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 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： 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 compare therapeutic effect of Losartan and hydrochlorothiazed compound prepara- tion and Losartan in patients with mild to moderate hypertension and to conduct economical evaluation. Methods The trial began with 2 weeks lead-in period and followed by 8 weeks therapy. 99 cases of mild to moderate hyperten- sion were randomly divided into two groups: compound preparation group ( n = 50) and Losartan (n = 49). The pa- tients were given Losartan 50 mg/h ydrochlorothiazed 12.5 mg compound preparation and Losartan 50 mg ,once a day. If the SeDBP≥85 mm Hg at 4th week, Losartan was added to 50 rag. Results After two, four and eight weeks treatment, systolic blood pressure and diastolic decreased obviously (P < 0.01 for each) ;The overall effective rate of of antihypertension was the same in both groups, but the different ratio of availability and validity in two groups was significant ( P < 0.05 for each). Conclusion Losartan/hydrochlorothiazed compound preparation has significant advantage in improving both systolic and diastolic pressure compared with monotherapy of Losartan. In ad- dition, the patients receiving compound preparation are well tolerated, with higher compliance.

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 discuss the imaging manifestations and clinical characteristics of Askin tumor.Methods 12 cases of Askin tumor confirmed by surgically and histopathologically were included in this study.The MSCT signs and clinical data were summarized.Results In 12 cases of Askin tumor,7 cases located in the chest wall;7 case were hospitalised with rapid enlargementd painful lump(58.3%,7/12).9 cases were performed surgery and postoperative radio chemotherapy,6 patients experienced metastatic or recurrent tumors during the following year(66.7%,6/9).Askin tumor often occurred in the chest-lung junction region,had the diameters of 2.0-13.0 cm,11 cases showed inhomogeneous density (91.7%,11/12), 1 case showed calcification (8.3%,1/12), ill-defined margin(100%,12/12),12 cases showed intense but inhomogeneous enhancement following contrast administrationin (100%,12/12),11 cases had the feature of pleura invasion (91.7%,11/12), 9 cases with pleural effusion(75.0%,9/12), 1 case with swollen lymph nodes in mediastinum(8.3%,1/12), and 4 cases with lytic lesion of adjacent bone(33.3%,4/12).Conclusion Askin tumor often occurrs in the chest-lung junction region with rapid enlargementd painful lump as the primary symptom;the tumor show the infiltration diffuse growth;calcification and adjacent lymph node metastasis is not very common.

60 mm Hg and PaCO2

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.

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