ObjectiveTo explore the diagnosis and surgical treatment techniques for the patients with primary presacral tumor.Methods Data from 31 patients with primary presacral tumor admitted into our Department for Surgery from Jan. 1999 to Jar. 2009 were retrospectively analyzed.All patients underwent surgical treatment,among them,10 received per-sacroiliac or per-perineum approaches to remove the tumors,18 receivedper-abdomentumorectomy, and3receivedcombinedper-peritoneumandper-perineum tumorectomy.Results Patients visited the doctor while exhibiting the compression symptoms by the the tumors.Final diagnosis could be reached with the help of rectal touch,B-mode ultrasound,computerized tomography,or magnetic resonance imaging.Complete resection was performed in 28 patients.Partial resection was performed in 3 patients.Fractionated resection was successfully performed in 2 patients with chronic infection or sinus tract.ConclusionThe primary presacral tumor should be surgically resected once final diagnosised and without surgical contraindications.Pelvic plexus should be preserved and presacral hemorrhage should be prevented.The tumor should be resected as complete as possible.

Objective To evaluate total gastrectomy and regular lymph node dissection for the treatment of advanced cardiac cancer. Methods Three hundred and eighty-seven patients with advanced cardiac cancer underwent total gastrectomy D2+ procedure. The relationships between depth of invasion, lymph node metastasis,the number of metastastic lymph nodes dissected and postoperative survival rate were analyzed. Results The 3-year and 5-year survival rates were 47.3% and 34.2% , respectively. Metastatic rate of N3 lymph node was 4. 8% and 15. 2% in advanced cardiac patients of PT3 and PT4, respectively. Survival rates significantly decreased along with the increase of lymph node metastasis. The 3-year and 5-year survival of patients who had less than 15 lymph nodes dissected was significantly poorer than those who had more than 15 lymph nodes dissected, respectively. The postoperative complication rate and mortality rate of the two groups were 14. 2% and 2. 52% , respectively. Conclution To improve the quality of life and survival rate, D2 + radical total gastrectomy should be performed for advanced cardiac cancer, and when indicated resection of spleen and/or body and tail of the pancreas should be performed.

AIM: To establish a simultaneous quantitative method which was simple and rapid for mixture of ephedrine、 D-pseudo-ephedrine and amygdalin. METHODS: Ephedrine、D-pseudo-ephedrine and amygdalin in Herba Ephedrae、Semen Armeniacae Amarum、Zhisou Lixiao Tablets、Zhisou Lixiao Capsules and its semi-finished products were determinated by HPLC. RESULTS: The methodological study showed that a good linear correlation existed in the range of 0.039 68-0.892 8 ?g for ephedrine hydrochloride and 0.106 3-4.252 ?g for amygdalin, respectively. The average recovery of ephedrine hydrochloride was 98.2%(n=9) and RSD was 1.6%; The average recovery of amygdalin was 99.4%(n=9) and RSD was 2.4%. CONCLUSION: This method is simple, accurate and reproducible and with high precision. The method can be used for quality control of Chinese preparations.

Objective To evaluate the cellular toxic and release of pharmaceutical dressing.Method Following the State standard GB/T14233.2-2005.the L929 cellular merphology was observed by inveded microscopy after 72h and proliferation of the cells was examined using mitochondrial function(MTT)assay.Relative growth rate (RGR)was calculated and cytotoxicity grade was evaluated by absorbency(OD)data.With PBS7.4 as dissolution media,and(32±0.5)℃as dissolution temperature,the release rate was determined with UV method with the determination wavelength of 288 nm and the dissolved liquid in 1/6,1/2,1,3,16,24,36 and 48 h.Results The average cell RGR of the pharmaceutical dressing is 91.25%and reaches 1 cytotoxicity grade.L929 cellular morphology is normal.Pharmaceutical dressing release accord to Higuchi equation,and the simulated equation is M_t/M_∞=0.3271t~(0.239).Conclusions Biologic compatibility of the pharmaceutical dressing is good,and the release of levofloxacin from the pharmaceutical dressing is sustained in vitro.

Objective To investigate the cellular fragments and particle image changes of inventory aleucocytic suspending RBC produced by the storage time extension ,RBC damage or hemolysis in order to provide the revelatory experimental basis for the transfusion safety .Methods The supernatant was prepared from different stored days (3 ,7 ,14 ,21 d) of stock aleukocytic suspen‐ding RBC .The particles in supernatant were observed and morphologically analyzed by using the microscopic static image analytic technology .Results There were a small amounts of visible particles in the sample supernatant preserved for 3 ,7 d and the parti‐cles′sizes are similar to cells′;the number of particles began to significantly increase from 14 d and the diameter became smaller . The particles filled the entire field until 21 d ,showing fragmentary status .Conclusion The cellular fragments and particles in the supernatants of stock aleukocytic suspending RBC with the storage period exceeding 14 d are significantly increased and have signif‐icant difference compared with those stored for less than 14 d .These exogenous fragments and particles may become antigens and induce the body immune response ,lead to transfusion adverse reactions .It is recommended that the patients should be transfused with stock aleukocytic suspending RBC within a storage period of 14 d .

Objective To investigate the application value of methylene blue excretion test in early reasonable nutritional support for severe traumatic brain injury.Methods One hundred and thirty-three cases of severe traumatic brain injury admitted to hospital from January 2010 to June 2012 were chosen as treatment group,while the 127 cases of similar patients admitted to hospital from January 2007 to December 2009 were chosen as control group.Patients in treatment group underwent methylene blue excretion test in 3 days,8 days,15 days after injury,and the nutritional support ways were determined according to the elimination time of methylene blue in patients' urine.The control group conventionally receive enteral nutrition support therapy firstly,after 15 days if they still cannot be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight,serum albumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.Glasgow coma score (GCS) of 3 months after injury were followed up.Results There was no significant difference on the average body weigh between these two groups before treatment.The average body weight of the treatment group was significantly higher than that of control group after 3 months treatment((56.3 ± 5.5) kg vs.(52.6 ± 5.3) kg,t =5.93,P ＜ 0.01).The serum albumin and hemoglobin of 14 d,21 d after injury were significantly higher than those of the control group (serum albumin of 14 d:(32.7 ±3.4) g/L vs.(28.8 ±3.1) g/L; serum albumin of 21 d:(34.3 ±3.8) g/L vs.(30.7 ±3.3) g/L;hemoglobin of 14 d:(113.4±12.5) g/L vs.(102.2 ±11.6) g/L;hemoglobin of 21 d:(118.5 ±13.3) g/L vs.(106.7 ± 12.4) g/L.Nutritional status of treatment group was significantly better than that of the control groupall P ＜ 0.05).After three months,the effective rate of treatment group (93.23％ (124/133)) was significantly higher than that of the control group (84.25％ (107/127)),the difference was statistically significant (x2 =5.29,P ＜ 0.05).Conclusion Determining the early reasonable nutrition support ways for patients with severe traumatic brain injury according to the elimination time of methylene blue in the urine,can provide comprehensive nutrition to patients,enhance their body resistance,reduce the incidence of complications,and create an important clinical value for improving prognosis.

Objective To discuss the efficacy of application combination Of minimal immunosuppressive drugs in chronic allograft nephropathy after renal transplantation. Methods Data were drawn from the First Hospital of Tsinghua University.From September 1,2004 to July 1,2006,31 cadaver kidney transplantations were performed using triple immunosuppression with tacrolimus(n=31)and MMF plus steroids before using new strategy.The new strategy is Rapamycin+tacrolimus+MMF+Prednisone.The serum ereatinine,GFR(ml/min/1.73 m2)and 24-hours urine protein before and after 12 months of using lOW dose combination of calcineurin inhibitors,MMF,Rapamune,Predsone and Q80 were recorded.During this time,the concentration of tacrolimus,rapamune were monitored as well. Results After 12 months follow-up,the serum creatinine of 28 patients were decreased from(300±21)μmol/L to(215±38)μmol/L.GFR(ml/min/1.73m2)was elevated from 42.54±2.95 to 49.98±3.05.Three patients whose serum creatinine was 416-464μmol/L had to take hemodialysis.The 24-hours urine protein(g)of 31 patients below 0.8 g did not increase urine protein during follow-up.One patient's 24-hours urine protein(g)increased from 0.95 to 1.29.The patient and graft survival rate was 100%(31/31),90.3%(28/31)respectively.The rapamune main side effect was hyperlipidemia. Conclusions Rapamune and low dose Tacrolimus+Myeophenolate Mofetil+Corticosteroid could be a safe treatment.It may improve renal function in chronic allograft nephropathy.

Objective To investigate the prevalence of nosocomial infections in Tianjin Children's Hospital and to provide database for monitoring and control of nosocomial infection.Methods The medical records of 6101 children admitted in the first half of 2005 and the laboratory results of isolated bacteria from clinical samples in 2005 were retrospectively investigated.Results The total nosocomial infection rate was 3.47%(212/6101),in which the surgical nosocomial infection rate was 2.66%(32/1204)and 2.95%(180/6101)infections were caused by non-surgical incisions.Respiratory tract was the most frequent infection site(119/212,56.1%).Several opportunistic pathogens were responsible for the major nosocomial infections,they were Escherichia coli,Coagulase negative staphylococcus,Enterococcus,Klebsiella pneumonia,Staphylococcus aureus and Pseudolnonas aeruginosa.Conclusion The pathogenic isolates for the infections show high resistance to most antibiotics.Monitor and control of the incidence of nosocomial infections and resistance to antibiotics should be enforced.

Objective:To determine bacteriostatic abilities ofArtemisia argyi extracts,and to explore the effect ofArtemisia argyi extracts on oral ulcer in rats.Methods:We extracted the mixture ofArtemisia argyi volatile oils and water-extraction by leaching method and evaluated the anti-microbial effect ofArtemisia argyi extracts on common oral floras in vitro.The rat cheeks were burnt by NaOH to establish the models of oral ulcer.The curative effects of crude drug of Artemisia argyi extracts at 2.0,1.0,0.5 g/mL on oral ulcer in rats were evaluated by measuring the oral ulcer healing time.Serum TNF-α level and expression of proliferating cell nuclear antigen (PCNA) were analyzed by ELASA and immunohistochemical staining.Results:Artemisia argyi extracts obviously inhibited the Staphylococcus aureus and Streptococcus.NaOH-made oral ulcer in rats were successfully established.The crude drug at 2.0 and 1.0 g/mL obviously reduced healing time,significantly inhibited the release of TNF-α,and improved the PCNA level in the ulcer tissues (All P＜0.01).The extracts obviously reduced the local inflammatory reaction and promoted tissue repair of oral ulcer.Conclusion:Artemisia argyi extracts promote tissue repair of oral ulcer via inhibiting bacterial growth,reducing the release of TNF-α and improving the PCNA level.

OBJECTIVE To understand nosocomial candidal infection among tuberculosis patients and its drug(sensitivity).(METHODS) Totally 6280 clinical samples from Jan 2002 to Dec 2004 were cultured;and part of(positive) ones were tested their drug sensitivity to FC,FLC,KET and ITC.RESULTS From all cultured samples 2767 Candida strains(positive rate was 44.06%) were isolated.From them C.albicans,C.glabrata,C.tropicalis,C.krusei and other Candida were 2006, 344,206,95 and 116 strains,their positive rate was 31.94%,(5.48%),3.28%, 1.51% and 1.85%,respectively.Their drug sensitivity rate to four drugs were as follows: to FC was 93.73%,to TTC 62.76%,to FLC 51.03% and to KET was 47.59%. CONCLUSIONS The condition of(tuberculosis) patient would become serious due to higher dual infection rate by Candida after too long anti-(tuberculosis) treatment.Among the four kinds of drugs the FC has the best anti-candidal activity.