Objective: To study superior mesenteric artery hemodynamics in patients with hepatic cirrhosis and to investigate the mechanism of hepatic cirrhosis ascites. Methods: superior mesenteric artery hymodynamics were measured py duplex Doppler ultrasound in 80 patients with hepatic cirrhosis,50 control supjects. Results: Both SMA-Pl and SMA-Rl in patients with hepatic cirrhosis compensation or decompensation were decreased. SMA-Pl was lower in those with ascites without ascites. and tends to worsen in relation to severity of varicosity in esophagus. Conclusion: SMA-Pl decrease occurs in cirrhosis since the early stage of the disease. Hyperdynamics of SMA relates to ascites formation and esophageal varicecosity.

Objective: To discuss the effect of non-contrast-enhanced magnetic resonance angiography in renal artery imaging. Methods:Twenty patients were selected with suspected as the research object, using non-contrast-enhanced MR examination, simultaneously enhanced MR examination, and relatively non-enhanced imaging examination effect on the results for statistical analysis and processing. Results: Non-contrast-enhanced ratio comparing contrast-enhanced, not statistically significant (x2=1.058, P>0.05). Conclusion:Non-contrast MR angiography is an effective, safe, non-invasive, high accuracy of the evaluation of renal artery screening tool, worthy of clinical application.

Objective To evaluate the value of cystography with low-concentration contrast medium in diagnosing small tumor of urinary bladder.Methods Cystography in 187 cases with bladder disease from 1992 to 2001 was performed using 6%～8% Meglumine Diatrizoate 100～120 ml under TV monitored.Radiogrames of A-P position and bilateral oblique position were taken when the focus was found.The radiogram on patient’s position at head low was adopted when necessary.Results Of 187 cases,106 cases of bladder tumors were detected,including 8 cases of small bladder tumor(≤1.0 cm in diameter),3 cases were misdiagnosed,the detectable rate was 73.0%.All cases were confirmed by operation and pathologiy.In these 8 cases,1 case was adenocarcinoma,5 cases were transitional epithelia cell carcinoma,2 cases were papilloma.The X-ray appearances were nipple-like or cauliflower shape with filling defect,a narrow pedicel could be occasionally found in papilloma or transitional epithelia cell carcinoma and it had somewhat movement when changed patient’s position.Conclusion Cystography with low-concentration contrast medium is a non-injury procedure in diagnosis of small tumor of urinary bladder.

Objective:To investigate the immune mechanism of 5-fluorouracil(5-Fu) and Octerotide(Oct)in the treatment of severe acute pancreatitis(SAP)and it’s kidney injury.Methods:55 male SAP rats induced by retrograde infusion of 5% sodium taurocholate into bilopancreatic duct were randomly divided into 3 groups:Normal saline group(n=17)were treatmented with normal saline infusion,Oct group(n=18):The first dose of Oct was 2?g/100g iv,then 0.2?g/(100g?h)continuous injection,5-Fu group(n=20):The dose of 5-Fu was 2mg/h?12h.Rats from each group were killed at 12h after opertation.The plasma levels of tumor necrosis factor-?(TNF-?),interleukin-1(IL-1)were assessed by ELISA method.Thromboxan B_2(TXB_2)and prostaglandinE_2(PGE_2)were assessed by radioimmunoassay method.The expression of TNF-? mRNA was detected by RT-PCR.The apoptosis rate of rat kidney tissue were detected by TUNEL method.Apoptosis rate of NRK cell treated by serum of different groups were assessed by flow cytometry methods.Results:The plasma level of TNF-?、IL-1 and TXB_2 in 5-Fu and Oct group were much lower than that in normal saline group.The expression of TNF-? mRNA of kidney tissue decreased significantly after the SAP was treated by 5-Fu or octreotide.The apoptosis rate of NRK cell disposed by normal saline group,oct group,5-Fu group and control group rat plasma were (38.67?11.4)%,(20.4?18.4)%,(10.5?11.0)% and (1.7?2.2)% respectively(P

AIM: To determine whether the viartrils could provide a beneficial effect on the prevention of early/middle stage osteoarthritis(OA) and affect the proliferation of chondrocytes. METHODS: An OA model was produced with severing the anterior, posterior cruciate ligaments of the knee in 24 adult New Zealand rabbits. The animals were then randomly divided into viartrils group and control group. After surgical operation, viartrils (mainly contains glucosamine sulphate) 2 pills per day were administered to the animals in viartrils group. The animals were sacrificed and specimens were taken from the weight-bearing portion of the femoral condylar seven weeks after operation. Each case was evaluated according to a modified histological-histochemical grading system(HHGS) using HE and safranin O/fast green staining slides, and immunohistochemical method was used to detect the proliferation of chondrocytes in articular cartilage. RESULTS: The method of severing the anerior, posterior cruciate ligaments of the knee could successfully induce the early/middle stage model of OA. The pathological remark in control group was significantly higher than that in the viartrils group (P

Objective To evaluate the value of endoscopic ultrasound (EUS) in differentiatied diagnosis for stromal tumour and lipoma in duodenal tract.MethodsThe EUS images of 44 cases of stromal tumour(30 cases) and lipoma( 14 cases) which were confirmed by pathological results were analyzed retrospectively.The location,size,layer of origin,margin,internal echo pattern and homogeniety of the lesion were recorded and compared.Results Compared with lipoma,stromal tumour showed a significant difference in the layer of origin,margin,internal echo and homogeniety ( P ＜ 0.05 ),but there was no statistical difference in the lesion location and size( P ＞0.05).ConclusionsEUS is greatly helpful to the differential diagnosis of stromal tumour and lipoma in duodenal tract.

Objective To evaluate whether second-look endoscopy could prevent endoscopic submucosal dissection complicated with delayed bleeding and to clarify what kind of lesions that need second-look endoscopy. Methods 98 patients with early gastric cancer by histological diagnosis from Oct. 2014 to Sep. 2016 were included in this study. Mucosal damage related bleeding within 24 h after ESD was considered delayed bleeding. Clinical data of patients, lesions, surgical factors, and the incidences of bleeding before and after the second endoscopy examination were retrospectively studied. Results The en bloc resection rate of 98 patients was 100.0%, and all incisal margins were negative. No gastrointestinal perforation, death or severe complications occurred. 5.1%of the patients (5/98) occurred delayed bleeding after ESD and had been successfully stopped in a second-look endoscopy, and none received operations. No delayed bleeding occurred in follow-ups of patients with negative delayed bleeding. 40.0 % of the patients (2/5) with delayed bleeding received blood transfusion. The median time of second-look endoscopy after ESD was the second day after operation (1 ~ 3 d). The median bleeding time of 5 patients with delayed bleeding after ESD was the first day after operation (1 ~ 10 d). The median duration of surgery was 75 min (60~150 min), and the prediction success rate was 94.9 %. The results of univariate analysis showed that age [(69.6 ± 7.9) vs (60.9 ± 10.1) years old, P = 0.003] and operation time [(90.0 ± 41.0) vs (66.0 ± 42.0) min, P = 0.000] were both the risk factors in delayed bleeding and non-bleeding group. Binary Logistic regression analysis showed that operation time (OR^ =1.07; 95%CI:0.73 ~ 14.63, P = 0.010) was the only predictor of delayed bleeding after ESD. Conclusions Second-look endoscopy might be effective in preventing delayed bleeding after gastric ESD, especially within 48 hours after ESD. The operation time was an independent risk factor for delayed bleeding after gastric ESD.

A 7?year?old girl presented with a plaque on the left side of the face for 4 years. Skin examination revealed a well?marginated circular firm plaque measuring 6 cm × 5 cm in size on the left side of the face with purulent crusts on the surface, which was nontender to palpation. Histopathologic study showed ulceration and necrosis in some areas in the epidermis, diffuse dermal infiltration of lymphocytes, histiocytes and epithelioid cells with the presence of many neutrophilic granulocytes in some regions. Both periodic acid?Schiff(PAS)staining and acid?fast staining were negative. After 25 days of tissue culture, scotochromogenic Mycobacterium colonies grew, and colony smears showed positive acid?fast staining. The sequences of 16S rRNA and hsp65 genes of the fungal isolate showed 100%and 99%homology with those of Mycobacterium szulgai, respectively. After the treatment with rifampicin, isoniazid and ethambutol, the patient′s condition was improved.

Objective To investigate the clinical value and relating problems in treating atlantoaxial instability by using transpedicular instrumentation with fusion. Methods The study reviewed 18 patients (11 males and 7 females, at age range of 13-82 years, mean 46.5 years) with atlantoaxial instability undergone transpedicular screw internal fixation with bone grafts fusion. There were 15 patients with type Ⅱ odontoid fractures, two with traumatic disruption of transverse atlantal ligament and one with fracture of the anterior ring of C1, all of which were associated with atlantoaxial subluxation or obvious instability. Preoperative JOA score was 6-13 points (average 9.5 points). Results The operation lasted for mean 115 minutes (range 75-180 minutes), with intraoperative blood loss of mean 235 ml (range 130-450 ml). One patient presented intraoperative plexus venous bleeding during removal of lower edge of the posterior arch of atlas and was treated with hemostasis using compession of gelatin sponge. All the patients were followed up for a mean period of 13.5 months (6-38 months), which showed no complications including infection, loosening or breakage of internal fixators or neurovascular injury related to internal fixation. Postoperative JOA score was 12-17 points (average 14.5 points). Reduction and solid fusion of the bone graft were achieved satisfactorily in all patients. Conclusions Posterior transpedicular screw internal fixation with bone grafts fusion can achieve good reduction, reliable fixation, high fusion rate and is a reliable method to manage atlantoaxial instability. Correct selection of the indication, familiarity with local anatomy and mastery of the operation technique are key to a satisfactory curative effect.

Objective To evaluate the clinical results of the PCL-retaining total arthroplasty in treatment of knee osteoarthris with valgus.Methods From June 2002 to January 2005,8 cases of osteoarthris with valgus knee were treated with PCL-retaining total knee replacement.The X-ray before operation showed average 21.6 degrees(ranging from 10 to 35 degrees) valgus.The cases were follow-uped from 6 to 36 months,each of them was evaluated with the Special Surgery Knee Scoring System.Results The X-ray after operation showed average 5.7 degrees(ranging from 3 to 9 degrees) valgus.The average HSS scores increased from preoperative 54 to postoperative 91.The range of motion was significantly improved from preoperative 83 degrees to postoperative 118 degrees.All of the cases were no pains after operation,and the function of knees were apparently improved.Conclusions The preliminary clinical results are quite satisfactory for the PCL-retaining total arthroplasty in treatment of osteoarthris with valgus knee.The adequate relaxing and balancing of soft tissue is the key factor to the success of total knee arthroplasty.The follow-up is necessary for further long-term outcome.