Objective To evaluate the efficacy of endovascular stent-graft placement for the treatment of Debakey Ⅲ type aortic dissection. Methods From June 2001 to July 2006, 31 patients with Debakey Ⅲ type aortic dissection were diagnosed by contrast-enhanced CT scan. Vascular access was obtained through the right or left femoral artery after arteriotomy and stent-graft was deployed into the true lumen to occlude the primary entry tear. Immediate aortography was performed after the procedure and the follow-up data of CT scan were evaluated. Results Stent-graft deployment was successfully performed in all the patients. Immediate aortography after the procedure showed no leakage in 27 patients and minor leakage in 4. After the operation, one patient showed paraplegia, and one developed left arm ischemia. No stent movement or organ ischemia was found at the early postoperative stage in the other patients. Six months after the operation, in all the 31 patients, contrast-enhanced CT scan showed the disappearance of the false lumen and thrombosis at the level of the stent; and the minor leakage of was improved in the 4 patients. Four years after the operation, one patient developed severe internal leakage at the approximal end of the stent, and was treated by thoracotomy. Conclusions Endovascular stent-graft placement is effective for the treatment of Debakey Ⅲ type aortic dissection. However, further studies are needed to evaluate its long-term outcomes.

Acute massive pulmonary thromboembolism after pneumonectomy usually results in death if not diagnosed early and treated aggressively.It was a case of acute embolism in the main pulmonary ar-tery with thrombus following right pulmonary wedge resection.Diagnosis was made clinically and with computerized tomography before emergency surgery.Thromboembolectomy was successfully performed on cardiopulmonary bypass and the patient was subsequently discharged home after uneventful recovery.Al-though the patient had no previous history of thrombosis,he took high dose of warfarin for anticoagulating postoperatively,which suggested that the patient with pulmonary embolism attack may be associated with the hypercoagulable state of his own.

There is a close relationship between osteoporosis and osteoarthritis .The joints of bearing weight often suffer the osteoarthristis with osteoporosis .There are some symptoms in the disease ,such as pain and motion disorder ,and joint abnormality in late＋ stage .The principle of rehabilitation is to improve osteoporosis , release pain and increase the function if motion .The treatment includes medicament ,acupuncture ,injection ,rehabilitation ,psychology and surgery therapies .The injection can release pain effectiverly .The methods of rehabilitation include physical therapy,exercise ,massage ,and occupational therapy.These therapies can release pain ,improve motion and increase the quality of life .The article reveiws the clinical symptoms ,diagnosis and treatment ,especially the rehabilitation therrapy.

Proteomics is a new field of studying the protein and its dynamic axiom of transmutation in cells.In recent years,it has been used as a powerful tool in research of life science.Proteomics functions as a new method to investigate the pathogenesis of diseases.In this article,the up-to-date information of proteomics technologies in autoimmune disease research are reviewed.

The paper first discusses the concept of hospital performance management systems and their relationship with the business systems and then dwells on the framework of the performance management systems, including extended business systems, database systems of shared business, subject driven systems and commercial intelligence systems. It also gives an account of the results of actual application of the Hospital Operational Performance Management Systems developed by the hospital the authors work with.

The paper was aimed to review the modeling methods of spleen-yang deficiency, which can be classified into imitating traditional Chinese medicine (TCM) etiology methods and modern medicine methods. At present, methods of modeling were not generally accepted and the main presented problems were as follows. Modern medicine methods did not conformed to the rules of TCM etiology and pathogenesis. The evaluation of yang deficiency models was not accurate. Some modeling methods can lead to other diseases at the same time. The names of spleen deficiency model were not unified. It was difficult to distinguish the modeling methods of spleen-yang deficiency and spleen-qi deficiency, and etc. Model evaluation of spleen-yang deficiency was various. However, the domestic standard evaluation system had not been formed. The main model evaluation problems were as follows. Macro symptoms of the model lacked of objective and quantitative evaluation. It lacked of evaluation indexes of pulse and tongue with TCM characteristics. The disproof of prescription selection was not unified. Similar syndromes had not been ruled out. The microscopic indexes were fragmented, and etc. This paper reviewed on animal modeling methods of spleen-yang deficiency.

This paper introduces the development and application of health-related quality of life (HRQOL) scales in research on coronary heart disease (CHD). Currently, the scales for CHD patients have been more systematically developed and widely used in foreign countries, while domestically in China, they are developed successfully but problematically; research in this field has started later and the scales introduced are limited and not suitable for the entire range of domestic CHD patients. Thus, this paper introduces 26 HRQOL scales in research on CHD, including five generic scales, ten disease-specific scales from abroad and eleven scales originating from China. With the deficiency of HRQOL scales, especially that in traditional Chinese medicine and specific scales, this paper analyzes and summarizes the problems existing in development of scales. The authors also provide solutions in order to help the development and application of scales in further studies.

ObjectiveTo investigate the efficacy and toxicity of postoperative radiochemotherapy compared with chemotherapy alone in the treatment of locally advanced gastric cancer.MethodsA total of 83 patients with resected adenocarcinoma of the stomach were randomly assigned to postoperative radiochemotherapy group (RCT) ( n =43 ) or chemotherapy alone group (CT) ( n =40 ).Patients in RCT group received radiotherapy concurrent with capecitabine chemotherapy then followed by 4 - 6 cycles of FOLFOX4 chemotherapy.The total dose of radiation was 45 Gy.The dose of capecitabine was 1600 mg/m2per day.In the CT group,patients received 6 - 8 cycles FOLFOX4 chemotherapy.Survival was analyzed using Kaplan-Meier method and Logrank test. Results The follow-up rate was 96％. The number of patients who had a minimum of 2-,3-year follow-up time were 37,12 in the RCT group and 31,10 in the CT group.The 1-,2-,3-year local control rates for RCT and CT groups were 100％,97％,94％ and 95％,87％,73％ (x2 =4.54,P =0.033),respectively.The 1-,2-,3-year survival rates were 98％,86％,81％ in the RCT group,with 93％,80％,64％ in the CT group ( x2 =3.96,P =0.047 ).The incidence of grade 3hematological toxicity in the RCT and CT group was 23％ vs 15％ ( x2 =0.93,P =0.630 ),and grade 3gastrointestinal toxicity was 16％ vs 10％ ( x2 =0.95,P =0.624 ). Conclusions Compared with chemotherapy alone,postoperative radiochemotherapy can improve survival of locally advanced gastric cancer patients with acceptable toxicities.

Objective To analyze the natural development of the residual subluxation after early close reduction for developmental dislocation of the hip,and to seek the early surgical timing and indication.Methods The research included 36 patients (48 hips) born before January 2000 who showed residual subluxation after close reduction in one year.All of patients had serial X-ray radiographs at every follow-up point.The radiographs were assessed using acetabular index (AI),Reimers index,center edge (CE) angle and the orientation of the sourcil of the acetabulum.The last follow-up results were evaluated according to the Severin classification,and Severin grade Ⅰ and Ⅱ were defined as satisfactory group and Severin grade Ⅲ and Ⅳ as unsatisfactory group.Then we compared and analyzed the serial radiological parameters between satisfactory and unsatisfactory groups.Results The mean age at close reduction was 1.6 years.At the last follow-up,the mean age was 13.8 years.The satisfactory group comprised 18 hips (37％),whereas the unsatisfactory group comprised 30 hips (63％).At the age of three to four years,there was a significant difference between the two groups in the Reimers index (34.4％±4.5％ vs.43.0％±4.6％,P ＜ 0.05).And at four to five years old,there were significant differences for both Reimers index and CE angle (29.3％ ±7.2％ vs.40.0％±6.2％,P ＜ 0.05; 21.0°±5.5° vs.10.6°±5.2°,P ＜ 0.05).When the Reimers index ＞38％ at the age of three to four years,18 of 18 hips fell into the unsatisfactory group.And when Reimers index ＞33％ at the age of four to five years,26 of 30 hips had unsatisfactory result,and in addition to that the sourcil orientation was upward,26 of 26 hips fell into the unsatisfactory group.Conclusion To avoid early osteoarthritis,surgical correction for residual subluxation was recommended if the Reimers index ＞38％ at the age of three to four years or the Reimers index ＞33％ with the sourcil upward at the age of four to five years.

Objective Endogenous cadiac stem cells become the famous star in the cardiac regeneration field in recent years.But the biological behavior of cardiac stem cells has not been fully explained clearly.This experiment intends to research the cardiac stem cell niche and its characteristics,as well as the succinct method for cardiac stem cells (Cardiospheres derived cells) culture in vitro.Methods Hearts from four 8-week-old SD rats were cut into pieces less than I mm3.Then,the small tissues were digested by trypsogen and collagenase in turn.And the undigested myocardium was collected and cultured in media until the de novo cells bespread the pertri-dish bottom.The 3rd generation of cardiac stem cells were harvested and prepared for immunofluorescence to detect the expression of related molecular markers,so as to identify the differentiation of these stem cells.Then,the cultural tissues were collected and embedded in paraffin,and the H-E staining,Masson staining,immunoflnorescence and TUNEL apoptosis assay were carried out.In addition,EdU was added into the medium and cuhured for 72 hours before the cultural tissues were harvested so as to label the proliferative cells.Results After 7 ～ 10 days in culture,some small,round and phase-bright cells aresed from the adherent plated tissue.These cells had the spontaneous differentiation potency in vitro culture.The immunofluorescence shows mitotic phase cells were c-kit positive,and most of passage cells were α-sarcomeric actin 、cardiac troponin T、flk-1 and vemintin positive while CD90 negative,but few of them were α-smooth muscle actin 、conexin-43 、CD31 and CD45 positive.There were lots of newborn cells grow exuberantly while accompanied apoptosis of myocardial cells in the paraffin section.The myocardial collagen remodels in the cultural myocardial tissues at the same time.The proliferative cells in the cultural tissues were EdU positive.Throe myocardium within the cultural tissues were MMP-2、MMP-9 and TGF-β1 positive,On the contrary,the proliferative cells were almost negative when stained with those antibodies.Conclusion Conclusions It's a convenient way to harvest cardiac stem cells by the use of myocarlial? tissues cultured in vitro.Those stem cells grow and proliferate in the cultural myocardial tissues accompanied with the degradation of extracellular matrix.Cardiospheres derived stem cells have the spontaneous differentiation potency when cultured in vito,and should be a promising? seed cells for stem cell therapy.