Objective:To investigate the configuration changes of human cord blood monocytes (HCMNCs)under specific culture conditions and the expression of NSCs marker under induction.Methods:HCMNCs were prepared from normal placenta after full term normal delivery. Observe the shape by microscope and reverse transcriptase polymerase chain reaction (RT-PCR) for nestin and musashi-1 antigen were performed to confirm nestin and musashi-1 antigen expression in HCMNCs.Results:RT-PCR demonstrated small amount of nestin expressed in HCMNCs but no musashi-1 antigen before induction, and both showed the strongest expression in 48h,then faded away gradually. The uncultivated MNCs were small and round.After culturing,the cells became larger,some cells change their shape into rhombic.Conclusion:The newly HCMNCs isolated by centrifugation over Lymphoprep densitgradient expressed nestin mRNA in low level and no musashi-1 show up,after induction,the former and musashi-1 increased intermittently and then decreased with the time of culturing.

Objective To explore the feasibility and value of ultrasonography during choledocholithotomy with fibroptic choledochoscope. Methods Fifty-one cases of intrahepatic bile duct stones after cholecystomsy as diagnosed by pre-operative examination with ultrasound, CT, magnetic resonance imaging from Jan. 2007 to Dec. 2008, underwent conventional lithotomy through fibroptic choledochoscope first, and then high-frequency probing with ultrasonography was done directly over the surface of liver to detect the existence of any residual stone in the bile duct. The position of residual stone, if there was any, was then accurately determined and removed through fibroptic choledochoscope under the guidance of ultrasonography. Results Of 51 patients who had undergone lithotomy through fibroptic choledochoscope, 12 patients were found to have residual stones in their bile ducts after operation. The rate of complete calculus removal was 76.5%, and of residual stones was 23.5%. Of the 12 patients with residual stones, 7 patients were found to have residual stones in their intrahepatic bile ducts complicated with deformed bile duct, 5 patients were found to have residual stones in their intrahepatic bile ducts complicated with stricture of bile duct. All residual stones in intrahepatic bile ducts of 12 patients were accurately located and then completely removed under the guidance of operative ultrasonography through fibroptic choedochoscope without any complications. Conclusions The difficulties of residual stones after lithotomy may be overcome by localization with ultrasonography and removal under the guidance of atfrasonography, so the technique is of practical value in clinical application.

Objective To evaluate the feasibility and value of percutaneous transhepatic multiple biliary drainage introduced under ultrasound guidance in treatment of advanced portal cholangiocarcinoma. Methods Thirty-two patients were accurately diagnosed as advanced portal cholangio carcinoma according to preoperational examination of ultrasound,enhanced computed tomography,nuclear magnetic resonance or endoscopic retrograde cholangiopancreatography (ERCP) in the hospital from Jan. 2006 to Dec. 2008. After making a reasonable therapeutic plan,3 or 4 drainage-tubes were successfully inserted in intrahepatic bile duct in turn using Seldinger technique under ultrasound guidance. Thus,retained bile was effectively drained from intrahepatic bile ducts. The changes in jaundice index after treatment and complications were observed,follow-up was performed during the patients' surviving period,and therapeutic effect was evaluated comprehensively. Results Of the 32 patients drained through multiple bile drainage-tubes,19 received 3 draining tubes simultaneously,and 13 with 4 bile drainage-tubes,with a total of 109 bile drainage-tubes inserted into all the patients. Bile drainage-tubes were inserted into all target bile ducts successfully in a 100% successful rate. 4-8 weeks after operation,the jaundice disappeared completely in 28 cases and decreased significantly in 4 cases. For all the cases,complication occurred in only 2 patients,and it disappeared after symptomatic treatment. The shortest survival time was 4 months,and the longest was for 15 months after operation. Conclusions For those patients with advanced portal cholangiocarcinoma,and the tumor could not be surgically resected,percutaneous transhepatic multiple biliary drainage is correct option,which is effective and safe,and it was valuable in relieving malignant obstructive jaundice.

Staphylococcus aureus is one of the common cause of respiratory tract infections in children.Methi-cillin -resistant staphylococcusaureus was reported in 1 960s,then the resistance of other drugs were found in recent years,which leading to many problems in the clinical treatment.Clinician have to master the resistance trend and mechanism of this bacteria and decrease the speed of resistance as much as possible.

Objective To explore the curative effects of color Doppter ultrasound guided interventional therapy in pelvic cyst. Methods From July 2006 to June 2008,the color Doppler ultrasound guided transabdominal or transvaginal puncture was performed in 34 pelvic cysts among 32 diagnosed cases,absolute alcohol was injected into the cysts for sclerotherapy.Results Among 34 cysts,the treatment only failed in one cyst of one case because of the over ropy hydatid fluid,which was hard to be aspirated.All of the cases were followed up for three months.Twenty-seven cysts were cured after the first treatment,the cure rate was 79.4%(27/34).The maximum diameter of other 4 cysts decreased more than 1/2.The effective rate was 91.2%(31/34) after the first puncture.Finally,33 cases showed curative effect after the puncture therapy,the total effective rate was 97.1%(33/34).No serious complications were observed.Conclusion This therapy is a simple,accurately,safe and effective treatment for many indications.It's worthy to be recommended in the therapy of pelvic cyst.

To investigate the contents and distribution of matrix metallproteinases(MMP) in abdominal aortic aneurysm(AAA) on protein level, forty male Wistar rats were randomly divided into two groups, the rats of experimental group were perfused with pancreatic elastase in the isolated abdominal aorta to construct the model of AAA. Laparotomy was preformed on the 14th day after operation, the aortas were measured and harvested. The rats of control group were operated with the aortas harvested immediately. Immunohistochemical staining and computer image analysis were performed to analyze the contents and distribution of MMP 2 and MMP 9. The aortic diameter progressed to aneurysmal dimension in the experimental group. Immunohistochemistry study revealed that the MMP contents in AAA exceeded that in normal aorta obviously. The MMP 2 cotents in AAA tunica media were higher than MMP 9. It is suggested that MMP 2 plays the main role in extracellular matrix degradation of AAA tunica media.

To investigate the prevention and management of postoperative complications of lower extremity amputation for arterial occlusive diseases, a retrospective analysis was made in 18 lower extremity amputations which were performed on 14 patients from Jan 1996 to Dec 1999. The mean age of the patients was 72. Before opeoation,78 6% of the patients were complicated with coronary artery disease, 69.9% with high blood pressure and 78.6% with diabetes mellitus, 43.4% with vascular reconstruction history. 6 above the knee amputations, 7 below the knee amputations, 1 hemiterpene amputation and 4 amputations of the toes were performed. Postoperative myocardial infarction occarred in 2 cases, gangrene of the stump in 3 cases and infection in 1 case, the total incidence rate of complication was 33%. The results showed that lower extremity amputation is not a complex operation, but preoperative estimation of the level of amputation and postoperative intensive care can reduce the postoperative rate of complication.

Colonic ischemia is a well documented complication of abdominal aortic reconstruction. In this retrospective study of abdominal aortic aneurysm patients undergone endovascular graft exclusion, the incidence and management of this complication were investigated. From Mar 1997 to Apr 2000,among the 40 patients who received elective endovascular graft exclusion for,infrarenal abdominal aortic aneurysm the bilateral hypogastric artery was retained in 30 patients, the unilateral hyogastric artery was retained in 10 patients. One patient had lower abdominal pain on the 28th day after operation, CTA showed the bilateral hypogastric artery occlusion, the symptoms were relieved after drug treatment. Retaining unilateral hypogastric artery can prevent the colonic ischemia after endovascular graft exclusion for abdominal aortic aneurysm, the chronic colonic ischemia secondary to bilateral hypogastric artery occlusion can be relieved by effective drug treatment.

To investigate the diagnosis and treatment of Stanford B thoracic aortic dissection eomplicated with renal ischemia, 29 cases of Stanford B thoracic aortic dissection admitted from January 1996 to April 2000 were retrospectively studied. Three of them had renal ischemia secondary to aortic dissection (2 acute,1 chronic). One patient in acute stage died 3 days after onset, the other patient in acute stage complicated with bilateral lower extremity ischemia was treated with fenestration of intimal flap, and the symptom was relieved. The patient in chronic stage was treated with endovascular graft exclusion for aortic dissection and the renal ischemia was relieved because of the restored true lumen blood. The results showed that palliative bypass helps relieve symptoms and improve survival rate. For the chronic aortic dissection complicated with renal ischemia, endovascular graft exclusion can restore the true lumen blood and relieve renal ischemia.

This paper reviewed the development of vascular surgery in diagnosis and treatment in recent years,the concepts and specialty of Duplex scan,MRA, CTA were discussed,the progress and problems of traditional revascularization and endovascualr technique were analyzed.