Objective To investigate the causes of acute intestinal obstruction aquired operation and to summer our diagnostic and therapeutic experience.Method Retrospective study was undertaken.Results Operations were performed on total 69 patients with acute intenstinal obstruction without perioperative death.Most common causes were malignant tumors 23 (33%), adhension 17(25%).The diagnosis mainly depend on typical history, physical examination and plain abdominal radiographs(in 90% patients) while sonography and CT were helpful in 30% patients. Laparotomy was performed on 56 cases after failure of conservative therapy including traditional medicine. Main operations included enterolysis in 18 cases, enterectomy in 14, colonstomy in 9, colonectomy in 13, enterolithotomy in 6.Conclusion Among numerous causes of acute intenstinal obstruction, malignant tumors and adhensions appear to be the most common initial diseases. Typical data from history, physical examination and plain abdominal radiographs are keys to diagnosis and treatment of acute intenstinal obstruction. CT and Sonography are valuable diagnostic procedures in some patients. Active laparotomy and appropriate operation should be considered if conservative therapy has not succeed.

Objective To evaluate the value of the methods of diagnosis and surgical intervention of liver cavernous hemangioma(LCH).Method The clinical data of 31 cases undergoing surgical treatment for LCH were retrosprectively analysed.Results Out of 31 cases,21 has only one focus each,the others has 2 or more foci each.The LCH were located only in the right lobe in 19 cases,only in the left in 9,and in both in 3.The diameter of the tumors were 10 cm(n=6).The correct diagnostic rate of BUS, CT, and Nuclear Imaging(NI) was 90.3%,95%,and 100%,respectively.Hepatectomy were performed on all 31 patients.There was no motality,and the complicative rate was 19.4%(6/31).Conclusions BUS and enhanced CT are important in discovering,diagnosing and differentiating LCH.We think that hepatectomy is the saftest and effective method for patients with LCH over 5 cm in diameter,especially for those with symtoms.

Up to now, advantages and disadvantages in the treatment of hypertensive middle_ and large_amount cerebral hemorrhage (HMLCH) by western medicine or traditional Chinese medicine,or by medical treatment or surgical treatment still exist. Mortality and disablement rate remain high. Western medicine combined with Chinese herbal medicine shows better effect in treating HMLCH, but the related research is preliminary. Therefore, thoughts of establishing comprehensive therapeutic protocols for HMLCH are presented as follows. Western medicine combined with Chinese herbal medicine is the fundamental therapeutic principle. Proper surgical operation should be employed promptly to clear away hemotoma and relieve the symptoms first according to the situation of the patient, hospital and the surgeon. Clearing heat and calming the liver, removing blood stasis and phlegm, relaxing the bowels and restoring consciousness are the fundamental therapeutic methods for HMLCH with yang_excess syndrome, and reinforcing Qi and activating blood circulation, removing phlegm and dredging channels, relaxing the bowels and restoring consciousness for yin_excess syndrome. Routine treatment and symptomatic treatment also should be taken into account.

Objective To investigate the procedures and therapeutic effects of reoperation of papillary thyroid carcinoma with lymph node metastasis.Methods The clinical data of 10 papillary thyroid carcinoma patients with lymph node metastasis received reoperation were retrospectively studied. Results Reoperation was successfully performed in 9 patients except one patient with tumor surrounding common carotid artery and brachial plexus who had partial tumor removed. Three patients had simple lymphectomy,2 had complete thyroidectomy, 2 had complete lobectomy plus ipsilateral cervical lymph node dissection and 2 had tumor resection plus cervical lymph node dissection. There were no new complications. Conclusions Papillary thyroid carcinoma has the characteristic tend to spread to spread to cervical lymph nodes. Rreoperation offers good outcome for recurrent papillary thyroid carcinoma.

Objective To establish the models with human rheumatoid arthritis (RA) synovial fibroblasts (RASFs)-cartilage-severe combined immune deficient (SCID) mice for the study of the RASFs in the pathogenesis of RA.Methods The 4th passage RASFs were marked with 5-bromodexyuridine (5-Brdu)and injected into a cavity of inert sterile gel sponge,then with the normal human cartilage co-implanted in the back subcutaneously of SCID mice to set up a novel model of RA.Osteoarthritis synovial fibroblasts (OASFs)were injected as control group.Thirty days after the surgery,the mice were killed,the grafts and the knee joints were proceed with histological study and immunohistochemistry to detect the expression of 5-Brdu and Vimentin in synoviocytes.The serum level of interleukin (IL)-6 and matrix metalloproteinase (MMP)-3 were detected with enzyme-linked immunosorbent assay (ELISA).Results Twenty-three mice survived except for one mouse in the RASFs group died of anesthesia.① Only in one case in the RASFs group,the IL-6 was detected,the others were unable to be detected.The MMP-3 in the OASFs group was (40±17) pg/ml,but in RASFs group only one case was detected.② There were 4 and 3 implanted cartilages loss in the RASFs group and OASFs group respectively.The histological scores of cartilage invasion by synoviocytes and cartilage degradation in grafts were higher in RASFs groups than in OASFs groups (0.6±0.7 vs 0.3±0.5,2.3±0.8 vs 1.7±1.0 respectively).③ The histological scores of synovial hyperplasia and cartilage invasion in the knee joints was significantly higher in the RASFs group than in the OASFs group (3.1±0.8 vs 1.7±1.0,P＜0.01,1.6±1.7 vs 0.6±1.4,P＜0.05 respectively).④ During the grafts,a lot of 5-Brdu and Vimentin markers positive synovio-cytes were found in the mice subcutaneous tissue,but manipulus positive synoviocytes were found on the area of cartilage invasion in both groups.In knee joints,single positive synoviocytes could be detected in bone marrow and hyperplasic area of the synovial tissue in both groups.Conclusion The isolated RASFs can survival and have the ability to invade and degrade the cartilage in vivo without the limitation of immunity induced inflammations,and can also migrate to the synovial joints in distance and induce arthritis.

Objective To determine the effect and safety of metallic stents in the treatment of acute malignant colorectal obstruction.Methods From May,2000 to June,2003, self-expanding metallic stents were implanted in 15 patients with acute left colonic obstruction caused by malignancies. The postoperative remission and complications were observed.Results Stents were implanted successfully in 12 cases(80.0%,12/15).Of the 12 cases,the obstruction were all disappeared within 24h. No death or colonic perforation happened in this series. Stent migration and anal pain developed each in one case after stent implantation. Elective radical resection was performed on 8 cases after bowel preparation and supportive therapy; and stents reserved permanently in other 4 cases. Conclusions The implantation of self-expanding metallic stents is a safe and effective method for the temporary remission or permanent treatment of acute left-colonic or rectal obstruction caused by malignancies,it can instead of colostomy.

Objective To evaluate the value of serum procalcitonin(PCT)on antibiotics use in treatment of acute exacerbations of chronic obstructive pulmonary disease( AECOPD). Method From May 2004 to December 2006, a total of 235 patients requiring hospitalization for AECOPD were randomly assigned into two groups: standard therapy group(group A, n = 117)and PCT-guided group(group B, n = 118) .PCT levels of all patients were measured after hospital admission by an amplified cryptate emission technology assay. On the base of similarly normal treatment, group A received antibiotics according to the attending physicians,and group B were treated with antibiotics according to serum PCT levels:antibiotic treatment was applied with PCT level ≥0.25 ng/ml and was discouraged with PCT level ＜0.25 ng/ml. Length of hospitalization,clinical efficacy,costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality,rate of exacerbation and rehospitalization within 1 year were observed. Analyses were performed by t test, Mann-Whitney U test or χ2 test. Results Clinical efficacy, hospital mortality, length of hospitalization, rate of exacerbation and rehospitalization within 1 year were similar in two groups (P =0.635,0.768,0.884,0.747,0.727) ;costs of antibiotics and hospitalization,rate of antibiotics use of PCT-guided group were lower than that of standard therapy group( P = 0.029,0.036,0.014). Conclusions PCT could be used in treatment of AECOPD for antibiotic use after hospital admission,which may reduce antibiotic use and lower costs of antibiotic and hospitalization.

Objective:To study the origin traceability of anemarrhenae rhizoma from Bozhou and Hebei based on multi-element fingerprints technology , and establish a discrimination model .Methods:The contents of 48 elements were determined by using induc-tively coupled plasma mass spectrometry ( ICP-MS) for 44 samples of anemarrhenae rhizome from Bozhou and Hebei province .Princi-pal component analysis ( PCA) and orthogonal partial least squares discrimination analysis ( OPLS-DA) were applied in the data analy-sis to screen out the significant elements .And then Fisher linear discrimination analysis was used to determine the origin of anemarrhe-nae rhizoma and the discrimination models were developed .Results:Two discrimination models were developed by the discrimination a-nalysis of the whole model method with nine significant elements identified by PCA and OPLS -DA, and 100％correct classification and 95.5％cross validation were achieved by the models .Conclusion: It is a promising approach to classify the geographical origin of anemarrhenae rhizome based on multi-element fingerprints analysis combined with multivariate statistical analysis .The discrimination models are good enough to be applied in the origin traceability of anemarrhenae rhizome.

OBJECTIVE： To analyze the characteristics of adverse drug reactions/events （ADR/ADE） caused by TCM injections in 18 third grade class A hospitals from Xi’an， and to provide reference for rational drug use in clinic. METHODS： Totally 304 ADR/ADE cases of TCM injection reported by 18 third grade class A hospitals of Xi’an were analyzed statistically during 2013-2018 in respect of gender and ages， time distribution of ADR/ADE， distribution of ADR/ADE-inducing drugs， organs/systems involved in ADR/ADE and clinical manifestations， grading of ADR/ADE， outcome and relationship evaluation， drug combination. RESULTS： Totally 6 683 cases of ADR/ADE cases were reported in same period， 304 cases were caused by TCM injection （4.55％）. Among 304 cases of ADR/ADE， the number of women （162 cases， 53.29％） was slightly higher than that of men （142 cases， 46.71％）. The age of patients was mainly over 40 years old （223 cases， 73.35％）. Among them， 118 cases （38.82％） were over 60 years old. ADR/ADE occurred within 1 min to 10 days after administration， especially within 30 min after administration （123 cases， 40.46％）. ADR/ADE involved 36 varieties， mainly including agent for promoting blood circulation and dredging， agent for reinforcing and tonifying and agent for clearing away heat and detoxification， and Danhong injection accounted for the highest proportion （43 cases， 14.14％）. A total of 352 ADR/ADE case times occurred in 304 patients， mainly lesion of skin and appendents （164 case times， 46.59％）， followed by cardiovascular system lesions （54 case times， 15.34％） and systemic lesions （51 case times， 14.49％）. The main clinical manifestations were mainly pruritus （117 case times）， followed by rash （68 case times） and palpitation （34 case times）. Among 304 ADR/ADE reports， 26 cases （8.55％） were severe， 8 cases （2.63％） were new ADR/ADE， 302 cases （99.34％） were cured or improved， 2 cases （0.66％） were unknown， but none of them died. 266 cases （87.50％） were evaluated as likely to be related. 46 patients （15.13％） had combined use of drugs， including 9 cases of combined use of TCM injection and 37 cases of combined use of chemical medicine injection. CONCLUSIONS： TCM injections had a high incidence of ADR/ADE due to the complexity of their components， individual differences and clinical use. Most of them were rapid-onset ADR/ADE within 30 min and mild ADR/ADE commonly seen in lesion of skin and its appendents. The incidence could be reduced by rational clinical use and drug monitoring. For cardiovascular diseases and other basic diseases， attention should be paid to distinguishing their primary diseases from ADR/ADE caused by TCM injections， and more attention should be paid to their individualized drug use.