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.

Purpose To explore the relationship of Tei index and the concentration of plasma brain natriuretic peptide (BNP) in patients with dilated cardiomyopathy. Materials and Methods Fifty healthy individuals (control group) and fifty dilated cardiomyopathy patients (study group) were recruited in this study. BNP level was measured by enzyme-linked immunosorbent assay (ELISA). Color Doppler echocardiography were performed to measure the cardiac indices including left ventricular end-diastolic dimension (LVEDd), left ventricular end-systolic diameter (LVESd), interventricular septal thickness at diastole (IVSd), left ventricular ejection fraction (LVEF). Tei index was then calculated. The indices between the two groups were compared and correlation of Tei index and BNP with cardiac indices was analyzed. Results LVEDd, LVESd, Tei index, and BNP were significantly higher in study group than those in control group (t=14.4, 23.4, 21.9 and 22.3, P<0.01). IVSd and LVEF were significant lower in the study group (t=12.4 and 12.5, P<0.01). BNP was negatively correlated with LVEF (r= -0.266, P<0.05), and positively correlated with Tei index and LVEDd (r=0.401 and 0.326, P<0.05). Tei index was negatively correlated with LVEF and E/A (r= -0.480 and - 0.241, P<0.05), and positively correlated with LVEDd (r=0.375, P<0.05). Multiple stepwise regression analysis showed that the variates of BNP stepwise regression equation were Tei index, LVEF and LVEDd (t=5.984, -2.477 and 2.326, P<0.05); after correcting LVEF, the stepwise regression analysis showed closer relationship between Tei index and BNP (t=2.728, P<0.05). Conclusion There is correlation between Tei index and BNP. Tei index may be a good index for accurately estimating global ventricular function.

Objective To evaluate the impact of donor age on graft short-term outcome after right lobe adult living donor liver transplantation (LDLT).Method Thirty living recipients were divided into 2 groups according to donor age:older donor group (O group,donor age ＞50,n =5) and younger donor group (Y group,donor age ＜30,n =25).Alanine transarninase (ALT),aspartate transaminase (AST),total bilirubin (TB),prothrombin time (PT) on the postoperative day 1 to 5 and graft liver regenerative ratio (LRR) on the postoperative month 0.5,1,3,and 6 between 2 groups were determined and compared.Result TB on postoperative day 1,2,3,4 and 5 was significantly higher in O group than in Y group there were significant differences between two groups (P＜0.01).There was no significant difference of other liver function parameters 2 groups (P ＞ 0.05).There was no significant difference in LRRs on the postoperative month 0.5,1,3 and 6 months postoperatively between 2 groups after LDLT (P＞0.05).Conclusion Although allografts from older donors in LDLT have prolonged jaundice than those of their younger counterparts,after strictly preoperative evaluation,donor age has little effect on short-term outcomes of graft after 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 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 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 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.

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.