Objective To study effects of hepatic microcirculation and hepatic function using low dose HSS40 preoperation on the partial hepatectomy patients.Methods Sixty-five partial hepatectomy patients were randomly divided into study group (32 cases with HSS40,4 mL/kg,in 30 min) and control group (33 cases with RL,4 mL/kg,in 30 min).Patients of two groups were monitored in liver microcirculation,hepatic function parameters at different times before and after the infusion.Results Compared with the study group,the control group were more infusion (2400 ± 1650) mL and blood transfusion (550 ± 190) mL,the differences were statistically significant (P ＜0.05).Control group of nitric oxide (NO) T3 time(17.84 ± 6.26) μmol/L in the preexpansion compared with preoperative T0 time(38.06 ± 9.34) μmol/L and the study groupT3 time (36.37 ± 9.15) μmol/L was significantly decreased (P ＜ 0.05),and endothelin (ET) (T3 time 185.16 ± 41.34 pg/mL) was significantly higher (P ＜ 0.05),and the study group(T3 time 99.75 ± 30.31 pg/mL) than the control group variation amplitude,time later,the difference was statistically significant (P ＜ 0.05) ; Control group ALT,AST,DBLI,TBLI rise after preexpansion (P ＜ 0.05),and significantly higher than the study group (P ＜ 0.01),and the study group than the control group variation amplitude,time later,differences were statistically significant (P ＜ 0.05) ; while no significant changes in the concentration ALB two groups,the difference was not statistically significant difference (P ＞ 0.05).Conclusion Using low dose HSS40 preoperation on the partial hepatectomy patients can improve cardiovascular stability,protective effect on ischemia-reperfusion injury of liver,can increase the tissue perfusion,and improve the hepatic microcirculation,better able to maintain the stability of the liver function.

In recent years, there's a new theory of lipid condensation or accumulation being the etiology for obstruction of qi in the chest result in heart disease. The theory believes that thick lipid exists in meridians. If one takes too much fatty diet, there will be lipid condensation or accumulation, resulting in disturbance of qi transformation in meridians,. Scholars explore the relationship of preventive treatment of disease by traditional Chinese medicine with lipid condensation or accumulation theory. This enriches the etiology of TCM.

At present PLA and its copolymer is a kind of most widely used biodegradable polymers to prepare microspheres because of its good biocompatibility. The double emulsion method is the most used technique for microspheres loade with water-soluble drugs, proteins and peptides. Microspheres with different particle size or release character could be used in different applications such as targeted drug delivery or long-acting drug delivery. The characters of microspheres are influenced by the preparative parameter. This article reviewed the preparative parameters that influence the character of microspheres.

0.05), which were lower than that with manual compression. The failure rates were 8.3% and 9.2% respectively, but the vascular complications were less than 1%. Hematoma and femoral artery infection were seen in the PCI group, but happened less compared with manual compression. The removing of the arterial sheaths will not be limited by the anticoagulation and antiplatelet therapies, and it could be performed immediately after CAG and PCI, making hemostasis more easy to archeive. It could also reduce the burden of the medical staff, and be accepted by the patients. Conclusion Femoral arterial closure following PCI using regular and intensive anticoagulation and antiplatelet therapies could be safe and effective with vascular complication rates similar to or lower than with manual pressure.

Purpose　To investigate whether thoracotomy can induce lung injury in the operative side and the protection by ambroxol in this procedure.　Methods　24 patients with esophageal carcinoma who were performed esophagectomy with anastomosis over the arcus aortae were randomized into 2 groups:an ambroxol group (ambroxol 1 g iv gtt qd×3,preoperatively) and a controlled group without any respiratory medication.General anesthesia by tracheo-cannula combined with continuous epidual anesthesia were used in all the patients.Bilateral broncho-alveolar lavage(BAL) was carried out after intubation preoperatively and before removal of the cannula postoperatively.Total Phospholipid(TPL),Saturated Phosphaytidylcholine(SatPC) and Total protein(TP) in the BALF were measured.The ratio of SatPC/TPL and SatPC/TP represented the activity of PS.　Results　In the controlled group,SatPC/TPL and SatPC/TP of the left lung(operation side) showed significant difference(P<0.05),compared with the right side(non-operation side).In the ambroxol group,no significant difference of such ratio was showed.　Conclusions　Thoracotomy can induce lung injury and bring out the decrease of PS and increase of protein exudation in the operative side.Large dose of ambroxol can promote in synthesize and secretion of PS and protect those changes.

BACKGROUND: Coronary angiography is called "the golden standard" for the diagnosis of coronary heart disease (CAD). Foreshortening of vessel segments in angiographic projection images usually caused by the inappropriate projection angles or positions may lead to misdiagnosis or missed diagnosis.OBJECTIVE: To investigate the optimal angiographic views of main coronary artery and its branches in different somatotype or heart type patients and to investigate the specific relationships between the optimal angiographic views and the different somatotypes and heart types with computer-assisted techniques.DESIGN: A controlled observation.SETTING: Department of Cardiology, the Second Affiliated Hospital of Nanchang University.PARTICIPANTS: Altogether 1 369 patients were admitted to the Second Affiliated Hospital of Nanchang University to undergo coronary angiography from January 2001 to December 2006 and recruited for this study. Written informed consents of coronary angiography were obtained from all the patients. The protocol was approved by the Medical Ethics Committee of Medical College of Nanchang University.METHODS: All 1 369 inpatients were assigned into 3 groups by body mass index (BMI): fat somatotype group (n =489, BMI: 26-31 kg/m2, transverse heart type), general somatotype group (n =502, BMI: 23-25 kg/m2, general heart type), and thin somatotype group (n =378, BMI: 17-22 kg/m2 vertical heart type). In each group, all arteries including left main coronary artery (LM), proximal segment of the anterior descending coronary artery (LAD), distal-mid segment of LAD, proximal segment of circumflex branch (LCX), distal-mid segment of LCX, proximal-mid and distal segments of right coronary artery (RCA) were properly and carefully analyzed using Compart software, and then we got its optimal angiographic viewing angle. Finally, we arranged these data and induced whether different somatotype group patients have different optimal angiographic viewing angles specifically for some coronary artery or not.MAIN OUTCOME MEASURES: Optimal angiographic viewing angles.RESULTS: All 1369 patients participated in the final analysis. Optimal angiographic viewing angle for LM: left anterior oblique (LAO)(40±5)°/ caudal (CAU)(25±5)° or right left anterior oblique (RAO) 25°/CAU35°. In the fat somatotype group, the angle should be added 10° to its optimal angle, and in the thin somatotype group, the angle should be decreased by 10°, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for proximal segment of LAD: RAO (50±8)°/ cranial (CRA)(23±8)°. In the fat somatotype group, the optimal angle should be added 10°, but in the thin somatotype group, it should be decreased by 10°. The differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significant (all P < 0.05). Optimal angiographic viewing angle for distal-mid segment of LAD: RAO (40±5)°/CRA (45±5)° or LAO (11±5)°/CRA (45±5)°. Optimal angiographic viewing angle for proximal segment of LCX: LAO (45±5)°/CAU (35±5)° or anteroposterior (AP)/CAU36°. Optimal angiographic viewing angle for distal-mid segmental of LCX: LAO (45±5)°/CAU (35±5)° or RAO (6±4)°/CAU (30±5)°. Optimal angiographic viewing angle for proximal-mid segment of RCA: LAO (35±5)°/CAU (14±5)° or LAO (48±5)°/CRA (15±5)°. For the thin or fat somatotype group, the optimal LAO angle should be increased by 15°, the optimal RAO angle should be decreased by10° for fat somatotype group and should be increased by 10° for thin somatotype group, and the differences between the general somatotype group and the fat somatotype group or the thin somatotype group were statistically significantly (P < 0.05). Optimal angiographic viewing angle for distal segment of RCA: LAO (53±5)°/CAU (17±5)°.CONCLUSION: The message can be got clearly about the whole coronary artery and the accuracy percentage of stenosis by changing angiographic viewing angle regularly to its own optimal angle in different somatotype or heart type patients. It's very important for making the choice of diagnosis and therapy

Objective To evaluate the role of phosphatase and tensin homolog deleted on ehromo-some ten (PTEN) protein in sevoflurane postconditioning-induced mitigation of focal cerebral ischemia-reperfusion (I/R) injury via activating PI3K/Akt pathway in rats.Methods One hundred and eight Sprague-Dawley rats,aged 2-3 months,weighing 250-280 g,were randomly assigned into 6 groups (n =18 each) using a random number table:sham operation group (group S),group I/R,I/R + sevoflurane postconditioning group (group I/R + S),I/R + normal saline group (group I/R + NS),I/R + selective PTEN inhibitor pic group (group I/R + P),and I/R + pic + sevofluraue postconditioning group (group I/R + P+ S).Focal cerebral I/R was induced by right middle cerebral artery occlusion (MCAO).The animals were anesthetized with intraperitoneal chloral hydrate.In I/R + P and I/R + P + S group,pic 20 μg/100 g (0.4 ml/100 g) was injected intraperitoneally every 3 h for 4 times before MCAO,and the equal volume of normal saline was given instead of pic in I/R + NS group.The rats in all sevoflurane postconditioning groups inhaled 2.5 ％ sevoflurane for 30 min starting from the onset of reperfusion,and the rats in the other groups inhaled oxygen for 30 min instead.At 24 h of reperfusion,neurological deficit scores (NDSs) were measured and the rats were then sacrificed.Their brains were removed for determination of infarct size (by TTC),cell apoptosis (by TUNEL),and expression of phosphorylated PTEN (p-PTEN) protein and phosphorylated Akt (p-Akt) (by Western blot).Apoptosis index was calculated.Results Compared with S group,the NDSs,percentage of cerebral infarct size and apoptosis index were significantly increased,and the expression of p-Akt and p-PTEN protein was up-regulated in the other 5 groups.Compared with I/R and I/R + NS groups,the NDSs,percentage of cerebral infarct size and apoptosis index were significantly decreased,and the expression of p-Akt and p-PTEN protein was up-regulated in I/R + S,I/R + P and I/R + P + S groups.There were no significant changes in the parameters mentioned above between I/R + S,I/R + P and I/R + P + S groups,and between I/R and I/R + NS groups.Conclusion Sevoflurane postconditioning can activate PI3K/Akt pathway via inhibiting PTEN protein,thus mitigating focal cerebral I/R injury in rats.

Objective To observe the effects of endobronchial decimeter wave therapy on ventilation func-tion of patients with the constrictive endobronehial tuberculosis (EBTB). Methods Forty-four EBTB patients weredivided into an experiment group and a control group. All the patients of the two groups were treated with generalchemotherapy, the patients of experiment group accepted endobronehial decimeter wave therapy at the same time. Thepurulent secretion or caseous necrosis of the diseased region was drawn-off from the bronchi lumina by bronchoseope,then the antenna of the decimeter wave irradiator was inserted into the diseased region through the biopsy pore to per-form the radiation. The vital capacity, forced expiratory volume in the 1st second and maximal voluntary ventilationwere tested before and 60 days after the operation. Results Endobronehial decimeter wave therapy significantly re-duced the constriction of bronchi, improved the lung ventilation function, and relieved the anhelation symptom of pa-tients in the experiment group to a significantly larger extent than those in the controls group (P< 0. 01 ). Moreover,the therapeutic effects of endobronchial decimeter wave therapy were more significant for the endomembrane tuberculo-sis with pulmonary closure due to ulcerous necrosis or granulation hyperplasy ( P < 0. 05 ) , but ineffective for the atro-phy due to fibrous constriction. Conclusion Endobronchial decimeter wave therapy could reduce the incidence oflung closure in endomembrane tuberculosis and improve lung function.

Objective To explore the effect of CYP2C19 polymorphism on plasma minimum concentration of Voriconazole in children with hematological malignancies complicated with invasive fungal infection.Methods Twenty children with hematological malignancies complicated with invasive fungal infection were selected from the Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University were selected,and 5 mL venous blood for each was extracted.CYP2C19 genotypes of the whole blood of all patients were detected by using the method of polymerase chain-reaction restriction -fragment length polymorphism(PCR -RFLP).All the patients were treated with Voriconazole at the same time and by the same way.Plasma concentration of Voriconazole was measured by the method of fluo rescence polarization immunoassay.The impact of CYP2C19 genotypes on plasma minimum concentration of voriconazole was analyzed by using the rank sum test.Results Typing results showed that the incidence of iuhomozygous extensive me-tabolizers (EM)genotype (CYP2C19* 1 /*1 )was 30%(6 /20 cases);the incidence of mixed sub extensive metaboli-zers (IM)genotype (CYP2C19*1 /*2 or CYP2C19*1 /*3)was 45%(9/20 cases),among which ,CYP2C19*1 /*2 was in 4 cases,CYP2C1 9*1 /*3 was in 5 cases;and that of poor metabolizer (PM)genotype (CYP2C1 9*2 /*2 or CYP2C1 9*2 /*3 or CYP2C1 9*3 /*3)was 25%(5 /20 cases),among which,CYP2C1 9*2 /*2 was in 3 cases, CYP2C1 9*2 /*3 was in 1 case,and CYP2C1 9*3 /*3 was in 1 case.The serum trough concentration of Voriconazole in EMgroup,IMgroup and PMgroup was(2.30 ±0.50)mg/L,(3.23 ±0.71 )mg/L,(4.84 ±0.29)mg/L,respec-tively.There was a statistically significant relationship between CYP2C19 genotype and plasma minimum concentration of Voriconazole (F =26.99,P =0.032).Conclusions CYP2C19 polymorphism has a significant effect on the mini-mum concentration of Voriconazole in children with hematological malignancies complicated with invasive fungal infec-tion,which indicates that administration of Voriconazole for clinical treatment should be based on individual CYP2C19 genotype.

OBJECTIVE To explore a management method for the prevention and control of infectious diseases in hospital. METHODS We applied the PDCA (plan,do,check and action) model to establish a management strategy for the prevention and control of infectious diseases for three years. The components of the management model included providing educational program for medical staff,designing and realizing direct network system for infectious disease reporting,monitoring diagnosed infectious diseases ,analyzing their epidemic tendency,guiding medical staff to prevent and control infectious diseases,and strengthening the surveillance,feedback,rewards and punishment. RESULTS The rate of delayed or missed report of infectious diseases was decreased from 5% to 1.1% by monthly check and from 6.8% to 0% by seasonally cross check. Although 46 cases of AIDS,5 cases of caesarean birth with HIV possitive and 1445 cases of hand-foot-mouth disease were admitted in our hospital,No medical staff and other patients was crossly infected. CONCLUSIONS Our way of management based on PDCA model can strengthen the prevention and control of infectious diseases and assure medical quality and patient safety.