Objective:To design an internal jugular vein catheter protective bag and it can be applied to fix internal jugular vein catheter for patients receiving hemodialysis.Methods: To use retrospective analysis to research the different method of fixed dialysis catheter for 40 patients cured by internal jugular vein catheterization. 40 patients were randomly divided into observation group (20 patients) and control group (20 patients) depended on different fixed catheter method. To use the internal jugular vein catheter protective bag to fix dialysis catheter on the observation group; and to use conventional gauze and 3 M transparent sticking to fix dialysis catheter on control group. And then to observe the level of fixed internal jugular vein catheter, detached catheter rate and infection rate.Results: The fixed level of internal jugular vein catheter fixed of observation group was higher than control group and the difference was statistical significantly (x2=26.334,P<0.05); both of the detached catheter rate and infection rate of observation group were lower than control group and the difference also was statistical significant (x2=5.796,x2=28.540;P<0.05).Conclusion: Internal jugular vein catheter protective bag can prevent inner sticking detachment, catheter slippage and infection, therefore, it can satisfy clinical application and have got patent license for utility model. This patent is worthy to popularize and apply.

Objective　To discuss the methods of treatment of sellar region tumors by microsurgery via modified transpterional approach.Methods　The clinical data of 326 patients with sellar region tumors were retrospectively analyzed. All of the patients(of them 158 patients with pituitary adenomas, 89 patients with craniopharyngiomas and 79 patients with meningiomas)were treated by microsurgery via modified transpterional in our hospital in recent 4 years. The most important part of preoperative arrangement was giving glucocorticoid and anti-epilepsy drugs. Modified transpterional craniotomy was performed, and the tumors were removed by employing microsurgical techniques via the 5 anatomy interspaces in sellar region after the subarachnoid cisterns were dissected carefully under surgical microscope. Consciousness, urine volume and serum electrolyte of the patients were observed strictly after surgery, and the complications such as diabetes insipidus, serum electrolyte disorder and epilepsy were remedied in time.Results　The rate of intact frontal branch of facial nerve was 92.18% and that of intact supraorbital nerve was 95.72%. Atrophy of temporal muscle occurred in none of the patients. Total and/or subtotal resection of tumors was achieved in 95.26% patients and the rate of intact pituitary stalk was 62.44%. The major postoperative complications included diabetes insipidus and serum electrolyte disorder. Although the incidence of complications was high to 61.42%, complete restore was achieved in 97.12% of the patients with the complications within 1 month.Conclusion　The modified transpterional approach for sellar region tumors may give a lower incidence of damage to frontal branch of facial nerve, super-orbital nerve and temporal muscle, and it can achieve higher total resection rate and a less postoperative complications by employing modified transpterional approach and the microsurgical techniques, combined with the active treatments of postoperative complications, therefore it is deserved to be spread to use in clinical works.

Objective To investigate the methods of total resection of craniopharyngioma and treatment of postoperative complications. Methods The abscission of CPG was performed in 24 patients with craniopharyngioma (CPG) which situated at sellar region after giving glucocorticoid and anti-epilepsy drug. The tumors were removed via the 4 anatomy spaces in sellar region by employing microsurgical technique. Consciousness, urine, and serum electrolyte of patients were observed strictly after surgery, and complications such as diabetes insipidus, serum electrolyte disorders and epilepsy were remedied in time. Results Total removal of tumors were achieved in 22 cases, and minor portion of tumors was left in 2 cases. All of the patients were sober after surgery. Diabetes insipidus, serum electrolyte disorder and body temperature disorder took place in 16 cases,12 cases, and 6 cases respectively. After treatment, serum electrolyte disorder and body temperature disorder were rectified in all cases, but diabetes insipidus was rectified in 13 of 16 cases. Conclusion Choosing the best operation approach according to the scope which tumor invades and being familiar with the 4 sellar anatomy spaces so as to be used correctly in operation are the keys to remove the CPG completely. Giving glucocorticoid before operation and active treatment of complications such as diabetes insipidus, serum electrolyte disorder can decrease mortality observably.

Objective To investigate the method of total resection of craniopharyngioma and prevention and treatment of post-operative complications. Methods Pterion craniotomy was performed in 24 patients with craniopharyngioma which was situated in sellar region after giving glucocorticoid and anti-epilepsy drug. The tumors were removed via the 4 anatomy spaces in sellar region by employing microsurgical technique. Consciousness, urine volume, and serum electrolyte of patients were observed strictly after surgery, and complications such as diabetes insipidus, serum electrolyte disorders and epilepsy were treated in time. Results Total removal of tumors were achieved in 22 cases, and minor portion of tumors was left in 2 cases. There was not obvious deficit of nervous system function in all of the patients after surgery. Diabetes insipidus, serum electrolyte disorder and body temperature disorder occurred in 16 cases, 12 case, and 6 cases respectively. After treatment, serum electrolyte disorder and body temperature disorder were rectified in all cases, and diabetes insipidus was rectified in 13 of 16 cases. Conclusion Choosing the best operation approach according to the scope of tumor invasion and being familiar with the 4 sellar anatomy spaces were the keys to remove craniopharyngioma completely. Giving glucocorticoid before operation and active treatment of complications such as diabetes insipidus and serum electrolyte disorder could effectively decrease mortality.

Objective To study the prevention and treatment of pneumoperitoneum-related complications after laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 1 100 cases of LC from October 1993 to January 2003. The cases were divided into two groups: 980 cases admitted before September 2001 received a 14 mmHg carbon dioxide pneumoperitoneum (Group A), and 120 cases after September 2001 received a 10 mmHg pneumoperitoneum (Group B). Results Carbonemia happened in 2 cases in the Group A but in no cases in the Group B. The incidence of postoperative shoulder pain was significantly lower in the Group B (19 2%, 23/120) than in the Group A (43 9%, 430/980) ( ? 2 =26 951, P =0 000). The incidence of postoperative nausea and vomiting (PONV) was significantly lower in the Group B (25 8%, 31/120) than in the Group A (61 2%, 600/980) ( ? 2 =54 750, P =0 000). Conclusions Carbonemia, shoulder pain and PONV can be reduced by regulating the ventilation and decreasing the pneumoperitoneum pressure.

Objective To study the prevalence and the related risk factors of diabetic peripheral neuropathy(DPN) after good blood glucose well controlled among in middle-aged and old-aged population with type 2 diabetes mellitus in a community of Beijing.Methods DPN was screened by Michigan neuropathy screening instrument (MNSI),and common blood biochemical parameters were tested,among over 45 years of age registered population patients with type 2 diabetes mellitus in Shuangjing community of Chaoyang District of Beijing.Results The blood glucose control rate was 90.36％ (253/280),and the prevalence of DPN was 25.36％ (71/280) with male of 24.47 ％ (23/94) and female of 25.81％ (48/186).Univariate analysis showed that both age and HbA1c in DPN group were higher than that of non-DPN group,and the differences were statistically significant(P =0.000,0.008).The level of plasma low density lipoprotein cholesterol(LDL-C) of the DPN group was lower than that of the non-DPN group,and the difference was statistically significant (P=0.017).The hypertension prevalence rate of the DPN group was 87.32％(62/71),higher than that of the nonDPN group(75.6％ (158/209)),and the difference was statistically significant (P =0.037).The multivariate logistic regression analysis showed that the estimate of parameter for age was 0.143 (P =0.0001),OR was 1.153,95％CI was from 1.029 to 1.219,for HbA1c was 0.529(P=0.03),OR was 1.698,95％CI was from 1.053 to 2.738,and for LDL-C was-O.919 (P =0.018),OR was 0.399,95％ CI was from 0.186 to 0.854.Conclusion The prevalence of DPN is still above 25％ among middle-aged and old-aged in a community,even though the well controlled rate of blood glucose control rate is above 90％.It is possible that old age and HbA1c are related to DPN,apart from blood glucose.

Objective To study the relationship between Helicobacter pylori (Hp) DNA positive detection in bile of gallbladder and intragastric Hp's colony and its plausible mechanism.Methods Sixty patients of gallbladder innocence diseases were recruited in the case group and 30 health populations were recruited in the control group.13CPDB was used to detect the infection of Hp.The cytotoxin associated gene antigen (cagA) in gall and gall-stone were detected through PCR.The empty function was tested through B ultrasound.Results The infection rate of Hp in all cases is 50.0% (30/60) and 7 of 30 bile (23.3%) ,1 of 30 gallstones (3.3%) were positive for Hp cag-A by PCR analysis in positive Hp infection group,with none of the 30 bile were positive in negative group( x2 = 5.822 ,P ＜ 0.05 ).The contraction rate of gallbladder of Hp positive group ( 56.8 ± 17.1 ) %was lower than negetive group' s ( 69.4 ± 13.1 ) % and the control group' s (63.3 ± 17.1 ) % ( F = 5.633,P ＜0.05).Conclusions Hp DNA is present in bile of gallbladder,and is related with Hp infection in stomach.Impairment of the gallbladder empty function may be related with Hp infection.

Safety is a critical link restricting the development of TCM injections.Hospital centralized monitoring is of importance in the safety evaluation of TCM injections.However,the results of centralized monitoring studies usually deviated from the actual situation because of problems in design and process quality.Our research team have completed several projects over centralized monitoring in recent years.Based on the previous research experience,this paper mainly discussed the current statuation,the significance and methods for standard process of hospital centralized monitoring in regard to TCM injections,in order to improve the quality of centralized monitoring studies and provide technique support for recognizing the safety of TCM injections.

Objective To investigate the relationship between the appearance of donor cells in urine and acute rejection and the clinical implication. Methods Eighty renal transplantation patients were observed, in which the donors were male and the recipients were female, or HLA DR antigen were mismatched (30 cases were at perioperative period, 20 cases were subjected to acute rejection, 30 cases had stable renal function). Urine samples were collected regularly. PCR and PCR SSP were applied to detect DYZ 1 (special gene fragment of Y chromosome) and DRB 1of HLA DR antigen respectively after DNA were obtained.Results Perioperative period group: donor cells in urine were detected in all the patients 24?h after operation. With the development of disease, the intensity of donor DNA expression in urine was decreased generally. 30 days later, donor cells in urine disappeared only in 3 cases of 30 cases, and acute rejection happened in 8 cases of the rest 27 cases. Acute rejection group: donor cells in urine were detected in 18 cases (90%); 2 weeks following anti rejection therapy, donor cells in urine were negative only in 3 cases, still positive in the other 15 cases, and the intensity of donor DNA expression in urine was decreased generally during the treatment. Donor cells in urine were negative in 16 cases ( 88.9% ) after treatment for 3 months. Stable renal function group: DYZ 1 or HLA DRB1 was positive in 2 cases ( 6.7% ), negative in 28 cases ( 93.3% ). Conclusion PCR and PCR SSP were used to detect DNA of donor cells in urine, which would be a new method to diagnose acute rejection of renal transplantation, but would not exactly fit for those happened in early stage. The intensity change of donor DNA expression in urine represented the recovery of renal transplantation, which provided the possibility to evaluate renal allograft rejection quantitatively at the same time.

Aim: To study the effect of Eudragit S-100, a pH-responsive polymer, on protein refolding level, using recombinant human keratinocyte growth factor-2 (rhKGF-2) as a model protein. Methods: The refolding of rh-KGF-2 was performed by directly diluting denatured rhKGF-2 into a refolding buffer containing different concentrations of Eudragit. The ability of Eudragit S-100 to enhance protein refolding level was investigated using MTT assay, reverse phase HPLC, fluorescence emission spectroscopy and circular dichroism spectroscopy. Results: The addition of Eudragit S-100 in the refolding buffer significantly increased the rhKGF-2 refolding yield to 71%, when dilution refolding was conducted at 0. 5 mg/mL rhKGF-2. The outcome from the refolding study showed possibility of a special interaction between rhKGF-2 and Eudragit, suggesting that the refolding-enhancing ability of Eudragit S-100 was due to this interaction between Eudragit S-100 and rhKGF-2. Mean while, the result showed that the concentration of urea was also an important factor for the optimization of the refolding in the presence of Eudragit. Conclusion: Eudragit S-100 can significantly increase the refolding level of rhKGF-2.