BACKGROUND:In the past, the surgical treatment of patients with hemophilia B was difficult, the bleeding was difficult to estimate, and the wound healing was difficult. In the perioperative period, the control of coagulation factor IX activity in a safe range can ensure the safety of the operation, resulting in wel wound healing, good recovery, and no significant complications appeared in the long term. OBJECTIVE:To study essentials of perioperative diagnosis and treatment in omarthritis patients with hemophilia B undergoing humeral head replacement, and to analyze the importance on prognosis and rehabilitation. METHODS:The significance of surgical treatment for hemophilia B patients with arthritis, the prevention and treatment of perioperative complications were summarized through literature review. Humeral head replacement was conducted in a patient with hemophilia omarthritis by monitoring coagulation factor activity and infusing human prothrombin complex and frozen plasma. RESULTS AND CONCLUSION:(1) According to the monitoring, patients, whose coagulation factor IX activity increased from 7%to 50%, underwent humeral head replacement. (2) Within three days after replacement, coagulation factor IX activity was control ed>30%, 3 days-2 weeks>20%. No obvious complication was found after surgery. (3) These results suggested that hemophilia B arthritis was commonly treated by surgical treatment, which plays an important role in assessing patient’s condition and treatment. During perioperative period, replacement therapy of human prothrombin complex and control of coagulation factor activity in a appropriate range can effectively prevent postoperative complications.

OBJECTIVE:To establish the quality standard of Compound duzheng tablets. METHODS:TLC method was used for qualitative identification of Vitis davidii,Aralia chinensis,Acanthopanax senticosus and Panax notoginseng in the preparation. The contents of syringoside,oleanolic acid,ginsenoside Rg1,ginsenoside Rb1 and notoginsenoside R1 were determined by HPLC. The determination was performed on Inertsil ODS-SP C18 column with mobile phase consisted of acetonitrile-water(gradient elu-tion)at the flow rate of 1.0 mL/min. The detection wavelength was set at 215 nm,and the column temperature was 25 ℃. The sam-ple size was 10 μL. RESULTS:TLC spots of V. davidii,A. chinensis,A. senticosus and P. notoginseng were clear and well-separat-ed without interference from negative control. The linear ranges of syringoside,oleanolic acid,ginsenoside Rg1,ginsenoside Rb1 and notoginsenoside R1 were 0.056-0.337 μg(r=0.9998),0.022-0.130 μg(r=0.9999),0.030-0.182 μg(r=0.9995),0.010-0.061 μg(r=0.9998),0.038-0.226 μg(r=0.9999),respectively. RSDs of precision,stability and reproducibility tests were all lower than 3.0%. The recoveries were 100.55%-103.80%(RSD=2.0%,n=9),100.00%-104.56%(RSD=3.0%,n=9),97.06%-102.94%(RSD=2.1%,n=9)、97.06%-102.94%(RSD=2.0%,n=9),96.67%-100.00%(RSD=1.5%,n=9). CONCLUSIONS:Established standard can be used for the quality control of Compound duzheng tablets.

Objective To explore the extraction process of Yinxing Huonao capusle.Methods Central composite design-response surface method was used to optimize the extraction process with quantity of water and boiling time as main factors and with syringin transfer rate,emodin transfer rate and solids retention rate as evaluation index.Results The conditions of the optimized extraction process were as follows:10-fold water,extracting time of 160 min,extracting 2 times.Conclusion It is feasible that central composite design-response surface method is used to optimize the extraction process of Yinxing Huonao capusle,and the optimized extraction process is simple and reliable.

Objective To discuss the role of IL-8 and NF-?B in the airway inflammation of COPD in stable stage.Methods From Mar.2003 to Sep.2005,select 26 COPD patients in stable stage,determine the concentration of IL-8 in the serum of induced sputum,separate the macropolycyte and determine the degree of active expression of NF-?B,the concentration of SOD,MDA and IL-8 in peripheral blood.Lung function(the percent of FEV_1/FEV_1 prospectived value,FEV_1/FVC)of all patients were investigated.Results The concentration of IL-8 in the serum of induced sputum of COPD patients was higher than the normal group obviously(P

Objective To explore the selection of reasonable interventional treatment to portal hypertension under different conditions.Methods The data of 76 patients with portal hypertension and interventional treatment from 1997 to 2002 were retrospectively analyzed. 26 patients were treated with transjugular intrahepatic porto-systemic stent shunt (TIPSS). Of these 26 patients, 11 patients suffered from hemorrhage after surgery treatment by devascularization, 6 patients with hemorrhage after stomach mirror treatment, and 9 patients with ineffective medicine treatment. 50 patients were treated with percutaneous transhepatic variceal embolization (PTVE) combined with partial splenic embolization (PSE), and they all showed inefficacy by medicine treatment. Free portal pressure (FPP) in pre- and post-treatment was measured in all 76 cases. The hepatic volume was measured by spiral-CT before and one year after the treatment.Results In TIPSS group, FPP was reduced from (3.85?0.42) kPa to (3.09?0.44) kPa (( t= 3.682, P

Objective To study the clinicopathological characteristics and prognosis of asymptomatie IgA nephropathy (IgAN) children with pmteinuria and/or microscope haematuria .Methods Clinical and pathological characteristics of 54 children with IgA nephropathy confirmed by renal biopsy were analyzed . These children with IgAN were divided into two groups according to their clinical characteristics at the first onset: asymptomatic IgAN group (AsIgAN) and symptomatic IgAN group (SIgAN) . Histologic changes were classified by Lee SM and Katafuchi semiquantitative scoring system . Results Eighteen children were in AslgAN group and 36 children were in SIgAN group . The degree of proteinuria in SIgAN group [(2 .3±2 .2) g/d] was higher than that in AslgAN group [(0 .4±0 .3) g/d] at the time of biopsy (P＜0 .05) . Although asymptomatic IgAN children were mainly of Lee's type Ⅰ ～Ⅱ, 2 children (11%) were of Lee's type Ⅳ～Ⅴ and 5 cases (27%) presented interstitial injury . Symptomatic IgAN children were mainly of Lee's type Ⅱ ～Ⅲ, there was no significant difference between two groups (P＞0 .05) . Urine micrealbumin was increased in 87% children presented with microscope haematuria . After an average of (26 .9±8 .8)months follow-up, only one case of Lee's Ⅴ progressed into renal failure and the others maintained normal renal function . Conclusions Although children with asymptomatic IgAN have minor clinical symptoms, severe renal pathological lesion and poor prognosis also occur . Urine screening helps to detect renal diseases and renal biopsy should be performed in the patients with increased urine microalbumin .

Objective To investigate the value of transrectal Doppler and contrast-enhanced ultrasonography(CETRUS)to discriminate benign and cancerous nodules in prostate. Methods Fifty-five patients with hypoechoic lesions(35 biopsy-proven benign nodules and 32 prostate cancer nodules)in the prostate underwent Color and power Doppler uhrasonography(PDUS),and the parameter of peak vascularization index(PVI)in each prostate nodule was recorded and the differences of PVI in the benign and cancerous nodules were analyzed.CETRUS was then performed on all cases.The enhancement patterns of the lesions and their surrounding peripheral zone tissues were observed.After CETRUS,lesion-specific TRUS-guided biopsy and the routine sextant biopsy were performed subsequently. Results PVI of 32 prostate cancerous nodules and 35 prostate benign nodules were (0.38±0.16),(0.24±0.19),respectively,measured by color Doppler ultrasonography.And the former was significantly higher than the latter(P=0.0023).PVI of the cancerous nodules and the benign nodules were(0.55±0.18),(0.32±0.21)(P<0.01).Malignant lesions showed significant increased peak intensity and earlier arrival time compared with their surrounding outer gland tissue,while benign lesions showed nearly equal peak intensity and time to enhancement compared with their surrounding gland tissue by CETRUS. Conclusions PVI measured by PDUS was more effective than that measured by color Doppler to discriminate benign and cancerous nodules in prostate.CETRUS could be helpful in discriminatory performance of benign and cancerous nodules in prostate.

Objective To investigate the role of NF-κB activation in the inflammatory mechanism of chronic obstructive pulmonary disease (COPD).Methods Monocyte were collected from patients with COPD and were cultured,and stimulated with lipopolysaccharide (LPS) ; NF-κB p65 activation was measured by immunohistochemistry; SOD ,MDA and IL-8 and lung function were determined synchronously.Results The NF-κB p65 was induced by LPS in monocyte in all subjects, but it was most markedly done in COPD patients with exacerbateions; There was positive correlation between the NF-κB p65 activation of monocytes and levels of IL-8 and MDA in circulation, but it was negative correlation to SOD.Conclusion NF-κB plays a vital role in regulating product of IL-8 in monocyte in COPD.

Objective To assess the significance and the relationship of BODE index score and inflammation factors in stable chronic obstructive pulmonary disease(COPD).Methods Sixty COPD patients in their stable condition were evaluated for BODE index score and the level of tumor necrosis factor-α(TNF-α),interleukin-8(IL-8) and C reactive protein (CRP) were determined.Results BODE index score in COPD patients was positively correlated with serum concentrations of TNF-α,IL-8 (r =0.455,P ＜ 0.01 ; r =0.303,P ＜0.05),but not with CRP (r =0.111,P =0.398).IL-8 and TNF-α were both significantly negatively correlated to body mass index(BMI),force exhale volume of the first second (FEV1) and 6 minute walking distance (6MWD) (r=-0.417,P ＜0.01;r=-0.538,P＜0.01;r =-0.419,P＜0.01 for IL-8;and r=-0.262,P＜0.05;r=-0.348,P＜0.01;r=-0.334,P＜0.01 for TNF-α).Conclusion The BODE index,as a simple multidimensional grading system for COPD,is closely related to system inflammation,which indicates that system inflammation may contribute to the systemic development of COPD.

Objective To report the experience in the use of laparoscopic extravascular stent for the treatment of the nutcracker syndrome. Methods Five patients (4 men and 1 woman) aged 20 to 35 years (mean 25) underwent laparoscopic extravascular stent of the left renal vein (LRV) for treatment of nutcracker syndrome associated with severe recurrent gross hematuria and left gonadal vein varices. All patients met the criteria for establishing the diagnosis of nutcracker syndrome. Ultrasonography, computed tomography, and magnetic resonance imaging revealed visible entrapment of the LRV between the superior mesenteric artery and aorta. Bleeding from the left ureteral orifice was detected by cystoscopy in 3 cases. An externally reinforced graft was selected to form an external stent around the LRV to relieve the compression. Results The mean operation time was 67 min (65-70min). No complications occurred during surgery. The postoperative follow-up was 9 to 39 months (mean 28). Total relief was achieved in 4 men without a relapse of symptoms and abnormalities were not found in urine tests. There was partial relief for the female patient due to microscopic hematuria after the operation. In all the 5 cases, Color Doppler ultrasonography showed that the blood outflow was smooth, the inner diameter and flow velocity of the aortomesenteric portion of the LRV were both decreased, and the gonadal vein varices had diminished in diameter. Conclusions The laparoscopic extravgscular stent of the renal vein could be a feasible approach for re-establishing free renal venous outflow in patients with nutcracker syndrome. This slightly invasive treatment could eliminate the symptoms of the condition.