Objective To investigate the effect of contrast material flow rate and delayed time on intracranial vascular spiral computed tomographic angiography(SCTA) imaging.Methods 30 patients were selected randomly who planed to do brain contrast enhanced CT examination.In all 30 patients a plane dynamic test scanning at suprasellar cistern level was preformed with 20ml contrast material at a flow rate of 2ml/s,3ml/s and 4ml/s respectively.A time-densty cure was originated from data collected with the software of Time-Lapse.Results The summit time of most intense enhancement of arteriovena was significantly shortened when the flow rate was increased from 2ml/s to 3ml/s or 4ml/s,and the summit time was shortened without satistically difference when the flow rate was increased from 3ml/s to 4ml/s.Conclusions The circulation time test with a little volume contrast material can become a routine procedure of SCTA examination to determine the best delayed time.The suitable flow rate of intracranial vascular SCTA is 3ml/s.

Objective To observe and investigate the influence degree of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation.Methods 76 patients with gastric and duodenal ulcer perforation were selected as study subjects,and they were divided into control group(conventional open operation group)and observation group(laparoscopic operation group)according to the random number table,38 cases in each group.The serum body stress hormones and antiinflammatory,proinflammatory related indexes of the two groups at first day before operation and at first,third,seventh day after operation were respectively detected and compared.Results The serum IL -2 levels of the observation group at first,third and seventh day after operation were (3.53 ±0.24)μg/mL,(3.25 ±0.22)μg/mL and (4.37 ±0.33)μg/mL,which were higher than those of the control group(F =5.876,P <0.05),while other serum body stress hormones and antiin-flammatory,proinflammatory related indexes were all obviously lower than those of the control group (all P <0.05), there were significant differences between those postoperative evaluation results of the two groups.Conclusion The influence of laparoscopic operation for the postoperative body stress and inflammatory state of patients with gastric and duodenal ulcer perforation is relatively small,and it shows that the bad body stress degree caused by the operation is relatively smaller.

It is well established that different sites within a protein evolve at different rates according to their role within the protein; identification of these correlated mutations can aid in tasks such as ab initio protein structure,structure function analysis or sequence alignment.Mutual Information is a standard measure for coevolution between two sites but its application is limited by signal to noise ratio.In this work we report a preliminary study to investigate whether larger sequence sets could circumvent this problem by calculating mutual information arrays for two sets of drug naive sequences from the HIV gp120 protein for the B and C subtypes.Our results suggest that while the larger sequences sets can improve the signal to noise ratio,the gain is offset by the high mutation rate of the HIV virus which makes it more difficult to achieve consistent alignments.Nevertheless,we were able to predict a number of coevolving sites that were supported by previous experimental studies as well as a region close to the C terminal of the protein that was highly variable in the C subtype but highly conserved in the B subtype.

Objective To evaluate the influence of preoperation medical treatment on recurrence of atrial fibrillation(AF) in valve replacement postoperative patients of rheumatic heart disease during in-hospital and other risk factors. Methods One-hundred and eight patients with rheumatic heart disease and AF that underwent valve replacement postoperative patients were randomly divided into 2 groups: the treatment group (n =54)and the control group (n = 54 ). The treatment group were treated with ranipril, felodipine and simvastatin for 1 month and other conventional preoperational treatments before operation . The control group were only treated conventional preoperational therapy. Occurrence of AF postoperation were observed during inhospital. Results The occurrence of atrial fibrillation of the two group was no difference( 35.85% vs 41.51%,P = 0.55) immediately after rebeat. There was significant difference in the occurrence of atrial fibrillation of the 2 groups within 24 h post-operation ( 47.17% vs 69.81%, P = 0.02 ) . Logistic regression showed that intervention before operation had significant effect on the occurrence of AF( OR =0.39,95% CI: 0.17 -0.86,P =0.018) ,as well as the diameter of left atrium (LAD) ( OR= 4.28,95% CI:1.12 - 18.23, P = 0.018 ),pulmonary artery pressure(PAP) ( OR = 3.28,95% CI: 1.14 - 12.25, P = 0.01 ), duration of atrial fibrillation (AFD) (OR = 4.19,95% CI: 1.15 -14.22,P = 0.011). ROC curve showed that the best cut-off of LAD was 46.5 mm to predict AF,with sensitivity of 73% and specify of 85% ;the best cut-off of PAP was 48.5 mm Hg,with sensitivity of 75.6% and specify of 80.3% ;the best cut-off of AFD was 7. 5 months,with sensitivity of 76.1% and specify of 88.3%. Conclusion The recurrence of AF can be effectively reduced during hospitalization by the preoperational triple treatments for patients with rheumatic heart disease successfully underwent valve replacement operation , which is also beneficial for maintenance of sinus rhythm after operation.

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.

Objective To analyze the therapeutic effects of different meth ods in operative treatment of intertrochanteric fractures of femur. Methods 106 cases were treated with operation and their average age was 72 year old. 39 case s of them were treated with external fixation, 3 cases with steeliness, 13 cases with Metanghin nail, 45 cases with DHS, and 6 cases with proximal femoral nail( PFN). Results The therapeutic effects of the dynamic hip screw(DHS) and PFN trea tment were the best among these methods. The excellent and good rates of DHS, PF N, external fixation, steeliness, and Metanghin were 100%, 87.2%, 33.3%, 69. 2%, respectively. Conclusion For the intertrochanteric fracture of lemur,DHS or PFN is recommendable to the patients who can tolerate an operation, whereas uni lateral external fixation is preferable to those who cannot or will not receive an operation.

To investigate the effects of oleanolic acid (OA) on the proliferation, migration and the formation of tube-like structure in human vascular endothelial cells (HUVECs). MTT assay, flat plate scarification, Transwell plates and matrigel-induced tube formation assay were performed to detect the effects of OA on proliferation, migration and tube formation. MTT assay showed that the inhibition rates of HUVECs treated with 60 and 100 microg x mL(-1) of OA for 24 h were 19% and 83% respectively. Treatment of HUVECs significantly inhibited the cell migration in a dose-dependent manner. The vascular indexes of HUVECs treated with 40 and 60 microg x mL(-1) OA were 33% and 20% respectively. Western blotting analysis showed that treatment of the cells with OA significantly attenuated the expression and secretion of VEGF. Additionally, VEGF could in part reverse the effects of OA on migration and tube formation of HUVECs. In conclusion, OA inhibits the proliferation, and VEGF plays an important role in OA induced decreased migration and tube formation of HUVECs.

OBJECTIVE To investigate the cytotoxicity of cyflumetofen for SH-SY5Y cells and the mechanism. METHODS SH-SY5Y cells treated with cyflumetofen 0.03, 0.06, 0.125, 0.25, 0.5, 1, 2, 2.6, 4, 6, 8 and 16 mmol·L-1 for 48 h. Cell survival was measured with MTT assay. The reactive oxygen species (ROS) was determined with the DCFH- DA probe, and mitochondrial membrane potential (MMP) was detected by JC-1 staining. The morphological changes in cell nuclei were observed with Hoechst33258 staining. Cell cycle and apoptosis were determined by flow cytometry. The protein levels of phosphorylated Jun Kinase (p-JNK) and p-P38 were measured by Western blotting. RESULTS Compared with solvent (DMSO) control group, cyflumetofen (≥0.06 mmol · L- 1) inhibited the proliferation of SH- SY5Y cells obviously (P<0.05), and the IC50 was 2.6 mmol·L-1. MMP declined and ROS levels increased significantly in cyflumetofen 1, 2, 4 and 6 mmol·L- 1 groups (P<0.01). Cyflumetofen 2, 4 and 6 mmol·L- 1 induced nucleic accumulation, nuclear shrinkage and disintegration in SH-SY5Y cells. Apoptosis rates of cyflu? metofen 2, 4 and 6 mmol·L- 1 groups increased from (0.7±0.1)% in DMSO control group to (6.7±0.1)%, (72.4±8.6)% and (90.7±3.2)% (P<0.01). Cyflumetofen 4 and 6 mmol·L- 1 induced G1 phase cell cycle arrest (P<0.01). In addition, Western blotting showed that cyflumetofen 4 and 6 mmol·L-1 up-regulated the expression of p-JNK (P<0.01), while the level of p-P38 in SH-SY5Y cells was increased in cyflumetofen 6 mmol · L- 1 group (P<0.01). CONCLUSION Cyflumetofen induces cell damage, apoptosis and G1 phase cell cycle arrest in SH- SY5Y cells. The mechanism may be associated with oxidative damage, and activation of P38 and JNK stress-response pathways.

OBJECTIVETo investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery.

METHODSFrom May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The MEUS together with regular color Doppler ultrasound ( CDUS) were conducted preoperatively to determine the anatomical features of perforators branching from supraclavicular arteries (SCA). The perforator with wider caliber, faster flow speed, longer pedicles and closer pivot point was selected and the flap was designed according to the observed results.

RESULTSThere were 37 perforators of SCA detected by CDUS, whose calibers were ranging from 0.5 to 0.8 mm [Mean: (0.6 ± 0.1) mm]. There were 48 perforators of SCA detected by MEUS. Compared to CDUS, the caliber obtained from MEUS for same vessel is significantly increased [(0.7 ± 0.3) mm vs (0.6 ± 0.1) mm, P < 0.05]. According to the results of MEUS and three-dimensional reconstructive techniques, in at least 65.4% (17/26) of the flaps, thoracic branch of SCA (TBSA) has large caliber and good flow velocity which can be regarded as the predominant vessel and used as the pedicle of flap. The results of the operations confirmed the existences of all the marked vessels. 25 flaps were obtained according to the preoperative plans and one case used perforators of internal mammary artery as free flaps since the perforator of SCA was found improper. The contrast-related complication occurred in one patient which was manifested by gastrointestinal adverse effect like nausea and anorexia. The patient recovered 1 day later without treatment. All the patients have been followed up for 3 to 16 months (Mean: 8 months) with well-survived flaps.

CONCLUSIONSThe perforators of SCA demonstrated significant variations and preoperative mapping was vital for the success of surgery. MEUS is a valuable imaging modality for the preoperative assessment of the vascular supply for supraclavicular artery based flap.

Arteries ; diagnostic imaging ; Humans ; Mammary Arteries ; Microbubbles ; Neck ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; Ultrasonography ; methods

BACKGROUND:For pediatric patients with aplastic anemia in China, it is difficult to find human leucocyte antigen-matched sibling donors that are mostly replaced by parental donors.
OBJECTIVE:To retrospectively analyze the clinical efficacy and safety of parental haploidentical peripheral blood hematopoietic stem cel transplantation in children with relapsed and refractory severe aplastic anemia.
METHODS:Seventeen children with relapsed and refractory severe aplastic anemia who had no matched sibling or unrelated donor and failed to respond to immunosuppressive therapy were subjected to parental haploidentical peripheral blood hematopoietic stem cel transplantation. A conditioning regimen of fludarabine+cyclophosphamide+rabbit anti-human thymocyte immunoglobulin antibody and the triple therapy of methotrexate, cyclosporine A and mycophenolate mofetil were applied to prevent graft-versus-host disease.
RESULTS AND CONCLUSION: (1) Of the 17 children, 16 cases (94%) reached hematopoietic reconstitution, and the median time of neutrophils≥ 0.5×109/L and platelets≥ 20×109/L was 13 (11-15) days and 17 (12-28) days, respectively. (2) Incidence of acute graft-versus-host disease was 47% (8 of 17 cases), including 29% (5/17) of grades I-II and 18% (3/17) of grades III-IV. Incidence of chronic graft-versus-host disease was 41% (7/17). (3) With a median folow-up duration of 268 (43-753) days, the overal survival rate was 70.6% (12/17). Five dead cases (29%) belonged to transplantation-related death, including one case of fungal skin infections, one case of graft-versus-host disease, three cases of severe lung infection. No relapse case was reported. These findings indicate that if there are no matched sibling or unrelated donors and the immunosuppression effect is poor, parental haploidentical peripheral blood hematopoietic stem cel transplantation is a safe and effective salvage treatment for children with relapsed and refractory severe aplastic anemia.