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.

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 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.

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.

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 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.