Objective Turn the CT sectional image into three-dimensional imaging based on VTK, in or-der to make better treatment programs for patients with liver cancer. Methods Establish visualization toolkit (VTK) visualization development environment based on VC6.0, obtain patient's CT images in DICOM format, use VTK filter and Laplacian sharpening template for pre-treatment of the images, and then use Ray-Casting algo-rithm for three-dimensional reconstruction. Results We can get three-dimensional images with higher resolu-tion and faster imaging speed through this method, which can also be cut, rotated and zoomed. Conclusion Ray-Casting algorithm based on VTK can be used for the three-dimensional imaging of human liver. With the as-sistance of three-dimensional images, doctors can detect the location of diseased tissue more easily and observe the shapes of diseased tissue intuitively.

AIM:To investigate the influence of free hemoglobin on the initiation and progression of atherosclerosis and the role of CD163 in this process.METHODS:Thirty male SD rats were randomly divided into three groups:control group(group C),atherosclerosis group(group A),atherosclerosis and hemolysis group(group P).The hemolysis and atherosclerosis animal model was established.The free hemoglobin(FHb)and MDA levels in plasma,(RAAPIs)and intima area/midmembrane area(I/M)of each group were measured.The expressions of CD163 and heme oxygenase-1(HO-1)in atherosclerosis plaques in group A and P were detected and measured by means of immunohistochemistry and Western blotting.RESULTS:Compared with group C,the FHb,MDA,CD163 and HO-1 in group A and group P increased significantly(P0.05).The FHb level in plasma and the expressions of CD163 and HO-1 in atherosclerotic plaques correlated with each other(r=0.526,r=0.498,r=0.653;P

According to the objective of fostering rehabilitation therapists, it is very essential to set up scientific and rational training base and training project to train students in practical ability. This paper recommended programs consulted the views of experts in rehabilitation.

BACKGROUND:Posterior lumbar fusion using pedicle screw-rod system fixation is the main surgical method for various lumbar diseases, and the accuracy of pedicle screw insertion is the key to success. Spinous processes are superficial in position, which serve as a anatomical landmark providing significant reference. OBJECTIVE: To analyze the anatomical classification of spinous process tilt of adult in northeast China, and to discussthe feasibility of it as the reference of anatomical landmark in pedicle screw fixation.METHODS: The tilt angle of spinous processes of 97 adults in northeast China was measured, and spinous processes of lumbar vertebrae were then classified. All subjects underwent simulative operation to determine the optimal insertion angle,measure the angle between pedicle screw and the spinous process, or standard sagittal plane for comparative analysis.RESULTS AND CONCLUSION: (1) The results were as follows: the distribution of type I was 75.1%, and 20.9% of typeII, 2.3% of type III, 1.7% of type IV. Moreover, there were no significant differences in the angle between pedicle screwand the spinous process, or standard sagittal plane. (3) These findings suggest that lumbar spine angle varies in different individuals, which shouldbe defined through relative examinations. Additionally, spinous process can be a reference inpedicle screw inserting operation.

Objective To evaluate the curative effect of coenzyme complex and potassium magnesium aspartate on the restoration of rhythm and anti-arrhythmia in postoperative valve replacement patients for rheumatic heart disease.Methods Eight two patients with rheumatic heart disease were randomized into 2 groups,with no statistical significance in the patients' parameters.Treatment group A (n =41 )received i.v.coenzyme complex and potassium magnesium aspartate 30 ml during operation.Group B ( n =41 ) were only given potassium magnesium aspartate 30 ml.Other conventional therapies were the same for the two groups.At the same time,rate of spontaneous restoration of rhythm and severe arrhythmia incidences and low cardiac output syndrome were also recorded.Results The rate of spontaneous restoration of rhythm in the treatment group were higher than that in the control group ( 97.56％ vs 80.49％,x2 =6.12,P =0.01 ).There were significant differences in the severe ventricular tachycardia,ventricle fibrillation and auricular flutter events between the 2 groups ( 19.51％ vs 41.46％,x2 =4.67,P =0.03 ).The rate of low cardiac output in the treatment group were lower than that in the control group( 14.63％ vs 36.58％.x2 =5.18,P =0.02).To evaluate the effect of combination therapy on the spontaneous restoration of rhythm,Logistic regression analysis showed that OR( odds ratio) value was 9.69 and 95％ CI( confidence interval) was 1.15 - 81.55 ( P =0.03 ).Other variables affecting the spontaneous restoration of rhythm included the time of aortic obstruction( OR =9.28,95％ CI 1.21 - 78.18,P =0.02) and cardiac function before operation ( OR =4.95,95％ CI 1.27 - 17.88,P =0.02),operating time (OR=3.99,95％CI 1.18- 11.62,P =0.04),age(OR=2.77,95％CI1.11 -9.74,P=0.04).Conclusion Combined administration of coenzyme complex and potassium and magnesium aspartate in the operation of valve replacement in patients with rheumatic heart disease is able to promote the spontaneous heart rhythm restoration and reduce the chance of severe ventricular tachycardia and low cardiac output events.

Objective To investigate the expression of cytokeratin 34βE12 in esophageal squamous cell carcinoma (ESCC),and its mechanism of action in the process of occurrence and development of an ESCC.Methods Immunohistochemistry was used to analyze the expression of cytokeratin 34βE12 in 252 ESCC patients,66 patients with esophageal carcinoma in situ,and 106 patients with adjacent normal esophageal mucosa before the relationship between its expression and biological behavior was evaluated on the basis of complete clinical information.In addition,Western blotting was used to determine the expression of cytokeratin 34βE12 in 60 patients with esophageal cancer and adjacent normal esophageal tissues.Results (1)The positive rate of caveolin-1 in ESCC,carcinoma in situ,and adjacent normal tissues was 85.7％,54.5％,and 25.7％,respectively.The difference between them was statistically significant (P ＜0.01).(2)The positive rate of cytokeratin 34βE12 in stages Ⅰ,Ⅱ,Ⅲ of ESCC was 76.5％,84.7％,and 96.3％,respectively.The expression intensity of cytokeratin 34βE12 in carcinoma tissue was gradually increased with the advance of clinical stages with a statistically significant difference (P =0.038).The positive rate of cytokeratin 34βE12 with group of lymph node metastasis was significantly higher than those without lymph node metastasis (P ＜ 0.01).(3)Western blotting results further confirmed that the expression of cytokeratin 34βE12 in ESCC was significantly higher than that in adjacent normal esophageal tissue (P ＜0.01).Conclusions The high expression of caveolin-1 might be involved in the occurrence and development of esophageal cancer.The expression of cytokeratin 34βE12 was correlated with the clinical stage of esophageal cancer.cytokeratin 34βE12 was a potential therapeutic target and a valuable prognostic indicator of esophageal cancer progression.

Objective To detect the expression of beta 2 adrenergic receptor in the infantile hemangiomas (IH) tissue and to explore its role in the pathological evolution of infantile hemangiomas as well.Methods 48 cases of infantile hemangioma were divided into two groups.29 cases were in the proliferating period,while the other 19 cases were in non-proliferating period.By using immunofluorescence technology,the endothelial nuclei and beta 2 adrenergic receptor of the IH tissue were marked by fluorescent tags,respectively,in two groups.The location of fluorescent labeling was shown in photos.By using the Image-Pro Plus 6.0 software,we analyzed and compared the average fluorescence intensity of endothelial cell nucleus and beta 2 adrenergic receptors in these two groups.Results Beta 2 adrenergic receptors were widely expressed in IH tissue,especially in endothelial cell nucleus shown in fluorescent images.The average fluorescence intensity of endothelial cell core in proliferating IH group was 0.031 ±0.002,which was much higher than that of fading period IH group (0.022±0.002).There was significant statistical different (P＜0.05).The average fluorescence intensity of beta 2 adrenergic receptor in proliferating IH group was 0.035± 0.003,which was much higher than that of fading period IH group (0.028± 0.002).There was significantly statistical different between the two groups (P＜0.05).Conclusions Beta 2 receptors are widely expressed in the endothelial cells of infantile hemangioma.

Objective To explore the effect of endoscopic sinus surgery combined with postoperative nasal irrigation on the symptoms improvement and prognosis for patients with allergic fungal sinusitis.Methods The clinical data of 145 patients with allergic fungal sinusitis who had received treatment in our hospital from January 2010 and January 2014 were reviewed.According to different treatment methods,they were divided into two groups,65 cases in the control group was treated with conventional surgical treatment,80 cases in the obeservation group was treated with endoscopic sinus surgery combined with postoperative treatment.The therapeutic conditions of two groups were compared. Results The symptom scores of patients with polyps,edema,rhinorrhea in two groups were decreased compared with those before treatment, and the obeservation group decreased more significantly (P <0.05,P <0.01).After the operation,patients with nasal mucociliary transport rate of two groups were higher compared with postoperative 6 months and 9 months,and the obeservation group improved more significantly (P <0.05).In addition,two groups of postoperative SNOT-20 scores (physiological problems,limitations and affective outcomes)treatment were lower than those before,and the obeservation group decreased significantly than that of the control group (P <0.05,P <0.01).Con-clusion Endoscopic sinus surgery combined with postoperative nasal irrigation can effectively alleviate the symptoms and improve the prog-nosis in the treatment of allergic fungal sinusitis.

BACKGROUND:Pedicle screw fixation is the mainstream type of spine operation currently. The key point of the fixation is to make the screw pass through the center of pedicle. The angle of pedicle screw implantation is a key factor for repair quality. In previous literatures, angle of pedicle screw is determined according to the patient body, and is easily disturbed by factors such as position of the body. OBJECTIVE:To determine the inserting angle of pedicle screw of lower lumbar spine taking local anatomic landmark as a reference using digital technology. METHODS:3D-CT data of 100 patients were selected. The fourth and fifth lumbar vertebrae received three-dimensional reconstruction, and the operation was simulated using digital technology to achieve optimal placement. After simulation, the angle of pedicle screw was measured. The angle of the planes of the midline of the screw and the midline of the spine served as coronal angle. The angle of the planes of the midline of the screw and the upper surface of the vertebral body served as sagittal angle. RESULTS AND CONCLUSION:Measure results suggest that each angle was bigger than the angle in previous studies, which might be induced by different reference markers. Standard deviation of each angle was also big. These findings verify that the anatomical differences of pedicles were apparent. Thus, we should insert the pedicle screws individual y. Method of locating reference using anatomic landmarks of a single vertebral body can maximize to avoid interference posture. The combination with preoperative three-dimensional reconstruction is more in line with the requirements of pedicle screw, and can effectively improve the accuracy of pedicle screws.

Objective To investigate the epidemiological characteristics and mortality risk factors of severe sepsis patients admitted into intensive care unit (ICU).Methods The clinical data of 419 severe sepsis patients admitted to an adult ICU of Beijing Friendship Hospital from January 2009 to December 2012 were retrospectively analyzed and evaluated.Logistic regression analysis was employed to identify independent risk factors for the death of patients with severe sepsis during ICU stay.Results Overall ICU mortality was 43.9％ (184/419),and the respiratory tract was the most common site of infection (50.8％),followed by infection of the gastrointestinal tract and abdominal cavity (27.8％),and hematogenous infection (4.3％).Gram-negative bacteria were the most common pathogens [46.0％ (214/465)].Iatrogenic infections accounted for 53.7％ (225/419) of the enrolled patients.Logistic regression analysis showed that age [odds ratio (OR)=0.003,95％ confidence interval (95％CI) 1.015-1.056,P=0.O00],vasoactive drug application (OR=3.251,95％CI 1.562-6.768,P=0.002),failure of 3 or more organs (OR=2.452,95％ CI 1.015-5.924,P=0.046),and iatrogenic infection (OR =1.775,95％ CI 0.981-3.221,P=0.046) were independent risk factors for ICU mortality.Conclusions Severe sepsis is a common cause of ICU admission.Patients with risk factors for high mortality should be carefully monitored,and aggressive treatment should be administered.