Objective To evaluate the application of the spleen-preservation technique in splenic injury.Methods The clinical data of 208 cases with splenic trauma were analysed retrospectively.There were,20 cases treated with non-surgical therapy;20 cases treated with simple splenorrhaphy,48 cases with ligation of splenic artery,splenorrhaphy and/or partial splenectomy,20 treated with splenectomy and autologous spleen transplantation,and 100 cases with simple splenectomy.Results In 108 splenic preservation cases,who were operated or non-operated(SP group),the value of lgM and CD3 was significantly higher than that in the splenectomy group(P

Objective Electronic portal imaging devices (EPIDs) are widely used as a replacement of portal films for patient position verification, but the image quality is not always optimal. Because of very low density resolution, the portal imaging is difficult to be used clinically. In this study, several transforming models and the optimization exposure or acquisition conditions were studied for optimization portal imaging, which based on DicomRT platform built by ourselves. Methods 6 MV X-ray from Varian 21EX linac was used to generate portal images by Portal Vision aSiS00 amorphous silicon detector image acquisition system. The density resolution study was based on the number of the lines which could be seen in the image of a special Las Vegas image quality test board. The optimization calculating models were focused on equalization after stretch transforming discrete wavelet transform (DWT) and Butterworth high pass filters. The calculation was performed in Matlab language. Results The optimal numbers of MU, average frames and reset number were 4 - 5,3 - 4 and 2 - 3, respectively. The density resolution of optimized imaging via equalization after stretch transforming, DWT and Butterworth high pass filter transforming was markedly improved. The bone structure could be definitely distinguished. The number of lines distinguished in Las Vegas image via equalization after stretch transforming, DWT and Betterworth high pass filter transforming was 3, 4 and 5, respectivly. Conclusions The proposed transforming systems, including DWT edge detection and Butterworth high pass filter transform, are suitable for improving density resolving power of MV X-ray portal image.

BACKGROUND:Current cardiac bioprostheses and mechanical valves are shown to have some flaws and shortcomings, and tissue-engineered heart valves which can avoid these problems are becoming an ideal choice for valve replacement.
OBJECTIVE:To explore the experimental progress in the construction of tissue-engineered heart valves.
METHODS:Experimental studies related to tissue-engineered heart valves were retrieved in databases. Three main elements for tissue-engineered heart valves are seed cells, scaffold materials, and cellseeding.
RESULTS AND CONCLUSION:Cardiac valve repair and replacement is the primarily surgical treatment for valvular heart disease. At present, seed cells mainly for construction of tissue-engineered heart valves include vascular endothelial cells, endothelial progenitor cells and bone marrow mesenchymal stem cells. The acellular scaffold has good biomechanical properties and histocompatibility. After cellseeding, a continuous celllayer wil form on the scaffold surface, which makes it possible to construct tissue-engineered heart valves. Tissue-engineered heart valve has a good prospect, but it is stil in the early stage of research and there are stil many problems that need to be solved.

Objective To explore the effect of the simvastatin administration on the expression of connective tissue growth factor （CTGF） in fihrotic lungs of rats. Methods The cats were treated with single intratracheal instillation of bleomycin （BLM） or instillation of the same volume of normal saline （NS） as a control. The administration of simvastatin（20 mg/kg）began once a day immediately or 7 days later after intratracheal BLM instillation respectively with the same volume of NS was given as a vehicle control. The rats were killed on day 7,14 and 28 respectively. Pathological alteration of lung tissue was observed hy HE staining and Masson staining. Hydroxyproline（HYP）content in lung tissue was used to determine the severity of pulmonary fibrosis. The expression of CTGF in lung tissue was exanfined by immunohistochem- istry staining and photodeusitometry. Results Histopathological changes of pulmonary fibrosis emerged gradually after the instillation of BLM. The expression level of CTGF was increased in lungs of rats after intratracheal instillation of BLM, compared with the control. The administration of simvastatin immediately or 7 days after intratracheal instillation of BLM, attenuated the histopathological changes of bleomycin- induced puhnonary fibrosis and prevented the increased expression of CTGF in lung tissue on day 28. Conclusion The adntinistration of simvastatin, immediately or 7 days after intratracheal BLM instillation, prevented the up-regulation of CTGF in fibrotic lungs of rats, which ntight be one of the mechanisms of the anti-fihrosis of simvastatin in lungs.

Objective To investigate the relationship among the average checking time of biochemistry results ,mental health of biochemistry results checkers and the rate of medical complains .Methods 258 biochemistry results checkers from 17 hospitals of Guangdong were tested by using symptom checklist(SCL‐90) ,biochemistry results checking time questionnaire and medical com‐plaints questionnaire .Results Compared with the national model data ,the mental health levels of biochemistry results checkers were worse relatively .The mental heath did not have gender difference ,however ,female checkers were significant worse than males in horror .The mental heath didn′t have gender difference between secondary and advanced technicians .However ,the junior techni‐cians were significant worse than technicians of other levels in obsession ,somatization ,anxiety ,depression and horror .The average checking time of biochemistry results was correlated with mental health of biochemistry results checkers .The average checking time of biochemistry results had relationship with the rate of medical complains .Conclusion The mental health conditions of biochemis‐try results checkers are bad .No mental health difference exists in gender .The junior technicians′mental heath are significant worse than secondary and advanced technicians .There are some relationships between the average checking time of biochemistry results , mental health of biochemistry results checkers and the rate of medical complains .

Purpose To observe the change of renal parenchyma elasticity in patients with chronic glomerulonephritis (CGN), and to explore the value of acoustic radiation force impulse (ARFI) in the assessment of renal histological damages in CGN. Materials and Methods 123 patients with CGN and 27 healthy volunteers were enrolled, CGN patients were divided into three groups according to renal histologic scores: mildly, moderately, and severely impaired. Shear wave velocities (SWV) of the renal parenchyma were measured and compared in different groups, the correlation between the SWV measurements and renal fibrosis Katafuchi scores, serum creatinine (Scr) and estimated glomerular filtration rate (e-GFR) was accessed, and receiver operating characteristic (ROC) curves analyses were also performed to assess the value of ARFI for the diagnosis of pathology impairment degree in CGN. Results There were statistically significant differences in SWV measurements between each CGN patient group and the control group (F=16.592, P<0.01); the mean SWV in patients with severe kidney impairment was significant lower than that of mildly impaired, moderately impaired, and the control groups (P<0.001). SWV measurements correlated significantly with renal fibrosis Katafuchi scores (r=-0.481, P<0.01), Scr (r=-0.441, P<0.01), and e-GFR (r=0.546, P<0.01); ROC analyses indicated that the sensitivity was 63.4%, 71.4%, 93.8%, specificity was 77.8%, 71.3%, 79.9%, and the area under the curve was 0.730, 0.738 and 0.870, when using the optimal cut-off value of 2.65 m/s for the diagnosis of mildly impaired kidneys, 2.50 m/s for moderately impaired kidneys, and 2.34 m/s for severely impaired kidneys, respectively. Conclusion ARFI is expected to become an effective tool for non-invasive evaluating of renal histological fibrosis in CGN patients.

Objective To evaluate the effect of hydrogen-rich saline on autophagy in the spinal neurons of rats with neuropathic pain.Methods Sixty pathogen-free male Sprague-Dawley rats,aged 8-l0 weeks,weighing 220-250 g,were randomly assigned into 3 groups (n=20 each) using a random number table:sham operation group (S group),neuropathic pain group (NP group),and hydrogen-rich saiine group (H group).Neuropathic pain was produced by chronic constriction injury of the sciatic nerve in the rats anesthetized with chloral hydrate.Hydrogen-rich saline 5 ml/kg was injected intraperitoneally once a day for 7 consecutive days in group H,while the equal volume of normal saline was given instead in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL)were measured at 1 day before operation (T0) and 1,3,5 and 7 days after operation (T1-4).The animals were sacrificed after measurement of pain threshold at day 7 after operation.L4-6 segments of the spinal cord were harvested to detect the expression of autophagy-related proteins microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p62 by Western blot.Results Compared with group S,the MWT was significantly decreased,and the TWL was significantly shortened at T2-4,and the expression of LC3 Ⅱ,Beclin-1 and p62 was significantly up-regulated at T4 in NP and H groups (P＜0.05).Compared with group NP,the MWT was significantly increased,and the TWL was significantly prolonged at T2-4,and the expression of LC3 Ⅱ and Beclin-1 was significantly up-regulated,and the expression of p62 was significantly down-regulated at T4 in group H (P ＜0.05).Conclusion The mechanism by which hydrogen-rich saline reduces neuropathic pain is related to induction of autophagy in the spinal neurons of rats.

Bile duct injury caused by abdominal trauma, usually accompanied with injuries of other abdominal organs, is rarely seen. For the reason of its complexity and often delayed diagnosis and treatment, bile duct injury usually leads to severe complications such as abdominal infection. This paper reports a group of 10 cases of bile duct injury treated in our center in the recent decade.

Objective To evaluate the short-term therapeutic effects of DNA immunoadsorbent (IA) combined with glucocorticoid and immune depressant on patients with severe systemic lupus erythematosus(SLE). Methods 32 patients with severe SLE were selected to undergo DNA IA treatment combined with glucocorticoid plus cyclophosphamide therapy, and each patient received IA therapy 3 times, once 2.5 hours, with an interval of 24-48 hours to take another two times of IA. The changes in SLE disease activity index(SLEDAI)score, health status evaluation indexes〔 physiologic functional( PF) and emotional health( MH) scores〕,renal function indexes〔 blood urea nitrogen(BUN)and serum creatinine(SCr)〕 were observed; and anti-double stranded DNA antibody( ds-DNA), immunoglobulin (IgA, IgG, IgM), complements(C3 and C4)and high-sensitivity C-reactive protein (hs-CRP) were examined before and after IA treatment for 2 weeks. Results Two weeks after the combination therapy, the SLEDAI score, BUN, SCr, dsDNA, IgA, IgG, IgM, hs-CRP were significantly lower than those before treatment 〔SLEDAI score : 14.38±3.85 vs. 15.69±1.40, BUN (mmol/L): 11.22±4.78 vs. 16.31±7.90, SCr (μmol/L): 127.02±38.17 vs. 167.25±45.63, dsDNA( U/L): 1.36±0.12 vs. 1.43±0.18, IgA( g/L): 2.41±0.73 vs. 2.59±0.86, IgG( g/L): 16.82±4.83 vs. 21.01±4.84, IgM( g/L): 1.64±0.45 vs. 1.75±0.58, hs-CRP( mg/L): 14.41±2.20 vs. 14.94±2.60, P<0.05 or P<0.01〕; PF score, MH score, complement C3 were increased〔 PF score : 71.19±17.53 vs. 56.66±22.41, MH score : 74.01±15.72 vs. 61.50±17.98, C3( g/L): 0.56±0.09 vs. 0.52±0.10, all P<0.05〕; clinical symptoms were improved significantly, and no significant adverse reactions were found. Conclusion IA combined with medical treatment has shown that it has significant therapeutic effect for treatment of patients with severe SLE, and it may decrease the levels of dsDNA, IgA, IgG, IgM,hs-CRP, and increase the level of complement C3.

Objective To investigate the predictive factors affecting the efficacy of cyclophosphamide (CTX) combined with glucocorticoids in the treatment of idiopathic membranous nephropathy (IMN),and to evaluate the efficacy of calcineurin inhibitor (CNI) adjustment due to poor treatment.Methods A retrospective cohort study was conducted.Two hundreds and twenty-eight patients with IMN diagnosed by renal biopsy in the People's Hospital of Guangxi Zhuang Autonomous Region from January 1,2007 to December 1,2016 were enrolled.All subjects were treated with CTX in combination with glucocorticoids.The patients were divided into two groups:remission group and no remission group.Multivariable logistic regression analysis was used to determine the baseline clinical-pathological influencing factors for the remission of IMN in the enrolled patients.Results The number of total remission (including complete and partial remission) of the first CTX combined with glucocorticoid treatment in 228 patients with IMN was 188(82.5％).Among them,141 patients (61.8％) had complete remission (CR),the median time for CR was 8(6,12) months,and the median time for partial remission (PR) was 3(1,4) months.The median follow-up time for this study was 25(13,43) months.Compared with the remission group,the serum albumin level was lower in the non-remission group,the 24-hour urine protein content,the blood complement C3 and C4 levels were higher,and the pathological stage was milder (all P ＜ 0.05).Multivariate logistic regression analysis suggested that the levels of baseline serum albumin,complement C4,and pathological stage were independent predictors of clinical remission in IMN patients.Twenty-four non-remission patients were treated with CNI.The overall response rate was 66.7％(16/24) at 6 months and 77.3％(17/22) at 12 months.Conclusions The levels of baseline albumin,blood complement C4,and pathological stage were independent predictors of clinical remission in IMN patients treated with CTX plus glucocorticoids.The non-remission patients with CTX combined with glucocorticoid therapy can still achieve a higher response rate after adjusting for CNI.