Objective To study the therapeutic effect of catgut net wrapping for preservation of the injured spleen.Methods Catgut net wrapping method was used to preserve the injured spleen,and the clinical material of those patients treated by the wrapping method was retrospectively evaluated.Results Ultimate spleen recovery was achieved in each case of 15 patients without postoperative bleeding observed,any abscess formation,or complications related to the use of catgut net wrapping.The patients were discharged after 10 to 14 hospital dayS.Two-week-fol-low-up results showed this therapeutic opinion is safe.Conclusion As a means of preserving the injured spleen,the catgut net wrapping method was simple,safe,and efficacious.

Objective To investigate the roles of cell apoptosis and the gene expressions of Fas, FasL, bcl-2 and bax in acute rejection of pancreaticoduodenal transplantation and to evaluate the function of duodenum biopsy for early detection of rejection in rats. Methods Wistar and SD rats were divided into two groups: ①Wistar rats that underwent allogenic pancreaticoduodenal transplantation from the organs of SD rats; ②Wistar rats that received homogenic transplantation. The grafts were then harvested on day 3, 5 and 7 after the transplantation, and all graft samples were observed with HE staining and TUNEL was also used to detect apoptotic cells. The expressions of Fas, FasL, bcl-2 and bax were measured by immunochemical method. According to Nakhleh’s score, pathologic features of transplanted pancreas and duodenum were ranged from one to three scores in order. Results The percentage of same or different scores between the pathological scores of pancreas and duodenum in allogenic pancreaticoduodenal transplantation group were 61.1% (11/18) and 38.9% (7/18) respectively, and there were 6 specimens of pancreatic tissue got higher scores with only one higher score for duodenum. There were significant differences of histopathologic rejection scores and apoptotic indices between the two groups, respectively (P

Objective To investigate effects of maintenance hemodialysis with citrate-bicarbonate dialysate on Th17 in peripheral blood of patients with chronic renal failure (CRF). Methods The CRF patients (n=57) with main-tenance hemodialysis for more than three months as well as free-active infection were selected and divided into two groups randomly, which were treated by citrate-bicarbonate dialysate and ordinary carbonate dialysate for mainte-nance dialysis in 12 month, respectively. The levels of interleulin-17 (IL-17) and percentages of Th17 subgroup in peripheral blood were detected by enzyme-linked immunosorbent assay and flow cytometer, respectively. ResultsThe levels of IL-17 and percentages of Th17 subgroup in patients treated with citrate-bicarbonate dialysate for more than six months were significantly lower than those treated with ordinary carbonate dialysate. Moreover, incidences of adverse reactions in group of citrate bicarbonate dialysate were lower than those of common carbonate dialysate group. Conclusion The pro-inflammatory effects of maintenance hemodialysis with citrate-bicarbonate dialysate on the patients are lower than those of ordinary carbonate dialysate. Citrate-bicarbonate dialysate causes the reduction of inflammatory state, and is worthy of being popularized in clinic.

Objective To investigate the value of low positive AFP level for the diagnosis of hepatocellular carcinoma(HCC)when a space occuping lesion was already identified in the liver.Methods The AFP level of 401 HCC cases from January 1999 to October 2006 were retrospectively analyzed.Results 22 cases of small liver cancer underwent reducing surgical resection in our hospital,increasing the quality of life and prolonging survival rate.Con- clusion(1)The AFP level between 20 and 200?g/L is of diagnostic for HCC when a SOL is identified.(2)The clinical reference diagnostic criteria using AFP level more than 20?g/L,instead of more than 200?g/L is helpful for the diagnosis.(3)Combined diagnosis of AFP level more than 20?g/L and ultrasonography or CT scanning yields higher sensitivity and specificity th.an traditional,diagnostic criteria.

Objective To investigate the activity changes of gelatinase in the formation of ascending aortic aneurysm.Methods Thirty five young Wistar rats were divided into two groups:the control group and the experiment group.The rat models induced by ascending aorta banding were made.The ascending aortas were taken after 3-5 months operation,changes of gelatinase activity was observed by gelatin zymography and film in situ zymography.Results Gelatinase activity of ascending aortic aneurysm was significantly increased compared with that of normal ascending aortic aorta.Conclusion Elevation of gelatinase activity may play a significant role in the formation of ascending aortic aneurysm.

Objective To compare clinical outcomes in cardiac transplant recipients treated with individualized dosing (ID) and fixed dosing (FD) of mycophenolate mofetil (MMF).Methods Fortyeight de novo cardiac transplant patients in ID group received MMF (2.0 g/day) in combination with calcineurin inhibitors and prednisone.The MMF dosages were adjusted individually based on clinical events and MPA trough levels (MPA-C0).The target range of C0 was maintained within 2.0-4.0rng/L.The FD group included 55 recipients retrospectively from the transplant database who were also treated with MMF (2.0 g/day).In this group,the MMF dose adjustment was performed empirically according to clinical events only.All of the follow-up data were collected up to 12 months post-transplantation.Results The follow-up rate was 95.8％ and the mean MPA-AUC0-12 was (54.37± 17.03) rng h-1 L-1 in the ID group.The mean MPA-C0 on the day 7 post-transplantation was significantly higher in the ID group than that at 12th month [(3.44 ± 0.58) mg/L vs.(2.79 ± 0.54)mg/L] (P＜0.05).The dose of MMF was significantly lower in the ID group at 4th week posttransplantation than in control group [(1.49± 0.48) g/day vs.(1.96 ± 0.39) g/d] (P＜0.05),while there was no significant difference at 12 th month post-transplantation [(1.61 ± 0.77) g/day vs.(1.68 ± 0.84) g/day] (P＞ 0.05).No significant difference was found in the incidence of acute rejection episode between two groups (8.7％ vs.9.1％,P＞0.05).57.6％ of overall side effects were observed within one month postoperatively,and the incidence of MPA-related side effects was significantly lower in the ID group than in the control group (47.8％ vs.67.3％,P＜0.05).Conclusion It was demonstrated that individualized use of MMF based on therapeutic drug monitoring may prevent MMF-related side effect and appears to be valuable to optimize the treatment of cardiac transplantation.

Objective To put forward reasonable and feasible recommendations aiming at enhancing the application safety of afterloading unit, through studying the human reliability in the emergency response against the source blockage of afterloading unit.Methods Based on the human cognition reliability model, ten operation errors during the emergency response against the source blockage of afterloading unit were analyzed and permissible time widow of emergency response operation were determined.The human error probability was calculated with the execution time of emergency response operation obtained through simulation, observation and recording.Results The operation action, relevant permissible time window and execution time were obtained with the corresponding human error probabilities in the range 0.04 - 0.27.Conclusions The human error model in emergency response against the source blockage of afterloading unit based on HCRmodel is feasible, and provides important reference basis to reduce the occurrence of potential exposure and mitigate the consequence of potential exposure.

Objective To discuss the laparoscopic retroperitoneal dismembered pyeloplasty in the treatment of ureteropelvic junction (UPJ) obstruction. Methods From 2004 to 2007, a total of 41 consecutive patients (20 men and 21 women) with a mean age 30 years (range 12-45 years) un-derwent laparoscopic retroperitoneal dismembered pyeloplasty for UPJ obstruction. One patient had a congenital solitary kidney, 3 patients had renal calculi and 3 patients had horseshoe kidneys. Diuresis renogram and intravenous urography were performed at 3 and 6 months postoperatively, and annually thereafter. Success was defined by the absence of symptoms and improvement of intravenous urogra-phy and the diuretic renogram. Results The mean operative time was 160 min (range 95 to 300 min) with the average estimated blood loss was 35 ml (range 20 to 80 ml). There was no conversion to open surgery. Crossing vessels were found in 10 patients. Among these cases, the ureter was trans-posed anteriorly. Three patients with coexisting renal calculi were successfully had the stones re-moved. The mean hospital stay was 7.5 d (range 5 to 14 d). There were no intra-operative complica-tions. Postoperative complication was recorded in 1 patient with urine leakage. One patient developed an anastomotic stricture who took open surgery afterwards. The success rate was 97.6 % (40/41) at a mean follow-up of 28 months (range 13 to 52 months). Conclusion Laparoscopic retroperitoneal dismemebered pyeloplasty is effective and feasible.

Objective To explore the role of monitoring the cellular immune function in preventing and treating the fungal infection in the recipients of liver transplantation. Methods 679 cadaveric liver transplantations (from Jan. 2004 to Jan. 2010) were retrospectively studied. All the cases were divided into 3 groups according to different treatments and preventing regimens. The patients in groups A, B, C were treated based on the clinical experiences (394 cases), T lymphocyte subsets counting (151 cases), and combination of ATP values of CD4+ T cell and T lymphocyte subsets counting (134 cases), respectively. The infection, mortality and acute rejection rate were analyzed. The relationship between fungal infection and cellular immune function was investigated.Results The fungal infection rate in groups A, B, and C was 28. 9 %, 21.2 %, and 19. 4 % (P<0. 05), the morbidity rate was 16. 7 %, 12. 5%, and 3. 8% (P>0. 05), and the acute rejection rate was 28. 4 %, 17. 2 %, and 13. 4 % (P<0. 01), respectively. The CD4+ T lymphocyte counting in all cases of fungal infection was (147±43)×106/L. The morbidity could reach 50. 0 % when the CD4+ T lymphocyte counting < 100 ×106/L, while it was 2. 4 % when the counting was between (100-200) ×106/L (P<0. 01). The CD4+ T lymphocyte counting had no linear relation with the ATP value.The ATP value in fungal infection cases was (117 ± 61)μg/L. Conclusion The cellular immune function test could be quantitatively evaluated according to the T lymphocyte subsets and ATP value of CD4+ T lymphocyte. And individualized immunosuppressive therapy could be adjusted accordingly.Therefore, cellular immune function could be instructive in preventing and treating the fungal infection after liver transplantation.

Objective To explore coping strategies and influence factors in primary glaucoma patients through describing characteristics of their coping strategies.Methods From November 2007 to June 2008,data were collected from 120 primary glaucoma patients in three hospitals in Guangzhou and Shenzhen.The final sample consisted of 100 patients and the data underwent analysis.Results Among different coping styles of primary glaucoma patients,facing was lower than norm,avoiding and yielding were higher than norm.The factors related to coping style were age,different cohabitant,different economic condition,different occupation,different educational level and health payment mode.Conclusions Primary glaucoma patients usually took avoiding or yielding coping styles.Nurses should help patients with low income and education background to face the disease positively.Besides,fully consideration should be given to patients with different age,at the same time,marriage and family support should also exert active function.