Since the emergence of the new syndrome, termed multiple system organ failure (MSOF), about two decades age, it has aroused an outburst of enthusiasm in clinical and experimental studies among many clinicians and investigators both abroad and at home. Nevertheless, it has also created much confusion in the concept as well as the diagnosis of the syndrome, mainly because the present term does not clearly differentiate this syndrome from some other irrelevant clinical conditions, such as senile dysfunction of multiple organs, agonal state etc. As it has been documented to occur almost as a rule after a septic state and also under the intricate interaction of many humoral and cellular mediators, we suggest that the diagnosis of MSOF should at least include two concurrent conditions, i. e. septic response and organ failure.Inasmuch as the present diagnosis of MSOF designates only the terminal state of a series of pat-hophysiological process, namely systemic inflammatory response---sepsis--septic syndrome--MSOF,it is not conducive to an early diagnosis, which is of utmost importance in the prevention and early treatment of this frequently fatal syndrome. In the light of current investigations, we propose that the name of the syndrome be changed to "sepsis and organ dysfunction" or "mediator injury of organs*. Our humble opinion welcomes further comments and discussion.

Objective To investigate the causer of, and the way to deal with the measurement of protecting from vascular compromise in free flap transplantation. Methods To retrospectively study the clinical data collected from the 89th Hospital of PLA including 305 cases of vascular compromise in free flap transplantation held on June, 1983 to December, 2006. Accoding to the different tissue flaps and different sites to be repaired, 11 factors of vascular compromise of free flap transplantation were to be investigated including operation design, the recipe of free flap, the variation of vascellum, the skill of recipe, the operation opportunity, the match of vascellum, the debride of vascellum, the vascellum angiotasis, the vascular anastomosis, the management of vascular articulo and the infection. Results Among the 305 cases of free flap transplantation, arterial compromise existed in 270 cases, 10 cases developed arterial compromise during operation, 6 cases were due to the injury of nutrient vessel, the flap survived after the revascularization. 4 cases obtained part necrosis of 10 cases, and the rotation flap and skingrafting covered the raw surface. The rest 213 cases survived and 47 cased failed. Another 35 cases of vein compromise were obtained. Among them, 5 cases survived, part necrosis of 10 cases, and 20 cases failed. Conclusion Vascular compromise is the factor of necrosis in free flap transplantation. It is of cardinal importance to timely and correctly treat the vascular compromise in free flap transplantation whether happened intra-or postoperatively. This is the key to access high successful rate. Preventive measures are even more beneficial than proper management after its occurrence. The venous return disorder was the main factor of free flap transplantation failure.

High mobility group A1 belongs to the family of high mobility group. It is widespread in human,and involved in the physiological and pathological situations. It is overexpressed in many human cancers including haematological malignancies as the oncogene.

Objective To investigate the efficacy and toxicity of neoadjuvant regional arterial chemotherapy in the treatment of advanced gastric cancer. Methods The clinical data of 158 patients with advanced gastric cancer and with the same clinical stages who were admitted to Renji Hospital of Shanghai Jiaotong University from February 2002 to May 2005 were retrospectively analysed. Preoperative regional arterial chemotherapy was applied to 76 patients (test group) and the remaining 82 patients only received surgical treatment (control group). The chemotherapy regimen was epirubicin (50 mg/m2) + cisplatin (60 mg/m2) + 5-fluorouracil (1000 mg/m2).This regimen was modified to oxaliplatin (130 mg/m2) + 5-fluorouracil (1000 mg/m2) since 2003, and surgery was performed 6-11 days after the chemotherapy. All patients received postoperative intravenous chemotherapy.The clinical effects, radical resection rate, operative complications and long-term survival of the two treatment methods were evaluated. All data were analysed using the chi-square test and Kaplan-Meier analysis. Results The radical resection rate was significantly higher at 86% (65/76) in the test group compared with 71% (58/82)in the control group ( x2 = 5.01, P ＜ 0. 05 ). The toxicity of the chemotherapy in the test group was mild. The postoperative complication rate was 20% (15/76) in the test group and 16% (13/82) in the control group, with no significant difference between the two groups (x2 = 0.41, P＞0.05). The median survival time was 41 months in the test group and 23 months in the control group. The 5-year overall survival rate was higher in the test group (44.6%) than that in the control group (29.1%) (x2 =3.95, P＜0. 05). Conclusions Neoadjuvant regional arterial chemotherapy is well tolerated by patients with advanced gastric cancer. It is also effective for increasing the radical resection rate and improving the long-term survival.

Two patients underwent liver transplantation of blood type incompatibility were collected from Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Case 1: A male who had primary hepatic carcinoma underwent classic orthotopic liver transplantation; the blood of donor was type A, and the blood of recipient was type O. Case 2: A female having history of type B hepatitis underwent classic orthotopic liver transplantation due to pregnancy combining with severe liver disease and coagulation disorder; the blood of donor was type B, and the blood of recipient was type O. Immunohistochemistry staining was used to observe pathological changes and deposition of various immunoglobulin and complement in two cases following liver transplantation of blood type incompatibility under optic microscope and to investigate diagnostic standard of humoral rejection. The results showed that linear or granular depositions of IgG, IgM, IgA, C4c, C4d, and Clq were found in endothelial cells of hepatic sinusoid, suggesting that IgG and other immunoglobulin exhibited a strongly positively diffused deposition on the endothelial cells of hepatic sinusoid, while expression of C4d and other complements was also found. All those mentioned above could be considered as evidences to prove onset of humoral rejection in transplanted liver tissue.

Aim To establish cerebrocardiac syndrome model in rats. Methods Right middle cerebral artery of rat was occluded (MCAO) with nylon thread and Ⅱ lead ECG was monitored continuously within 2 h to record the emerging of arrhythmias. 30 min, 2 h, 24 h after middle cerebral artery occlusion or 6 h reperfusion after 2 h occlusion, left ventricular myocardiums were observed with transmission electron microscope to find the morphological damage and brains were marked with TTC to locate infarction area. Results (14.9?11.4) minutes after MCAO, 71%(60/85)model rats had abnormal ECG changes including 38 %(32/85)premature ventricular contraction, 27 %(23/85)atrial premature beats, 5%(4/85)ventricular tachycardia, 1.2%(1/85)sinus tachycardia. Arrhythmias sustained (29.0?23.2 )minutes. Ventricular myocardial cell injury was obvious: chaotic and broken mitochondria ridges, aggregated chromatin under the nucleus membrane, deposited glycogen granules in the cytoplasma. 30 min, 2h, 24h after MCAO the infarction rates were 8.7%?1.1%,11.4%?2.3% and 13.7%?3.1% respectively. Conclusion A stable cerebrocardiac syndrome model in rat might be induced by means of occluding right middle cerebral artery and the morphological bases of cerebrogenic cardiac arrhythmias are myocardial cell injury caused by cerebral infarction.

National Health Information System is mainly used to support decision-making and to improve the current national health situation.Its importance to display the current national health situation and its problems in developing countries were analyzed with the need to construct its effective evaluation framework system pointed out.Construc-tion of UML-based evaluation framework system for National Health Information System was proposed in order to support decision-making and to provide evidence for the health policy makers by comparing the evaluation frame-work systems for National Health Information System in developing countries .

Human cytomegalovirus (HCMV) is the most common cause of congenital infection, resulting in birth defects such as microcephaly. In this study, RT-PCR and Western Blotting were performed to quantify the regulation of endogenic nerve growth factor expression in neuroglia cells by HCMV infection. The results showed that basal, endogenous NGF expression in U251 was unchanged during early HCMV infection. NGF expression is strongly down-regulated during the latent phase of infection. These results suggest that HCMV can depress the NGF expression in U251 cells.

Objective To study expression of CD147 in rabbit VX2 tumor tissues after transarterial embolization with hydroxyapatite nanoparticles loaded with lipiodol.Methods Thirty rabbits implanted with tumor tissue of cell line VX2 were divided into three groups: control group, lipiodol group, and hydroxyapatite nanoparticles loaded with lipiodol group. The transarterial embolization was performed superselectively via gastroduodenal artery of rabbits, and each rabbit in control group was infused with 1ml normal saline, that in lipiodol group was infused with 0.3ml lipiodol per kg, and o.3ml hydroxyapatite nanoparticles loaded with lipiodol per kg for that in the last group.Results of treatment were detected by using CT on day 3 after operation. After two weeks, three-step Immunohistochemical technique(S-P) and Western blot technique were used to investigate the expression of CD147 in tumor tissues of the 3 groaps. Results Immunohistochemical results showed that CD147 was expressed on membrane of tumor cells in all three groups. The positive ratios of CD147 in three groups were (31.33?5.88)%,(75.63?4.44)%, and (80.03?5.59)% respectively, while the expression of CD147 in tumor tissues in control group was significantly different from others(P0.05). Protein half-quantitation detecting of CD147 with Western blot technique displayed that expression of CD147 in tumor tissues increased after embolization in last two groups as compared to that of control group(P

Objective To investigate the preopera ti ve diagnosis and the surgical treatment of primary retroperitoneal tumor(PRT). Methods The clinical dat a of 71 patients with PRT were retrospectively analyzed including clinical manif estation, radiologic studies, pathologic examination and surgical procedures. Results There were 32 cases of benign tumor, 38 cases of malignant tumor and 1 case of borderline tumor. Of the 32 patients with benign tumor, 31 underwent complete surgical resection. Of the 38 patients with malignant tumor, 29 underwent complete resection. One patie nt with borderline tumor underwent total resection. The 5-year survival rate of benign PRT was 89.29%, the 5-year survival rate of malignant PRT was 20.80%. Four cases of recurrent benign PRT underwent complete resection. Ten cases of r ecurrent malignant PRT underwent complete resection and 3 underwent partial rese ction. ConclusionsRadiolog ical study is crucial for the diagnosis. Complete resection is the key for the t reatment of PRT.