Objective To prevent and manage spinal ischemia caused by cross-clamping the thoracoabdominal aorta often undertaken in clinical surgical practice. Methods Forty-five rabbits were divided for 3 experiments. A variety of vasoactive agents were used to manage spinal ischemia; The effect of cerebrospinal fluid drainage was evaluated; Hypothermia was used to alleviate the spinal ischemia injury. Results Among the above three experiments neuron degeneration was the mildest in hypothermia group though prostaglandin and cerebrospinal fluid drainage do have some positive effects. Conclusion It was suggested that administration of hypothermia and prostaglandin are the most effective for the prevention of spinal ischemic injury during major thoracoabdominal aorta surgery.

Objective To explore the complication s and management of the placement of vena caval filter in patients suffering from deep venous thrombosis (DVT). Methods From 1998 to 2005, 80 DVT patients were treated by vena caval filte r placement. Before the placement 46 cases received CTA, 27 cases did radionucli de imaging(LPS), 16 cases did color Doppler ultrasonography, 5 cases underwen t venography. Result The p rocedure was successful in all 80 cases. New DVT developed in contralateral fem oral vein in 2 patients and vena caval obliteration developed in 3 patients afte r one year. Conclusion The complications of vena caval filter placement could be prevented by correctly de fine indication and good expertise.

Objective To make a clinical and mycological analysis of tinea capitis in Guangzhou region. Methods A retrospective analysis was performed on 241 cases of tinea capitis collected from Feb, 1997 to Aug, 2010 in the Department of Dermatology, Sun Yet-sen Memorial Hospital. Results Among the 241 cases, 179 (74.27%) were tinea alba, 34 (14.11%) tinea kerion, 28 (11.62%) black dot ringworm, and no favus was observed. The dominant pathogenic fungi in decreasing order were Microsporum canis (182,80.89%), Trichophyton violaceum (25, 11.11%), Trichophyton mentagrophytes (10, 4.44%), Trichophyton tonsurans (3, 1.33%), Trichophyton rubrum (2, 0.89%), Microsporum gypseum (2, 0.89%) and Trichophyton verrucosum (1, 0.44%). Children were the main population (39.00%) suffering from tinea capitis. Conclusions In Guangzhou region, tinea alba is the most common type of tinea capitis, Microsporum canis is the main causative pathogen, and children are the predominate population affected by tinea capitis.

Objective To evaluate total gastrectomy and regular lymph node dissection for the treatment of advanced cardiac cancer. Methods Three hundred and eighty-seven patients with advanced cardiac cancer underwent total gastrectomy D2+ procedure. The relationships between depth of invasion, lymph node metastasis,the number of metastastic lymph nodes dissected and postoperative survival rate were analyzed. Results The 3-year and 5-year survival rates were 47.3% and 34.2% , respectively. Metastatic rate of N3 lymph node was 4. 8% and 15. 2% in advanced cardiac patients of PT3 and PT4, respectively. Survival rates significantly decreased along with the increase of lymph node metastasis. The 3-year and 5-year survival of patients who had less than 15 lymph nodes dissected was significantly poorer than those who had more than 15 lymph nodes dissected, respectively. The postoperative complication rate and mortality rate of the two groups were 14. 2% and 2. 52% , respectively. Conclution To improve the quality of life and survival rate, D2 + radical total gastrectomy should be performed for advanced cardiac cancer, and when indicated resection of spleen and/or body and tail of the pancreas should be performed.

Objective To evalute perioperative whole course cerebral protection for patients undergoing carotid endarterectomy (CEA) Methods From 2002 to 2004, 20 patients received CEA in our hospital using whole course perioperative cerebral protection Preoperatively carotid angiography was performed in only one patient, while Doppler ultrasonography and CTA were applied to all patients Measures of intraoperative cerebral protection included general anaesthesia, selective shunting, and transcranial Doppler monitoring (TCD), followed by postoperative delayed removal of tracheal cannula, brain ice bag, maintaining blood pressure and appropriate use of diuretics under the guidance of TCD Results Shunt was used in 7 cases (35%), 15 patients (85%) underwent patch angioplasty There were no postoperative cranial nerves related complications Mortality was 0% Conclusion Perioperative whole course cerebral protection could effectively decrease postoperative cranial nerves related complications in patients undergoing carotid endarterectomy

Objective To investigate the relationship between the concentration of plasma (1→3)-?-D-glucan (?-D-glucan) and deep fungal infection. Methods Thirteen patients were recruited in this study, who were suspected with deep fungal infection. G-test TE reagent for ?-D-glucan measurement was used to detect the plasma (1→3) ?-D-glucan in the patients by using UV-2450 spectrophotometer at 545 nm wavelength. The final concentrations were calculated according to concentration conversion formula. Results Nine of thirteen patients were confirmed as deep fungal infection by positive tissue culture, in whom high concentrations of ?-D-glucan were detected, the highest concentration was 352.94 pg/mL (mixed infection), with a mean value of 203.47 pg/mL. In the other four patients with negative culture, the ?-D-glucan concentration was over 54.40 pg/mL in three patients and 16.16 pg/mL in the another. Our results showed that the sensiti-vity, specificity, positive predictive value and negative predictive value of this test were 92.31%, 100%, 100% and 98.36%, respectively. Conclusion G-test TE method is a simple and rapid test and may be used for the diagnosis of patients with deep fungal infection.

Objective To analyze the incidence of the disease, clinical features, diagnostic criteria, therapy and prognosis of Penicilliosis marneffei found in Guangdong province. Methods To analyze patients data, clinical features, laboratory findings, response to therapy, and prognosis of 15 cases Penicilliosis marneffei found in Guangdong province of China. Results The male was predominant compared with the female (ratio 2 to 1) and without occupational preference, but the patients with AIDS as underlying disease were mostly drivers and the unemployed. Thirteen patients were immunocompromised such as AIDS, connective tissue disease, and kidney transplant. Clinical features showed different manifestations, such as high fever, loss of weight, skin lesion, and respiratory system symptoms. Biopsy of the skin lesion showed PAS stain positive yeast-like, or sausage-form spores. Four patients were localized infection of the skin, eleven patients were systemic infection. Nine patients died, five recovered, 1 patient refused to be treated. Fifteen isolates from different anatomic sites of the patients were identified to be Penicillium marneffei by morphology and dimorphism in the culture, and eleven isolates among these 15 isolates were also confirmed by DNA sequence analysis. Conclusion The incidence rate of Penicilliosis marneffei become higher in the recent years and many patients were accompanied with AIDS in Guangdong province. Attention should be paid to the disease.

Objective To evaluate the role of complement receptor 3 (CR3) on murine macrophages in the recognition of Penicillium marneffei.Methods RAW264.7 murine macrophage cells were cultured in vitro,and divided into four groups to be cocultured with inactivated and live Penicillium mameffei yeast cells as well as inactivated and live Penicillium marneffei conidia respectively at 37 ℃ in 5％ CO2 for one hour.The RAW264.7 cells incubated with phosphate-buffered saline (PBS) served as the blank control group.Then,reverse transcription-PCR was conducted to detect CR3 mRNA expression,Western blot to measure CR3 protein expression,flow cytometry to determine phagocytosis rate,enzyme-linked immunosorbent assay (ELISA) to quantify cytokine levels in culture supernatant.Some RAW264.7 macrophages were transfected with a specific siRNA targeting CR3 gene and cocultured with inactivated Penicillium marneffei conidia,subsequently,phagocytosis rate and supematant cytokine levels were determined.Data were processed by the SPSS 16.0 software,and one-way analysis of variance (ANOVA) was conducted for inter-group comparisons of these parameters.Results No significant differences were observed in the mRNA or protein expressions of CR3 among the four groups of RAW264.7 cells cocuhured with different forms of Penicillium marneffei (both P ＞ 0.05).The phagocytosis rate was 95.14％,89.56％,91.03％ and 90.78％ in RAW264.7 cells cocultured with inactivated conidia and yeast cells,as well as live conidia and yeast cells of Penicillium marneffei,respectively (P ＞ 0.05).The levels of interleukin (IL)-2,interferon (IFN)-γ,IL-4 and IL-10 in culture supernatant were increased at different degrees after one-hour coculture in the four coculture groups compared with the blank control group,but no statistical difference was noted among the four coculture groups in the supernatant levels of these cytokines (all P ＞ 0.05).After coculture with inactivated Penicillium marneffei conidia,the siRNA-transfected RAW264.7 cells showed a statistical decrease in phagocytosis rate (10.89％ vs.92.78％,P ＜ 0.05) and supernatant levels of IL-2,IFN-γ IL-4 and IL-10 compared with untransfected RAW264.7 cells.Conclusions In early stage of innate immunity,CR3 on macrophages may be one of the pattern recognition receptors participating in the recognition and mediation of phagocytosis of Penicillium marneffei.It's possible that both Thl-and Th2-type cytokines,such as IL-2,IFN-γ,IL-4 and IL-10,are involved in the immune response of macrophages against Penicillium marneffei.

Gilbert Disease ; Hemochromatosis ; Humans

With the continuous development of laparoscopic techniques and the concept of individualized treatment, laparoscopic surgery is also moving from "minimally invasive" to "minimally invasive plus precision" . Lymph node metastasis is one of the most important risk factors affecting the prognosis of gastric cancer (GC). Reasonable lymph node dissection has always been an important exploration direction in the field of GC surgery. In recent years, domestic and foreign studies have found that the new tracer, indocyanine green (ICG), can detect the lymphatic vasculature non-invasively, and more accurately display the perigastric lymph nodes, providing a new perspective in laparoscopic lymph node dissection for GC. Alternatively, since the application of ICG in laparoscopic gastrointestinal tumor surgery, especially in gastric cancer surgery is still in the early stage of exploration and experience accumulation, more high-level medical evidences are needed to evaluate its clinical value.