AIM:To investigate the depressant effect and mechanism of atorvastatin on the chronic rejection of aortic allograft in rats.METHODS:The models of abdominal aorta transplantation were made with micro-surgery in rats.The recipients were divided into three groups:allograft control group,atorvastatin-treated group and isograft control group.Vascular intimal thickness in all of the groups was observed by histological examination.The expression of proliferation cell nuclear antigenl(PCNA)and ?-smooth muscle actin(?-SMA)were determined by immunohistochemistry.The content of nitric oxide was measured by nitrate reductase chromatometry.RESULTS:The vascular intimal thickness in atorvastatin-treated group(11.60%?2.40%)was lower than that in allograft control group(34.60%?6.40%,P

ObjectiveTo evaluate the diagnostic value of ultrasound or CT guided percutaneous Trucut needle biopsy on the diagnosis of pancreatic tumors.Methods One hundred and twenty-four patients clinically diagnosed as pancreatic cancer without pathological diagnosis underwent percutaneous pancreatic biopsy by using Trucut needle under ultrasound or CT guidance.ResultsOne hundred and nine procedures of ultrasound-guided biopsy and 15 procedures of CT-guided biopsy were performed,and one patient received 2.3times of punctures.Tissue samples were obtained in all 124 patients,the diagnostic accuracy was 95.2％,among them 115 were adenocarcinoma,5 were cystadenoma,2 were metastasis cancer,1 was cancer of unknown origin and 1 was normal.The sensitivity,specificity,and accuracy were 99.2％ 100％,and 99.2％,respectively.Transient serum amylase increase was observed in 3 patients; 5 patients' abdominal pain aggravated,but all recovered with conservative management.One patient was found to have tumor seeding on the spot of insertion after 34 days.No other major complications occurred.ConclusionsUltrasound or CTguided percutaneous pancreatic 16 ～ 18G Trucut needle biopsy is a safe and simple procedure with excellent diagnostic value for pancreatic cancer.

Objective To approach the surgical timing for the conjoined twins, location of the separation line for the joined liver, and the separation method.Methods The common bile ducts of the conjoined twins were considered as two vertical lines, and a vertical line running parallel to the two lines was set as the separation line for the joined liver.Local blood flow blocking method was then used to separate the joined liver.Results Among all the three cases of the conjoined twins, one case was with sternoxiphopagus and the other two with thoracoabdominalpagus.All the three cases of con-joined twins shared the common livers, but each case had respectively separated gallbladders and bile ducts.They underwent the surgical separation at the age of 28 d and 96 d and 89 d successfully.Their liver sections bled rarely by blocking the local blood flow.The liver function recovered successfully af-ter the operation.All the 6 sick children recovered and were discharged from our hospital.Conclusion Porvided the conjoined twins shared the joined liver with respectively separated common bile ducts, in most cases, the injuries of the important liver vascular as well as bile ducts could be avoided when the separation line for the joined liver was selected with the common bile ducts of the conjoined twins as the longitudinal coordinate.The local blood flow blocking method only blocked the local blood flow, in-terfering to the liver blood flow in the non-operating areas rarely, which was instrumental in the recovery of the liver function and increase of the survival rate of the conjoined twins after the operation.

Objective To study the depressant effect of atorvastatin on arteriosclerosis of aortic allograft in rats.Methods The models of abdominal aorta transplantation were established in rats with the use of(micro-surgery).The recipients were divided into three groups:allograft control group,allograft experimental group and isograft control group.After 60 days of transplant,vascular intimal thickness(VIT) in all of the groups was observed by histological examination.The expression of PCNA and ?-SMA was determined by(immunohistochemistry).Results The degree of VIT in rats of the allograft experimental group was lower than that in the allograft control group;the VIT area ratio in the allograft control group,allograft experimental group and isograft control group was(12.40?2.65)%,(5.20?6.35)%,and(1.2?1.10)%,respectively,A statistical difference between these groups was observed(P

Objective To investigate the feasibility of combined laparoscopic resection of gallbladder and other viscera. Methods The clinical data of 69 cases of combined laparoscopic resection of gallbladder and other viscera from January 1999 to July 2004 were reviewed retrospectively. Results The laparoscopic operation was successful in 69cases,and no case was converted to laparotomy.The average operation time was(85.5?18.6)min,and the time of return of gastrointestinal function was(27.3?6.2)h. The average hospitalization time after operation was(3.9?0.8)d.There were no operative or postoperative complications , and the therapeutic results were satisfactory. Conclusions The combined laparoscopic resection of the gall bladder and other viscera is safe and feasible. It is possible to treat gallbladder diseases and associated lesions of abdominal viscera simultaneously. The lesions of several organs can be treated at one operation. This can significantly decrease patients′ pain and lower the cost of treatment, and is worthy of wide usage.

Objective To assess the results of emergency endovascular stent-grafting for patients with acute Stanford type B aortic dissection(type B AAD)within 24 hours of onset.Methods Between June 2007 and October 2008,30 patients with acute type B aortic dissection underwent emergency endOVascular stent-grafting within 24 hours of presentation.Under general anesthesia,stent-graft was deploved at the proper position of first tear entry through femoral artery under X-ray monitering.Follow-up by CT was performed 1 w,1 m ,3 m,6 m,1 y postoperatively to observe the efficacy and complications such as endoleak,migration and fracture of stent-graft. Result The technical success rate was 100%;13.4%(4 cases) endoleak rate was identified immediately after deployment.Follow up was made between 1 month to 19 months,averaging at(12±8)months,3.3%type-1 endoleak Was observed after 6 months;One patient died within 30 days possibly of dissection rupture;One patient died of acute liver failure during the follow-up. Conclusion Endovascular repair with stent-graft within 24 hours of presentation was effectivefor the treatment of acute type B aortic dissection.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.