Objective To investigate the influences of photochemotherapy with psoralen and ultraviolet A (PUVA) on skin photoaging and its possible mechanism. Methods HE stain, Verhoeff stain, electron microscopy, enzyme cytochemistry and immunocytochemistry were used to study influences of PUVA on the skin photoaging with characteristic biological markers in the non-lesion back skin of patients with psoriasis vulgaris. Results After treatment with PUVA, the degenerated collagen and elastic fibers were increased with derangement profile in dermis, and fibroblasts displayed growth suppression and morphological changes of cell senescence with a permanent switch of mitotic to stably postmitotic phenotypes, of group B and group A, the positive rates of SA-?-Gal were 13.6 % and 0.00 % and the positive rates of p16 protein were 81.8 % and 42.9 % respectively, there were significant differences between group B and group A(? 2=21.412, P

Objective To evaluate the method of hemodialysis patients with the diagnosis and treatment of herpes zoster.Methods Diagnosis and treatment of 27 cases of hemodialysis patients with varicella-zoster virus (VZV) infection in patients with clinical data.Results All patients in addition to continuing the line hemodialysis treatment,use the ganciclovir,topical recombinant human interferon α -1b cream,vitamin Bl,Methycobal,antibiotics to prevent bacterial infection,oral medicine,comprehensive treatment of pain.The total effective rate of treatment group is 92.59％.Conclusion VZV was a common disease in hemodialysis patients,easy diagnosis,rational drug treatment is very important,need comprehensive treatment can achieve good results.

Objective To explore effective treatment of uremic hemodialysis patients with chronic helicobacter pylori-negative erosive gastritis.Methods Fourty-eight cases of uremic hemodialysis patients with helicobacter pylori-negative chronic erosive gastritis were diagnosed by detection of helicobacter pylori and endoscopic examination.Fourty-eight patients were randomly divided into two groups,treatment group (24 patients) with oral pantoprazole 40 mg,once a day,combinding with oral Marzulene-S particles,each 0.67 g,three times a day,the control group (24 cases ) only with the dose of pantoprazole treatment.Effect of treatment was compared in these two groups after treatment for 21 days.Results Twenty-one days after treatment,the clinical symptoms of uremic hemodialysis patients with upper gastrointestinal improved in treatment group,and the performance of endoscopic and histopathological has varying degree of improvement.It shows that pantoprazole combined with Marzulene-S treatment group has a significant effect than that single treatment with pantoprazole group.In the treatment group,the total effective rate was 95.83％,however it was 83.33％ in the control group( U =2.716,P ＜ 0.01 ).Repair of mucosal lesions were significantly different between the two groups ( total effective rate 83.33％ vs 45.83％,U =2.349,P ＜ 0.05 ).Conclusion Pantoprazole combined with Marzulene-S therapy has a significant effect on uremic hemodialysis patients with chronic Helicobacter pylori-negative erosive gastritis.

Objective To evaluate the feasibility,safety and efficacy of percutaneous transluminal stenting angioplasty for severe complicated stenosis of vertebrobasilar system. Methods From November 2003 to February 2006,5 candidates underwent percutaneous transluminal stenting for severe complicated stenosis of vertebrobasilar system. Results Four out of 5 candidates,had occlusion of unilateral vertebral artery (VA),1 had severe bilateral proximal segmental stenosis of VA. There were 4 with severe proximal segmental stenosis of the VA associated with multiple segmental stenosis of intracranial VA and basilar artery (BA),and 1 with multiple segmental severe stenosis of intracranial VA and BA. Stenosis rate ranges from 80% ～95% with involved length from 10-20 mm. Technical success was achieved in all of the patient (100%),and residual stenosis rate was less than 20%. All the symptoms due to vertebrobasilar blood supply insufficiency disappeared. Follow-up with DSA 6-12 months later demonstrated no restenosis; showing satisfactory short term efficacy. Conclusions Percutaneous transluminal stenting for vertebrobasilar blood supply insufficiency is a safe and efficacious option with favorable short term outcome,especially with furthermore prevention of stroke.

Objective To investigate the relationship between expression of matrix metalloproteinases of dermal fibroblasts and wrinkle formation in photoaging skin.Methods In situ hybridization histochemistry and immunocytochemistry were used to detect the expression of matrix metalloproteinases MMP-1,MMP-3mRNA and the expression of tissue inhibitor of MMP-1at(TIMP-1)protein in dermal fibroblasts from non-lesional skin of psoriatic patients during and after PUVA treatment.Results The expression of MMP-1and MMP-3mRNA of dermal fibroblasts from non-lesional skin was persistently up-regulated during PUVA thera-py,and lasted more than6months after treatment;while the expression of TIMP-1protein was only slightly expressed for a short period during PUVA therapy.Conclusion Wrinkle formation in photoaging skin after PUVA therapy is correlated with the imbalance of expression of matrix metalloproteinases and their inhibitors of dermal fibroblasts.

ObjectiveTo investigate the effect of tranexamic acid on inflammatory response in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Sixty ASA Ⅰ -Ⅲ and NYHA Ⅰ -Ⅲ patients of both sexes,aged 45-64 yr,with body mass index 16-22 kg/m2,undergoing elective OPCABG,were randomly divided into 2 groups ( n =30 each):control group (group C) and tranexamic acid group (group T).Anesthesia was induced with iv injection of midazolam,fentanyl and pipecuronium.The patients were tracheal intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.Tranexamic acid 1 g was infused intravenously over 30 min after induction followed by continuous infusion at 400 mg/h until the end of operation in group T.While equal volume of normal saline was given in gtoup C.Anesthesia was maintained with inhalation of isoflurane and intermittent (i)v boluses of fentanyl and pipecuroninm.Venous blood samples were taken before induction,at the end of operation and 24 h after operation for determination of Hb,platelet count,prothrombin time,international normalized ratio and plasma D-dimer and IL-6 concentrations.The volume of chest tube drainage was collected and recorded at 6 and 24 h after operation.The requirement for transfusion of allogeneic red blood cells and fresh frozen plasma was recorded.The complications during hospital stay were also recorded.ResultsCompared with group C,the plasma concentrations of D-dimer and IL-6 were significantly decreased at the end of operation and 24 h after operation,and the volume of chest tube drainage and the requirement for transfusion of allogeneic red blood cells and fresh frozen plasma were significantly decreased after operation in group T ( P ＜ 0.05 or 0.01).There was no significant difference in Hb,platelet count,prothrombin time and international normalized ratio between the two groups (P ＞ 0.05).No complications occurred during hospital stay in the two groups.ConclusionTranexamic acid can reduce inflammatory response in patients undergoing OPCABG.

Objective To compare the effect of different positive end-expiratory pressures (PEEPs) on the efficacy of volume therapy guided by global end-diastolic volume index (GEDVI) and central venous pressure (CVP) in patients with septic shock.Methods Twenty-five patients with septic shock complicated with respiratory failure,of both sexes,aged 18-64 yr,were enrolled in the study.Their APACHE [[scores were 13-31.The patients were endotracheally intubated and underwent volume-controlled ventilation,PEEP was 5-15 cmH2O,and pulse oxygen saturation was maintained ＞ 90 ％.The patients were divided into low PEEP (5-10 cmH2 O) group and high PEEP (11-15 cmH2 O) group depending on the different PEEP levels.6 ％ hydroxyethyl starch (200/0.5)6 ml/kg was infused over 30 min for volume therapy.Right internal jugular vein or subclavian vein was cannulated for CVP monitoring,and GEDVI was continuously monitored by pulse indicator continuous output monitoring (PiCCO) technology.CVP and GEDVI were recorded before and after volume therapy and the changing rate was calculated.Results Compared with CVP and GEDVI before volume therapy,CVP and GEDVI were significantly increased after volume therapy in low PEEP group (P ＜ 0.05),and GEDVI was increased after volume therapy (P ＜ 0.05) and no significant change was found in CVP after volume therapy in high PEEP group (P ＞ 0.05).Compared with low PEEP group,the changing rate of CVP was significantly decreased (P ＜ 0.05),and no significant change was found in the changing rate of GEDVI in high PEEP group (P ＞ 0.05).Conclusion High PEEP can decrease the efficacy of volume therapy guided by CVP,while exerts no effect on the efficacy of volume therapy guided by GEDVI in patients with septic shock.

Objective To explore the application value of the modified hypotonic method of intestinal system contrast ultra-sonography in elder patients with small intestinal diseases .Methods Group A were 28 patients with small intestine disease and 8 patients who was found abdominal mass suspected source of intestinal tumors by routine abdominal ultrasound inspection .We con-trast the mannitol intestinal system contrast ultrasound with modified hypotonic method of intestinal system ultrasound contrast , and compare with gastrointestinal ,gastrointestinal barium meal contrast ,then contrast the results of pathology .Group B were 37 patients ,with definite diagnosis with duodenal ulcers ,polyps ,the descending part of the diverticulum ,who respectively treated with drinking water method and modified hypotonic method of intestinal system ultrasound contrast ,then carry the two methods into comparison .Results The nidus detection increase from 9 to 12 in group A ;the nidus detection increase from 13 to 33 in group B . The modified hypotonic method of intestinal system contrast ultrasonography ,which eliminate intestinal gas more obvious and relax the intestinal lumen more sufficient than conventional contrast ,can improve the nidus detection rate .Conclusion The modified hy-potonic method of intestinal system contrast ultrasonography could be as a routine inspection method for elder small intestinal dis-ease paitents .

Objective To assess the outcome of percutaneous vertebroplasty for symptomatic vertebral hemangiomas. Methods Five cases with 7 symptomatic vertebral hemangiomas were treated with percutaneous vertebroplasty. Aggressive lesions were treated with absolute alcohol injection in addition. Patients were followed-up and clinical manifestations were observed and CT, MRI and X-ray plain film were compared between before and after vertebroplasty. Results Procedures were successful without complications. Most of the symptoms resolved within 24 hours after vertebraplasty. All patients were followed-up for 12～50 months and free of neurological deficits and symptoms. Imaging follow-up showed no vertebral collapse, nor recurrance of hemangiomas. Conclusion With effective long-term follow-up and quick elimination of symptoms, precutaneous vertebroplasty, added with absolute alcohol injection in aggressive cases, proves to be a safe and effective treatment for symptomatic vertebral hemangiomas.

Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.