0.05),and presented significant increase after half a year of retention(P

Objective To study the relationship between velocity of middle cerebral artery(MCA),severity of disease and watershed infarction(WSI) in patients with extracranial internal carotid artery(EICA) stenosis or occlusion.Methods Transcranial Doppler(TCD) was used to detect the mean velocity(MV) of MCA in 120 patients with EICA stenosis or occlusion.The National Institutes of Health Stroke Scale(NIHSS) was used to evaluated the patients′ condition.And CT or MRI was used to diagnosised the WSI.Results MV of MCA was severe reduced in 10 cases,middle reduced in 38 cases,and mild reduced in 42 cases,while there were 30 cases with normal MV.The scores of NIHSS in the four groups(12.5?4.7,3.9?4.8,3.2?4.7,2.4?4.9 respectively) had significant different(P

Surgical treatment is the only cure treatment for patients with inferior vena cava tumor thrombus in hepatic segment and upper hepatic segment.The accurate diagnosis of tumor thrombus is very important.In preoperative imaging examination,the abdominal enhanced CT scan and the inferior vena cava MRI scan were the best methods for the diagnosis and evaluation of the tumor thrombus in hepatic segment and upper hepatic segment.Compared with the tumor thrombus below the liver,the tumor thrombus in hepatic segment or above hepatic segment extend widely,and the operation are more difficult.For simple inferior vena cava tumor thrombus (the top of the thrombus has reached the level of hepatic vein),Retroperitoneal approach combined with transperitoneal approach should be used.Open surgery is the standard procedure for other tumor thrombus in hepatic segment and upper hepatic segment.In addition to exposure of inferior vena cava below the hepatic vein,the liver and the first hepatic hilum should be exposed.For tumor thrombus in the atrium,after the longitudinal incision of diaphragm,we use Milking technology to squeeze thrombus into inferior vena cava.Then we use catheterization technology to remove thrombus.For difficult atrial tumor thrombus,an extracorporeal circulation should be performed.The median incision in the chest should be performed to open the chest and open the pericardium and remove the tumor thrombus.Patients with tumor thrombus in hepatic segment or upper hepatic segment should be diagnosed as early as possible and they need actively treated by operation.

Objective To investigate the effects of autologous blood transfusion and acute normovolemic hemodilution inflamma‐tory response in patients with spinal surgery .Methods 60 patients with spinal surgery ,were randomly divided into the control group ,autologous blood transfusion group ,acute normovolemic hemodilution group ,20 cases in each group .The control group in in‐traoperative bleeding time and blood input variants of inventory .Autologous blood transfusion group was used in combination with intraoperative autologous blood recovery unit ,lose banked blood hemoglobin was low .Acute normovolemic hemodilution group via peripheral vein input must first crystal liquid or gel liquid ,then through internal jugular vein slowly pulled out the body′s blood into the special bags containing anticoagulant ,swing machine through blood kept shaking ,input when appropriate .Preoperative(T1) , After surgery 2 h(T2) ,6 h(T3) ,12 h(T4) and 24 h(T5) blood at each time point 5 mL ,detect the WBC ,IL‐6 ,TNF‐α.Records with and without postoperative complications .Results WBC in autologous blood transfusion group and acute normovolemic he‐modilution group were higher than that of preoperative ,difference was statistically significant(P<0 .05);In T2 -T5 ,serum IL‐6 , TNF‐a and the WBC concentration compared with the basis of their respective value(T1) increased significantly ,but were signifi‐cantly lower than control group ,the difference was statistically significant(P< 0 .05) .Postoperative follow‐up of the autologous blood transfusion group and acute normovolemic hemodilution group and no complications .Conclusion The autologous blood trans‐fusion group and acute normovolemic hemodilution group could effectively reduce the intraoperative and postoperative systemic in‐flammatory response ,which obviously save blood resources .

Objective To clarify the influence of Ca and P on bone metabolism by investigating theeir effects on proliferation, differentiation and mineralization of osteoblasts (OBs) in vitro. Method OBs were cultured in media with Ca(1, 2,4 mmol/L),P(1, 2,4 mmol/L),Ca:P 1:2 (1 mmol/L Ca+2 mmol/L P), and Ca:P 2:1 (2 mmol/L Ca+1 mmol/L P). Cell proliferation, activity of alkaline phosphatase (ALP), content of osteopontin (OPN) and collagen type I (Col-I) of OBs, and their corresponding mRNA expression were measured. Results Compared with control group,Ca at 4 mmol/L promoted OBs proliferation significanty (P

"Treatment based on diseases identification and formulas corresponding to diseases" is one of important therapy modes of Chinese medicine. Although it originates from Huangdi Neijing, it is seldom systematically discussed. Modern Chinese medicine (CM) now faces diseases mostly with comparatively confirmed Western medical diagnoses. Most of them have specific pathophysiological changes. How to interpret these specific pathophysiological changes, play CM's advantages, and improve clinical efficacies has become an inevitable problem for modern CM in clinic. Authors expounded historic development and clinical application of "formulas corresponding to diseases", and its difference from "formulas corresponding to syndromes", put forward that we should combine "formulas corresponding to diseases" and "formulas corresponding to syndromes" in CM clinics. We should focus on the disease and summarize treatment rules, thereby improving targeted CM formulas.
Drug Compounding ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Syndrome

Purpose:To evaluate the thrombolytic effect of transcatheter intra-arterial infusion of urokinase injectio salviae miltiorrhizae and heparine.Materials and methods:A 5F catheter was delivered to the thrombotic site via femoral artery,then infused urokinase.Injectio salviae mihionrrhizae via catheter.During and after the procedure heparin was given for antico- agulation.Finally to evaluate the effect by femoral arteriograms.Results:Blood circulation of 10 eases were inproved with complete pateney.One case wasn't very fluent and the last one remained obstructed.Total effective rate was 92%.Conclusion:Transcatheter Intraarterial thrombolysis by combing urokinase,injeetio salviae miltiorrhizae and heparin was a effective and safe theraputic method.

Objective: To explore a way of getting satisfactory face shape and function with a retrospective study in 70 patients with midface fractures.Methods:70 cases were selected.Fractures were treated with miniplate according to the sites and different operation methods.Results:Occlusions and face profiles were normal.Each operation method had its own advatages and disadvanges.Conclution:The rigid internal fixation is effective for midface fracture and the choice of operation methods should depend on the sites of fractures.

Objective To explore the performance of serum AFP-L3 and PIVKA-Ⅱ in differential diagnosis of benign and malignant liver disease in high risk population.Methods The serum levels of AFP-L3 and PIVKA-Ⅱ in 48 patients with primary hepatic carcinoma,43 patients with cirrhosis and 81 patients with chronic hepatitis B were analyzed retrospectively.Results There was no statistically different significance among the median levels of serum AFP in primary hepatic carcinoma patients,cirrhosis patients and chronic hepatitis B patients (x2=4.014,P=0.134).Both median level of AFP-L3 and PIVKA-Ⅱ in primary hepatic carcinoma patients were higher than cirrhosis patients and chronic hepatitis B patients (x2 =33.93,52.33,both of P values were below 0.001).The specificity (92.74％) of AFP-L3 and the sensitivity (79.17％) of PIVKA-Ⅱ were all higher.The accuracy (84.88％) of combined detection in series was the highest,with its 47.92％ of sensitivity and 99.19％ of specificity.Conclusion Combined detection PIVKA-Ⅱ and AFP-L3 series will help to differential diagnosis of benign and malignant liver disease in high risk population.

Objective To observe the effects of dexmedetomidine on the perioperative stress response and immunologic function in hepatectomy patients with hepatitis cirrhosis.Methods Forty patients(Child-Pugh A or B),ASA Ⅱ or Ⅲ with hepatitis cirrhosis undergoing hepatectomy were randomly divided into dexmedetomidine group(group D)and control group(group C)with 20 cases in each.Patients in group D were administered 0.5 μg/kg bolus dose of dexmedetomidine over 10 min, followed by 0.4 μg·kg-1 ·h-1 infusion until closing abdomen.And patients in group C were given normal saline by the same way as in group D.Flow cytometry was used to detect peripheral blood T lymphocytes (CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + ),NK cells at 30 min before anesthesia(T0 ),imme-diately(T1 ),24 h(T2 )and 48 h(T3 )after surgery.Enzyme-linked immunosorbent assay was used to detect the levels of inflammatory cytokines concentration(IL-2,IL-10)at T0-T3 and stress hormones (Cor,ACTH,ALD)at T0 ,T2 and T3 .The levels of SBP,DBP and CVP at T0 ,immediately with intu-bation(Ta ),T1 and extubation(Tb ).Results Compared to those at T0 ,the levels of CD3 + ,CD4 + , CD8 + ,CD4 +/CD8 + at T1 and T2 were significantly lower in both groups(P <0.05),and the levels in group D were obviously higher than those in group C(P <0.05).The levels in group D were back to preoperative levels at T3 ,but the levels in group C were still lower than those at T0 (P <0.05).The levels of NK cells were higher at T1 in both groups,and the levels in group D was significantly higher than those in group C(P <0.05).Compared to those at group D,the concentration of IL-2 was lower at T1 and T2 ,the concentration of IL-10 was higher at T2 and T3 in group C (P <0.05).The levels of Cor,ALD,ACTH at T2 and T3 were significantly higher than those at T0 in both groups,but those in group D were markedly lower than those in group C (P < 0.05 ).The SBP,DBP and CVP of two groups was no statistically significant difference at T0 ,and SBP,DBP and CVP of the group D at Ta , T1 ,Tb was lower than that of T0 and group C (P <0.05).Conclusion Patients with hepatitis cirrho-sis underwent general anesthesia has certain immune suppression after liver cancer surgery,and con-tinuous intravenous infusion of dexmedetomidine during anesthesia may suppress the perioperative stress reaction effectively and alleviate the inhibition of immunologic function.