Objective To explore the changes of the serum matrix metalloproteinase 9(MMP-9) in coronary artery bypass grafting(CABG) under cardiopulmonary bypass (CPB) and the correlations between the serum MMP-9 and tumor necrosis factor alpha (TNF-α),interleukin 8 (IL-8).Methods Twenty-two patients who subjected to CABG were selected.Artery blood samples were collected at the following time points:before intubation (T0),15 min after initiation of CPB (T1),the end of operation (T2),2 h after operation (T3) and 6 h after operation(T4).The serum MMP-9,TNF-α and IL-8 levels were detected by ELISA and analyzed.Results The serum MMP-9 levels at T1,T2,T3 and T4 were (102.82 ± 19.03),( 428.80 ± 32.91 ),( 305.64 ± 29.75 ),( 157.78 ± 22.18 ) μg/L,respectively,which were significantly higher than that at To [ (38.67 ± 10.15 ) μ g/L] (P ＜ 0.05 ).The serum MMP-9 level gradually increased during CPB and reached the peak at T2,and then decreased.The serum TNF- α and IL-8 levels had the same change as MMP-9,the peak levels at T2 were (287.06 ±24.58),(143.12 ± 16.36) ng/L,respectively.The serum MMP-9 level had positive correlation with TNF- α and IL-8 levels ( r =0.69,0.54,P ＜ 0.05 ).Conclusions CPB can lead to the increased release of MMP-9,TNF-α and IL-8.TNF-α and IL-8 may induce the activation and release of MMP-9.The serum MMP-9 can contribute to the general inflammatory reaction of CPB.

Ampullary cancer is a relatively uncommon cancer,which is often considered to have a best prognosis among periampullary cancers.Preoperative endoscopic uhrasonography and transpapillary intraductal ultrasonography Call provide useful information not only for tumor staging but also for making therapeutic decisions,especially in patients who are appropriate for endoscopic papillectomy.Whipple resection and pylrus preserring panereaticoduodenectomy are considered to be the standard treatment for ampullary cancer.Although transduedenal ampullectomy is regarded as a less-invasive treatment compared with Whipple resection,it has a high morbidity and hish rate of cancer-cell remnant at the resected margin.Endoscopic papiilectomy may be the treatment of choice for selected cases of ampullary cancer. As to unresectable ampullary cancer,the performance of a biliary-enteric bypass is considered routine to solve obstructive ianndice.The decision as to whether to perform gastrojejunostomy in patients without obvious gastroduodenal obstruction secondary to the tumor remains controversial.We believe that prophylactic gastrojejunostomy should be performed routinely when a patient is undergoing surgical palliation for unresectable ampullary cancer.

Objective To investigate the correlation between electrogastrogram and gastric emptying in functional dyspepsia (FD) patients.Methods Fifty-one patients with FD were detected by polygraf ID 4-channel electrogastrogram(EGG) analysis system and solid radiopaque marker 5 h after a solid meal.Results 31.4％ (16/51) patients showed delayed gastric emptying(GE),and 72.5％(37/51) patients showed abnormal EGG.The rate of GE between normal EGG patients and abnormal EGG patients had no significant difference(P ＞ 0.05).In patients who had both abnormal EGG and delayed GE,EGG abnormality mainly exhibited dysrhythmia and the dominant frequency of EGG was normal.Some patients also exhibited non enhanced postprandial dominant power.The rate of GE among mild,moderate and severe symptom patients had no significant difference (P ＞ 0.05).The rate of abnormal EGG in severe symptom patients was significantly higher than that in mild and moderate symptom patients [92.9％ (13/14) vs.62.5％ (10/16),66.7％(14/21)] (P ＜0.05).The rate of abnormal EGG in mild and moderate symptom patients had no significant difference (P ＞ 0.05).The rate of GE between Helicobacter pylori (Hp) positive patients and Hp negative patients had no significant difference (P ＞ 0.05).The rate of abnormal EGG in Hp positive patients was significantly higher than that in Hp negative patients [90.0％ (18/20) vs.61.3％ (19/31)] (P ＜ 0.05).The rate of GE and the rate of abnormal EGG had no significant difference between patients with and without active gastritis(P ＞ 0.05).Conclusions The abnormality of EGG plays an important role in the pathogenesis of FD.There is no significant relationship between EGG and GE.The patients with severe symptom and with Hp positive have higher abnormal EGG percentage.Gastritis has no significant correlation with EGG or GE.

Purpose: To investigate the diagnosis, pathological characteristics and treatment of primary malignant lymphoma of the breast (PMLB). Methods: Clinical and pathological data of 16 cases of PMLB were analyzed retrospectively. Results: No case was correctly diagnosed before operation. All the 12 cases were operated and identified by pathology, in which total mastectomy, radical mastectomy and modified radical mastectomy were carried out in 5, 3 and 4 patients respectively. Moreover, all cases were combined with post-operative chemotherapy or radiotherapy. 10 cases were followed up 1 - 10 years. 4 cases who survived 22 months on the average died of the tumor spread and metastasis during follows-up, and the others are still alive. Especially, 1 case, recurring 2 times locally, has survived for 4. 5 years after reoperation. Conclusions: The final diagnosis of this disease depends on the pathological examination. The majority of PMLB is non-Hodgkins lymphoma ( NHL), and mostly of B cell origin and are mostly related to the mucosa-associated lymphoid tissue ( MALT). Total mastectomy or mastectomy plus axillary nodes dissection is the preferred method of operation and the adequate post-operative chemotherapy is very important.

Objective To investigate the indication,safety and the validity of intervertebral discectomy via posterior approach.Methods There were 8 cases in our group.All received posterolateral intervertebral discectomy and nerve root decompression via posterior approach.The average follow-up period was 5.2 years.The improvement on pain and neurological signs were evaluated.Results Pain disappeared completely in 5 patients and significantly alleviated in the other 3.As to muscle strength and tendon jerk,we observed significant improvement in 6 patients and improvement in the other 2 patients.7 patients got back to their original work and 1 patient shifted to an easy job.No patient had complication.Conclusions Nucleus pulposus removal via posterior approach was a secure and effective one for posterolateral cervical intervertebral disc herniation.

Intervention and prevention of IGT population is crucial for reducing high incidence of diabetic.This paper analyzed the insufficiency of the existing IGT intervention and prevention models by introduing the concept of human health view of ecological theory,and emphasized the close relationship between IGT population and environment.The ecological explanation of TCM etiology of IGT and the ecological evaluation standard of IGT intervention and prevention model were also discussed.This paper further indicated that only by focusing on adapting to the living environment,applying the concepts of "integrated ecosystem management" can we successfully construct a sustainable IGT prevention and intervention model and effectively promote the model into a large-scale community.

Objective To study the chest X-ray appearances and dynamic imaging changes in severe acute respiratory syndrome diagnosed clinically. Methods The sequential chest X-ray examinations at 1-4 day intervals were performed in 72 patients with severe acute respiratory syndrome. Results The findings on chest X-ray images were analyzed. The abnormalities on the chest X-ray films most commonly occurred at 4-7 days after onset (53 cases, 73.6%), and the most severe manifestations on the chest films usually presented at 8-14 days (54 cases, 75.0%). The absorption of the abnormal changes on the films occurred at 15-21 days in most cases (37 cases, 51.4%). The main features included bilateral or unilateral single or multiple patchy shadows (58 cases, 80.6%), and the lesions changed rapidly at the peak period. The lesions presented wandering features in some cases. The lesions still remained on CT scans in 11 cases (11/20, 55.0%) within one month after the absorption on X-ray film. Conclusion The chest radiography can be used to display dynamic changes of SARS, but it isn't able to distinctly demonstrate tine pulmonary lesions of SARS.

Objective To evaluate the effect of controlled hypotension with nitroglycerin and esmolol in the operation of endoscopic nasal surgery.Methods 60 patients undergoing selective endoscopic nasal surgery were randomly divided into three groups averagely: control group (groupⅠ), controlled hypotension with nitroglycerin group(group Ⅱ), controlled hypotension with nitroglycerin and esmolol group (groupⅢ). Every group has 20 patients.Mean artery pressure (MAP), HR, scores of surgical field quality(SSFQ) were recorded before anaesthesia and 10,20,30,40 minutes after anaesthesia. After the operation, bleeding capacity, operation time and dosage of nitroglycerin were recorded too.Results The bleeding capacity and operation time in groupⅡ and Ⅲ was significantly less than that in groupⅠ(P

Purpose:To investigate the clinical characteristics, diagnosis and treatment of accessory breast tumors.Methods:Clinical and pathological data of 16 cases of accessory breast tumors were analyzed retrospectively. Results:There were 5 cases of accessory breast fibroadenoma, 2 cases of intraductal papilloma, 9 cases of accessory breast carcinoma. Local mass resection and radical resection were carried out respectively. All these patients had post operative chemotherapy and radiotherapy. 13 cases (81.3%0 were followed up for 1—10 year. As to results, 3 cases died of metastasis in 2,2.5 and 4 years respectively after operation;one case, reoperated because of local recurrence, still survives (over 3 years):and the others recovered well.Conclusions:It is possible for benign or malignant tumor to occur in the accessory breast,and the manifestation of the accessory breast tumors is similar to that of the primary breast tumor. Operation is the first choice for all treatment benign tumor with local mass resection including the whole accessory breast while accessory breast carcinoma should be treated by radical dissection.

Cone-Beam Computed Tomography ; Humans