Objective To evaluate the clinical value of serum high density lipoprotein cholesterol (HDL-C)in the evaluation of synthetic function of the patients with liver diseases.Methods Abbott Aeroset automatic biochemical analyzer was used to detect serum HDL-C level in control group (30 cases) and liver disease group(87 cases).T test was used to analyze the differences of serum HDL-C level in liver disease group and control group,different liver disease groups and control group,and different liver disease groups.Results HDL-C level was (1.28 ±0.20)mmol/L in the control group,(0.77 ± 0.15)mmol/L in the liver disease group,and (0.81 ± 0.13)mmol/L in the hepatitis group,(0.68 ± 0.14)mmol/L in the liver cirrhosis group,(0.54 ± 0.05)mmol/L in the liver cancer group.The HDL-C level in liver disease group and hepatitis group,liver cirrhosis group,liver cancer group was significantly lower than that in the control group(t =15.5569,14.2463,45.4393,25.6344,all P ＜ 0.01).The HDL-C level in liver cirrhosis group and liver cancer group was significantly lower than that in hepatitis group (t =3.6583,16.9057,all P ＜ 0.01).The HDL-C level in liver cancer group was significantly lower than that in liver cirrhosis group(t =4.4103,P ＜ 0.01).Conclusion Serum HDL-C level can be used to evaluate synthetic function of the liver,the lower of serum HDL-C level,the more serious liver synthesis function is impaired.

Objective: To investigate the chemical consituents from the active fraction in the roots and rhizomes of Cynanchum paniculatum with reversal activity of multidrug resistance. Methods: The active fraction was evaluated for reversing activities toward three human drug-resistance cell lines to clininally common used anticancer chemotherapeutic drugs. The compounds were isolated and purified by chromatography on ODS and preparative HPLC. Their structures were elucidated on the basis of chemical and spectroscopic methods, including MS, 1D, and 2D NMR spectral techniques. Results: The active fraction exhibited the significant effects in sensitization of human drug-resistance on gastric carcinoma cell line SGC-7901/VCR and human drug-resistance on colonic carcinoma cell line HCT-8/VCR to fluorouracil (5-FU). Nine compounds were isolated and identified as hancogenin B 3-O-β-D- oleandropyranoside (1), 3β,14-dihydroxy-14β-pregn-5-en-20-one (2), neocynapanogenin F (3), glaucogenin A (4), glaucogenin C (5), neocynapanogenin F 3-O-β-D-oleandropyranoside (6), glaucogenin C 3-O-β-D-thevetoside (7), glaucogenin A 3-O-β-D- oleandropyranoside (8), and 20-hydroxypregna-4,6-dien-3-one (9). Conclusion: Compound 1 is a new steroidal saponin named paniculatumoside D. C21 Steroids isolated from the active fraction in the roots and rhizomes of C. paniculatum have the potential value as multidrug resistance reversing agents.

BACKGROUND: Some studies have revealed that plasma levels of D-dimer and fibrinogen are closely related to blood coagulation status before any occurrence of cardiovascular disease and cerebrovascular disease.OBJECTIVE: To investigate the difference in plasma levels of D-dimer and fibrinogen, two markers of prethrombosis, between elderly patients with cardiovascular or cerebral vascular disease and elderly and younger healthy persons.DESIGN: Case analysis based on patients.SETTING: Cadre ward of a military general hospital of Chinese PLA.PARTICIPANTS: From October 2000 to March 2002, 153 patients with cardiovascular disease and 116 patients with cerebral vascular disease, aging over 60 years, hospitalized in the Second Cadre Ward of the General Hospital of Shenyang Military Area Command of Chinese PLA were selected into this study. Meanwhile, healthy persons with normal results of physical examination conducted in this hospital were selected as controls. Of all the control persons,68 with an age less than 60 years were allocated into the younger control group and the other 98 persons were allocated into the elderly control group.METHODS: On the second day after hospitalization, a venous blood sample was taken from each patient. For those receiving medications of aspirin, their venous blood samples were taken on the 4th day after withdrawal. The plasmas of the samples were measured by using STA Compact, a fully automatic coagulation analyzer(Diagnostica Stago) and the auxiliary kit. The level of D-dimer was detected by employing the immunoturbidimetry assay(ITA) And the concentration of fibrinogen was measured by using the magnetic bead technologies.MAIN OUTCOME MEASURES: The plasma levels of D-dimer and fibrinogen were detected in each group.RESULTS: All the 435 participants entered the statistical analysis procedure. The plasma levels of D-dimer and fibrinogen of elderly control group [(0.91 ±0.51) mg/L and (3.69±1.25) g/L] were significantly higher than those of the younger control group[0.48 ± 0. 15) mg/L and(3.12±0.76) g/L] (t=2.39-2.66, P ＜ 0.05) .The plasma levels of D-dimer and fibrinogen of the elderly cardiovascular group [ (1.35 ± 0. 72) mg/L and(4. 16 ± 1.30) mg/L] and the elderly cerebral vascular group [(1.16±0.98) mg/L and(4.05±1.98) g/L]were significantly higher, as compared with the elder control group and the younger control group( t = 4.23-5.41, P ＜ 0.01 ).CONCLUSION: Compared to the younger control group, the plasma levels of D-dimer and fibrinogen of elderly population increase significantly, especially in those with cardiovascular disease or cerebral vascular disease.

BACKGROUND: Hyperlipemia is one of the important risk factors of coronary atherosclerotic cardiopathy. Great attention has been paid on how to explain the correlation between blood lipid and coronary heart disease and the correlation of characteristics and level of blood lipid with coronary heart disease.OBJECTIVE: To probe into the correlation among the characteristics, the level of blood lipid and coronary heart disease in senile people.DESIGN: Case-control observation and stratified analysis.SETTING: Second Cadre Ward of General Hospital of Shenyang Military Area Command of Chinese PLA.PARTICIPANTS: Totally 105 inpatients were selected in coronary heart disease group, diagnosed as coronary heart disease, tallied with WHO Diagnostic Standard on Coronary Heart Diseases, in Second Cadre Ward of General Hospital of Shenyang Military Area Command of Chinese PLA from January 2001 to January 2002. Totally 99 inpatients, by checked, without coronary heart disease and cerebral vascular disorder were selected in the control in the same period.METHODS: 2 mL venous blood was collected in fasting in the morning and the serum was collected after centrifuged at 3 000 r/minute, for 5 minutes. Auto-biochemical analyzer and enzyme kit were used to determine cholesterol, triglycerin, high density lipoprotein cholesterol and low density lipoprotein cholesterol. Compared with the data in the control, the ranges of cholesterol, triglycerin and low density lipoprotein were calculated successively and divided by 10; at the class intervals of 0.53, 0. 39 and 0.29 mmonl/L, the frequency table was worked out. According to the frequency table, P25 (the 25th percentile), P50 (the 50th percentile), P75 (the 75th percentile) and P90 (the 90th percentile) of cholesterol, triglycerin and low density lipoprotein cholesterol were calculated successively. The stratified groups were divided based on P ＜ 25, P25 to PS0, PS0 to P75, P75 to P90 and ＞ P90, by which, the cases belonging to 5 groups were determined in coronary heart disease group and the control respectively. The exposure factor was determined by ＞ P90, compared with other 4 groups, Menta-Haensecel method was used to calculate x2. If the exposure factor was related with coronary heart disease, the relevant coefficient and 95% confidence interval should be calculated. In accordance with the standards (Proposal on Prevention of Abnormal Blood Lipid and Targets of Abnormal Blood lipid on 2-grade Prevention of Coronary Heart Disease), the cases beyond the targets and morbidity were determined in two groups.MAIN OUTCOME MEASURES: Determination of blood lipid, abnormal cases and morbidity in two groups; cases beyond targets of blood lipid and morbidity; stratified comparisons of percentiles in two groups.RESULTS: According to intention measurement, 204 cases entered result and the control, there was no significant difference in cholesterol, triglycerin cases presented hypercholesterolemia, 34.3% cases hypertriglycerlipidemia and 11. 4% cases low density lipoprotein-hypercholesterolemia. It was indicated that the blood lipid was in the normal range among 64. 8% to 88.6% comparison between the cases with cholesterol ≥5.47 mmonl/L and the cases with cholesterol varied from 3.85 to 4.63 mmol/L, the morbidity of coronary heart disease in the former was 2.98 times as high as the latter (x2 = 6.29, 95% confidence interval was 1.27 -6.98) . In the comparison between the cases with cholesterol ≥ 5.47 mmol/L and the cases with cholesterol varied from 4.64 to 5.05 mmol/L, the correlation with coronary Lipid for 2nd Prevention of Coronary Heart Disease, among the patients with coronary heart disease, cholesterol ≥ 4.68 mmonl/L in 54. 2% cases,triglycerin ≥ 1.70 mmol/L in 34. 3% cases and low density lipoprotein ≥ 2.6 mmol/L in 52. 3% cases.CONCLUSION: For senile patients with coronary heart disease, the satisfactory level of cholesterol is 3.85- 4.63 mmol/L. For those with cholesterol ≥ 5.47 mmol/L, compared with those varied from 3.85 to 4.63 mmol/L, the morbidity of coronary heart disease in the former is possibly 2.98 times as same as the latter(x2 = 6.29, 95% confidence interval was 1.27 - 6.98).

Objective To evaluate donor remnant liver regeneration and influencing factors at different stages after right lobe adult living donor liver transplantation (LDLT) using multi-slice spiral computed tomography (MSCT).Methods 68 living donors were included in this study,We did CT volumetric measurement of the liver by using IQQA-Liver workstation.Liver regenerative ratio (LRR) at different stages of donors after LDLT were calculated and compared,correlation coefficient and stepwise regression analysis were calculated.Results The difference between LRRs at different stages after LDLT were significant (F =3.323,P =0.009),there were significant difference between LRR of 7-day and 1-month,3-month (respectively t =-2.065,-2.214,all P ＜ 0.05).The inclusion of middle hepatic vein and donor gender had no influence on LRR (respectively t =0.600,-0.622,1.464,0.926,-1.228,0.624,-0.688,0.131,all P ＞ 0.05).There were negative correlation between the remnant liver volume and LRRs (P ＜ 0.05).Conclusions MSCT is a valid modality to evaluate remnant liver regeneration after LDLT.Most evident remnant liver regeneration occurs in early stage after adult LDLT.

Objective To evaluate the impact of donor age on early remnant liver function and regeneration after right lobe adult living donor liver transplantation (LDLT) donation.Methods 43 living donors were divided into 2 groups:donor age ＞ 50,n =8,and donor age ＜ 30,n =35.Alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TB) and liver regenerative ratio (LRR) of donors between the 2 groups were compared.Results There were no significantly different in ALT,AST and TB on days 1,2,3,5 after LDLT between the 2 groups (respectively t =0.147,1.030,-0.903,0.013,0.043,1.362,0.817,0.003,1.121,0.241,1.061 and 0.943,all P＞0.05).There was significant difference between LRR on day 7 (t =-0.965,P =0.042),but the difference was not statistically significant in LRR when evaluated on day 15 after LDLT (t =0.585,P =0.385).Conclusions Remnant liver regeneration on the first week is reversely affected by donor's age after hepatectomy,while the influence of age decreases significantly after 2 weeks.

Objective To evaluate and compare liver regeneration between normal donors and recipients at the different stages after right lobe adult living donor liver transplantation (LDLT) using MSCT.Method Sixty-eight living donors and 63 recipients without complications were included in this study.We did CT volumetric measurement of the liver by using IQQA-Liver workstation.The relationship between graft volume measured by preoperative MSCT and intraoperative actual graft volume was evaluated.The liver regenerative ratio at different stages of donors and recipients after LDLT was calculated and compared.Result Preoperative measurement of total liver and grafts resulted in a mean volume of (1366.99 ± 234.75) cm3 (standard deviation) and (862.73 175.94) cm3 (VCT-right),respectively.Intraoperative volume of the grafts was (654.46 ± 151.23) ml (Vintraop).Corresponding pre-and intraoperative data were correlated significantly each other (r =0.795,P=0.000).Vintraop can be calculated with the equation:Vintraop =64.949 + 0.683 VCT-right.There was significantly difference in LRR between donors and recipients at 0.5,1,3 and 6 months after LDLT (P＜ 0.05).Conclusion The patterns of normal liver regeneration between donors and recipients after LDLT are different.The liver of donors regenerates more significantly and quickly than recipients.Liver volumetric measurement by using MSCT is a valid modality to evaluate liver regeneration after LDLT.

Objective To investigate the application of transthoracic echocardiography (TTE) and 320-row CT in diagnosis of complex congenital heart disease(CCHD).Methods A retrospective analysis was performed in 68 patients with CCHD,which contained the echocardiographic apprarance,320-row CT and surgical outcoming.All of malformations were divided into three groups:intracardiac group,heart-large vascular connecting group and extracardiac group.Results One hundred and eighty-four malformations were comfirmed by surgery in the 68 cases.The misdiagnosis and missed diagnosis rate of CT and TTE:for the intracardiac anomalies were 12％ (11/93),1％ (1/93) respectively (P ＜ 0.05),for the heart-large vascular connecting malformation were 4％ (2/49),6％ (3/49) respectively (P ＞ 0.05),and for the extracardiac anomalies were 2％(1/42),19％(8/42) respectively (P ＜0.05),for the total anomalies were 8％(14/184),7％ (12/184) respectively (P ＞0.05).While it was 1％ (2/184) in diagnosis of total anomalies by both CT and TTE.Conclusions Both 320-row CT and TTE have their own advantages and shortcomings in the diagnosis of CCHD.Joint application of two methods could reduce the rate of misdiagnosis and missed diagnosis of CCHD.

Objective To evaluate graft regeneration and influencing factors after right lobe adult living donor liver transplantation (LDLT) using MSCT.Method Sixty-three living recipients were included in this study.We measured graft volume periodically by using MSCT and IQQA-Liver workstation.The liver regenerative ratio (LRR) of different stages of recipients after LDLT was calculated and compared,and stepwise regression analysis was done to set up the regression equation.Result Within 0.5 month after LDLT,graft volume was increased rapidly,and LRR reached maximum [(106.11 + 30.90)％],then decreased slowly.There was significant difference in LRR among 0.5,1 month and 3,6 months after LDLT (P＜0.05).The following factors,including whether the graft containing middle hepatic vein or not,age and sex of recipients,had no significant influence on LRR after LDLT (P＞0.05).The status of liver function of recipients preoperatively had significant influence on LRR 0.5 month after LDLT (P＜0.05).There was significantly negative correlation between the graft volume and LRRs of recipients at different stages after LDLT (P ＜ 0.05).Regression equation could be derived.Conclusion Most evident graft regeneration occurs in early stage after adult LDLT.There are many and different factors influencing graft regeneration at the different stages after LDLT.Graft volumetric measurement by using MSCT is a valid modality to evaluate graft regeneration after LDLT.

Objective To investigate the application of prenatal ultrasonograpy in diagnosis of fetal heart disease during the medium-term and terminal pregnancy,and to avoid misdiagnosis.Methods The prenatal ultrasonographic screening was conducted in 7020 pregnant women with medium-term and terminal pregnancy.All confirmed and suspicious cases of fetal heart disease were observed by echocardiography once 4 weeks until postnatal sixth month to 1 year while normal cases was traced at the intervals of 8 weeks.All the cases were confirmed by autopsy or surgery while part of them were confirmed by postnatal angiocardiography before surgery.The reasons of misdiagnosis were analyzed.Results In fifty-three cases of fetal cardiovascular abnormality,43 cases were found,2 cases were misdiagnosis while 8 cases were missed diagnosis.2 cases of misdiagnosis included 1 case of pulmonary valve stenosis and 1 case of tetralogy of Fallot.8 cases of miss diagnosis included 2 cases of inferior vena cava in ectopic drainage and 6 cases of ventricular septal defect (defect diameter ＜ 5 mm).The accuracy rate of diagnosis of fetal heart disease was 81.1 ％ by echocardiography.Conclusions Using high frequency probe,image zoom,enhancing the detection of vein-atrium connection and the structure of right ventricular outflow with pulmonary artery are important factors to avoid missed diagnosis and incomplete diagnosis.