Objective To find out about the distribution both of the kinds of diseases afflicting outpatients and of the volume of outpatient service in the hospital so as to control the quality of outpatient sen'ice in a scientific way. Methods Using the method of whole group sampling survey, an investigation was made into all the outpatients to the hospital during the five working days of a certain week in April, 2002. Results The departments ranking in the first five places with regard to the volume of outpatient service were respectively the Departments of Orthopedics, Dermatology, Endocrinology, Otorhinolaryngology and Gastrointestinal Diseases. The kinds of diseases ranking in the first five places were respectively upper respiratory tract infection, diabetes, hypertension, gastritis and pregnancy. First-visit patients accounted for 54.6% while return-visit patients accounted for 45.4% . Conclusion It is imperative for the hospital to enhance its discipline development, define the orientation of its discipline development in line with the disease spectrum, take active steps to meet various challenges and improve the o, uality of its medical service.

Objective To discuss the clinical effect and postoperative complications of endoscope with plas-ma eletrosection and holmium laser in the treatment of urethral stricture. Methods 37 patients, suffering urethral stricture were treated by endoscopic plasma eletrosection and holmium laser. Tthe therapeutic effect was evaluated. Results All patients were succeeded in operation, and with almost no bleeding. Then indwelling catheter for 3-5 weeks. After the removal of the urinary catheter, 33 patients were voided well, and no complications such as urinary incontinence ; Within 3 days 4 cases were urine thinning, avoiding difficulty, given regular urethral dilation, 3 cases ineffective, and one case of the resumption. All patients were followed up for 6-24 months. There are 8 cases of plasma in patients with resection in voiding difficulty after 1-8 months, given regular urethral dilatation, then: 2 ca-ses of recovery ; 5 cases of poor results were given plasma vaporization of the trip again, haven good results ; 1 case was given routine Bladder ostomy. Conclusion The right intracavity, endoscopic endovascular treatment of urethral stricture for other lower urinary tract obstruction disease is a safe, minimally invasive and effective treatment meth-od.

Objective: To study the effect of hyperplasia suppressor gene (HSG) in inducing vascular smooth muscle cell apoptosis and the underlying mechanisms. Methods: The cultured VSMCs were transfected with an adenoviral vector containing rat HSG gene. Effects of HSG on VSMC apoptosis were investigated by fluorescent dye staining to detect the tact of nuclei, and by flow cytometry to define the content of DNA and to detect the levels of caspase-3. The expressions of Bcl-2 and Bax were also performed by Western blot analysis. Results: The increased expression of HSG in VSMCs infected with AdHSG induced apoptotic cell death detected by flow cytometry assay and nucleic staining. Compared with control groups, HSG induced vascular smooth muscle cell apoptosis 72 h after infected with adenoviral vector (39.6%?3.2% vs. 2.6%?0.9%,P

Objective To assess the diagnostic value of MRI on multiple focal nodular hyperplasia (FNH) of the liver. Methods MR images of 9 cases with pathological-confirmed multiple FNH were retrospectively analyzed. MRI features of the lesions were correlated with pathological findings. Results Multiple FNH was considered in all these 9 cases. Among them, the primary diagnosis was FNH in 5,hepatic adenoma in 3 and fibrolamellar hepatocellular carcinoma in 1 case. A total of 31 lesions were detected in the 9 cases. On T2WI, 19 lesions presented slightly high-signal intensity, and the other 12 presented iso-signal intensity. On T1WI, 12 lesions presented slightly low-signal intensity, 7 presented iso-signal intensity, and the other 12 presented high-signal intensity. On opposed-phase, the signal intensity of 1 lesion dropped unevenly. After bolus injection of contrast agent Gd-DTPA, in hepatic arterial phase 18 lesions showed mild to marked heterogeneous enhancement, 11 showed marked homogeneous enhancement, 1 showed moderate ring-like enhancement, and the last one did not have obvious enhancement In portal venous and delayed phase, all the lesions turned to iso- or slightly high-signal intensity gradually. Sixteen of 31 lesions presented central scar, which demonstrated mild star-like enhancement in delayed phase. Conclusion Multiple FNH presented certain MRI features, which contributed to the preoperative diagnosis.

Objective To investigate the value of magnetic resonance imaging(MRI)in the evaluation of microwave ablation(MA)for liver cancer.Methods The clinical data of 51 patients with liver cancer who received MA at the General Hospital of PLA from November 2005 to June 2009 were retrospectively analyzed.The MRI findings of 65 nodules before and after the treatment of MA were evaluated by serological examination and needle biopsy of liver.Results All patients received MRI within 1 month after MA.Of all nodules.63 were presented with high signal intensity on T_1-weighted images(T_1 WI)and low signal intensity on T_2-weighted images (T_2 WI)and with peripheral ring-like enhancement.They were diagnosed as complete coagulation necrosis,and the alpha-fetoprotein(AFP)level of the patients decreased from 333.83μg/L before MA to 37.68 μg/L after MA.Two nodules were presented with low signal intensity on T_1 WI and high signal intensity on T_2 WI,and they were diagnosed as local residual.All patients were followed up l month after MA,and 5 nodules showed enhancement with the same image characteristics as local residual.They were diagnosed as local recurrence of liver cancer by needle biopsy of liver and AFP level detection.New intrahepatic nodules in 23 patients and an abdominal nodule in 1 patient were detected with an increase of AFP level(mean,120.16 μg/L).Conclusion MRI Can exactly evaluate the efficacy of MA in the treatment of liver cancer.

ObjectiveTo investigate the molecular mechanism of prostaglandins E2 ( PGE2 ) in promoting bone formation by detecting the changes of gene expression profiles of MC3T3-E1 osteoblasts treated with PGE2. MethodsThe genes with differential expression in MC3T3-E1 osteoblasts treated with 10 μmol/L PGE2 for 30 minutes were performed by gene chip technology. Several major genes during bone regeneration were selected for Western blot analysis. ResultsAfter co-culture of MC3T3-E1 cells with PGE2 at concentration of 10 μmol/L for 30 min, 276 genes were up-regulated, including bone regeneration related MMD (monocyte to macrophage differentiation associated), NR4A2 (nuclear receptor subfamily 4, group A, member 2), BMP-7 ( bone morphogenetic protein-7), POSTN ( periostin, osteoblast specific factor) and catenin (cadherin-associated protein) genes; and 168 genes were down-regulated,including bone regeneration related Idl ,2,3 ( inhibitor of DNA binding 1,2,3 ) genes. Western blot analysis indicated that the expressions of nuclear factor (NF)-κB p65 and BMP-7 protein in the osteoblasts treated with 10 μmol/l PGE2 were apparently higher ( P ＜ 0. Ol ) than that of the controls, whereas the ld2 expression decreased (P ＜0. O1 ) under the same conditions, which was almost the same as the results of gene chip technology. ConclusionsWith the results of gene chip and Western blot, it can be speculated that the PGE 2 firstly activates the nuclear receptor NR4A2 and then the nuclear transcription factor NF-κB, induces the changes of the downstream gene BMP-7 and Id2 expression and finally results in the differentiation of the osteoblasts and promote the bone regeneration.

Objective To compare two separation medium of isolation of adult rat cardiomyocytes , and to observe the characteristics of excitation-contraction coupling of cardiomyocytes .Methods The isolated adult rat heart was hanged on to the Langendorff apparatus for aortic counter-current perfusion and collagenase digestion using two different separation medium.The single cardiomyocytes were cultured and infected with adenovirus . The morphological features of cardiomyocytes were observed with microscope and fluorescent microscope . The shortening-re-lengthening features of sarcomere and the intake-discharge features of calcium were simultaneously recorded by IonOptix equipment .Results 70%rod-shaped with clear-striation adult rat cardiomyocytes could be obtained with the stated two separation medium and cultured in serum-free medium for more than 7 days.GFP could express more than 7 days when the cardiomyocytes were infected with adenovirus .Cardiomyocytes obtained by the first separation medium could not contract with the electrical stimulation, while cardiomyoctyes obtained by the second separation medium could be used for the detection of excitation -contraction coupling .The shortening fraction of sarcomere was 11.61%±2.15% and the relaxing time was ( 0.177 ± 0.031) s.The amplitude of calcium transient was 30.79% ±9.74 % and the decaying time of calcium transient was (0.300 ±0.074) s.Conclusion With the stated two separation medium , adult rat cardiomyocytes can be well isolated , cultured and infected with adenovirus .The second separation medium can be used for the detection of excitation-contraction coupling characteristics .

Objective To assess the differences in carotid artery stiffness properties and endothelium-independent dilation (EID)between elderly and young patients,and evaluate the echotracking (ET)system for vascular stiffness at different ages.Methods A total of 79 outpatients with multiple cardiovascular risks were recruited.Clinical data including medical history,height,weight,blood pressure,fasting blood glucose and blood lipid were collected.We evaluated the arterial stiffness parameters of carotid artery and EID using an ultrasonic ET system in 46 elderly subjects,compared with 33 sex-matched non-elderly subjects.The impaired EID function was defined as brachial artery nitroglycerin mediated dilation (NMD)below 4％.Results All stiffness parameters including pressure-strain elasticity modulus stiffness index β (Ep),pulse wave velocity β (PWVβ)and augmentation index (AI)were significantly increased in elderly group compared with the non-elderly group [(138.9±64.7)kPa vs.(100.6±30.8)kPa,(10.9±4.7)vs.(8.2±2.3),and (6.9±1.4)m/s vs.(6.1±0.9)m/s,P＜0.05 respectively],while the exception of arterial compliance (AC)was reduced (0.9±0.3)mm2/kPa vs.(1.0±0.5)mm2/kPa(P＜0.05).The incidence of impaired EID in elderly group was higher than in non-elderly group [56.5％ (26 cases) vs.33.3％ (11 cases),P＜0.05].ET parameters including Ep,stiffness index β,PWVβ,AC and AI were related to age (r=-0.44,-0.45,-0.40,-0.40,0.34,all P＜0.01)； Ep,stiffness index β,PWVβ and AC were also related to impaired EDI (r=-0.38,-0.40,-0.34,-0.29,all P＜0.01).Conclusions Arterial stiffness properties and EID measured by ET system was more serious in elderly with multiple cardiovascular risks than in non-elderly subjects.As a convenient and accurate assessment of stiffness parameters,ET system is optimal option for measuring arterial stiffness and EID in elderly people.

Objective To discuss the diagnostic value of DSA for massive hemorrhage in lower gastrointestinal tract resulting from tumour. Methods 24 patients with massive lower gastrointestinal hemorrhage were performed DSA and then operated as tumour. Results Among 24 patients, 17 cases demonstrated direct signs of hemorrhage, 9 cases visible turnout vessels; 24 patients all showed clumping tumour-specifie dyeing. Conclusion DSA is of great value to determining the location and qualitation of the massive lower gastrointestinal hemorrhage resuhing from tumours.

Objective This study is designed to observe the effect of ischemic postconditioning in rats underwent acute myocardial ischemia/reperfusion injury and to investigate the related mechanism.Methods A total of 30 SD rats were randomly divided into sham operation group (control group,n =10),ischemia/reperfusion group (IR group,n =10) and ischemic postconditioning group (PC group,n =10) based on random number table.Rats in IR group underwent 30 minutes myocardial ischemia by occlusion of the proximal portion of left anterior descending (LAD) coronary artery followed by 2 hours reperfusion.In control group,there was no IR intervention.In PC group,at the start of reperfusion,three cycles of 30 seconds reperfusion and 30 seconds LAD reocclusion preceded the 2 hours of reperfusion.The hemodynamic values were measured via a cannula inserted into the right common carotid artery.The area at risk was assessed by Evans blue staining and the infarct size as measured by TTC staining.Western blot and Real time PCR were respectively used to assess the expression of predicted target gene Bim and microRNA-214(miR-214) in the area at risk at the end of 2 hours reperfusion.Results (1) The hemodynamic monitoring in different groups:the left ventricular systolic pressure (LVSP),± dp/dt and heart rate of IR group and PC group were lower than those of control group,but left ventricular end-diastolic pressure (LVEDP) was higher than that of control group (all P ＜ 0.05).The LVSP and ± dp/dtmax of PC group were higher than those of IR group,and LVEDP was lower than that of IR group (all P ＜ 0.05).(2) Myocardial ischemia area and infarction range in different groups:there was no statistically difference in the proportion of area at risk (AAR) in left ventricle (LV) (AAR/LV) between PC group and IP group ((27.00 ± 7.55) ％ vs.(26.67 + 11.68) ％,P ＞ 0.05).The proportion of infarct size in the area at risk (IS/AAR) of PC group was lower than that of IR group((30.67 ±3.51)％ vs.(48.67 ±4.62)％,P＜0.05).(3) The expression of Bim protein in rats ischemic myocardial tissue in different groups:the expression of Bim protein in ischemic myocardial tissue of IR group was higher than that of control group (2.34 ± 0.15 vs.0.75 ± 0.05,P＜0.05),and that of PC group was lower than IR group (1.25 ±0.14 vs.2.34 ±0.15,P＜0.05).(4) The expression of of miR-214 in rats ischemic myocardial tissue in different groups:the expression of miR-214 of IR group was lower than that of control group(0.20 ±0.04 vs.1.00,P ＜0.01),and that of PC group was higer than that of IR group (0.85 ±0.20 vs.0.20 ±0.04,P ＜0.01).There was no statistically difference between PC group and control group (P ＞ 0.05).Conclusions Postconditioning could significantly decrease the ischemia/reperfusion injury by reducing the infarct size and improve cardiac function in this in vivo rat model.The expression of Bim in postconditioning group is significantly depressed,which may play an important role in the protection process of postconditioning,and the downregulation of Bim might be mediated with the increase of miR-214 expression.