Objective To investigate the clinical outcomes of alprostadil in prevention of portal vein thrombosis after splenectomy and devascularization.Methods 113 patients with PHT who were treated with prophylactic alprostadil after splenectomy and devascularization procedures from May 2009 to Apr 2013 were included into the treatment group.112 conservative patients with PHT who were treated with traditional prophylactic anticoagulants after the same operations before May 2009 were included as the control group.The postoperative complication rates,mortality,postoperative drainage volume from the abdominal cavity,blood platelet counts,prothrombin time,liver function,Child-Pugh's scores and portal vein thrombosis rates between the two groups were compared.Results When compared with the control group,the postoperative complication rate and mortality in the alprostadil group were not increased,while the postoperative drainage volume from the abdominal cavity was significantly reduced.The increase in blood platelet counts and prothrombin time were similar in the 2 groups.Furthermore,the extent of hepatic dysfunction on the 3rd and 7th after operation was significantly decreased.On short term follow-up,color droppler ultrasonography showed the portal vein thrombosis rate of the treatment group was significantly lower than the control group,with less extensive degree of thrombosis in the treatment group.Conclusion Alprostadil is a safe and effective anticoagulant which provided better prevention of portal vein thrombosis after splenectomy combined with devascularization.

Pancreatic sinistral portal hypertension is a localized kind of portal hypertension that usually occurs as a result of the splenic vein obstruction caused by pancreatic diseases.Furthermore,it is also an important cause of upper gastrointestinal hemorrhage.Management in clinical practice should be directed at the sinistral portal hypertension and primary pancreatic diseases.

The trigemino-cerebellar projections of the rats were studied by introducing HRP microelectrophoretically in to various deep icerebellar nuclei (dentate nucleus, ND; interpositus nucleus, anterior part, NIA; interpositus nucleus, posterior part, NIP; fastigial nucleus, NF). The results indicate that all nuclei of the trigeminal nerve give their projections to bilateral (mostly ipsilateral) deep cerebellar nuclei. Most of them come from the interpolar and oral subnuclei of the spinal nucleus of the trigeminal nerve. The caudal subnucleus of the spinal nucleus of the trigeminal nerve and the principal sensory nucleus of the trigeminal nerve (VP) take the second place. Least of all come from the mesencephalic nucleus (ME) and the motor nucleus (MO) of the trigeminal nerve. In addition, cells in the region ventrolateral to the motor nucleus (VMO) and in the root of the trigeminal nerve (VR) also project to deep cerebellar nuclei. Fibers coming from ME terminate mostly in NF and NIA. Fibers from the spinal nucleus of the trigeminal nerve and VP terminate more in NIP and ND. Fibers from MO terminate in NF, NIA and ND. Fibers from VMO and VR have the same termination as those from the sensory nuclear complex of the trigeminal nerve.

Objective To investigate the feasibility of monitoring the tumor's hypoxic changes by 99Tcm-2-(2-methyl-5-nitro-1H-imidazol-1-yl) ethyl eihydrogen phosphate (MNLS) imaging after radiotherapy.Methods (1) H22 cells were cultured and mice model with liver cancer xenografte was made.The mice were imaged at 0.5,1,2,3,4,6 and 8 h (six mice in each group) after injected with 7.4 MBq 99TcmMNLS when the tumor size reach about 1 cm.Then the mice were sacrificed.The T/NT and ％ID/g of each time point was calculated.(2) The liver cancer bearing mice of radiotherapy group (25 Gy) and control group were imaged at 0,24,48 h,and then the technique of ROI was adopted to calculate the T/NT at each time point in the two groups.Immunohistochemical stain method was used to evaluate the expression level of HIF-1α in liver cancer.(3) One-way analysis of variance,the least significant difference t test,two-sample t test and Spearman correlation analysis were performed.Results (1) The uptake of 99TcmMNLS in the liver cancer bearing mice was significant at 2 h after injection and the ％ID/g was the highest.99Tcm-MNLS was excreted mainly through kidneys.(2) The T/NT and HIF-1α expression level in radiotherapy group at 24 h (2.65±0.27,(50.62±3.78)％) were lower than those at the instant (3.35±0.19,(85.32±0.94)％,t=5.640,6.701,both P＜0.05),but higher than those at 48 h (2.23±0.52,(21.69±0.75)％,t=7.674,4.911,both P＜0.05).The T/NT and HIF-1α expression in the radiotherapy group were significantly higher than those in the control group at the instant (2.74 ± 0.29,(28.26 ± 1.70) ％,t =4.235,3.473,both P＜0.05) but lower at 48 h (3.15±0.88,(67.64±3.55) ％,t =7.902,3.258,both P＜0.05).However,no significant difference was observed at 24 h between radiotherapy group and the control group (2.98±0.16,(58.45±0.98) ％,t =0.525,2.043,both P＞0.05).The change of T/NT closely correlated with the expression of HIF-1α in both the radiotherapy group and control group(r,=0.793,0.756,both P＜0.05).Conclusion 99Tcm-MNLS hypoxia imaging has potential to monitor changes of hypoxia in tumor after radiotherapy.

Purpose To explore the features of 99Tcm-AnnexinⅤscintigraphy of venous thrombus and its feasibility of discriminating fresh venous thrombus from old one. Materials and Methods The rabbits (n=15) were randomly divided into three groups (fresh thrombus group, old thrombus group and control group). The inferior vena cava thrombus models were developed in the rabbits of thrombus groups by inserting screw cooper wire into inferior vena cava. The rabbits of control group received sham operation. 99Tcm-AnnexinⅤwas injected in the rabbits of fresh thrombus group and control group one day after operation;the same was done in the rabbits of old thrombus group 14 days after operation. Planar anterior abdominal images were obtained at 30, 60, 90 and 120 min after 99Tcm-AnnexinⅤinjection in all groups respectively. The ratios of thrombus to background of the two thrombus groups and the ratios of the area correspondent to the thrombus groups to background of the control group were calculated by ROIs counts. Then rabbits were executed, and thrombus was used for pathology examination. Results 99Tcm-AnnexinⅤuptake in thrombi was clearly visualized in all rabbits of the fresh thrombus group;whilst negative images showed in all rabbits of the old thrombus group and control group. The thrombus to background ratios of the fresh thrombus group (4.06±0.49) were higher than that of the old thrombus group (2.46±0.38), and also higher than the inferior vena cava below inferior pole of right kidney level to background ratios (2.27±0.24) of the control group (t=5.746, 7.318;P<0.05). All the thrombi of the fresh thrombus group were confirmed as fresh mixed thrombi by HE staining, and those of the old thrombus group were confirmed as old mixed organized thrombi. Conclusion 99Tcm-AnnexinⅤmay become a new acute venous thrombus imaging tracer used to discriminate fresh venous thrombus from old one.

Objective To investigate the application of expanded p01ytetrafluoroethylene(ePTFE)grafts in upper arm to build arteriovenous aCCeSS for hemodialysis. Methods ePTFE graft vascular access was built in the upper arm in 20 uremia patients.Three operation strategies were applied according to the reference,including loop grafts connected axillary artery and axillary vein,straight graft connected axillary artery and elbow basilic vein,and bridge connected elbow brachial artery and axillary vein. Results Twenty operations were successful and after 6-8 weeks the fistula of all cases were used in hemodialysis.The blood flows were 220-300 ml/min without re-circulation found.Conclusion ePTFE graft arteriovenous vascular access in the upper arm could be an alternative for hemodialysis patients who are difficult to build native arteriovenous fistula.

Eight rabbits were used in this study.The position of the phrenic nucleus in thespinal cord,the morphology of the phrenic motoneurones and position of the cellbodies of the sensory neurons of the phrenic nerve were determined by using themethod of HRP labelling through the centralcutting end of the left phrenic nerve atthe root of the neck.The results were as follows:1.The phrenic nucleus in the rabbit was located in C_3,C_4,and C_5 segments.Itis a longitudinal cell column lying between the ventromedial and the ventrolateralcolumns of the ventral horn of the spinal cord.2.Phrenic motoneurones differed in shape and size.Most of the cell bodies ofthe rabbit's phrenic motoneurones were round or oval in shape,ranging from 5 to45 ?m(mean 25 ?m)in diameter.3.The rabbit phrenic nerve arises from the ventral rami of the 3 rd,4 th and5 th cervical nerves,and the nucleus of this nerve does not extend beyond the 3 rd-5 th segments——the location of the nucleus corresponds with the segmental rootsfrom which the phrenic nerve arises.4.The cell bodies of the sensory neurones of the rabbit's phrenic nerve werelocated in the dorsal root ganglia of the third and fourth cervical nerves.Besides,50 rabbits were dissected,and the origin of their phrenic nerves werestudied.

The trigemino-cerebellar projections of rats were studied by introducing HRP microelectrophoretically into various areas of the cerebellar cortex. The results indicate that the following parts of the cerebellum receive bilateral (mostly ipsilateral) trigeminal projections, namely, the simple lobule, the crusa Ⅰ and Ⅱ, the paramedian lobuIe, the dorsal paraflocculus, the lateral part of the lobule Ⅷ and the vermal cortex of the lobules Ⅵ～Ⅸ.Fibers from the interpolar subnucleus and the principal sensory nucleus of the trigeminal nerve project to all of the above mentioned areas.The caudal subnucleus projects to the crus Ⅰ, the paramedian lobule, the dorsal paraflocculus, the lateral part of the lobule Ⅷ and the vermal cortex of the lobules Ⅵ～Ⅸ.The oral subnucleus gives its projections to the crus Ⅱ, the paramedian lobule, the lateral part of the lobule Ⅷ and the vermal cortex of the lobules Ⅶ～Ⅸ.The mesencephalic nucleus of the trigeminal nerve sends fibers to the crura Ⅰ and Ⅱ, the paramedian lobule, the lateral part of the lobule Ⅷ and the vermal cortex of lobules Ⅶ～Ⅸ.A few labeled neurons were found in the motor nucleus of the trigeminal nerve; while in the region ventro-lateral to the motor nucleus, in the root of the trigeminal nerve and in areas adjacent to it large amount of labeled cells were seen in all the cases studied.Unexpectedly, several labeled neurons were seen in a semilunar ganglion of the trigeminal nerve.

Objective To study the clinical features,treatment methods and clinical outcomes of acute tibialis posterior tendon rupture.Methods Using [(posterior tibial tendon) OR (tibialis posterior tendon)] AND (rupture OR injury OR disruption OR trauma OR tear) as the search words,we searched the PubMed database to retrieve the 19 articles involving 24 cases of acute tibialis posterior tendon rupture.The injury mechanisms,X-ray manifestations,operational findings,treatment methods and clinical outcomes were analyzed.Results The mechanisms of the fracture-related tibialis posterior tendon rupture included motor accident (50.0％,12/24),falling from a height (41.7％,10/24) and sports injury (8.3％,12/24).The tendon rupture was mostly complicated with malleolar fracture (91.7％,22/24),especially the pronation type (70.8％,17/24).Direct suture of the tendon was adopted in 91.7％ of the cases (22/24).Favorable outcomes were achieved in 95.5％ of the cases (21/24).Conclusions Acute tibialis posterior tendon rupture is mostly seen in high-energy medial malleolus fracture.The mechanism of the rupture might be tendon distraction or bone flake incision.Early operation can lead to favorable outcomes.

Objective To observe the changes of CD4+CD25+ regulatory T cells, Foxp3 mRNA and soluble interlukin 2 receptor (sIL-2R) in the peripheral blood of kidney transplantation recipients and to evaluate their effect on the diagnosis of acute rejection. Methods Forty-two renal transplant recipients and 30 healthy controls were enrolled in this study. CD4+CD25+ regulatory T cells proportion, Foxp3 mRNA and sIL-2R of pre-transplantation and those of day 7,14, 28, 56 of post-transplantation were measured by flow cytometer, fluorescent quantization PCR and enzyme-linked immunosorbent assay (ELISA), respectively. Biochemistry appliance was used to detect serum creatinine. The diagnosis of acute rejection in transplanted kidney was based on the clinical symptoms, the laboratory examinations, Doppler ultrasound and biopsy. Results (1)At day 7, 14, 28, 56 of post-transplantation, CD4+CD25+ regulatory T ceils proportion, Foxp3 mRNA level in acute rejection group were significantly decreased compared with those in non-acute rejection group. (2) There were significant differences of peripheral blood CD4+CD25+ regulatory Tcells[(9.22±3.53)% vs (6.09±1.99)%, P<0.01], Foxp3 mRNA[(0.82±0.36)×10-3 vs (0.50±0.28)×10-3, P<0.01] and sIL-2R levels [(856.30±108,24) U/ml vs (247.35±11.24) U/ml, P<0.01]between patients of pre-transplantation and healthy control group. (3)Plasma CD4+CD25+ regulatory T cells [(16.53±4.14)%] and the expression of Foxp3 mRNA [(4.97±1.94)×10-3] was significantly increased, but sIL-2R level [(463.72±31.23) U/ml] was significantly decreased as the transplanted renal function was restored (all P<0.01). (4) Plasma CD4+CD25+regulatory T cells [(12.18~2.86)%] and the expression of Foxp3 mRNA [(3.15±1.22)×10-3] was significantly decreased (P<0.01), and sIL-2R level [(748.36±115.41) U/ml] was significantly increased (P<0.01) when acute rejection occurred. The above changes had an earlier onset than the change of Scr. (5)The percentage of CD4+CD25+ regulatory T cells was positively correlated with the Foxp3 mRNA level (P<0.01), but was not correlated with sIL-2R level in all the patients. Conclusion The measurement of these markers in peripheral blood may be an important guideline to the diagnosis and prognosis of acute rejection in renal transplant recipients.