Carotid endarterectomy (CEA) can effectively treat symptomatic carotid stenosis, however, perioperative stroke is the most important complication of CEA. The microemboli generated before and after the operation are the most important reason for causing perioperative stroke. In addition, the hypoperfusion and postoperative hyperperfusion syndrome caused by intraoperative clipping of carotid artery, as well as carotid restenosis or occlusion after CEA are all the causes of perioperative stroke. As a non-invasive, real-time monitoring tool, transcranial Doppler (TCD) can be widely used in intraoperative monitoring of CEA, It is able to detect a variety of perioperative blood flow changes and the production of microemboli, and thus effectively predicts the occurrence of perioperative stroke, and decreases the risks of perioperative stroke.

Sarcopenia is a major clinical characteristic of cancer cachexia .The main pathophysiologic mechanism of sarcopenia related to cancer cachexia is abnormality between anabolic and catabolic pathways of muscle mediated by chronic inflammation .The major treatments for sarcopenia in cancer cachexia currently in-clude hormone therapy , nutrition support , exercise therapy , and other medications , which could not effectively prevent muscle loss or enhance muscle function .Better understanding of the pathogenetic processes of cancer cachexia-related sarcopenia may help in finding targets for an effective therapy .

OBJECTIVE： Evaluating clinical efficacy of ceftriaxone in the treatment of lower respiratory tract infections METHODS： Applying meta－ analysis to evaluation of clinical efficacy of ceftriaxone， cefotaxime and cefuroxime in the treatment of lower respiratory tract infections RESULTS ＆ CONCLUSION： Ceftriaxone is worthy of popularization and application in clinical practice because of its better efficacy and lower cost

Objective To evaluate the actual mismatch risk for KIR genes,KIR ligand HLA-C gene and KIR ligand HLA-Bw4I80 related genes in kidney transplant recipients and their donors.Method KIR genes,KIR ligand HLA-C gene and KIR ligand HLA-Bw4I80 related genes were analyzed in 322 recipients and their donors who received kidney transplantation.The effect of mismatches on acute rejection after transplantation was studied as well.Result In 322 cases of recipients and their donors,average mismatch risk for KIR-L gene was 4.73％,9.10％ for KIR-S gene and 1.95％ for KIR ligand HLA-C gene respectively.There were 245 cases (76.09％) of KIR ligand HLA-Bw4I80 related genes mismatch and 77 cases (23.91 ％) of match resepctively.There was no statistically significant difference in AR rate between KIR ligand HLA-Bw4I80 related genes mismatch group and match group (8.16％ in 245 vs.7.79％ in 77) (P＞0.05).AR reversal rate in mismatch group and match group was 95.0％ and 66.7％ (P＞0.05).Conclusion The mismatch risk for KIR ligand HLA-Bw4I80 related genes was even common between kidney transplant recipients and their donors,and this specific mismatch may be of benefit to patients who undergo actuate rejection.Further study is still required.

Objective To study the surgical treatment of the primary retroperitioneal sarcoma(RPS). Methods The treatment and prognosis of 63 patients with primary retroperitoneal sarcomas (liposarcomas and leiomyosarcomas) from Jan 1992 to Dec 2000 were analyzed retrospectively. Results The rate of complete tumor resection was 88.2%, and concomitant resection of involved adjacent organs was 21.6%. There was no operation death. The median survival time(MST) in liposarcomas that for was 36.5months, and leiomyosarcomas was 27.6 months. The MST in highly differentiated tumor was 34.7 months,and that of intermiade and low differtiated tumors was 18.1months(P

OBJECTIVE:To evaluate the quality of antidiabetics in Beijing so as to provide the reference for pharmaceutical manufacturers,patients and governmental departments of drug control.METHODS:236package samples of4kinds of common oral antidiabetics(glibenclamide,gliquidone,metformin,and phenformin)in Beijing medicine market were randomly selected and analyzed.RESULTS:4samples were found to be unqualified,with the disqualification rate of1.7%.CONCLUSION:The quality of4kinds of common oral antidiabetics in Beijing medicine market in2004is satisfactory on the whole.

Nine known compounds were isolated from the chlorofrom soluble fraction of ethanolic extract of Belamcanda chinensis(L. )DC.. Their structures were identified as irigenin(Ⅰ),dichotomitin(Ⅱ),irisflorentin (Ⅱ),3-stigmastenol (Ⅳ), apocynin (Ⅴ), tectoridenin (Ⅵ), ?-sitosterol (Ⅶ), 3', 4', 5, 7-tetrahydroxy-8-methoxyisoflavone (Ⅶ)and polyoctapenten (Ⅹ) by spectorscopic methods (UV, IR, EIMS, 1HNMR, 13CNMR). Compounds Ⅱ, Ⅳ, Ⅹ and Ⅻ were obtained for the first time from the plant.

Objective To compare the protective effect of colloidal bismuth subcitrate-1 (CBS-1, Lizudele), or colloidal bismuth subcitrate-2 (CBS-2, De-Nol) and sucralfate against gastric mucosal lesion and to investigate their mechanisms. Methods Gastric mucosal injury of rats was induced by ethanol, stress, aspirin and hydrochloric acid. Gastric ulcer was then induced by 50% acetic acid applied to the gastric tunica serosa. We observed the protective effects against gastric mucosal lesion and measured the injury index and the area of ulcer in each group. Statistical t test was used to compare the difference of each group. Results (1)CBS-1, CBS-2, and sucralfate had protective effect against lesions caused by ethanol, stress, aspirin and hydrochloric acid and could promote acetic acid-induced gastric ulcer healing. (2) The mechanisms of protective effect and ulcer healing promotion were that these drugs could increase gastric blood flow and increase activities of QR, GST and GR, and could also promote overexpression of bFGF mRNA and iNOS mRNA. Conclusion Gastric mucosal protective drugs, CBS and sucralfate had effect of resisting injury and promoting ulcer healing. The mechanisms were that they could increase gastric mucosal blood flow and the expression of bFGF mRNA and iNOS mRNA, and reduce oxygen free radical.

Objective To discuss the prevention and treatment of hemorrhage during or after minimally invasive percutaneous nephrolithotomy (PCNL). Methods Clinical data of 12 cases of hemorrhage during or after minimally invasive percutaneous nephrolithotomy from July 2005 to October 2005 in this hospital were retrospectively analyzed. Results Intraoperative hemorrhage occurred in 10 cases. The bleeding was stopped by pressure in 6 cases and a re-operation of open nephrolithotomy 5 days later was required in 4 cases. Postoperative hemorrhage was seen in 2 cases. The bleeding was successfully stopped by endoscopic electrocoagulation in 1 case and by interventional highly-selected embolization on the 4th day after operation in 1 case. Conclusions Prevention should be put first for hemorrhage during or after minimally invasive percutaneous nephrolithotomy. Accurate puncture and skillful tunnel expansion are the key to minimize the hemorrhage. Interventional embolization should be the first choice in case of massive or repeated bleeding.

Objective To establish fully automated sample pooling, nucleic acid extraction, amplification and detection method for HBV DNA testing, and investigate the seroconversion and genotype in HBV DNA positive donors. Methods Individual donor plasma samples serologically negative for HBV were pooled by STAR2000 sampling processor with a size of 24. Nucleic acid were automatically extracted by MPLC simultaneously, amplified and detected by Roche COBAS AMPLICOR system. The sensitivity of detection was determined by international standard. HBV DNA positive donors were genotyped and followed up by serological tests. Results The 95% detection limit for this automated HBV DNA testing system was 38.9IU/ml,with 95% confidence interval (21323),eight out of 16512 specimens were PCR positive for HBV DNA,with a positive rate of 0.049%. Three of the 8 DNA positive donors were genotype C,2 genotype B, 1 genotype D,and the other 2 uncertain。Six of the eight HBV DNA positive donors were followed up, and three of them seroconverted。 Conclusion Fully automated HBV DNA detection method can be applied in blood screening,and will further increase the safety of blood supply.