In recent years,with the rapid development of orthopedic surgery and minimally invasive surgery,superficial fascia and its structures are receiving much recognition and more and more attention.Although opinions on naming and definition at different levels still vary,in-depth study of related structures offers clinical surgeons a broad prospect.

Aim To study the receptor mechanism of carvedilol(CAR) on heart failure.Methods Established rat model of heart failure was induced by abdominal aortic coarctation.With modified Langendorff model of rat,isoproterenol(ISO),carvedilol,propranolol(PRL) and the specific ?3 adrenergic receptor(?3AR) blocker SR59230A were given perfusion on heart failure and normal rats' hearts.Then the cardiac function was investigated.At the same time,plasma norepinephrine in normal and heart failure group was measured.Results ① The ?dp/dtmax of heart failure group were significantly reduced compared with those of the normal group,and the norepinephrine level was remarkably higher than that of the normal group.② In heart failure group,perfused PRL on the basis of ISO,the maximum rate of left ventricular pressure rise(+dp/dtmax) decreased by 40.37%? 2.52%,the maximum rate of left ventricular pressure decrease(-dp/dtmax) reduced by 41.36%?1.10%;perfused CAR on the basis of ISO,+dp/dtmax decreased by 24.73%? 3.60%,-dp/dtmax reduced by 22.05%?1.27%.There were differences between these two groups,and the cardiac function perfused CAR was better than PRL.③ Perfused CAR in heart failure group,+dp/dtmax increased by 41.57%?14.98%,-dp/dtmax increased by 33.39%?6.41%;perfused ?3AR specific blocker SR59230A,+dp/dtmax increase by 45.75% ?2.64%,-dp/dtmax increased by 42.81% ?9.62%.There were no differences between these two groups.Conclusion Another receptor mechanism of CAR in heart failure model was probably blocked by ?3AR.

ObjectiveTo improve the therapies for recurrent arterial embolism of the extremities. MethodsFrom Dec. 1984 to Dec. 1997, 35 patients of recurrent embolism of the extremities were treated,results were compared to that of 248 patients with first onset.ResultsThe recurrent cases accounted for 12.4% of the disease.One year recurrence developed in 63% of the 35 cases.32 cases suffered from second arterial embolism and 3 cases had third onset with a total of 42 limbs.The rates of cure,mortality and amputation were respectively 54.3%,22.9%, and 2.9% in the recurrent group,compared to 72.6%,10.1%,and 14.9% in the control group.There were statistically significant differences of cure,mortality and amputation rates between the two groups(? 2test, P

Objective To study the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) expressed in invasive pituitary adenomas (IPA). Methods The expression of TNF-α and IL-6 were observed with immunohistochemstry (SP approach) in tissue from 40 cases of non-invasive pituitary adenomas (NIPA) and 40 cases of IPA. Results The expression of both TNF-α and IL-6 was significantly increased in the IPA tissues compared with those of NIPA (P<0.05). Conclusion TNF-α and IL-6 may play a role in the occurrence and development of IPA.

Objective To summarize our experience in the management of extensive small bowel necrosis from acute superior mesenteric arterial (SMA) embolism. MethodsSeven cases with extensive small bowel necrosis from acute SMA embolism were treated from 1991 to 1999. Results In this group small bowel of 28～ 30 cm and 70～90 cm were remained respectively in 3 and 4 cases after surgery. Two patients died of septic shock while the other 5 developed short or ultra short bowel syndrome and were finally cured by means of combined intravenous nutrition and oral feeding. 5 patients were followed up for 18～36 months, all are in good health. Conclusions Timely diagnosis and prompt operation are important to elevated survival rate. SMA embolectomy helps in preserving living intestine. For patients with short or ultra short bowel syndrome, comprehensive measures of intravenous nutrition and stepwise oral feeding in combination can quickly restore digestive and absorptive function of the residual intestine.

ObjectiveTo evaluate the efficacy of axillo-axillary bypass grafting for the treatment of contralateral arterial ischemia of upper limb. Method 53 cases underwent axillo-axillary artery PTFE graft bypass among those there were 46 cases of subclavian artery occlusion and 3 cases of subclavian artery aneurysm and 4 cases of trauma. Preoperatively 33 cases suffered from a symptom of extremity ischemia and 18 cases with subclavian artery blood steal. Result Good results were achieved in all cases without any complications. Doppler test showed the gradient of bilateral brachial pressure artery was less 10 mmHg in all cases. ConclusionAxillo-axillary artery PTFE graft bypass is an effective method for subclavian artery reconstruction with less trauma and complications. It is especially suitable for the elders with concomitant heart brain and lung diseases. It is also applicable for cases in which the subclavian arteries are not easily accessible due to artery aneurysm and artery trauma.

ObjectiveTo evaluate the result of in situ great saphenouse vein bypass for the treatment of lower limb ischemia.MethodsFrom 1995 to 2000, 34 patients with femoro popliteal artery occlusive disease underwent in situ great saphenouse vein bypass using self made valvulotome in our hospital.The distal anastomosis was made on above knee popliteal artery in 3 cases, below knee popliteal artery in 16 cases, posterior tibial artery in 11 cases and anterior tibial artery in 4 cases, respectively.ResultsOn discharge, the rest pain disappeared in 26 cases and intermittent claudication disappeared in 7 cases, with average ankle/brachial index changing from 0 34(0～0 52) preoperatively to 0 78(0 48～1 2) postoperatively.The cumulative patency rate at 6,12,24,36 and 48 monthes were 91 18%?88 14%?84 99%?80 52%?80 52%,respectively.ConclusionIn situ great saphenouse vein bypass is effective for the treatment of lower limb arterial ischemia. The vein valve was disrupted successfully with self made valvulotome.

Objectives To study the diagnosis, treatment and prognosis of acute peripheral artery injury, and ways to improve the treatment. Methods Clinical data of 211 cases of acute peripheral arterial injuries admitted between January 1988 and June 2002 in Anzhen hospital were analyzed retrospectively. Of the 211 cases,73 cases were with blunt injuries, 99 penetrating injuries, 37 iatrogenic injuries, 2 gunshot injuries. Management procedures included arterial primary or patch repair in 28 cases, ligation alone in 17, end-to-end anastomosis in 41, interposition reverse saphenous vein graft in 37, interposition prosthetic graft in 29, thrombectomy in 14, excision of pseudoanurysm in 36, interventional thrombolytise in 2, ultrosonic-guided packing in 2, conservative management in 2. One hundred and ninety-two patients were cured,10 patients amputed, 4 patients died respectively.Results Ratio of cure,amputation,and mortality was 90.1%,4.74%,1.8% respectively.Amputation rate in blunt injuries was significantly higher than that in penetrarting injuries (P

Objective To investigate the efficacy of laparoscopic cholecystectomy(LC) followed by endoscopic retrograde cholangiopancreaticography(ERCP) for gallbladder and bile duct stones.Methods A total of 58 patients with both gallbladder and bile duct stones received endoscopic sphincterotomy(EST) in our hospital.After the stones were removed,LC was performed on the patients.Results Of the 58 patients,56 were successfully treated with EST and LC.Two cases were unsuccessful owing to difficulty in intubation during ERCP in one and failure to remove all the stones from the bile duct in the other.These two patients were then cured by LC combined with electronic choledochoscopy.Perioperative complications included bleeding during EST in 1,acute edematous pancreatitis in 2,and mild infection of the puncture site in 1.The overall complication rate was 7.1%(4/56).Retained common bile duct stone was observed in 1 patient,and was successfully removed by subsequent ERCP.Conclusions LC combined with ERCP is a safe and effective minimal invasive method for the treatment of concurrent gallstones and bile duct stones.

0 05); but the data by catheter photography in PDA were obviously smaller (3 5?2 5 vs 5 2?2 3, P