BACKGROUND: Serious lesion to liver function may cause the pulmonary artery hypertension and fluctuation of haemodynamics directly induces changes of pulmonary artery pressure during neo-hepatic stage in liver transplantation. OBJECTIVE: To observe the change of pulmonary artery pressure during liver transplantation and to explore treatment for pulmonary artery hypertension. DESIGN, TIME AND SETTNG: Controlled observation was carried out among the liver transplant recipients who were enrolled from the 181 Hospital of Chinese PLA from June 2004 to June 2006.PARTICIPANTS: Totally 13 patients, all males, were reviewed. Their ages ranged from 19 to 53 years. They were selective for the liver transplantation. METHODS: Undergoing general anesthesia, mean arterial blood pressure, central venous pressure, pulmonary arterial pressure and pulmonary arterial wedge pressure were continuously monitored by Swan-Ganz catheter method and reversible Fick's law continuous monitoring. Available respiration administration, low dose of glyceryltrinitrate (0.1-5.0 u g/kg/min) and Alprostadil (1.0-2.0 u g) were administered to diminish elevated pulmonary arterial pressure and pulmonary arterial wedge pressure during the period after unclamping portal vein in liver transplantation. MAIN OUTCOME MEASURES: Changes of mean arterial blood pressure and pulmonary arterial pressure. RESULTS: The mean arterial blood pressure deceased at the time of unclamping portal vein in all 13 patients, pulmonary arterial pressure and pulmonary arterial wedge pressure both increased significantly at 5 and 15 minutes within neo-hepatic stage, which were more obvious than those during anhepatic stage in 13 patients(P＜0.05).The pulmonary arterial pressure and pulmonary arterial wedge pressure revived to the level before unclamping inferior vein by treatment with glyceryltrinitrate and Alprostadil within 30 minutes. CONCLUSION: Reasonable application of glyceryltrinitrate and Alprostadil can obviously release pulmonary arterial pressure during neo-hepatic stage in liver transplantation.

Objective:To explore the diagnostic value of treadmill exercise test (TET)and its Duke score in menopa-usal female patients with coronary heart disease (CHD).Methods:A total of 102 menopausal female patients re-ceived TET and coronary angiography (CAG)examination.With CAG as control,accuracy indexes etc.of TET combined Duke score diagnosing coronary artery disease in these patients were compared and analyzed.Results:Compared with single application of TET or Duke score,there were significant rise in specificity (27.12% vs. 30.50% vs.44.44%),positive predictive value (47.56% vs.46.75% vs.54.55%),negative predictive value (80%vs.72% vs.90.91%)and accuracy (53.92% vs.52.94% vs.64.94%)diagnosing CHD by TET combined Duke score both positive and negative,P <0.05 all;but there was no significant difference in sensitivity,P >0.05 both. There was no significant difference in CHD diagnosis between single use of TET and Duke score,P >0.05 all.Con-clusion:False positive rate of treadmill exercise test is higher in menopausal women.Treadmill exercise test com-bined Duke score is helpful to improve specificity,positive predictive value,negative predictive value and accuracy of the test.

Objective To investigate the effect of endoscopic treatment of delayed hemorrhage after endoscopic sphincterotomy.Methods Retrospectively analyzed the data of 2 638 patients who underwent endoscopic sphincterotomy.There were 26 patients who delayed hemorrhage after endoscopic sphincterotomy.All the 26 patients underwent duodenoscopy,and endoscopic treatment was underwent for the patients who had active bleeding.Results There were 21 patients had active bleeding,and the other 5 cases had no bleeding.There were 12 patients with capillary hemorrhage and 9 cases with petechial hemorrhage.In the 12 patients with capillary hemorrhage,9 patients had been sprayed tissue glue,and 3 patients had been local injected with 1 10 000 noradrenalin.In the 9 patients with petechial hemorrhage,5 patients were treated with titanium clip,and 4 patients were treated with argon ion.All the 21 patients were crued,and no patient was operated and no patient died.Conclusion There are few patients who delayed hemorrhage after endoscopic sphincterotomy.Tissue glue sprayed,local injection,argon ion and titanium clip can cure the bleeding.

BACKGROUND: Serious lesion to liver function may cause the pulmonary artery hypertension and fluctuation of haemodynamics directly induces changes of pulmonary artery pressure during neo-hepatic stage in liver transplantation. OBJECTIVE: To observe the change of pulmonary artery pressure during liver transplantation and to explore treatment for pulmonary artery hypertension. DESIGN, TIME AND SETTING: Controlled observation was carried out among the liver transplant recipients who were enrolled from the 181 Hospital of Chinese PLA from June 2004 to June 2006. PARTICIPANTS: Totally 13 patients, all males, were reviewed. Their ages ranged from 19 to 53 years. They were selective for the liver transplantation. METHODS: Undergoing general anesthesia, mean arterial blood pressure, central venous pressure, pulmonary arterial pressure and pulmonary arterial wedge pressure were continuously monitored by Swan-Ganz catheter method and reversible Fick’s law continuous monitoring. Available respiration administration, low dose of glyceryltrinitrate (0.1-5.0 ?g/kg/min) and Alprostadil (1.0-2.0 ?g) were administered to diminish elevated pulmonary arterial pressure and pulmonary arterial wedge pressure during the period after unclamping portal vein in liver transplantation. MAIN OUTCOME MEASURES: Changes of mean arterial blood pressure and pulmonary arterial pressure. RESULTS: The mean arterial blood pressure deceased at the time of unclamping portal vein in all 13 patients, pulmonary arterial pressure and pulmonary arterial wedge pressure both increased significantly at 5 and 15 minutes within neo-hepatic stage, which were more obvious than those during anhepatic stage in 13 patients (P

In order to explore the clinical feature, diagnosis and differential diagnosis of adrenal incidentalomas, we reviewed 98 cases of adrenal incidentalomas for which adrenalectomy was performed in our hospital from 1993 to 2002. It was found that the average age of the patients was 48 years old, 16 cases (16 3%) had no specific symptoms, and others were incidentally diagnosed. Of the 98 cases, 18 (18 4%) were malignant lesions, including 8 metastatic cancers, 8 adrenal carcinomas and 4 lymphangioma, and 80 were benign lesions. Twenty one cases were functioning adrenal adenoma. Ultrasound, CT scan, MRI or MIBG were effective methods to detect adrenal incidentalomas.

In order to investigate the distribution and diagnosis of adrenal tumors, 282 cases of patients who had undergone adrenalectomy in our hospital from March 1993 to December 2001 were reviewed. There were 147 (52 1%) women and 135 (47 9%) men, with a mean age of 43 6?13 0 (3～75) years. Of the 282 patients, 83 patients (29 4%) were operated on because of hyperaldosteronism, 59 (20 9%) pheochromocytoma, 27 (9 5%) hypercortisolism, 105 (37 2%) incidentaloma, 36 (12 8%) malignant tumors and 13 (4 6%) for other reasons. The average diameter of adrenal tumors was 4 8?3 4 (0 3～22 5)cm. The size of tumor mass was smallestin hyperaldosteronism, while the largest was malignant tumor. The conformation rate of the preoperative diagnosis and pathological findings was 65 2%.

Objective To observe the effect of hyperthyroidism decoction on thyroid hormone and thyroid pathological changes of ex-perimental hyperthyroid rats. Methods 40 rats were randomly divided into four groups: Normal group,hyperthyreosis model group, western drugs control group and hyperthyroidism decoction group. The model rats were constructed by drenching Youjiale. Hyperthyroidism decoction group were given hyperthyroidism decoction of respective dosage, western drugs control group were given propylthiouracil. The serum contents of T3, T4, FT3, FT4 and TSH were determined by radio-immunity method, the thyroid pathological changes effected by hyperthyroidism de-coction were observed. Results Compared with model group, the contents of serum T3, T4, FT3, FT4, of hyperthyroidism decoction group were decreased, while the contents of serum TSH were increased. Hyperthyroidism decoction may improve thyroid pathological changes of ex-perimental hyperthyroid rats. Conclusion Hyperthyroidism decoction can effectively improve the thyroid function of experimental hyperthy-roid rats.

Object To establish a proper research evaluation system for level-two general hospital.Method By using Delphi method,experts were invited by letter to review research evaluation indices for three times.Result Totally 62 indices were weighted and evaluated,including two primary-degree indices,14 secondary-degree indices,and 46 third-degree indices. A research evaluation system was preliminarily established in a level-two general hospital.Conclusion The evaluation system is simple and practicable,and can reflect the main aspects of research in the leveltwo general hospitals.

Objective To explore the relationships between the expression of PECAM-1 and the degree of ALI in Paraquat induced lung injury model of rabbits. Method Thirty six adult New Zealand rabbits were randomly divided into three groups: 8 mg/kg (Group A), 16 mg/kg (Group B) and 32 mg/kg ( Group C) according to the dose of Paraquat which were infusion into stomach. After poisoned, the animals were monitored for seven days, and then sacrificed. The upper lobe of lung were removed for HE,Masson staining and immunohistochemisty. The ALl score, fibrosis of lung and expression of PECAM-1 were semiquantitative analyzed. Results Each group has 12 animals suffered from poisoning. The survival time of animals in Group C was (6. 47 ± 0. 99 ) days, shorter than (6. 09 + 1.04) days ( P = 0. 031 ) in Group B and (4. 77 + 2. 04) days ( P = 0. 0 07) in Group A. The ALI score were ( 8. 33 ± 1.03) points in Group A, superior to (9. 83 ± 1.17) points ( P = 0. 047 ) in Group B and ( 11.50 + 1.38) points ( P ＜ 0. 01 ) in group C, Group B vs Group C, P=-0.03o The fibrosis degree of lung was (31.09 +2.05)% in Group A,not severe as (34. 37 ±1.62)% (P=0. 002) in Group B and (36. 54 ±0. 44)% (P ＜0. 01 ) in Group C, Group B vs Group C, P = 0. 026. The Pearson correlation analysis showed the expression of PECAM-1 was negative correlated to ALI score (Coe = -0. 732, P =0. 001 ) and fibrosis degree of lung (Coe = -0. 779, P ＜ 0. 001 ) . Conclusions The expressions of PECAM-1 were significantly decreased in New Zealand after Paraquat poisoned, which were dose dependent, correlated to ALI scored and fibrosis degree of lung, so it may play an important role in the development of lung injured induced by Paraquat.

The paper analyzes the current status of and problems in the development of non-government medical institutions in Shanghai, the advantages non-government medical institutions possess and the difficulties they face in the process of development. It advances the development orientation of non-government medical institutions, arguing that it is imperative to create circumstances and conditions for fair competition, formulate perfect supporting policies, and lead non-government medical institutions to the integration of their own development with the reform and development of the medical and health cause of the country. It argues, on the other hand, that non-government medical institutions must stress simultaneously the accumulation and the operation of capital so as to have a niche in the fierce competitions of the medical market.