Objective To investigate the effectiveness of Rh-negative patients receiving Rh-positive renal grafts.Methods Three Rh-positive kidneys were transplanted in 3 Rh-negative uremia patients respectively. The pre- and intraoperative conditions were evaluated. All patients were regularly followed up.Results Dysfunction occurred in one graft kidney 5 years after the operation, and the patient died of cardiovascular complication 8 years after the operation. The remaining 2 patients have survived 22 and 2 months respectively with normal renal function, and their Rh antibodies were negative 21 and 2 months after the operation respectively.Conclusion Fully perfused Rh-positive renal grafts can be transplanted to Rh-negative uremia patients. The short-term effect is satisfactory.

OBJECTIVE:To observe clinical effects and safety of small dose of octreotide for preventing hyperamylasemia and acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).METHODS:One hundred and twenty ERCP pa tients were selected from our hospital during Oct.2014-Jan.2015 and then divided in to observation group and control group in accordance with random number table,with 60 cases in each group.Both groups were given Diazepam tablet 10 mg+Meperidine hydrochloride tablet 100 mg+Phenobarbital scopolamine tablet 2 tablets 0.5 h before surgery for sedation and analgesia,and routine acid suppression and anti-infective therapy.Observation group was additionally given Octreotide acetate injection 0.1 mg hypodermically and then given Octreotide acetate injection 0.1 mg immediately after surgery,8 h after surgery.The levels of serum amylase and blood glucose were observed in 2 groups,and the occurrence of postoperative complication and ADR were recorded.RESULTS:Before operation,there was no statistical significance in the levels of serum amylase and blood glucose between 2 groups (P＞ 0.05).After operation,the level of serum amylase in control group was significantly higher than in observation group,with statistical significance (P＜0.05).There was no statistical significance in blood glucose level between 2 groups after operation (P＞0.05).The incidence of hyperamylasemia and ADR in observation group was significantly lower than in control group,with statistical significance (P＜0.05),and there was no statistical significance in the incidence of acute pancreatitis between 2 groups after operation (P＞0.05).CONCLUSIONS:Small dose of octreotide can effectively reduce the level of serum amylase and the incidence of hyperamylasemia after ERCP with good safety.

Objective To study the relationship between M3 receptor and prostastic tumor by analyzing the expressions of M3 and vascular endothelial growth factor(VEGF)in adult human normal and neoplastic prostatic gland tissue. Methods The specimens included 36 normal prostates(fresh),36 benign prostatic hyperplasia(BPH)tissue(fresh),and 36 cancer tissue(8 fresh).RT-PCR was used to detect M3 receptor,VEGPs genetic expression.At protein level,VEGF,Ms receptor,CD34 were detected by western-blot and immunohistochemical method. Results VEGF and M3 receptor's genetic expressions were higher in prostate cancer tissue(O.8354±0.1897,0.7824±0.2047)than in BPH tissue(0.6735±0.1603,0.6021±0.1637),while the expressions of these genes were lowest in normal prostate tissue(0.5425±0.1629,0.3436±0.1581)(P<0.001).There was a positive correlation between M3 and VEGFs gene expression(r=0.4999,P

The effects of gypenosides (Gps) on the levels of fasting plasma glucose (FPG),fasting in- sulin (INS),total cholesterol(TC),triglyceride (TG),serum lipid peroxide (LPO) value and serum super- oxide dismutase (SOD) activity in STZ-induced diabetic rats were studied.The levels of FPG、INS、TC、TG and serum LPO value were decreased while serum SOD activity was increased significantly in diabetic rats after four weeks of Gps treatment in comparison with those in control rats.These results suggest that Gps have the effects of decreasing the levels of blood sugar,lipid and possibly scavenging free radicals.

Objective To compare the clinical effect of off-pump coronary artery bypass grafting (eft-pump CABG)and on-pump coronary artery bypass grafting(on-pump CABG).Methods The clinical dates of 152 cases with coronary artery bypass grafting(off-pump CABG group 85 cases,on-pump CABG group 67 cases)were received from June 2005 to December 2008,the preoperative dates,postoperative mortality and the rate of complication were compared between two groups.Results The preoperative dates of two groups were no significant difference(P>0.05);2 cases(2.35%)were died in off-pump CABG group and 13 cases(15.29%)had complications in off-pump CABG group;9 cases(13.43%)were died in on-pump CABG group and 25 cases(37.31%)had complications in on-pump CABG group.The mortality and the rate of complication in off-pump CABG group was significantly less than that in on-pump CABG group.it was significant difference(P<0.01).Conclusion Off-pump CABG is safe therapy of mieosurgieal operation.

Objective To evaluate the electrocardiographic(ECG)-gated 4-dimensional computed tomographic angiography (4D-CTA) in the determination of pulsation of unruptured cerebral aneurysms (URCAs).Methods This study included 48 patients with 62 URCAs.Examinations of ECG gated 4D-CTA of dual-source CT were performed.Twenty sets of image data with the time intervals of 5％ in a cardiac cycle were obtained after postprocessing on the workstation.The convex was defined as the point of pulsation if small bubble or small pointed convex could be found in continuous three or more images at the same location.The 62 URCAs were divided into two groups based on whether having a point of pulsation.All the URCAs were scanned at the follow-up by 3D-CTA or ECG gated 4D-CTA more than 120 days later.The diameters of aneurysms and aspect ratio between the two groups were compared with independent t test,while neck of aneurysms and follow-up time were compared with two-independent samples Mann-Whitney U test.The other variables including history of hypertension,type 2 diabetes,smoking et al between the two groups were analyzed by x2 test.The sensitivity and specificity of aspect ratio for diagnosis of pulsation were analyzed by receiver operating characteristic (ROC) curve.Results Pulsation was observed in 28 of the 62 URCAs.Aspect ratios in whose pulsation was or was not detected were 1.5±0.3 and 1.1±0.3,respectivelyThe difference between the two groups was statistically significant (t=-2.274,P＜0.001).The sensitivity and specificity of the aspect ratio were 75.0％ and 70.6％.After follow-up more than 3 months,of the 28 URCAs in which pulsation was observed,11 showed a change in shape,while in 34 URCAs without visible pulsation,5 showed a change in shape.The aneurysms with detectable pulsation were more likely to show a change in shape (x2=4.891,P=0.027),with an odds ratio of 3.753.Conclusions URCAs with a large aspect ratio are easily to show the pulsation by ECG gated 4D-CTA.Besides,the aneurysms with visible pulsation are more likely to show a change in shape after follow-up,which suggests a higher risk of rupture.

Objective To analyze the occupational characteristics in patients with avascular necrosis of femoral head and related factors.Methods A random sample of 1062 patients with avascular necrosis of femoral head of inpatient medical record data from 2007 to 2008 was selected, all patients were confirmed by X-ray, CT, MRI or radionuclide bone scan.Patients were assigned to three groups of agriculture (320 cases), non-agricultural (424 cases), the other(318 cases) groups by different occupation.The patient's age, gender, ethnicity, single or bilateral, etiology, staging, time of onset and region were compared in each group.Results The proportions of gender (male/female) were 21.94％ (233/1062) and 8.19％ (87/1062) in agriculture group,32.77％ (348/1062) and 7.16％ (76/1062) , 21.66％ (230/1062) and 8.29％ (88/1062) in non-agricultural and the other groups respectively.The proportions of region (Northeast, North, East, South, Southwest, Northwest of China) were 3.30％ (35/1062), 8.00％ (85/1062), 8.10％ (86/1062), 4.80％ (51/1062), 3.11％(33/1062) ,2.82％ (30/1062) in agriculture group, 8.29％ (88/1062), 10.08％ (107/1062), 7.72％ (82/1062), 7.25％ (77/1062), 2.26％ (24/1062), 4.33％ (46/1062), and 4.05％ (43/1062), 8.38％ (89/1062) ,8.10％(86/1062) ,4.61％(49/1062) ,2.17％(23/1062) ,2.64％(28/1062) in the group of non-agricultural and the other.The proportions of etiology (alcohol, hormones, trauma, two or more, the other) were 5.46％ (58/1062), 6.97％ (74/1062), 4.43％ (47/1062), 0.94％ (10/1062), 12.34％ (131/1062) in agriculture group, 10.55％ (112/1062), 7.72％ (82/1062), 5.74％ (61/1062), 2.26％ (24/1062), 13.65％ (145/1062), and 4.90％ (52/1062), 5.93％ (63/1062), 4.90％ (52/1062), 0.66％ (7/1062), 13.56％ (144/1062) in the group of non-agricultural and the other.The proportions of gender, region, etiology in each group were analyzed by x2 test, the differences were statistically significant (x2 =12.77, 24.55, 26.36, P ＜0.05).The onset time and ARCO staging in each group, the correlations were analyzed by Spearman test, the differences were statistically significant(rs =0.282,0.232,0.208, P＜0.05).The onset of time and average age in different occupational group with different, due to factors such as gender, ethnicity, single or bilateral, region, and so on.Conclusion Patients with avascular necrosis of femoral head in different occupational group have different epidemiological characteristics.The occupational characteristics analysis can provide scientific data for diagnosis,treatment and prevention in patients with avascular necrosis of femoral head.

@@

This study was aimed to observe the antipyresis and cholagogue effect of theFructus Gardeniae-Fructus Forsythiaeherb couple in order to explore the possible pharmacodynamic mechanism. Dry yeast suspension was subcutaneously injected into the back of rat to establish the fever model. The freeze-dried powders ofF. Gardeniae,F. Forsythiae, andF. Gardeniae-F. Forsythiaeherb couple were prepared. They were dissolved in the water for intragastric administration. SD rats were randomly divided into the normal group, model group, positive control group and Chinese medicine group. The Chinese medicine group was subdivided into the group ofF. Gardeniae,F. Forsythiae, andF. Gardeniae-F. Forsythiaeherb couple. The concentration of herbal water extract was 10 mL·kg-1 (which equaled to 3 g·kg-1 of a single crude herb). The concentration of positive control was 10 mL·kg-1. Intragastric administration of equal amount of normal saline was given to the blank group and the model group. Except rats in the normal group, rats in other groups were subcutaneously injected with 10 mL·kg-1 of 15% dry yeast suspension on the back of to establish the fever model. Electronic thermometer was used to record the body temperature of rats at 0, 1, 4, 5, 6, 7 and 8 h after the injection, respectively. Meanwhile, bile was collected from 1-1, 1-2, 2-4, 4-6, 6-8, 8-12, 12-24 h, respectively. Observation was given on changes of body temperature and bile amount of rat. The results showed thatF. Gardeniae,F. Forsythiae, andF. Gardeniae- F. Forsythiaeherb couple had certain effect to reduce the body temperature of rats. The temperature-reducing effect of the combination of both herbs was better than a single herb. TheF. Gardeniae -F. Forsythiae herb couple can reduce the body temperature of fever rat (P < 0.05, orP < 0.01). It had a little effect on the body temperature of normal rat. TheF. Gardeniae - F. Forsythiaeherb couple can promote the bile secretion, which was better than the single using of F. Gardeniae (P < 0.05). It was concluded that theF. Gardeniae - F. Forsythiaeherb couple had better temperature-reducing effect than the using of a single herb; however, there was no significant difference. But it had obvious effect on the promotion of bile secretion, which indicated the strengthening of cholagogue effect.

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.