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.

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

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.

The quail model of hyperuricemia combined with abdominal obesity was induced by high purine diet.Body weight in model group showed no change.Serum uric acid level in model group was increased significantly on 7,14,21,and 28 d( P＜0.05 or P＜0.01 ).Abdominal fat index in model group increased significantly on 28d.On 7 d and 28 d,serum free fatty acid level was increased significantly.Acetyl-CoA carboxylase( ACC ) protein expression in the liver of model quail was increased as shown by ELISA and immunohistochemisty ( P＜0.05 or P＜0.01 ),suggesting that the alteration of ACC expression contributes to the pathogenesis of hyperuricemia combined with abdominal obesity.

Objective To observe the effects of ischemic preconditioning of hindlimb (HIP) on the expressions of heat shock protein70 (HSP70) in spinal cord of rats after spinal cord injury (SCI). MethodSprague Dawleys rats were randomly( random number) divided into three groups (20 rats in each group).In sham injury group, rats received laminectomy without SCI; while in the SCI group, rats received traumatic SCI. In HIP group, rats received HIP 8 h before SCI. The SCI animal models were made by using modified Allen's weight-drop device (50 g·cm) on L3-L4 vertebrae. HIP was induced by compressing the two lower limbs of rats alternately with a tourniquet for three cycles of ten-minute ischaemia followed by ten-minute reperfusion. Rats were sacrificed 24 h and 48 h after injury separately. The protein and mRNA of HSP70 of involved spinal cord segments were determined by using RT-PCR, hybridization in situ and immunohistochemistry. Results There was weak expression of HSP70 mRNA in rats of sham injury group, and sporadic positive cells in spinal tissue were found by using immunohistochemistry. The expressions of HSP70 mRNA 24 h and48 hours after SCI in HIP group[(22.18±3.69) and (14.15 ±4.18)] were higher than those in SCI group[(13.97±4.46) and ( 8.73 ± 3.55 )], and the differences were statistically significant (F=16.06, P = 0.005 and F = 7.43, P = 0. 028). The protein levels of HSP70 24 h and 48 hours after SCI in HIP group [(16.71±4.02) and (9.85±2.20)] were higher than those in SCI group [( 14.85 ± 3.73)and (8.78 ±2.05)], and the differences were statistically significant (F =90. 13, P =0.032 and F=34.70, P = 0. 036). Conclusions HIP can increase the transcription and expression of HSP70 in spinal cord of rats following SCI and may have the protective effects on neural tissue.

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.

Objective To study the angiogenic effects of adenovirus mediated human vascular endothelial growth factor 165 and human angiopoietin-1 (Ad 5-VEGF 165 , Ad 5-Ang-1) in rat models of hindlimb ischemia. Methods Rat models of hindlimb ischemia were established by ligation and peeling off rat′s femoral arteries. Ad-VEGF 165 and Ad-Ang-1 were intramuscularly transferred into the rat ischemic hindlimbs. The expression of VEGF 165 and Ang-1 were examined by Western blotting. Immunohistochemistry was performed to illustrate the effects on rat ischemic muscles after gene transferring. Results (1) Western blotting showed a high expression of VEGF 165 and Ang-1 in the ischemic hindlimb muscle transferred with Ad 5-VEGF 165 and Ad 5-Ang-1 VEGF 165 respectively. (2) There was no significant difference between groups on 7 days after the transfer. The capillary to muscle fiber ratio was significantly higher in the treating groups than that in control groups and were significantly higher in VEGF 165 +Ang-1 group than in VEGF 165 or in Ang-1 groups on day 14th and day 21th. (3) Many structured vessels surrounded by a layer of smooth muscle cells were found in Ad-VEGF 165 and Ad-VEGF 165 +Ad-Ang-1 groups, the number of SMA + vessel per muscle fiber was obviously higher than those in control groups. (4) Enormous cells positive for BrdU appeared in treated muscles in Ang-1, VEGF 165 , VEGF 165 +Ang-1 groups and many of them were positive for C-Kit, an antigen expressed by pluripotent marrow stem cells. Some C-Kit+ cells were incorporated in sites of neovascularization. Conclusion (1) Vascular endothelial growth factor 165 and angiopoietin-1 can promote neovascularization in rat models of hindlimb ischemia and the angiogenic effect is much more significant in Ad-VEGF+Ad-Ang-1 group. (2) VEGF 165 can increase the number of vessles that are coated with smooth muscle cells which shapes are similar to arterioles. (3) Not only angiogenic effect but perhaps vasculogenic effct also contribute to the neovascularization.