Objective To investigate the effects of continuous infusion of moderate dose tranexamic acid and ulinastatin on fibrinolysis during orthotopic liver transplantation (OLT).Methods Thirty ASA Ⅲ or Ⅳ patients aged 34-63 yr with a body mass index of 17-37 kg/m2 and end-stage liver disease score 6-34,undergoing OLT,were randomly assigned to one of 3 groups ( n =10 each):group control (group C) ; group tranexamic acid (group T) and group ulinastatin (group U).The patients received continuous infusion of normal saline at 10 ml/h in group C or ulinastatin at 100 000 U/h in group U immediately after tracheal intubation until 120 min after portal vein was declamped,while in group T the patients received a loading dose of tranexamic acid 1 g followed by continuous infusion at 10 mg· kg-1 ·h- 1.Prothrombin time (PT),activated partial thromboplastin time (APTT),international normalized ratio ( INR),fibrinogen (Fg),D-dimers (D-D) and fibrin degradation product (FDP) were measured before induction of anesthesia (baseline),at 120 min after skin incision,30 min after clamping of portal vein (anhepatic phase),30 and 120 min after declamping (neohepatic phase) and at the end of operation.The amount of blood loss and transfusion were recorded.The patients were followed up after operation for hepatic artery and portal vein thrombosis in groups U and T.Results There were no significant differences in PT,APTT,Fg,INR and amount of blood loss and transfusion among the 3 groups.The plasma D-D concentration and percentage of patients with plasma FDP ＞ 20μg/ml were significantly lower in group T than in group C.There were no significant differences in plasma D-D concentration and percentage of patients with plasma FDP ＞ 20 μg/ml between groups U and C.No hepatic artery and portal vein thrombosis was detected after operation in groups T and U.Conclusion Continuous infusion of moderate dose tranexamic acid can inhibit fibrinolysis during OLT,but can not reduce the amount of blood loss.Continuous infusion of ulinastatin ( 100 000 U/h) has no significant effect on fibrinolysis during OLT.

OBJECTIVE To study commonly encountered pathogenic bacteria leading to lung infection and their drug sensitivity. METHODS In the period of Jan 2003 to Feb 2005,the pathogenic species and drug sensitivity of 233 positive samples isolated from 496 phlegm samples were analyzed.RESULTS Totally 234 strains of pathogenic bacteria were(isolated) from 233 phlegm samples.It had been found that 132 strains of Gram-negative bacilli,(accounted) for(56.4%);57 strains of Gram-positive cocci,accounted for 24.4 %;41 strains of fungi,accounted for 17.5%;and 4 strains of Gram-positive bacilli,accounted for 1.7%.The pathogens of the highest infective rate were:(Pseudomonas) aeruginosa(15.4%),Candida albicans(11.6 %),Enterobacter cloacae(6.0%),Klebsiella(pneumoniae)(5.6%),Escherichia coli(5.1%),Staphylococcus aureus(4.3 %),Streptococus pyogenes((4.3%)),Acinetobacter baumannii(3.6%),and C.tropicalis(3.6 %).Results of drug sensitivity indicated that drugs selected sensitive to Gram-negative bacilli were:imipenem(75.4%),piperacillin/tazobactam(38.9%),(ciprofloxacin)(37.3%),gentamicin(37.3%),and amikacin(36.5%).Drugs sensitive to Gram-positive cocci were:vancomycin(75%),rifampin(55%),and erythromycin(35%).CONCLUSIONS The commonly encountered pathogens of lung infection in our hospital are: P.aeruginosia,C.albicans,E.cloacae,K.pneumoniae,E.coli,S.aureus,and S.pyogenes.Infective rate of Candida is increasing evidently.Antibiotic resistance of bacteria(becomes) severe,drugs applied became less and less.Clinic should(actively) develop phlegm cultivation and drug sensitivity test,applying antibiotics reasonably,reducing production of bacteria resistant to drugs.

By analyzing the status quo of moral construction of current Chinese medical students,the authors make an in-depth analysis and accurate grasp of human nature,establish a scientific concept of morality education,and clarify the objective which aims to develop students into real "socialized individuals" with mental health,personal integrity and all-round development.Four moral methods including vertical process,horizontal extension,virtual network and class building are created to promote the ideological and moral construction for medical students.

ADVANCE trial demonstrated that stable intensive glucose control could improve prognosis and the target HbA1c should be 6.5%.While ACCORD and VADT trials suggested aggressive glucose lowering in diabetics at high cardiovascular risk is potentially harmful,tight glucose control yields no significant effect on long duration,poorly controlled patients with complications.DCCT and UKPDS research confirmed benefits of early intensive glucose control could persist due to legacy effect.Steno-2 research showed patients benefit greatly from comprehensive control of risk factors.In sum,early intensive control of risk factors and individualized treatment in diabetics are mainstream therapy.

Objective　 To investigate aetiology of alopecia seborrhoeica. Methods　Immunocytochemical localization of androqenic receptor(AR) was performed in the skin with baldness, and serum Fe,Cu,Zn,SOD and MDA detected, together with an interrogation. Results　 Expression of androgenic receptor in alopecia was higher than that in normal controls.There was no correlation between the positive expression of AR and familial history. No expression of AR was found in about 35 % of the patrents.More than two factors involved in the pathogenesis of alopecia seborrhoeia.. Conclusion 　Alopecia seborrhoeica is a disease entity related to multple pathogenic factors.

Objective To construct an eukaryotic expression vector carrying human glutathione-S-transferase(GST)A1gene and to provide study materials for toxicology and pharmacogenetic.Methods The GST A1cDNA was amplified and separated from human liver total RNAs by RT-PCR approach and recombined with eukaryotic expression vector pcDNA3.The recombined plasmid pcDNA3-hGSTA1was verified using PCR,restriction analysis and sequencing determination.Results Human GST A1gene was recombined correctly with pcDNA3,compared with Genbank,in code152T→C,amino acid Met→Thr.Conclusion The eukaryotic expression vector pcDNA3-hGSTA1was constructed for research on toxicology and pharmacogenetics.

[Objective]To evaluate the method and curative effect of posterior internal fixation and bone grafting fusion for atlantoaxial fracture or dislocation.[Method]Posterior internal fixation and bone grafting fusion were made on 26 patients with atlantoaxial fracture or dislocation in condition of tracheal intubation anesthesia.Occipitocervieal fixation(Aixs) and bone grafting fusion were performed on patients with fracture of vertebral lamina-arch.Vertebral lamina splint fixation (Apofix) was performed on patients without fracture of vertebral lamina-arch and decompression of vertebral canal.[Result]Followed up for 5 to 60 months(averaged,16.8 months),the vertebral artery and spinal cord injury were not occurred and clinical symptom was relieved in all patients.X ray examination showed screws in vertebral articular process and occipital condyle were normotopic without laxation and fragmentation.The bone grafting transformed into osseous fusion after 3 months.[Conclusion]Aixs fixation and bone grafting fusion and Apofix fixation are effective methods for atlantoaxial fracture or dislocation.

Objective To investigate drug-resistance and the genotypes of extended-spectrum ? lactamases (ESBLs) producers in Beijing Tiantan Hospital and Beijing Chaoyang Hospital. Methods Standard agar dilution method, transconjugation test, isoelectric focusing, DNA sequencing were preformed in 52 clinical isolates of Escherichia coli and Klebsiella pneumoniae. Results ESBLs producers were resistant to many antibiotics. DNA sequencing of amplicons of 52 strains revealed that ESBLs-encoded genes were CTX-M-14, 22,24 and SHV-2,12,respectively. Conclusions We should pay great attention to detect ESBLs producers and investigate their genotypes, so that we could prevent regional prevalence of ESBLs producers and utilize antibiotics reasonably.

Objective To determine the feasibility of ex vivo liposome-mediated gene transfer ( Lac-Z gene ) to lung isografts and to get expression. Methods An orthotopic rat left lung transplant model was developed with the use of a modification of the “cuff” technique. 18 SD rats were divided into three groups randomly. Gene transfer group ( group 1 ): PSV-?-gal/ liposome ( Lipofectin R○ ) complex was transfered into the donor left lung via the left pulmonary vein route at the time of lung harvesting. Liposome group ( group 2 ) and Control group ( group 3 ) : Grafts underwent the same procedure but received liposome and 0 9% saline solution respectively. Donor lungs were harvested one day after transplantation. The transgene expression of Lac-Z gene was detected by histochemical staining. Results Transgene expression of ?-gal in group 1 was detected in bronchial epithelial cells and alveolar epithelial cells. But no expression of ?-gal was found in groups 2 and 3. Conclusion Ex vivo plasmid vector/liposome complex-mediated gene transfer to lung isografts via the left pulmonary vein route is feasible. This study provides the scientific proof to the feasibility of functional gene therapy of complications such as ischemia-reperfusion injury, rejection and infection after rat lung transplantation.

Objective To explore the treatment of traumatically amputated penis and the causes of success and failure in the varieties of procedures used to heal the wound and restore function. Methods Two patients with traumatically amputated penis were treated by operation. Results In one case the operation was successful, and in the other case it was unsuccessful. Conclusion There were numerous variables contributed to the success or failure of penile replantation. The most important factors were contamination and exsanguine time of the amputated portion of the penis. The actual surgical procedures and the appropriate pre-operative and post-operative treatments were crucial to the outcome as well.