Objective To investigate the comparative roles of the pathologic changes of gastrocnemius on the pathologic process of varicosis of the lower extremity(VLE). Methods By means of electron microscopy and light microscopy, image analysis and the capillary basement membrane and gastrocnemius muscle cell in 30 patients with VLE and 10 contrast subjects were studied. Results (1) Light microscopically, smearing of cross-striation, sarcolemmal proliferation, fibrinoid degeneration, fatty degeneration, and haemorrhage were seen in muscle of patients with VLE. (2) Electron microscopically, increase in thickness of the capillary basement membrane, increase in lipid droplets and glycogen, swelling of mitochondra, myelin figure, lipofusin, disruption of the myofibrils, and myopathic changes were seen in muscle cells of patients with VLE. The area and thickness of the capillary basement membrane in patients with varicosis were higher than those in the control subjects ( P 0.05). Conclusions (1) It is suggested that the ultrastructure changes of gastrocnemius muscles result from ischemia and hgpoxia. Among the changes, the capillary basement membrane plays an important role in the induce insuficiency of the calf muscle pump function which result in VLE extremities. (2) It is suggested that degeneration of gastrocnemius muscle cell may relate to the insufficiency of calf muscle pump function. (3) In early pathologic process, insufficiency of the calf muscle pump function can be compensate by muscle cells hypertrophy. The transverse areas of muscle cells in early period were bigger than that in later period, so that the compensation was limited, chronic ischemia and hypoxia can affecte the calf muscle pump function.

Aim To investigate the toxicity of isopsor-alen in HepG2 cells and its effects on bile acid, bile acid synthesis and transport. Methods Cell viability was evaluated by MTT assay and bile acid was deter-mined inside HepG2 cells, with exposure to various isopsoralen for 24h. The mRNA transcription of BSEP, MRP2, MRP3, NTCP, OATP2, OSTα, CYP7A1, CYP27 A1 , FXR and PXR were assessed by real-time PCR. Results The cell viability was decreased dose-dependently with isopsoralen in HepG2 cells, and IC50 was 118. 1μmol·L-1 exposure to isopsoralen for 24h. Bile acid inside cells significantly increased with 100 and 400 μmol · L-1 isopsoralen. Isopsoralen caused the down-regulation of MRP2 , MRP3 , CYP7 A1 mRNA at 25 μmol · L-1 . Beside these, the up-regulation of OATP2,OSTα,CYP27A1,FXR,PXR with 100 μmol· L-1 isopsoralen, but there was no significant change of BSEP and NTCP. Conclusion The results show that isopsoralen induces bile acid accumulation and cytotox-icity which may be associated with the down-regulation of MRP2, MRP3 in HepG2 cells.

Objective To evaluate the effect of velocity of inspiratory flow on the severe asthma patients.Methods Twenty patients were ventilated thirty minutes respectively when the peak velocity of flow was 40L/min,60 L/min,80 L/min,100 L/min and 120 L/min,and then we measured their airway peak pressure(Ppeak),plateau pressure(Pplat)and intrinsic positive end expiratory pressure(PEEPi)and arterial blood gas analysis,accounting shunt fraction(QS/QT)and Dead space value(VD/VT).Results When velocity of flow enhanced from 40L/min to 60L/min,Ppeak increased while Pplat,PEEPi,VD/VT decreased obviously.When velocity of flow enhanced from 60L/min to 80L/min,Ppeak increased also but Pplat,PEEPi,QS/QT and VD/VT changed no significant.When velocity of flow enhanced from 60L/min to 100L/min,Pplat and PEEPi increased indistinctly while Ppeak,QS/QT and VD/VT increased distinctly.Conclusions The velocity of inspiratory flow,60~80L /min,can reduce PEEPi、QS/QT 及VD/VT and improve respiratory status.

Objective: To summarize the research progress of hydrogels for the regeneration and repair of degenerative intervertebral disc and to investigate the potential of hydrogels in clinical application. Methods: The related literature about the role of hydrogels in intervertebral disc degeneration especially for nucleus pulposus was reviewed and analyzed. Results: Hydrogels share similar properties with nucleus pulposus, and it plays an important role in the regeneration and repair of degenerative intervertebral disc, which can be mainly applied in nucleus pulposus prosthesis, hydrogel-based cell therapy, non-cellular therapy, and tissue engineering repair. Conclusion: Hydrogels are widely used in the regeneration and repair of intervertebral disc, which provides a potential treatment for intervertebral disc degeneration.

Objective To discuss the advance and experience of postoperative management in multivisceral transplantation(MVT).Methods Five patients with abdominal multiple organs malig- nances were subjected to multivisceral transplantation.The excised specimens included the liver,pan- creas,duodenum,stomach,spleen,mesentery and all of the involved lymph nodes.The transplanted organs were liver,pancreas,duodenum and parts of intestine.Patients were monitored and sustained stably in breath,hemodynamics and homoeostasis.The coagulation was also monitored and kept in balance.The intensive immunosuppressive protocol,including steroid,tacrolimus,mycophenolate mofetil and Zenapax,was used to prevent the acute rejection.The endocrine and exocrine of pancreas were tested,color Doppler examination was done every day,and Somatostatin was used to prevent pancreatitis.Drugs to bacteria,fungus and virus infection were prophylactically used.Results All patients waked up with 4-6 h after operation and began recovering with 3-7 days.Dynamic examina- tions revealed that the functions of grafted liver,pancreas and duodenum were satisfactory.No com- plications of acute rejection,pancreatitis,bleeding and thrombosis occurred.Conclusion Many ques- tions in postoperative management related to multivisceral transplantation are devoted to study.Nice experience of management to organ transplantation,detailed monitoring and prophylactically medica- tions are safeguards to steady recovering and further prognosis.

Authors described the patterns,core measures and mechanisms of coordinated care delivery in the localities and analyzed initial outcomes of this practice.It is found that such practice has optimized distribution of regional healthcare resources,implemented first visit to primary institutions, and the care delivery to separate emergency from outpatient service.In addition,the paper analyzed problems found in localities in terms of policy,public hospitals and primary institutions,and proposed elements required for coordinated care delivery system to succeed,such as enhanced policy support, enhanced multi-departmental coordination,and public hospital reform to explore feasible approaches.

This paper summarized practices and experiences of other countries in coordinated care delivery system building,and described the care delivery systems used in various healthcare fundraising patterns.It is found that most countries have defined duties and service coverage of healthcare institutions at all the levels and measures to ensure rational patient flow.In the end,the paper concluded found experiences of these countries and inspirations for China.

The effect of paper publication time on knowledge discovery in biomedical literature was studied by analyzing the role of time factor in indirect link mining and tested using the PubMed-covered data set,which showed that recently published papers played a better role than early published papers in knowledge discovery,indicating that the time factor plays a certain role in knowledge discovery in biomedical literature and can thus improve the efficiency of knowledge discovery in biomedical literature.

OBJECTIVE To investigate the resistance of clinical isolated strains to the commonly used antibacterials in our hospital 2007-2008.METHODS Clinical isolated strains and sensitivity of drugs were detected by ATB system.The result of drug sensitivity was judged by CLSI standard and analyzed with statistical software WHONET5.3.RESULTS Altogether 3150 strains bacteria were isolated,17.4% were Gram-positive strains and 82.6% were Gram-negative strains,and the top five isolates were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Staphylococcus aureus.The reasistance rate of Gram-positive strains to minocycline was 15.4%.Five VRE strains were isolated.Various Enterobacteriaceae bacteria were sensitive to imipenem meropenem,cefoperazone-sulbactam and piperacillin-tazobactam,and their rate was 86.5% to 97.7%.Some of Acinetobacter and Stenotrophomonas maltophilia were multidrug resistant.CONCLUSIONS It is serous that multidrug resistance of isolated strains of the patients exists in our hospital.

Purpose To investigate the clinicopathologic characteristics of colorectal metastatic tumors. Methods Cases which were clinically diagnosed as metastatic tumors to the colorectum were retrieved from the data base of the Department of Pathology, Peking U-niversity Third Hospital. The clinicopathologic features were studied and immunohistochemical stains were performed on some of the ca-ses for differential diagnosis. Results Fifty three cases which showed intestinal wall involvement were studied. In 43. 4% (23/53) of them, only serosa/subserosa was involved and mucosal involvement was observed in 37. 7% (20/53) of the cases. Sigmoid colon and rectum were the most frequently involved intestinal segments (24/53, 45. 3%). Female reproductive system was the most common ori-gin of the metastatic tumors (33/53, 62. 3%), followed by the digestive system (15/53, 28. 3%). The most common histological type was ovarian serous carcinoma (22/53, 41. 5%). 96. 2% (51/53) of the metastatic tumors were centrally located at the serosa/subserosa or the muscular propria and prominent lymphovascular invasion was observed in 26. 4% (14/53) of the cases. In cases with mucosal involvement, 35% ( 7/20 ) had foci that were lack of desmoplastic reaction, 20% ( 4/20 ) exhibited in-situ growth and/or paradoxical maturation of tumor cells which led to misdiagnosis in 2 of the 17 pre-operative biopsies. Conclusions Metastatic carcino-ma in the colorectum can be highly informed by predominantly involving the serosa/subserosa or muscular propria and prominent lym-phovascular invasion. In-situ growth and paradoxical maturation of tumor cells in the mucosa are diagnostic pitfalls in pre-operative co-lonic biopsy and should be aware in practice.