Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula ( AVF) and 8 cases of artificial vessel arteriovenous fistula ( AVG).In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension , while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing (χ2 =17.77, P<0.001).All patients underwent percutaneous transluminal angioplasty ( PTA ) . In all patients the vascular diameter was increased significantly after PTA treatment [(3.6 ±0.2) vs.(1.2 ±0.1) mm, t=18.52, P<0.001].The blood flow during hemodialysis was increased significantly after PTA treatment in patients with anastomoti stenosis [(265.4 ±21.5) vs.( 150.5 ±23.1 ) ml/min, t =21.81, P <0.001 ]; however, there were no significant changes in venous pressure [(68.6 ±8.7) vs.(69.3 ±6.1) mmHg(1 mmHg=0.133 kPa), P>0.05].The blood pressure was decreased after PTA treatment [( 71.2 ±7.9 ) vs.( 170.4 ± 15.7) mmHg, t=34.62, P<0.001] in patients with venous outflowtract stenosis , however, there were no significant changes in the blood flow [(264.1 ±15.2) vs.(260.7 ±17.3) ml/min, t=1.04, P>0.05].

Objective To evaluate the diagnostic value of combined test of C-reactive protein,amylase and lipase for acute pan-creatitis patients in early stage,and its practicability in assessment of disease severity.Methods 71 cases of acute pancreatitis pa-tients in the hospital from March 2012 to March 2014 were enrolled in the study,including 60 cases of mild pancreatitis patients,11 cases of severe pancreatitis patients.Meanwhile,30 cases of non-acute pancreatitis patients were enrolled as Control Group A,and 50 cases of adults who underwent conventional examination and proved to be healthy were enrolled as Control Group B.Detection of C-reactive protein,amylase and lipase of these samples were performed and the results were recorded,compared and analyzed.Re-sults The serum amylase level of acute pancreatitis patients was (759.42±721.63)U/L,and serum lipase level were (1 624.34± 1 598.25)U/L,which were significantly higher than people in Control Group A and Control Group B,with statistical significance (P <0.05).However,C-reactive protein level of acute pancreatitis patients were (44.61±34.21)mg/L,which were not statistical-ly different compared with Control Group B.Combined test of the three indicators demonstrated that the sensitivity was 95.9%, specificity was 100% and accuracy was 96.9%,all of which were higher than other test combinations or singe test with statistical significance(P <0.05 ).Conclusion The combined test of C-reactive protein,amylase and lipase for acute pancreatitis patients doesn′t only improve early diagnostic efficiency,but also is helpful in disease severity judgment.

Tumor markers play an important role in tumor mass screening, diagnosis and differential diagnosis of tumor, tumor staging, therapeutic evaluation and prognosis assessment. According to the nature,tumor markers can be classified as follows: embryonic antigen, carbohydrate antigens, proteins, enzymes, hormones, and so on. And tumor markers have been used in clinical widely.

Objective To evaluate the effects of hypothermic cardiopulmouary bypass(CPB) on depth of anesthesia measured by BIS and auditory evoked potential index(AEPI) monitoring and cerebral O_2 and glucose metabolism. Methods Twenty-eight ASA Ⅱ-Ⅲ patients of both sexes(15 males, 13 females) aged 29-55 yrs undergoing elective cardiac valve replacement under hypothemic CPB were studied. Patients were excluded from the study if they had hearing disturbance, hepato-renal dysfunction, diabetes melhtus, hypertension, cerehro-vascular or mental diseases. The patients were premedicated with intramuscular morphine 0.15 mg?kg~(-1) and scopolamine 0.3mg. Anesthesia was induced with midazulam 0.05-0.1 mg?kg~(-1), fentanyl 10 ug?kg~(-1) and pancuronium 0.1 mg?kg~(-1) and maintained with intermittent ⅰ.ⅴ. boluses of fentanyl, diazepam and pancuronium. Radial artery was cannulated for BP monitoring and blood sampling. A CVP catheter was inserted into right internal jugular vein and advanced in a cephalad direction until jugular bulb for blood sampling. BP, HR, T℃(naso-pharyngeal), BIS and AEPI were continuously monitored during operation. Arterial and jugular bulb blood samples were obtained before CPB(T_1), T℃ was lowered to 33℃(T_2)during stable hypothermia(T_3) during rewarming at 33℃(T_4) and 30 min after termination of CPB(T_5) for blood gas analysis and determination of glucose and lactate concentrations. Cerebral oxygen extraction rate(O_2 ER) cerebral glucose extraction rate(GER), arterial-jugular bulb venous lactate difference(DLa-jv) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) were calculated. Results Blood glucose and lactate concentrations were significantly increased, while arterial blood pH and DLa-jv did not change significantly during CPB. Cerebral oxygen extraction rate(O_2ER), cerebral glucose extraction rate(GER) and arterial-jugular bulb venous O_2 content difference (Ca-jvO_2) decreased while jugular bulb venous oxygen saturation (SjvO_2) increased with decreasing body temperature. BIS and AEPI values decreased with decreasing T℃ and both were well correlated with T℃. AEPI was positively correlated with O_2 ER and negatively correlated with Ca-jvO_2 whereas BIS was positively correlated with PaO_2. Conclusion Cerebral metabolism is decreased during hypothermic CPB which also deepens anesthetic depth measured by BIS and AEPI monitoring.

Objective To study the results of diagnosis and treatment of duodenal papilla carcinoma. Methods The clinical data of 48 cases of duodenal papilla carcinoma admitted and treated in our hospital during a 7-year period were analyzed retrospectively. The main clinical symptoms included jaundice(43 cases), upper abdominal pain(23 cases), pruritus of skin(12 cases) and other symploms (7cases). The diagnosis accuracy rate of B ultrasound, CT, and ERCP examination were 39.6%, 50.0% and 93.3% respectively. Pancreaticoduodenectomy was performed in 39 cases. (of these, 1 case underwent pylorus-preserving procedure), 5 cases underwent cholecystojejunostomy and/or gastroenterostomy, and 3 were willfully discharged after diagnosis.Results Thirty-six patients were followed up.Survival beyond 1 year and beyond 2 years afer pancreaticoduodeneoctomy were 66.7% and 30.6% (respectively), and 2 cases among 8 cases of 7-year survivors are alive now. But the 3 discharged patients who refused operations lived less than 1 year; and only 1 patient among those who underwent cholecystojejunostomy and/or (gastroenterostomy) lived more than 1 year. Conclusions ERCP plus biopsy are the primary means of diagnosis, and radical resection is the main treatment modality for duodenal papilla carcinoma.

Objective To investigate the effects of titanium nitride(TiN) coating on corrosion resistance of dental Co-Cr alloy in the simulated oral environment. Methods The Co-Cr alloy commonly used was casted with specimen sized of 10 mm× 10 mm×3 mm. Then the specimen was coated with a thickness of 2.5 μm TiN coating on the surface by multi-arc physical vapor deposition. The Tafel polarization curves of the specimen before and after coating titanium nitride in artificial saliva were measured by electrochemical station. Results From the Tafel polarization curves, the specimen after coating TiN showed that both anodic polarization curve and cathodal polarization curve were fiat, natural corrosion potential moved to the positive way, and passivation interval got longer. From the annular anodic polarization curves, the specimen after coating TiN had almost no "delay area". Conclusion TiN coating can improve corrosion resistance of Co-Cr alloy.

Objective To investigate the etiology and provide data for clinical treatment and therapeutic assessment of congenital clubfoot(CCF) via neuroelectrophysiology on motor and sensory nerves and ultrastructure of sural nerve.Methods Totally 248 patients diagnosed with CCF(338 clubfeet) were studied.Motor nerve conduction velocity(MCV),sensory nerve conduction velocity(SCV) and wave amplitude were detected for any changes.An ultra-structural study of sural nerve ramification was also conducted in 36 patients(36 clubfeet) under electron microscope.The correlation between deformity degree,nerve conduction abnormality and therapeutic outcomes was analyzed.Results The motor nerve conduction in 291 clubfeet(86.1%) and the sensory nerve conduction in 252 clubfeet(74.6%) were found with different degrees of abnormalities such as prolonged latency,declined/disappeared wave amplitude,etc.The ultrastructural observation of sural nerve ramification demonstrated abnormalities in all the 36 cases,showing proliferation of myelin sheath in peripheral myelinated nerve fibers,formation of vacuoles,segmental demyelinating lesions and so on.Part of axial cord was squeezed by the proliferated myelin sheath,which resulted in disappearance of axoplasm.The correlation study showed that as deformity became more severe,the nerve conduction abnormality was more evident,requiring more complicated treatments,and the therapeutic outcomes were less satisfactory.Statistical analysis by Mantel-Haenszel method showed that:① the abnormality rate of motor nerve in different types of CCF is signifi-cantly different(?2=32.31,P

Fuzzy c-means (FCM) clustering algorithm is a popular model widely used in the segmentation of magnetic resonance image (MRI). The conventional FCM doesn't involve the spatial information of MRI and then unexpected segmentation results appear when it is applied to inhomogeneous MRI with noise and bias field. Modifying the objective function of FCM and introducing a variable as the parameter to control the tight degree of neighborhood effect present a spatial model to FCM clustering algorithm. The variable can reasonably use the spatial information of MRI. The experiment results show that the proposed algorithm can provide a powerful segmentation than the conventional FCM and others.

Generally speaking,embryonic stem cells,embryonic germ cells and embryonal carcinoma cells are pluripotent stem cells and they have the potential to differentiate into germ cells.Spermatogonial stem cells is unique adult germline stem cells and can differentiate into sperm.Recent research with stem cells from both embryonic and adult origin will be discussed with particular attention to results that challenge conventional wisdom about the presence of germline stem cells in adults and the plasticity of adult stem cell types.This review focuses on the progress in the research of germline stem cells and introduces the origin and plasticity of adult germline stem cells and its future directions in medical science.