ObjectiveTo evaluate the therapeutic effect of gastroesophageal devasculariztion on cirrhotic portal hypertensive bleeding.MethodsClinical data of 85 cirrhotic patients with portal hypertentsive bleeding undergoing gastroesophageal devascularization were retrospectively analyzed. Results The following-up rate was 78％. The 1-yr,3-yr and 5-yr survival rate was 95％, 88％and 82％respectively.There was significant difference in survival time after devascularization between patients of Child-Pugh A and Child-Pugh B.For the whole group the 1-yr,3-yr and 5-yr recurrent bleeding rate was 6％,16％ and 28％ and postoperative hepatic encephalopathy was 7％.ALT,AST and ALB recovered to pre-operative level on post-operative day 7.ConclusionsGastroesophageal devascularization was an effective therapy in treating portal hypertensive variceal bleeding.Liver function remains a significant factor influencing long term survival.

Objective To summarize clinical experience on the diagnosis and management of pancreatic regional portal hypertension. Methods The clinical manifestations,diagnostic methods and therapeutic modalities of 40 cases of pancreatic regional portal hypertension were analyzed retrospectively.Results Male:female =26: 14.The average age was (40 ± 10)yrs.Among these patients,16 patients (40％) were accompanied by upper gastrointestinal bleeding and 20 patients (50％) by hypersplenism.There were 16 patients (40％) suffering from benign lesions and 6 patients (15％) from malignancy at pancreatic body and tail respectively,and 8 patients(20％ ) from severe necrotic pancreatitis accompanying pseudocyst and 10 patients (25％) from chronic pancreatitis. The average splenic venous pressure was (28.4±4.2) cm H2O(P ＜0.01 ).The average diameter and speed of splenic vein bloodflow by Doppler examination was ( 1.3 ± 0.2 ) cm ( P ＜ 0.01 ) and ( 9.3 ± 0.5 ) cm/s ( P ＜ 0.05 ).The follow-up rate was 100％.Splenectomy was effective for controlling gastrointestinal bleeding. Conclusions It is not difficult to diagnose pancreatic regional portal hypertension based on findings of US,CT and endoscopic examination,together with its clinical features. Therapy should be aimed at both regional portal hypertension and underlying diseases.

ObjectiveTo systematically evaluate the therapeutic effect of gastroesophageal devascularization( GD),portasystemic shunt( PSS),devascularization plus portasystemic shunt ( GD + PSS) for the treatment of 4250 cirrhotic portal hypertension cases reported in Chinese literature. MethodsThe literatures about the effect of gastroesophageal devascularization,portasystemic shunt,devascularization plus portasystemic shunt on portal hypertension were collected from Wanfang databases, China National Knowledge Infrastructure(CNKI) from 1980 to 2011.RevMan 4.2 and SPSS 13.0 were used for data analysis. ResultsIn this study 17 reports were enrolled into the meta-analysis.The results of the mta-analysis showed that long term survival rate in the group of GD plus PSS was higher than that in group of GD [OR=1.73,95％CI (1.23,2.44),P ＜0.01].That in group of PSS was similar with the group of GD [ OR =0.87,95 ％ CI (0.63,1.20),P =0.40 ].That of group GD plus PSS was similar with the group of PSS [ OR =1.73,95％ CI (0.95,3.13),P =0.07 ].For recurrent variceal bleeding rate,that in group of PSS was lower than that in the group of GD[ OR =0.46,95％ CI (0.35,0.61 ),P ＜0.01 ].That in the group of GD plus PSS was lower than that in the group of GD [ OR =0.25,95％ CI (0.18,0.35),P ＜ 0.01 ].The group of GD plus PSS was similar to that of group of PSS [ OR =0.72,95％ CI ( 0.40,1.29 ),P =0.27 ].Encephalopathy rate was higher in the group of PSS than the group of GD [ OR =3.57,95％ CI (2.43,5.23 ),P ＜0.01 ].That in group of GD plus PSS was lower than that in the group of PSS[ OR =0.37,95％ CI (0.20,0.69),P ＜0.01 ],while that in GD plus PSS was similar to the group of GD[ OR =1.58,95％ CI (1.02,2.43),P =0.04 ].ConclusionsThe only significant factor influencing the long term result in Chinese patients with portal hypertension is preoperative liver function.The three types of operation have different benefits and disadvantages.

Objective To understand the distribution,variation and prevalence of virulence-related gene of the V.cholerae at the molecular level.Methods PCR technique was applied to detect ctxAB,and zot gene of CTX? genetic element,cri gene of TLC cluster of the 176 strains of V.cholerae isolated from 1964 to 2008.Results One hundred and thirty-one strains of V.cholerae carry ctxAB and zot of CTX? genetic element in 176 strains,the positive rates were 72.72%(128/176 strain) and 73.30%(129/176 strain) respectively.69.00%(69/100 strain) of V.cholerae O1 strains isolated from 1964 to 1996 carried cri gene,however the rate was only 1.33%(1/75) in the strains isolated from 1998 to 2008.ctxAB,zot and cri in V.cholerae O139 were all positive.Conclusion Detection of virulence-related genes can reflect the molecular characteristics of strains,and it is important to the molecular epidemiology of V.cholerae research.

Objective To explore the clinical value of Delphian node (DN) metastasis in papillary thyroid cancer(PTC).Method In this study,86 cases of unilateral PTC proved by frozen pathology and initially undergoing surgical treatment were enrolled to evaluate Delphian nodes metastasis in its correlation with age,sex,tumor size,extra-thyroid extension and central and lateral compartment nodes.Results All patients underwent homolateral thyroidectomy plus contralateral subtotal thyroidectomy,central compartment and region Ⅲ and Ⅳ lymphadenectomy.There were no mortality and major morbidities.The following-up rate was 91.9％ (79/86).The mean following-up time was 45 months,and there was no tumor recurrence and metastasis.DN-postive was in close relation to extra-thyroid extension ( 60％ vs.24％ ;P =0.019)positive central compartment ( 80％ vs.27％ ;P ＜ 0.01 ) and lateral compartment lymph node metastasis (40％ vs.5％ ;P ＜ 0.01 ).DN-postive was also in close relation to the number of metastastic nodes ( average 7 vs.2 numbers of node;P =0.002 ) and the size of the node (2.1 cm vs.0.8 cm;P =0.02).Conclusions DN-postive has close relationship with extra-thyroid extension and central and lateral compartment nodes in PTC patients.

Objective To evaluate the clinical outcomes and correction accuracy of posttraumatic varus and valgus knee deformities using the Taylor Spatial Frame (TSF).Methods From June 2006 to December 2010,26 patients with posttraumatic varus and valgus knee deformities who had been treated with the TSF combined with less invasive high tibial osteotomy (HTO) or supracondylar femur osteotomy (SFO) were retrospectively analyzed,including 19 males and 7 females with an average age of 39 years.There were 20 cases of posttraumatic varus knees and 6 valgus knees.Twenty one patients were treated with HTO and 3 with SFO,2 with HTO and SFO simultaneously.During the operation,the TSF was firstly assembled and then the parameters of the frame were measured followed by less invasive percutaneous osteotomy.Correction was started seven to ten days after the operation following the time schedule provided by the computer program.Correction of the struts were performed 3 times per day,with a total movement of 0-3 mm.Results Through 7-35 days frame adjustments,20 cases of deformities were fully corrected.X-ray showed that the mechanical axis deviations of the tibia and femur all were recovered to normal range,and the deformity of rotation,angulation and crispation were fully corrected.Six cases had residual slight angulation or crispation deformity ( ＜ 4° or ＜ 10 mm).Through the second 4-10 days frame adjustments,these 6 cases of deformities were fully corrected finally.New bone formation and consolidation on the osteotomy site were good.The fixators were removed from 2.5-6.0 months after surgery and the appearance of the limbs and the patients' gait recovered to normal and the keen pain disappeared.All patients were followed up for 12-60 months and without the recurrence of the deformity.Eleven cases occured pin site infection and were controlled by use of the sensitive antibiotics.One case occured refracture of the distal femur osteotomy site 1.5 months after frame removal.Through conservative treatment,the fracture finally healed.Conclusion Posttraumatic varus and valgus knee deformities can be effectively corrected by using TSF and with a high accuracy.

In order to survey antibiotic resistance of clinical isolates carbapenem-resistant A cinetobacter baumannii in Meizhou and to investigate resistance mechanism and molecular epidemiological characteristics ,a total of 210 non-duplicated clinical isolates of carbapenem-resistant Acinetobacter baumannii from January 2012 to December 2012 were collected .The K-B disk diffusion method was applied for the drug-susceptibility test ,a modified Hodge test was used for the screening of carbapen-emase ,PCR was used to amplify carbapenemase genes (including IMP ,VIM ,OXA-23 ,OXA-24 ,OXA-51 and OXA-58) ,and the positive products were sequenced .Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR) was used for DNA typing and test of homology .Our results on the percentage of strains resistant for antibiotics tested were higher than 60% except for polymyxin B was 0 .48% .There were 163 positive strains by the modified Hodge test ,accounting for 77 .62% .OXA-51 gene was identified in 198 strains (94 .29% ) ,OXA-23 in 165 strains (78 .57% ) ,and VIM in 9 strains (4 .29% ) ,OXA-24 ,OXA-58 and IMP gene was not identified by PCR amplification .Seven genomic types were included in the 210 carbapenem-resistant Acinetobacter baumannii .The major prevalence types were Type A (97 strains) ,Type B (44 strains) and Type H (25 strains) . In conclusion ,multiple drug resistance of clinically isolated carbapenem-resistant A cinetobacter baumannii is a serious problem in Meizhou .Production of OXA-51 ,OXA-23 and IMP carbapenemases is an important mechanism of resistance to carbapenem antibiotics ,and there is prevalence of the same clones in these carbapenem-resistant strains .

Objective To analyze the detection rate and drug resistance tendency of Acinetobacter (A .) baumannii in Meizhou area during 2008-2012 in order to provide the guidance for clinicians′medication .Methods The detection rate and drug resistant rate of A .baumanii in the clinical specimens submitted from 5 hospitals in Meizhou during 2008 -2012 were retrospectively ana-lyzed .The antimicrobial susceptibility test was performed by the disk diffusion method .The WHONET 5 .4 and SPSS18 .0 soft-wares were adopted to analyze the data .Results The detection rates of A .baumanii in these five years were 12 .91% ,15 .40% , 11 .94% ,13 .59% and 14 .00% respectively .In the sources of strains ,sputum had the highest distribution rate of 68 .99% (1 713/2 483) ,in the distribution of departments ,ICU had the highest distribution rate of 33 .91% (842/2 483) .The resistance rate of A . baumannii to cefoperazone/shubatam ,meropenem and imipenem were below 30% in the five years ,but showed the upward tenden-cy .The 5-year total drug resistance rates of A .baumanii to 18 kinds of antibacterial drugs were statistically different between ICU and non-ICU department (P<0 .05) ,the drug resistant rate of isolates from ICU was higher than that from the non-ICU depart-ments .The isolation rate of multi-drug resistant strains of A .baumanii was fluctuated in about 50% during these five years except the lower isolation rate in 2008 ,the isolation rate of pan-drug resistant A .baumanii and carbapenem resistance A .baumanii showed the upward tendency .Conclusion The drug resistance rate of A .baumanii is gradually increased .The drug resistance monitoring of A .baumanii in ICU should be strengthened .Antimicrobial agents should be reasonably used for maximizing to retard the emergence of drug resistant strains .

Objective To prepare cetuximab-β-glucosidase conjugates and to identify its enzymatic activity and an?tibody activity. Methods Cetuximab andβ-glucosidase were crosslinked by Sulfosuccinimidyl-4-(N-maleimidomethyl) cyclohexane-1-carboxylate (Sulfo-SMCC). Cetuximab-β-glucosidase conjugates and its enzymatic and antibody activity were examined by non-reduced SDS-PAGE, colorimetry and indirect immunofluorescence assay. Results We can see clear bands ofβ-glucosidase, cetuximab, cetuximab-β-glucosidase conjugates through electropherogram. Although the en?zymatic activity of cetuximab-β-glucosidase conjugates was lower than that ofβ-glucosidase (U/L:672.97±46.19 vs 869.50± 57.28,t=5.972,P<0.05) shown by colorimetry assay, it still maintain good enzymatic activity. Under fluorescence micro?scope, we can see the conjugates interacted with human bladder cancer EJ cells are in a red fluorescence. Conclusion Ce?tuximab,β-glucosidase were crosslinked successfully by Sulfo-SMCC without altered its enzymatic and antibody activity.

OBJECTIVE:To study the therapeutic efficacy of compound glycyrrhizin tablets(SNMC)combined with hep?atocyts growth-promoting factor(PHGF)in the treatment of severe hepatitis.METHODS:126patients with severe hepatitis were randomly divided into the trial group and the control group.RESULTS:The effective rate was87.2%in the trial group and70.0%in the control group,which existed a significant difference(P