OBJECTIVE:To study the quantity-effect relationship of reptilase with surgical hemostasis used at different dosages perioperatively and postoperatively.METHODS:120patients undergoing urological and general operations were ran-domly divided into experimental and control group.In the experimental group reptilase was administered at the dose of2KU by iv during the operation and continuously given at the dose of1KU～2KU by iv drip or iv twice a day after the operation until bleeding stopped.In the control group reptilase was administered at the dose of1KU by iv during the operation and continu-ously given at the dose of1KU by iv drip or iv once a day after the operation until bleeding stopped.RESULTS:The bleeding volumes in experimental and control group were(141?11.2)ml and(198?12.1)ml(P

Objective To optimize the extraction process and to establish a method for the content determination of the polysaccharides in Ophiopogonjaponicus.Methods With extracts rate of polysaccharide as the index,an orthogonal de- sign test was adopted to optimize the extraction process.And phenol-sulphuric acid colorimetric method was used to de- termine the content of polysaccharides in Ophiopogonjaponicus.Results The optimum extract conditions were as follows: refluxing twice with eight times amount of water,thirty minutes each time,and precipitation with 80 % alcohol.A good linearity of polysaccharides was in range of 0.02032～0.10008 mg(r=0.9998),and the average recovery rate was 102.41%,RSD was 1.78 %.Conclusion The polysaccharide can be fully extracted under these conditions.

Objective To investigate the effectiveness of surgical resection for metastatic liver cancer in patients of gastric carcinoma, and evaluate the prognosis. Methods Clinical data of 24 gastric cancer cases undergoing hepatectomy for hepatic metastatic tumor were collected retrospectively. There were 18 cases of synchronous resection and 6 cases of heterochronous resection. The prognostic values of clinicopathological factors were assessed by univariate and multivariate analyses. Results Postoperatively all cases were followed up until the death of the patietns. Counting from the time of liver resection the 1-,3- and 5-year survival rate was 67%, 21% and 13% respectively. Univariate analysis showed lymph node involved, tumor size of hepatic metastases, vascular invasion and R0 margin as significant prognostic factors;Multivariate analysis indicated that tumor size of hepatic metastases and vascular invasion were independent prognostic factors influencing the survival. Conclusion These results suggest that for patients with liver metastasia from gastric cancer, better prognosis can be obtained by surgical treatment.

Objective To study the clinical feature,diagnosis,treatment and prognosis of hepatocellular adenoma(HA).Methods The clinical data of 10 patients confirmed pathologically with HA,were retrospectively analyzed.Results There were four females and six males,aging from 25 to 71 years(mean:42.6 years).Among these 10 patients,6 cases were discovered to have no clinical symptom.Tumors were located in the right lobe of the liver in 4 cases,and in the left lobe in 6 cases.Uhrasonography was performed in all cases.Six cases underwent CT examination and three cases experienced MRI as well as angiography was conducted in one case.All cases were confirmed by complete excision and pathology.All of them were followed up for 5 months to 9 years without tumor recurrence.Conclusion The combination of imaging data is helpful in the diagnosis of HA.Surgery is the best treatment with satisfactory results,and its prognosis is fairly good.

Objective To study the diagnosis and treatment of pancreatic cystadenoma and cystadenocarcinoma.Methods The clinical data of 21 surgically treated patients of the cystic neoplasms of pancreas(CNP),confirmed by pathology,in recent 8 years were retrospectively analyzed.Results CNP was more frequently seen in young to middle-aged women.Upper abdominal mass and abdominal distention and pain were the main clinical presentations.The CNP resection rate was 95%(100%and 80%in benign and malignant CNP respectively).Of the 21cases,pancreaticoduodenectomy and distal pancreatectomy were performed in 2 and 16 respectively;and middle segment pancreatectomy in 2 patients.Postoperative pancreatic fistula was the leading complication.Conclusion CNP have no clinical characteristics.Ultrasonography and CT could be helpful to the diagnosis of CNP.The resection of the whole tumor with part paratumor pancreas tissue is advocated.

Objective To establish a type of porcine model for controlled Cardiac Deceased Donor.Method Using the wuzhishan miniature pig 2 ～ 4 months of age.After intravenous general anesthesia and respiratory,after open heart surgery to produce myocardial infarction model,to heartbeat stop completely,stop breathing machine and drug support,so we established a miniature pig cardiac death donor model.Record during the heart rate,systolic pressure,diastolic blood pressure,central venous blood pressure,blood oxygen saturation and regularly take on blood gas analysis.Before cardiac arrest,monitoring hemodynamic,blood gas analysis,and the time of death before the circulatory failure.After cardiac arrest respectively 0 min,15 min and 30 min,perfusion for donor organs (liver/kidney),get the pig's liver/kidney in the different time of the groups,observed the pathological changes of liver/kidney tissues by HE staining.Result The heartbeat stop completely occurs 7 ± 0.17 minutes after left descending coronary artery ligation and cease of assisted respiration in the different groups,systolic pressure,diastolic blood pressure,central venous pressure,blood oxygen saturation,CO2 partial pressure changed significantly;Immediately after cardiac arrest for compared group (0 min),schemia-reperfusion that group of 15 min after cardiac arrest injury is obvious,ischemia-reperfusion that group of 30 min after cardiac arrest injury is further.Conclusion Miniature pig donor model obtained in this method respiratory cycle failure stability,can be controlled,no adverse drug reactions,the organ ischemia-reperfusion injury caused by repetitive is better.

Objective To compare the pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in the patients undergoing spinal surgery in prone position supported by a Wilson frame.Methods Forty patients,of ASA physical status Ⅰ or Ⅱ,aged 30-64 yr,with body mass index ＜ 30 kg/m2,scheduled for elective spinal surgery in prone position supported by a Wilson frame under general anesthesia,were randomly allocated to receive mechanical ventilation using either VCV (n =20) or PCV (n =20) mode.Endotracheal intubation and mechanical ventilation were performed after induction of anesthesia.The tidal volume (VT) was set at 10 ml/kg according to the ideal body weight in group VCV.The maximal inspiratory pressure of the anesthesia machine was adjusted to maintain the VT at 10 ml/kg in group P.Both ventilation modes were required to maintain PET CO2 within the normal range.VT,respiratory rate,minute ventilation (MV),dynamic lung compliance (Cdyn),peak and mean airway pressure (Ppeak,Pmean),mean arterial pressure (MAP) and HR were recorded at 10 min after the patients were turned to supine position and at 30 min after the patients were turned to prone position after intubation.Arterial blood samples were collected for blood gas analysis,and oxygenation index(OI) and physiologic dead space fraction (VD/VT) were calculated.Results Compared with those at 10 min after turning to supine position,Ppeak was significantly increased and Cdyn,VT and MV were decreased at 30 min after turning to prone position in both groups.Compared with group VCV,Ppeak was significantly decreased,respiratory rate and Cdyn were increased,and no significant change was found in VT,MV,OI,VD/VT,Pmean,MAP and HR in PCV group.Conclusion Compared with VCV,PCV can improve the ventilatory efficacy and reduce the influence of prone position on respiratory dynamics in the patients undergoing spinal surgery in prone position supported by a Wilson frame.

ObjectiveTo investigate the clinical efficacy of combined traditional Chinese and western medicine for treatment of patients with deep venous thrombosis(DVT)in lower extremity.Methods A retrospective study was conducted. Forty patients with DVT admitted into Mindong Hospital Affiliated to Fujian Medical University were randomly divided into control and treatment groups, 20 cases in each group. Conventional therapy was given in both groups. The patients in control group were hypodermically injected with low molecular heparin 3.075 kU, and orally took warfarin sodium; the former injection was terminated on the 3rd day, and afterwards warfarin was solely administered. On the basis of the treatment in the control group, the patients in treatment group were additionally treated with Huoxue Tongmai decoction(ingredients: peach kernel 15 g, red paeonia 15 g, honeysuckle flower 15 g, rhizoma alismatis 12 g, semen coicis 30 g, semen plantaginis 9 g, suberect spatholobus stem 12 g, radix scrophulariae 9 g, pawpaw 12 g, radix achyranthis bidentatae 12 g), the formula could be modified in accordance with patients' symptoms and signs, and Jiangjun powder was applied at the lesion externally(ingredients of the powder: rhubarb 250 g, mirabilite 200 g, flour 100 g, vinegar 500 g were mixed to form a smooth paste), once a day, 30 days constituting a therapeutic course and totally 2 courses being taken. The perimeter of the affected limb, visual analogy score(VAS), revascularization rate, curative effect and adverse reaction were observed before and after treatment and compared between the two groups.Results The total effective rate in treatment group was higher than that in control group〔90.0%(18/20) vs. 70.0%(14/20),P<0.05〕. After treatment, the perimeter of the affected limb in both groups was significantly smaller than that before treatment, the decrease in treatment group being more marked〔the upper leg(cm):46.21±4.80 vs. 53.18±4.45, the lower leg(cm): 32.57±4.26 vs. 36.21±5.01, bothP<0.05〕. TheVAS scores were significantly decreased in both groups after treatment for 1 month, they reached the valley values after treatment for 2 months, the degree of descent being more significant in the treatment group(2.24±0.58 vs. 3.36±0.61,P<0.01). The revascularization rate of the treatment group after treatment was higher than that of the control group〔85.0%(17/20) vs. 70.0%(14/20),P<0.05〕.ConclusionThe combined treatment of traditional Chinese and western medicine was obviously superior to the sole western medicine for treatment of patients with DVT.

Objective To observe the serum cyclophilin A(CyPA)level change in the patients with coronary heart disease (CHD)and to investigate its clinical significance.Methods 64 patients with CHD(CHD group)were divided into three groups ac-cording to the clinical types:stable angina pectoris(SAP)group,unstable angina pectoris(UAP)group and acute myocardial infarc-tion(AMI)group;which were divided into three groups according to the coronary artery lesion range:single vessel lesion group, double vessels lesions group and multi vessels lesions group;while 26 controls with normal coronary arteries were select as the con-trol group.Serum levels of CyPA and matrix metalloproteinase-9 (MMP-9 )were detected by ELISA,and C-reactive protein(CRP) concentration was detected by the immune scattering turbidimetry test.Results The CyPA,MMP-9 and CRP levels in the CHD group were significantly higher than those in the control group(P<0.01);the CyPA and CRP levels in the AMI group and the UAP group were significantly higher than those in the control group and the SAP group(P<0.05),the CyPA and CRP levels had no statistically significant difference between the SAP group and the control group(P>0.05);serum CyPA,MMP-9 and CRP levels in the single vessel lesion group,the double vessels lesion group,multi vessels lesion group were significantly higher than those in the control group(P<0.05),serum CyPA,MMP-9 and CRP levels were elevated with the increase of coronary artery lesion vessels (P<0.05).In the CHD group,serum CyPA with MMP-9 and CRP showed the significantly positive correlation(r=0.772,0.749, P<0.01).Conclusion Serum CyPA level is significantly increased in the patients with CHD,CyPA may have some relationship to CHD and the plaque stability.

The clinical data of 147 patients with carcinoma of ampulla of Vatar at our hospital from January 1998 to December 2012 were retrospectively analyzed.The neutrophil-to-lymphocyte ratio ( NLR) was calculated from pre-operative complete blood count.They were divided into low NLR group (NLR<5,n=121) and high NLR group (NLR≥5,n=26).The 5-year survival rates of two groups were compared and the prognostic risk factors examined by univariate analysis and Cox model.The 5-year free survival rates of low and high NLR groups were 57.9%and 27.6%respectively ( P=0.005 ).Univariate analysis revealed that depth of invasion (P=0.006),pancreatic invasion (P=0.002),lymph nodal metastasis (P=0.008), poor differentiation ( P =0.008 ) , tumor stage ( P =0.003 ) and per-operative NLR ( P =0.005 ) were significant prognostic factors.Multivariate analysis showed that per-operative NLR significantly increased the risk of recurrence (P<0.05).Pre-operative NLR represents a significant independent prognostic indicator for patients with carcinoma of ampulla of Vatar.