Objective To evaluate the effects of different surgical treatments on polycystic hepatic disease and multiple simple hepatic cysts.Methods A total of 35 cases of polycystic hepatic disease and 54 cases of multiple simple hepatic cysts were surgically treated in our department from Jan.1998 to Jan.2006.Of the 35 cases of polycystic hepatic disease,12 were treated with the partial hepatic resection in combination with cyst fenestration,18 with laparotomic fenestration,5 with laparoscopic fenestration.Of the 54 cases of multiple simple hepatic cysts,6were treated with percutaneons aspiration and instillation of sclerosing agents (ethanol) under the guidance of ultrasonography B,36 with laparotomic fenestration,13 with laparoscopic fenestration.The surgical outcome and longterm follow-up outcome were retrospectively analyzed.Results After treatment,all polycystic hepatic disease patients experienced relief of symptoms when discharged.And the follow-up for an average of 3.0 years showed that 2 patients developed recurrence after the partial hepatic resection in combination with cyst fenestration,8 after the laparotomic fenestration,5 after the laparoscopic fenestration.The recurring rates were 16.7%,44.4% and 100.0% ,respectively.However,all patients of multiple simple liver cysts cured.Conclusions The approach of partial hepatic resection in combination with cyst fenestration is the most effective treatment for polycystic hepatic disease.Liver transplantation can cure polycystic hepatic disease,and is the only effective approach for severe cases.Percutaneous aspiration under the guidance of ultrasonography B is only effective for relief of symptoms before operation.Laparoscopic fenestration should be applied with caution.Laparoscopic fenestration is the first choice for multiple simple hepatic cysts with clinical symptoms.

AIM: To establish an HPLC for determining notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1 in Xueshuantong Injection (total saponin of Radix et Rhizoma Notoginseng).METHODS: The analysis was performed on UltimateTM XB C18 column(4.6 mm ? 250 mm,5 ?m) with a gradient mobile phase of acetonitrile(A)water(B) (0-30 min,20% A→38% A;30-31 min 38% A→20% A;31-40 min,20% A) at a flow rate of 1.0 mL/min.The column temperature was maintained at 40 ℃,and the detection wavelength was set at 203 nm.RESULTS:The linear range of notoginsenoside R1 fell within 0.40 -4.01 ?g (r =0.999 9 ) and the average recovery was 99.36 % (RSD = 0.72% ,n = 6).The linear range of ginsenoside Rg1 fell within 1.47-14.69 ?g (r = 0.999 9) and the average recovery rate was 99.41% (RSD = 0.52% ,n = 6).The linear range of ginsenoside Rb1 fell within 1.50-15.03 ?g(r = 0.999 9) and the average recovery rate was 99.47% (RSD = 0.50% ,n = 6).CONCLUSION: This method is accurate,simple,rapid and can be used for the quality control of Xueshuantong Injection.

Objective To evaluate the clinical efficacy of green light photoselective vaporization(PVP)combined testicular resection plus anti-androgen treatment on advanced prostate cancer and bladder outlet obstruction.Methods Twenty cases with PVP of advanced prostate cancer and bladder outlet obstruction were selected as our subjects,who underwent PVP testicular resection plus anti-androgen treatment.The clinical information was recorded.Results All patients were succeed through surgery.Maximum urinary flow rate (MFR) at the pre-operation was (2.0 ± 1.0) ml/s,and increased to (14.0 ± 4.5) ml/s after operation.Serum prostate specific antigen (PSA) was decreased from the preoperative (176.5 ± 160.5) μg/L to (2.0 ± 1.0)μg/L International prostate symptom score (IPSS) was from (25.0 ± 5.0) down to (8.0 ± 1.0) points.The quality of life (QOL) score was (4.0 ± 2.0) at pre-operation,higher than after operation (1.0 ± 1.0)points.There were significant differences between preoperative and postoperative (t =9.502,7.371,5.328,8.350,P ＜0.05).Every patient was followed up from 3 to 18 months.The improvements regarding of clinical symptoms were seen including voiding,and all patients survived with tumor.Conclusion Advanced prostate cancer associate with bladder outlet obstruction.The therapy plan of PVP joint testicular resection plus antiandrogen is proved to improve symptoms of urethral obstruction and patient quality of life.

Objective To investigate the effect of propofol on the expression of c-fos protein and c-fos mRNA in hippocampus during global cerebral ischemia-reperfusion in rats. Methods Forty male Wistar rats weighing 250-320 g were randomly allocated to one of five groups: group A received sham operation ( n = 8); group B received ischemia-reperfusion (I-R n = 8); group C received intraperitoneal propofol 50 mg?kg-1(C1 n = 8) or 100 mg@kg-1(C2 n = 8) or 150 mg2kg-1(C3 n = 8) 10 min before I-R. The animals were anesthetized with intraperitoneal pentobarbital 40 mg?kg-1.Vertebral arteries were surgically exposed and permanently occluded by coagulation. Bilateral common carotid arteries were exposed. 4-0 silk suture was placed around the arteries. Global cerebral ischemia was induced by lighting the suture for 10 min which was then loosened for reperfusion. At the end of 60 min reperfusion the animals were decapitated on ice and brain was immediately removed. Different brain tissues were either kept in liquid nitrogen ( - 80℃) or fixed in 10% formalin. The changes in c-fos protein in brain was evaluated by immuno-histochemical methods and c-fos mRNA expression in hippocampus was detected using semiquantitative RT-PCR technique.Results The c-fos expression was minimal in sham operation group. I-R induced significant increase in the expression of c-fos protein and c-fos mRNA and propofol significantly inhibited the increase in c-fos expression induced by I-R. The levels of c-fos expression were higher in group C1 than that in group C2 (P 0.05) . Conclusion The study shows that propofol can significantly inhibit expression of c-fos protein and c-fos mRNA induced by global cerebral I-R.

Objective To investigate the effects of propofol on ketamine-induced HSP 70 mRNA and protein expression in the rat posterior cingulate cortex and to explore the possibility of using propofol to prevent or treat ketamine-induced psychotomimetic effects and neuronal damage. Methods Thirty male Wistar rats weighing 250-300 g were randomly divided into 5 groups with 6 animals in each group: group 1 received normal saline intraperitoneally ip (NS); group 2 received ketamine 100 mg? kg-1 ip (K); group 3 received propofol 100 mg ? kg-1 ip (P); group 4 received propofol 50 mg?kg-1 + ketamine 100 mg?kg-1 ip (P1 K) and group 5 received propofol 100 mg?kg + ketamine 100 mg?kg-1 ip (P2K) . In group 4 and 5 the interval between propofol and ketamine administration was 15 min. Twenty-four hours after ketamine and/or propofol administration, the animals were decapitated and brain was removed. HSP 70 mRNA expression in the posterior cingulate cortex was detected by using semi-quantitative RT-PCR technique; HSP 70 protein expression in posterior cingulated cortex was determined by immuno-histochemical method. Results The levels of HSP 70 mRNA and HSP 70 protein expression were significantly different among the 5 groups. Ketamine induced marked HSP 70 mRNA and HSP 70 protein expression in the posterior cingulated cortex. Propofol itself did not induce HSP 70 gene expression in this brain region. Propofol significantly inhibited ketamine-induced HSP 70 mRNA and HSP 70 protein expression in the posterior cingulate cortex in a dose-dependent manner. Conclusions Propofol pretreatment can significantly inhibit ketamine-induced HSP 70 mRNA and protein expression in the posterior cingulated cortex. It may be one of the mechanisms of inhibition of ketamine-induced psychotomimetic effect and neuronal damage by propofol.

Objective To study the main infectious bacteria and their drug-resistance after liver tra nsplantation. Methods K-B method was used to detect the susceptibility of agents of the main bacteria after liver transplantation. ESBLs and AmpC ?-lactamase among the main negati ve bacillus were detected by three-dimensional tests. ?-lactamase and Van gen e among Enterococcus were dectected by standard agar dilution susceptibility tes ts and Nitrocefin respectively. Results Among the main Gram-negative bacteria in 55 cases of infection following liver transplantation, the ratio of resistance to 4 or more antibiotic were all beyond 40% . The detectable rate of ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherichia coli was 32.4% and 36.8% , and 33.8% and 10.5% re spectively. Moreover, the detectable rate of both ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherich ia coli was 24.3% and 7.0% repectively. 8.8% and 11.1% produced ?-lactamases in Enterococcus faec alis and Enterococcusfaecium, with the ratio of resistance to Vancomycin being 11.2% and 18.5% respectively. Conclusions The primary pathogens have the high and multiple resistance to antimicrobial aft er liver transplantation. ESBLs and AmpC ?-lactamases were the main two factor s of drug-resistance among Gram-negative bacillus. we should pay much attentio n to the high detectble rate of Enterococcus which are resistant to Vancomycin a fter liver transplantation.

ve To determine the most approprite hypoxic concentration and duration for prenatal hypoxic adaptation animal experiment by exposing pregnant rats to the hypoxic air of different oxygen concentration.Methods Full-term pregnant rats( gestation time 22 days) were placed in an airtight cabin specially designed for hypoxic adaptation experiment. The rats were divided into 7 groups. The Q2 concentration in the airtight cabin was decreased from 21% (group Ⅰ as control) to 18% (group Ⅱ), 17% (group Ⅲ), 16% (group Ⅳ), 15% (group Ⅴ), 14% (group Ⅵ) and 13% (group Ⅶ) respectively. The animals were exposed to short duration of hypoxic air twice with a break of 5min breathing fresh air. The duration of the first hypoxic episode lasted 10 min (group Ⅰ ) , 5 min (group Ⅱ), 7.5min (group Ⅲ), 9.83 min (group Ⅳ), 11.5 min (group Ⅴ), 13.17 min (group Ⅵ) and 14 min (group Ⅶ) respectively. The second hypoxic episode lasted 10min, 9.33 min, 11 min, 15.17 min, 13.33 min, 17 min and 18 min respectively. Ten newborn rats (1 day after birth) randomly selected from each group were placed in a 100ml airtight bottle and the duration from the start to the time when the newborn rat stopped breathing was recorded as hypoxia surviving time. Another 10 newborn rats randomly selected from each group were decapitated and brain was removed for light and electron microscopic examination to determine the degree of neuronal damages. Results In group Ⅰ-Ⅴ the newborn rats were normal (pink skin color and good extremity movement) . In group VI 10/55 (18%) newborn rats were cyanotic with diminished extremity movement, the others were normal. In group VIII 11/52(21% ) newborn rats died, 14/ 52(27%) were cyanotic with diminished extremity movement. Neuronal damages could be seen in cyanoticnewborn rats including decreased number, swelling, apoptosis of neurons and expanded mitochondria. The hypoxia surviving time was significantly longer in group Ⅳ, Ⅴ and Ⅵ than that in control group. Conclusions Hypoxic air containing 15% O2 is appropriate for animal experiment of prenatal hypoxic adaptation. It is better to divide prenatal hypoxia into two episodes lasting 11.5 min and 13.33 min with a break of 5 min between them when animals breathe fresh air.

Objective　To investigate the changes of plasma epinephrine (E) and norepinephrine (NE) in rabbits with firearm thoracic wounds. 　Methods　 A total of 24 rabbits were divided into 3 groups randomly, the simple thoracic penetrating injury group (Group A, n = 8), the pseudo-injury group (Group B, n = 8)and the normal control group ( Group C, n = 8). The pressures of carotid artery and jugular vein were recorded by eight-road physiological recorder at 5 minutes before injury. And the concentrations of plasma E and NE were detected through high-performance liquid chromatography (HPLC) and electrochemical detection (ED) at 5 minutes, 30 minutes, 1 hour, 3 hours, 6 hours, 12 hours and 24 hours after injury in all the rabbits. 　Results　The concentrations of plasma E and NE in Group A were significantly higher than those of Group C (P<0.01) and changed regularly. There was no significant difference between Group B and Group C. The pressures of carotid artery and jugular vein of Group A increased by 1.8 and 6.8 times, respectively, during 2 millisecond after injury, then decreased to normal immediately. They decreased to the minimum (0.63 and 0.25 time, respectively) in 30 minutes and 5 minutes respectively and averagely, and raised to normal slowly after 6 hours and 12 hours respectively and averagely. There was no significant difference between Group B and Group C.　Conclusions 　 The concentrations of plasma E and NE increase significantly in the rabbits with thoracic firearm wounds. Their changes have close relationship with the severity of wound and can be used as a judging criterion during the early period of wound.

Objective To identify the influencing factors for pediatric nursese' reporting of adverse events at 3A hospitals in Beijing. Methods Adopting the random sampling of ten 3A hospitals with pediatric wards in Beijing and conducting an questionnaire survey of some nurses in those hospitals. Results The possibility of adverse events reporting increased with the awareness of adverse events which was related with their severity. Except for title, educational background, length of service, position and past experiences were not associated with the barriers. The major perceived barrier was fear of colleague relationship brokenup and some other undesirable consequence. Conclusions Better training of awareness of adverse events and changes of the punitive culture by the roots as well as some regulation or policy were the major solutions to improve incident reporting.

BACKGROUND: The choline acetyltransferase (CHAT) is the key synthetic enzyme for acetylcholine, and is the important symbol of the functional activity of the cholinergic system. There was a relationship of the cholinergic neurons damage with the pathogenesis of Alzheimer disease (AD) and the mild cognitive impairment (MCI). Whether or not the fimbria/fornix transection may affect the expressive variety of ChAT in different cerebral regions of rats (cortex, hippocammpi CA1, amygdala, Meynert nucleus) is very important for the recognition of the pathogenesis of AD and MCI and the establishment of experimental animal model of AD.OBJECTIVE: To observe the expressive variety of ChAT in different cerebral regions of rats with fimbria/fornix transection and discuss exploratorily the methods of simulative experimental AD.DESIGN: A randomized and control study.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of the Qingdao University Medical College and the Department of Neurology, No. 1People' s Hospital of Jining.MATERIALS: The experiment was completed in the Institute of Cerebrovascular Disease, Affiliated Hospital of the Qingdao University Medical College from March to December 2003. Totally 14 adult healthy female Wistar rats aged 5 months were randomly divided into model group and control group with 7 in each group.METHODS: ① The bilateral fimbria-fornix of brain in model group were transected on the stereotaxic apparatus to set animal model. After opening the skull, at the coordinates, along the bregma posterior 2.2 mm-2.5 mm and lateral 1.0 mm according to the atlas of Paxinos and Watson, and the dorsal fornix, the anterior part of hippocampus and the fimbria were cut off with a double blade under visual inspection. Rats in the control group were not performed with fimbria/fornix transection, and the other procedures were completed as those in the model group. ② On the 28 day after the surgery, all rats were killed under anesthesia to take out the brain tissues and make coronary sections for histochemical observation in a immunohistochemical way. The expressions of the ChAT positive neurons were observed in the cortex, hippocammpi CA1, amygdala, Meynert nucleus, and the brown neurons under microscopy was the ChAT positive neurons.MAIN OUTCOME MEASURES: Expressions of ChAT positive neurons in the cortex, hippocammpi CA1, amygdala, Meynert of the basal forebrain in the model group and the control group.RESULTS: All the rats entered the final analysis without any loss. The expression of ChAT positive neurons in the cortex, hippocammpi CA1,amygdala, Meynert of the basal forebrain in the model group were distinctly decreased than that in the control group (2.97±1.45, 32.60±7.33, t=10.51,P ＜ 0.01); (6.83±2.41, 50.57±5.85, t=1 8.30, P＜ 0.01); (14.43±6.75, 35.43±10.49,t=4.47, P ＜ 0.01); (5.77±6.62, 48.77±7.10, t=1 1.72, P ＜ 0.01), and the differences were significant.CONCLUSION: Finbria/fomix transection can decrease the expression of ChAT positive neurons in many cerebral regions of rats, and can be used in a method of setting the experimental animal model of AD.