Objective To explore the common complications and methods of treatment in the malignant obstruction of upper alimentary tract with stent insertion. Methods With interventional procedure under fluoroscopic guidance fourteen self expanding stents were implanted in twelve patients, including nine with strictures or obstructions of esophagus, three with obstructions of gastroduodenum. Of the fourteen, nine were coated stents and five were uncoated stents. Results All stents were implanted successfully, but complications after the procedure occurred sometimes. There complications included: 1. Food bolus obstructed in three patients. 2. Chest pain occurred in four patients. 3. Tumour overgrowth or hyperplasia of granulation tissue in three patients caused restenosis of gastrointestinal tract. 4. Stent replacement in three patients. 5. Hemorrhage occurred in two patients (over 300 ml) causing threat to life. Conclusions The implantation of self expanding stent is a simple and effective method offering good palliation for upper alimentary tract obstructions. The complications shoud be treated correctly.

The incidence of severe viral pneumonia increased year on year,cardiac dysfunction is one of the commonest complications in severe pneumonia.But it is still controversial whether or not the severe pneumonia is associated with heart failure.This article focuses on the mechanisms and the treatment of severe pneumonia complicated with cardiac dysfunction.

OBJECTIVE:To cultivate qualified prescription-checking pharmacists and to ensure patients'rational drug use. METHODS:The status quo of prescription-checking pharmacists in China was analyzed and some concrete suggestions on how to cultivate qualified prescription-checking pharmacists were made.RESULTS:The phenomena of low educational level and low professional title,lack of professional knowledge and medical knowledge,lack of staff members were widespread in today's Chinese prescription-checking pharmacist professionals.CONCLUSION:The rational drug use can only be realized through being fully aware of the importance of prescription-checking pharmacists,enhancing whose admittance qualifications,working out professional standards for whom,clearly defining their responsibilities,strengthening their cultivation and increasing their numbers.

The mi nimizign time on mechanical ventilait on is one of the great importna t issues in crit-ical ill patienst ,only limited guidance on weaing and extubation is available from the pediatric literature.T he clinical application ofni dicta ions for weaning are even less clear,and the protocol-based wae ningw ith sponta-neous breaht ing trail is a feasible way in pediatric intensive care unit.

0.05), so they were called the non-Dampness-Stagnation type. After adjusting age, sex, blood pressure, blood fat and blood glucose, Logistic regression analysis demonstrated that insulin sensitivity was closely correlated with SDT (P

Objective To study the feasibility and safety of laparoscopically assisted hepatectomy without choledochotomy and T-tube drainage for the treatment of hepatolithiasis.Methods The study included 11 patients with hepatolithiasis in the left intrahepatic duct.Of the 11 patients,8 patients were complicated with choledocholith and 5 patients with cholecystolithiasis.After laparoscopically assisted left hepatectomy,extrahepatic bile duct stone removal and right hepatic duct exploration were carried out under video-assisted choledochoscopy through the left hepatic duct,without choledochotomy and T-tube drainage.Results The operation was successfully accomplished in all the 11 patients.Liver procedures included laparoscopically assisted left lateral lobectomy in 5 patients and left hemihepatectomy in 6 patients.The mean operation time was 128 min(range,110~150 min),and the mean blood loss was 95 ml(range,50~150 ml).No serious postoperative complications occurred.The mean postoperative hospital stay was 7 d(range,5~10 d).The 11 patients were followed for a mean of 7.6 months(range,2~16 months).The curative effects were classified as excellent in 10 patients and good in 1.No residual or recurrent stones were noted.Conclusions Laparoscopically asisted hepatectomy without T-tube drainage for the treatment of hepatolithiasis is feasible and safe for selected patients.This procedure offers advantages of simplicity of performance,short operation time,and fewer complications,being a worthwhile minimally invasive alternative.

0.05),were remarkably higher than those of the control group(P

Objective To evaluate the clinical effectiveness of direct coronary stenting without predilatation in acute myocardial infarction (AMI) Methods Intracoronary stent was directly deployed without ballon predilation in 22 patients within 12 hours from onset Single vessel disease was in 12 patients (54 5%),double vessel disease in 4 patients(18 2%) and triple vessel disease in 6 patients(27 3%) Infarct related arteries (IRA) were left anterior descending artery in 12 patients (54 5%), left circumflex in 5 patients (22 7%), right coronary artery in 5 patients (22 7%) Thrombolysis in myocardial infarction TIMI 1 flow in 5 patients (22 7%), TIMI 2 flow in 13 patients (59 1%) TIMI 3 flow in 4 patients (18 2%) Results Twenty two stents were implanted (1 stent/patient) Post stenting residual stenosis decreased to 3 2?2 9%, stent deployment was successful in 100% of the cases, There were no complications, no death, no Q wave or non Q wave myocardial infarction and no repeated recanalizations during the hospitalization Conclusion Direct coronary stenting without predilatation can be performed in AMI with its high successful rate and low complication

Objective To evaluate the effect and mechanism of HMG-CoA reductase inhibitor simvastatin on experimental interstitial fibrosis. Methods Experiments on rat 5/6 nephrectomy chronic renal failure model and primary cultured renal interstitial fibroblast cells were conducted in this study. The cell proliferation, extracellular matrix, c-fos mRNA expression of rat interstitial fibroblasts were measured by MTT assay, immunohistochernitry, semi-quantitative reverse-transcript PCR methods, respectively. Results Serum cholesterol, triglyceride and creatinine of treated group were significantly reduced by simvastatin as compared with controls. No statistical significance in BUN was observed between untreated and simvastatin-treated rats. Histological examination revealed that simvastatin caused a reduction in the glomeruli with sclerosis. Tubulointerstitial injury paralleled the degree of glomerular damage. Simvastatin in a dose-dependent manner inhibited the proliferation of renal intersititial fibroblasts, decreased the secretion of lamimn( LN), and suppressed the expression of c-fos mRNA, as compared with normal controls. No obvious effect on hyaluronic acid( HA) secretion of fibroblasts was found. Conclusions Simvastatin is anti-proliferative in interstitial fibroblasts and decreases the secretion of laminin. This effect is exerted, at least in part, via inhibition of the c-fos and c-jun-dependent mitogenic pathway. Simvastatin may prevent interstitial fibrosis development and attenuate renal damage in uremic rats with hvperlipidemia.

Objective To investigate the effect of hypoxia on renal tubular cells and the mechanism of renal interstitial fibrosis. Methods Effect of chronic hypoxia on the proliferation, cell cycle and expression of TGF-?1 mRNA in cultured MDCK cells was examined. Quiescent cells were exposed to hypoxia (3%O2) or normoxia (18%O2) for 24, 48, 72 and 96 hours. At the end of each incubation, cellular proliferation and cell cycle were assessed by MTT method and flow cytometry, respectively. TGF-?1 mRNA level of cells were analyzed by semi-quantity RT-PCR. Results Exposure of MDCK cells to hypoxia induced a significant increase in proliferation and a significant decrease in the percentage of G0-G1 stage and a significant increase in the percentage of G2-M stage at 24, 48 and 72 hours. Meanwhile, TGF-?1 mRNA expression increased in a time-dependent manner as compared with normoxia group when MDCK cells were stimulated with 24, 48, 72 and 96 hours in hypoxia condition. Conclusion Chronic hypoxia-induced proliferation of MDCK cells is associated with increased expression of TGF-?1. Chronic hypoxia of renal tubular cells may be one of the causes of renal interstitial fibrosis.