Insulin resistance(IR) is a independent risk factor of ichemic angiopathy .The abnormal state of thrombosis and fibrinolysis is a critical pathology component of IR,and play a vital role in initiating and developing cardiovasculer disease. Under IR state, the,inhancement of plasminogen-activator inhibitior-1(PAI-1)synthesis by adipose tissue and the reduced generation of nitric oxide with endothelial dysfunction contribute to the hypo-fibrinolytic/pro-thrombotic state and promote atherosclerotic. Accompanied with IR developing, when B cell function can't keep normal glycemia, the advanced glycosylation end products(AGEs) are increased as a result of hyperglycemia. AGEs can aggravate endothelial injury and accelerate the course of atherosclerotic. Fully comprehending the pathogenesis of thrombosis and fibrinolysis in IR and taking therapy for the pathology have clinical significance.

The paper analyzes the new theory of “a modern property right system” put forward for the first time at the Third Plenary Session of the Sixteenth Central Committee of the CPC. It dwells on the opportunities and challenges facing state owned hospitals in establishing a modern hospital system. It is suggested that domestic hospitals should adopt a modern hospital system that fits in with the modern market economy and embodies modern property right features.

Objective To investigate the changes of rectoanal function after intersphincteric resection(ISR). Methods In this study,27 lower(3～5 cm from anal verge)rectal adenocarcinoma patients(T0-T2 determined by MRI and endoanal uhrasonography before surgery)undergoing intersphincteric resection between January2005 and January 2007 were followed up,their rectoanal function was assessed by rectoanal manometry 1 week preoperatively and 2 weeks,3 months,6 and 9 months postoperatively.The data were compared by using student t test and X2 test.Results For these 27 patients,within 3 months after surgery,the mean resting pressures(44±6)mm Hg to(19±3)mm Hg,maximum resting pressures(60±8)mm Hg to(33±4)mm Hg,squeezing pressures(180±19)mm Hg to(131±16)mm Hg and msximum tolerable volume(165±20)ml to(55±8)nd were decreased significantly(P＜0.05),and the rectoanal inhibitory reflexes(BAIR)were all absent;6 months after surgery,the resting pressures,squeezing pressures and maximum tolerable volume began to increase obviously,and 6 patients presented RAIR;3 months later the mean resting pressures,maximum resting pressures and squeezing pressures were(41±5)mm Hg,(57±8)mm Hg and(173±19)mm Hg respectively,close to the normal range(P＞0.05),though the maximum tolerable volume increased to(110±16)mi,still lower than the preoperative value(P=0.0153),11 patients restored BAIR.Conclusions The rectoanal function is injured obviously after intersphincteric resection within a short time period,but with time it was gradually restored.

Purpose:To investigate the mechanisms,susceptibility,prevention and treatment of the tumor patients'renal function,which was injured by the Body Gama Kinfe treatment.Methods:There were 7 patients,who had been observed for the effect of hydration,vaso-dilation,diuresis,basifying urine,anti-coagulation,detocifiation,even hemodialysis.Results:All patients' renal function gradually recovered.Conclusions:The tumour patients' renal function can be acutely injured by Body Gama Kinfe treatment.The patients who were elderly or inherent in renal failure would be prone to injary.In general we could improve the situation by better prevention,early-diagnosis,efficient treatment,so that we can not only alleviate the injuries,but also speed recovery,thus achieving better prognosis.

Objective To investigate the feasibility of autogenous vein graft as a connector to repair recurrent laryngeal nerve(RLN) defect. Methods 20 healthy dogs were randomly devided into 4 groups: group 1(n=6), 2(n=6), 3(n=5) and control group(n=3). Left RLN of dogs in group 1,2,3 were resected for 1,2,3 centimetres respectively and followed by repairment with autogenous vein graft, while RLNS of dogs in control group were resected but not conducted by autogenous vein graft. Six months after operation, the vocal fold movement, phonation and induced action potensial as well as morphologic observation of the aryngeal muslces were studied. Results In group 1, phonation of dogs was all restored to normal. The vocal fold of RLN resected side showed no atrophy symmetrical to the normal side and adducted apparently when phonating. Furthermore thyroarythenoid muscle and posterior cricoarytenoid muscle both could generate induced action potentially. Regenerated nerves in verin graft and distal nerve were observed by light microscope and electron microscope. In group 2,3 and control group hoarseness improved six months after op eration, the vocal fold of RLN resected side was atrophied apparently and fixed paramedianly. Fissure existed in glottis when vocal fold closed, and compensative movement of opposite vocal fold across over the median line was found. Thyoarthenoid muscle and posterior cricoarytenoid muscle unable to generate an action was found. Regenerated nerves were not observed in vein graft or distal nerve by light microscope and electron microscope. Conclusions It is feasible to repair RLN defect in certain length by autogenous vein graft.

Objective To investigate the diagnosis and treatment of Hashimoto's disease. Method The clinical data of 51cases of Hashimoto's disease admitted to our department from 1986 to 2001 were collected and analyzed. Result The preoperative misdiagnosis rate is 78.4%. 37 of 51 cases undergone surgical treatment and the results were satisfied. Follow up data, which were collected from 30 patients, showed that 6 patients(16.2%) developed hypothyroidism . Conclusion The examination of antithyroglobulin (TGA) and antimicrosomal (TMA) and the frozen section examination during operation are helpful to the diagnosis. Appropriate operation is a safe and effective treatment for patients with Hashimoto's disease who have received effectiveless thyroxine treatment.

Objective To investigate the relationship of postoperative complications of thyroid surgery with primary thyroid disease, operation procedures and operative manipulation. Methods The clinical data of 1805 cases of thyroid diseases treated by surgery in our department between 1990～2001 were analyzed retrospectively . Results There were 67 complications occurred in 1805 cases (3.7%). The postoperative complications rate in Hashimoto′s disease and thyroid carcinoma were 6 (16.2%) and 27 (12.2%) respectively ,which were obviously higher than that in other primary thyroid disease( P

Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

The relationship between elevated concentration of circulating free fatty acids (FFA) and insulin resistance wag studied,and the pathophysiological mechanism of insulin resistance,especially focused on oxidative stress,was explored.It was found that the elevated circulating FFA level led to insulin resistance in rats, which was partly caused by oxidative stress,and that antioxidative treatment was able to reverse the pathologic change.As a result of enhancing reactive oxygen species production[(886±105 vs 427±42)mmol/L,P<0.05] and disrupting antioxidant[(272±47 vs 561±36)μmol/L,P<0.05],elevated concentration of FFA may induce oxidative stress.

Objective To sum up the effect and experience in radiofrequency ablation(RFA) for liver cancer(LC). Methods The clinical data of 102 patients with LC treated by percutaneous and intraoperative RFA were analysed retrospectively. Results RFA was used to treat 195 tumors (median diameter 5.6 cm,ranging from 1.5 to 9.5 cm) in 102 patients.Of them, primary liver cancer was found in 80 patients( 78.4%),and metastatic liver tumor was in 22 patients(21.6%). Percutaneous RFA(PRFA) and intraoperative RFA(IRFA) was performed in 77 patients(75.5%) and 25 patients(24.5%) respectively. There was no severe complications after RFA in this series. All of the 102 cases had been followed up for 3～24months,AFP positive returned to negative in 70.3%(52/74)of the patients.The rate of concreted necrosis of liver cancer showed by CT was 88.2%(90/102). The 1 year survival rate was 93.8%.Conclusions RFA is a safe and effective treatment for patients with LC. Patients with small and readily accessible tumor are the indications of PRFA;while the patients with large,multiple,perivascular or otherwise inaccessible liver tumor are also the indications for IRFA.The adoption of the TACE and other methods to occlude the vascular inflow can improve the efficacy of RFA.