Objective To investigate the causes of high rate of false positives in the detection of syphilis in elderly patients.Methods We used RPR,TP -ELISA and TPPA to detect the antibody of syphilis in 1 200 patients, and the samples were divided into the elderly group (60 or higher)and the control group (<60 years old),confirmed by TPPA,then counted the positive rate and false positive rate,and the results were analyzed.Results The positive rate (8.00%)and false positive rate (4.50%)of the elderly group were significantly higher than the control group (3.83%,1.87%,χ2 =9.36,9.47,all P <0.05).The false positive rate significantly rised with the increase of age of the elderly group.Conclusion The reason of false positive may be associated with the physical condition of the patients,and we should consider it with the clinical manifestations when diagnosed.

Objective To evaluate the efficacy of endovascular aortouniiliac repair (EVAR) combined with cross-femoral bypass grafting (CFBG) for the treatment of abdominal aortic aneurysm (AAA). Methods From May 1997 to February 2007, 8 patients with AAA, in whom bifurcated stent-graft could not be used because of complex iliac anatomy, were treated with EVAR using AUI stent-graft combined with CFBG. The endoleak, ischemic syndromes,patency of the bypasses, and blood supply of the lower limbs were observed after the operation. Results There were no perioperative mortalities in this series. One patient died of myocardial infarction 15 months after the operation. Three patients developed primary endoleak, and was cure spontaneously 1, 3, and 6 months postoperation. The 8 patients were followed up for a mean of 24 months (3-72 months), during which the patency rate of cross-femoral bypass was 100%. One year after the operation, 1 patient developed mild anastomotic stoma stenosis without ischemia of the lower limbs, but no limb ischemia. Conclusion In patients with complex iliac anatomy unfavorable for bifurcated endografting, EVAR using AUI combined with CFBG is safe and effective.

Objective To investigate the effects of chondroitinase ABC injection on motor and acetylcholinestarase (AchE) expressed inthe motor end-plate of gastrocnemius in adult rats with spinal cord injury. Methods The spinal cords in T10 of 40 male Wistar rats (10 weeksold) were exposed and the right sites were semi-transected. The left sites were considered as the control (group A), the transected sites wereas the injured group (group B) and chondroitinase ABC-treated group (group C). The rats were assessed with Basso, Beattie & Bresnahan(BBB) score for ethological test, and sacrificed 3 d, 7 d, 14 d and 28 d after operation. The AchE expressed in gastrocnemius was detectedwith zymochemistry staining. Results BBB score in group C was significant higher than that in group B 14~28 d after operation, while theAchE activity in group B and C was lower than that in group A (P<0.05), and lower in group B than in group C (P<0.05). Conclusion ChondroitinaseABC injection can enhance AchE activity and promote the locomotor recovery after spinal cord injury in adult rats.

Objective To investigate the activation of nuclear factor-κB(NF-κB),which was stimulated by angiotensin-Ⅱ(AngⅡ)through classical pathway in human pulmonary microvascular endothehal cells(HPMEC).Method The experiment was divided into two groups:in Ang Ⅱ group,HPMECS were incubated with 10-6mol/L AngⅡ for 0,0.5,1,2 and 4 hours,respectively;in losartan group,HPMEC was pretreated with 10-6mol/L losartan(inhibitor of AngⅡ type 1 receptor)for 1 hour,and then stimulated with 10-6mol/L AngⅡ for 2 hours,and the nucleax protein and the cell plasma protein were prepared by lysis and centrifugation.Electrophoretic mobility shift assay(EMSA)was used to detect the NF-κB DNA binding activity.The inhibitor of κBa(IκBα)was detected by Western blotting.The data were expressed as(x±s)and analyzed with one way analysis of variance.A P value less than 0.05 indicated significant difference.Results Compared with the activity of NF-κB at 0 h (100.0±25.1)after AngⅡstimalation,the activity increased significantly at 0.5 hour(144.5±16.1,P＜0.05),and reached peak value at 2 hours(270.1±27.2,P＜0.05).The concentration of IκBα at 0 hours was 44.4%±2.1%,decreased markedly at 0.5 hours(38.9%±3.6%,P＜0.05),and to the lowest level at 2hours(32.6%±2.3%,P＜0.05).The activity of NF-κB(115.4±10.7)and the concentration of IκBα(43.6%±3.7%)in losartan group had ilo significant difference with AngⅡ group at 0 h(P＞0.05).The activity of NF-κB and the concentration of IκBα in losartan group had significant difference with AngⅡ group at 2hours.Conclusions NF-κB can be activated through classical pathway,which stimulated by AngⅡ in HPMEC.

Objective To identify risk factors for anastomotic leakage,and study the influence of high ligation of the inferior mesenteric artery on anastomotic leakage after rectal cancer resection.Methods The chi-test and the student t test were used for statistics.Clinical data were analyzed for 291 patients who underwent rectal cancer resection between August 2008 and November 2011.Results Anastomotic leakage occurred in 27 (9.3％) patients.Anastomotic leakage significantly increased in patients with tumours located within 10 cm from the anal verge,in male patients,and intraoperative blood loss.The use of high ligation of inferior mesenteric artery,which was associated with lower tumor location and surgical modality,was not a risk factor for anastomotic leakage,though it was associated with tumor stage and postoperative urinary retention.Conclusions Anastomotic leakage after rectal cancer resection is related to the tumor level,male gender,and perioperative bleeding,use of a high tie was not associated with an increased rate of symptomatic anastomotic leakage.

Objective To evaluate early results of Endurant stent-graft in the treatment of abdominal aortic aneurysms (AAAs).Methods From July 2010 to June 2011,68 patients (57 men,11 women; mean age 74.3 years) were treated with Endurant stent-graft at our center.26 cases had hostile proximal neck in the anatomy.According to ASA classification,15 cases were class Ⅱ ; 32 cases were class Ⅲ and 21 cases were class Ⅳ.Results Intraoperative immediate technical success was achieved in all cases.At completion angiography,a type Ⅱ endoleak was detected in 18 (26％) of the 68 patients.The mean operation time was (96 ± 29) min,the mean blood loss was (99 ± 68 ) ml,and the mean contrast usage was (122 ± 65) ml.No intraoperative conversion to open surgery,stent migration,types Ⅰ/Ⅲ endoleak,other major complications,or death was encountered.49 patients (72％) had a postimplantation syndrome with fever,leukocytosis,and increase of C-reactive protein levels,which completely resolved within two weeks.The mean follow-up time was (8 ± 5) months.Conclusions Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair,even in patients with hostile aortoiliac anatomy.

ObjectiveTo investigate the effects of methylprednisolone （MP） on the proliferation and expression of glial fibrillary acidic protein (GFAP) in astrocytes after spinal cord injury in rats. MethodsThe spinal cords in T8～T10 in 48 male Wistar rats (10 weeks old) were exposed and the right site were semi-transected. 24 rats were administrated MP through tail vein as experiment group, and the other rats were injected equal volumes of normal saline as the control group. They were assessed with Basso, Beattie, and Bresnahan (BBB) score for ethological test every 4 d, and were sacrificed, perfused 3 d, 7 d, 14 d and 28 d after operation. The spinal cords were removed and postfixed, The expression of GFAP was observed with immunohistochemical staining and gray values determination. The GFAP positive cells were also counted. ResultsThere was no significant difference in BBB score between these groups until 21 d after operation; but the MP group rats showed significantly better functional recovery than the control group 25 d after operation. The number of positive astrocytes was less in the MP group than in the control group 3 and 7 d after operation, but there was no significant difference 14 d after operation. The GFAP expression in glial scar was significantly lower in the MP group than in the control in the first 21 d after operation, but no significant difference 28 d after operation. ConclusionThe large dose methylprednisolone administration can decrease the number of active AS, attenuate the formation of glial scars, and improve the functional recovery of the hind limbs after acute spinal cord injury.

Objective To compare the therapeutic effect of endovascular repair (EVAR) and open surgical repair(OSR) of abdominal aortic aneurysm in high-risk patients. Methods The clinical data of 55 patients from 1998 to 2008 with infrarenal abdominal aortic aneurysm who received surgical treatment were analyzed by using the customized probability index. The perioperative and short term advantages and disadvantages of OSR group (n=20) were compared with EVAR group (n=35). Results All patients in OSR group were followed up, 94% patients in EVAR group were followed up, the mean follow up time were 75 and 70 months respectively. (1) Compared to OSR group, the EVAR group had shorter operation time [(3.1±0.6) h vs (4.9±0.9) h, P<0.05], (2) EVAR group had shorter ICU and hospital stay after operation and less blood loss (P<0.01), (3) Compared to OSR group, the EVAR group had lower mortality within 30 d(2.86% vs 15%), (4)the EVAR group had lower peri-operative complications(17% vs 40%), (5) The main complications of EVAR were endoleak (8.57%), (6) The main complications of OSR was cadiovascular incidence(25%). Conclusions Endovascular treatment, indicated for AAA in high-risk patients, can cut down the perioperative incidence of cadiovascular events, mortality and complications. CPI is useful to estimate the perioperative incidence of cadiovascular events, mortality and complications, and can be used to guide the therapeutic method.

Objective To evaluate aneurysm sac pressure monitoring during endovascular repair (EVAR)of abdominal aortic aneurysm. Methods From April 2006 to May 2007,12 patients with abdominal aorta aneurysm underwent endovascular aneurysm repair.The average max-diameter of the aneurysm WR8(5.83±0.95)cm.The sac pressure was monitored during the whole process of the operation.The correlation between the pressure and endoleaks and long-term outcomes was observed during follow-up.Results Before the stentgraft was delivered.sac pressure was equal to the systemic blood pressure in all the 12 cases.After the EVAR wag finished,the sac systolic pressure dropped by＞40% in 11 cases,among which sac blood pressure bropped by ≥50% in 7 cases.sac pressure did not change in 1 case.In all the 12 cases,pulse pressure diminished by＞30%,and＞75%in 6 cages.During the follow-up,there were no endoleaks and death.In 5 Cases.with sac systolic pressure drop＞50%,the max-diameter of the aneurysm decreased by 1.6～3.1 mm,while in one c88e,in which sac pressure had no change the postoperative maxdiameter of the aneurysm has increased by 3.2 nma. Conclusion Abdominal aorta aneurysm sac pressure monitoring during EVAR helps to predict the change of the sac pressure after EVAR,and to detect the endoleaks.

Objective To compare selective coverage and chimney technology of the left subclavian artery (LSA) in thoracic endovascular aortic repair (TEVAR).Methods Eighty-one cases were retrospectively reviewed from January 2005 to January 2013 with two different management of the LSA during TEVAR:selective coverage (SC) vs chimney (C).Technical success rates,operating time,endoleaks,and perioperative cerebrovascular accidents,spinal cord ischemia (SCI),left arm ischemic symptoms and mortality were analyzed.The survival rate was also evaluated.Statistical analysis was performed using the x2 test,t-test and Kaplan-Meier survival curve.Results There were 37 patients in group SC and 34 in group C.Operating time was (61 ± 22) min for SC,and (101 ± 20) min for C (P =0.000) ; left arm ischemic symptoms occurred in 23.4％ in group SC,and 2.9％ in group C (P =0.011).Technical success rates were 100％ and SCI were 0 for both SC and C.Endoleaks,perioperative cerebrovascular accidents,and mortality were similar between the two groups.Conclusions During TEVAR,selective coverage of the left subclavian artery is safe,effective; meanwhile,chimney technology is safe,effective for patients whose left subclavian arteries need revascularization.