The inhibition of bronchoalveolar surfactant function by endotoxic rat plasma was compared with that by normal rat plasma with M-8601 film balance. The results showed that endotoxic rat plasma significantly inhibited surfactant function of bronchoalveolar lavage (BAL). In the same protein concentration, the inhibition effects caused by endotoxic rat plasma were comparable with those by normal rat plasma. There were no changes of the inhibition effects after incubation of BAL with either endotoxic or normal plasma at 37℃ for 30min. These results suggest that the inhibition of surfactant function by the leakage of plasma in endotoxic lung injury is mainly due to protein components.

Objective To study the anatomic characteristics of hepatogastric artery(HGA) and its significance in preventing gastrointestinal complications in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization(TACE).Methods 1000 cases of hepatic arteriograms were retrospectively reviewed,the aberrant gastrointestinal arteries that originate from proper hepatic artery(PHA)and distal intrahepatic arteries to PHA were named HGA.The frequency,origine,course and distribution of all of HGAs were carefully analyzed.The trial group consists of 34 cases(42 times of TACE)who had HGA and controlled group consists 32 cases(56 times of TACE)who had no HGA.The incidence of gastrointestinal complications after TACE between two groups were compared.Within trial group,superselective catheterization was made and had the tip of catheter away from orifice of the HGA before infusion of embolic agents(Lipiodol)during TACE in 18 times,which was called relative safety group;whereas,the tip of catheter was not laid distal to orifice of HGA when infused Lipiodol through catheter in 24 times,which was called dangerous group.The incidence of complications between this two groups was also compared.Results Of 1000 cases of hepatic arteriography,HGA was found in 740 cases (74%).The incidence of gastrointestinal complication and its grave degree in trial group were more excessive than that in controlled group((?=0.004),similarly,the frequency of gastrointestinal complication and its graveness in dangerous group exceeded significantly that in relative safety group((?=0.000).Conclusion HGA is common vascular variation.That embolic agents (Lipiodol)was perfused carelessly into HGA may induced occurrence of gastrointestinal complications in patients after TACE,and having the tip of catheter away from the orifice of HGA by superselective catheterization during TACE could efficiently prevent happening of this kind of complications after operation.

Objective To investigate the anatomic characteristics of hepatopancreatic artery(HPA) by DSA and its significance in preventing pancreatic complications after transcatheter arterial chemoembolization(TACE) in patients with hepatocellular carcinoma.Methods 1 000 cases of hepatic arteriograms have been retrospectively reviewed. The aberrant pancreatic arteries that originate from proper hepatic artery(PHA) and all distal intrahepatic branches to PHA were called hepatopancreatic arteries. The incidence of HPA has been summed up and its anatomic characteristics such as origine, course, branches and distribution have been described. Results Of 1000 cases, HPA were found in 16 cases(1.6%). There were 2 branches of HPA in one case and there was only one branch of HPA in other 15 cases. Altogether 17 branches of HPA were found; of which, 7 branches originated from PHA(41.2%,7/17), 6 branches arose from right hepatic artery(RHA)(35.3%,6/17) and 4 branches came from left hepatic artery(LHA)(23.5%,4/17). Conclusions HPA is a kind of rare variations of pancreatic artery. The importance to avoid embolizing HPA during TACE is preventing pancreatic complications.

Objective To study the characteristics of hepatogastric artery (HGA) with DSA and its clinical significance in transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma. Methods One thousand cases of hepatic DSA arteriograms had been retrospectively reviewed. The aberrant gastrointestinal arteries that originated from proper hepatic artery (PHA) or distal intrahepatic arteries to PHA were named HGA. Furthermore, according to their different courses and distributions, HGAs were subdivided into right gastric artery (RGA), aberrant left gastric artery (AbLGA), aberrant gastroduodenal artery (AbGDA), aberrant right gastroepiploic artery (AbRGEA), superior duodenal artery (SDA) and other difficult-to-named HGA. The incidence of each of them had been summed up and their anatomic characteristics such as origin, course, branches, and distribution had been described. Results Of the 1000 cases, at least one branch of HGA was found in 740 cases (74%), and altogether there were 839 branches of HGA in them. The composition of 839 branches of HGA was as follows: 682 branches of RGA (81.29%, 682/839), 84 branches of AbLGA (10.01%, 84/839), 45 branches of SDA (5.36%, 45/839), 21 branches of AbGDA (2.50%, 21/839), 1 branch of AbRGEA (0.12%, 1/839) and 6 branches of difficult-to-named HGA (0.72%, 6/839). Of the 839 branches of HGA, 412 branches originated from PHA (49.11%, 412/839), 314 branches from left hepatic artery (LHA)(37.43%, 314/839), 98 branches from right hepatic artery (RHA)(11.68%, 98/839), and 15 branches from middle hepatic artery (MHA)(1.79%, 15/839). Conclusion HGA is a common gastrointestinal arterial variation and it is very important to be familiar with it so as to prevent the gastrointestinal complications after TACE in patients with hepatocellular carcinoma.

Objective To investigate the effectiveness and feasibility of laparoscopic splenic artery ligation in the treatment of hypersplenism and thrombocytopenia in children. Methods From August 2014 to December 2014, four children with hypersplenism and three children with ITP (idiopathic thrombocytopenic purpura) were treated in our hospital.Laparoscopic splenic artery ligation was performed in all the patients.During the operation, the gastric colon ligament was cut with an ultrasonic knife, and the gastric wall was suspended to expose the pancreas and the spleen.The splenic artery was ligated at the upper edge of pancreas closing to the splenic hilum.The splenic venous branches were dissected and ligated at the splenic hilum by using the Hem-o-lok, which leaded to an area of splenic infarction more than 50%. Results The laparoscopic splenic artery ligation was successfully performed in all the patients, without conversion to open surgery.The operative time was 120-150 min ( mean, 126 min) , and the intraoperative blood loss was 10-20 ml ( mean, 15 ml) .No patient underwent blood transfusion.The length of postoperative hospital stay varied from 4 to 11 days (mean, 6.6 days).The splenic length significantly decreased postoperatively [(13.6 ±2.6) cm vs.(15.1 ±1.7) cm, t=3.199, P=0.049], and so was the splenic thickness [(3.8 ±1.0) cm vs.(4.1 ±0.8) cm, t =3.703, P=0.034].Partial splenic infarction and decreased splenic blood flow were found in the 7 patients by postoperative ultrasound.After surgery, four children suffered from fever, which were 38.8 ℃, 39.0 ℃, 38.6 ℃, and 39.2 ℃, with the duration of fever of 2, 4, 8, and 5 days, respectively.All the patients were followed-up for 6 -10 months (mean, 8.4 months).The complete blood cell count was within normal range. Conclusion The laparoscopic splenic artery ligation is an effective treatment for hypersplenism and thrombocytopenia in children.

Objective To observe the impact of rosuvastatin on serum Ang-2 and hs-CRP in patients with metabolic syndrome(MS) to collect data on safety of rosuvastatin in treating MS.Methods Eighty MS patients were enrolled and divided into the treatment group(n =40) and the control group(n =40).The treatment group received both antihypertensive therapy and rosuvastatin with a dose of 10 mg/d.While the control group were only given antihypertensive therapy and but not any lipid-lowering drugs.The levels of plasma Ang-2 and hs-CRP and liver and kidney functions were measured and compared before and after 8-week treatment.Results (1) The levels of plasma Ang-2 and hs-CRP were significantly lower after 8 weeks than before treatment in the treatment groups[Ang-2:(0.30±0.01) μg/L vs.(1.81±0.47) μg/L,t =9.02,P ＜0.01 ;hs-CRP:(2.02±0.26) mg/L vs.(6.32±1.28) mg/L,t =5.75,P ＜ 0.01].Whereas statistical difference was not found in the control group[Ang-2:(1.80±0.45) μg/L vs.(1.79±0.48) μg/L,t =0.19,P > 0.05 ; hs-CRP:(6.28±1.34) mg/L vs.(6.20±1.42) mg/L,t =0.23,P ＞ 0.05].(2) After 8 weeks'treatment,the levels of plasma Ang-2 and hs-CRP were significantly lower in the treatment group than in the control group[Ang-2:(0.30±0.01) μg/L vs.(1.79±0.48) μμg/L,t =2.34,P ＜ 0.05 ;(2.02±0.26) mg/Lvs.(6.20±1.42) mg/L,t =2.58,P ＜ 0.05].(3) The adverse reaction in the treatment group was fewer than the control group and the security of rosuvastatin treatment on MS was fine.Conclusion Rosuvastatin can reduce plasma Ang-2 and hs-CRP levels and improve insulin resistance in patients with MS.Its security is fine.

Objective To investigate the efficacy of rosuvastatin on treating patients with metabolic syndrome(MS).Methods Eighty MS patients were divided into rosuvastatin group (n =40) and atorvastatin group(n =40).Patients in rosuvastatin group were received schufftan at dose of 10 mg/d and in atorvastatin group were received lipitor at dose of 10 mg/d orally.Patients were followed-up for 12 weeks.The ratio of apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) and inflammatory factors including high-sensitivity Czreactive protein (hs-CRP),tumor necrosis factor-oα (TNF-α),interleukin-6 (IL-6),and interleukin-18 (IL-18) were measured.Meanwhile Secondary factors:blood lipids,blood glucose,fasting insulin (FIN),insulin resistance index (HOMA-IR),blood pressure,urine albumin excretion rate (UAER),body mass index (BMI).As well as safety indicators:hepatic and renal function and creatine kinase (CK) were detected.Results (1) After 12-week's treatment,the serum levels of ApoB/ApoA1,hs-CRP,TNF-α,IL-6,IL-18,ApoB,total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triglyceride (TG),FIN,HOMA-IR,systolic blood pressure (SBP),diastolic blood pressure (DBP),and UAER significantly decreased compared to before treatment in the two groups(rosuvastatin group:1.26 ± 0.25 vs.0.63 ± 0.22,t =4.44 ; (6.89 ± 1.43) mg/L vs.(2.41 ± 0.36) mg/L,t =7.12;(27.63 ±7.12) ng/L vs.(12.98 ±3.74) ng/L,t =4.23;(26.47 ±6.59) ng/L vs.(13.16± 3.55) ng/L,t =4.45;(318.36 ±90.45) ng/L vs.(172.77 ±50.65) ng/L,t =3.92;(1.58 ±0.29) g/L vs.(0.83 ± 0.23) g/L,t =4.20; (5.78 ± 0.86) mmol/L vs.(3.53 ± 0.69) mmol/L,t =3.85 ; (3.52 ± 0.54) mmol/L vs.(2.04±0.49) mmol/L,t =3.89;(2.87 ±0.65) mmol/L vs.(1.91 ±0.57) mmol/L,t =3.78; (12.08 ± 2.87) mU/L vs.(6.87 ± 1.89) mU/L,t =3.98 ; 3.42 ± 0.57 vs.1.60 ± 0.31,t =4.65 ; (144.6 ± 13.3) mm Hg vs.(135.1 ±12.7) mm Hg,t =3.57;(93.6 ±9.5) mm Hg vs.(85.2 ±7.6) mm Hg,t =3.59; (29.86 ± 3.37) μg/min vs.(22.52 ± 2.56) μg/min,t =3.71 ; atorvastatin group:1.24 ± 0.23 vs.0.92 ± 0.24,t =3.74 ; (6.84 ± 1.37) mg/L vs.(3.50 ± 0.75) mg/L,t =4.24 ; (27.22 ± 7.36) ng/L vs.(18.70 ± 5.82) ng/L,t =3.76; (26.28 ±6.84) ng/L vs.(19.34 ± 5.96) ng/L,t =3.75 ; (311.22 ±91.98) ng/L vs.(246.50±74.73) ng/L,t=3.63;(1.56±0.27) g/L vs.(1.14±0.26) g/L,t =3.74;(5.65 ±0.76) mmol/L vs.(4.67±0.65) mmol/L,t =3.68;(3.51 ±0.55) mmol/L vs.(2.65 ±0.57) mmol/L,t =3.70; (2.86±0.68) mmol/Lvs.(2.05 ±0.54) mmol/L,t=3.78;(12.04±2.95) mU/L vs.(8.91 ±2.32) mU/L,t =3.74;3.38 ±0.54 vs.2.18 ±0.35,t =3.80;(144.0 ± 13.8) mm Hg vs.(135.7 ±12.5) mm Hg,t =3.56 ; (93.4 ± 9.3) mm Hg vs.(85.8 ± 8.9) mm Hg,t =3.58 ; (29.77 ± 3.28) μg/min vs.(23.02 ± 2.83) μg/min,t =3.67 ;P ＜ 0.01).ApoA1 and high-density lipoprotein cholesterol (HDL-C) had increase,but there was no significant difference(P ＞ 0.05).Fasting plasma glucose(FPG),2 h postprandial blood glucose (2 hPG) and BMI tended to decrease,but there were no significant differences(P ＞ 0.05).(2)The serum levels of ApoB/ApoA1,hs-CRP,TNF-α,IL-6,IL-18,ApoB,TC,LDL-C,FIN and HOMA-IR in the rosuvastatin group were significantly lower than those in the atorvastatin group at the 12th-week follow-up(t =2.11,2.10,2.09,2.12,2.08,2.07,2.05,2.04,2.04,2.06 respectively; P ＜ 0.05).The serum levels of HDL-C and ApoA1 in the rosuvastatin group tended to increase compared with the atorvastatin group after 12-week treatment (P ＞ 0.05).There were no statistically significant differences in term of TG,SBP,DBP,UAER between the two groups (P ＞ 0.05).(3) The adverse effect in the rosuvastatin group was fewer than that in atorvastatin group.Conclusion Rosuvastatin can reduce ApoB/ApoA1 ratio and the levels of inflammatory cytokines,improve insulin resistance in patients with MS and less adverse effect were seen.

Objective To evaluate the application value of ureteroscopy in the diagnosis and treatment of ureteral obstruction.Methods Clinical data of 52 cases of non-calculous ureteral obstruction treated by ureteroscopy were analyzed retrospectively.Results Of 35 cases of ureteral stricture,19 cases of routine dilatation,13 cases of balloon dilatation,and 3 cases of ureteroplasty were accomplished under ureteroscope.Holmium laser resection was employed in 13 cases of ureteral polyps.Conversions to open surgery were required in 3 cases of ureteral cancer,and an ureteroplasty was carried out in 1 case of retrocaval ureter.Complications included 2 cases of ruptured mucous membrane or urethral false passage and 1 case of ureteral perforation.Conclusions Ureteroscopy can clarify the etiology of ureteral obstruction and offer corresponding treatment.

Objective To detect apoptosis of transplanted lung adenocarcinoma cells in nude mice after 125I brachytherapy by 99Tcm-Annexin V combined with diffusion weighted MRI (MR-DWI).Methods Twenty-five BALB/c-nu nude mice models subcutaneously transplanted with A549 cells were divided into experimental group (EG,n=13) and control group (CG,n=12) by random number table method.One 125I seed with apparent activity of (24.8±6.3) MBq was implanted into each mouse in EG,while CG underwent cold seed implantation.Both of 99Tcm-Annexin V imaging and MR-DWI were performed within 7-10 d after brachytherapy,then all mice were sacrificed and tumor cell apoptosis was detected by terminal oxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL) immunofluorescence,Survivin expression was assayed by SP.Two-sample t test,x2 test and Pearson correlation analysis were used for data analysis.Results Positive rate of cell apoptosis by 99Tcm-Annexin V imaging was 69.2％(9/13) and 8.3％(1/12) respectively in EG and CG (x2 =12.73,P＜0.01).The uptake ratio of 99Tcm-Annexin V,apparent diffusion coefficient(ADC) value and apoptosis index(M) of the tumor in EG were 2.91±0.85,(2.03±0.44)×10-3 mm2/s and (49± 18) ％,respectively,which were significantly higher than those of CG (1.26 ± 0.37,(1.29 ± 0.21) ×10-3 mm2/s and (11±4)％ respectively,t=5.930,5.452,7.606,all P＜0.05).Survivin expression in EG and CG was (46± 13) ％ and (15±7) ％ respectively (t =5.158,P＜0.05).The value of ADC was correlated with AI and uptake ratio(r=0.756,0.788,both P＜0.05).Uptake ratio was correlated with AI (r=0.754,P＜0.05),while Survivin expression was negatively correlated with AI (r =-0.772,P＜0.05).Conclusions Down-regulation of Survivin expression may play an important role in apoptosis induced by 125I brachytherapy.99Tcm-Annexin V combined with MR-DWI could effectively evaluate apoptosis of lung adenocarcinoma cells in a non-invasive way,thus it might be helpful in evaluation of early efficacy of 125I brachytherapy.

Objective To investigate MR imaging characteristics of MELAS syndrome.Methods The clinical data and MRI features of 13 cases with MELAS syndrome were retrospectively analyzed.Results Multiple hypointense on T1WI and hyperintense on T2WI lesions were showed predominantly in the gray matter of the temporal, parietal and occipital lobes. The lesions crossed vascular boundaries. No stenosis and occlusion of main artery were displayed by MRA.Basal ganglia calcifications and cerebral atrophy with widening of ventricles were also frequent found. Increased ADC value of the leison on DWI and appearance of Lac peak on1H-MRS were useful in diagnosis.Conclusion There are some characteristics of MRI in patients with MELAS syndrome.Combined clinical informations with neuroimaging and muscle biopsy, the diagnosis of MELAS syndrome can be made correctly.