OBJECTIVE： The compound nucleic acid granules were prepared， observed for their therapeutic effects， and determined for their pharmacological actions METHODS： Quality control was used in their preparation The therapeutic effects were observed on 22 patients with coronary heart disease of stable angina pectoris with hyperlipemia who were chosen according to clinical diagnosis standard RESULTS： （ 1） Improvment of clinical symptoms for angina pectoris： satisfactory 22 7％ ， improved 68 2％ ， failure 9 0％ ； （ 2） Blood lipid analysis： cholesterols and triglycerides were improved significantly after administration of the preparation（ P0.05;P<0.01).CONCLUSION:The compound nucleic acid granules have marked effects on coronary heart disease, angina pectoris and hyperlipemia.

Objective To investigate the value of fluid resuscitation strategy in septic shock patients by pulse indicator continuous cardiac out ( PiCCO ) .Methods 42 septic shock patients were divided into the PiCCO group(n=26) and the control group(n=16).All patients measured heart rate(HR),mean artery pressure(MAP), central venous pressure(CVP);CI,GEDVI,SVRI,EVLWI,CVP as indicator of fluid resuscitation after 0h,6h,24h of the diagnosis were measured respectively in PiCCO group;CVP as guiding volume resuscitation was measured in the control group .The effect of fluid resuscitation was compared between two groups .To analyse the relationship between CVP,GEDVI and CI in PiCCO group .according to CVP increase 2mmHg ,GEDVI whether elevated 10%.Results After 6h EGDT treatment bundle HR ,MAP,APACHEII score and clearance rate of lactic in PiCCO group improved more than those in control group [(101.3 ±7.8) and (119.4 ±7.2),t=-7.520,P<0.05;(71.8 ±7.6) and (51.5 ±8.9),t=7.873,P<0.05;(17.0 ±3.4) and (22.7 ±4.1),t=-4.978,P>0.05;(53.6 ±11.5) and (-16.5 ±5.2),t =9.283,P <0.05].There were no differences in 28-Day mortality between two groups (t =-2.162,P>0.05),but ICU hospitalization time decreased in PiCCO group [(13.8 ±2.6) and (23.3 ±2.2),t=-5.075,P<0.05].Changes in GEDVI was positively correlated with Changes in CI (r=0.799,P<0.05),while changes in CVP was poorly correlated with CI (r=-0.446,P>0.05).Conclusion Hemodynamic monitoring by PiCCO directed fluid resuscitation strategy can elevate reversal rate .Compared with pressure index CVP ,GEDVI is a sensitive indicator of cardiac preload .Correlation between CVP and GEDVI can reflect cardiac function ,Especially for septic shock patients with cardiac depression .

Objective To assess the efficacy and safety of urinary kallidinogenase combined with sodium ozagrel for cerebral infarction (CI), and provide references for clinical rational drug use. Methods Retrieved from Cochrane library, PubMed, CBM, FMJS, VIP, Wangfang database and CNKI ( published until January 2015), randomized controlled trails (RCT)about urinary kallidinogenase combined with sodium ozagrel for treatment of CI were included,then methodological quality were evaluated and statistical analysis of those studies were carried out by Rev Man 5.3.4 software. Results 19 RCTs were included,involving 1 747 patients. Results of Meta-analysis showed that urinary kallidinogenase combined with sodium ozagrel could significantly improve total effective rate[RR= 1.18, 95%CI(1.13, 1.23), Z= 7.97, P<0.000 01], cure rate[RR = 1.42, 95%CI(1.23, 1.64), Z= 4.86, P<0.000 1], neurological deficit scores[MD= -4.40, 95%CI(-5.36, -3.43), Z= 8.90,P<0. 000 01] and activity of daily living scores[MD = 19.14, 95%CI(17.39, 20.90), Z = 21.36, P<0.000 01]. Conclusion Urinary kallidinogenase combined with sodium ozagrel was effective in the treatment of CI, and no significant adverse reactions were observed. The combination therapy was worthy of clinical application.

Objective To study the relationship between polymorphisms of NQO1 and hepatocellular carcinoma (HCC) in Zhengzhou and Guilin area.Methods The Zhengzhou group was a hospital-based case-control study which included 146 cases of HCC and 151 cases of controls with nontumor seen in the People's Hospital of Zhengzhou.The Guilin group was a hospital-based case-control study which included 136 cases of HCC and 123 cases of controls with non-tumor seen in the Guilin Medical University Hospital.NQO1 polymorphisms were determined by polymerase chain restriction with TaqMan MGB probe.All data were analyzed by conditional logistic multiple factor regression analysis with SPSS 18.0 statistical package.Results The frequency with mutation allele (T) in the case group was significantly different between the Zhengzhou and Guilin groups (x2=23.307,P＜ 0.05).The odds risk of NQO1 mutation homozygote and mutation heterozygote to wild homozygote were significantly increased (OR=2.476,CI:1.518～4.038).Conclusions NQO1 mutation genotype is the predisposing gene with relatively different susceptibility to the development of HCC in the Zhengzhou and Guilin regions.There are synergistic effects between the NQO1 predisposing genotype,drinking and smoking.

Objective To evaluate the outcome of patients with alcoholic liver disease (ALD) after orthotopic liver transplantation (OLT) and to study the prognostic factors.Methods The data of 17 patients who underwent OLT for ALD from January 2010 to March 2013 were analyzed retrospectively.The data on age,gender,history of gastrointestinal bleeding,history of splenectomy,Child-Pugh score,Maddrey' s discriminant function and MELD score were evaluated using the Kaplan-Meier method for univariate analysis.The log-rank test was applied to compare the survival rates.Results The overall survival rate at 100 weeks in patients less than 55 years old was 90％ (9/10),while that in patients more than 55 years old was 28.57％ (2/7).There was a significant difference between the two groups (P ＜ 0.05).There were no statistically significant differences between female and male patients,between patients with or without a history of gastrointestinal bleeding or splenectomy (P ＞ 0.05).There was no significant difference on survival rates after liver transplantation between patients with Child-Pugh B and Child-Pugh C,patients with Maddrey' s scores ＜ 70 and ≥70,and patients with a MELD score ＜ 30 and ≥ 30 (P ＞ 0.05).Conclusions Better survival rates were observed in ALD patients who were ＜ 55 years old after liver transplantation.The Child-Pugh score,Maddrey' s discriminant function and MELD score were of no prognostic significance.These findings still need to be verified by prospective large-scale studies.

Objective To predict the severity of acute pancreatitis by detecting the changes of microRNA in the serum,and whether paracentesis catheter drainage (PCD) should be applied to the patients.Methods The peripheral blood of 120 patients with acute pancreatitis who were admitted to the General Hospital of Chengdu Military Command from October 2013 to March 2014 were collected.Thirty-five patients with severe acute pancreatitis (SAP) or moderately severe acute pancreatitis (MSAP) were in the group A,and 85 patients with mild acute pancreatitis (MAP) were in the group B.The scores of the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),RANSON and bedside index for severity in acute pancreatitis (BISAP) were assessed.The expressions of the miR-146a,miR-10b,miR-21 and miR-26a in the serum were detected by the real-time quantitative PCR.The differences in the expressions of the 4 kinds of microRNAs in the 2 groups were compared,and the correlation between the 3 exaluation system was analyzed.Factors influencing the timing of the PCD for the PCD patients were analyzed.The measurement data were analyzed using the t test,and the relationship between the variables was analyzed using the linear correlation analysis or the rank correlation analysis.Univariate or multivariate analysis was done by the Logistic regression analysis.Results (1) The scores of the APACHE Ⅱ,RANSON and BISAP were 8.28 ±0.61,3.42 ±0.54 and 1.71 ±0.32 in the group A,and 3.18 ±0.52,1.43 ±0.25 and 0.37 ±0.06 in the group B,with significant differences between the 2 groups (t =4.266,7.809,4.113,P ＜ 0.05).(2) The expressions of the miR-146a,miR-10b,miR-21 and miR-26a were 1.41 ± 0.21,2.94 ± 0.49,1.62 ± 0.25,1.21 ± 0.20 in the group A,and 6.29 ± 0.91,0.52 ± 0.09,2.82 ± 0.33 and 3.57 ± 0.64 in the group B.There were significant differences in the expression of the miR-146a and miR-10b between the 2 groups (t＝-2.156,2.110,P ＜0.05),while no significant difference in the miR-21,miR-26a was detected between the 2 groups (t =-1.114,-1.571,P ＞ 0.05).(3) There was correlation between the expressions of the miR-146a,miR-10b and the APACHE Ⅱ,RANSON,BISAP in the group A (r =-0.826,0.837,-0.874,0.866,-0.833,0.899,P ＜ 0.05),while no correlation was detected between the expressions of the miR-21,miR-26a and the 3 exaluation systems in the group A (r =0.642,0.321,0.701,0.750,0.716,0.716,P ＞ 0.05).There was no significant difference between the miR-146a,miR-10b,miR-21,miR-26a and the APACHE Ⅱ (r =0.067,0.347,0.133,0.111,P＞0.05),RANSON (r=0.178,0.078,0.092,0.142,P ＞0.05) and BISAP (r =0.103,0.260,0.216,0.285,P ＞ 0.05) in the group B.(4) The results of univariate analysis showed that miR-10b,RANSON and BISAP were the factors influencing the timing of PCD (OR =4.170,5.612,2.500,95 ％ confidence interval:1.092-15.932,1.232-21.622,1.190-5.254,P ＜ 0.05).The results of multivariate analysis showed that miR-10b was the factor influencing the timing of PCD (OR =2.374,95％ confidence interval:1.115-5.056,P ＜ 0.05).Conclusions miR-10b and miR-146a might be the predictors of severity of severe acute pancreatitis; miR-10b might be the indicator in judging whether PCD should be applied.

BACKGROUND:The incidence of intestinal necrosis during liver transplantation is low, and most of them abandon transplantation and thus leading to death. OBJECTIVE:To retrospectively analyze the reasons which result in smal intestinal necrosis during liver transplantation, and to explore the viable treatment options. METHODS:The clinical data of 207 patients were reviewed, two patients complicated with smal intestinal necrosis during liver transplantation. Case 1 underwent liver transplantation combined with necrotic smal bowel resection. Case 2 abandoned liver transplantation, and received conservative treatment. RESULTS AND CONCLUSION:Both of the two patients had preoperative portal system thrombosis. In Case 1, there was upper gastrointestinal bleeding before transplantation, and repeated application of hemostatic drugs could increase the thrombosis and thus resulting smal intestinal necrosis. At 10 days after liver transplantation, the patients complicated with intestinal fistula and were treated with fistulation. After fistulation, the patient suffered from abdominal cavity and lung infections. At 7 days after anti-infection treatment and immunosuppressant stopped, the infections were cured. At 40 days after fistulation, the intestinal fistula was healed and the patient was discharged after rehabilitation. After fol owed-up for 2 years, the patient was stil healthy living. The Case 2 suffered with mass ascites which lead to abdominal compartment syndrome, the intestinal venous disorders lead to extensive smal bowel necrosis. At 2 days after abandon the liver transplantation, the patient was dead because of multiple organ failure. The patients who waiting for liver transplantation had preoperative portal system thrombosis, abdominal pain and abdominal distention, should be pay attention to intestinal necrosis. Patients with smal bowel necrosis during liver transplantation can be cured with liver transplantation combined with necrotic smal bowel resection.

Objective To analyze the clinical efficacy and outcomes of adult patients who underwent ABO-incompatible living donor liver transplantation.Methods The clinical data of 7 patients who underwent ABO-incompatible living donor liver transplantation at the Henan Provincial People's Hospital and Zhengzhou People's Hospital from January 2013 to December 2015 were analyzed retrospectively.Age,gender,primary disease,blood type antibody level,graft volume/standard liver volume (GV/SLV),postoperative complications and prognosis were analyzed.Results The recipients' average GV/SLV was 52.0％.There were 4 recipients who underwent splenectomy,including 3 patients who underwent the procedure concurrently,and one patient who underwent the procedure a few years before,the liver transplantation.Seven recipients were treated with plasmapheresis,Rituximab and Basiliximab.No patients experienced acute rejection during the perioperative period,and the 1-year survival rate was 85.7％ (6/7).Conclusion ABOincompatible liver transplantation in adult living donor can have favorable clinical outcomes using appropriate preoperative evaluation for recipients,optimized surgical procedures,pretransplant plasmapheresis,and perioperative Rituximab,Basiliximab injection and intravenous immunoglobulin administration.

The China Mechanical Virtual Human (CMVH) is a human musculoskeletal biomechanical simulation platform based on China Visible Human slice images; it has great realistic application significance. In this paper is introduced the construction method of CMVH 3D models. Then a simulation system solution based on Creator/Vega is put forward for the complex and gigantic data characteristics of the 3D models. At last, combined with MFC technology, the CMVH simulation system is developed and a running simulation scene is given. This paper provides a new way for the virtual reality application of CMVH.
Algorithms ; Anatomy, Cross-Sectional ; Biomechanical Phenomena ; China ; Computer Graphics ; Computer Simulation ; Humans ; Imaging, Three-Dimensional ; methods ; Models, Biological ; Muscle, Skeletal ; anatomy & histology ; physiology ; Software ; User-Computer Interface ; Visible Human Projects

Objective: To compare the clinical effects between laparoscopic cholecystectomy and choledochotomy versus traditional open cholecystectomy plus choledochotomy. Methods: One hundred and sixty-eight elderly patients with gallbladder and choledocholithiasis were divided into a laparoscopy group(n=75, receiving laparoscopic cholecystectomy and choledochotomy)and an open abdominal group(n=93, undergoing traditional open cholecystectomy and common bile duct exploration). The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay and postoperative complications were compared between the two groups. Results: The surgical incision length, operation time, intraoperative blood loss, anal exhaust time, hospital stay were lower in the laparoscopic group than in the open abdominal group(P<0.05). The incidence of postoperative complications was lower in the laparoscopic group than in the open group(P<0.05). Conclusions Laparoscopic cholecystectomy and choledochotomy can obviously improve the clinical efficacy and reduce complications in elderly patients with gallbladder and choledocholithiasis, and it is worthy of clinical application.