The surgical treatment for portal hypertension (PHT) aims to control and prevent the gastroesophageal variceal bleeding.The choices of surgical timing and procedures are dependent on the liver reserve function.Except for Child-Pugh classification and model for end-stage liver disease scoring system,the future liver remrant and pre-albumin are the important evaluation indexes,meanwhile,the choice of surgical procedures would be dependent on portal hemodynamics that can reduce incidence of rebleeding of postoperative hepatic encephalopathy.Hepatic venous pressure gradient is the most important objective index forecasting bleeding risk and severity of PHT.

Pancreatic portal hypertension (PPH),which accounts for about 5％ of extrahepatic portal hypertension cases,is mainly caused by pancreatic tumor,chronic pancreatitis and pancreatic ductal lithiasis.The pathogenesis and pathological characteristics of PPH are attributed to anatomical structure between splenic vein and pancreas.It is different from cirrhotic portal hypertension,PPH patients may present with less esophageal and gastric fundus varices,but more significant gastric body varices.The portal vein radiography is recognized as the golden standard for PPH diagnosis.There are two types of treatment modalities for PPH,symptomatic treatment and pathogenesis-based treatment.In clinically,we should take careful consideration into portal hypertension and primary disease,aim to resolve causes and manage complication concurrently.

Objective To study the effect and mechanism of Feibi Decoction on pulmonary fibrosis.Methods SD rats were randomly divided into sham-operation group,model control group,Feibi Decoction large-close group,Feibi Decoction mid-dose group,Feibi Decoction samll-dose group and western medicine control group,each of 10 rats.Bleomycetin was used to copy rat's pulmonary fibrosis model.Feibi decoction was drenched to rats in large,medium and small dose of Chinese medicine groups.Prednisone was given to werstern medicine control group.The rats were executed 28 days later.The expression of p38 MAPK and transforming growth factor ?1(TGF-?1) was tested.Results In comparison with sham operation,Chinese medicine and western medicine groups,the expression of p38 MAPK and TGF-?1 in model control group increased significantly(P

Drinking ; physiology ; Humans

ABSTRACT:Objective To investigate the regulation of adenovirus type 36 infection on precursor protein particles progranulin expression in Uygur obese patients.Methods Based on the diagnostic criteria of obesity,the samples were divided into obese group and non-obese group.Serum neutralization test was used to detect the antibody of Ad36.The progranulin mRNA expressions in abdominal omental and subcutaneous adipose tissues were detected by real-time quantitative PCR.ELISA method was used to determine serum progranulin protein levels. CD68 protein expression of macrophage was detected by immunohistochemistry. Results ① In the Uygur population of our study,compared with that in the non-obese group (38/1 1 7,32.5%),the number of obese patients (54/1 1 5,47.0%)infected with Ad36 was significantly higher than that in non-obese group (P <0.05 ).② Serum progranulin was significantly increased in the Ad36-infected obese group (408.45±1 56.92)than in non-obese group (326.1 1±1 58.60)(P <0.05).The mRNA expression of progranulin did not differ between the two groups.③ The macrophage infiltration was significantly higher in the Ad36-infected obese group (14 730.1 6 ± 2 227.39 )than in non-obese group (10 786.50 ± 2 772.80 )(P < 0.05 ).Conclusion Ad36 infection may be associated with the occurrence of obesity in Uygur population,and adenovirus type 36 infection may regulate the expression of serum progranulin at the protein level.

Objective To investigate the clinical significance of silent mating-type information regulation 2 homologue 1 (SIRT1) in hepatocellular carcinoma (HCC).Method We analyzed p53 mutation by gene sequencing and activation of SIRT1 and AMP-actived protein kinase (AMPK) using western-blot in 252 patients with hepatitis B virus-positive HCC.Results A higher proportion of tissues with mutant p53 were demonstrated to harbor activated SIRT1 (64.8％ vs 31.8％ ; P ＜ 0.01).Activated SIRT1 predicted a longer relapse-free survival.On multivariate analysis,activated SIRT1 remained significant (OR:0.339,CI:0.160-0.720,P =0.005).Analysis of 252 paired specimens revealed a significant correlation between activated SIRT1 and activated AMPK in HCC tissues harboring mutant p53 (P =0.007).Conclusion SIRT1 exerted anti-carcinogenic effects through the AMPK pathway in HCC in the context of mutant p53.

Objective To explore the clinical efficacy and safety of complex splenectomy.Methods The retrospective cohort study was adopted.The clinical data of 235 patients including 135 from Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,67 from Shanghai Jiaotong University Affiliated First People's Hospital,26 from Shanghai Jiaotong University Affiliated Sixth People's Hospital,7 from 85 Hospital of PLA who underwent complex splenectomy from January 2005 to December 2015 were collected.All the patients received total splenectomy after splenic artery ligation.The observation indexes included:(1) surgical situations,(2) major complications including intraperitoneal hemorrhage,pulmonary complication,left subphrenic abscess and peritoneal effusion,(3) follow-up situations:portal vein (PV) complications (splenic venous thrombophlebitis,thrombosis of splenic vein and main portal vein thrombosis),survival of patients.The follow-up using outpatient examination and telephone interview was performed up to March 2016,and patients received regularly ultrasound reexamination,computed tomography (CT) rescan,routine blood retest and coagulation function.Measurement data with normal distribution were presented as-x ± s,and count data were analyzed using the chisquare test.Results (1) Surgical situations:of 235 patients,200 patients underwent secondary spleen pedicle severance and 35 patients underwent non-secondary spleen pedicle severance.Volume of intraoperative blood loss and duration of splenic resection were (268 ± 103) mL and (82 ± 29) minutes.(2) Major complications:of 31 patients with postoperative complications,intraperitoneal hemorrhage was detected in 12 patients,pulmonary complication in 17 patients,left subphrenic abscess in 3 patients and massive peritoneal effusion in 21 patients.Some patients were combined with multiple symptoms.The patients with above complications were cured after reoperations and non-operative treatments.(3) Follow-up situations:PV complications:splenic venous thrombophlebitis was detected in 16 patients,thrombosis of splenic vein in 17 patients,thrombosis of splenic vein combined with main portal vein thrombosis in 7 patients,and they were improved after the treatments of antiinflammation,anti-coagulation and thrombolysis.The thrombi rate after splenectomy was 32.4％ (12/37) in patients with schistosoma-related cirrhosis and 8.1％ (12/149) in patients with HBV-related cirrhosis,with a statistically significant difference (x2 =10.9,P ＜ 0.05).Survival of patients:of 235 patients,228 were followed up for (7.9 ± 4.2) years,with good survival.Conclusion Complex splenectomy is safe and effective,and the key procedure determining the safety of complex splenectomy includes careful preoperative evaluation,delicate surgical technique,proper splenic pedicle severance and peritoneal wounds.

OBJECTIVETo investigate the possible differences in antimicrobial resistance of Escherichia coli isolated from different samples in children.

METHODSSix hundred and twenty-nine samples from urine, sputum, blood and secretion were collected from June 2004 to May 2009 for bacterial identification by VITEK-32 automatic system and antimicrobial susceptibility tests by Kirby-Bauer method. The drug resistance rate of Escherichia coli isolated from different samples was compared.

RESULTSTwo hundred and sixty strains of Escherichia coli were isolated , and 108 of which were from urine , 64 from sputum, 54 from secretion and 23 from blood. ESBLs were detected in 96 (36.9%) of the 260 isolates, AmpC enzymes in 32 (12.3%), and ESBLs+AmpC in 8 (3.1%). The ESBLs positive rate of Escherichia coli isolates from sputum was significantly higher than that from other samples (P<0.05). The antimicrobial resistance rate of Escherichia coli strains from different samples to amoxicillin/clavulanic acid, ticarcillin/clavulanic acid, piperacillin, cefotaxime, cefuroxime, cefepime, gentamicin, cotrimoxazole, and nitrofurantoin was different. The resistance rate of the strains from sputum samples was higher than that from the other samples (P<0.05).

CONCLUSIONSEscherichia coli isolated from different samples have different antimicrobial resistance rates in children, so the selection of antibiotics for infections confirmed by bacterial cultures from different samples should based on drug sensitivity results.

Adolescent ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Escherichia coli ; drug effects ; enzymology ; isolation & purification ; Female ; Humans ; Male ; beta-Lactamases ; analysis

Objective To study the regulation mechanism of bone mesenchymal stem cell (MSC)combined co-translation of islets in differentiation of Follicular Helper T cell (Tfh),and its roll on immunotolerence induction in non-obese diabetic (NOD) mice transplantation model.Methods The NOD mice were divided into 4 groups:Group A with islet transplantation alone;Group B with MSC co-transplantation with islets (MSC:0.5 × 106);Group C with MSC co-transplantation with islets (MSC:2 × 106);Group D with MSC co-transplantation with islets (MSC:3 × 106).ELISA was used to test the expression level of diabetes autoantibody GAD65Ab and IAA.Tfh cell count was detected by FACS.Results The survival time of transplantation groups was much longer in MSCs co-transplantation group than islet-alone group;the level of GAD65Ab,IAA and Tfh cell count were much lower in MSCs co-transplantation group than islet-alone group.Conclusion MSC may protect the islet transplants by regulating the Tfh cell differentiation.

Background Evaluation of acute myocardial infarction after reperfusion by dual phase contrast-enhancement multislice computed tomography (MSCT) was implicated in porcine model. There have been few attempts to use this diagnostic modality for the early assessment of coronary reperfusion in patients with ST-elevation myocardial infarction (STEMI), especially after primary percutaneous coronary intervention (PCI). In elderly patients with STEMI, the safety issues remain unknown. Methods Dual phase contrast-enhancement MSCT examinations were performed in 11 elderly patients (≥60 years old) with STEMI within one week after primary PCI. The presence, location and enhancement pattern on MSCT were evaluated. MSCT findings were compared with the catheter angiographic results and area under the curve of creatine kinase (CK) release. Serum creatinine level was recorded before and after MSCT scan. Results MSCT scans were successfully performed in all the patients. Early myocardial perfusion defect (early defect, ED) was detected in all of the 11 patients (100%) in the early phase of the contrast bolus (subendocardial ED in 10 patients and transmural in 1 patient). Mean CT attenuation value of ED was significantly different from CT attenuation value of remote myocardium (46±17 HU vs 104 ± 17 HU; P < 0.01). Location of ED area correlated well with infarction related artery territory on catheter angiography in all of the 11 patients (100%). On delayed phase of MSCT scan, different enhancement patterns were observed: isolated subendocardial late enhancement (LE) in 6 patients, subendocardial residual perfusion defect (RD) and subepicardial LE in 1 patient, subendocardial RD in 4 patients. Infarct volume assessed by MSCT correlated well with area under the curve CK release (R=0.72, P < 0.01). Serum creatinine level after MSCT scan showed no difference with that before MSCT scan. Conclusion Dual phase MSCT could be safely implicated in elderly patients with STEMI. Variable abnormal myocardial enhancement patterns were seen on dual phase MSCT in these patients with STEMI after primary PCI. Assessment of myocardial attenuation on MSCT gives additional information of the location and extent of infarction after reperfusion.