Objective:This study compares titanium ring-pin stapler and hand-sutures in the end-to-end anastomosis between renal artery and internal iliac artery in clinical kidney transplant. Methods:In 75 renal allograft recipients, the arterial reconstruction were randomly assigned to anastomoses with either 6/0 interrupted nylon sutures(39 patients) or titanium ring-pin stapler(36 cases). Results:Arterial anastomosis with ring-pin stapler was significantly faster(17.8 versus 28.1 min). In 2 cases, a lower pole artery was successfully anastomosed to the epigastric artery with 2 mm ring. All 75 renal arteries were patented without episodes of postoperative bleeding, or need for revision of the anastomosis in both groups. Mechanical anastomosis resulted in slightly but not statistically significantly less artery stenosis during 2-5-year follow-up.Conclusion:Renal artery anastomosis with ring-pin stapler is as safe and effective as hand-suture. The time required for mechanical anastomosis is only about 1/2 that required for suture anastomosis.

Target therapy is a major progress in treatment of advanced colorectal cancer. Cetuximab and bevacizumab are the most widely used target agents in colorectal cancer, which target against EGFR and VEGF respectively. The addition of target agent to chemotherapy improve efficacy and prolong survival in the first line setting, as well as in the second line setting. The increased respectability of liver metastases from colorectal cancer is of great importance, k-ras gene mutation is a definite predictor of cetuximab, however, there is no clear predictor for bevacizumab.

Objective To observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

Objective To evaluate the therapeutic effect of Buqi-Huoxue decoction on cervical spondylotic arteriopathy(CSA). Methods 182 patients were diagnosed with CSA in our hospital during the period of March 2009 to November 2013. Among which 92 cases were assigned to a test group(outpatients) and 90 cases to a control group. The test group was treated with traditional Chinese medicine Buqi-Huoxue decoction, while the control group was treated with flunarizine and nimodipine. The level of seriousness of the symptoms, abilities and physical signs were recorded by clinical assessment scale for cervical spondylosis(CASCS), and velocity of blood flow at systolic peak(Vs)and mean blood flow velocity(Vm) of vertebral arteries(VA)and basilar artery(BA)were measured by transcranial doppler(TCD) monitoring to evaluate the blood supply before and after the treatment. After 30 days of treatment, CASCS and the TCD were recorded again to observe the clinical symptoms and the degree of blood supply improvement, and then the data were analyzed to value the curative effect. Results CASCS score of the two groups was 88.82±5.19, and 83.46±5.72 respectively, with P<0.05. The TCD results showed that, the patients less than 60 years old in the test group had Vs values of LVA, RVA and BA at(50.52±6.86)cm/s,(49.14±5.81)cm/s,(57.20± 5.37)cm/s after the treatment, and these values of the control group were(53.70±8.14)cm/s, (51.67±7.45)cm/s, (59.76±5.11)cm/s respectively;while patients over 60 years old in the test group had Vs values of LVA, RVA and BA at(40.37±2.24)cm/s, (40.78±1.85)cm/s, (51.04±3.81)cm/s after the treatment, these values of the control group were(37.58±2.86)cm/s, (37.58±2.72)cm/s, (46.92±5.26)cm/s respectively. The effective rate of the test group was 97.83%, while the value was 88.89%of the control group, which also showed a significant difference(χ2=13.743, P=0.01). Conclusion More significant effects of Buqi-Huoxue decoction for treating disease of CSA was achieved compared with the treatment of flunarizine and nimodipine.

Objective Explore the relationship of ventricular late potential (VLP) and the heart function of children with viral myocarditis,and provide the evidence for their diagnosis and therapy.Methods The clinical data of 152 cases of epileptic children were collected.The patient group was divided into three groups (severe arrhythmia,heart failure,and cardiogenic shock).The patient group was also divided into two groups (cardiac dilatation,and non-cardiac dilatation) according to UCG.Serum levels of cTnI and VLP in children with viral myocarditis were detected.Results The VLP was negative in the mild and control groups,but the positive rate of VLP is 75.0 ％ in the severe group.The positive rate of VLP was 60.0％ in the severe arrhythmia group,77.78％ in the heart failure group,and 100％ in the shock group.There is one kind of negative rank correlation between LAS,RMS40 and LVFS (P ＜ 0.05),and another negative rank correlation between RMS40 and LVEF (P ＜ 0.05).Conclusions The children with viral myocarditis have a favorable prognosis.The sever patient in the minority must be diagnosed in time and treated because of the critical state of viral myocarditis children.The serum level of cTnI and VLP were increased in children with viral myocarditis,and they were sensitive parameters to reflect patients’ condition.

Objective The aim of this study is to elucidate the current status of hilar cholangiocarcinoma with regard to its epidemiology,clinical features,diagnosis,Bismuth-Corlette typing,pathologic categories,treatment,complication and prognosis in China.Methods Original articles published form January 1991 to August 2008 were searched in the CBM disc,VIP information and CNKI.Clinical appraisal and data extraction were conducted independently by 2 reviewers.The outcomes of 2280 procedures from 22 retrospective studies were analyzed.Results When radical resection was compared with palliative resection,the 1-yr survival rate (84.0％ vs.46.8％,OR=5.71,95％CI 3.99～8.17,P＜0.01) and 3-yr survival rate (31.5％ vs.13.5％,OR=4.43,95％CI 2.07～9.47,P＜0.01) were significantly higher.For the palliative resection group,the 1-yr survival rate of the drainage group (27.2％ vs.38.7％,OR=0.47,95％CI 0.31～0.72,P＜0.01) was significantly higher than the palliative resection group.The rate of tumor resection rose after 2002 (x2=35.9588,P＜0.01),but the rate of radical resection did not significantly rise ((2 =2.1052,P=0.1468).Conclusions Radical resection is still the optimal treatment for hilar cholangiocarcinoma.If radical resection is technically not possible,palliative drainage is a reasonable treatment.Palliative resection do not improve survival and it is not recommended.

Objective To explore the clinical significance of DSA and MRA detection in cerebrovascular desease of patients with diabetes mellitus.Methods 142 diabetic patients were selected in the study. The vascular structure was detected by digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) . Results There was 1123 (56.5%) branches of artery atherosclerotic stenosis in a total of 1988 detecting artery and there was no significant difference between the DSA and MRA (χ2=0.36、0.47、0.53,P>0.05) . The results showed that the DSA and MRA methods had no significant difference on display average count in detecting bilateral ACA,MCA,PCA 284 vessels (t=0.27、0.56、0.89,P>0.05) . There were 656 arteries stenosis in checking the Willis ring vascular by DSA evaluation of the Willis ring and the sensitivity and specificity by MRA were more than 90%. Conclusion MRA and DSA can be applied in diagnosis of in cerebrovascular disease of patients with diabetes mellitus.The noninvasive advantages of MRA are worth to be concerned by clinician.

A gas chromatographic method was established for determination of cholesterol. The egg yolk was directly saponified with 1ml 40% potassium hydroxide and 20ml ethylene glycol. The unsaponifiable substances were extracted by diethyl ether and then dried with anhydrous sodium sulfate. The extract (2?l) was injected into the gas chromatograph. The average percentage of recovery was 100.0?2.6%. The precision of the method was good, the coefficient of variation was 1.9%. The mean cholesterol content of egg yolk determined by this method was 1247.1?80.1 mg/100g and agreed with the value reported in literature.

Sophocarpine ( SC ) , an alkaloid extracted from sophora alope -curoides L. , was found to have a rapid and significant hypotensive action both in anesthetized dogs and in conscious renal hypertensive rats. On superior cervical ganglia and nictitating membrane preparation ,SC 15mg, administered via lingual artery, briefly relaxes the rigid contraction of nictitating membrane caused by continuous stimulation of sympathetic preganglionic fibers. SC 50, 100, 200?g/kg reduced the vascular resistance index 13.1 ?1.6%, 20.5?4.6%, 27.8?4.1% respectively when perfused into the femoral artery .Measurement of the changes of hemodynamics with constant voltage transthoracic admittance plethysmograph in 5 intact anesthetized dogs showed that SC iv 25mg/ kg enhenced the index of myocardial contractility 18% and heart beat index 40%, shortened Q -Y interval 37%.These results suggest that hypotensive action of SC should be realized by both relaxing the peripheral vascular smooth muscules and blocking the transmission of impulse through the sympathetic ganglia.

OBJECTIVE: To study the active fractions from Antipyretic analgesics powder.METHODS:The active fractions were extracted from Antipyretic analgesics powder by supercritical-CO2 fluid extraction technique,separated and purified by molecular distillation(MD) technique.The active fractions were selected with the analgesic effect as index.RESULTS: The active fractions obtained showed remarkable analgesic effect.CONCLUSION: The result serves as a theoretic basis for the development of the active fractions-based new drugs.