Abstract:Familial adenomatous polyposis （FAP） is an autosomal dominantly inherited syndrome. It will inevitably progress to colorectal carcinoma if not handled properly. The extracolonic manifestations of FAP play important role in the clinical diagnosis and prognosis of FAP patients, This paper reviews the clinical characteristics of FAP and current progress in its research.

Abstract:Objective：To discuss the clinical manifestations of familial adenomatous polyposis （FAP） and summarize our experience in diagnosing and treating the FAP patients. Methods： Clinical data of 96 FAP patients （1985-2003） were reviewed and colonoscopic findings were analyzed retrospectively. Abdominal CT findings and endoscopic findings of the upper digestive tract in 22 FAP patients （2001-2003） were analyzed retrospectively in an attempt to seek extrarectal pathological manifestations in FAP patients. Results.- Densely grown polyps were found in the colorectum in most patients（52/96,54.2%）, while moderateto-high density of polyps were found in the left hemicolon and rectum. Frequency of cancerization was high for rectal adenoma （23/41,56.1%）. Of the 22 FAP patients, 19 （19/22, 86.3%） had proliferative polyps of the gastric antrum and 18 （18/22, 81.8%） had duodenal polyps, including 12 duodenal adenornatous polyps, without a single case of cancerization. In 3 of the 22 FAP patients, desmoid tumors were detected in the abdominal wall, abdominopelvic cavity or mesentery of small intestine 5 years after colectomy. Of the 3 patients, only one was cured by complete resection of the tumor. Conclusion： Dense growth of polyps in the colorectum is a typical clinical manifestation of FAP. Frequency of cancerization is high for rectal adenoma. Colonoscopy is safe and effective for early diagnosis of FAP. Presence of polyps in the upper digestive tract is a common extrarectal manifestation of FAP. Cancerization of duodenal adenoma is rare in Chinese FAP patients. Desmoid tumor significantly influences postoperative quality of life of FAP patients who received prophylactic colectomy

Abstract:Objective：To explore the characteristics of germline APC gene mutations in Chinese patients with familial adenomatous polyposis（FAP）. Methods： Six FAP patients （March 2004 to March 2005） were screened for germline mutation of APC gene by PCR-denaturing high-performance liquid chromatography and direct sequencing. Results： Mutations were identified in 3 patients from 6 unrelated families. The first and second mutation was at codon 1 509, resulting in an amino acid change from Arginine to Glutamine; the third mutation involved four base-pairs insertion in the sequence of AGAA at intron 14. Conclusion： Chinese FAP patients with same APC genotype mutation may have different phenotypes

Abstract:Objective：To study the diagnostic value of colonoscopy in screening of family members of a familial adenomatous polyposis （FAP） family. Methods： The colonoscopic findings of 38 sibs from 23 FAP families （1985-2002） were retrospectively studied. The diagnostic value of colonoscopy for screening FAP in FAP families was analyzed through determining the amount, morphology, and pathology of polyps. Results： Sixteen of the 38 sibs were found to have polypous growths, the positive screening rate being 42.1% ; of the 16 cases of polypous growths, one was found to be severe atypical proliferation. The left hemicolon and rectum had dense polyps. Conclusion： Colonoscopy is a safe and reliable screening examination in sibs of FAP families.

Abstract:Objective：To discuss the value of congenital hypertrophy retinal pigment epithelium （CHRPE） in diagnosis of familial adenomatous polyposis （FAP）. Methods： Twenty two FAP patients who have received treatment in our department （January 2001 to June 2003） and 10 patients with sporadic colorectal polys （as control group） were subjected to optical fundus examination. The incidence, morphological feature and distribution of CHRPE were analyzed. Results： Seventeen（81.8%） of the 22 FAP patients were found to have CHRPE in optical fundus. The lesions showed a bilateral and multiple（≥2） distribution along the peripheral vessels with oval pigmentation. One patient was found to have CHRPE in the control group. Conclusion： Optical fundus examination is a highly sensitive and specific adjuvant diagnosis for FAP. It is a safe and effective way for screening FAP in FAP family members

Abstract:1 临床资料 患者，女，35岁，因“间断心慌伴颜面、下肢水肿1个月”在外院就诊，拟诊“结核性心包积液”，行心包切开引流术，术后一直予抗结核治疗。反复复查B超提示心包内大量积液，并间断行心包穿刺。症状无明显好转。7个月后转入我院，查体：BP105／85mmHg（1mmHg=0．133 kPa），Hr101次／min；颜面水肿，颈静脉充盈；双肺呼吸音清晰，未闻及干湿性啰音；心界扩大，心音遥远，未闻及病理性杂音；腹软，肝脾不大，无移动性浊音；双下肢见轻度水肿。询问病史，20年前曾因“肺结核”行抗结核治疗。无明确胸背部手术、外伤史。胸片及胸部CT均仅提示心包大量积液（未发现明确肺部结核病灶及钙化点）。结核菌素试验（PPD）阴性，红细胞沉降率（ESR）20mm／1h。入院后行心包穿刺引流（使用深静脉导管），起始为暗红色血性液体，5d后引流逐渐呈粉红色，1周后呈乳白色。引流液检查：乙醚试验（＋），胆固醇4．6mmol／L，三酰甘油36．6mmol／L，总蛋白90．2g／L。每日引流约300-400ml。外周血查丝虫微丝蚴阴性。确诊为特发性乳糜性心包炎。行乳糜管低位结扎及心包切开引流术，术后恢复好，出院后3个月复查，心包内未见积液。[第一段]

Abstract:Objective：To evaluate the short- and long-term outcomes of subtotal proctocolectomy for familial adenomatous polyposis （FAP）. Methods： Twenty-one FAP patients who had undergone subtotal proctocolectomy during 1985-2000 in our department were followed up colonoscopically to observe whether there was any recurrence of polyps in postoperatively residual colon or/and rectum. Results： Adenomatous recurrence with variant degrees was detected in the residual colon or/and rectum in all 21 patients, the recurrence rate being 100%. Polypous growth was denser in the residual rectum than in the proximal residual colon. The adenomatous polyp in one patient cancerized 4 years after the initial operation. The cumulative occurrence of colorectal cancer was 4.8 %. Conclusion： Subtotal proctocolectomy is a simple procedure for FAP with fewer complications, but there is a risk of polyps cancerization in the residual colon or/and rectum.

Abstract:Objective：To analyze the expression of cyclooxygenase-2（COX-2） in patients with familial adenomatous polyposis and to discuss the possible role of COX-2 in adenoma formation and cancerization. Methods： The adenoma specimens were obtained from 10 FAP patients （2001-2003）. Different sizes （≤0.5 cm and ≥1 cm） of adenomas and cancerous adenomas were subjected to Envision immunohistochemistry for analysis of COX2 protein expression. Results： COX2 was mainly detected in epithelial cells, with some in interstitial cells. When ≤0.5 cm, COX-2 expression in adenomatous epithelial cells was stronger than in normal epithelial cells （P〉 0.05）; the same was true when ≥1.0 cm, but with statistical significance （P〈0.01）. The expression of COX-2 in different sizes of adenomas was significantly different（P〈0.01）, with that in ≥1.0 cm adenomas stronger than that in ≤0.5 cm adenomas. Expression of COX-2 in cancerous adenoma was stronger than that in normal epithelial cells （P〈0.01） and epithelial cells of ≥1.0 cm adenomas （P〉0.05）. Conclusion： COX-2 may be a stimulative factor in the progression of FAP and may participate in adenoma formation and cancerization. Selective inhibition of COX2 may be an effective strategy for preventing FAP

Abstract:Objective：To compare the effects of Zn^2＋ on the P2X receptor-mediated, ATP-induced currents in neurons separated from rat superior cervical ganglion （SCG）, nodose ganglion （NG）, and otic ganglion （OTG）. Methods.. Whole-cell patch clamp recording technique was used to study the regulatory effects of Zn2＋ on ATP/αβ-me ATP-induced currents in the above 3 ganlglion neurons. Results： All SCG neurons responded to ATP with a sustained current, while no neurons responded to αβ-me ATP：Zn^2＋ potentiated ATP-induced sustained currents to （1 442±34）% of the original value. All NG neurons responded to ATP and αβ-me ATP with a similar sustained current,coapplication of Zn^2＋ （10μmol/L） potentiated their responses to （180±12） % and （262±28）% ,respectively. All OTG neurons responded to both ATP and a~-me ATP with a sustained current. Coapplication of Zn^2＋ （10μmol/L） did not significantly potentiate the sustained currents induced by 10 μmol/L ATP, but when ATP was at 30μmol/L, Zn^2＋ （10-100μmol/L） inhibited ATP-induced sustained currents in a dose dependent manner. If TNP-ATP （100 nmol/L） was first used to inhibit ATP-induced current to （26±2）% of the original value, Zn^2＋ at 10μmol/L potentiated the inhibited current to （127±9）% of its original value. Coapplication of Zn^2＋ （10μmol/L） potentiated αβ-me ATP-induced currents to （146 5± 5）% of the control. Zn^2＋ （300μmol/L） had no effect on ton and toff of ATP- and αβ-me ATP-induced （30μmol/L） currents in OTG neurons. Conclusion, （1） Zn^2＋ is an allosteric modulator of P2X2 and P2X2/3 receptors in SCG and NG neurons and can potentiate the currents they induced. （2）The predominant receptor subtypes in OTG appear to be homomeric P2X2/3 and a little P2X2. Zn^2＋ has an inhibitory effect on the ATP-induced currents in OTG neurons, suggesting some novel members of the P2X purinoceptor exist in these neurons.

Abstract:Objective：To observe the morphological changes and analyze the differential protein spectrum of human malignant glioma cells SHG-44 after treated with Nordy （Chinese patent number：ZL02133700.4）, an analog of Nordihydroguaiaretic acid. Methods： The differentiation of SHG-44 cells was induced by 100μmol/L or 200 μmol/L Nordy; the morphological changes of cells were observed 24, 48 and 72 h after Nordy treatment and the findings were compared with those of the control group （received no treatment） . The total proteins were extracted from SHG-44 cells treated with 200 μmol/L Nordy for 72 h and cells in control group, then were subjected to two-dimensional gel electrophoresis. PDquest 7. 1 software was employed to compare the protein expression differences. The highly expressed differential proteins were identified by matrix-assisted laser desorption/ ionization-time of flight-mass spectrometry （MALDI-TOF-MS）. Results： The morphological changes of SHG-44 cells treated with 200 μmol/L Nordy were more obvious than those treated with 100 μmol/L Nordy, and the most obvious differentiation was found in the cells treated for 72 h. Compared with those of control group, 23 differential protein spots were identified by the two-dimensional electrophoresis, including 21 down-regulated ones and 2 up regulated ones. MALDI-TOF-MS showed that the highly expressed proteins were： an unknown protein, proliferation-associated gene A, Upl, alternative splicing factor ASF-3, cofilinl（non-muscle）, eukaryotic translation initiation factor 5A, beta galactoside binding lectin, and glutathione-S-transferase Pi. Conclusion.. Nordy can induce differentiation of human malignant glioma cells SHCr-44 in a time-effect and dose-effect dependent manner. The Nordy-induced differential proteins may function in multiple aspects such as cell proliferation, apoptosis and gene transcription

Abstract:Objective：To establish a two-dimensional eletrophoresis system for total brain stem proteins of seasickness adaptive and non-adaptive rats and to identify the differentially expressed proteins for investigation of the possible mechanism of seasickness adaptation. Methods： According to the kaolin intakes after seasickness stimulation, 30 rats were divided into nonseasickness group （n= 10）,seasickness adaptive group （n=12） and seasickness non-adaptive group （n=8）. Another 10 normal rats not receiving stimulation were taken as blank control. The brain stem proteins of seasickness adaptive and seasickness nonadaptive rats （n= 6） were isolated by two-dimensional electrophoresis; the differentially expressed proteins were identified by peptide mass fingerprint （PMF）. Results： During a 21-day stimulation, the amount of kaolin consumption in seasickness adaptive rats experienced an increasing phase and a subsequent decreasing phase; seasickness non-adaptive rats consumed significantly more kaolin during the whole 21-day stimulation than the blank control rats did （P〈0.01 or P〈0.05）. Nine seasickness adaptive proteins were identified by PMF： peroxiredoxin Ⅰ , peroxiredoxin Ⅱ,light molecular-weight neurofilament, ubiquitin carboxyl-terminal hydrolase PGPg. 5, and glutamine synthetase were highly expressed ; carbonic anhydrase Ⅱ , triosephosphate isomerase Ⅰ , phosphoglycerate mutase isozyme B and mitochondrial voltage dependent anion channel were lowly expressed. Conclusion： Adaptation to seasickness can induce changes in the protein expression pattern of brain stem in the seasickness adaptive rats, which may be associated with energy metabolism, neurotransmitter adjustment and oxidative stress.

Abstract:Objective：To study the hepatic gene expression profile early after 60^Co-γ irradiation in mice with eDNA microarray, in an attempt to understand the molecular mechanism of irradiation damage to liver in mice. Methods： Total RNA was extracted from mice liver 2 days after irradiation with ^60Co-γ ray and from normal mice liver. Hepatic gene expression patterns of irradiated and normal mice were compared with eDNA microarray（4 096 genes）. RT-PCR was performed to validate the eDNA microarray results. Results： Compared with normal group, 124 genes showed a differential expression in irradiation group, with 46 genes upregulated（maily cell cycle and transcription regulation related proteins） and 78 down-regulated（mainly cytoskeletal genes）. Of the 124 genes, 57 had identified functions and could be divided into 6 groups： DNA repair and stress response,cytoskeleton, hydronium channel/transport protein, signaling transduction, intermediary metabolism, and immune related proteins. RT-PCR analysis indicated that the expression of heat shock 70kD protein 5 （HspaS）, RAS p21 protein activator 3 （Rasa3）,and NAD（P）H dehydrogenase, quinone 1 （Nqol） were consistent with eDNA microarray data. Conclusion： Irradiation-induced hepatic injury is of multi-target and multi-pathway

Abstract:Objective：To investigate whether plasma lipoprotein-associated phospholipase A2 （Lp-PLA2） activity correlates with severity and stability of coronary atherosclerosis and other established cardiovascular risk factors. Methods.. Coronary angiography （CAG） was performed in 180 hospitalized patients who were suspected as having coronary heart disease （CHD）. The severity of pathological changes of the coronary artery was assessed by the number of diseased coronary branches and Gensini＇s score. According to the results of CAG, the 180 patients were divided into 2 groups： CHD group （n=112） and non-CHD group （n=68）. The CHD patients were further divided into subgroups according to the clinical types, the number of diseased coronary branches and Gensini＇s score. Lp-PLA2 activity, white blood cell （WBC） count, high sensitive C reactive protein （hsCRP）, lipids, blood pressure and body mass index were measured. The age, sex and prior medical histories including hypertension, diabetes mellitus and smoking status were obtained before CAG in all patients. Lp-PLA2, WBC count and hsCRP were compared statistically between the subgroups, and correlation coefficients of Lp-PLA2 activity with WBC count, hsCRP and other conventional risk factors for CHD were calculated. Results： Plasma Lp-PLA2 activity in CHD patients was significantly higher than that in controls （P〈0.01）. No significant difference was found in Lp-PLA2 activity between patients with acute coronary syndrome and stable angina pectoris. Lp-PLA2 activity increased with the increasing number of diseased coronary branches and Gensini＇s score. Plasma Lp-PLA2 activity was positively correlated with TC and LDL-C, negatively correlated with HDL-C, weakly correlated with WBC count, and not correlated with hsCRP. Conclusion： Plasma Lp-PLA2 activity can be used as a parameter to predict pathological severity of coronary atherosclerosis, though it is not associated with stability of pathological changes of the coronary artery.

Abstract:Objective：To observe the changes of structure and function of pharyngeal muscle in SD rats with altitude hypoxia induced obstructive sleep apnea syndrome （OSAS） , in an attempt to investigate the remodeling of pharyngeal space and the possible biomechanical mechanism of OSAS. Methods： Twenty-four SD rats（ 12 male and 12 female） were randomly assigned to 4 groups with 6 rats in each group. Rats in group A and B were male and those in group C and D were female. Rats in group A and C were placed in altitude chamber and treated with altitude hypoxia 6 h per day for 22 days. The pressure in the chamber was 53.9 kPa with an oxygen concentration of 10.0%-11.2%. Rats in group B and D, serving as controls, received no treatment. All rats were sacrificed on the 23^rd day. The open-angle and the inside diameter of rats＇ pharyngeal-ring and the pathology of pharyngeal tissues were examined in all rats. Results： The open-angles of rats＇ pharyngeal-ring of group A, B, C and D were （55±24）°, （ 15±8）°, （38±20）°, and （35 ± 15）°, respectively; and the inside diameters of the pharyngeal-ring（cm） were 0.4±0.2, 0.2±0.1, 0.3±0.1, and 0.3±0. 1, respectively. The open-angle and the inside diameter of rats＇ pharyngeal-ring in group A were significantly higher （P〈0.05） than those of group B, C, and D, with no significant difference found between group C and D. Microscopic findings showed that, compared with group B, the muscle fibers of group A were fatter and were arranged disorderly, with unclear transverse striation, dropsical and congestive subcutaneous tissues infiltrated with inflammatory cells. Local unclear transverse striation of muscle fiber was seen in group C; the muscle fibers in group B and D were orderly arranged and no inflammatory cells were seen subcutaneously, Electron microscope showed disarranged muscle fibers with dissolved myofilament, disturbance and disappearance of the Z line in part of muscle fibers, expanded sarcoplasmic reticulum, and slightly condensed muscle cell nuclei. Local myofilament dissolving was found in group C. Conclusion： Twenty-two days＇ intermittent altitude hypoxia can induce OSAS in SD rats through changing the structure and function of pharyngeal muscle and remodeling the pharyngeal space

Abstract:Objective：To evaluate the biocompatibility of 3 kinds of artificial,biodegradable graft materials, including T20 [Poly （ butylene terephthalate）-co-poly （ cyclohexylene dimethanol terephthalate）-b-poly （ ethylene glycol）], PHBV （ Poly3hydroxybutyrate-Poly3-hydroxyvalerate） and PEGT/PBT [Poly （butylene terephthalate）/poly （ethylene glycol） terephthalate], and to study their effects on canine smooth muscle cells（SMCs） growth after surface modification. Methods： The contact angles were measured to compare the hydrophilicity of T20, PHBV, and PEGT/PBT scaffolds. Then SMCs were cultivated on these biodegradable scaffolds; their proliferation and growth were assayed by MTT assay, FITC and electron microscopic observation for evaluation of their in vitro biocompatibility. The growth of SMCs was also assayed on the 3 scaffolds after they were pretreated with gelatin or Poly-l-lysine. Results： The contact angles of 3 scaffolds were all less than 90°（PEGT/PBT〉T20〉PHBV）. MTT assay showed that SMCs adhered to and grew well on T20, PHBV, and PEGT/PBT scaffolds. The cell viability began to increase 24 h after cultivation （PEGT/PBT〉T20〉PHBV, P〈0.01）, followed by a decrease, but increased again 72 h after cultivation （T20〉PEGT/PBT〉PHBV, P〈0.01）. FITC observation showed that SMCs grew well and electron microscopic observation showed a confluent growth of SMCs with abundant extracellular matrix. The viability of SMCs was significantly higher on scaffolds pretreated with gelatin or Poly-l-lysine than on those without pretreatment（P〈0.01）. Conclusion： T20,PHBV,PEGT/PBT have good in vitro biocompatibility; the scaffolds made of these materials can obviously improve cell attachment after surface modification.

Abstract:Objective：To observe the changes of alveolar cells apoptosis and the expression of Fas/FasL protein in pulmonary injury induced by ischemia/reperfusion in rabbbits, and to explore the related mechanism of pulmonary injury. Methods： The left pulmonary arteries of 30 healthy New Zealand rabbits （either sex） were obstructed and reperfused by inflating and discharging gas of 5F Berman sacculus catheter. The rabbits were then randomly divided into 5 groups： sham operation group, ischemia 1 h group, ischemia 2 h group,ischemia 2 h and reperfusion 1 h group,and ischemia 2 h and reperfusion 2 h group. Another 6 healthy rabbits were taken as control. The pulmonary tissues were harvested after experiment and the lung wet/dry ratio was determined. Alveolar cells apoptosis and Fas/FasL protein expression were determined using flow cytometry and immunocytochemistry techniques,respectively. Results： The lung cell apoptosis was obviously increased in ischemia groups compared with that in the control and sham group. The reperfusion after ischemia further increased the cell apoptosis compared with simple ischemia groups, and the apoptosis was positively related with the reperfusion time （P〈0.05 or 0.01）. Fas and FasL protein expression was significantly higher in ischemia and ischemia/reperfusion group than that in other groups （both P〈0.01）. Significant positive correlation was found between apoptosis index with lung wet/dry ratio and expression of Fas and FasL （r= 0. 769, 0. 820,0. 820 respectively, P〈0.01 ）. Conclusion： Pulmonary artery ischemia/reperfusion may activate the Fas/FasL system and induce alveolar cells apoptosis,leading to pulmonary damages

Abstract:Objective：To study the intrarenal expression of Fas ligand （FasL） and T cell intracellular antigen-1 （TIA-1） protein during acute rejection after renal transplantation. Methods： Immunohistochemical technique was used to detect FasL and TIA-1 expression in 32 transplanted renal samples,2 living donor kidneys and 8 adjacent samples of renal cancer （including 14 acute rejection samples, 15 chronic and 13 non-rejection ones according to Banff criteria）. Results： The positive FasL staining was observed mainly in cytoplama of renal tubule epithelia,and the positive rate was significantly higher in acute rejection samples than in others（P〈0.01 ）. TIA-1 was found in both tubular epithelial cells and interstitial infiltrating lymphocytes,occasionaly in small arterial endothelial cells. The positive staining rate of TIA-1 acute rejection samples was also higher than those of other samples（P〈0.05）. The expression of FasL and TIA-1 in acute rejection samples was positively correlated with the severity of tissue damages. Conclusion： Over expression of FasL and TIA-1 in acute rejection renal allograft tissues may indicate the activation of T cells,and its detection may be helpful for early diagnosis of acute rejection

Abstract:Objective：To investigate the characteristics of peripheral circulating lymphocyte subsets in severe hepatitis patients with chronic HBV infection（SHPCHI）. Methods： The numbers of circulating lymphocyte subsets, including CD3^＋, CD4^＋ and CD8^＋ , NK cells （CD3^- /CD16^＋/CD56^＋ ）, and NKT cells （CD3^＋/CD16^＋ CD56^＋ ）, were determined in SHPCHI （n = 61 ）, patients with chronic hepatitis B （CHB, n = 21 ）, patients with cirrhosis （ LC, n = 26） and healthy volunteers （ n = 10） by flow cytometry. The absolute values of each lymphocyte subset were calculated and statistically analyzed. Results： The absolute numbers of circulating CD3^＋ , CD4^＋ and CD8^＋ T cells were significantly reduced in SHPCHI group compared with those in the other 3 groups （P〈0.01 or P〈0.05）. There was a decreasing trend in the absolute numbers of peripheral CD3^＋ , CD4^＋ , CD8^＋ and NK cells in non-surviving SHPCHI compared with surviving SHPCHI,but the decrease was not statistically significant. Conclusion： SHPCHI has an disorderd cellular immune function, which might be related to the prognosis of SHPCHI.

Abstract:Objective：To study the outcomes of a modified cavoportal hemitransposition technique for liver transplantation in treatment of diffuse portal vein thrombosis. Methods： Two patients with diffuse portal vein thrombosis received liver transplantation by modified cavoportal hemitransposition. Anastomosis between the native inferior vena cava and the graft coeliomesenteric vein and adjuvant anastomosis between the native portal vein and graft spleen vein were performed to reconstruct the blood flow of portal vein. The post-operation liver function, portal flow, renal insufficiency, edema of lower extremities, and the varices of esophagus or gastric fundus were observed. Results： The operation was successful in both cases, with normal post-operation liver function and satisfactory portal flow. There was no complication such as renal insufficiency, edema of lower extremities, and varices of esophagus or gastric fundus. Conclusion： This modified cavoportal hemitransposition technique in liver transplantation is proved effective for diffuse portal vein thrombosis.

Abstract:Objective：To analyze the clinical outcomes of the locking compression plate（LCP） fixation for the unstable sacral fracture. Methods： Nine patients with unstable sacral fracture were treated with locking compression plate fixation in our department,including 7 males and 2 females,with an average age of 34.8 years （ranged from 25 to 49 years）. AO classification system found 1 B1 ,4 B2 ,2 B3 and 2 C1 type. Dennis classification found 6 Ⅰ section sacral fracture and 3 Ⅱ section sacral fracture. Incisions （6-8 cm） were made from each side of superior iliac spine to ipsilateral inferior iliac spine along iliac crest. After the fractures or dislocations were exposed and reduced,LCPs were chosen and remodeled. The iliosacral posterior ligaments were restored if injured. The LCP was pushed cutaneously to the other incision, placed on both dorsal ilia and fixed with locking screws. Each side of postal LCP was fixed with 3 locking screws for effective fixation. The reduction and fixation of fractures or dislocation were assured by radiostereoscopy. The operations lasted 45 min averagely （ranged from 30-80 minutes） and no patient needed blood transfusion. The average X-ray exposure period was 4 min（from 2-10 minutes）. Results： All the patients were followed-up for a mean of 13.8 months,ranged from 6 months to 21 months. There was no iatrogenic nerve injury. The function and the feeling of sacroiliac joint and low extremities recovered to normality. According to the Majeed standards, the results were excellent in 4,good in 4,and fair in 1. Conclusion： The locking compression plate fixation is a simple and effective treatment for the unstable sacral fractures,with less trauma and complications.

Abstract:Objective：To compare the pharmacokinetics and relative bioavailability of rapid oral disintegrating tablet of dimenhydrinate （RODTD） and those of market available tablet of dimenhydrinate （DMH）. Methods： Eight healthy volunteers were evenly randomized into 2 groups, one group received RODTD （25 mg） and the other received available market tablet of dimenhydrinate （25 mg）. The blood levels of DMH were determined by high performance liquid chromatography （HPLC） before and after drug administration in 2 groups. Chromatography conditions were： Nova-Pak Clsas chromatographic column, methanol triethylamine buffer （1 ： 1）, flow rate： 1.0 ml/min, detection wavelength： 225 nm, and room temperature. The pharmacokinetics and relative bioavailability of RODTD and market available tablets were investigated. Results： The standard curve of DMH in the blank plasma was linear within the range of 5-500 ng/ml, with the regression equation being C=0. 004 4 A＋4. 745 and R^2 =0. 996. The limit of detection was 2 ng/ml; the average recovery rate was （90.55±4.69） % and the RSD was 0. 041%. The intra-day derivations of 3 different concentrations （low, middle, and high） of plasma were 9.27%, 4.93%, and 2.95%, respectively （n = 5）, and the inter-day derivations were 9.97 %, 3.81%, and 3.06 %, respectively （ n = 5 ）. Blood samples （3 ml） were subjected to HPLC assay and significant difference was found between the 2 forms of DMH. The pharmacokinetic parameters of RODTD were： AUC= （602.04±113.82） ng . h. ml^-1 ,Cmax= （95. 86±21. 28） ng.ml^-1 ,and Tpeak = （1. 8±0. 32） h, the pharmacokinetic parameters of market available tablets were： AUC = （342.73±84.96） ng.h.ml^-1 , Cmax = （46.34±10.32） ng.ml^-1 ,and Tpeak = （2. 65±0. 24） h. Statistical analysis showed there was significant difference in the relative bioavailability of 2 forms of DMH（P〈0.01）. The relative bioavailability of RODTD to market tablet was 175.66%. Conclusion： The developed RODTD can obviously increase the relative bioavailability of DMH

Abstract:Objective： To determine AR-Ⅰ content in total furostanol saponins of Asparagus cochinchinensis. Methods： High performance liquid chromatography （HPLC） was used and the condition was： Diamonsil C18 column （5 mm×250 mm, 5μm）, mobile phase： CH3CN-H2O （36 ： 64） ：flow rate： 0.8 ml/min; injector volume：20μl;colum temperature： room temperature. Evaporative light scattering detector（ELSD） condition was： drift tube temperature： 40℃, and nebulizer gas pressure （N2） ： 2.0×10^5 Pa. Results： The linearity was good when AR-I was within the range of 0. 094-0. 940 0 g.L^-1 （r=0. 999 2）. The test had higher sensitivity and good stability. The average recovery was 101.3% （n= 6）and RSD was 2.36%. Conclusion： HPLC-ELSD is practical and reliable for the determination of the furostanol saponins of Asparagus cochinchinensis

Abstract:Objective：To establish an orthotopic autologous liver transplantation model with bile duct ischemia-reperfusion injury in rats, so as to make it easy for the operation. Methods： Eighty SD rats were used to establish the models. The method used for this model was the same as the one for orthotopic liver transplantation, except for the blood vessel anastomosis and the constant pressure perfusion of portal vein and abdominal aorta. The portal vein and the hepatic artery reperfusion were controlled by artery clamp. Results： The successful rate of the operation for establishing the model was 95 % （76/80） and the anhepatic phase was （16±2） min. The periods of hot and cold ischemia and reperfusion could be accurately controlled and the effect of double constant pressure perfusion was good. There was no erythrocyte in the capillary of bile ductal wall under the light microscope after the reperfusion. Conclusion： This technique, simulating the whole process of liver transplantation, is simple and has high successful rate. Besides,it rules out the influence of immune agent on bite ducts impairment, and better reflects the pathophysiological process of bile ducts ischemia and reperfusion injury, providing a novel approach for investigation of bile ducts injury during liver transplantation

Abstract:Objective： To introduce 3 methods for preparation of stomach-conserving gastroesophageal reflux disease （GERD）model in rats, so as to improve the quality and successful rate of model preparation. Methods： Male Sprague-Dawley rats were divided into sham-operated（SO） group （n= 20） and 3 stomach-conserving reflex model groups： d uodenogastroesophageal reflux （DGER） group （n= 47, esophagogastroduodenal anastomosis）, gastroesophageal reflux（GER） group（n= 20, partial pyloric ligation ＋ cardiomyotomy followed by gastric fundus-esophagus anastomosis） and duodenoesophageal reflux （DER） group （n= 21, jejuno-esophageal anastomosis followed by duodeno-esophageal anastomosis）. Rats were observed closely after operation and their body weights were monitored. The rats that died unexpectedly were autopsied immediately and the surviving rats were sacrificed to observe the esophageal pathological changes at 1, 2, 3, and 4 months after operation. Results： Three rats died due to anesthetic accidents;26 （24. 1% ） died unexpectedly after operation, 18（38.3%）in DGER group, 1 （5%） in GER group, and 7（33.3%）in DER group; no rat died in SO group. Necropsy showed that the death cause of rats included obstruction, infection, asphyxia, hemorrhage, anastomosis leakage and perforation, etc. Esophageal pathological changes were noticed in all rats of 3 model groups; the life quality of surviving rats was good. Conclusion： The 3 methods for establishing rat stomach-conserving GERD model can produce high quality model and high rate of pathological changes, but with high post-operation mortality. In addition to rational operative methods, avoiding post-operation complications and unexpected death are also very important for successful GERD model preparation

Abstract:目的:评价肝移植术后Banff积分指导下抗急性排斥反应(AR)个体化治疗的临床价值.方法:2002年1月至2004年8月,246例肝移植(LT)患者术后3个月内共发生肝穿刺病理证实的AR 44例(52例次),按患者第1次原位肝移植手术的年月次序分2组抗AR治疗,病理按Banff参数评分.对照组(n=24,29次),均采用大剂量甲泼尼龙(MP,总量2 100 mg)冲击治疗;个体化治疗组(n=20,23次),据Banff积分将AR分为交界性、轻度和中重度,分别应用总量1 000、1 500、2 100 mg的MP冲击.观察2组治疗效果和不良事件.结果:对照组和个体化治疗组的AR发生率分别为18.2％(24/132)和17.5％(20/114).对照组中需用ATG抗AR 1例,出现骨髓抑制、肺部感染、上消化道并发症和MCV感染各1例;个体化治疗组出现上消化道并发症1例和肺部感染2例.以抗AR治疗次数累计不良事件,其发生率2组分别为17.2％(5/29)、13.0％(3/23),两者无显著差异(xc2=0.645 8,P=0.421 8).结论:Banff积分指导下的个体化抗AR和经典MP冲击抗AR治疗近期效果一致,不良事件的发生率也无明显差异,有一定的临床应用价值.

Abstract:目的:观察内皮素转换酶1(endothelin-converting enzyme-1,ECE-1)在动脉粥样硬化(atherosclerosis,AS)大鼠中的表达情况,探讨AS可能的内皮发生机制.方法:雄性SD大鼠,随机分为正常组和AS组(n=8);AS组大鼠以高脂饮食方法建立AS模型,正常组大鼠正常饮食.免疫组织化学法、RT-PCR分别分析两组动脉组织中ECE-1蛋白及mRNA表达;提取动脉血管膜蛋白,以内皮素前体作为底物与一定量的组织膜蛋白进行酶解反应,放射免疫法测定酶解产物ET-1的含量,观察组织ECE-1的体外活性;放射免疫法比较两组大鼠血浆中ET-1的含量.结果:正常组大鼠的血管内皮细胞和中膜平滑肌细胞(SMC)中有ECE-1微弱表达(8.58±0.92),阳性染色常位于细胞膜和胞质内;AS组大鼠的血管内皮细胞和内膜SMC中ECE-1表达显著增高(19.12±0.37,P＜0.01).AS组大鼠血管组织ECE-1 mRNA表达(2.04±0.18)明显高于正常组(0.83±0.01,P＜0.01);AS组大鼠血管组织ECE-1体外活性高于正常组[(22.47±1.49)vs(18.89±1.55)Pg/ml,P＜0.05];AS组大鼠血浆ET-1值明显高于正常组(79.42 vs 32.25 pg/ml,P＜0.01).结论:大鼠血管组织ECE-1异常表达可能通过提高血浆ET-1含量促进AS的发生发展.

Abstract:目的:研究准分子激光原位角膜磨镶术(LASIK)、准分子激光上皮瓣下角膜磨镶术(LASEK)手术前后人眼波前像差的变化规律及影响因素,为个体化切削奠定基础.方法:对行LASIK或LASEK的患者44人(86眼)于术前,术后1、3及6个月分别行波前像差检查,数据结果进行统计分析.结果:术后1、3、6个月(瞳孔直径6 mm),总波前像差比术前分别减少约61％、65％、62％;高阶像差增加110％、76％、64％,其中球差增加最明显,为285％、119％、125％.术后总波前像差和高阶像差随瞳孔直径的增加而增加.术后高阶像差的增加随切削量的增大而增加,随切削区直径的增大而减少.两种手术方式下,术后高阶像差均高于术前(P＜0.05),但两种手术方式对术后高阶像差的影响无显著差异.结论:LASIK和LASEK手术均能降低总波前像差,增加高阶像差,其改变程度受瞳孔直径、手术切削量以及切削区直径等因素的影响.

Abstract:目的:通过对腹腔镜手术套管针直接第一穿刺技术的临床应用,探讨这一穿刺方法的可行性和安全性.方法:回顾性分析2003年11月至2005年11月我院采用套管针直接第一穿刺技术进行的700例腹腔镜手术的穿刺情况.结果:700例脐孔穿刺采用套管针直接第一穿刺技术方法完成的患者中,穿刺成功685例(97.86％);穿刺不顺利15例(2.14％);无穿刺失败者.结论:应用腹腔镜手术套管针直接技术后可以提高脐孔第一穿刺的安全性,减少第一穿刺步骤及第一穿刺并发症.

Abstract:目的:探讨环氧化酶2(COX 2)在肝衰竭损伤肝组织中的表达.方法:BALB/c小鼠随机分为正常对照组(n=6)和肝衰竭组(n=24),前者以生理盐水200μl腹腔注射,后者采用内毒素(LPS)10 μg/kg和D-氨基半乳糖(D-Gal)900 mg/kg联合腹腔注射,对照组在注射后8 h、肝衰竭组在注射后不同时点(2、4、6、8 h)检测血浆谷丙转氨酶(ALT)、谷草转氨酶(AST)、白介素10(IL-10)、肿瘤坏死因子α(TNF α)、细胞黏附分子1(ICAM 1);处死动物,以原位灌注消化法分离肝Kupffer细胞后,半定量RT PCR检测其中COX-2 mRNA的表达.结果:与对照组相比,肝衰竭组血浆ALT、AST、IL-10、TNF α、ICAM-1水平均显著升高(P＜0.05),且随损伤时间的延长而逐渐升高(P＜0.001);COX-2 mRNA仅在肝衰竭组表达,表达量随肝损伤时间延长也逐渐增高(P＜0.001).结论:COX-2在损伤肝组织中大量表达,且表达量随肝损伤程度而升高,提示其可能参与了LPS/D-Gal诱导的肝衰竭模型肝损伤过程.

Abstract:1 病历摘要患者．女．23岁，因“双下肢水肿及泡沫尿3个月”于2000年12月26日入院。患者2000年9月下旬无诱因下出现双下肢水肿和泡沫尿，无膀胱刺激征、皮疹、关节肿痛、牙龈出血和腹痛。发病前1个月内无发热、咽痛及皮肤疖肿等。当地医院查尿蛋白（卅），红细胞5～6个／HP．Scr 59 μmol／L．诊断为“肾炎”，治疗（具体不详）后双下肢水肿无改善。2000年12月22日我院门诊查尿蛋白（＋＋），尿红细胞8～10个／HP，予泼尼松30mg／（kg·d）．为进一步诊治收入院。患者无结核、肝炎等传染病史，无药物过敏史，无疫水及毒物接触史，无烟酒嗜好，无家族遗传病史。[第一段]

Abstract:异质性评价是Meta分析中必须要进行的一项工作,对于保证Meta分析的质量具有重要的意义.本文介绍了异质性含义、来源和检验方法,重点讨论了异质性的处理方法.

Abstract:机械通气相关肺炎（VAP）是指机械通气（MV）48h后及停用机械通气去除人工气道48h内发生的医院内获得性肺炎，是医院内获得性肺炎最常见类型之一，发生率高、死亡率高，医疗成本昂贵。防治VAP的重要一环就是了解其发生的危险因素，采取针对性的预防措施。[第一段]

Abstract:β-环糊精（p—cyclodextrin，β-CD）及其衍生物是在毛细管电泳手性拆分研究中应用最为广泛的一类手性添加剂，目前的研究多集中在经化学修饰的β-CD衍生物上，希望通过特定结构侧链或基团的引人能在增加β-CD衍生物溶解性能的同时增强其对手性化合物的拆分能力。麻黄碱对映异构体中只有D-型麻黄碱具有药理活性，临床上所应用的麻黄碱类药物都不同程度的混杂有对映异构体。已有文献报道以毛细管电泳方法对麻黄碱和伪麻黄碱进行拆分研究，但拆分效果始终不太理想。本研究参考有关文献制备了β-CD硫酸酯，并尝试通过将自制的手性添加剂β-CD硫酸酯和市售羟丙基β-环糊精组成混合手性添加剂，采用毛细管电泳法对麻黄碱和伪麻黄碱混合液中的2对口型和D-型对映体进行分离，取得了较好的效果。[第一段]

Abstract:本研究采用血清学、肝组织病理学、免疫组织化学及实时定量PCR等方法，对8例急性、亚急性重型乙型病毒性肝炎存活病例的肝炎病毒标志物、HCV—RNA、HBV—DNA及前C区变异情况进行随访检测，以观察其远期预后。[第一段]

Abstract:以往研究发现根据肺癌的发病环节寻找肺癌防治的有效靶点是降低肺癌的发病率、死亡率及提高其生存率的重要途径之一。本研究应用免疫组织化学方法观察非小细胞肺癌（NSCLC）中VEGF的表达，探讨它在NSCLC发生发展中的意义。[第一段]

Abstract:三尖瓣关闭不全多为功能性，常继发于左心瓣膜病变致肺动脉高压和右心室扩张，器质性病变者多见于风湿性心脏病，常为联合瓣膜病变。单纯性三尖瓣关闭不全非常少见，见于先天性三尖瓣发育不良、外伤、右心感染性心内膜炎等。本院1997年3月至2005年5月手术治疗单纯性三尖瓣关闭不全12例，现报告分析如下。[第一段]

Abstract:我们自2000年7月至2005年5月，共施行主动脉弓部动脉瘤手术61例，取得了比较满意的临床效果，现将围术期处理的经验报告如下。[第一段]

Abstract:随着医学研究的不断发展，对家族性疾病的家系登记需要建立一套实用可靠的自动化管理系统。我们应用Office2000中的Access2000数据库软件，设计并开发了一套家族性腺瘤性息肉病（familial adenomatous polyposis，FAP）登记管理系统，取代了以往的卡片登记，不仅极大提高了工作效率，更主要的是无需编程，方便了资料的保存、查询和利用。现报告如下。[第一段]

Abstract:肺肿瘤已成为人类癌症死亡的主要原因之一，且发病率及死亡率增长迅速，因此对其早期诊断有着重要意义。^18F—FDG PET-CT是目前很有发展前途的一种相对无创性肿瘤诊断技术，本研究对56例肺部肿块患者进行了^18F—FDG PET—CT检查，并与穿刺或术后病理结果对照，旨在评价其在肺癌诊断中的临床应用价值。[第一段]

Abstract:消化道肿瘤患者晚期常并发有腹水，治疗较为棘手，预后较差。我科自2003年5月至2005年10月采用腹腔内注射国产肿瘤坏死因子（tumour necrosis factor，TNF，商品名纳科斯，上海赛达生物工程有限公司生产）治疗恶性腹水患者共46例，现将其疗效和不良反应报告如下。[第一段]