Objective　To investigate the possible causes for asymptomatic process of hepatic artery thrombosis in the patients following orthotopic liver transplantation (OLT). Methods　Hepatic functional tests, color Doppler ultrasonic observation, hepatic arteriographic examinations were done during the course of the development of the hepatic arteriothrombosis. All possible factors leading to the asymptomatic process were comprehensively analyzed. Results　At the 4th postoperative day, thrombosis started to form along the anastomosis line. At the 21st postoperative day, the artery became completely thromboses. During this course, serial liver biopsy revealed introhepatic cholestasis, hydropic degeneration of hepatocytes, atrophy of the biliary epithelium and fibrosis in the portal area. Serial monitoring of liver function gradually revealed normal with the exception of elevation of r-GT and ALP. At the 71st day after OLT, arteriography showed that hepatic artery remained completely occluded, while the collateral circulation and compensatory expansion of the portal vein were established. The patient didn't have any symptoms of arterial thrombosis. Conclusions　In this case, it was the collateral circulation and the compensation of the portal vein that made the allograft survive and helped to prevent the patient from retransplantation after hepatic artery thrombosis. Color Doppler ultrasonic examinations within 2 weeks following OLT were helpful to the early diagnosis of hepatic arteriothrombosis.

As tremendous genomic data avalanches, exploring biological mechanism by data analysis and theory methods has become important for theoretical biology research. This method is significant for the study of complex gene functions and gene networks. Bowers used higher order logic relationships to decipher protein network organization, which is a systemic method called logic analysis of phylogenetic profiles (LAPP). LAPP is a data modeling and different from traditional computational methods. This computational approach identifies logic relationships of the elements (or components) in complex networks through the logic analysis of their expression data. The method can be used to infer functional relationships of two associated proteins to one another. It is important for discovering the new function mechanism of the protein. The clusters of orthologous groups (COGs) involved in a gene network usually are large groups and therefore LAPP is also an approach for complex gene logic networks. After the establishment of the gene logic network, it is convenient for the regulation of gene through the network. The method can used in many fields, such as species evolution, oncologic diagnosis and so on. LAPP was systematically described and analyzed and recent developments in methodologies and applications were highlighted. Some opinions of them were also given.

BACKGROUND: The assessment of chronic nerve root injury is mainly depend on indirect evidences of imaging results.OBJECTIVE: This study is designed to find out the relationship between the degrees of the pathological changes of nerve roots and motor evoked potential (MEP) changes due to chronic compression.DESIGN: A self-controlled trial with animals as subjects.SETTING: Spine Surgery Department of the Second Clinical Hospital of Jinan University.MATERIALS: The trial was completed in the Spinal Surgery Department of the Second Clinical Hospital of Jinan University from October 2001 to May 2003. The subjects were 30 healthy cats of either gender weighing 3 to 5 kg.INTERVENTIONS: The compression model was established by wedging a Ⅴ-shape bone flap into the right intervertebral foramens between C7, C8 and T1 vertebrae. The left foramens served as controls. The cats underwent CT examination on the 2nd, 4th, 8th and 12th postoperative week to show the foramen changes. Six randomly selected cats underwent magnetic stimulation MEP each time on the 2nd, 4th, 8th, 12th and 24th week. The injuries to the compressed nerve roots were assessed according to Mackinnon Standard and they were compared with the MEP wave.MAIN OUTCOME MEASURES: Whether the superficial magnetic stimulated MEP monitoring result was in correspondence with the pathological changes of the chronically compressed nerve roots.RESULTS: The MEP did not show any abnormal changes for Grade Ⅰ injury prolonged to 9.6- 10. 2 ms. There was almost no evoke potential at all stimulation points for grade Ⅴ nerve root injury.CONCLUSION: That the injured nerve root presents dysesthesia and normal MEP results suggests grade Ⅰ injury. Prolonged latency including prolonged F wave suggests grade Ⅱ injury. And additional amplitude decrease together with widened and unclassifiable waves implies the injury be grade Ⅲ. The prominent features of grade Ⅳ nerve injury is much more decreased amplitudes and more prolonged latency. For grade Ⅴ injury there is always disappearance of whole MEP or some potential components. The superficial magnetic stimulated MEP monitoring results are in correspondence with the pathological changes of the nerve roots due to chronic compression, which means MEP monitoring results could serve as the quantitative indication to pathological changes of nerve injury.

BACKGROUND: Many clinical cases have proved that the satisfactory reposition, fusion and internal fixation in the internal fixation for inferior lumbar spondylolisthesis are not consistent with the postoperative symptoms and physical signs, and functional restoration.OBJECTIVE: To investigate the application of somatosensory evoked potential(SEP) in the monitoring during internal fixation for inferior lumbar spondylolisthesis, and the effects of SEP monitoring on the improvement of postoperative symptoms and the spinal functions as well.DESIGN: A randomized controlled trial.SETTING: Inpatient department of spinal surgery, an affiliated hospital of a university. PARTICIPANTS: Fifty-two patients with inferior lumbar spomlylolisthesis including 23 male and 29 female cases aged between 18 and 68 years old were admitted by the Department of Spinal Surgery, Second Affiliated Hospital(Shenzhen People's Hospital) of Jinan University, from June 2000 to December 2003. All cases were randomly divided into control group(n = 20) and monitor group ( n = 32).METHODS: SEP induced by segmental stimulation in cutaneous nerve was used in the control group for preoperative and intraoperative monitoring, and postoperative follow up. The intraoperative potential changes in patients with excellent and good improvement in postoperative functions had been retrospectively investigated to confirm the effective indices for intraoperative monitoring, which thereby provided references for intraoperative monitoring in patients of monitor group.MAIN OUTCOME MEASURES: ① Evaluation of postoperative spinal function; ② SEP latency and amplitude.RESULTS: SEP values after postoperative anesthesia were set as basis.The manifestations of intraoperative potential alterations: ① If the latency reduced 10% -15% or the amplitude increases more than 40% after fixation, it suggested favorable prognosis; ② The potential indices were stable during monitoring, or the reduction of latency was less than 10%,or the increase of amplitude was less than 30%, the fixation could be continued, and partial functions of nerve root and symptoms could be improved after surgery; ③ During the surgery, if potential indices had transient lluctuation, which could be recovered to basic potential within 15 to 20 minutes, fixation should be stopped during the fluctuation. Still partial functions of nerve root and symptoms could be improved after surgery; ④If the intraoperative latency prolonged more than 5%, or amplitude reduced more than 10%, or part of the components disappeared, or the wave shape dispersed, it might suggest postoperative aggravation of pain and dyskinesia. So intraoperative adjustment was necessary. The coincident rate of the improvement of the indices of intraoperative monitoring and the improvement of postoperative spinal function reached 93.75%.CONCLUSION: SEP induced by segrmental stimulation in cutaneous nerve is an objective and effective method in the monitoring and instruction of decompression, reposition, fixation of internal fixation for inferior lumbar spondylolisthesis, which has important merits in the improvement of the function of nerve root and the restoration of spinal function.

Objective To investigate the effects of femoral nerve block combined with celecoxib on postoperative analgesia in elderly patients with hip fracture. Methods Two hundreds ASA -Ⅲ patients aged 65-89 yrweighing 35-90 kg undergoing hip fracture surgery were randomly divided into 4 groups ( n = 50 each):control group (group Ⅰ ), femoral nerve block group ( group Ⅱ ), celecoxib group (group Ⅲ ) and femoral nerve block +celecoxib group (group Ⅳ ). Operations were performed under combined spinal-epidural anesthesia. Groups Ⅲand Ⅳ were given oral celecoxib 400 mg at 1 h before operation, and 200 mg at 1 and 2 days after operation twice a day. Groups Ⅰ and Ⅲ received iv injection of sufentanil 0.06 μg/kg before the patients were placed in the position, while in groups Ⅱ and Ⅳ femoral nerve block was performed using a nerve stimulation with 20 ml of 0.5%ropivacaine and 10 min later the patients were placed in the position. All the patients received postoperative patient-controlled intravenous analgesia with sufentanil to maintain visual analogue scale score ≤ 3. The condition of satisfactory analgesia and sufentanil consumption within 24, 48 and 72 h were recorded. The coagulation function was measured on the day of admission to the hospital, at 1 day before operation and at 4 days after operation. Cardiac troponin Ⅰ (cTnI) concentrations were measured before operation, at the end of operation and at 1 day after operation. Postoperative complications was observed and recorded. Results Compared with group Ⅰ , the consumption of sufentanil was significantly reduced during each period in group Ⅳ ( P ＜ 0.01 ). Compared with group Ⅱ , the consumption of sufentanil was significantly reduced within 48 and 72 h after operation (P ＜ 0.05), while no significant change was found within 24 h after operation in group Ⅳ ( P ＞ 0.05). Compared with group Ⅲ , the consumption of sufentanil was significantly reduced within 24 h after operation ( P ＜ 0.05 ), while no significant change was found within 48 and 72 h in group Ⅳ ( P ＞ 0.05). The level of satisfactory analgesia was significantly higher in group Ⅳ than in the other three groups, and in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05). The 4 groups were comparable with respect to the increased rate of cTnI concentrations at the end of operation and after operation, and perioperative blood coagulation. No postoperative complications were found in the 4 groups. Conclusion Femoral nerve block combined with celecoxib can reduce postoperative opioid consumption and enhance postoperative analgesia in elderly patients with hip fracture.

Objective To explore the mechanism of IL-6 in EAE. Methods 25 female Wistar rats were randomly divided into 2 groups, EAE group( n=15 ) and normal control group( n=10). The expression of IL-6, TNF-αtand TGF-β of the two groups rots were ob-served by immunohistochemistry staining, and then correlation analysis of the expression of IL-6, TNF-αtandTGF-β was made. Results There was negative correlation between gray scale of IL-6 and symptom scores( r=-0.953, P＞0.05). IL-6 and TGF-β had no statistical-ly significant correlation ( r=-0.492, P＞0.05). There was negative correlation between gray scale of TNF-α and symptom scores( r=-0.978, P＜0.05), and both of the correlation between TNF-α and TGF-β ( r=-0.502, P＞0.05), TGF-β and scores( r=0.470,P＞0.05 ) were not statistically significant. Conclusions IL-6 may participate in EAE as a inflammatory factor.

Objective: To explore the relationship between lower extremity atherosclerosis disease (LEAD) and cardiovascular risk factors in elder people.
Methods: A total of 700 consecutive patients receive lower extremity Color Doppler ultrasound in our hospital from 2013-05 to 2014-11 were investigated. The patients were divided into 3 age groups: Young and middle group, n=83, Elder group, n=377 and Senile group, n=240. Based on ultrasound scoring system, the patients were divided into 4 groups: Normal group, n=112, Mild atherosclerosis (Mild) group, n=81, Moderate group, n=466 and Severe group, n=41. The cardiovascular risk factors among different groups were compared.
Results: Multivariate unconditional logistic regression analysis showed that age, smoking, history of diabetes, uric acid (UA), ankle-brachial index (ABI) were the independent risk factors for LEAD (B=0.144, 1.496, 0.963, 0.004, -2.510; 95% CI: 1.120-1.190, 2.257-8.824, 1.456-4.716, 1.001-1.007, 0.012-0.534;P=0.000, 0.000, 0.001, 0.006, 0.009 respectively. Ordinal logistic regression analysis indicated that age, male gender, smoking, ABI, UA, history of hypertension were related to the severity of atherosclerosis (B=0.130, 0.737, 0.592, -3.365, 0.003, 0.735; 95% CI: 0.097-0.162, 0.222-1.252, 0.052-1.132, -4.674 to -2.055, 0.001-0.005, 0.313-1.157;P=0.000, 0.005, 0.032, 0.000, 0.005, 0.001 respectively. Compared with Young and Middle groups, Elder and Senile groups had increased rates of moderate and severe arteriosclerotic lesions; compared with Elder group, Senile group presented the higher incidence of moderate and severe lesions, allP<0.01. With elevated age, the severity score of LEAD increased accordingly,P<0.01.
Conclusion: Lower extremity atherosclerosis lesions were more severe in elder patient, and it was particularly severe in senile patients.

To probe into a method for establishing the fuzzy mathematical model for syndrome differentiation of gastric cancer.

BACKGROUND:At present, vertebroplasty and spinal canal decompression are common methods for treatment of metastatic spinal tumors. Iodine-125 (125 I) radioactive seed implantation has been shown to control the tumor. However, there were few clinical studies on combined therapy using above-mentioned methods. OBJECTIVE:To compare the differences of 125I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation and vertebroplasty combined with titanium al oy nail-rod fixation for treating thoracolumbar metastases on pain control, general performance and improvement of the spinal cord function, and to evaluate clinical value of 125 I radioactive seed implantation combined with therapeutic plans. METHODS:Thoracolumbar metastases patients undergoing titanium al oy nail-rod fixation were selected in the Department of Spinal Surgery, Shenzhen Municipal People’s Hospital in China from October 2009 to March 2013. They were assigned to experimental and control groups according to with or without 125 I radioactive seed implantation. Improvement in neurological function was observed before and 2 weeks, 1, 6, and 12 months after titanium al oy nail-rod fixation in both groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 7 to 29 months, averagely 15.8 months. There was no loosening of titanium al oy nail-rod fixation and the position of bone cement was good. No seed migration or radioactive spinal cord injury was observed. No relapse or diffusion in the surgical site was observed during fol ow up. Visual Analogue Scale and Karnofsky Performance Status scores were higher in the experimental group than in the control group (P<0.05). Frankel level was obviously improved after fixation in both groups compared with preoperation. No significant difference in the improvement of neurological function was detected between the two groups (P>0.05). Results indicated that 125 I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation for treatment of metastatic spinal tumors showed obvious outcomes in relieving cancer pain.

BACKGROUND: As a novel procedure in minimally invasive spine surgery (MISS), percutaneous laser disc decompression(PLDD) has been applied widely in the recent development in clinical practices.OBJECTIVE: This study was designed to evaluate the influences of PLDD on the stability in cervical spinal constructs.DESIGN: A before-after comparison trail based on patients.SETTING: The experiment was performed at the spine surgery department of a hospital affiliated to a university.PARTICIPANTS: Twenty-eight patients who were diagnosed as lateral cervical disc herniation at the Spine Surgery Department of Shenzhen People' s Hospital, Second Hospital Affiliated to Jinan University were involved from October 2001 to April 2003. Of all of the patients, 17 were male and 11 were female. They have 29 cervical disc protrusions altogether.INTERVENTIONS: Monitored by X-ray, a 400 μm fixed optical fiber was introduced into the injured intervertebral disc via a 9-gauge flexible trocar through an anterior cervical approach. An Nd-YAG laser system,with a 1 060 nm wavelength and an output power of 15W, was employed to ablate or decompress the inner disc tissue. The disc tissue was exposedto 500- 950 J laser powers.MAIN OUTCOME MMEASURES: Before and 6 months after the PLDD, the deviation of adjacent vertebra displacements was observed and changings of the wedge angles of the intervertebral discs were calculated respectively.RESULTS: The deviation of adjacent vertebra displacements showed no significant difference between before and after operation, when the patients were examined with a more flexed-position or a more extended-position(t=0.811 7-0.827 2, P＞ 0.05), and no significant changes in the wedge angles of the intervertebral discs could be observed either(t=0.768 7-0.827 1,P ＞ 0.05).CONCLUSION: Applying percutaneous laser disc decompression to lateral cervical disc herniation has many advantages, such as simplicity of operation, minimal invasion and having no impact on the stability in cervical spinal constructs.