Objective Experiment the effective method to improve cell injury of cerebral ischemia.MethodMake Mongolirn-Gerbil acute full cerebral ischemia model with ligation of double main carotid arteries,observe the influence of intervening abdomen injection of western medicine Nimodipin and TCM Xingnaojing on MDA and SOD in cerebral tissue of Mongolirn-Gerbil in acute period of ischemia reperfusion.ResultIt finds that Nimodipin and Xingnaojing both can markedly increase SOD activity and decrease MDA content,there’s no obvious difference between them,while there’s difference among different dosages of Xingnaojing,the effect is rising with dosage increased.ConclusionAs a Chinese drug of anti-free radical injury,Xingnaojing has similiar effect with Nimodipin.

Objective To evaluate whether the comparability of 3 automatic blood cell analyzers meet the clinical requirements by conducting the comparative study on the detection results of these instruments.Methods With the Sysmex 2100 automatic blood cell analyzer as the reference instrument,Sysmex 1000i and Abbott 1800 as the experimental instrument,the original quality control provided by the instrument factory and the patient′s fresh anticoagulant blood samples in the laboratory were adopted to monitor for continuous 40 d by these three instruments and the detection results of WBC,RBC,HGB,HCT and PLT were analyzed.Results The detection results of these 3 instruments were statistically tested by the F test,the differences showed no statistical significance (P >0.05)and the bias was in 1/2 of the maximum permissible error range in America department clinical test revised regulations (CLIA′88).Conclusion The detection results by these 3 instruments are comparable and can meet the clinical requirements.

ObjectiveTo investigate the risk factors for percutaneous transhepatic biliary drainage (PTBD) related cholangitis in patients with malignant obstructive jaundice.MethodsOne hundred and fifty-four consecutive patients with malignant obstructive jaundice and without leukocytosis,fever and other manifestations of biliary tract infection received initial PTBD drainage.They were enrolled in this study.An uncontrolled prospective study was conducted of cholangitis occurrence within 30 days after PTBD.Twenty potential preoperative risk factors were assessed by univariate and multivariate analysis.ResultsFifty-five patients (55/154,35.7％ ) developed PTBD-related cholangitis,which composed of cholangitis group.Other patients composed of non-cholangitis group (99/154).The cholangitis-related mortality rate was 2.6％ (4/154).Intraoperative bile culture were performed for 131 patients (131/154),including 45 in cholangitis group and 86 in non-cholangitis group.Positive result occurred in 26 patients (26/45) in cholangitis group and 17 patients (17/86) in non-cholangitis group.There was statistical significant difference between these two groups ( x2 =19.357,P ＜ 0.01 ).By univariate analysis,diabetes ( x2 =10.470,P ＜ 0.01 ),Child-Pugh C grade ( x2 =36.324,P ＜ 0.01 ),undrained biliary duct ( x2 =9.540,P ＜0.01 ),external-internal drainage ( x2 =9.856,P ＜ 0.01 ),history of ERCP or cholangiojejunostomy (x2 =14.196,P＜0.01),QOL (t =-3.288,P ＜0.01),KPS(t =-2.099,P＜0.05),ALT (t =-2.112,P＜0.05),PT (t =-3.648,P ＜0.01),albumin (t =-2.071,P ＜0.05),WBC (t =2.022,P ＜ 0.05 ),proximal obstruction ( x2 =6.190,P ＜ 0.05 ) and cirrhosis ( x2 =5.439,P ＜ 0.05 )were significantly different between cholangitis group and non-cholangitis group.By multivariate analysis,diabetes ( OR =5.093,P ＜0.01 ),Child-Pugh C grade ( OR =13.412,P ＜0.01 ),undrained biliary duct ( OR =3.348,P ＜ 0.05 ),external-internal drainage ( OR =3.168,P ＜ 0.05 ) and history of ERCP or cholangiojejunostomy (OR =8.330,P ＜ 0.01 ) remained significant difference.ConclusionsPTBD is an effective and safe palliative treatment for patients with malignant obstructive jaundice.Sufficient preoperative preparation and effective control of risk factors may reduce the incidence of cholangitis after PTCD.

Objective To investigate clinical features of lower motor neuron lesion (LMNL) caused by the single level lower thoracic disc protrusion (LTDP),and to observe clinical outcomes of surgical treatment.Methods Between January 1997 and December 2009,17 patients with LMNL caused by single level LTDP underwent en bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation in our hospital.MRI and CT scans were taken to confirm lesion levels:T10-11 in 4 patients of whom 3 had patellar clonus and ankle clonus,T11-12 in 5 patients of whom 4 had ankle clonus,and T12L1 in 8 patients who only had positive Babinski sign.The neurologic status was assessed using the Japanese Orthopaedic Association (JOA) scoring system.The muscle strength of the tibialis anterior was assessed using the Manual Muscle Test (MMT).Sagittal Cobb angle and cross-sectional area of the dural sac at the level of maximal compression in MRI were also observed.Results All patients were followed up for 22 to 76 months (average,48.6 months).The mean JOA score increased from preoperative 5.88±1.11 to 9.53±0.94 at final follow-up (t=16.143,P＜0.05).The muscle strength of the tibialis anterior recovered to more than grade 4 in all patients.Postoperative Cobb angle was unchanged compared with that before operation.MRI indicated that the cross-sectional area of the dural sac at the level of maximum compression increased from preoperative 35.8±7.3 mm2 to postoperative 132.9±6.5 mm2 (t=70.78,P＜0.05).Conclusion LMNL can be caused by LTDP.The eu bloc resection of the superior articular process,Cave-in 360° circumferential decompression and internal fixation can provide a satisfactory decompression effect and marked recovery of neurological function.

Objective To explore the therapeutic efficacy and operation experience of Prolene Hernia System (PHS) in the tension-free repair operation of inguinal saddle hernia. Methods All 41 cases using PHS were selected as the subjects of this study and the results were analyzed. Results All patients were performed operation under the local anesthesia, and lasted from 25 min to 60 min. They had been keeping in ward for observation from 24 h to 72 h. No serotal swelling, hematoma, and incisional wound infection hap-pened after the operation. The follow-up time had been lasting from 6 months to 42 months, and none of pa-tients catehed a relapse or had the sensation of the foreign bodies. Conclusions Using PHS is safe and ef-fective in the tension-free repair operation, and it is more suited to inguinal saddle hernia. The key of opera-tion success is attaching importance to operation skills.

Objective In-hospital mortality rate in patients undergoing percutanous transhepatic biliary drainage for malignant obstructive jaundice remained high.This study aimed to assess pre-,intra-and post-procedure risk factors which were independently associated with increased in-hospital mortality.Methods One hundred and fifty-five consecutive patients with malignant obstructive jaundice received initial PTBD drainage.Twenty-five pre-procedure,4 intra-procedure and 6 post-procedure factors potentially related with in-hospital mortality were assessed by univariate and multivariate analysis.Results In-hospital mortality rate was 16.8％ (26/155).Of 25 pre-procedure variables analysed,Child-Pugh classification C,creatinine (≥ 6.93 μmol/L) and quality of life (≤ 30) were found to be significant in univariate and multivariate analysis.Increased mortality was seen in this study with two or more risk factors,significantly different from patients who had none or one risk factor(P ＜0.01).None of the intra-procedure factors were important in identifying patients at risk of death.Multivariate analysis indicated post-PTBD cholangitis and unsuccessful drainage as post-procedure risk factors that correlated with in-hospital death.Conclusions Three pre-procedure and two post-procedure risk factors were identified associated with in-hospital mortality.

BACKGROUND: Endothelium-dependent vasodilatation (EDD) has been assessed by intracoronary acetylcholine infusion and digital subtraction angiography. However, its applications in continuous observing on early onset, progression and outcomes of clinical interventions of the disease are limited due to the potential trauma of the method. OBJECTIVE: This study was designed to assess the changes in brachial EDD in patients with hyperlipidemia using high-resolution ultrasound and to compare the outcomes of the patients to those of the healthy individuals. DESIGN: Case-control study SETTING: This study was carried out at the Cardiology Department and the Ultrasound Department of Xinyang CentralHospital PARTICIPANTS: Sixty patients with hyperlipidemia, 37 males and 23females, with an age ranging from 36 to 75 years old, were selected at the Cardiology Department of Xinyang Central Hospital from May 2001 to March 2002. They were divided into 3 groups according to abnormalities in blood lipid, as hypercholesterolemia group (HC, 20 cases),hypertriacylglycerolemia group (HTG, 20 cases) and mixed hyperlipidemia group (HLP,20 cases). Twenty voluntary individuals with normal physical examination findings were allocated into control group, 12 males and 8 females. Informed consents were obtained from all the eligible. METHODS: The brachial artery inner diameter and the changes in blood flow of the brachial artery were assessed using high-resolution ultrasound.After the patients having a rest for more than 10 minutes, the inner diameter (D0) and the baseline blood flow of their brachial artery were measured. The blood pressure cuff was placed under the elbow with a pressure at 300 mm Hg, lasting for 4 to 5 minutes and followed with a sudden deflation. 15 s after deflation, the reactive brachial artery inner diameter (D1) and the blood flow of the brachial artery were detected. The patients took another rest for more than 15 minutes and after the artery restored to a normal condition,the patients took nitroglycerol sublingually at a dose of 400 μg. Three to four minutes later, the brachial artery inner diameter (D2) and the blood flow of the brachial artery were detected. The increasing rate of the inner diameter of brachial artery were calculated, the increasing rate of reactive brachial artery inner diameter (%)= (D1-D0)/D0×100% and the increasing rate of post-treatment brachial artery inner diameter (%)=(D2-D0)/D0 ×100%.Meanwhile, the increasing rate of reactive blood flow (%)=(reactive blood flow-baseline blood flow)/ baseline blood flow (100% and the increasing rate of post-treatment blood flow (%)=(the post-treatment blood flow-baseline blood flow)/baseline blood flow×100%. MAIN OUTCOME MEASURES:In three hyperlipidemia groups and the control group, the inner diameter of the brachial artery were measured under resting conditions, in reactive congestion status and after sublingual nitroglycerol treatment respectively using high-resolution ultrasound. RESULTS: All the 60 patients with hyperlipidemia and 20 healthy controls entered the analysis procedure. In HC group, HTG group and HLP group, the increasing rate of reactive brachial-artery inner diameter were significantly lower than that in control group [(5.7±3.2)%, (5.4±3.0)%,(3.8±2.4)%, (11.3±3.1)%,P ＜ 0.05], which was most significant in HLP group. The increasing rate of both the reactive and the post-treatment blood flow in three experimental groups and the increasing rate of the post-treatment brachial-artery inner diameter were not significant (P ＞ 0.05). CONCLUSION:EDD were impaired significantly in patients with hyperlipidemia. High-resolution ultrasound is capable of assessing EDD accurately and reliably.

Surgery is so far the most widely used and effective treatment of neoplastic diseases.However,residual tumour cells during surgery remain a major trigger of cancer recurrence and matastasis.Although intraoperative rapid pathological R0 resection can be achieved based on preoperative imageological examination,but for small satellite lesions and the naked eye can not find the error quickly and so often cause pathological presence of residual tumour cells.Thus,quick and accurate identification of residual cancer cells is crucial for prognosis of cancer patients.Indocyanine green (ICG) is a new type of fluorochrome that can stain tumours under the near-infrared fluorescence during surgery,the paper will be reviewed latest developments in the reagent for fluorescence in tumours.

Objective To understand the status of soil?transmitted nematode infections in rural residents so as to provide the evidence for formulating the guidance for prevention and control of the diseases. Methods The national surveillance sites of soil?transmitted nematode infections were established in Shuyang County,Suqian City,Jiangsu Province from 2006 to 2015. At least 1 000 fecal samples of residents aged 3 years or above were collected in every autumn,and the intestinal helminth eggs were detected with the Kato?Katz technique and the Enterubius vermicularis eggs were detected by the cellophane tape method for children aged 3-12 years. The soil samples were collected from vegetable fields,lavatories,courtyards and kitchens to exam?ine Ascaris lumbricoides eggs and larvae of hookworm. Results The infection rates of soil?transmitted nematodes in residents and E. vermicularis in children reduced from 1.81%(19/1 049)and 4.72%(5/106)in 2006 to 0.25%(3/1 180)and 0(0/263) in 2015,respectively,in the surveillance sites. The infection intensity was mild in all the infected cases. The soil samples were negative for detecting A. lumbricoides eggs and hookworm larvae. Conclusion The infection rates of soil?transmitted nema?todes in the residents and E. vermicularis in the children show a decreasing trend and keep at a low level of prevalence in Shuy?ang County.

Objective +o evaluate percutaneous intervetional therapy for portal vein anastomotic occlusion after liver transplantation.Method From July 2005 to July 2013,13 patients (9 male and 4 female; aged 25-65 years) with portal vein occlsion underwent interventional therapy.All patients accepted the imaging examation and 8 patients had typical clinical signs of portal hypertension.Percutaneous hepatic balloon venoplasty and stent placement was performed,trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways performed if necessary.+echnical success rate,complication rate and clinical symptoms were analyzed.Follow-ups including clinical course,stent patency and potal vein thrombosis which evaluated by imaging were performed.Result +echnical success was achieved in l1of 13 patients (84.6％) and 15 stents were deployed.Seven patients with localized portal vein occulsion accepted balloon dilation and stents deployment,4 patients with long segment cculsion also accept trans-catherter urokinase infusion for thrombolysis and embolization for collateral pathways.Portal vein flow recovered in all 11 patients.Procedure related complication occurred in 2 patient with hemothorax.During the follow-up period of 4-42 months,the clinical signs of portal hypertension were not observed in all patients.Stent stenosis was found in one patient with ultrasound in 23 months,but stent patency was proved by the percutaneous portal angiography.Conclusion Interventional therapy is effective for portal vein occulsion after liver transplantation,comprehensive interventional therapy should be performed in long segment portal vein cculsion.