Abstract:Several epidemic influenza viruses leading to worldwide periodical pandemics all result from the genetic reassortment of different influenza viruses. The novel 2009 A/H1N1 virus is a reassortment virus evolved from swine influenza virus A/H1N1,avian influenza virus H5N1,and human influenza virus A/H1N1. The 8 fragmente genes of the novel A/H1N1 virus had their own evolutionary characteristics.All the pandemic viruses in humans originate from avian influenza viruses and are transferred into humans after reassortment processes in pigs. Pigs as middle host and a mixing vessel of influenza A virus play an important role in the evolution of the 2009 novel A/H1N1 virus. More attention should be paid on the role of swine in the prevention and control of novel H1N1 virus epidemics in future.

Abstract:Since the first reported case of swine influenza A in Mexico, a total of 15 510 cases have been confirmed in 53 countries by May 29, 2009.On April 29, 2009, the World Health Organization (WHO) raised its pandemic alert from grade 4 to grade 5.The virus is described as a new subtype of A/H1N1 and is not detected in pigs or humans previously.The virus is sensitive to oseltamivir and zanamivir, but resistant to amantadine and rimantadine.The genetics of the virus are so novel that humans are unlikely to have much immunity to it.The virus can transmit from human to human; therefore it is necessary to enforce quarantine measure for close contactors because the virus transmits during latency.Precaution methods like covering noses and mouths with a tissue when coughing or sneezing can reduce the transmission opportunity.Hands should be washed frequently with soap, especially after coughing or sneezing.Public places with ventilation conditions, personal health behavior and health condition are critical for the prevention and control of this epidemic.

Abstract:Objective:To investigate the evolutionary relationship of the hemagglutinin（HA）gene of novel influenza virus A/H1N1 in 2009 pandemic with the HA genes of A/H1N1 viruses isolated in different parts of the world previously. Methods: The sequences of the HA gene of the novel A/H1N1 strain and the reference sequences of human, swine, and avian influenza A viruses were retrieved from NCBI. MEGA 4.0 software was employed to align, blunt nucleotide sequences, and construct phylogenetic tree. The deduced amino acid sequences of the HA genes of novel influenza virus A/H1N1 were compared with those of the A/H1N1 isolates in North America, Europe, and Asia.Results: Phylogenetic tree of the HA genes of A/H1N1 strains worldwide showed that the HA genes of novel influenza virus A/H1N1 in 2009 shared a high homology with those of the 7 human A/H1N1 influenza viruses isolated in North America during 1976 to 2007, and shared a low homology with those of the human influenza viruses A/H1N1 isolated in Europe and Asia. Phylogenetic tree of the HA gene between different species showed that the HA genes of novel influenza virus A/H1N1 in 2009 had a close evolutionary relationship with those of the two swine A/H1N1 strains isolated in 1998 and 2007 in North America,but a distant evolutionary relationship with those of swine and avian A/H1N1 isolated in Europe and Asia. Alignment of amino acid at important antigenic sites showed that the HA gene of the novel A/H1N1 strains shared important antigen sites with the swine A/H1N1 influenza viruses isolated in North America, and did not share with the swine A/H1N1 influenza viruses isolated in Europe and Asia or the human A/H1N1 influenza vaccine strains.Conclusion: The HA genes of the novel influenza virus A/H1N1 might originate from swine A/H1N1 influenza viruses in North America after a long time evolution and the reassortment with fragments of human A/H1N1 in the area, and the current A/human/H1N1 influenza vaccine may not be effective for the novel A/H1N1 virus.

Abstract:Objective:To investigate the genetic characterization (evolution,antigenicity,enzymatically active site,and glycosylation site) of the neuraminidase (NA) gene of the novel influenza virus A/H1N1 in 2009 pandemic. Methods:Genetic evolution and amino acid substitutions of the 43 NA gene sequences of influenza virus A of different years were retrieved from GenBank and were analyzed by using MEGA 4.0 software. Results:The new A/H1N1 influenza virus strains and avian H5N1 influenza virus strains had similar antigen sites of the NA genes,sharing a homology of 85%.Amino acid residues at the enzymatically active site of the NA genes were strictly conserved in all influenza virus strains,but the glycosylation sites varied. Conclusion:The NA genes of novel H1N1 influenza viruses may originate from avian H5N1 influenza virus endemic in Asia. The new H1N1 influenza viruses may respond well to the neuraminidase inhibitor treatment.

Abstract:Objective:To analyze evolutionary characteristics of the matrix protein (M) and nucleoprotein (NP) genes of influenza virus A/H1N1 in 2009 pandemic.Methods: The M and NP genes of A/H1N1 viruses were downloaded from NCBI database.MEGA4.0 software and NJ method were used for sequence alignment,protein sequence alignment,and the phylogenetic tree construction.Meanwhile,Epi Info software was used to analyze the linear trend of evolutionary distance of the M and NP genes of human H1N1 strains isolated during 1918 to 2009.Results: The M and NP gene sequences were similar among the novel A/H1N1 viruses,but different from those of the previous influenza H1N1 viruses.Using reference sequences of human H1N1 strains isolated during 1918 to 2008,we found that changes in evolutionary distances of the M genes between novel A/H1N1 strains and each of the reference A/H1N1 strains increased with increasing year intervals (Ptrend = 0.001).Compared with the amino acid sequence of M2 protein of reference human A/H1N1 virus strains isolated during 1918 to 2008,the novel A/H1N1 viruses had the amino acid substitutions at 6 sites: 11,43,54,57,77,and 78.Compared with swine and avian A/H1N1,the novel A/H1N1 virus only had the amino acid substitutions at 43 and 77.Conclusion: The NP gene of novel A/H1N1 virus,which is routinely considered as a conserved sequence,is different from those of the previously isolated human H1N1 influenza viruses; the related mechanisms and consequences on viral activity remain to be elucidated.The substitution to threonine at 11 and 43 amino acids of M2 protein might contribute to amantadine resistance of the novel H1N1 virus pandemic in 2009.

Abstract:Objective:To elucidate the genetic characteristics and deduced protein variation of nonstructural protein(NS)gene of the novel influenza virus A/H1N1 in 2009 pandemic.Methods: The sequence of NS gene of A/H1N1 viruses isolated in North America,Europe,and Asia during 1930-2009 were downloaded from NCBI database.MEGA4.0 software and NJ method were used for sequence alignment,protein sequence alignment,and the phylogenetic tree construction.Results: The NS genes of novel influenza virus A/H1N1 in 2009 pandemic were originated from A/swine/H1N1 virus of 2005-2007; they shared a high homology of 97.5％-97.6%.There was an obvious evolutionary relationship between the NS genes of novel A/H1N1 virus and those of the influenza A/swine/H1N1 viruses isolated in North America from 1930 to 2007.No obvious changes were found in the amino acid sites for the antagonistic function of NS1 against the host antiviral capacity among these viruses.Conclusion: The NS gene of novel influenza virus A/H1N1 in 2009 pandemic might evolve from swine A/H1N1 influenza viruses isolated in the United States.The antagonistic function of NS1 against the host antiviral capacity is not changed.

Abstract:Objective:To elucidate the evolutionary characteristics of polymerase PA,PB1,and PB2 genes of the novel influenza virus A/H1N1 in 2009 pandemic. Methods: The sequences of the PA,PB1,and PB2 genes of the novel H1N1 strains in 2009 pandemic,and the reference sequences of human,swine,and avian influenza viruses isolated during different years at different locations were retrieved from NCBI. Molecular Evolutionary Genetics Analysis version 4.0 （MEGA4.0） software was employed to align and blunt nucleotide sequences,construct phylogenetic tree,deduce and align PB2 protein sequences,and the results were compared between the novel A/H1N1 and each of the reference strains. Results: The sequences of the PA,PB1,and PB2 genes of 2009 novel A/H1N1 strains isolated from different locations shared a high homology and clustered in a unique new clade,and were close to the swine influenza viruses. The PA,PB1,and PB2 genes of the novel H1N1 viruses had a high similarity with the corresponding sequences of a human H1N1 strain isolated in Iowa State of USA in 2005 (A/Iowa/CEID23/2005/H1N1). Alignments of the deduced protein sequences showed that the 627th amino acid of PB2 of the novel H1N1 strains and A/Iowa/CEID23/2005/H1N1 were glutamic acid (Glu),which was the same as that in the avian influenza virus in Iowa State of USA in 2005 (DQ889682), and was different from those of the reference sequences of human A/H1N1 strains isolated from 1918 to 2008,which were lysine (Lys). Conclusion: The 2009 novel A/H1N1 virus might be originated from the human A/H1N1 strains isolated in 2005 in Iowa State of America (A/Iowa/CEID23/2005/H1N1),and the polymerase gene of the novel H1N1 virus might reassort with avian A influenza virus.

Abstract:. Objective:To analyze the recombination of full-length genomic sequences of novel influenza virus A/H1N1 in 2009 pandemic.Methods:The full-length sequences of the novel A/H1N1 and reference sequences were downloaded from NCBI database. MEGA4.0 software was used to connect, align sequences, and analyze the similarity between the full-length sequences of the novel virus and each of the reference strains.Recombination was analyzed by Simplot software (version 3.5.1).Results:Simplot analysis indicated that the PB1 genes (polymerase B1, PB1) of the novel A/H1N1 viruses might evolve from human H3N2 virus (identity:93.7%); the PB2 genes (polymerase B2, PB2) and the PA genes (polymerase A, PA) might evolve from avian H5N1 viruses (identity:89.0%, 89.9%, respectively); the HA genes (hemagglutinin, HA), the NP genes (nucleoprotein, NP) and the NS genes (non-structural protein, NS) showed high similarities with those of swine H1N1 viruses isolated in North America (identity:91.7%, 93.1%, and 93.1%, respectively); and the NA genes (neuraminidase, NA) and the MP genes (matrix protein, MP) might evolve from European swine H1N1 viruses (identity:90.5%, 95.5%, respectively). The full-length sequence of the novel A/H1N1 viruses had a highest similarities with swine H1N1 viruses isolated in North America (identity:83.9%).Conclusion:The novel influenza virus A/H1N1 is a recombinant virus evolving from human H3N2 viruses, swine H1N1 from North America, swine H1N1 from Europe, and swine H5N1 from Asia.

Abstract:Objective:To investigate the protective effects of proanthocyanidin on radiation-induced injury of AHH-1 and HIEC cells,and to explore the possible molecular mechanism.Methods: CCK-8 assay was applied to examine the survival of AHH-1,HIEC cells after γ-ray irradiation with or without proanthocyanidin pretreatment.Annexin-Ⅴ/PI staining and flow cytometry analysis were used to evaluate the apoptosis and cell cycle of AHH-1 and HIEC cells.The expression of Bcl-2 protein was analyzed by Western blotting assay.Results: Pretreatment with proanthocyanidin significantly increased the cell survival rate after radiation(P<0.01).The apoptosis rates of cells in the proanthocyanidin+radiation group were (11.78% at 4 Gy\[AHH-1\] and 5.32% at 8 Gy\[HIEC\],respectively) greatly lower than those of the single radiation group (26.38% at 4 Gy\[AHH-1\] and 12.45% at 8 Gy\[HIEC\],respectively,P<0.01).Moreover,the inhibition of Bcl-2 protein expression in AHH-1,HIEC cells was attenuated in the proanthocyanidin+radiation group.Conclusion: Proanthocyanidin has satisfactory protective effect on radiation-induced cellular injury; the mechanism may be related to the attenuation of Bcl-2 protein inhibition.

Abstract:Objective:To observe the effect of imatinib mesylate on pulmonary fibrosis (PF) induced by bleomycin in mice and to explore the related mechanism. Methods: Totally 120 C57BL/6 mice were evenly randomized into control group, model group, dexamethasone group and imatinib group. The pulmonary fibrosis model was established using a single intratracheal infusion of bleomycin; the corresponding drugs were given to mice in each group. Ten mice was sacrificed in each group on day 7,14, and 21 after operation, respectively. The expression of matrix metalloproteinase 1(MMP-1), tissue inhibitor of metalloproteinase 1 (TIMP-1), and transforming growth factor β1(TGF-β1) in the lung tissues was semi-quantitatively analyzed by immunohistochemistry method. Results: Immunohistochemistry results showed that the expression of TIMP-1,MMP-1, and TGF-β1 in lung tissues of the dexamethasone group and imatinib group was significantly lower than that in the model group(P<0.01). There was a positive correlation between TGF-β1 and TIMP-1 expression(r=0.243,P=0.004). A negative correlation was found between MMP-1 and TIMP-1 in all the other 3 groups other than in the normal control group(r=-0.291,P＜0.000 1). Conclusion: Imatinib may downregulate TGF-β1 expression, inhibit TIMP-1 expression, and upregulate MMP-1 expression, maintaining the balance of TIMP-1/MMP-1,subsequently inhibit the development of pulmonary fibrosis, showing a similar effect of dexamethasone.

Abstract:1临床资料患者，男，27岁，骑摩托车高速行驶中撞到栏杆致右股骨近端开放性粉碎性骨折，当地医院摄片（图1A、1B）诊断为右股骨近端开放性粉碎性骨折，并行清创术，1周后于2006年11月转入我院治疗。入院查体：右胫骨结节牵引术后，右股骨近端后外侧可见长25 cm弧形切口，已缝合，未拆线，肿胀明显，末梢循环良好，右下肢感觉无明显异常。诊断为股骨近端开放性粉碎性骨折Gustilo分型ⅢB，MESS评分＜7分。完善相关术前检查和准备后，在硬腰联合麻醉下行“右股骨近端开放性粉碎性骨折外固定术”，术中在C臂机下牵引复位，在股骨大粗隆下3 cm处沿股骨颈方向钻入1枚外固定螺钉，在股骨远端钻入1枚外固定螺钉，装上合适的外固定支架，以先前2枚钢针为基准打入其余螺钉，其中1枚螺钉穿骨折处单侧皮质。患者恢复顺利，术后第2天在床上即可行髋关节、膝关节被动活动。术后1个月复查X线片：骨折对位、对线良好（图1C、1D）。

Abstract:Objective:To explore the value of cadaveric vein allografts in hepatic vein reconstruction in adult-to-adult living donor liver transplantation (LDLT).Methods: The clinical data of 9 recipients, who underwent LDLT (including the hepatic vein reconstruction) in the right liver lobe without middle hepatic vein(MHV) from June 2007 to January 2008,were retrospectively analyzed.The cadaveric vein allografts were stored in 4℃ UW solution within seven days and were used for construction of large hepatic veins such as: tributaries of the middle hepatic vein from Ⅴ,Ⅷ and right inferior hepatic vein.Results: Cadaveric interposition vein allografts were used for venous reconstruction in 9 (81.8%) of 11 cases receiving a modified right liver graft,6 cases receiving one-vein reconstruction,2 cases receiving two-vein reconstruction and 1 case receiving three-vein reconstruction.Only 1 recipient died of renal failure and severe pulmonary infection on day 14 after transplantation without any hemiliver venous outflow obstruction.Doppler ultrasound showed no thrombosis and the blood flowed smoothly in the other 7 recipients during the 9 to 15 months follow-up period.The cumulative patency rates of the 8 survivals for interposition vein grafts were 72.7%(8/11),54.5%(6/11), and 36.5%(4/11) at 3,6, and 9 months,respectively.The regeneration of paramedian sectors was equivalent.Conclusion: Cadaveric vein allograft is safe,simple,and effective in adult-to-adult right lobe living donor liver transplantation for hepatic vein reconstruction.

Abstract:Objective:To observe the dynamic changes of chemokine IP-10 and its soluble receptor CXCR3 in bile,and to explore its relationship with acute graft rejection (AR) after liver transplantation.Methods: A total of 28 patients who underwent orthotopic liver transplantation in our hospital between October 2007 and March 2008 were included in the present study.They were divided into 2 groups according to the presence of AR: AR(n=8) and NAR(n=20).Another 10 patients who underwent endoscopic nasobiliary drainage (ENBD) for cholelithiasis in our hospital served as controls.The levels of chemokine IP-10 and sCXCR3 in the bile were determined by ELISA assay on 1,3,5,and 7 days after transplantation in all the patients and on 1,3,and 7 days after the anti-rejection therapy with glucocorticoid in patients of AR group; the relationship between their levels and the rejection active index (RAI) obtained by Banff criteria were evaluated; and its diagnostic value for AR was assessed.Results: The levels of IP-10 and sCXCR3 in bile gradually increased after liver transplantation and reached the peak on the 5th day after transplantation,and starting from day 5 after transplantation,their levels were significantly higher in the AR group than in the NAR group and ENBD group (P<0.05).Besides,the levels of IP-10 and sCXCR3 in bile were significantly decreased after treatment with glucocorticoid (P<0.05).On the day of AR diagnosis,the the levels of IP-10 and sCXCR3 in bile were significantly correlated with RAI (P<0.05).On the 5th day after transplantation,the diagnostic sensitivity and specificity of IP-10 level for AR were 87.5% and 100%,respectively (cut-off point=964.45 pg/ml); on the 7th day after transplantation,the diagnostic sensitivity and specificity of sCXCR3 were 87.5% and 80%,respectively (cut-off point=819.35 pg/ml).Conclusion: The levels of IP-10 and sCXCR3 in bile are closed related with early graft acute rejection,and their levels may serve as a non-invasive diagnostic indicator for AR and outcome of anti-rejection therapy.

Abstract:Objective:To investigate the protective effect of remifentanil preconditioning on liver ischemia and reperfusion injury in rats.Methods:Forty-eight healthy adult SD rats,weighing 200-300 g,were divided into 4 groups:ischemic reperfusion group(I/R),ischemic preconditioning group(IPC),sham operation group(Sham),and remifentanil preconditioning group(RPC).The RPC group was further subdivided into 3 subgroups according to the dose of remifentanil:0.2 μg·kg-1·min-1(RPC1 group),1 μg·kg-1·min-1(RPC2 group ),and 10 μg·kg-1·min-1(RPC3 group).All rats except for those in the sham group were subjected to ischemia for 45 min and followed by reperfusion for 2 hours.Serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST) and liver homogenate levels of MDA,SOD were determined.H-E staining was used to observe the hepatic histopathological changes and TUNEL staining was used to examine hepatocyte apoptosis.Results:In I/R and RPC1 group,serum ALT and AST were significantly increased; hepatic homogenate MDA content was increased and SOD content was decreased,accompanied by aggravated pathological injury; TUNEL staining showed large amount of apoptotic cells.Compared with I/R and RPC1 groups,serum ALT and AST levels in IPC,RPC2,and RPC3 groups were significantly decreased after liver ischemia and reperfusion,accompanied by decreased homogenate MDA level,increased SOD level,and improved pathological injury.TUNEL staining showed much less apoptotic hepatocytes in IPC,RPC2,and RPC3 groups compared with I/R and RPC1 groups.No obvious changes in histopathology or in other parameters were observed in the sham group.Conclusion:Pre-treatment with remifentanil,like ischemic precondition,can protect liver from ischemia and reperfusion injury.

Abstract:Objective:To study whether sodium-hydrogen exchange inhibitor(NHEI)can enhance the protective effect of hyperpolarized preservation solution containing potassium channel opener (PCO),and the effect was compared with that of Celsior solution.Methods: After equilibrated on a crystalloid-perfused Langendorff model for 30 min,rabbit hearts were divided into four groups:(1) Cel group:receiving another 30 min of equilibration,8 h cold storage with Celsior solution and 1 h reperfusion; (2) Pin group:arrested and stored with pinacidil (a type of PCO) hyperpolarizing cardioplegia; (3) Cel+Car group:receiving the same treatment as Cel group except that 10 μmol/L cariporide (a type of NHEI) was administered during the second equilibration period and reperfusion; and (4) Pin+Car group:receiving cariporide treatment and hyperpolarized arrest and storage.Results: Recovery rate of systolic function in the Pin+Car group was significantly higher than that in the Pin group (\[87.4±11.9\]% vs \[69.0±7.2\]%,P<0.05) and comparable to that in the Cel group (\[93.4±5.2\]%,P>0.05 ).No significant differences were found in any parameters between Cel group and Cel+Car group.There were no differences in coronary flow among all groups.Conclusion: NHEI can greatly enhance the protective effect of PCO hperpolarized preservation solution on the donor heart,and the combination of them has a comparable protective effect to Celsior solution.

Abstract:Objective:To investigate whether transplantation of mesenchymal stem cells(MSCs) through renal arteries can protect kidney from acute tubular necrosis(ATN),so as to lay a foundation for MSC transplantation in treatment of ATN.Methods: Five-week-old nude mice were randomly divided into three groups:normal control group(n=10),acute tubular necrosis(ATN) model group without(n=10) and with MSCs treatment group(n=11).ATN nude mice were induced with 50% glycerin.MSCs labeled with enhanced green fluorescent proteins(EGFP) were injected into kidney through renal arteries.Serum creatinine was determined in all groups and pathological changes of renal tissues were detected using H-E staining.The amount and distribution of the EGFP-marked MSCs in renal tissues were determined with fluorescence microscope.Results: Degeneration and exfoliation of renal tubular epithelial cells,and even renal tubular tamponade with cast-off cells were observed in the ATN group; these pathological changes were mainly located at renal cortex and juncture of renal cortex and medulla.The damages were greatly alleviated in the ATN+MSCs transplantation group,with no swelling of epithelial cells,nuclear condensation or edema.Fourteen days after MSCs transplantation,EGFP positive cells were increased in renal tubules of recipient mice.Conclusion: The MSCs transplantation via renal artery can locate in renal tubular epithelium,and promote the repair of injured renal tubular epithelial cells.

Abstract:Objective:To observe the differential expression of epithelial membrane antigen (EMA) and renal cell carcinoma marker (RCC-Ma) in early renal carcinoma and corresponding adjacent (0.5, 1.0, and 2.0 cm) tissues, so as to estimate the safe margin of laparoscopic partial nephrectomy for renal tumors.Methods:Tissue microarrys, including 44 tissues of clear cell renal cell carcinoma［A］ and normal renal cortex tissues of different distances to the tumor：0.5 cm［B］，1.0 cm［C］ and 2.0 cm［D］, were constructed.The expression of EMA and RCC-Ma was examined by immunohistochemical staining in the four groups. Results:Intensive membranous and(or) cytoplasmic staining of EMA and RCC-Ma was observed in the cancer and adjacent tissues. The positive rate in group A was significantly higher than those of the other three groups（A \[15.91%/18.18%\]，B\[84.09%/79.55%\]，C\[86.36%/77.27%\] and D\[79.55%/75.00%\], P<0.01）.The positive rates of EMA and RCC-Ma expression were not significantly different between the group B, C, and D（P>0.05）.Conclusion:Our data denote that, when laparoscopic partial nephrectomy is done for early renal carcinoma, at least 5 mm of normal parenchyma tissue beyond the pesudocapsule should be excised with the tumor.

Abstract:Objective:To study the role of clinical classification of adult polycystic liver disease (APLD) in guiding the selection of treatments for the patients.Methods:The clinical data of 43 APLD patients who were treated in our hospital from May 1995 to Oct. 2007 were retrospectively analyzed.The patients were divided into 3 stages according to the clinical manifestations and imaging examination:non-symptom or slight symptom stage,obvious symptom stage,and lethal symptom stage.Seventeen patients in our group received outpatient clinical follow-up;26 were treated by partial hepatectomy combined with fenestration.Results:Among the 15 cases at non-symptom or slight symptom stage,one had primary hepatic carcinoma simultaneously and died 4 mouths after diagnosis; the rest 14 case were followed up for a mean of (42.8±37.9) months; 12 of them had slow progression and 2 had rapid progression of APLD; the latter 2 cases received operation.The 24 cases at obvious symptom stage were treated by partial hepatectomy combined with fenestration.There were no perioperation deathes and the mean follow-up period was (61.4±43.0) months; 2 cases died of renal failure and 3 had post-operation recurrence.Two of the 4 cases at the lethal symptom stage were treated by partial hepatectomy combined with fenestration:one had no symptom relieve after operation and one developed hepatic dysfunction and received liver transplantation 8 months after operation; the other 2 patients received percutaneous cyst aspiration at the outpatient department,one patient died of upper gastrointestinal hemorrhage 5 months later,and one had the symptom slightly relieved.Conclusion:Our classification of APLD can help to select treatments for patients:patients at non-symptom or slight symptom stage should be followed up,those at the obvious symptom stage can be treated surgically,and those at the lethal symptom stage are not suitable for routine operation and liver transplantation may be the best choice for them.

Abstract:Objective:To investigate the effect of continuous positive airway pressure (CPAP) on serum NO and plasma ET and myocardial structure in mini pigs with obstructive sleep apnea syndrome (OSAS).Methods: Twenty-four male mini pigs were evenly randomized into 4 groups: normal control group (group A), OSAS model group (group B), CPAP treated group (group C) and positive control group (group D).Animals in group A were not treated and those in the other 3 groups were treated with intermittent hypobaric hypoxia 6 h daily for 22 d.Animals in groups C was also given further CPAP treatment 6 h daily for 30 d.The animals in group D were raised for 30 d and were sacrificed together with those in group C; the animals in group A and group B were sacrificed simultaneously.Sleep monitoring and determination of serum NO and plasma ET were performed before execution and pathological examination of myocardial structure after execution.Results: The apnea-hypopnea index (AHI) of group C was significantly lower than those of group B and D and higher than that of group A (P<0.05); the SpO2 of group C was significantly higher than those of group B and D (P<0.05), and was similar to that of group A.The levels of NO in group A, B, C, and D were (0.221±0.062), (0.115±0.061), (0.110±0.033), (0.077±0.043) μmol/L, respectively, and the levels of ET were (40.2±4.8), (99.8±22.4), (67.1±18.5), and (103.7±30.1) pg/ml, respectively.Group C had significantly higher NO level and lower ET level compared with group D (P<0.05).The ET level in group C was significantly lower than that in group B (P<0.05).Pathological examination showed that the myocardial structure in group B, C, and D all had hypoxia and ischemia damage compared with group A; the damage in group C was slighter than that in group B and D, but severer than that in group A.Conclusion: Thirty day-treatment with CPAP can improve the sleeping indices, plasma ET and serum NO level, and myocardial structure of OSAS mini pigs.

Abstract:Objective:To analyze the association of recognition and behavior of diabetic rats with the expression of β-amyloid protein (Aβ) and cAMP response element binding protein (CREB),so as to pave a way for studying the role of diabetic metabolic disorder in the mechanism of Alzheimer’s disease.Methods:Animal model of diabetes mellitus was established by intraperitoneal injection of streptozocin.Wistar rats were randomly divided into normal control groups(N),4 week diabetes mellitus model group (M4),6 week diabetes mellitus model group (M6),and 8 week diabetes mellitus model group(M8).The changes of recognition and behavior were tested by Morris water maze task and shuttle box task.Congo red staining was used to detect the deposition of beta-amyloid in the brain tissues.Expression of Aβ was measured by enzyme linked immunosorbent assay.CREB and pCREB were tested by enzyme linked immunosorbent assay,RT-PCR,and Western blotting assay.Results:Behavioral tests showed that the learning ability and memory of animals in the diabetes mellitus model groups were impaired and significantly decreased compared with those in the normal control group(P<0.01).Compared with the normal control group,the model groups showed higher Aβ expression and lower CREB and pCREB expression (P<0.01),with no significant difference found between the three model groups.The expression of Aβ was negatively correlated with the expression of CREB and pCREB,and was positively correlated with learning and memory impairment of animals.CREB and pCREB were negatively correlated with the learning ability and memory impairment of animals.Conclusion:Diabetes mellitus can contribute to Alzheimer’s disease through increasing expression of Aβ and decreasing expression of CREB and pCREB.

Abstract:Objective:To observe the influence of spent culture supernatant (SCS) of Lactobacillus acidophilus strain LA14 on the contraction of isolated intestinal smooth muscle and to discuss the related mechanism.Methods: The ileum samples of rabbits were prepared and the contraction frequency and amplitude of intestinal smooth muscle were observed as the normal control.Then the SCS, bacterium suspension, and SCS with bacterium suspension were added by an accumulative dose to the culture media (0.3 ml per times, at an interval of 6 min), respectively.Four minutes after each administration, the contractive curves were recorded for 2 min.The influences of various groups of Lactobacillus acidophilus on the contraction of isolated intestinal smooth muscle were observed.The effect of SCS on M cholinoceptor was observed by adding in order pilocarpine, atropine or SCS, and pilocarpine.Results: After continuous administration of SCS or SCS with bacterium suspension (0.6-1.5 ml), the contraction frequency of the intestinal smooth muscle was significantly lowered compared with before administration（P<0.05 or P<0.01），and there were no significant differences between before administration and other volume groups（P>0.05）.Within the range of 0.3-1.5 ml, the SCS, bacterium suspension, and SCS with bacterium suspension resulted in no significant difference in reducing the contraction amplitude, except for SCS with bacterium suspension at 1.5 ml（P<0.05）.SCS or atropine significantly inhibited pilocarpine-induced increase of contraction amplitude（P<0.05 or P< 0.01）.SCS also reduced the contraction frequency of the intestinal smooth muscle（P<0.01）.Conclusion: SCS of Lactobacillus acidophilus may inhibit the peristalsis of the intestinal smooth muscle of rabbits by blocking M cholinoceptor.

Abstract:Objective:To examine the pathologcial changes of glial cells after chronic optic nerve compression,so as to discuss the interaction between the glial cells and neurons. Methods:Thirty adult cats were randomly divided into 6 groups (n=5),namely,control group,sham operation group,1-week compression group,2-week compression group,4-week compression group,and 8-week compression group. The chronic optic nerve injury model was produced by an inflatable balloon implanted under the optic chiasm in the latter 4 groups.All the animals were sacrificed and perfused; the optic nerves were removed and the cellular responses of the nerves were observed by electronic microscopy; and the expression of glial fibrillary acidic protein(GFAP),myelin basic protein(MBP),carbonic anhydraseⅡ(CAⅡ ) and ED-1 was exmined at various time points by immunohistochemical staining.Results:Under the electron microscopy,the normal optic nerves had integrated myelin structure,clearly and closely arranged neural plate.The optic nerve presented slight demyelination 2 weeks after compression; myelin laminalle dissociating and glial cell degenerating occurred 4 weeks after compression; and the demyelination became more obvious and the most myelin became thiner 8 weeks after compression.No obvious immunohistochemistral changes were found in the optic nerves during the first two weeks of compression.The MBP staining was disturbed and lost at 4 weeks after compression,which became more obvious 8 weeks after compression.The CAⅡ staining in the compressed region was irregular and lost at 4 weeks,which was more obvious at 8 weeks; the staining in non-compressed region was normal.The intensity of GFAP staining was reduced in the compressed region and increased at proximal portion of the nerve at 4 weeks,which became more significant at 8 weeks.The ED-1 positive cells were found in the normal nerve with low density.The positive cells increased around the compressed region at 4 weeks and became more significant at 8 weeks.Conclusion:Glial cell degeneration and death occur in the compressive region afte chronic compression of optic nerve.The proximal portion of the compressed nerve has astrocyte proliferation and microglia activation,indicating that functional change of glial cells may contribute to chronic optic nerve injury.

Abstract:Objective:To isolate endophytic fungi from Panax ginseng and study their antifungal and antitumor activities.Methods:Endophytic fungi were isolated from 5-year-old garden ginseng and 15-year-old transplanted ginseng.The antifungal active endophytes were screened with Pyricularia oryzae P-2b model using mircodilution method, and the activities of endophytes against pathogenic fungi were tested in vitro. The antitumor activities of the endophytes were examined by MTT method in vitro. Results:Sixteen (33.3%) of the 48 endophytic fungi fully suppressed the activity of P.oryzae P-2b; 11 (22.9%) colonies showed satisfactory antifungal activities against Candida albicans, Cryptococcus neoformans, Trichophyton rubrum, and Aspergillus fumigatus; and 5 (10.4%) colonies showed satisfactory antitumor activities against tumor cell lines MKN45, LOVO, HepG2, and HL-60. Among the bioactive colonies, Yuan-25 showed best antifungal activity, with its MIC80 aganinst Trichophyton rubrum being 4 mg/L, which was similar to that of fluconazole. Yuan-27 showed the best antitumor activity, with its IC50 similar to that of doxorubicin.Conclusion:Isolated endophytic fungi of Panax ginseng has antifungal and antitumor activities and is worth further exploring.

Abstract:Objective:To observe the serum profile of Th17-related cytokines（IL-1β,IL-6,IL-17A,IL-23, and TGF-β）in patients with primary biliary cirrhosis,so as to study the role of Th17 cells in the pathogenesis of primary biliary cirrhosis (PBC).Methods:Seventy-eight patients with PBC,30 patients with HBV-related posthepatitic cirrhosis(PHC),and 60 healthy controls (HC) were enrolled in this study.The serum levels of above five Th17-related cytokines were determined by enzyme-linked immunosorbent assay (ELISA).Results:The levels of IL-1β,IL-6,IL-17A, and IL-23 in PBC group were significantly higher than those in HC group (P<0.05); the levels of TGF-β were comparable between the PBC group and HC group.The levels of IL-1β,IL-6, and TGF-β were significantly lower and IL-17A,IL-23 were significantly higher in the PBC group compared with those in the PHC group (P<0.05).Conclusion:Our findings indicate that PBC patients are in a status of chronic inflammation.Th17 subset may play an important role in the development and progression of PBC.

Abstract:Objective:To observe the presence of dentritic cells (DC) in lung tissues of rat models of chronic obstructive pulmonary disease (COPD) and the influence of budesonide and ipratropium bromide on the number of DCs.Methods: Sixty male SD rats were randomly divided into four groups(n=15): control group,COPD model group,budesonide treatment group and ipratropium biomide treatment group.The COPD rat models were established by intratracheal instillation of lipopolysaccharide (LPS) twice and exposure to tobacco smoke for 4 weeks.Drug inhalation group received inhalation of budesonide (Pulmicort) or ipratropium bromide (Atrovent) since the second week.The rats were sacrificed at the 31th day.Lung slices were observed with H-E staining for pathological changes and the status of DC were determined by immunohistochemical method.Results: The COPD model group,budesonide treatment group, and ipratropium biomide treatment group all had the pathological changes of COPD,and their DC numbers were significantly higher than that in the control group (P<0.01).DC number in Pulmicort treatment group was significantly less than that in the COPD model group (P<0.01),and there was no significant difference between the Atrovent treatment group and the COPD model group.Conclusion: The pulmonary DCs play an important role in the pathogenesis of COPD.Pulmicort can decrease the number of DCs in rat model of COPD,and ipratropium bromide has no obvious effect on DC number.

Abstract:Objective:To study the prevalence and major risk factors of low blood pressure in the rural area of Maoxian County in Sichuan Province.Methods: A cross-sectional study of low blood pressure was conducted using sampling survey of blood pressure in Maoxian County.Low blood pressure was defined for systolic (SBP) and diastolic (DBP) pressure according to child blood pressure (10-14 years:SBP ≤80 mmHg or DBP≤50 mmHg,1 mmHg=0.133 kPa) and adult low pressure criteria (over 15 years:SBP≤90 mmHg or DBP≤60 mmHg).Results: The prevalences of low blood pressure for males and females were 8.2% and 12.2%,respectively.Prevalences of low blood pressure were 17.3%,12.3%,4.8%,and 5.5% for age groups 10-,20-,40-,and 60-,respectively.Logistic regression showed that the age (OR=0.566,95%CI 0.406-0.789),gender(OR=1.999,95%CI 1.171-3.411) and nationality (OR=6.967,95%CI 2.322-20.905) were correlated with low blood pressure.Conclusion: Younger age is the risk factor of low blood pressure.Females and non-Qiang minorities have higher risk for low blood pressure,which offers clues for further study the causes of low blood pressure.

Abstract:Engraftment with expulmonary adult stem cells has great potential for treatment of acute lung injury (ALI).The engrafted adult expulmonary stem cells can migrate to the injured lung tissue guided by a series of signal factors released by injured pulmonary tissue cells.Stem cells localized in the injured lung tissue and inflammatory area can differentiate into lung tissue cells (including lung epithelial cells and pulmonary vascular endothelial cells) and exert their functions.The engrafted expulmonary adult stem cells are not only capable of differentiation,but also have antiinflammatory effect and immunomodulatory effect,making the related area a focus of study.

Abstract:Bone marrow mesenchymal stem cells (BMSCs) are multipotent nonhematopoietic progenitor cells capable of differentiating into multiple lineages,such as bone,fat,and cartilage.BMSCs preferentially home to the damaged tissue and are beneficial to tissue repair.In vitro studies have shown that they do not induce immune response and can inhibit immune cells involved in alloantigen recognition and elimination.In animal models,BMSCs have been shown to induce peripheral tolerance and migrate to injured tissues,where they can inhibit the release of pro-inflammatory cytokines and promote the survival of damaged cells.The unique properties of MSCs suggest a role in cell therapy and treatment of immunomediated diseases.

Abstract:Signal transducer and activator of transcription 3 (STAT3) is an important member of STATs family and is highly expressed in many kinds of cancer. It regulates the tumor growth by influencing the apoptosis of tumor cells and tumor angiogenesis and becomes a new target for tumor therapy. This article reviews the structure of STAT3,the stimulating factors of STAT3,the tumor growth regulating pathway of STAT3,and its potential as a target for tumor therapy.

Abstract:Protease activated receptor-2 (PAR-2) is a G-protein-coupled receptor.Recent studies indicate that PAR-2 is mainly expressed in leukocytes and activated by pancreatin and (or) tryptase,which subsequently induces inflammation through degranulation of leukocytes.Activation of PAR-2 in leukocytes is possibly involved in the pathogenesis of rheumatoid arthritis.

Abstract:目的:研究通络方药(Tongluo recipe,TLR)对糖尿病(DM)大鼠肾小球内皮细胞增殖的作用。方法:大鼠随机分为正常对照(NC)组、糖尿病对照(DMC)组、糖尿病TLR干预(DM+TLR)组(n=7)。DMC和DM+TLR组大鼠采用链脲佐菌素(STZ,65 mg/kg)腹腔注射诱导糖尿病,1周后血糖≥16.7 mmol/L者为糖尿病模型制备成功;DM+TLR组按每天1 g/kg TLR灌胃,NC和DMC组给予等量的生理盐水。干预12周后,测肾功能和24 h尿白蛋白(UAE),比色法测血浆丙二醛(MDA)和超氧阴离子水平(O2-),ELISA法测糖基化终末产物(AGE),H-E染色及CD31免疫组化染色观察肾组织病理改变,蛋白质印迹法检测肾组织AGE受体(RAGE)、血管内皮生长因子(VEGF)、VEGF受体(Flk-1)、血管生成素(Ang)-1、Ang-2和Ang-2受体(Tie-2)蛋白表达。结果:与NC组相比,DMC组肾质量/体质量(KW/BW)、24 h尿白蛋白(UAE)、MDA、O2-、AGE、RAGE、VEGF、Flk-1、Ang-2、CD31水平和肾小球系膜面积增加,肌酐清除率(Ccr)、Tie-2水平降低(P<0.01或0.05)。与DMC组相比,DM+TLR组大鼠KW/BW、UAE、MDA、O2-、AGE、RAGE、VEGF、Flk-1、Ang-2、CD31水平和肾小球系膜面积降低,Ccr、Tie-2水平升高(P<0.01或0.05)。结论:TLR可能通过降低糖尿病大鼠肾小球氧化应激水平,抑制AGE-RAGE、VEGF表达,进一步抑制肾小球内皮细胞增殖,从而减少糖尿病时肾小球新生血管形成,减轻肾损伤。

Abstract:目的:探讨在高容量血液滤过(HVHF)防治多器官功能障碍综合征(MODS)中血管内皮细胞功能的变化及意义。 方法:18只健康雄性家猪在接受失血性休克复苏再灌注联合内毒素血症的两次打击后,随机分为模型组(MODS组,n=9)和血液滤过组(HF组,n=9)。判断MODS的发生,并计算MODS发生率和病死率。利用ELISA法检测两组不同时间点血清中TXB2和6-keto-PGF1α的浓度及可溶性E-选择素(sE-selectin)和可溶性VCAM-1(sVCAM-1)的表达情况。 结果:与MODS组比较,HF组MODS发生率和病死率明显降低(P＜0.01)。HF组血清中TXB2浓度较MODS组明显降低,6-keto-PGF1α有显著升高(P＜0.01)；HF组血清中sE-selectin的表达在滤过开始后24 h低于MODS组(P＜0.01),而在滤过72 h后又高于MODS组(P＜0.05)；同时血清中sVCAM-1的表达HF组在滤过48 h后低于MODS组(P＜0.05),而处死前又高于MODS组(P＜0.01)。 结论:在复合打击后早期予以HVHF干预,可有效改善血管内皮细胞功能,从而发挥防治MODS的作用。

Abstract:目的:探讨骨桥蛋白（OPN）在宫颈癌中的表达及其作为诊断和预后指标的临床意义。方法:采用免疫组化S-P法检测150例宫颈癌及癌前病变组织（宫颈上皮内瘤样变，CIN）和20例正常宫颈组织中OPN的表达;采用ELISA法检测25例宫颈癌及20例癌前病变（CIN）患者血浆及手术切除标本组织匀浆中OPN的含量，并以10例子宫良性病变（子宫肌瘤、子宫内膜异位症）患者为对照。结果:免疫组化法测得OPN在宫颈癌组织中表达阳性率\[53.2%(50/94)\]显著高于正常宫颈组织\[10.0%(2/20)\]及CIN\[10.7%（6/56）,P<0.05\]；临床Ⅱ、Ⅲ期宫颈癌组织OPN表达阳性率显著高于Ⅰ期者（P<0.05）；宫颈癌有淋巴结转移者OPN表达阳性率显著高于无转移者（P<0.05）。正常宫颈组织、CIN、宫颈癌组织匀浆及相应患者血浆中OPN含量也呈类似的变化趋势。结论:OPN可能与宫颈癌的发生、发展和转移有关，定量检测其表达可作为判断宫颈癌的预后和术后复发的评估指标之一。

Abstract:目的:评价64排螺旋CT血管造影(CTA)对冠心病患者旁路移植(CABG)术后冠状动脉桥血管病变的诊断价值。方法:以选择性冠状动脉造影(SCA)为金标准,采用64排螺旋CT对46例冠心病CABG术后患者可评估的114条桥血管进行分析,评价其诊断冠状动脉桥血管病变的敏感性和特异性。结果:CTA能够清晰判断CABG术后患者桥血管通畅、显著狭窄或闭塞,并能清楚显示桥血管吻合口的情况。CTA正确诊断22处病变,漏诊1处,误诊3节段；敏感性96%,特异性97%,阳性预测率88%,阴性预测率99%；准确率96%。结论:CTA显示冠状动脉桥血管图像清晰,具有诊断价值,可作为评价冠状动脉桥血管病变的一种重要无创手段。

Abstract:退变性腰椎侧凸(degenerative lumbar scoliosis,DLS)是指发生于骨髂成熟后的退变性脊柱畸形,主要发生于50岁以上的中老年人[1]。患者主要表现为不同程度的腰痛、下肢痛、神经源性间歇性跛行等神经根压迫症状,部分甚至合并有马尾神经综合征。DLS以往大多采用卧床休息、药物、理疗、功能锻炼和支具保护等保守治疗手段,但因长期卧床常合并心肺功能下降、坠积性肺炎、褥疮及泌尿系感染等并发症。目前对于保守治疗效果不佳的DLS多主张采用手术治疗。尽管年龄>60岁被认为是造成脊柱手术并发症的一个独立危险因素[2],但随着手术技术、内固定材料及麻醉、监护水平的提高,DLS手术治疗围手术期并发症的发生率已明显下降[3]，且高龄患者的脊柱外科手术已不是绝对禁忌。然而老年尤其是高龄DLS患者常并存各种内科疾病,手术风险相对较大,所以必须强调该类患者手术的围术期处理。

Abstract:孤立性肺结节(solitary pulmonary nodule,SPN)是指不伴有肺门和纵隔淋巴结肿大、肺不张或肺炎的肺实质内的圆形或椭圆形致密影,直径≤3 cm。结节大部分位于周围肺,其影像学检查为无明显典型特点、临床近乎无症状的肺内结节改变[1]。由于CT和MRI的迅速发展及人们对社区健康体检的认知,SPN的被发现率明显提高,早期发现肺癌的机会也明显增多。由于SPN病因复杂,临床上不易明确其良恶性,常延误治疗。正确判断SPN的性质对疾病的治疗起重要作用。对恶性病灶,应尽量早期切除而不至于延误病情;而良性病变,则应避免不必要的开胸手术。因此,SPN的定性诊断与外科治疗策略是放射科和肺外科医生共同面临的重要任务之一[2]。

Abstract:羊水过少(oligohydramnios)即羊水量少于300 ml，是产科常见并发症之一，可发生在妊娠各期，但以晚期妊娠为常见，妊娠早、中期的羊水过少大都以流产告终\[1-4\]。随着B型超声技术在妇产科临床得到广泛的应用，羊水过少的检出率显著增加，羊水过少对围生儿的不良影响也日益受到产科临床医护人员的高度重视\[5-7\]。但目前仍缺乏对B型超声技术诊断效果的全面分析。 彩色多普勒超声仪包括B型成像、彩色多普勒及多普勒流速曲线，既能判断羊水量，又能评价有无脐带缠绕及其血流动力学情况，目前被广泛应用于临床，但对其有效性及应用价值的评价仍很缺乏。因此，本研究对2006年1月至2008年5月我院采用彩色多普勒超声仪诊断为羊水过少的106例孕晚期孕妇的围产情况进行了分析，探讨彩色多普勒技术的诊断效果，并评价其对围产预后的判断价值，为临床应用提供指导价值。

Abstract:高压油漆喷枪直接喷射手指可导致喷射部位油漆注射伤并引起手筋膜室综合征。我院自2006年5月至2008年1月共收治手指高压油漆喷枪注射伤合并手筋膜室综合征6例，通过及时准确的术前和术后处理，患者得到及时的治疗，取得较好的预后，现报告如下。

Abstract:腱膜性上睑下垂是最常见的后天性上睑下垂之一。轻者眼部表现为双眼睑裂大小稍不对称;重者上眼睑遮盖瞳孔,需抬头仰视、额纹增多等。这不仅有碍美观,而且影响视功能,给工作和生活带来不便。临床实践过程中,随着对本病认识的逐步深入,已将手术的重点从上睑提肌术式转移到腱膜术式,为治疗这一类型的上睑下垂开创了新途径,提高了治疗效果。我院2006～2008年对明确诊断为腱膜性上睑下垂的患者分别行提上睑肌腱膜缩短、折叠或修复术,取得了满意效果,现总结报道如下。

Abstract:肝硬化患者胆囊结石的发生率是普通人的2倍\[1\],而针对此类患者的外科治疗难度较大\[2\]。常规腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗晚期肝硬化胆囊结石仍存在不足。我院自2002年3月至2008年6月采用改良LC治疗了69例晚期肝硬化合并胆囊结石患者,取得较好疗效,现总结如下。

Abstract:1临床资料患者36岁,孕2产1,因“停经22周,胎动消失2 d,牙龈出血7 h”于2008年11月13日4:55急诊入院。患者末次月经2008年5月27日,未产检,入院前2 d开始未觉胎动,未重视,入院前1 d夜间无明显诱因出现牙龈出血,后来我院急诊就诊,超声示:无胎心搏动,胎盘位于右前壁,胎盘内低至无回声区。血常规:WBC 15.11×109/L,Hb 100 g/L,PLT 92×109/L。凝血功能:PT＞180 s,APTT＞109 s。拟诊“死胎、胎盘早剥、弥漫性血管内凝血（DIC）？”，即收住入院。患者曾于1996年平产1胎,有“肾结石”病史2年,平素口服中药治疗,否认高血压病史。入院体格检查:体温36.7℃,脉搏80次/min,呼吸20次/min,血压125/83 mmHg(1 mmHg=0.133 kPa),宫底脐上4指,轻压痛,腹肌略紧张,宫缩规律（30 s/2 min）,强度中弱。入院后复查血常规:WBC 16.74×109/L、Hb 92 g/L、PLT 75×109/L。凝血功能:PT＞120 s、APTT＞180 s、FDP＞129 μg/ml。超声示:无胎心,双顶径6.1 cm,胎盘上方见11.6 cm×6.9 cm回声不均区。诊断:死胎、胎盘早剥、DIC。立即报病危,予吸氧,补充血容量,完善备血、血小板、冷沉淀等术前准备,急诊行全麻下剖宫取胎术,术中见子宫增大如孕5个半月大小,两侧宫角处呈紫蓝色,切开子宫下段,宫腔内大量不凝血涌出,迅速徒手取出胎儿及胎盘组织,检查胎盘80%面积见凝血块压迹。术中见胎盘剥离面及子宫切口广泛渗血,宫缩尚可,术中以试管法取静脉血5 ml,轻叩管壁,15 min后仍不凝,术中复查血常规:WBC 14.34×109/L、Hb 75 g/L、PLT 48×109/L。交替输注纤维蛋白原2 g,冷沉淀20 U,血小板10 U,红细胞悬液及血浆1 200 ml,并按摩子宫、应用促宫缩药物及缝扎止血，组织渗血情况好转,宫缩好,腹腔留置引流管1根后关腹。宫腔内积血及术中出血共约800 ml,术后转ICU监护2 d,抗生素预防感染,输血及冷沉淀改善凝血功能,低分子肝素改善循环功能,呋塞米利尿及对症治疗,术后2 d各项指标基本恢复正常。术后第8天,患者恢复良好出院,出院前复查血常规Hb 131 g/L、PLT 202×109/L,凝血功能:PT 25.6 s、APTT 28.9 s、FDP 11.63 μg/ml。出院诊断:孕22周,G2P1,死胎；胎盘早剥（重度）;DIC。

Abstract:1.1一般资料患者,男,65岁,于2007年10月8日出现无明显诱因的肉眼血尿,伴尿频、尿急、尿痛,给予消炎、止血等对症处理后,肉眼血尿消失,但尿频、尿急、尿痛等症状仍无缓解。体检：肛门指诊提示前列腺Ⅱ度增生,表面光滑，质韧，中央沟消失,无触痛，未触及结节。CT检查：符合前列腺癌表现。B超检查：膀胱三角低回声团块突入,可能来源前列腺,恶性可能性大；前列腺肥大,尿道周围回声明显偏低。经外院穿刺活检病理诊断为前列腺癌后来我院行根治治疗。

Abstract:1临床资料患者男性,29岁,因“炼钢炉爆炸钢水倾覆致全身烧伤后30 h”于2006年6月10日入院。患者除头部0.5%总体表面积(TBSA)未烧伤外,其余大部分为黑色焦痂创面,左手已碳化、干性坏死、呈树枝状。双上肢切开减张,见大量肌肉坏死,左上肢尤为严重,前臂和上臂肌群呈鱼肉状。头部后侧尚有约2%深Ⅱ度创面,除体表皮肤烧伤外,左眼角膜严重烧伤穿孔。双上肢切开减张,见肌肉部分坏死。诊断:(1)烧伤(钢水)99.5%TBSA Ⅱ～Ⅳ度,深Ⅱ度2%,Ⅲ度74%, Ⅳ度23.5%;(2)左眼烧伤伴角膜穿孔。入院后即行抗休克、抗感染、气管切开、呼吸机辅助呼吸、有创循环监测等,以维持内环境稳定,保护各脏器功能,并且尽早行胃肠道营养。适时根据药敏结果调整抗生素,遵循短程、足量的原则。患者休克期度过平稳。于伤后第3天行四肢、前躯干切痂,异体皮覆盖术,切痂面积达75％TBSA 。第5天行头部取皮、自体微粒皮片移植术。因患者头皮有限,每次手术取头皮约0.5%TBSA,按照先四肢后躯干的顺序,每次覆盖创面约10%TBSA,其余未植皮创面用异体(种)皮覆盖,保护创面。每次手术间隔约10 d,逐步封闭创面。总植皮成活率约80%,其中左上肢因肌肉严重坏死,于入院后第2周行截肢术。右上肢、双下肢部分肌肉坏死，逐次清除坏死组织,并用异体(种)皮覆盖,待创面基底条件许可时行植皮手术。伤后第10天开始,患者四肢、躯干因创面深,坏死组织脱落过程中,多次发生小动脉破裂出血,予密切观察,缝扎止血。伤后第15天夜间,左踝部小动脉破裂出血达2 000 ml,发现后立即止血、输血。伤后3个月余创面基本封闭,伤后1年,患者全身瘢痕增生,右上肢外展受限,会阴部瘢痕粘连,计划多次手术整复并加强其功能康复。