Objective　To study the effects of deliberated hypotension combined with acute simple hemodilution on blood loss,postoperative hemoglubin of the patients undergoing spinal side(back) protrude correction(SSP).Methods　Twenty four ASA grade Ⅰ to Ⅱ patients undergoing elective SSP were randomly divided into two groups:control group(n＝12) and hypotensive group(n＝12).The all patients received with general anesthesia.In the hypotensive group:acute simple hemodilution was accomplished with infusion of lactated Ringer's solution and Gelofusine of as three times as blood loss.Deliberated hypotensin was induced and maintained with 0.01% sodium nitroprusside 2～6μg/kg/min iv.Intraoperative blood loss,blood transfused volume during operation and postoperative hemoglobin were recorded and compared between both groups.Results　 Blood loss was about 51% lower in the deliberated hypotensive group than that in the control group at the end operation.The average volume of transfused blood during operation was(1200±140)ml in control group,blood transfusion was(400±128)ml in the hypotensive groups.Conclusion Deliberated hypotension combined with acute simple hemodilution can significantly decrease the intraoperative blood loss and the SSP operation can be better tolerated for the indicated patients.

Objective　To explore the correlative factors of ovulation-failure induced with clomiphene(CC) in polycystic ovary syndrome(PCOS).Methods　The relationship between ovulation rate(OR),ovulation cycle rate(OCR) among 178 cases,569 taking medicine cycles and clinical features,endocrine markers were retrospectively analysed.Results　OR was 73.0%,OCR was 45.3%,OCR of both the dysfunctional uterine bleeding(DUB) and anovulatory menstruation groups were markedly higher than those of secondary amenorrhea group(P＜0.005，0.05)，OCR of the DUB group was significantly higher than that in oligomenstruation group too(P＜0.05).OR of the nonpilosity and nonobesity groups were markedly higher than that of pilosity and obesity groups respectively(P＜0.01，0.005).OCR of the unmarried group was significantly higher than infertility and fertilized groups(P＜0.025，0.005).OCR of LH/FSH≥3 and serum testosterone(T) level-normal groups were respectively higher than LH/FSH＜3 and serum T level-elevated group(P＜0.05～0.025).There was markedly correlation among LH/FSH radio,T level,BMI and OR,OCR,PRL levels and OR(P＜0.05～0.01).Conclusions　The findings suggest that effect of the ovulation induced with CC in PCOS relate to types of menstruation,pilosity,status of marry-fertility,levels of LH/FSH,T,PRL.

Objective:To study the value of detection of rpsl gene mutation in streptomy cin(SM)-resistance in clinical isolates of mycobacterium tuberculosis by PCR -SSCP,and to expect to set up a r apid detective method of rpsl gene mutation in mycobacterium tuberculosis,Method Eighty seven specimens isolated from patients were detected by PCR-SSCP silver staining,and using strain H 37Rv as a control,Results In 87 mycobacterium tuberculosis clinical isolates,the r psl DNA fragments from 16 drug-susceptible isolates had no mutation in rpsL gene ,48 of 62 sputum specimens showed rpsl gene mutation by PCR-SSCP,positive rate w as 77.4%.Conclusions The rpsL gene mutation is an important molecular mechanism of M.tuberc ulosis resistance to SM.PCR-SSCP might become a rapid detecting method of SM-r esistance of M.tuberculosis.

Objective:To study the significance of detection o f lymph node micrometastas is by immunohistochemical method with monoclonal anti-karatin antibody in patie nts with colorectal cancer.Methods:We examined 331 lymph nodes obtai ned from 47 colo rectal cancer patients who underwent a curative operation and diagosed by using immunohistochemistry SB techniques.Monoclonal mouse anti-keratin antibodies (AE1,AE1/AE3,AE3)were used as the primary reagents to identify tumor cells both in tumor tissues and lymph nodes.Results:A total of 36 micrometa stasis among 331 lymph nodes(11.9%) were found.Duke's C staging patients had more lymph nodes m etastasis than that in Duke's B staging patients(P＜0.05).Postoperative fol low-up revealed that recurrence rate was high and the latent period of distant metastasis was much shorter in patients with occult mirometastasis th an those without.Conclusions:Even in histologically negative lym ph nodes,there i s a considerable possibility that micrometastasis may exist.The immunohistochemical detection of monoclonal anti-keratin antibody can explica te clinical staging a nd as an indication for colorectal cancer therapy.

Objective To compare the gas and heat exchange performance of membrane oxygenator DDMO-100S and membrane oxygenator Terumo SX-10 in cardiopulmonary bypass(CPB)in children.Methods 39 children aged 3-12 yrs who suffered from congenital heart disease were selected,and the repair of ventricle septal defect or/and atrial septal defect was performed under cardiopulmonary bypass.The 39 children were randomly divided into Group DD(n =21)and Group SX(n = 18).Membrane oxygenator DDMO-100S(Made by Xi'an Daidai,China)was used in Group DD and Membrane oxygenator Terumo SX-10(Made by Terumo,Japan)in Group SX,respectively.The hypothermic cardiopulmonary bypass with high perfusion flow and the cool crystalloid cardioplegia were applied in all children.The artery blood samples were taken for measuring PO2 and PCO2 and the oxygenating index(OI)was calculated by the formulae(OI = PaO2/FiO2).The temperature at nasal pharynx was monitored and the rewarming time was recorded.Results The total priming volume in Group DD was bigger than in Group SX [(742.5 ± 107.3)ml vs(531.3 ± 84.3)ml,P ＜ 0.05].The PO2,OI and PCO2 at 15 min after CPB or at 5 min before cease of CPB had no differences in both group(P ＞0.05).The rewarming time had no difference in both group [(31.5 ± 10.2)min vs(30.61 ± 8.2)min,P ＞0.05].Conclusions Under our observation condition,the gas and heat exchange performance of membrane oxygenator DDMO-100S were the same as membrane oxygenator Terumo SX-10,when it was used in cardiopulmonary bypass in children,but it had a little bit more priming volume.

Objective　To investigate the role of endothelin(ET) in the pathogenesis of asthma and analyze the relationship between level of endothelin in induced sputum and pulmonary function:forced expiratory volume/forced vital capacity(FEV1/FVc).Methods　Induced sputum was obtained by inhaling 5% saline.Endothelin level in induced sputum obtained from 25 patients with mild or moederate attacking asthma(Group Ⅰ),26 patients with stable asthma(Group Ⅱ) and 30 healthy controls(Group Ⅲ) were measured by radioimmunoassay.Results　⑴FEV1/FVC in Group Ⅱ was higher than those in Group Ⅰ(P＜0.01),and lower than those in Group Ⅲ(P＜0.01),respectively.⑵The number of all inflammatory cells and macrophages in induced sputum from both the Group Ⅰ and Group Ⅱ were higher than those from the Group Ⅲ(P＜0.01)，respectively.⑶The level of ET in induced sputum from Group Ⅰ was higher than those from both Group Ⅱ and Group Ⅲ(P＜0.01)，respectively.⑷The level of ET in induced sputum from Group Ⅰ was negatively correlated with FEV1/FVC and oxygen partial pressure(PaO2),and positively correlated with the number of macrophages.Conclusions　There is non-specific chronic airway inflammation in patients with asthma.Endothelin may be involved in the pathological process of asthma,especially in the airway inflammation and its remodeling.The level of ET in induced sputum can reflect the level of ET in airway.

Objective To study the clinical significance of the change of plasma BNP levels in patients with grades sepsis and its correlation with the left ventricular ejection fraction.Methods One hundred patients of sepsis who were admitted in intensive care unit of Taizhou hospital were selected.It was divided into four groups:30 patients with septic shock,40 patients with severe sepsis,30 patients with sepsis and 20 persons without disease as control group.The concentration of plasma BNP was determined using sandwich immunoflurescence,and ultrasonic cardiogram was used to evaluate heart function and clinical features in all groups.To compare with the differences of the concentration of plasma BNP and the correlation between the concentration of Plasma BNP and LVEF in all groups,the data of clinical features,28-day mortality,prognostic values of BNP and the length of stay (ROG) in ICU were collected and compared.Result Plasma BNP levels in patients with septic shock[ (976.3 ± 160.7) pg/ml] were obvious higher than severe sepsis[ (648.4 ± 267.3) pg/ml ],sepsis [ (217.2 ± 89.7) pg/ml ] and control group [ (50.3 ± 25.4)pg/ml] (P ＜0.01).LVEF in patients with septic shock [ (48.2 ±9.6)% ] was obvious lower than severe sepsis[ (52.8 ±9.4)% ],sepsis[ (61.3 ± 8.9)% ] and control group[ (66.4 ±9.3)% ] (P ＜0.05 or P ＜0.01).It appeared to be inverse relationship between LVEF and the plasma BNP levels (r =-0.876,-0.724,P ＜0.01).BNP levels were significantly higher in non-survivors compared with survivors[ (1367.6±506.4)pg/ml vs (420.3 ±82.6)pg/ml,P ＜0.01 ].The receiver operating characteristic (ROG) curves indicated that values of areas under the curve of plasma BNP levels for 28-days mortality were 0.918(P ＜0.01).Conclusion The concentration of plasma BNP in patients was different in different grades of sepsis.It appeared to be negative correlation between the concentration of plasma BNP and LVEF.Plasma BNP levels had predictive value to the patients with sepsis.

Objective To investigate the clinical significance of high mobility group box-1 protein (HMGB1) in chronic,severe hepatitis B patients and liver cirrhosis.Methods The contents of HMGB1 was measured by enzyme-linked immunoassay (ELISA) in the patients (include 40 patients with chronic hepatitis B and 18 severe hepatitis B patients and 18 liver cirrhosis patients) and 20 health controls.The levels of relative biochemical indicators,prothrombin time activity percentage (PTA) and the hepatic fibrosis were determined by biochemical methods.Results The contents of HMGB1 was significantly increased in severe hepatitis patients in comparison with that in chronic hepatitis B patients(P ＜0.01).The contents of HMGB1 in the chronic hepatitis were significantly increased in health controls(P ＜0.01).The contents of HMGB1 had significant difference among the liver cirrhosis patients,the severe hepatitis patients and the chronic hepatitis(P ＜0.01).There was positive correlation among the contents of HMGB1 and total bilirubin (TBIL),the proportionality of aspartate aminotransferase and alanine aminotransferase (AST/ALT),hyaluronic acid (HA) and procollagen Ⅲ N-terminal peptide (P Ⅲ NP) (r = 0.865,0.646,0.783,0.662,P ＜ 0.01).There was negative correlation among the contents of HMGB1 and prothrombin time activity percentage (PTA) and albumin (ALB) (r =-0.915,-0.852,P ＜0.01).Conclusion The contents of serum HMGB1 were closely associated with disease severity in chronic hepatitis B patients.HMGB1 was an index to auxiliary diagnosis hepatic fibrosis.

Objective To study the values of apparent diffusion coefficient (ADC) changing with time and space in cerebral infarction,and to provide the evidence in defining the infarction stages.Methods 117 work-ups in 98 patients with cerebral infarction (12 hyperacute,43 acute,29 subacute,10 steady,and 23 chronic infarctions) were imaged with both conventional MRI and diffusion weighted imaging.The average ADC values,the relative ADC (rADC) values,and the ADC values or rADC values from the center to the periphery of the lesion were calculated.Results The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously.rADC values in hyperacute and acute stage was minimized,and progressively increased as time passed and appeared as "pseudonormal" values in approximately 8 to 14 days.Thereafter,rADC values became greater than normal in chronic stage.There was positive correlation between rADC values and time[ (174 ±3.47)% vs (58±6.75)%,t =2.03,P ＜0.05 ].The ADC values and the rADC values in hyperacute and acute lesions had gradient signs that these lesions increased from the center to the periphery.The ADC values and the rADC values in subacute lesions had adverse gradient signs that these lesions decreased from the center to the periphery.Conclusion The ADC values of infarction lesions have evolution rules with time and space.The evolution rules with time and those in space can be helpful to provide the evidence in guiding the treatment or judging the prognosis in infarction.

Objective To investigate the effect of HbA1c meeting the standard or not on microalbuminuria,blood lipids and liver enzymes in patients with type 2 diabetes.Methods A retrospective analysis was performed on 457 subjects who had type 2 diabetes.They were divided into substandard group and standard group according to HbA1c result.The general information and relevant laboratory indicators of patients were.collected and compared between two groups.Results The microalbuminuria,serum triglyceride and liver enzymes (glutamyl transpeptidase,alkaline phosphatase,aspertate aminotransferase) were significantly different between two groups [ (189.8 ± 235.3) mg/dl vs (38.9 ± 85.5) mg/dl,(2.64 ± 2.99) mmol/L vs (2.02 ± 1.50)mmol/L,(41.7 ±52.9)U/L vs (29.7 ±24.9)U/L,(83.6 ±28.6) U/L vs (74.3 ±25.8)U/L,(26.7 ±19.1)U/L vs (22.0 ±10.5) U/L,P ＜0.05].HbA1c level was positively correlated with microalbuminuria,glutamyl transpeptidase and alkaline phosphatase (r =0.209,0.115,0.11,P ＜0.01).The microalbuminuria was an independent risk factor of affecting HbA1c to reach the standard (OR = 1.009,P ＜0.05).Conclusions HbA1c meeting the standard or not can influence many factors except blood glucose.