Usually the blood pressure will elevated in patients with acute ischemic stroke during the first 24 hours after the onset of symptoms, and the blood pressure levels are associated with the prognosis of patients. Regardless of trying to reduce or elevate blood pressure, the management of blood pressure in acute stroke is controversial. This article reviews the relations between the changes of blood pressure in the acute phase of ischemic stroke and the management of blood pressure and stroke prognosis.

Polyamidoamine (PAMAM) dendrimers is considered a better genetic carrier for its ability to form with DNA a nano-sized polyelectrolyte complex of high stability and dissolubility. The mechanism of PAMAMmediated gene endocytosis has been fairly clear and the researches in vitro have confirmed that PAMAM had high transfection efficiency and low cytotoxicity. The researches in vivo have further confirmed that PAMAM had a potential application foreground in the field of gene therapy including in the prevention and treatment of ewing's sarcoma and pulmonary fibrosis, in heart transplantation, and in the preparation of falciparum malaria vaccine.

Objective To investigate the expression of ER and PR in hyperplasia of mammary glands and breast cancer. Methods The expression of ER and PR in 68 hyperplasia of mammary glands cases and 168 breast cancer cases were quantified by immunohistochemical method. Results The expression of ER in breast cancer(30%) was significantly higher than that in hyperplasia of mammary glands(10 %)(P ＜0.05) and there was no significant difference in PR between them. The expression of ER in postmenopausal breast cancer was significantly higher than that in postmenopausal hyperplasia of mammary glands (P ＜0.05) and there was no significant difference in ER between two premenopausal groups. The expression of PR in invasive lobular carcinoma was significantly higher than that in invasive ductal carcinoma and other types (P=0.005).Conclusion The expression of ER and PR may identify the characteristics of patholobiology in breast disease.

Objective To evaluate the effect of procedure for prolapse and hemorrhoid(PPH)for the treatment of prolapsed internal hemorrhoids. Methods 23 patients with the third or fourth degree circular prolapsed internal hemorrhoids were managed by means of PPH. Results The mean operative time was 22 minutes,and hospital stay was 3.5 days after operation.Pain in 48 hours after operation was evaluated and 18 cases had no pain(78 3%),5 cases less pain(21 7%).The anastomoses healed in (4～5) weeks and there was no recurrence in (1～6) months after the patients were discharged from hospital. Conslusions Compared with the traditional operation,PPH has the advantages of simpleness,less pain,less complications and quiker recovery,but the cost is higher.

Objective To evaluate the clinical effects of surgical treatment for diabetic retinopathy (DR) with diffuse diabetic macular edema (DDME) and massive subretinal hard exudates (MSHE) with vitrectomy, endolaser photocoagulation to the retina under perfluorocarbon liquid and long acting gas tamponade. Methods Fifteen eyes of twelve patients with DR complicated with DDME and MSHE admitted from October 2001 to December 2003 were enrolled for study, in whom 9 eyes were in 7 males and 6 eyes in 5 females. The patients were aged from 36~65 years (mean 53.4). The best corrected visual acuity (BCVA), color fundus photography and fundus fluorescein angiography were recorded, and optic coherence tomography was performed preoperatively. Pars plana vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade were the therapeutic modalities used to treat the diseased eyes. Results Preoperative BCVA was finger counting to 0.05 in all 15 eyes. Improved vision was observed in eyes during 4~25 months of follow up period (mean 10.26 months), 0.03~0.04 in 2 eyes(13.3%), BCVA ≥0.09 in 13 eyes(86.7%), and 1 eye(6.7%)showed an improved vision from 0.04 to 1.0. Significant decrease in macular edema and retinal thickness were observed, and marlsed to complete absorption of intra-retinal and pre-retinal hemorrhage as well as MSHE was also seen. Conclusions Vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade may offer satisfactory effects in the treatment for DDME complicated with MSHE.

Objective To investigate the therapeutic effects of scleral buckling operations on treating long-standing retinal detachment with subretinal proliferation. Methods The clinical data of 36 patients (40 eyes) with long-standing retinal detachment with subretinal proliferation who had undergone scleral buckling operation were retrospectively analyzed, and the clinical features, therapeutic methods and curative effects were summarized. Results The diagnosis of long-standing retinal detachment mainly based on the examination of ocular fundus. The features of the affected eyes were: flat retinal detachment, thin and transparent retina, and formation of subretinal cords. In 40 eyes undergone scleral encircling and buclking, 36 (90%) had one-off successful operation, and the visual acuities over 0.05 were found in 77.5% of the whole eyes. Conclusions Scleral encircling and buckling procedures can be used to treat long-standing retinal detachment with subretinal proliferation with fairish cured rate.

Objective To evaluate the clinical value of ulinastatin on the treatment of systemic inflammatory response syndrome in severe acute panereatitis. Method Eighty-four patients with severe a-cute pancreatitis were randomly divided into two groups. In the treatment group (42 cases),on the base of routine treatment, ulinastatin was administered intravenously for seven days after hospitalization, while in the control group only routine treatment was given (42 cases) to. Inflammatory factors in serum, the change of liver function and renal function were measured in two groups before and after the treatment, and the clinical efficacy were observed. Results There was significant difference, in the serum level of tumor necrosis factor-α, interleukin-1, interleukin-6, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen and creatinine on the 7th day between two groups (P < 0.05 or < 0.01 ) ,there were significant differences in the incidence of complications, hospitalization time, incidence of multi-organ failure between two groups [14.3%(6/42) vs 38.1%(16/42), (29.4 ± 1.5)d vs (34.4 ± 1.8)d, 28.6%(12/42) vs 47.6%(20/42), P<0.01 or <0.05 ]. Conclusions Ulinastatin can suppress the secretion and release of some inflammatory factors, protect the important viscera functions and reduce the incidence of complications, and it has favorable clinical efficacy.

Objective To explore the effect and significance of systemic inflammatory response syndrome(SIRS )score in predicting prognosis in acute craniocerebral trauma. Methods The clinical data of 620 patients were collected at admission from January 2003 to December 2007, GCS and SIRS score were calculated in 24 hours.The relation of the mortality rates and GCS score were analyzed in different SIRS score patients by controlling age. Results With SIRS score increasing,mortality rates increased as well,and pa-tients with SIRS (score≥2) mortality rates had significantly higher,and also in the same age and GCS score group.Mortality rotes were significant in staifistics (P<0.05). Conclusion SIRS score is significant inde-pendent predicting prognosis in acute craniocerebral trauma and in clinic.

Objective To study the variation of the pancreatic head arteries and its value in pan- creas transplantation.Methods The DSA data of 300 cases were studied retrospectively:192 cases of celiac trunk angiography,102 cases of superior mesenteric artery angiography,and 6 cases of the com- bined.The distribution and variation of the arteries on the pancreatic head were observed.Results In the celiac angiography cases,typical gastroduodenal artery,superior pancreaticoduodenal artery and its branches were visualized in 73 cases(38%).The posterior superior panereaticoduodenal artery was not anastomosed with the posterior inferior pancraticoduodenal artery in 3 cases.The posterior pancre- aticoduodenal arcade was discontinued in 1 case.The anterior superior pancreaticoduodenal artery, posterior superior pancreaticodoodenal artery,and dorsal pancreatic artery were only distributed across the upper head of the pancreas separately but were not anastomosed each other in 1 case.The variation rate of pancreaticoduodenal arterial arcades was 6.8%(5/73).In 102 cases of the superior mesenteric artery angiography,the inferior pancreaticoduodenal artery was visualized in 42 cases(41%)while its branches were not visualized.In 6 cases of the combined angiography,superior panereaticoduodenal artery was visualized in all of the cases,of which anterior and posterior arcades were visualized in 4 cases(66.7%).The gastroduodenal artery reconstruction was performed in 3 cases of clinical pancre- as transplantation,all of the receivers maintained a normal blood glucose level after transplantation and no surgical complications were found.Conclusions The superior pancreaticoduodenal artery might of- fer more blood supply than inferior pancreaticoduodenal artery in the pancreatic head.The arterial re- construction of the transplanted pancreas should include the gastroduodenal artery because of the pos- sibility of arterial variation on the pancreatic head.

Objective To investigate the relationship of the expressions of transforming growth factor ?_1(TGF?_1),vascular endothelial growth factor(VEGF) with angiogenesis in thyroid cancer.Method TGF?_1,VEGF and microvessel countt(MVC) were detected by immunohistochemical method in 46 thyroid cancer specimens.Results The mean MVC was significantly higher in tumors with positive TGF?_1 or VEGF than in tumors with negtive TGF?_1 or VEGF[(26.18?4.05) vs (20.13?4.29) for TGF?_1 and (25.82?3.61) vs (19.65?6.32) for VEGF,P