AIM To establish an animal experimental model for study on prevention of cisplatin toxicity and explore the possible mechanisms of the toxicity induced by cisplatin administration. METHODS Cisplatin was administered i.p consecutively for five days to male mice weighted from 28 to 30 g. The toxic effects induced by different doses of cisplatin on hearing, liver and kidney were determined. RESULTS Dose dependent decrease of body weight, abnormality of kidney and liver coefficients, levels of BUN and activities of ALT in serum were induced by cisplatin administration. Furthermore, Levels of GSH, activities of GSH Px and SOD increased significantly in kidney. Reversely, levels of GSH, activities of GSH Px and SOD in liver decreased and levels of LPO increased significantly in animals given cisplatin compared with those in control animals. CONCLUSION Obvious damage on hearing, liver and kidney of mice could be induced after consecutively 5 days administration of cisplatin with doses range from 3 0 to 4 0 mg?kg -1 (body weight). Oxidative damage is one of the mechanisms of these toxic effects on liver and kidney induced by cisplatin. But for different organs or at different stages of cisplatin administration, the main mechanism may be different.

Objective: To investigate the clinical effect of Huangqishengmai Oral Solution for Viral myocarditis. Methods: 128 patients in the therapeutic group were treated with Huangqishengmai Oral Solution. 72 patients in the control group were treated with routine treatment. The changes of heart rate, heart function, electrocar-diogram ST-T, arrhythmia, SOD and MDA before and after treatment were observed. Results: (a) The heart rates of both groups slowed down after treatment, and there were obvious differences in various markers of heart function between before and after treatment. (b) ST-T change of patients in the therapeutic group was obvious. The effective rate of the therapeutic group was higher than that of the control group. (c) SOD level of patients in the therapeutical group rised. MDA level decreased. (d) No obvious difference in treating arrhythmia was observed between two groups. Conclusion: Huangqishengmai Oral Solution is effective for viral myocarditis and should be widely applied in clinic.

Stroke is the disease which caused by many risk factors.The relationship between insulin resistance(IR) and young adult stroke is one of the focuses now in the neurological field.IR refered to the series of pathological and physiological changes,it happens when the response of the target tissue organ to insulin is depressing or losing.There are many ways of detection of IR,the insulin sensitivity index(ISI) is one of the most satisfied indexes to reflect the sensitivity to insulin.IR could cause a series of pathological and physiological changes,which caused hyperinsulinemia,hyperglycemia,hyperpiesia,blood-fat derangement,fibrinolytic system anomaly,blood vessel endothelium change,artherosclerosis,et al,maybe in ways of many metabolic risk factors.Atherosclerosis is the main etiopathogenisis factor in young adult stroke,as a conclusion,IR is also existed in young adult stroke.But,does IR exist in all types of young adult stroke? What is the mechanism? Is the level of IR related with the pathogenetic condition and prognosis? These questions are still not clear at present,and the study on the relationship between IR and young adult stroke is important to prevent young adult stroke.

Objective To investigate the usage of oral cardio-cerebrovascular Chinese patent medicine in Tiantan Community Health Service Center of Beijing (hereinafter referred to as “the centre”) during 2010-2015. Methods Varieties, dosage and sales amount of oral cardio-cerebrovascula Chinese patent medicine during 2010-2015 were analyzed through hospital information system database of the centre. DDDs, DDC and B/A values were calculated. Results Oral cardio-cerebrovascular Chinese patent medicine accounted for 23.67% of all kinds of medicine during 2010-2015. The average annual growth rate of the amount of sales was 11.96%, accounting for 48.73% of total sales. DDDs showed an upward trend over six years, including DDDs of Compound Danshen Dirpping Pills ranking the first. DDC and B/A also showed the daily cost of most of oral cardio-cerebrovascular Chinese patent medicine was less than 10 yuan. B/A value was approximately equal to 1, indicating that these kinds of medicine had better synchronization, and high frequency of usage. Oral cardio-cerebrovascular Chinese patent medicine dominated in all kinds of Chinese patent medicine during 2010-2015, which was related to the reason that most patients were old people. The frequentness during 2010-2015 in the centre did not changed much, and the structure was relatively stable. Conclusion The usage of oral cardio-cerebrovascular Chinese patent medicine in the center is reasonable, with some problems, which need to be further supervised.

Objective To study the changes and significance of plasma atrial natriuretic peptide (ANP),endothehn-1 (ET-1),von Willebrand factor (vWF) levels in newborns with persistent pulmonary hypertension (PPHN) after the treatment of sildenafil.Methods Sixty-six cases with PPHN group and 40 cases with non-PPHN (control group) were enrolled.PPHN group was in the treatment of sildenafil.Collected the blood when before the treatment of sildenafil and 3,7 d after treatment,respectively.Arterial blood gas were done and pulmonary arterial systolic pressure (PASP) was measured before treatment and 3,7 d after treatment,and by the same time recording pulse oxygen saturation (SpO2).Plasma ANP,ET-1,vWF levels were measured by ELISA method.Results The levels of PASP,SpO2 arterial partial pressure of oxygen (PaO2),arterial partial pressure of carbon dioxide (PaCO2) and plasma ANP,ET-1,vWF in PPHN group before treatment [(66.5 ± 13.4)mm Hg (1 mm Hg =0.133 kPa),0.726 ±0.531,(46.3 ±7.2)mm Hg,(59.2 ± 7.4) mm Hg,(272.6 ± 20.3)ng/L,(221.3 ± 24.3) ng/L,(142.5 ± 20.3)％] compared with controlgroup [(25.0±6.2) mm Hg,0.896 ± 0.767,(88.3 ±7.6) mm Hg,(41.1 ±6.1) mm Hg,(68.4 ± 7.9) ng/L,(39.8 ± 6.5) ng/L,(95.3 ± 18.5)％] were statistically significant(P ＜ 0.05).Their levels in PPHN group 3 dafter treatment[(48.3 ± 3.2) mm Hg,0.841 ± 0.416,(73.6 ± 9.3)mm Hg,(50.5 ± 7.2) mm Hg,(102.6 ±20.3) ng/L,(79.6 ± 15.2) ng/L,(103.6 ± 14.1)％] were significantly improved,there was significantdifference compared with before treatment and control group(P ＜ 0.05).Their levels in PPHN group 7 d aftertreatment [(25.2 ± 3.6) mm Hg,0.882 ± 0.724,(85.4 ± 7.4) mm Hg,(40.2 ± 6.4) mm Hg,(64.4 ± 3.6)ng/L,(37.3 ± 5.4)ng/L,(92.9 ± 11.7)％] were significantly improved,there was significant difference compared with 3 d after treatment (P ＜ 0.05),the difference was no statistically significant compared with control group (P＞ 0.05).Linear correlation analysis showed that ANP,ET-1,vWF and PASP,PaCO2 were significantly positively correlated (P ＜ 0.01),ANP,ET-1,vWF and SpO2,PaO2 were significantly negatively correlated (P＜ 0.01).On the basis of cardiac ultrasound monitoring PASP,ANP evaluation of the efficacy of sildenafil sensitivity was 82.2％,specificity was 83.4％ ;ET-1 was 86.4％ and 87.6％; vWF was 85.1％ and 84.7％.Conclusion ANP,ET-1,vWF may play an important role in the mechanism of the treatment of PPHN by sildenafil,and could be used as an objective index to evaluate the effect of sildenafil on PPHN.

Objective To evaluate the effect of pepliteal artery endovascular angioplasty for the treatment of diabetic foot. Methods 65 cases (69 limbs) of diabetic foot were treated by long bloon endovascular angioplasty. Results No death occured. 60 cases (64 limbs) were successfully treated and 5 cases (5 limbs) failed. The imme-diately success rate was 92.75%. The pain relieved, the temperature was improved and the ankle brachial index (ABI) was up to 0.84±0.11. Anterior tibial artery or posterior tibial artery of 39 limbs could be touched. 21 limbs were cured by debride and change dressings. 10 limbs were cured after the gangrene was ablated. 6 limbs were cured after the gangrene was debrided. 22 limbs were cured after toe amputation. Half of the foot was amputated. No limb was amputated. Every month was further consulted by Doppler and the rate of follow upwas 100%. 6 limbs of 6 cases were reobliterated (1,1,2,2 cases occurred after 1,6,12,18 month respectively.) and treated by endovascular an-gioplasty again. Conclusion Endovascular angioplasty below the knees for the treatment of diabetic foot is an effec-tive method for the limbs saving, with minimal invasive, safety, less complication and retreatment. It can be used as a first choice for the artery obliteration of diabetic foots.

Objective To explore the visinin-like protein-1 (VILIP-1) levels in the blood in the Alzheimer disease (AD) and mild cognitive impairment (MCI) due to AD patients,and also to explore its feasibility as a biomarker for the early diagnosis of AD and for the detection of progression of AD.Methods Fifty-eighty participants were included:20 cases for AD group,19 cases for MCI due to AD group,19 cases for normal control group.The level of VILIP-1 was tested by the ELISA method.Results The level of VILIP-1 in AD group was significantly higher than that in normal control group and MCI due to AD group:(9.0 ± 2.9) ng/L vs.(3.3 ± 1.7) and (6.5 ± 3.1) ng/L,and that in MCI due to AD group was significantly higher than that in normal group,there were statistical differences (P ＜ 0.01).The MMSE score in AD group was significantly lower than that in normal group and MCI due to AD group:(15 ± 3) scores vs.(27 ± 2) and (23 ± 2) scores,and that in MCI due to AD group was significantly lower than that in normal group,there were statistical differences (P ＜ 0.01).The level of VILIP-1 was negatively correlated with MMSE score (r =0.463,P ＜ 0.01),but positively correlated with age (r =0.417,P =0.01).Conclusions With the progression of the disease,the cognitive impairment of the AD patient is decreasing.VILIP-1 increased in the blood of the patients of AD and MCI due to AD.It means that the blood VILIP-1 could be a new and potential biomarker for the early diagnosis of AD,and it may be clinical useful for the early diagnosis and effective detection of AD to some extent.

Objective To compare the two kinds of purification method for purifying recombinant human cardiac troponin I(cT-nI)to obtain the stable cTnI and promote the study of cTnI diagnosis standardization.Methods The cTnI inclusion body was ob-tained by the ultrasonic broken engineering,after washing by 2% Tritonx-100,2M urea,dissolved in 8M urea,then purified by the column refolding on CM-FF and the dilution refolding respectively.The cTnI yields were compared between the two kinds of meth-od and the stability at 4 ℃,20 ℃,-80 ℃ and on the freeze-dried condition was compared.Then the purification method to effi-ciently obtain the stable cTnI was established.Results The protein about 2 mg and 1.4 mg could be obtained by CM-FF on the col-umn refolding and the dilution refolding from 0.1 g of wet inclusion body,respectively.The former method had the short cycle and high efficiency.The cTnI purified by the column refolding on CM-FF was more stable at 4 ℃,20 ℃,-80 ℃ and on the freeze-dried condition.Conclusion The column refolding on CM-FF is more stable and highly efficient in purification of cTnI than the dilution refolding.

Objective To analyze the clinical features of recurrent acute pancreatitis (RAP).Methods The clinical data of patients diagnosed as RAP were collected in Changhai Hospital, the Second Military Medical University between January 2016 to July 2016, and chronic pancreatitis(CP) patients and RAP patients to matching, as control group.A prospective cohort study about the clinical features of RAP and CP was set.The survival analysis model was established by Kaplan-Meier′s method, to calculate the cumulative rate of RAP which progressed into CP.Results The morbidity of male patients was 69.0% in the RAP group(n=100) and 60% in the CP group(n=100).The average first onset age of RAP and CP was 38 and 21 years old, respectively;and the teenagers accounted for 12% and 38.6%.The incidence of diabetes was 49.5% and 9%;and the incidence of fatty diarrhea was 46.6% and 19% of the two groups.The cumulative incidence of CP was 2% within 1 year, 4.6% in 3 years, and 12.4% in 5 years.Conclusions Men has higher morbidity in both RAP group and CP group.RAP patients′ first onset age was older than that of CP.Teenagers had a low incidence in RAP group.The risk of diabetes and fatty diarrhea was lower in RAP group than CP group.A certain proportion of RAP patients can progress to CP.

OBJECTIVETo evaluate the feasibility and the short-term safety of self-pulling and latter transected esophagojejunostomy(SPLT) in totally laparoscopic total gastrectomy (TLTG).

METHODSOne hundred patients with gastric cancer received TLTG-SPLT at General Surgery Department of Huashan Hospital (Fudan University) from June 2014 to January 2017(SPLT group). The clinicopathologic characteristics, surgical and postoperative outcomes were collected retrospectively and compared with the conventional group undergoing TLTG plus overlap or functional end-to-end anastomosis from October 2013 to December 2015. D2 lymph node dissection was regularly performed for all the patients. In SPLT group, a sterile hemp rope was held to ligate and drag down the esophagus to maintain "self-pulling" after the duodenum was transected by the first stapler, allowing the detachment of the posterior mediastinum. Then a hole 2-3 cm above the ligature rope was made on the right-posterior wall of the esophagus. When the mesenteric tension was checked, another hole was made at the anti-mesenteric border of the jejunum 20 cm distal to the ligament of Treitz. A side-to-side esophagojejunostomy (E-J) was then performed between the right-posterior wall of esophagus and the anti-mesenteric wall of the jejunum with the second linear stapler, forming an entry hole. The "latter transection" was applied with the third stapler inserted from the assistant's Trocar, which facilitated the esophagus and the afferent loop jejunum to be simultaneously transected above the level of the entry hole. After that, a side-to-side jejunojejunostomy(J-J) with another 2 staplers was carried out between the afferent loop stump and the Roux limb 40 cm below E-J, in which the E-J entry hole could also work as the entrance for the stapler. The TLTG-SPLT was therefore completed and the specimen was removed through the incision from the umbilical Trocar site.

RESULTSThere were 66 male and 34 female patients in the SPLT group with median age of 64 years. The clinicopathologic baseline data of two groups were comparable(all P>0.05). All the patients underwent operations successfully, and none was converted to open surgery. No positive margin was found in either group. Mean operation duration was (178.2±35.9) minute in SPLT group, including (22.9±7.1) minute of reconstruction, which both were significantly shorter than those in conventional group [(204.4±55.8) minute, P=0.003; (30.5±7.2) minute, P=0.000]. Less blood loss [(74.3±72.5) ml vs. (104.2±71.6) ml, P=0.017] and earlier time to the first flatus [(1.9±1.6) days vs. (2.7±1.3) days, P=0.001] were observed in SPLT group. There were no significant differences in postoperative hospital stay and pathological findings between the two groups(all P>0.05). Postoperative operation-associated complications were found in 7 cases of SPLT group. Of these 7 patients, 1 case developed gastrointestinal bleeding, 3 pancreatic leakage, 2 chyle leakage, who all were discovered within postoperative 1 week and were cured by conservative treatment, while the other 1 case developed anastomotic fistula complicated with peritoneal infection who received laparoscopic exploration and peritoneal scavenge and drainage, then discharged 34 days later. Six patients in conventional group developed postoperative operation-associated complications, including 1 case of anastomotic bleeding, 3 cases of pancreatic leakage, 1 case of chyle leakage and 1 case of peritoneal infection. Morbidity of postoperative operation-associated complication was not significantly different between two groups [7.0%(7/100) vs. 11.5%(6/52), χ=0.414, P=0.520]. Fifty patients from two groups underwent endoscopic examination at postoperative 6-month and 12-month, and no obvious anastomotic stenosis and esophageal reflux were observed.

CONCLUSIONSPLT is a safe procedure with feasibibility in intracorporeal esophagojejunostomy.