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.

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.

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.

This study examined the effect of artesunate (Art) on the proliferation, DNA replication, cell cycles and apoptosis of vascular smooth muscle cells (VSMCs). Primary cultures of VSMCs were established from aortas of mice and artesunate of different concentrations was added into the medium. The number of VSMCs was counted and the curve of cell growth was recorded. The activity of VSMCs was assessed by using MTT method and inhibitory rate was calculated. DNA replication was evaluated by [3H]-TdR method and apoptosis by DNA laddering and HE staining. Flowmetry was used for simultaneous analysis of cell apoptosis and cell cycles. Compared with the control group, VSMCs proliferation in Art interfering groups were inhibited and [3H]-TdR incorprating rate were decreased as well as cell apoptosis was induced. The progress of cell cycle was blocked in G0/G1 by Art in a dose-dependent manner. It is concluded that Art inhibits VSMCs proliferation by disturbing DNA replication, inducing cell apoptosis and blocking cell cycle in G0/G1 phase.
Aorta/cytology ; Apoptosis/*drug effects ; Artemisinins/*pharmacology ; Cell Cycle/drug effects ; Cells, Cultured ; DNA Replication/*drug effects ; Muscle, Smooth, Vascular/*cytology ; Sesquiterpenes/*pharmacology

OBJECTIVE:To investigate clinical efficacy and safety of Xuebijing injection in the treatment of chronic ob-structive pulmonary disease (COPD) complicated with community-acquired pneumonia (CAP). METHODS:A total of 88 COPD patients with CAP selected from our hospital during Feb. 2013-Jan. 2015 were divided into control group and observa-tion group according to random number table,with 44 cases in each group. Control group received routine treatment as an-ti-infection,reducing phlegm,fluid replacement,nutritional support,etc. Based on control group,observation group was ad-ditionally given Xuebijing injection 50 mL added into 0.9% Sodium chloride injection 100 mL,ivgtt,for 30-40 min,bid, for consecutive 10 d. Clinical efficacy,application time of antibiotics,pulmonary function indexes [FEV1,FVC,FEV1/FVC,VC] were observed in 2 groups. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group was 88.64%,which was significantly higher than 70.45% of control group,with statistical significance(P<0.05). The application time of antibiotics in observation group was significantly shorter than control group,with statistical significance (P<0.05). There was no statistical significance in FEV1,FVC,FEV1/FVC,VC between 2 groups before treatment (P>0.05). After treatment,FEV1 and VC of 2 groups were improved significantly,and the observation group was better than the control group,with statistical significance(P<0.05). There was no statistical significance in FVC,FEV1/EVC before and af-ter treatment and betwean the two groups (P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Xuebijing injection has significant therapeutic efficacy for COPD complicated with CAP and can significantly shorten the use time of an-tibiotics,improve pulmonary function with good safety.

Gastrointestinal bleeding in children is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach.The causes of hemorrhage are numerous and varies with age.The clinical presentation of gastrointestinal bleeding in children ranges from asymptomatic microcytic anemia to hypovolemic shock.Therefore,the primary focus in a child with gastrointestinal bleeding is rapid assessment,stabilization,and resuscitation followed by a diagnostic modalities.

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 investigate the effect of batroxobin on the plasma levels of endothelin (ET) and calcitonin gene-related peptide(CGRP) in patients with acute cerebral infarction(ACI). Methods 60 patients with ACI were randomly divided into therapy group(n = 30) and control group(n = 30),500 ml of 5% GS plus 1.0g ramme of Troxerutin was intravenously dripped par day and ticlopidine 250mg/day in the control group. Based on the control group therapy,Batroxobin was intravenously dripped with 10U on the 1st day and 5U on the 3rd and 5th day for seven days. The plasma levels of ET and CGRP were detected pre and post treatment by radioimmunoassay. Results Plasma levels of ET and CGRP in batroxobin therapy group post treatment ( 81.25±27.38 ) ; ( 44. 13±13.30) ng/L were significantly different from those pre treatment(109. 83±38.24) ; (24. 73±13.59) ng/L (all P＜0. 01 ) ,and were also significantly different from those post treatment in the control group(98.07±30. 39) ; (37.02±12. 41 )ng/L (all P＜0. 01 ). Conclusion Batroxobin can accommodate the equilibration between ET and CGRP, and protect brain cell and blood vessel endothelial cell.

Objective To quantify Contribution to LE at Birth from Mortality Variation for Some Diseases in Shanghai.Methods Health problem for population was classified into 5 group: infectious group,tumor,cerebrovascular group,injury and others.Cause elimination life table methods was employed to analyze the mortality registry data for Shanghai residents during 1953 to 1999.Chisquare for trend was used to analyze the variation for ASMR and Pearson correlation was used to describe the relationship between the variation of LE at birth and social economic factors.Results During 1953 to 1999,crude mortality rate(CMR),mortality rate by area,age-specific mortality rate(ASMR) from infectious group diseases showed obvious trends of descending.Also CMR and ASMR from injury for urban residents showed obvious trends of ascending.However,for suburb residents,CMR from injury had a trend of decline but ASMR had no significant trend.CMR from tumor and cerebrovascular group for Shanghai residents showed a rising trend but mortality rate by area and ASMR not.After 1979,the proportion of contribution for the rise of LE at birth for Shanghai urban residents from infectious group was about 33%,which was much higher than that of other 3 groups.The proportions of contribution in suburb male group from injury and cerebrovascular were 40.26% and 25.18%,respectively.The variation of mortality risk from tumor for urban male residents gave a negative contribution to respondent rise of LE at birth.Besides,the proportions of contribution in suburb female group from infectious disease(21.60%) and injury(12.55%) were largest.Compared to the mortality in 1996,among infectious group,injuries,tumor and cerebrovascular group,potential decline of mortality from tumor contribute the most to the rise of LE at birth,cerebrovascular group has the second,injury had the third and infectious group has the least.Development of Shanghai medical service resource showed a significant correlation with the rise of LE at birth.Conclusion Shanghai has successfully prevented and controlled the infectious disease group.The future strategy for disease prevention and control ought to focus on tumor,cerebrovascular diseases and injury.Based on the theory of risk competing,cause elimination life table method help greatly to set proper LE aims for public health plan.

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.