Objective Turn the CT sectional image into three-dimensional imaging based on VTK, in or-der to make better treatment programs for patients with liver cancer. Methods Establish visualization toolkit (VTK) visualization development environment based on VC6.0, obtain patient's CT images in DICOM format, use VTK filter and Laplacian sharpening template for pre-treatment of the images, and then use Ray-Casting algo-rithm for three-dimensional reconstruction. Results We can get three-dimensional images with higher resolu-tion and faster imaging speed through this method, which can also be cut, rotated and zoomed. Conclusion Ray-Casting algorithm based on VTK can be used for the three-dimensional imaging of human liver. With the as-sistance of three-dimensional images, doctors can detect the location of diseased tissue more easily and observe the shapes of diseased tissue intuitively.

20/min,PaCO2 12?109 or 0.10.26 patients with sepsis infected by Gram negative bacilli were categorized as G-group,15 infected by Gram positive coccus as G+ group and 15 healthy persons as control group.All the cases were proved to have infection by body fluid examination under microscope or bacterial culture.The level of flagellin was determined by ELISA.The peripheral blood mononuclear cells(PBMC)were isolated by the density gradient centrifugation,and total RNA of PBMCs was extracted by RNA BIOzol extract.The level of TLR5 mRNA in the peripheral blood was detected by semi-quantitative RT-PCR.The statistic significance among groups was examined by Students' t test.Results Plasma flagellin levels were below the detection limit of the ELISA kit in both G+ and control groups,while the mean level of plasma flagellin amounted to 6.636?5.147ng/ml in G-group.TLR5 mRNA expression in G-group was significantly higher than that in G+ and control groups,and no significant difference was found between G+ group and control group.Conclusion Flagellin may be involved in the development of ALI through interacts with TLR5.

Objective To probe into the safety and effectiveness of transcatheter coil embolization for congenital coronary artery fistula. Methods Between May 1999 and December 2002, coil embolization of coronary artery fistula was attempted in 6 patients aged 38 to 70 years (mean, 50.7 years). The fistulae connected the left coronary artery to the pulmonary artery in 2 patients, the right coronary artery to the pulmonary artery in 2, the right coronary artery to the right infra-pulmonary vein in 1, bilateral coronary artery (the left anterior descending artery and right coronary artery) to the pulmonary artery in 1. Results Complete fistula occlusion was achieved in 5 patients (83.3%); one failed to go through the tortuous fistula and gave up coil embolization. There were no operative or late deaths and complications. Follow-up evaluation by physical examination and echocardiography in 5 patients showed no evidence of recurrent or residual coronary artery fistula. Conclusion On the basis of our result, we believe that transcatheter coil embolization of coronary artery fistula is a safe, effective and convenient procedure without a thoracotomy and the use of cardio-pulmonary bypass in some cases.

Nanotechnology is a newly rising subject.In order to reflect achievements and developments of nanotechnology,applications of nanotechnology to modern medicine are summarized,and its influences were analyzed dialectically.Nanotechnology will evoke a novel technical revolution,although there is still a long way to go before it is widely used.

Objective:To observe the influence of post-operative early enteral nutrition(EEN) for oral tumour patients.Methods:Sixty patients with oral tumour were randomly divided into EEN group (30 cases) and tradition enteral nutrition(TEN) group (30 cases). The nutritional support with Nutrision fiber started within the first 12~16 h post-operatively in EEN group, The enteral feeding started within the recovery time of the gut function in TEN group. Nutritional parameters were measured before and after the operation. Results:The mean hospitalization days in EEN group and TEN group were 10.14?1.58 and 15.29?3.26 respectively(P

Objective To investigate the clinic characteristics and treatment methods of coronary ectasia. Methods One hundred and fifty-four cases in Anzhen hospital during the last 10 years, whom with coronary aneurysm diagnosed by coronary artery angiogram and summarized the characteristics of symptom, sign, diagnosis and treatment. Results All patients were proved with coronary angiography. There were 112(72.7%)patients presenting angina, but with no specific manifestation in electrocardiogram, X-ray and echocardiogram.Thrombolysis in emergency were taken to 3 cases with acute myocardial infarction patients. One hundred and fifty-four cases were treated with aspirin or heparinizeation, and with nitroglycerin, Calcium channel blocker to dilate vessel. The followed up of 154 cases about 1-20 years, six cases were suffered with acute myocardial infarction. One of the 6 cases was reinfarction and one case was sudden death. Conclusions Angina is the main clinical manifestation and coronary angiography is the accurate diagnostic method. Long-term application with anticoagulant agent and vasodilator should be done to prevent coronary spasm and myocardial infarction. If acute myocardial infarction occurs, prompt thrombolysis should be used, if it is ineffective, coronary artery bypass grafting should be carried out.

Objective To investigate the effect of ropivacaine combined with dexanmethasone sprayed intratracheally in patients with resistant tubes and postoperative sore throat.Methods Eighty patients ASA Ⅰ-Ⅱ grade undergoing laparoscopic cholecystectomy were randomly divided into four groups by random digits tabel method,20 patients in each.2 ml of 0.75％ ropivacaine combined with 1 ml dexamethasone (group A) ; 2 ml of 0.75％ ropivacaine combined with 1 ml 0.9％ sodium (group B) ; 3 ml of 1％ tetracaine (group C); 3 ml of 0.9％ sodium (group D) were immediately intratracheal sprayed before intubation.The resistant tubes and degree of postoperative 24 h sore throat [by visual analog scale (VAS) scores],comfort [by Bruggrmann comfort scale (BCS) scores] and the incidence of sore throat were recorded.Results The resistant tubes appraised rate in group A,B and C was higher than that in group D [65.0％ (13/20),60.0％ (12/20),70.0％ (14/20) vs.5.0％ (1/20)] (P ＜ 0.05),but there was no significant difference among group A,B and C (P＞ 0.05).The incidence of sore throat at 24 h after surgery in group A,B and C was lower than that in group D [20.0％(4/20),25.0％ (5/20),25.0％ (5/20) vs.90.0％ (18/20)] (P ＜ 0.05),but there was no significant difference among group A,B and C (P＞ 0.05).The VAS and BCS scores in group A were better than those in group B,C and D [(0.52 ± 1.14) scores vs.(1.68 ± 1.42),(1.59 ± 1.33),(4.22 ± 1.95) scores,(2.80 ± 1.54) scores vs.(1.60 ± 1.19),(1.80 ± 1.20) and (0.45 ± 0.81) scores] (P ＜ 0.05),but there were no significant differences between group B and group C (P ＞ 0.05).Conclusion Ropivacaine combined with dexamethasone sprayedintratracheally can significantly increase the degree of postoperative resistant tubes,decrease the rate of sore throat after general anesthesia,and increase patient' s comfort.

Objective To evaluate the methods of standard patient (SP)combined with case-based learning (CBL ) in humanistic quality cultivation for interns in the department of thoracic surgery. Methods Medical interns in the department of thoracic surgery were divided randomly into experimental(n=30)and control group(n=30)respectively. In experimental group,SP combined with CBL was used while in control group traditional teaching was used. At the end of the study,teaching effect was assessed by the final examination and questionnaires and the data were processed by t test andX2 test. P<0.05 signifies statistical differences. Results There was no significant difference in test scores between the two groups (P>0.05). Scores of history-taking,medical check-up,paper writing quality in the final examination in experimental group were significantly higher than those in control group(P<0.01). Satisfaction degrees of doctor-patient communication,responsibility and service attitude in experimental group were better than those of control group(X2=16.484,10.335,20.376,32.851,P<0.01). Conclusions SP combined with CBL teaching method can stimulate the students' interests in thoracic surgery practice,improve the doctor-patient relationship and strengthen the ability of human-istic concern. It is a better clinical thoracic practice teaching method and it is beneficial to cultivating medical students with humanistic concern.

Objective:To develop a luminescent oxygen channeling immunoassay for pregnancy associated plasm a protein A.Methods:The monoclonal antibody of PAPP-A was labeled with biotin ,the polyclonal antibody of PAPP-A was coated on receptor particles.The LOCI reagents also contained sensitizer particles coated with streptavidin.The optimal test conditions and analytical per-formance of the method were studied.Results:The within-run and the between-run coefficients of variation were 5.91%-7.94% and 6.14%-9.69%,respectively;the analytical sensitivity was 2.8 mU/L and the function sensitivity was 4.6 mU/L,good linear in 2.8 mU/L-8 000 mU/L range;the recovery rate was 96.7%-100.3%.The interference rate of hemolysis , icterus and triglycerides were less than 10%; there is no Hook effect of PAPP-A concentrations up to 8 000 mU/L;the correlation coefficient between clinical samples detection results and Time resolved fluoroimmunoassay analysis results was 0.974.Conclusion:This LOCI can be used for the quantitative of serum PAPP-A,and detection performance in line with the requirements of clinical diagnostic reagents .

Objective To evaluate the effect of remifentanil pretreatment on myoclonus after etomidate injection.Methods Sixty patients undergoing scheduled for intestinal endoscopy under general anesthesia were divided into remifentanil group and control group by random digits table method with 30 cases each.Before 0.3 mg/kg etomidate was given,the patients in remifentanil group and control group were pretreated with remifentanil 0.5 μ g/kg or amount of 0.9％ sodium chloride.Myoclonus was observed and recorded.Nausea,pruritis and apnea were observed after procedures.Results The incidence of myoclonus was 73.3％(22/30) in control group,mild in 11 cases,moderate in 10 cases and severe in 1 case.The incidence of myoclonus was 6.7％(2/30) in remifentanil group and mild in 2 cases.There was significant difference in the incidence of myoclonus between two groups (P ＜ 0.01).In control group,the ratio of myoclonus was 14/16 in males and 8/14 in females.In remifentanil group,male and female each had 1 case of myoclonus.There was no nausea,pruritis and apnea in remifentanil group.Conclusion Pretreatment with 0.5 μ g/kg remifentanil reduces myoclonus after etomidate injection,male patients are more associated with the incidence of myoclonus than female patients.