Primary aldosteronism is a common cause of secondary hypertension.Laparoscopic surgery has become the golden standard for treatment of primary aldosteronism since the first laparoscopic adrenalectomy was performed in 1992.Adrenal-sparing surgery was recommended in surgical treatment for aldosterone-producing adenoma.This article reviews the factors influencing the improvement of postoperative blood pressure,and introduces the indications of the surgical treatment in patients with idiopathic hyperaldosteronism.

Objective To study the influece of probucol on high-sensitivity C-reactive protein(hs-CRP) and bone morphogenetic protein-7 (BMP-7) in serum of patients with diabetic nephropathy.Methods 124 patients with diabetic nephropathy were randomly divided into two groups,the control group (n =62 cases) and the observation group(n =62 cases).The patients of the control group were treated through the conventional treatment.However,the patients of the observation group were treated by probucol on the basis of conventional treatment.They were treated for eight weeks.The 24-hour urinary protein,hs-CRP and BMP-7 were detected before and after treatment.Results The 24-hour urinary proteins were decreased in both two groups after treatment (t =6.161,5.23,P ＜ 0.01).There was significant difference between two groups(t =5.35,P ＜ 0.05).The hs-CRP and BMP-7 were improved after treatment (t =10.50,5.54,all P ＜ 0.05),while those of the observation group were more significantly improved than those of the control group(t =10.28,4.36,all P＜0.05).Conclusion Probucol could improve the conditions of diabetic nephropathy which was through improving hs-CRP and BMP-7.

The three-level quality management organization system established in the hospital required both the hospital and department indicators to be submitted to quality management and patient safety committee and they will be approved after discussion .The quality manager of each department need to report the monitoring data monthly , and the leaders can directly consult the monitoring data in real time by logging in quality management system .When the abnormal data or adverse trend are found , the management and relevant departments will analyze the reasons , and the relevant departments will draw up and implement the plan to continuously improve the medical quality .

According to laws and regulations , rules and relevant standards , combined with the actual condition of our hospital, to develop the hospital management policies of covering the whole process of medical care , and to update in time, which is the basis of ensuring the quality of medical care .Our hospital standardized the management of the policies , designed a unified process from the formulation , review, approval, issuance, revision, abolishment of the hospital management poli-cies, and supervised and implemented effectively , in order to achieve the sustainable development of hospital management policies standardly , integrally , dynamically .

Ultrasonography has grown rapidly and gained widespread acceptance in various fields.It has become a favored diagnostic imaging tool for its non-invasive,non-ionizing radiation,fast,convenient and portable.This article described briefly the application of ultrasound in vascular and its related diseases.

Objective To observe the efficacy of drug treatment of coronary aneurysm complicated with embolism in Kawasaki disease (KD). Methods The clinical data of eight KD children with coronary aneurysm and embolism were retrospectively analyzed. Results Eight KD children (six males and two females) at age of 0.25-5.2 years (mean=2.89) ,were diagnosed with gigantic coronary artery aneurysms. The diameter of aneurysm was around 8.3-13.8mm. Thrombosis appeared from 19 days to five months after coronary aneurysms formation. The onset manifestations included sudden chest pain and myocardial infarction with symptoms of heart failure in one case, shock in one case and no symptom in six cases. The maximum diameter of the thrombus was 2.8 mm×15.4 mm in the shape of funicular. Four cases had thrombus in the right coronary artery, two cases in the left coronary artery, and two cases in both sides. The patients underwent anticoagulant therapy taking heparin, urokinase, warfarin, aspirin and dipyridamole. Anticoagulant therapy was successful in 7 cases and the thrombus was completely dissolved in 7 days to more than 4 months. One case had recurrent coronary thrombosis after 4 months. One case died in 12 hours after thrombolysis. Conclusions Coronary thrombosis usually appears in the half year after the onset of KD coronary aneurysm. Thrombolysis therapy takes long time in Kawasaki patients. Breaking off of thrombus are rarely seen.

Objective To investigate the factors of postoperative complications of elderly patients with gastric cancer. Methods One hundred and fifth elderly patients with gastric cancer were selected as our subjects,who were underwent surgical treatments in general surgery department Jiangsu Shengze Hospital from Jan. 2009 to Dec. 2012. The general informations including age,staging of gastric cancer,radical operation performed or not,resection combined with other organs and operation periods were recorded. Results There were no significant differences between postoperative complications patients in terms of age,staging of gastric cancer,radical operation performed or not,resection combined with other organs( χ2 = 3. 113,P = 0. 078,χ2= 0. 465,P = 0. 495,χ2 = 0. 518,P = 0. 472,χ2 = 0. 303,P = 0. 582). The cases with operation periods < 3 h in complication group and no complication group were 30(57. 9% )and 51(81. 0% ),and the operation periods> 3 h were 22(42. 3% )and 12(19. 1% )respectively,and the difference was significant( χ2 = 6. 326,P= 0. 012). Conclusion Operation period is the main influencing factor of the elderly patients with gastric cancer. Therefore,reducing operation period under ensuring operation quality is more efficiency to decrease the complication.

During the management of Crohn's disease,there are some special situations that may be encountered by the clinicians,such as postoperative recurrence,fistulating disease in CD,pediatric CD,pregnancy,psychosomatics,and extra-intestinal manifestations.In this review,we concerned the progress in these fields in recent years.

Adiponectin is one of the adipocytokines that are derived from adipose tissue. It has anti-inflammatory, anti-diabetic, anti-atherogenic and insulin-sensitizing effects. Its receptors AdipoR1 and (AdipoR2) mediate the function of adiponectin. Recent researches show that AdipoR1 is abundantly expressed in skeletal muscles, whereas AdipoR2 is predominantly expressed in the liver. Both AdipoR1 and AdipoR2 are found to be expressed in human and rat pancreatic ? cells and the expression levels are similar to those in liver and higher than those in muscles; AdipoR1 and AdipoR2 can also be found in monocytes and macrophages. GH and agonists of PPAR-?, PPAR-? and LXR also affect the exprssion and regulation of adiponectin receptors.

Objective To generally analyse the current situations and advances in the biotherapy of gastric cancer. Methods The published papers about the current situations and research advances in the biotherapy of gastric cancer were reviewed.Results The main research fields and treatments in the biotherapy of gastric cancer include immunomodulator therapy, guided therapy of monoclonal antibodies and their joint-bodies, cytokine therapy, adoptive immunotherapy and gene therapy, etc. Conclusion As a beneficial complement for surgery, chemotherapy and radiotherapy, biotherapy plays an important auxiliary role in the multiple treatments for gastric cancer.