Abnormalities of the inferior vena cava occur infrequently.Except a few patients,most with the abnormalities of the inferior vena cava have not symptoms and do not need surgical procedure.However,attentions should be pasd to these anomalies in operation,particularly in the retroperiwneal procedure.only when the anomalies are identified before operation,its pessible to avoid the disaster caused by side-damage.Understanding embryo development of the inferior vena cava is usdful to comprehend the generation mechanism and classification of abnormalities of the inferior vena cava and its main branches.Exact judgment to abnormalities of the inferior vens cava has the important clinical significance.

Bricker operation was used to treat advanced paraplegia with severe upper uninary tract deterioration, bilateral ureterohydronephrosis, recurrence urinary tract infection, and chronic renal failure.Three cases have good results. The operation is an extensive and complex procedure,indication should be strict.

Objective To study the methods and effects of endoscope-assisted partial thyroidectomy through subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle.Methods The study included 15 patients with unilateral thyroid benign nodules.A transversal subclavicular incision 2~3 cm in length was made.Endoscope-assisted partial thyroidectomy was performed through the subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle.Results The operation was accomplished successfully in all the 15 patients.The operation time was 40~80 min(mean,50 min) and the intraoperative blood loss was 10~50 ml(mean,20 ml).No surgical complications occurred.The patients were discharged from hospital on 3~4 postoperative days.Follow-up observations in the 15 patients for 1~12 months(mean,7 months) revealed no recurrence.Conclusions Endoscope-assisted partial thyroidectomy through subclavicular approach between the cervical anterior muscles and the sternocleidomastoid muscle has the advantages of minimal invasion,little blood loss, low complication rate,quick recovery,and good cosmetic results.

BACKGROUND: Rejection is the main cause of the failure in small bowel transplant. Chemotatic factor RANTES and receptor mediated cellular immunity are very important in acute rejection.OBJECTIVE: To explore the immunosuppressive effect of early adopting chemokine receptor antagonist, Met-RANTES after small bowel transplant on acute allograft rejection and its coordinative effect with Tacrolimus (FK506).DESIGN: Randomized complete-block design, controlled animal experiment.SETTING: Department of General Surgery, the 451 Hospital of Chinese PLA; Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University of Chinese PLA; Electronic Microscope Center, School of Basic Medicine, Fourth Military Medical University of Chinese PLA.MATERIALS: This study was carried out in the Laboratory of Department of Gastrointestinal Surgery, Xijing Hospital,Fourth Military Medical University of Chinese PLA from September 2003 to March 2005. Totally 192 animals including 96 SD rats (donors) and 96 Wistar rats (recipients) were involved in this study. Heterotopic segmental small bowel transplantation was performed.METHODS: The transplant rats were divided into 4 groups averagely by the randomized complete block design: control group (allogeneic small bowel transplant untreated group), Met-RANTES group(200 μg/d, 0-7 days, i.p.), FK506 group [0.5 mg/(kg·d) ,0-7 days,i.p.], Met-RANTES + FK506 group [Met-RANTES, 200 μg/d,0-7 days,i.p.+ FK506 0.5 mg/(kg ·d),0-7 days, i.p.]. Rats in the latter 3 groups were intraperitoneally administrated after transplant within 7 days successively.Rats in the control group were not given any treatments before and after transplant. Postoperatively, gross status,survival time and immunocyte infiltration were observed. Pathological examination was conducted in 6 rats of each group on postoperative days 3, 5 and 7. Fluorescent staining and successive quantitative measurement were conducted to detect the expressions of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocyte. Survival duration of the rest 6 rats of each group was observed for 5 weeks.MAIN OUTCOME MEASURES: ① Survival time of rats in each group following transplant. ② Pathological changes of small bowel intragraft of rats in each group. ③ RANTES and T lymphocyte expressions of rats in each group.RESULTS: Following transplantation, 96 Wistar rats (recipient) were all involved in the final analysis. ①Compared with control group, the survival time of rats in Met-RANTES group, FK506 group, Met-RANTES + FK506 group was significantly longer (P ＜ 0.01). In addition, rats in Met-RANTES + FK506 group survived the longest. There were significant differences in survival rate as compared with Met-RANTES group and FK506 group (P ＜ 0.01). ②All rats in the control group died of acute rejection and infection. Histopathologic examination showed mild, moderate and severe rejection on the postoperative days 3,5 and 7, respectively. No obvious rejection was found in the rats in the Met-RANTES group, FK56 group and Met-RANTES+FK506 group on the postoperative days 3,5 and 7. ③Postoperatively, intragraft RANTES expression of rats was significantly higher in each time period in control group than in the other 3 groups (P ＜ 0.01), and its dynamic change was positively correlated with the process of acute rejection; The expression of intragraft RANTES, CD4+, CD8+ and CD25+ T lymphocytes of rats was significantly lower, respectively, in the Met-RANTES group and Met-RANTES+FK56 group than in the control group (P ＜ 0.01).CONCLUSION: Met-RANTES may obviously suppress acute allograft rejection in small bowel transplant, effectively protect the function of grafts, and significantly prolong the survival time of the recipients. In addition, Met-RANTES may enhance the immunosuppressive function of small dose of FK506[0.5 mg/(kg · d)].

OBJECTIVE:To investigate the healing-promoting effect of total tanshinone on sore and ulcer of model rats. METH-ODS:Staphylococcus aureus levitation liquid was made to reproduce model rats with sore and ulcer,sc. 50 rats were randomly di-vided into normal group(equal volume of CMC-Na solution),model group(equal volume of CMC-Na solution),ampicillin group (positive drug 20 mg/kg)and total tanshinone high and low dose groups(200 and 100 mg/kg),ig,once a day for continuous 12 d. The general conditions were observed. The content of lysozyme(LZM)and immunoglobulins G(IgG)in serum were tested af-ter 12 d;the content of LZM and IgG in purulent secretion of model rats were respectively tested after dosing of 4 d,8 d and 12 d. The integral of wound deterioration were evaluated. RESULTS:Compared with normal control group,the index was worse in model group. Compared with model group,the appetite and activity amount of total tanshinone in high dose group (200 and 100 mg/kg)were increased,with no secretion on the wound and a clean escharosis;content of LZM and IgG in serum of rats in in to-tal tanshinone high and low dose group were increased after 12 d;also,the content of LZM and IgG in purulent secretion of rats in total tanshinone high and low dose groups were increased after dosing of 4 d,8 d,and 12 d;the integral of wound deterioration in total tanshinone high dose group were decreased after dosing of 8 d and 12 d,with significant difference (P<0.01 or P<0.05). CONCLUSIONS:Total tanshinone can promote the wound healing on sore and ulcer of model rats by a mechanism that is related to the content of LZM and IgG in serum and purulent secretion.

OBJECTIVE:To discuss ward drug control to ensure safe.METHODS:We analyzed retrospectively the application of 5S theory in ward drug control.RESULTS & CONCLUSION:By this drug control mode,drugs were classified according to varieties,usage,frequency of use etc,drug control quality and work efficiency were enhanced,patients' needs could be satisfies and staff' s professional quality was enhanced.

Objective: To observe therapeutic effects of ticagrelor combined tirofiban on patients with ST elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and their short-term prognosis.Methods: A total of 280 STEMI patients undergoing emergency PCI were selected.According to random number table, patients were randomly divided into clopidogrel group (received clopidogrel combined tirofiban therapy) and ticagrelor group (received ticagrelor combined tirofiban therapy).TIMI blood flow grade of infarct related arteries, platelet aggregation rate and P2Y12 reaction unit (PRU) before and after PCI, and incidence of major adverse cardiovascular events (MACE) within 30d follow-up, hemorrhage event and cardiac function were measured and compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of TIMI blood flow grade 3 (81.4% vs.91.4%), and significant reductions in platelet aggregation rate [(55.2±4.1)% vs.(50.8±4.4)%] and PRU [(196.2±15.1)U vs.(180.8±12.0)U] in ticagrelor group, P<0.05 all.Compared with clopidogrel group after 30d follow-up, there were significant reductions in incidence rates of re-myocardial infarction (5.0% vs.2.9%) and cardiogenic death (2.9% vs.0.7%), left ventricular end-diastolic dimension [(53.1±2.8)mm vs.(49.0±2.0)mm] and left ventricular end-systolic dimension [(40.2±2.1)mm vs.(37.4±1.8)mm], and significant rise in left ventricular ejection fraction [(51.8±2.7)% vs.(55.4±2.5)%] in ticagrelor group, P<0.05 all.There were no severe hemorrhage events in both groups, and no significant difference in incidence rate of mild hemorrhage (5.0% vs.6.4%) between clopidogrel group and ticagrelor group, P=0.591.Conclusion: For STEMI patients undergoing emergency PCI, ticagrelor combined tirofiban can effectively reduce platelet aggregation rate, improve TIMI blood flow of infarct related arteries, therapeutic effects and their short-term prognosis without increasing hemorrhage risk, which is worth extending.

AIM: To investigate the changes of intracellular calcium ion (Ca2+) concentration in mouse H9c2 (2-1) cells transfected with or without FK506 binding protein 12.6(FKBP12.6) gene by ultrasound mediated destruction of microbubbles. METHODS: The pcDNA3.1-FKBP12.6 plasmid, mingled with albumin-coated microbubbles agents, was transfected into H9c2 (2-1) cells by ultrasound-mediated destruction of microbubbles. The H9c2 (2-1) cell growth state was investigated by inverted microscope. The changes of intracellular Ca2+ concentration was determined by laser scanning confocal microscope. The FKBP12.6 protein expression was checked by immunohistochemistry. RESULTS: As compared with control cells, the H9c2 (2-1) cells, transfected with FKBP12.6 gene, grew better, had higher gross intracellular Ca2+ concentration. CONCLUSION: FKBP12.6 gene augments Ca2+ concentration in mouse H9c2 (2-1) cells, enhances the contractibility of the myocardial cell, which may be helpful to improve the myocardial dysfunction.

Objective To evaluate the effects on blood pressure and vascular endothelial-1 function of combined therapy of atrovastin and nifedipine controlled released tablet in essential hypertension.Methods A randomized,double-blind,controlled trial was performed.Eighty-two patients with essential hypertension were randomly divided into two groups,receiving nifedipine controlled released tablet 30 mg once daily,or atrovastin 10 mg once daily and nifedipine controlled released tablet 30 mg once daily for 12 weeks.Another 30 subjects with normal blood pressure served as normal blood pressure control.Antihypertensive efficiency was observed during the whole study period.The concentration of plasma endothelin-1(ET-1) nitric oxide(NO) were measured before and after treatment.Results Blood pressure decreased significantly in both groups,but more significant in combined therapy group.In the combined therapy group,atrovastin resulted in a significant reduction of plasma ET-1 and a rise of nitric oxide(NO)(P

Objective To investigate the role of Jiawei-sini Dection on expression of rat transforming growth factor-β1 receptor Ⅰ,Ⅱ(TβRⅠ,TβR Ⅱ), and study its treatment of anti-HF and the possible mechanisms. Methods The model of rat hepatic fibrosis was setup by subcutaneous injection of carbon tetrachloride and drinking alcohol freely;According to random block method, the successful model rats were divided into three groups:pathological model group (group B),Fufangbiejiarangan tablet group (group C), and Jiawei Sini Decoction group (group D), each group containing ten rats. Group A and group B were given two milliliters saline, group C was given Fufangbiejiarangan tablets 0.625 grams per kilogram of body weight, group D was given Jiawei Sini liquid 15.625 grams per kilogram of body weight.Each rat was fed once a day for 8 weeks.In order to avoid the natural repair of the hepatic affecting the experimental results, the rats,except group A, were still injected 40% CCl4 three milliliters per kilogram of body weight after feeding drug once a week. Fufang-Biejia-Ruangan Ttablet group was set as a positive control;The effects on expression of TβRⅠ,TβR Ⅱ were determined by immunohistochemical method. Changes of alanine aminotransferase (ALT), aspartate aminotransferase(AST),alkaline phosphatase(ALP) and TβRⅠ,TβR Ⅱ were observed in rats. Results The expression of TβRⅠ、Ⅱ, compared with the pathological model(16.63±2.69)%, (14.57±1.09)%, were significantly reduced in Jiawei-Sini Dection group[they are(8.09±0.71)%,(6.51±0.48)%, the difference was statistically significant(P＜0.05).The effects of Jiawei-Sini Dection was equal to the effect of Fufang-Biejia-Ruangan Tablets on expression of TβRⅠ,TβR Ⅱ(P＞0.05). Conclusion Jiawei-Sini Dection was able to inhibit the expression of TβRⅠ and TβR Ⅱ, thus affected the combination of TGFβ1, and their receptors.