Objective To study the curative effectiveness of external iliac-popliteal artery artificial graft cross bypass in treating extensive arterial occlusion in unilateral lilac-femoral arteriosclerosis. Methods From Sep. 1999 to Oct. 2007, 39 elder patients were diagnosed as having extensive arterial occlusion in unilateral lilac-femoral arteriosclerosis by color Doppler ultrasonography, CTA or DSA. 25 patients (61.5%) had resting pain, 14 had ulcers or gangrenes in the toes. The average ankle-brachial index was 0. 19. Contralateral external iliac-popliteal artery artificial graft cross bypass surgeries were performed on 22 patients from left to right, the other 17 were from right to left. Results There were no perioperative death or amputation. The ankle-brachial index increased from 0 ～ 0. 41 ( preoperative ) to 0. 85 ～ 1.02(postoperative) ; the claudication distance increased from 15 ～ 60 m (preoperative) to 350 ～ 500 m or more than 500 m [ postoperatively at the speed of (100 ～ 120) m/min] ; The postoperative color Doppler uhrasonography showed the average velocity of the popliteal artery was 45 cm/s. In the anterior tibial artery or the posterior tibial artery, little blood flow was showed in preoperative color Doppler ultrasonography examination, the postoperative average blood flow velocity was 41 cm/s. 35 patients (89. 7% ) were followed up for an average of 3.4 years, with an accumulative patency rate of 85.7%. Four patients had amputation, the limb salvage rate is 88.6%. Conclusion External iliac-popliteal artery artificial graft cross bypass is effective in treating unilateral lilac-femoral arterial occlusion, particularly for aged patients with vital organ incompetence.

A liver transplant invol ves more medical aspects than complex surgery,with different characteristics than general surgery.The medical risks the patient disputes focus on the informed consent rights.Analysis of dispute causes,especially through the relevant study of jurisprudence,suggests that we should be highly sophisticated with informed consent rights.to prevent disputes and improve the quality of clinical diagnosis and treatment.

Obstructive jaundice is a common disease of hepatobihary surgery,including malignant and benign ones whose treatment and prognosis are obviously different.Malignant obstructive jaundice is one of the dieseases with a worse curative effect,the surgical treatment of this disorder has made much progress in recent years.however there are also some points of disagreement.This acticle reviews the advances of the preoperative preparation,radical excision and palliative drainage in the surgical treatment of malignant obstructive jaundice by reviewing the pertiment literature of China and abroad of recent years.

Objective To observe the physiopathologic changes of lung in rats with acute ischemic kidney injury,and to study the roles of cytokine,epithelial sodium channel protein (ENaC) and aquaporin 1 (AQP1) in acute lung injury brought on by acute ischemic kidney injury in rats.Methods A total of 60 healthy male Wistar rats (300-320 g) were randomly (random number) divided into control groups (group A,n =30) and acute kidney injury group (group B,n =30).The model of acute ischemic kidney injury in rats was made by bilateral renal arteiovenous blockage with clamps.Six rats of each group were sacrificed at 0,2,4,6 and 8 hours after modeling.Lung tissue of rats was harvested and stained with hematoxylin-eosin (HE) staining method,and the pathological changes of lung were observed under microscope.The ratio of wet and dry weight (W/D) of lung was calculated.The levels of protein in bronchoalveolar lavage fluid (BALF) were measured.The levels of IL-6 and TNF-α both in serum and BALF were tested.The concentrations of AQP1 and α-ENaC in lung were measured.Results At six hours after modeling,the pH value of arterial blood of rats in group B began to get lowered compared to group A.There was no difference in partial pressure of oxygen in arterial blood between two groups during entire period of experiment (P ＞0.05).Protein level in BALF and W/D of lung increased significantly two hours after modeling in rats of group B (P ＜ 0.05).The histopathological changes of acute lung injury including swollen aleolar epithelium,widened interalveolar septum,edema of alveoli and alveolar interstitium,alveolar neurophil sequestration,erythrocytes and protein in exudates were observed.The levels of TNF-α and IL-6 in serum and in BALF began to increase at two hours after modeling.The levels of AQP1 and α-ENaC of lung in rats with acute kidney injury decreased gradually and were lower than those in rats of group A (P ＜0.05).Conclusions Aleolar epithelial-endothelial barrier function was already compromised at the beginning of AKI,suggesting the acute lung injury was already brought on.The levels of TNF-α,IL-6 in serum and in BALF increased after the occurrence of acute kidney injury.The decreases in lung AQP1 and α-ENaC might contribute to the lung injury caused by early acute kidney injury.

BACKGROUND:The isokinetic muscle strength test system can quantitatively testtheshoulder flexor and extensormusclesand objectively analyze the relationship between size and balance of flexor and extensor.Therefore,itcould be used forstrength trainingmonitoringas wel asprediction and rehabilitation of sports injuries. OBJECTIVE:To understand shoulder flexor and extensor strength characteristics of adolescent softbal players, and find out shortcomings in the shoulder flexor and extensor strength to provide guidance for adolescent athletes’ strength trainingandpoint out possible sports injury risks caused by imbalanced strength. METHODS:ISOMED2000 isokinetic testing system(D&R,Germany)was employedto test theisokinetic strengthofshoulderflexor andextensor of12adolescentfemalesoftbal playersfromShanghaiSports University, China. RESULTS AND CONCLUSION:With the increase of test speed, the bilateral shoulder flexor and extensor peak torque, the flexor and extensor average power ratio,andthe flexor and extensor powers were reduced, but the flexor and extensor average power was on the rise. Under the same test speed,flexor and extensor peak torque, the flexor and extensor peak torque ratio, the flexor and extensor average power, the flexor and extensor average power ratio and the flexor powersof the throwing shoulderwere significantly larger thanthoseofthenon-throwingshoulder(P< 0.05), whiletheextensor peak torque and the extensor average powerof thethrowingand non-throwing shouldersshowedno significant differences (P> 0.05).Under the same test speed, bilateral shoulder homonymous flexor strength ratio was larger than that of the extensor, andthe extensor powerof the throwing shoulderwas less thanthatof the non-throwingshoulder.The ratio ofhomolateralshoulder flexor and extensor ranged from 70% to 80%. These results indicate that there is a significant difference betweentheflexor strength ofthebilateral shoulders inadolescent softbal players,but the bilateralextensor strengthis similar.Flexor fast strength and extensor maximum strengthof the throwing shoulderare lower. Besides, the isokinetic muscle strength test system canbe used toevaluate the flexor and extensor strengthinadolescent softbal athletes,based on whichcoachescangivetargetedstrength traininginadolescent softbal athletes.

Objective To investigate the effect of fluvastatin and butylphthalide soft capsules in the treatment of acute cerebral infarction and the dynamic effect on serum C reaction protein.Methods 80 patients with ACI were randomly divided into the observation group and control group with 40 cases in each group.All ACI patients were given conventional treatment,the control group was given fluvastatin,the observation group based on this to use butylphthalide soft capsule.The NIHSS score,ADL score,blood rheology indexes and CRP levels of two groups were compared before and after treatment,and evaluated clinical efficacy.Results The total effective rate of observation group was 92.5%(37/40),the control group was 70%(28/40),the difference was statistically significant (P<0.05).The NIHSS score of observation group at 7 d and 14 d of treatment were significantly lower than those in the control group (P<0.05),the ADL score of observation group at the 30,90 d of treatment were significantly higher than that in the control group (P<0.05 ).The hematocrit,fibrinogen in observation group after treatment were significantly lower than that of control group (P<0.05 ). The CRP of ACI patients in two groups were decreased after treatment,and at the third day significantly lower than those before treatment in the observation group (P<0.05 ),while the control group had significant difference at the seventh day after treatment compared with those before treatment (P<0.05).Comparing two groups,the CRP levels of observation group at 3,7,14 d of treatment were significantly lower than that of control group (P<0.05).Conclusion Compared the single use of fluvastatin,combination of atorvastatin and butylphthalide soft capsules in the treatment of acute cerebral infarction can improve the blood rheology,faster the recovery of neural function and CRP decrease quickly,and with higher efficacy,is worthy of clinical application.

?AIM: To observe the efficacy of 25G vitrectomy for traumatic cataract.?METHODS:Retrospective analysis of 70 cases (70 eyes) of traumatic cataract treated by 25G vitrectomy with lensectomy from February 2013 to February 2015 in our hospital was made for the study.In the patients, there were 43 males ( 43 eyes ) , 27 females ( 27 eyes ) , aged from 22-51 years old with an average of 35.23±2.54 years, mean visual acuity was 0.10±0.03.They were all followed up for 6 -12mo postoperatively. Anterior segment, fundus, complications, best corrected visual acuity ( BCVA ) and intraocular pressure were observed during the follow - up. BCVA preoperatively, 1wk postoperatively, 1 mo postoperatively, 6mo postoperatively were compared.? RESULTS: All the patients underwent the surgery successfully, and visual acuity improved at different degrees. The differences of BCVA preoperatively compared with 1 and 6m postoperatively were all statistically significant ( P <0. 05 ). Postoperative complications:5 cases with corneal edema, 10 cases with ocular hypertension, 4 cases with ocular hypotension, 5 cases with retinal spotting.The symptoms improved after symptomatic and supportive treatment.? CONCLUSION: 25G vitrectomy with lensectomy is effective on treating traumatic cataract, with decreased operation risk, complications and improved visual acuity.

Objective To prepare an internal quality control substance of free hemoglobin (FHb),and evaluate its perform-ance.Methods ① 5 normal whole human blood samples with known hemoglobin (Hb)concentration was selected and dilu-ted with distilled water in the ratio of 1∶500,1∶1 000,1∶2 000,1∶4 000 respectively.After 20 FHb solutions was fully mixed,the concentration of FHb solutions was tested and compared with its theoretical data.②One of the highest value and the lowest value solutions were chosen as qualitye control substance,packed and stored in -20℃ fridge.Each group was an-alyzed 20 days continuously in the routine conditions,where average (-x )of the groups,standards deviation (s )and coeffi-cients of variation (CV)were calculated and Levey-Jennings control chart was conducted.Then,the test was repeated every week,and the data on the chart was updated accordingly until (CV)of the reagents were changed.The average (-x)of the-groups,standards deviation (s)and coefficients of variation uality control material was calculated during the whole test peri-od.Results ①The theoretical value (-x ±s)of the concentration of free hemoglobin was 125.44±93.04 mg/L,and the actu-al value was 125.22±93.08 mg/L,there was no statistic significance (t value was 0.706,P >0.05).② During 20 continu-ously daystest,the detected values (-x ±s)of the highest quality control material was 303.55±3.70 mg/L;the values of the lowest quality control material was 69.29 ± 1.88 mg/L.The coefficients were 1.22% and 2.68% respectively.Both the highest and the lowest quality control material were under control during the whole detecting period.The (-x ±s )values of the highest was 302.56±3.99 mg/L,the CV value of it was 1.32%;The (-x ±s)values of the lowest was 69.04±1.88 mg/L,the CV value of it was 2.71%.Conclusion The preparation method of internal quality control substance of free hemoglo-bin is convenient and stable,and was applicable in blood station’s and clinical laboratory.

Objective To explore the effect of treadmill exercises on disuse osteoporosis and the media effect of OPG-RANKL-RANK system of osteoclast differentiation in the process.Methods Forty six-week-old male Sprague-Dawley rats were randomly divided into a normal control group,a disuse model group,a normal recovery group and an exercise recovery group,each of 10.The normal control group were sacrificed 4 weeks later without receiving any special treatment.The disuse model group were sacrificed after 4 weeks of tail suspension.The normal recovery group were sacrificed after 4 weeks of tail suspension and keeping quiet for 4 weeks.The exercise recovery group were sacrificed after 4 weeks of tail suspension and another 4 weeks of treadmill exercises.The indicators of bone mineral density (BMD),bone histomorphometry,bone tissue TRACP-5b staining,bone metabolism and cytokines related to the osteoclast differentiation OPG-RANKL-RANK system were tested immediately after the rats were sacrificed.Results The BMD,trabecular bone volume percentage (TBV),trabecular bone width (Tb.Wi),concentration of serum alkaline phosphatase (ALP) and the gene expression of bone marrow oculopneumoplethysmograph (OPG) of the disuse model goup were significantly lower than those of the normal control group (P＜0.01),while the trabecular bone spacing (Tb.Sp),average positive staining area percentage (APSAP) of tartrate-resistant acid phosphatase (TRACP)-5b,concentration of serum Ca2+ and TRACP-5b and the gene expression of bone marrow cytokines including RANKL,macrophage colony-stinulating factor (M-CSF),RANK,interleukin (IL)-6 and tumor necrosis factor (TNF)-α of the disuse model goup were significantly higher than those of the normal control group (P＜0.01).The BMD,TBV,Tb.Wi,concentration of serum ALP and the gene expression of bone marrow OPG of the exercise recovery group were significantly higher than those of the normal recovery group (P＜0.05 or P＜0.01).The Tb.Sp,APSAP,concentration of serum Ca2+ and TRACP-5b and the gene expression of RANKL,M-CSF,RANK,IL-6 and TNF-α of the exercise recovery group were significantly lower than those of the normal recovery group (P＜0.05 or P＜0.01).Conclusion The 4-week tail suspension can lead to disuse osteoporosis in rats.Treadmill exercise can promote the recovery of rats with the disuse osteoporosis.The occurrence of disuse osteoporosis and the effect of exercises on disuse osteoporosis were related with the expressing of OPG-RANKL-RANK system-related cytokines of osteoclast differentiation in bone marrow microenvironment.

Objective To study the diagnostic value of anti-neutrophil cytoplasmic antibody (ANCA) detction in patients with systemic lupus erythematosus (SLE). Methods Indirect immunofluorescence (IIF) and Western blotting were applied to detecting the expression of sera ANCA, antinuclear antibody (ANA), anti-double-stranded DNA antibody, anti-SmithD1 antibody in 25 samples of control group and 106 samples of patients with SLE. Results ALL samples of control group showed negative; 47.2% (50/106) sera showed ANCA positive in patients with SLE,and all of them were peripheral nuclear pattern (pANCA). In ANCA positive group, the positive rate of ANA, anti-SmithD1 antibody and anti-ds-DNA antibody was respectively 100% (50/50), 82% (41/50) and 94% (47/50); in ANCA negative group, the positive rate was respectively 91.1% (51/56), 67.9% (38/56)and 50% (28/56). There were no statistical differences in positive rates of ANA and anti-SmithD1 antibody between ANCA positive and negative groups (both P＞0. 05), but there was in positive rates of anti-ds-DNA antibody (P＜0.01). ANCA positive rate was respectively 84.6% (44/52) and 11.1%(6/54) in active SLE group (n=52) and inactive SLE group (n=54) (P＜0.01). Conclusion The determined ANCA in patients with SLE is not correlative with ANA and anti-SmithD1 antibody, but positively relates to anti-double-stranded DNA antibody. The positive rate of ANCA in patients with active lupus is significantly higher than that in non-active lupus.