Carotid endarterectomy (CEA) can effectively treat symptomatic carotid stenosis, however, perioperative stroke is the most important complication of CEA. The microemboli generated before and after the operation are the most important reason for causing perioperative stroke. In addition, the hypoperfusion and postoperative hyperperfusion syndrome caused by intraoperative clipping of carotid artery, as well as carotid restenosis or occlusion after CEA are all the causes of perioperative stroke. As a non-invasive, real-time monitoring tool, transcranial Doppler (TCD) can be widely used in intraoperative monitoring of CEA, It is able to detect a variety of perioperative blood flow changes and the production of microemboli, and thus effectively predicts the occurrence of perioperative stroke, and decreases the risks of perioperative stroke.

Sarcopenia is a major clinical characteristic of cancer cachexia .The main pathophysiologic mechanism of sarcopenia related to cancer cachexia is abnormality between anabolic and catabolic pathways of muscle mediated by chronic inflammation .The major treatments for sarcopenia in cancer cachexia currently in-clude hormone therapy , nutrition support , exercise therapy , and other medications , which could not effectively prevent muscle loss or enhance muscle function .Better understanding of the pathogenetic processes of cancer cachexia-related sarcopenia may help in finding targets for an effective therapy .

OBJECTIVE： Evaluating clinical efficacy of ceftriaxone in the treatment of lower respiratory tract infections METHODS： Applying meta－ analysis to evaluation of clinical efficacy of ceftriaxone， cefotaxime and cefuroxime in the treatment of lower respiratory tract infections RESULTS ＆ CONCLUSION： Ceftriaxone is worthy of popularization and application in clinical practice because of its better efficacy and lower cost

Objective To investigate sexual function in male kidney transplant recipients and their offsprings health condition.Methods We studied 60 male kidney transplant recipients who had a normal sex life before kidney failure and had good renal graft function after transplant.The questionnaire was used to investigate the time of first spermatorrhea,viability of sex activities,frequency and sexual intercourse satisfaction of sex activities,procreation status,growth and intelligence status of the offspring.Semen routine tests before and after the transplantation were done.Results Hyposexuality or declined sexual function was found in all over 60 cases of recipients.And after surgery,sexual function of the recipients was improved obviously following the graft function gradually regained.Fifty-four patients had spermatorrhea in the first 1-3 months post-transplantation,and rest 6 cases had no spermatorrhea because of sexual life.After operation 56 male patients began to have sex life in 2-4 months with satisfaction rate of 86.7％ (52/60),except the other 4 cases who refused sex life due to worrying about graft damage by sex life.Sixty-eight children were born by 56 recipients after operation,and the growth and intelligence status had no significant difference from the children of the same age.No transplant graft failure or rejection was found after the recipients had children.Conclusion After kidney transplantation,the sexual function of male recipients could return to the normal status and the growth and intelligence status of the offspring is normal.

Objective To compare therapeutic effect of Losartan and hydrochlorothiazed compound prepara- tion and Losartan in patients with mild to moderate hypertension and to conduct economical evaluation. Methods The trial began with 2 weeks lead-in period and followed by 8 weeks therapy. 99 cases of mild to moderate hyperten- sion were randomly divided into two groups: compound preparation group ( n = 50) and Losartan (n = 49). The pa- tients were given Losartan 50 mg/h ydrochlorothiazed 12.5 mg compound preparation and Losartan 50 mg ,once a day. If the SeDBP≥85 mm Hg at 4th week, Losartan was added to 50 rag. Results After two, four and eight weeks treatment, systolic blood pressure and diastolic decreased obviously (P < 0.01 for each) ;The overall effective rate of of antihypertension was the same in both groups, but the different ratio of availability and validity in two groups was significant ( P < 0.05 for each). Conclusion Losartan/hydrochlorothiazed compound preparation has significant advantage in improving both systolic and diastolic pressure compared with monotherapy of Losartan. In ad- dition, the patients receiving compound preparation are well tolerated, with higher compliance.

Objective To discuss the imaging manifestations and clinical characteristics of Askin tumor.Methods 12 cases of Askin tumor confirmed by surgically and histopathologically were included in this study.The MSCT signs and clinical data were summarized.Results In 12 cases of Askin tumor,7 cases located in the chest wall;7 case were hospitalised with rapid enlargementd painful lump(58.3%,7/12).9 cases were performed surgery and postoperative radio chemotherapy,6 patients experienced metastatic or recurrent tumors during the following year(66.7%,6/9).Askin tumor often occurred in the chest-lung junction region,had the diameters of 2.0-13.0 cm,11 cases showed inhomogeneous density (91.7%,11/12), 1 case showed calcification (8.3%,1/12), ill-defined margin(100%,12/12),12 cases showed intense but inhomogeneous enhancement following contrast administrationin (100%,12/12),11 cases had the feature of pleura invasion (91.7%,11/12), 9 cases with pleural effusion(75.0%,9/12), 1 case with swollen lymph nodes in mediastinum(8.3%,1/12), and 4 cases with lytic lesion of adjacent bone(33.3%,4/12).Conclusion Askin tumor often occurrs in the chest-lung junction region with rapid enlargementd painful lump as the primary symptom;the tumor show the infiltration diffuse growth;calcification and adjacent lymph node metastasis is not very common.

OBJECTIVE:Evaluating clinical efficacy of ceftriaxone in the treatment of lower respiratory tract infections METHODS:Applying meta-analysis to evaluation of clinical efficacy of ceftriaxone,cefotaxime and cefuroxime in the treatment of lower respiratory tract infections RESULTS & CONCLUSION:Ceftriaxone is worthy of popularization and application in clinical practice because of its better efficacy and lower cost

6 hours). The APACHE Ⅱ and POSSUM scoring system during perioperative period was in positive correlation with postoperative morbidity and mortality. Conclusions Pancreatoduodenectomy for the treatment of periampullary carcinomas is with high risks. Postoperative mortality and morbidity were in close correlation with the risk factors.

60 mm Hg and PaCO2

OBJECTIVE:To evaluate the quality of antidiabetics in Beijing so as to provide the reference for pharmaceutical manufacturers,patients and governmental departments of drug control.METHODS:236package samples of4kinds of common oral antidiabetics(glibenclamide,gliquidone,metformin,and phenformin)in Beijing medicine market were randomly selected and analyzed.RESULTS:4samples were found to be unqualified,with the disqualification rate of1.7%.CONCLUSION:The quality of4kinds of common oral antidiabetics in Beijing medicine market in2004is satisfactory on the whole.