Objective To investigate the association between intima-media thickness (IMT) and free fatty acids (FFA) in hypertensive patients with metabolic syndrome (MS). Methods IMT, FFA and body mass index (BMI) were measured in 69 hypertensive patients with metabolic syndrome (MS group) ,57 hypertensive patients without metabolic syndrome ( Non-MS group) ,and 50 healthy controls ( NC group). Results In the MS group,The BMI, serum levels of triglyceride (TG), fasting blood glucose (FPG) and FFA were ( 26.0 ± 2.1 ) kg/m2, (24.0 ±0.81 ) mmol/L and (5.64 ± 0.82) mmol/L respectively, which were significantly higher than those in the Non-MS group ( (24.9 ± 2.3 ) kg/m2, ( 1.93 ± 0. 55 ) mmol/L and ( 5.10 ± 1.08 ) mmol/L respectively ) and the NC group ( (23.6 ± 1.6), ( 1.49 ± 0.36) mmol/L and (4.70 ± 0.90) mmol/L respectively) ( F = 20.06, 30.96 and 15.17,P ＜0.05 or 0.01 ). FFA in the MS group ((562.11 ± 55.12)μmol/L) were significantly higher than that in the Non-MS group (402.65 ± 49.53 ) μmol/L) and the NC group ( ( 356.23 ± 45.93 ) μmol/L) ( F = 277.28, P ＜0. 01 ). IMT in the MS group, Non-MS group and NC group were (1. 10 ± 0. 13 )mm, (0. 82 ± 0. 12 )mm and (0.70 ± 0.11 ) mm, respectively, with significantly difference ( P ＜ 0. 01 ). In addition, the incidence of thickening was 28.99% (20/69), 17.54% ( 10/57 ) and 2.00% ( 1/50 ), respectively, with significantly difference ( P ＜0.01 ). Conclusions Serum level of FFA is associated with IMT in hypertensive patients with metabolic syndrome.

Objective To investigate the effect of MOTOmed movement therapy on balance and ability in the activities of daily living (ADL) of convalescing stroke patients with hemiplegia. Methods Forty convalescent stroke patients exhibiting hemiplegia were randomly divided into a treatment group and a control group with 20 cases in each group. The control group received routine rehabilitation training; the treatment group received MOTOmed training in addition. Balance function of all the patients was assessed using Berg's balance scale (BBS) , and the Barthel Index ( BI) was used to assess ADL ability at the beginning of the program and after 6 weeks of treatment. Results Balance and ADL ability improved significantly in both groups after 6 weeks of treatment. The effect in the treatment group was significantly better than in the control group. Balance and ADL ability were positively correlated. Conclusions Applying MOTOmed therapy along with routine rehabilitation training can distinctly improve balance and the ADL ability of hemiplegics after stroke.

Objective To investigate the clinical features of early postoperative inflammtory small bowel obstruction,and discuss its diagnosis,treatment and preventive measures.Methods The clinical data of 68 cases of early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results Within the 68 cases,65 cases were cured by non-operative treatment including gastrointestinal decompression,anti-inflammatory drugs,somatostatin,total parenteral nutrition(TPN) and traditional Chinese medicine.The mean time from the onset of symptoms to the recovery of bowel function was 14 days.Three cases were cured by transferring to operation.One case of them was transferred to operation for strangulated intestinal obstruction during the period of conservative treatment.One case underwent oper.ion because the patient didn t recover after 4 weeks expectant treatment.One case underwent operation for the impatience with the conservative treatment of both the doctors and the patient.Conclusion Non-operative therapy should be the first choice for the treatment of early postoperative inflammatory small bowel obstruction,and its therapeutical effect was well-accepted.

To investigate the effect of preceding naloxone injection into the third cerebroventricle or acute subdiaphragmatic vagotomy on the gastric acid secretion inhibited by the somatostatin analogue octreotide given by intracerebroventricular (icv) injection. The third ventricles were cannulated in male Wistar rats anesthetized with sodium pentobarbital. One week later, acute gastric lumen perfusion was carried out. The gastric perfusion samples were collected every 10 min and were titrated by 0.01 mol/L NaOH to neuter. On the basis of subcutaneous injection of pentagastrin (G-5, 160 micro, g/kg), icv injection of physiological saline (group A, n = 20), icv injection of octreotide (0.05 micro g) (group B, n = 20), icv injection of naloxone (2.5 micro g)+octreotide (0.05 micro g) (group C, n = 20), acute subdiaphragmatic vagotomy+ icv injection of physiological saline (group D, n = 20), or acute subdiaphragmatic vagotomy+icv injection of octreotide (0.05 micro g) (group E, n = 20) were conducted. Before and after icv injection, 1-h total acid output (TAO) was determined and compared. The experimental data were expressed in change rate (%) of TAO. The change rates (%) of TAO were 4.60% in group A, -20.35% in group B, -18.06% in group C, 5.01% in group D and -21.59% in group E, respectively. Comparison of group B or C versus group A showed that P < 0.01 and comparison between the group E versus group D showed that P < 0.01. Whereas the differences between group C and group B, group E and group B were not statistically significant (P > 0.05 for all). The results indicate that the central inhibition of gastric acid secretion by octreotide may not be mediated by the endogenous opiate substance or its receptor and the peripheral pathway for icv injection of octreotide to suppress gastric acid secretion is via extra-vagus route.

Objective To identify the fungi isolated from two acute radiation sickness(ARS)patients as a result of an accidental 60Co irradiation,and to observe the sensitivity of the fungi to antifungal agents.Methods The pathogenic fungi were morphologically examined and identified with the VITEK 2 automatic microorganism analyzer and API 20C AUX yeast identifying card.The susceptibility of fungi to antifungal agents was tested with broth microdilution method.Results Candida parapsilosis and Sporothrix schenckii were identified from case A in the samples of blood,bone marrow,urine and stool etc.Most of pathogenic fungi were sensitive to the antifungal drugs in vitro.In case B,Candida parapsilosis,Candida tropicalis,Trichosporon asahii and Aspergillus terreus were identified in the samples of sputum,urine or stool etc.Accompanying with the prolongation of antifungal treatment,the sensitivity of fungi to the antifungal drugs were decreased remarkably.Conclusion Multiple infections in different organs could be caused by pathogenic fungi,such as Trichosporon asahii and Sporothrix schenckii.Although most of pathogenic fungi were sensitive to the antifungal drugs in vitro,the effects of antifungal treatment were not satisfactory owing to poor general conditions of 2 acute radiation sickness(ARS)patients and marked compromise of the immune system.Because of antibiotic and antifungal drugs were used early for preventive purpose,the clinical samples should be specially treated in order to raise the positive rate of fungal identification.

Objective To study the genetic origin of mitochondrial dysfunction in patients with mitochondrial myopathy.Methods The esphagus carcinoma cells were cultured by ethidium bromide, and established stabile,cell line of long term survival mitochondrial DNA(mtDNA).The platelets of patients with mitochondrial myopathy and the normal controls were carried out cell fusion.the mitochondrial function of fusion cell was determined. Results The esphagus carcinoma cells were cultured by ethidium bromide for 12 days, the cells were completely depleted of mtDNA,which can be passed stably. The respiratory capacity of transformants derived from patients with mitochondrial myopathy was lower than those from the control.Conclusion The mtDNA mutation can play a role in the pathogenesis of mitochondrial myopathy.

Objective To evaluate the value of endoscopic endonasal approach in the surgical treatment of skull base lesions. Methods From May 2002 to December 2006, 112 patients with skull base lesions were treated by endoscopic endonasal surgery. Among them, 39 cases had cerebrospinal fluid (CSF) leak, 4 pituitary adenoma, 3 meningoencephalocele, 9 sphenoethmoidal cyst, 2 sphenoiditis complicated with ploypi, 12 fungal sphenoiditis, 11 inverted papilloma, 6 nasopharyngeal fibroangioma, 2 ossifying fibroma, 2 fibrous dysplasia, 7 chordoma, 2 craniopharyngioma, 10 squamous cell carcinoma, 1 undifferentiated carcinoma, and 2 papillomatous change. Results Follow-up ranged from 6 to 60 months. All the operations were completed under an endoscope. In 20 cases including 8 patients with squamous cell carcinoma, 1 undifferentiated carcinoma, 7 chordoma, 2 craniopharyngioma, and 2 fibrous dysplasia, the lesion was removed subtotally. In the 39 patients with CSF leak, the lesion was cured after the first operation in 31 patients (79.5%), after the second operation in 4, and the third in 4; the final success rate was 100%. One of the patients with meningoencephalocele showed recurrence complicated CSF leakage 2 months after the operation, and then was cured by re-operation using endoscopy. In the 11 patients with inverted papilloma, 1 had recurrence 11 months after the operation, and was re-treated by lateral rhinotomy. One of the patients who had fungal sphenoiditis developed recurrence 4 month after the operation and received endoscopic endonasal surgery for the second time. One patient who had CSF leak before the operation developed intracranial infections after the endoscopic surgery. Conclusion Endoscopic endonasal surgery is a safe, effective, and minimally invasive approach to treat skull base lesions. Clinicians should understand the operation indications precisely, especially for malignant tumors.

Objective To study the technique and clinical effect of naso-endoscopic surgery for cerebrospinal fluid(CSF)rhinorrhea.Methods From June 2002 to May 2007,14 patients with spontaneous CSF rhinorrhea and 28 patients with traumatic or iatrogenic CSF rhinorrhea were treated by naso-endoscopy.The CSF fistula was exposed via different surgical routes by naso-endoscopy according the sites of the lesions(including the cribriform plate or fovea ethmoidalis,sphenoid sinus,and frontal recess).Middle turbinate mucosa,fascia lata,and abdominal fat were used to repair the fistulae by using multilayer "underlay","overlay" or "Bath-plug" techniques.Results Thirty-four cases(81.0%)were cured at the first operation,4 were healed at the second attempt,and 4 were treated successfully at the third attempt.The success rate of the first operation in the patients with a fistula orifice larger than 10 mm in diameter was significantly lower than that in the patients who had a fistula orifice less than 10 mm in diameter(53.8%,7/13 vs 93.1%,27/29;?2=6.606,P=0.010).Two patients developed complications after the endoscopy(intracerebral infection in one,and hydrocephalus another),and were cured afterwards.Totally 42 patients achieved a 6-to 36-month(mean,14 months)follow-up,none of them had recurrence during this period.Conclusions Naso-endoscopic surgery is a safe,effective,and microinvasive treatment for patients with CSF rhinorrhea.Measures should be done to prevent and control the complications of the surgery.The outcomes of the treatment depend on the size of the fistula orifice.Autologous fat tissues are recommended for the repair of the fistulae larger than 10 mm in diameter.

Objective To assess the nutritional risk of patients with inflammatory bowel disease (IBD).Methods The nutritional status of 112 IBD patients from PUMC Hospital were evaluated by Nutritional Risk Screening 2002 (NRS 2002).Using Chinese standard,a body mass index (BMI) that was lowered than 18.5 kg/m~2 according to clinical material was regarded as malnutrition,and the score was recorded as 3.The se-verity of ulcerative colitis (UC) was evaluated using True-Love criteria as mild,moderate,and severe.Crohn's disease (CD) was evaluated using Harvey-Bradshaw Index as in remission stage (≤4),moderately active stage (4-8),and severely actively stage (≥9).Results All these 112 patients,including 70 UC cases and 42 CD cases,were evaluated by NRS2002.Forty-five patients (40.2%) were judged as at the risk of malnutrition.The incidence of malnutrition was significantly higher in CD patients than in UC patients (52.4% vs.32.9%,P<0.05).It was also significantly correlated with the severity of disease.In patients with severe IBD,the rate of mal-nutrition evaluated by BMI according to clinical material was significantly lower than the rate of nutritional risk.Con-clusions The risk of malnutrition is high in IBD patients.NRS 2002 can be used for nutritional risk screening.

Objective To investigate liver regeneration after transplantation of microencapsulated hepatocytes in rats with acute liver failure (ALF). Methods ALF rat model was established by intraperitoneal injection of D-galactosamine (D-GalN). After 18 h, rats were randomized into control group ( Ⅰ ), free hepatoeyte transplantation group ( Ⅱ ) and the microencapsulated hepatecyte transplantation group (Ⅲ). Six rats for each group were randomly selected and sacrificed at 6, 12, 24, 36, 48, 72, 120, 168 and 240 h after ALF induced and blood samples from inferior vena cava were collected. Liver functions were tested in blood samples, and the expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. Results Ten-day survival rates of 3 groups were 26.7% (4/15), 40.0% (6/15) and 73. 3% (11/15), respectively (x2 = 9. 349,P = 0. 009). Survival rate of group Ⅲ was significantly higher than that of group Ⅰ and Ⅱ. Levels of ALT and AST in each group increased significantly at 6 h after ALF induced, and peaked between 48 ～ 72 h. Levels of ALT and AST in group Ⅱ and Ⅲ declined from 36 h, which was more significant in group Ⅲ. Tbil levels in group Ⅰ gradually increased after ALF induced and peaked at 72 h. Tbil in group Ⅱ and Ⅲ declined from 48 h, which was more markedly in group Ⅲ. In normal rats, the expression of PCNA protein was almost negative, but it was strongly expressed in ALF rats and peaked at 48 h. The number of positive cells in group Ⅲ was higher than that in group Ⅰ and Ⅱ, and the differences were of statistical signifieance. Conclusion The transplantation of microencapsulated hepatocytes can promote the regeneration of liver, and it can improve the liver function and prognosis in rats with ALF.