％(50/50)and 97.93％(142/145),compared with the satisfactory of control group 90.00％(45/50) and 90.51％(143/158),and the differences between two groups were statistically different(x2=5.263,7.459,P ＜ 0.05).Conclusions Implementing the electronic preoperative preparation checklist can reduce the incidence of mistake before operation and ensure patient operation schedule.Therefore,it could improve nursing care quality and efficiency.

Objective To study the effect of intra-articular injection of dehydroepiandrosterone (DHEA) on the balance of ADAMTS/TIMP-3 system in a rabbit osteoarthritis models.Methods Sixty rabbits were underwent bilateral anterior cruciate ligament transection (ACLT).Rabbits were randomizedn to the following treatment:one knee of each rabbit was treated with 100 μmol/L DHEA dissolved in dimethylsulphoxide (the experimental group) and the other knee was treated under the same schedule using dimethylsulphoxide (the control group) 4 weeks after transection,once a week for eight weeks.Twelve weeks after ACLT,all rabbits were killed after X-ray assessment and the knee joints were evaluated by gross morphology and histology.The concentration of hydroxyproline and glycosaminoglycan in the cartilage were analyzed.The mRNA expression of ADAMTS-4,ADAMTS-5,tissue inhibitor of metalloproteinases-3 (TIMP-3),transforming growth factor (TGF)-β1.Aggrecan and Collagen Ⅱ in the cartilage were analyzed using reverse transcription polymerase chain reaction (RT-PCR).The protein expression of aggrecan ARGxx and Collagen Ⅱ in the cartilage were analyzed by Western blot.Results By Mann-Whitney test,Gross morphologic scores on femoral condyle and tibial plateau in the control group were significantly higher than the experi-mental group (Z=-3.517,P＜0.01 ; Z=-2.518,P＜0.05).By unpaired Student's t test,histological evaluation showed that the grade of cartilage damage in the experimental group [(5.3±1.2) μg/ml] were less severe than that in the control group (10.1 ± 1.3,P＜0.01).The concentration of hydroxyproline [(5.7±0.3,23.6± 1.7) μg/ml] and glycosaminoglycan (30±4) in the experimental group increased significantly when compared with the control group [(4.6±0.5),(18.5±1.4),(24±4) μg/ml,P＜0.01].The mRNA expression of ADAMTS-4 (0.15±0.03)and ADAMTS-5 (0.10±0.04) in the experimental group decreased significantly compared with the control group (0.29±0.08,0.15±0.05; all P＜0.05).The mRNA expression of TIMP-3 (0.85±0.10),TGF-β1(1.2±0.4),Aggrecan (0.87±0.31) and Collagen Ⅱ (2.74±0.59) in the experimental group increased significantly when compared with the control group (0.70±0.13,0.8±0.4,0.49±0.16,2.2±0.5; all P＜0.05).The protein expression of Aggrecan ARGxx (0.53±0.10) in the experimental group decreased significantly when compared with the control group (0.81±0.12,P＜0.01).The protein expression of Collagen Ⅱ (2.3±0.7) in the experimental group increased significantly when compared with the control group (1.7±0.5,P＜0.05).Conclusion DHEA protects against cartilage degradation and inhibits the progression of OA,TGF-β1,Aggrecan and Collagen Ⅱ in cartilage may be the mechanism of the protective effect of DHEA on OA.