Objective To assess the feasibility of evaluation of coronary flow reserve (CFR) for left anterior descending (LAD),left circumflex (LCx),and right coronary posterior descending artery(PDA) as well as diagnostic accuracy for patency of each branches by transthoracic Doppler echocardiography (TTDE). Methods CFR of main coronary artery branches at the distal sites were studied by TTDE with adenosine infusion (140 μg · kg-1 · min-1) in 439 consecutive patients with suspected coronary heart disease. The relations between CFR and stenosis rates of coronary bifurcations were analyzed. Results Twenty-eight of LAD,12 of LCx and 21 of PDA were occluded in 439 patients. The success rate of CFR assessment of LAD, LCx and PDA were 96.8% (395/411), 74.9% (320/427), 83.0% (347/418)respectively. Then CFR≤2.0 and CFR≤1.7 were chosen as the criteria of coronary stenosis (≥50 %) and severe stenosis(≥75%). The sensitivity and specificity of detection of LAD,LCx and PDA stenosis were 81% and 87% ,64% and 82%, 79% and 85%, respectively. The sensitivity and specificity of diagnosis of LAD, LCx and PDA severe stenosis were 86% and 81%, 70% and 85%, 81% and 82%, respectively.Conclusions CFR evaluation of main coronary artery branches has high feasibility and can provide valuable information for relevant vessel patency.

Rhinovirus

Objective To understand the clinical features of children with acute pancreatitis.Method Clinical data of 106 in patients in Children′s Hospital with acute pancreatitis from Jul.1991 to Jan.2005 were analyzed retrospectively.Results The most frequent(etiologic) factors of childhood acute pancreatitis were idiopathic(35.8%),mumps virus infection(33.9%)and biliary tract diseases(15%).Abdominal pain(96.2%),vomiting(72.6%)and fever(45.3%) were the most common clinical symptoms.And the most common signs were abdominal tenderness(73.6%),abdominal wall rigidity(17.9%)and abdominal distention(10.6%).Multisystem damage usually occurred in childhood acute pancreatitis.Serum amylase,urinary amylase and serum lipase elevated 84.8%,58.5% and 55%in patients,respectively.Fifty-one percont patients had abnormal ultrasound imaging and 81% had abnormal computed tomographic imaging.In 5 patients who were subjected to endoscopic retrograde cholangiopancreatography(ERCP) and magnetic resonance cholangiopancreatography(MRCP),the pancreaticobiliary system was visualized clearly.Nonsurgical therapy was done in most patients,only 6 cases received surgical therapy.Sixty-five cases were cured and 40 cases straightened up,only 1 case died.The efficiency rate was 99%.Pseudocysts occurred in 2 patients.Conclusions Idiopathic pancreatitis and mumps virus infection are the most frequent etiologic factors for childhood acute pancreatitis.Symptoms and signs such as abdominal pain and abdominal tenderness are the important diagnostic bases of childhood acute pancreatitis.Childhood acute pancreatitis was always accompanied by multisystem damage.Pancreatic enzyme test and radiography test were helpful in the diagnosis of childhood acute pancreatitis.Nonsurgical therapy is the leading therapeutic means of childhood acute pancreatitis.Timely diagnosis and allopathy help to improve the prognosis of childhood acute pancreatitis.Pseudocyst is the primary complication of childhood acute pancreatitis.

AIM: To compare the effect of small incision extracapsular cataract extraction and phacoemulsification on corneal endothelial cells and explore the differences between these two most commonly used surgeries for grade Ⅱ-Ⅲ lens nucleus. · METHODS: Retrospective study. We retrospectively evaluated the data of age-related cataract patients who had completed surgery in our hospital between June 2013 and December 2015. There were 84 eyes of 84 patients. The corneal endothelial cell density of all the patients were greater than 2000/mm2 and lens nucleus were gradeⅡ- Ⅲ. The patients were divided into manual small incision cataract surgery ( MSICS ) group and phacoemulsification ( Phaco ) group. MSICS group included 42 cases (42 eyes) and Phaco group included 42 cases ( 42 eyes ) . Postoperative evaluations were performed at 1d, 1wk, 1mo and 6mo and included uncorrected visual acuity ( UCVA ) , corneal endothelial cell density and the proportion of hexagonal cells. · RESULTS: There were no statistically significant differences of the two groups in preoperative basic data, UCVA, corneal endothelial cell density and the proportion of hexagonal cells, nuclear classification. The postoperative UCVA were significantly improved in both groups (x2=148. 01, P<0. 001; x2=165. 97, P<0. 001). The postoperative UCVA were on the rise as time goes on. The postoperative corneal endothelial cell density was obviously reduced in both groups compared with the preoperative (F=37. 74, P<0. 001; F=24. 56, P<0. 001). The proportion of hexagonal cells in Phaco group was declined at 1d (P=0. 002) after the operation and returned to baseline by 1wk (P=0. 894) after surgery. There was no significant difference between the two groups in UCVA, corneal endothelial cell density and the proportion of hexagonal cells at each observation point (P>0. 05). ·CONCLUSION: Manual small incision cataract surgery and phacoemulsification can indiscriminately improve UCVA and decrease the density of corneal endothelial cells. However, the change of hexagonal cells proportion was not obvious. These two surgeries for cataract patients with corneal endothelial cell density greater than 2000/mm2 , grade Ⅱ-Ⅲ lens nucleus have similar efficacy and safety.

Objective To evaluate retroperitoneal laparoscopic adrenalectomy. Methods From June of 1999 to January of 2001, retroperitoneal laparoscopic adrenalectomy was performed on 52 patients with adrenal diseases, including 34 cases of aldosterone-preducing adenoma,3 nodular hyperplasia bilateral in 1, 5 Cushing's syndrom,1 Cushing's disease, 3 adrenal pheochromacytoma (bila- teral in 1), 4 nonfunctional adrenal adenoma, 1 myelolipoma and 1 metastasis carcinoma. Results 54 sessions of retroperitoneal adrenalectomy have been carried out for 52 patients (2 on both sides) with success in 51 procedures. The procedure was converted to open operation in 3 occasions because of bleeding or adhesion. The mean operation time was 135 minutes (40～270 min), and the estimated blood loss 45 ml (5～150 ml) with no need of transfusion. The postoperative hospital stay was 6 d (3～14 d) and the mean analgesia consumed 8.5 mg (0～50 mg) of morphine equivalents with no need of any analgesic at all in 17 patients. Conclusions Retroperitoneal laparoscopic adrenalectomy was less traumatic to the patients, with less postoperative discomfort and quicker recovery. The procedure should be considered as the first choice of therapy for benign adrenal diseases.

Objective To evaluate retroperitoneal laparoscopic surgery in the treatment of primary aldosteronism. Methods Retroperitoneal laparoscopic surgery was performed in 90 patients with primary aldosteronism (92 sites on either or both sides).Their clinical indicators were compared with those of 30 cases undergoing open surgery. Results Retroperitoneal laparoscopic procedures were successfully performed in 91 of the 92 sides.In these successful cases,mean operative time was 93 minutes (compared with 114 minutes in open surgery cases),mean volume of blood loss was 36 ml (compare with 87 ml),mean postoperative hospital stay was 6.8 d(compared with 11.0 d),mean time to flatus was 1.6 d (compared with 3.1 d),and mean time to walk around was 2.1 d(compared with 3.3 d), P

Objective To evaluate the feasibility of transperitoneal laparoscopic adrenalectomy for 3 patients with primary aldosteronism who previously underwent ipsilateral adrenal surgery or nephrectomy. Methods From October 2003 to March 2004,transperitoneal laparoscopic adrenalectomy was performed on 3 male patients with primary aldosteronism,including 2 patients (39 and 72 years,respectively) who had previously undergone ipsilateral retroperitoneal laparoscopic partial adrenalectomy for Conn’s adenoma and 1 patient (42 years) who had previously undergone ipsilateral open nephrectomy for renal tuberculosis. Results Transperitoneal laparoscopic adrenalectomy was successfully performed on all the 3 patients; no complication occurred.The mean tumor size was average 1.7 cm in greatest dimension;the mean operative time was average 93 min;the mean estimated blood loss was average 18 ml,and no one needed blood transfusion.The postoperative food intake time was average 17 h,and postoperative hospital stay was average 5.0 d. Conclusions Although scar and adhesion of previous operation may present more difficulties in the subsequent operation,it is feasible to perform transperitoneal laparoscopic adrenalectomy through different surgical access on the patients who have previously underwent ipsilateral retroperitoneal adrenal or nephric surgery.

Objective To investigate the methods of diagnosis and treatment for delayed infection after hip arthroplasty. Methods From March 1998 to April 2004, 11 patients with delayed infection after hip arthroplasty were analyzed retrospectively. There were 4 males and 7 females with average of 66 years, ranging from 49 to 81 years. The interval between infection and primary hip arthroplasty varied from 9 to 96 months(mean 25.5 months). Pain is the most common symptom in all patients with an infected hip arthroplasty. Abnormal ESR was observed in 9 cases. The increase of CRP was found in 8 patients, and fistula occurred in 5 patients. Radiography findings, such as loosening, osteolysis, and endosteal scalloping, are present on 10 patients. One-stage exchange arthroplasty was performed in 8 patients, among whom 7 prostheses with antibiotic-impregnated cement and one with plain cement for fixation were chosen. Two-stage exchange arthroplasty was performed in 3 patients. After thorough irrigation and debridement of the infected joint and the removal of the femoral and acetabular components, a temporary spacer with irrigation device and antibiotic-loaded beads or a bulb were inserted between the first and second stage. The interval was a minimum of 4 weeks. During the delayed reconstruction, the final prostheses were fixed with antibiotic-loaded cement after the infection was eliminated. Results All 11 patients were followed up for a period of 8 to 72 months. Fracture of femoral shaft happened during the debridement in one patient. None of recurrent infection was found during the average 29.3 months follow-up. Conclusion No test is 100 percent specific; therefore, the diagnosis of infection relies on the patients' history, and the physical examination findings, and the lab test combined with results of imaging study, etiology as well as pathology. The key to success is that the treatment must be tailored to the patients' status.

Objective To investigate the behaviors character of men who have sex with men(MSM) in the local place,learn about the prevail situation of STI and HIV/AIDS among MSM group,and provide evidences for the health promotions on AIDS and STI among MSM.Methods Based on a snowball model,survey on MSM were conducted with an anonymous model.3～5 ml vein blood of the MSM were also collected at the same time.Results The awareness rate of HIV/AIDS information among 452 MSM was high.98.45% can give the right answer to question of whether would be infected with HIV if inject blood or blood product which have been infected with HIV.Total understand rate was 92.86%.The rate of condom use in their last anal sex with male was 64.43%.Rate of never using condom and condom using in every anal sex with male in the late 6 months was 10.95% and 34.83% respectively.The 3 services of HIV that most been welcomed by them were IEC(67.92%),condom distribution(62.61%) and lube distribution(57.30%).1.99% has a positive result on anti-HIV testing. 8.85% have a positive result on syphilis testing.Conclusions High dangerous behaviors are prevalent among MSM in Nanning and propaganda on HIV/AIDS information is not sufficient.Multi-types approaches should be adopted to prevent the epidemics of HIV/AIDS among MSM.

OBJECTIVE:To establish a HPLC method for the determination of yohimbine in corynanthe yohimbe K.schum.METHODS:The analysis was performed on C18 column with column under room temperature.The mobile phase consisted of methanol-phosphoric acid buffer-triethylamine(30∶ 70∶ 0.5,pH5.0)with a flow rate of 1.0mL? min-1.The wavelength was set at 270nm.RESULTS:There was a good linear relationship when the sample size of yohimbine was over a range of 10～ 1 000? g? mL-1(r=0.999 8),with recovery at 96.5% and precision at 1.23%.CONCLUSION:This method was simple and reliable,and suitable for the determination of content of yohimbine.