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 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 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 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 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.

The daily management of medical equipment in the shelter hospital of CAPF was explored, and some measures were put forward including completing administration, determining responsibilities, improving supervising system, creating management tools, strengthening application for military and civilian uses, enhancing professional awareness and etc. The problems were solved in the discrepancies between construction and management, application and maintenance as well as training and daily service, so that the equipment was improved in efficiency, service life, metrology and stability. References may be provided for the shelter hospital or other medical units of CAPF for daily management of medical devices.

BACKGROUND:Pneumonectomy, extracorporeal circulation, lung transplantation and pulmonary embolism can cause ischemia/reperfusion injury of lung tissue. Lung ischemia/reperfusion injury is an important factor of lung function disorders after lung transplantation. OBJECTIVE:To analyze the effect of ischemic postconditioning on rat models of lung ischemia/reperfusion injury. METHODS:Twenty-four male SD rats were randomly divided into sham, ischemia/reperfusion and ischemic postconditioning groups (n = 8 rats/group) to establish the lung ischemia/reperfusion injury model. The rats in the sham group were only subjected to separation of the hilum of left lung and pulmonary arteries and veins, without blocking. The rats in the ischemia/reperfusion group were subjected to another 2 hours of reperfusion after 1 hour of lung ischemia. The rats in the ischemic postconditioning group were first subjected to 30 seconds of lung ischemia and 30 seconds of reperfusion for three times, and then to 2 hours of reperfusion. After the experiment, the specimens of lung tissue were obtained to detect the wet/dry weight ratio of lung tissue, activities of superoxide dismutase, malondialdehyde and myeloperoxidase, the contentsof inflammatory cytokines tumor necrosis factor α, interleukin-1β and interleukin-6, and the histopathological changes of lung tissue were observed. RESULTS AND CONCLUSION:Compared with the sham group, the wet/dry weight ratio of lung tissue, activities of myeloperoxidase and myeloperoxidase, the levels of tumor necrosis factor α, interleukin-1β and interleukin-6 were significantly increased (P < 0.05) in the ischemia/reperfusion and ischemic postconditioning groups, however, the increase levels of these indices were not significant in the ischemic postconditioning group, and the contents and activities in the ischemic postconditioning group were al significantly decreased (P < 0.05) compared with those in the ischemia/reperfusion group. In the ischemia/reperfusion and ischemic postconditioning groups, the activity of superoxide dismutase was obviously lower than that in the sham group, however, the activity of superoxide dismutase in the ischemic postconditioning group was obviously higher than that in the ischemia/reperfusion group. Pathological examination showed that thickened alveolar wal, edema and a large amont of inflammatory cel infiltrations were observed in the lung tissue of rats in the ischemia/reperfusion group. The degrees of alveolar wal thickening and edema in the lung tissue of rats in the ischemic postconditioning group were mild compared with the ischemia/reperfusion group, and in addition, some inflammatory cels were infiltrated. The histopathological scores of lung tissue in the ischemic postconditioning group were lower than those in the ischemia/reperfusion group. These results suggest that ischemic postconditioning plays its protective role on rat models of ischemia/reperfusion injury by inhibiting inflammatory cel accumulation, oxygen free radical production and pro-inflammatory cytokine release after ischemia/reperfusion injury.

0.05),but decrease of BP in groupⅠandⅡhad conspicuous difference compared with groupⅢ(P

HLA-G belongs to non-classical HLA-class Ⅰ genes.It is expressed in the fetal-maternal interface on the extravillous cytotrophoblast and in such immune privilege tissues as the cornea and pancreas.However, under pathological conditions, such as tumor, inflammatory diseases and post transplantation, HLA-G is expressed abnormally.HLA-G can interact with its acceptors or immune cells and suppress the function of immune cells, which facilitates the escape of the surveillance of the human immune system and the consequent damage.In clinical studies,HLA-G is related to some clinical parameters.This review will focus on the expression, function and regulatory mechanisms of HLA-G in cancer immunology.