Objective To analyze and compare the emergency therapeutic methods for renal colic,and to explore the preferable way of emergency therapies for renal colic.Methods A total of 340 cases of renal colic in emergency department were randomly divided into groups A (pethidine),B (diclofenac sodium),C (phloroglucinol),and D (diclofenac sodium + phloroglucino).The average time of therapeutic effect after given 30 min in different groups was observed.Results The average time of effect in group A [(9.53 ±3.34) min],group D[(10.49 ±2.54) min],and group B[(10.51 ±2.27)min] and they were much shorter than group C [(18.51 ±4.86) min] (P ＜0.01).There was no significant difference in the effective rate among the 4 groups(P ＞ 0.05).The relapse rate of group C (11.43％) and group D (9.00％) were much lower than group A (24.59％) and group B(23.75％).There was no adverse reaction in group C.The rates of adverse reactions in group B (2.27％) and group D (2.78％) were much lower than group A (27.27％).Conclusions Diclofenac sodium combined with phloroglucinol was preferable emergency treatment for renal colic.

Objective:To establish an animal model of slow transit constipation and the pathobiological changes in interstitial cell of Cajal in colon. Methods:The mouse model was established by subcutaneous administration of morphine. Fecal weight was recorded daily. Transit functions of intestinal movement were examined by activated charcoal suspension pushing test and the changes of interstitial cell of Cajal were observed by immunohistochemical methods. Results:Compared with the controlled mice, there was a significant decrease in fecal weight daily(P

Objective To evaluate the clinical application value of MR/DSA- 3D fusion software. Method Fusion imaging was made with fusion software after performing MR and DSA examinations on nine cerebrovascular diseases sufferers. Results The fusion image of six sufferers could display the exact part having pathological changes to cerebral vessel and specify the relationship between the tissue of pathological changes and cerebral vessel, offering a scientific basis for clinics and the fusion images of three sufferers were not ideal. Conclusion MRDSA-3D fusion software can provide image with high diagnostic accuracy and treatment precision.

Objective To study the clinical application of Multi-slice spiral CT angiography (MSCTA) in renal arterial stenosis. Methods 36 patients clinically suspected of renovascular hypertension were examined by 16 slice or 64 slice spiral CT angiography. After scanning , three dimensional reconstruction of the blood vessels were operated. 28 cases were detected diseases of renal vessels and perivascular, and then compared with DSA. Results In the 36 cases, MSCTA showed 19 renal areterial stenosis, 3 adrenal gland neoplasms, 2 adrenal hyperplasia, 1 polycystic kidney disease. In 19 cases with MSCTA , there were 2 double renal areterial stenosis and 2 renal areterial anatomical variants. DSA showed 21 renal areterial stenosis with various degree, the accordant rate of MSCTA and DSA exceeded 90%. Conclusion MSCTA play an important role in clinical application in diagnosis of renal arterial stenosis.

Objective To evaluate the value of Bolus chase technology for angiography of lower extremity. Methods 12 cases with diabetes foot or leg pain were examined with Bolus chase technology. Results Low extremity artery thrombosis was found in 12 cases. Conclusion Bolus chase technology is better than standard DSA in the display of lower extremity vessel.

OBJECTIVE To study the isolation,distributive characteristics and drug resistance of AmpC enzyme producing Gram-negative bacilli in nosocomial infection of two years and provide the evidence for treatment. METHODS A total of 528 strains of Gram-negative bacilli collected from daily specimens were identified with Bio-Fosun-Ⅰ,and AmpC enzyme was screened by cefoxitin disk and then corroborated by EDTA disk method. All data were analyzed statistically. RESULTS Among 528 strains collected,136 (25.75%) were AmpC enzyme producing strains,the respective percentage of Pseudomonas aerugionsa,Echerichia coli,Enterobacter cloacae,Klebsiella pneumoniae and Citrobacter was 32.35%,28.67%,18.38%,8.09% and 5.15%,respectively. Most strains (38.9%) were detected in ICU. The common infection sites were lungs. The resistance rate of AmpC enzyme producing strains to the first,second and third-generations cephalosporins was 71.3-99.5%. The susceptive rate of AmpC enzyme producing strains to imipenem,cefepine,amikacin and piperacillin/tazobactant were low. CONCLUSIONS For effective supervision and control of AmpC enzyme producing Gram-negative bacilli in nosocomial infection,detection of AmpC enzyme shoud be paid much attention by clinical microbiology laboratory.

Objective To investigate the risk factors for postoperative liver failure of patients with hepatocellular carcinoma (HCC) and bile duct tumor thrombus through a risk evaluation model.Methods The clinical data of 107 patients with HCC and bile duct tumor thrombus who received hepatic resection at the Eastern Hepatobiliary Surgery Hospital from March 2002 to February 2011 were retrospectively analyzed.All patients were divided into the non-liver failure group (98 patients) and liver failure group (9 patients).Risk factors associated with liver failure were analyzed and a risk evaluation model was established.All data were analyzed using the bivariate regression model,and factors with significance were further analyzed using the multivariate regression model.Results Of the 107 patients,105 received hepatic resection + choledochotomy + thrombectomy and 2 received hepatic resection + extrahepatic bile duct resection + cholangiojejunostomy.The operation time was 2.0-5.5 hours,and the intraoperative blood loss was 200-3500 ml.In the non-liver failure group,5 patients had pleural and peritoneal effusion,3 had biliary bleeding,2 had incisional infection,1 had biliary infection,1 had bile leakage,1 had stress-induced ulcer of upper digestive tract and 1 had thoracic epidural hematoma.The bleeding of the patients with thoracic epidural hematoma was stopped after thoracic spinal decompression,but subsequent paraplegia occurred.In the liver failure group,2 patients died of postoperative acute liver failure,and 7 patients died of postoperative subacute liver failure (death caused by tumor recurrence or medicine was excluded).The results of univariate analysis showed that preoperative total bilirubin,albumin,pre-albumin,albumin/globulin ratio,distribution of tumor thrombus,operative blood loss and ratio of postoperative residual liver volume to the total liver volume were correlated with the postoperative liver failure in patients with HCC and bile duct tumor thrombus (OR =3.017,0.191,0.248,2.681,9.048,4.759,13.714,P ＜ 0.05).The results of multivariate analysis showed that preoperative total bilirubin ＞ 256.5 μmol/L,albumin/globulin ratio ≤ 1.3 and postoperative residual liver volume ＜ 50％ were the independent risk factors of postoperative liver failure (OR =5.537,11.107,172.450,P ＜ 0.05).The risk evaluation model was Z =1.77 × preoperative total bilirubin + 2.408 × preoperative albumin/globulin ratio + 5.150 × ratio of postoperative residual liver volume to the total liver volume-17.288.The risk of postoperative liver failure increased as the increase of Z value.The risk of postoperative liver failure ＞ 50％ when the Z value ＞ 0.Conclusions Preoperative total bilirubin ＞ 256.5μmol/L,albumin/globulin ratio ≤ 1.3 and postoperative residual liver volume ＜ 50％ were the independent risk factors of postoperative liver failure.Risk evaluation model is helpful in screening the risk factors so as to decrease the incidence of postoperative liver failure.

Objective To evaluate T cell and CD4+ CD28-T in the development and progression of abdominal aortic aneurysms (AAAs).Methods Fifty Wistar rats were randomly divided into 5 groups (n =10 each).An AAA animal model is established by enhancing perfusing elastase to the infrarenal abdominal aorta of the rats.The levels of T cell,B cell and macrophage cell of abdominal aorta of the rats on days 3,7,14 and 28,were detected by enzyme linked immunosorbent assay(ELISA).CD4+ CD28-T cell of the peripheral blood were measured by flow cytometry.Result There was significant T-lymphocyte infiltration both in middle and outer membrane of the artery of the rats on day 7 after surgery.T-lymphocyte,B-lymphocyte and macrophage cell infiltration were on the peak in middle and outer membrane of the artery on day 14 after surgery.The ratio of CD4+ CD28-T cell in rat peripheral blood reached peak on day 7(P ＜0.05).Conclusions T cell and CD4+ CD28-T cell expression increased in peripheral blood and abdominal aorta in AAA rat model,suggesting a potential role of T cell and CD4+ CD28-T cells in the pathogenesis of AAAs,especially during the early development of AAAs.

Objective To investigate the clinical value of serum procalcitonin (PCT) in the diagnosis and treatment of the patients with high fever of acute illness.Methods A total of 285 febrile patients suffered from acute illness were divided into the conventional group (n =122) and the PCT group (n =163).The routine blood examination and serum level of C-reactive protein (CRP) detection were carried out for the dignosis of these febrile patiens of two groups,and in addition,serum PCT determination was carried out in the patients of PCT group.The diagnosis was comnfirmed by etiology or immunologic assays.Routine guidelines of administrating antibiotics were used for treatment in the conventional group.Whereas the antibiotic therapy given to patients of PCT group was guided by the serum PCT levels.Two groups were compared in respect of the antibiotics costs,duration of treatment with antibiotics,percentage of patients treated with antibiotics,efficiency of antibiotics treatment and the mortality rate.The patients of PCT group were further divided as per inflammatory markers of bacterial infection into three subgroups,namely bacterial infection group,viral infection group and non-infection group.At last,the relationship between serum PCT level and the prognosis of patients was analyzed.Results The cost of antibiotics,percentage of patients treated with antibiotics,and course of antibiotics treatment were (Y) (3586.5 ± 703.3),95.08％ and (15.01 ± 11.21) days,respectively in conventional group,whereas (Y) (1871.2 ± 433.5),54.60％,(11.22 ±7.10) days in PCT group with statistically significant difference between two groups (P ＜ 0.01),but there were no significant differences in clinical efficiency and mortality between groups (P ＞ 0.05).Serum PCT (1.12 ± 0.88) ng/ml in bacterial infection group was higher than that in both virus infected group (0.21 ± 0.1 1) ng/ml and non-infected group (0.18 ± 0.13) ng/ml.There was no statistics difference in serum PCT level between virus infected group and non-infected group (P ＞ 0.05).The diagnosis of bacterial infection with serum PCT was better than other inflammatory markers because serum PCT had high sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV).Conclusions Serum PCT level was reliable to differentiate the nature of acute infection with high fever and to evaluate the prognosis by emergency physicians.There was an important significance for rational use of antibiotics by the guidance of PCT levels.

Objective To study the effects of the antiarrhythmic drugs of propafenone, amiodarone and dilthiazem on c-type Kv1. 4 channels in Xenopus laevis oocytes with two-electrode voltage-clamp technique. Methods Defolliculated oocytes ( stage Ⅴ - Ⅵ) had transcribed cRNAs of ferret Kv1. 4△N channels injected. The oocytes were continuously perfused with control solution or propafenone, amiodarone and dilthiazem under monitoring of software of Clampfit v 9. 0. Results All of the three drugs blocked ferret Kv1. 4△N channel in voltage-, frequency- and concentration-dependent manners. The values of IC50 (50%inhibiting concentration ) of propafenone, amiodarone and dilthiazem were ( 103.4± 2. 2 ) μ mol/L,(501.22 +5.9) μmol/L and (353.62 +9.9) μmol/L, respectively. The currents under the actions of propafenone , amiodarone and dilthiazem were decreased to 41%, 32% and 21% of control group, respectively. Propafenone (100μ mol/L), Amiodarone (500μmol/L), dilthiazem (350μmol/L) inhibited currents to (54. 6 + 1.9 ) %, ( 46. 3 + 3.5 ) %, ( 52. 8 ± 2. 8 ) % of control group in voltage-dependent blockage. Conclusions The results suggested that all the three drugs blocked the kv1. 4△N channel in the open state. The three drugs block the kv1. 4△N channel maybe had the similiar effects in some respects, but each had its unique characteristics.