26 cases of sudden death caused by diseases of heart and blood vessels collected in our department in the past 30 years have been analysed and studied in the course of autopsy. It has been found that sudden death caused by diseases of cardiovascular system takes the first place in all cases of the sudden death ,and the highest incidence of them is atherosclerotic corcnary heart disease and fatty heart. The characters of these cases in pathology and etiology have been discussed and analysed.

Objective To investigate the significance of the expression levels of humans telomerase reverse transcriptase(hTERT) gene in peripheral blood mononuclear cells with lung cancer patients. Methods From Mar.2002 to Feb.2005,the expression levels of hTERT were detected in 30 lung cancer patients and 15 normal humans by quantitative measurement with RT-PCR. Results The expression levels of hTERT mRNA in lung cancer patients (0.906?0.112) were significant as compared with those health controls(0.407?0.104). Conclusion It is effective to diagnose lung cancer by the quantitative measurement with RT-PCR for the expression levels of hTERT mRNA.

Objective To study the diagnostic value of radial echoendoscopy combined with ultrasonic micro-probe for differentiating mediastinal disease from esophageal submucosal lesion.Methods Data of 53 patients with esophageal eminence with unknown origin detected by gastroscopy or CT in China-Japan Union Hospital were reviewed.Ultrasonic micro-probe was performed first and followed with radial echoendoscopy.The diagnosis was compared with the results of CT.Results The diagnostic sensitivities of EUS and CT for esophageal submucosal lesion were 90.9％ (20/22) and 50.0％ (11/22),and the specificities were 93.5％ (29/31)and 83.9％ (26/31).The sensitivities for the benign mediastinal disease were 91.7％ (22/24) and 70.8％ (17/24),and the specificities for the benign disease were 93.1％ (27/29)and 62.1％ (18/29).The sensitivity and specificity for malignant mediastinal disease were both 100.0％.Conclusion Radial echoendoscopy combined with ultrasonic micro-probe shows prominent advantage in the diagnosis of the esophageal submucosal lesion and mediastinal disease over CT,especially in the specificity and sensitivity for esophageal submucosal lesion and benign mediastinal disease.

AIM To set up the model of stom- effects of its treatment drugs. METHODS To ap-ach smooth muscle cells contraction and assess the ply the culture of isolated stomach fundus smooth muscle cells in rats in vitro and to obtain the mixture of stomach smooth muscle cells. The cells were examined with the Trypan blue dilution technology under microscope and the length of cells and the contraction rate of muscle cells were adopted to the evaluation index of effects. The change of cells in different time was observed and calculating the survival rate and time of cells. The selected neuro-medium and its antagonist, such as acetyl-choline chloride (ACh) and atropine, 5-HT and domperidone(Domp) , histamine( His) and diphen-hydramine(Diph) were added to the mixture cells so as to provoke irritant reaction observe the effects of drugs. RESULTS Obtaining cells in stomach fundus smooth muscle was more than 1 X 106 in each rat by this way, and the survival rate and time of cells was 95% and 2. 5 h. The contraction of cells was observed after adding ACh 5-HT or His ,and the effects of these agents were antag- onized by antagonist atropine, Domp and Diph respectively. The effects of maximum contraction of ACh in concentration 1?10-8 mol ? L-1 was 38%, and in 5-HT may exist two receptors, and the maximum rate was 20. 7% and 10. 5% respectively. The effective dose of contraction was 1 X 10-13 -1?10-10 mol ? L-1 induced by His, the contraction effects was significantly weakened in high of 1 ?10-10 mol ? L-1 and antagonized by Diph. CONCLUSION The smooth muscle cells by digesting stomach fundus smooth muscle of rats would be more than 95% survivors and survival time was more than 2. 5 h. ACh,5-HT and His could induce the contraction of smooth muscle cells, and the effects of contraction were antagonized by atropine, Domp and Diph respectively.

AIM: To analyze the lovastatin-induced differential gene expression in HepG2 cells using a cDNA microarray assay. METHODS: Total RNA was extracted from the lovastatin-treated HepG2 cells and control group. cDNA was synthesized from RNA with Cy3/Cy5-labelled dCTP. Then the hybridization was conducted. The result was analyzed using Imagene and Genespring software. RT-PCR was carried to confirm the hybridization results. RESULTS: 30 genes were up-regulated while 11 genes were down-regulated in lovastatin-treated HepG2 cells, involved in some major functional areas including signal transduction, cell cycle regulation, tumor immunity, and so on. CONCLUSION: The analysis of differentially expressed genes in lovastatin-treated HepG2 cells is helpful to explore the mechanism of the anti-tumor activity of statins.

Objective To evaluate the long-term efficacy of modified loop choledochojejunostomy (MLC). Methods The clinical data of 259 patients who had underwent choledochojejunostomy in First Affiliated Hospital of Sun Yat-Sen University from January 2000 to December 2006 were retrospectively analyzed. Of all the patients, 130 underwent MLC (MLC group) and 129 underwent Roux-en-Y choledochojejunostemy (RYC, RYC group). The changes in incidence of cholangitis and liver function between the 2 groups were compared. All the data were analyzed by t test, chi-square test or Fisher exact probability. Results The levels of alaninetransa-minase and alkaline phosphomonoesterase were (63±42) U/L and (147±147) U/L in MLC group, and (84±52)U/L and (256±201)U/L in RYC group, with statistical difference between the 2 groups (t=1.634, 1.655, P>0.05). The level of gamma-glutamyl transferase in MLC group was (116±91)U/L, which was signifieandy lower than (169±96)U/L in RYC group (t=2.461, P<0.05). Three patients (2.3%) in MLC group and 9 (7.0%) in RYC group suffered from acute cholangitis after operation, with no statistical difference in the incidence between the 2 groups (P>0.05). Of the 12 patients with acute cholangids, 1 in MLC group and 7 in RYC group were hospitalized, with statistical difference between the 2 groups (P<0.05). Conclusions The incidence of acute cholangitis in patients who underwent MLC is comparable to that of RYC. However, the procedure of MLC is simpler than RYC, and patients have milder symptom and lesser frequency of reflux cholangitis onset after MLC.

Objective To investigate the relationship of matrix metalloproteinases(MMP?3 and MMP?9)and the tissue inhibitor TIMP?1 with left ventricular hypertrophy(LVH)in patients with primary hypertension. Methods Totally 140 patients with primary hypertension and 132 healthy controls were included. Matrix metalloproteinase?3(MMP?3),matrix metalloproteinase?9(MMP?9)and tissue inhibitor metalloproteinase?1 (TIMP?1)were measured. All subjects were taken echocardiography examination ,then left ventricular mass index(LVMI)was calculated. Re?sults MMP?3,MMP?9,TIMP?1(488.32±100.32 vs 314.59±99.78;340.56±43.21 vs 290.15±33.98;389.16±57.53 vs 243.45±62.31;P<0.001) and LVMI(113.7±9.9 vs 88.3±10.4,P<0.001)in patients with primary hypertension were significantly higher than those in controls. In a multiple stepwise regression analysis with LVMI as the variable,it was found that age,SBP,MMP?3,MMP?9 and TIMP?1 were main determinants for LVMI (r2=0.78,P<0.001). 3. Patients with primary hypertension were divided into two subgroups according to LVMI,i.e.,hypertension with LVH (group A)and hypertension without LVH(group B). SBP,MMP?3,MMP?9 and TIMP?1(178±31 vs 166±25;490.14±99.13 vs 405.56±53.12;340.56±43.21 vs 290.15±33.98;393.45±47.69 vs 301.58±39.57;P<0.05)of group A were significantly higher than those of group B. Conclusion MMP?3,MMP?9 and TIMP?1 are influencing factors for LVH in patients with primary hypertension.

OBJECTIVE:To study the development of community pharmaceutical care.METHODS:The significance of community pharmaceutical care was elaborated based on its status quo analysis,and the way to improve the pharmaceutical care was discussed theoretically.RESULTS&CONCLUSIONS:Patient-centered community pharmaceutical care is the primary responsibility of community pharmacists,the community pharmacists should strengthen their study,update their knowledge structure and play an important role in community pharmaceutical care.

Objective To investigate the value of interventional therapy in bile duct injury (BDI) due to laparoscopie cholecystectomy (LC). Methods Data of 24 BDI patients, who received interventional treatment after LC from June 1997 to May 2007, were retrospectively analyzed. Results According to Liu Yunyi criteria of BDI classification, there were 5 cases of type Ⅰ , 11 cases type Ⅱ , 2 type Ⅲ and 6 type Ⅳ. BDI was found during LC in 2 patients and the operation was switched to open cholecysteetomy, but bile duct infection was experienced 10 months and 2 years after the operation, respectively. BDI was diagnosed postoperatively in 22 patients, in which 13 eases occurred 3-12 days after LC, 7 cases 20-60 days after LC, and 2 cases 2 years after LC. Complete remission was achieved by interventional therapy in 5 patients, the other 19 patients received curative operation after control of cholangitis and jaundice. Among 13 patients who were diagnosed BDI 3-12 days after LC, 6 underwent emergency operation and failed. Of the 7 other patients who received interventional therapy, 3 were cured and the others underwent curative operation after cholangi-tis and jaundice were controlled. Conclusion Application of interventional therapy in BDI after LC can a-chieve successful bile duct support and drainage, and can obtain complete image of bile duct system, which is effective not only in control of cholangitis and jaundice for the safety of the following surgery, but also in cure of BDI.

Objective To analyze the factors influencing the prognosis of patients with pancreatic cancer.Methods The clinical data of 276 patients with pancreatic cancer who had been admitted to our department from September 1995 to August 2005 were retrospectively analyzed.Cox regression analysis was used to screen out independent risk factors influencing the prognosis of patients with pancreatic head cancer or pancreatic body and tail cancer,and Kaplan-Meier method to calculate the median survival time.The effects of tumor location on the prognosis were examined by Log-rank and Breslow test.Results Cox regression analysis showed that the diameter of tumor,invasion of the superior mesenteric vessel and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic head cancer;while age,lymphadenectasis and treatment method were the independent risk factors influencing the prognosis of patients with pancreatic body and tail cancer.The median survival time of patients with pancreatic head cancer and pancreatic body and tail cancer after radical resection were 460 days and 480 days,which were significantly longer than 240 days and 200 days of patients who received palliative treatment or gave up treatment.The median survival time of patients with whole pancreatic cancer was 117 days,which was significantly shorter than 330 days of patients with pancreatic head cancer and 300 days of pancreatic body and tail cancer.Conclusions Radieal resection is currently the best choice for pancreatic cancer.The prognosis is poor for patients with pancreatic head cancer(diameter≥4 cm)and invasion of the superior mesenteric vessel.Patients with age≤60 and lymphadenectasis are the factors resulting in poor prognosis of pancreatic body and tail cancer.The prognosis of patients with pancreatic head cancer and pancreatic body and tail cancer are close.Patients with whole pancreatic cancer is in the terminal stage with the worst prognosis.