Objective To improve the understanding of systemic mastocytosis(SM) with associated clonal haematological non-mast-cell lineage disease (SM-AHNMD). Methods The clinical and laboratory features, treatment and prognosis of a rare case of SM-AHNMD was reported and the related literatures were reviewed. Results As the second most common subtype of SM, SM-AHNMD mainly has multifocal dense infiltrates of mast cells detected in sections of bone marrow and/or other extracutaneous organs, and some special cytology or biochemical markers(toluidine blue staining,tryptase,CD117,CD25 and/or CD2) results are positive. C-kit mutations are found in most adult patients. SM-AHNMD also has clinical characters of other clonal haematological non-mast-cell lineage disease (HNMD), such as myelodysplastic syndrome,myeloproliferative neoplasms, acute myeloid leukemia. Conclusion SM-AHNMD meets criteria for SM and other HNMD. Treatment for SM-AHNMD is mainly about the therapy of HNMD, and the prognosis greatly depends on the accompanying hematological disorder.There is no special treatment for SM,and the treatment should be directed at symptomatic control.

Objective To evaluate the possible effect of percutaneous transluminal coronary angioplasty(PTCA) on myocardial injury. Methods Serum cTnI and CK MB levels were measured in 173 patients with coronary artery disease undergone PTCA before and 6, 12, 24, 48 and 72 hours after the procedure. Cardiac events during follow up in these patients were recorded. Results Serum cTnI level was increased after PTCA in 42 patients, remained normal in 84, and was over baseline level before and after the procedure in 47. Serum CK MB level was above baseline before and after the procedure in one patient and increased in 10. Compared with normal cTnI group, elevated cTnI was related to total balloon inflation time, total pressure, number of dilation and stents deployed, contrast medium dose and occurrence of angina during balloon inflation ( P 0.05). Conclusion cTnI was more sensitive and specific than CK MB in identifying minor myocardial injury during PTCA. This injury was related to the intensity of PTCA, but not enough to make worse influence on overall outcome.

0.05).Conclusion hs-CRP and TCH/HDL-C are closely associated with the stenosis,their combined detection would also be helpful in the evaluation of the severity of coronary artery disease.

Objective: To compare the effects of deliberate hypotension and hemorrhagic hypotension on systemic and renal hemodynamics in dogs. Method: Twelve mongrel dogs were randomly divided into nitroprusside-deliberated hypotension group and hemorrhagic hypotension group. After surgical preparation, the MAP of the dogs was decreased to 8kPa either by infusing nitroprusside or by withdrawing arterial blood and was kept for 30 min. RBF, MAP, HR, CO and CVP were monitored continuously. Result: Hypotension induced by hemorrhage was associated with significant decrease in CO, SV and CVP compared with nitroprusside. There was no significant change in HR in both groups. Hemor rhage caused more decrease in RBF than nitroprusside did (59.0% vs 37.5%). In recovery period, RBF in both groups increased, but remained significantly less than baseline in hemorrhage group. Conclusion: Hemorrhage can cause more pronounced interference in hemodynamics and more decrease in RBF with a subsequent slower recovery than with nitroprusside at the same level of hypotension.

Objective:To compare the effects of induced hypotensions with sevoflurane and nitroprusside on hemodynamics in dogs. Method:Fourteen mongrel dogs were randomly divided into sevoflurane group and nitroprusside group. After experimental preparation,the MAP was decreased to 8kPa and was kept for 30min either with sevoflurane inhalation or with nitroprusside infusion. MAP, HR,CO,CVP,SV and SVR wrer monitored continuously. Result: During induced hypotension, CO in sevoflurane and nitroprusside groups decreased by 30.7% and 21.6% respectively; HR decreased significantly in sevoflurane group, but not in nitroprusside group; SVR in both groups showed reduction, but more pronounced in nitroprusside group. However,after the termination of sevoflurane or nitroprusside, MAP elevated over baseline with the significant increase of SVR,and CO remaining low. Conclusion:As compared with nitroprusside, sevoflurane has inhibitory effect on circulation,yet it is still efficient to induced hypotension.

Objective To evaluate protective function of ischemia preconditioning for myocardium during percutaneous transluminal coronary angioplasty (PTCA), using cardiac troponin I (cTnI) as myocardial injury marker. Methods One hundred and fifty patients with coronary artery disease (CAD) undergoing PTCA were divided into two groups: Group Usual Cure (G-UC), including 120 cases, and Group Ischemia Precondition (G-IP), including 30 cases. Serum cTnI were measured before and 6, 12, 24, 48 and 72 hours after the procedure respectively. The relative factors were analyzed. The cardiac events were followed-up.Results The serum cTnI levels of 29 cases elevated in G-UC, while those of 2 cases elevated in G-IP. There was statistical difference on elevated cTnI levels between the two groups (P

Objective To evaluate the efficacy of endoscopic injection hemostasis and sequential application of sandostatin in treatment of Dieulafoy's lesion. Methods After diagnosis of Dieulafoy's lesion confirmed, endoscopic injection hemostasis(EIH) together with mixture hypertonic saline and epinephrine(HSE) was performed, and then sandostatin was given consecutively for 7 days. The control group included the patients who were not given sandostatin or given just for 1 to 2 days. Results The rates of recurrent bleeding and transfer into surgery in sandostatin group were significantly lower than those in control group,(12.5% and 6.3% versus 53.8% and 46.2% respectively, P

Objective To explore the neuroprotective mechanism of mild hypothermia by studying the effect of mild hypothermia on neuronal apoptosis after transient global cerebral ischemia in rats.Methods A model of transient global cerebral ischemia was made by bilateral common carotid artery occlusion and hypotension in rats. The neuronal demage in the CA 1 section of the hippocampus after cerebral ischemia was observed by nissel body stain mothed;apoptosis was detected by in situ end-labeling of fragmented DNA using the terminal deoxynucleotidyl transferase reaction (TUNEL) and the electrical microscope.Results The hippocampal CA 1 section neurons in normothermic ischemic group were significantly deficit as compared with the false operative group in mild hypothermic ischemic group (P

Objective To evaluate the efficacy and safety of transplantation of autologous bone marrow mesenchymal stem cells (BMSCs) and mononucleus cells (BMMNCs) for treating coronary heart disease. Methods Ten patients who had suffered from coronary heart disease with myocardial infarction, were selected. In 7 patients BMSCs+BMMNCs were transplanted immediately following PCI and 3 patients only accepted transplantation of BMSCs+BMMNCs without PCI. Autologous BMSCs+BMMNCs were isolated and cultured for 2-3 weeks. And (0.9～3.5)?106 BMSCs+1.6～6.1?106 BMMNCs were transplantated through intracoroary way. Cardiac functions were determined by 2-D echocardiography、 technetium- 99m methoxyisobutylisonitrile ( 99m Tc-MIBI) and ECG Holter monitor before and 6 months after the procedure. Results Left ventricular ejection fraction (LVEF) was significantly increased by 10.5% (4.0%-18.0%) and left ventricular diastolic diameter(LVDd) reduced by 2.2 mm (-4 mm-8 mm) and neither obvious arrhythmia nor complication was observed during the 6-12 months′ follow up in all the 10 patients. Conclusion The preliminary study showed that in the patients who suffered from coronary heart disease complicated with myocardiac infarction, transplantation of BMSCs+BMMNCs could improve cardiac function and cardiac perfusion without significant complication and arrhythmia during the 6-12 months′ follow-up.

Objective To study the prevention and treatment of intra- or post- operative complications of radiofrequency ablation (RFA) for hepatic malignancy. Methods A series of 353 patients with primary hepatic carcinoma or secondary hepatic malignancy verified by pathological examinations and clinical manifestations underwent 452 times of RFA between October 1999 and March 2003, including 344 cases of percutaneous RFA and 9 cases of RFA during open surgery. There were 198 cases of primary hepatic carcinoma previously unoperated, 81 cases of recurrent hepatic carcinoma after surgery, and 74 cases of secondary hepatic malignancy. All the patients were followed up to make out short- or long-term surgical complications. Results Complications happened in 12 cases: skin burn by the electrode (2 cases), pneumothorax (1 case), right hydrothorax (1 case), vena cava thrombus (1 case), right bile duct injury and stricture (1 case), gastric external fistula (1 case), bile leakage in the left lateral lobe of the liver (1 case), hepatic abscess (1 case), external fistula of the ascending colon resulted from hepatic abscess (1 case), internal fistula of the duodenum, liver and right thorax resulted from hepatic abscess (1 case), and intra-abdominal hemorrhage (1 case). The incidence of complication was 2 65% (12/452) and the complication-related mortality was 8 33% (1/12). Conclusions RFA is a kind of minimally invasive procedure. But RFA especially percutaneous RFA may involve some risks for patients with the tumor located at the porta hepatic or the surface of the liver, or adhered to hollow organs, especially those who had a history of abdominal operation and adhesions of hollow viscera to the liver. Some complications can be prevented and effectively treated in the event of proper selection of patients, careful performance during the surgery, intensive postoperative care, effective hemostasia and efficient infection prevention.