Liver resection is one of the important treatments of liver diseases,especially hepatocellular carcinoma.In China,the vast majority of liver cancer patients suffer from generalized damage of the liver parenchyma such as cirrhosis,lead to liver reserve function reducing in various degrees.Liver dysfunction or even liver failure after liver resection becomes an important reason of perioperative death and influences the patients' long-term survival.Therefore,accurate preoperative evaluation of liver reserve function is very important.Though there are seveal kinds of assessment of liver reserve function in recent years,it still lack of a clinically recognized,comprehensive assessment method.This paper reviewed the clinical commonly used preoperative liver reserve function evaluation methods,summarizes and analyzes the value and the insufficiency of several important methods,and prospects the development of evaluation methods about preoperative liver reserve function.

Objective To investigate the genetic variations of Toxascaris leonina isolates from different hosts in Jiuquan City, Gansu Province. Methods The mitochondrial sequences of partial mitochondrial nicotinamide adenine dinucleotide dehydrogenase subunit 1 (pnad1) and pnad5 of eleven T. leonina isolates from domestic dogs, foxes and pet dogs in Jiuquan City, Gansu Province, were amplified using PCR, and the amplification product was sequenced. The genetic variations of pnad1 and pnad5 genes in T. leonina isolates were analyzed. Results The sequences of T. leonina pnad1 and pnad5 genes measured 530 bp and 550 bp in size, respectively. The nucleotide sequence homology was 99.4% to 100.0% for T. leonina pnad1 gene and 99.5% to 99.8% for T. leonina pnad5 gene, and the sequences of T. leonina pnad1 and pnad5 genes shared 99.2% to 99.9% and 99.1% to 99.9% with corresponding sequences of known T. leonina isolates. In addition, there were 19 and 24 polymorphic sites detected in the sequences of T. leonina pnad1 and pnad5 genes, with 10 and 9 haplotypes, haplotype diversity of 0.982 and 0.964 and nucleotide diversity of 0.039 4 and 0.034 2, respectively. Phylogenetic analysis based on pnad1 and pnad5 gene sequences showed that the eleven T. leonina isolates and known T. leonina isolates were clustered into the same branch with a random distribution, which were close to the branch where Toxocara canis was clustered, and far from the branch where other Ascaris species were clustered. Conclusions There is a minor genetic variation in pnad1 and pnad5 genes of T. leonina isolates from different hosts in Jiuquan City, Gansu Province, and the pnad1 gene is more suitable as a molecular marker than pnad5 gene for analysis of genetic variations in T. leonina.

OBJECTIVETo observe the clinical effects of retrograde intramedullary nailing and cannulated screws in the treatment of femoral condylar fracture.

METHODSFrom June 2009 to June 2015, 13 patients with femoral condyles fracture were treated by retrograde intramedullary nailing and cannulated screws including 6 males and 7 females with an average age of 46.1 years old ranging from 16 to 76 years old. There were 10 cases of closed fractures, 3 cases of open fraetures. According to AO classification criteriam, 4 cases were type C1, 7 cases were type C2, 2 cases were type C3. Postoperative reduction of fracture and the knee joint function recovery were observed.

RESULTSAll patients were followed up for 12 to 36 months with a mean of 24 months. X-ray examination showed that the union time of fracture was 18 to 24 weeks, 21 weeks on average. There were no cases of loosening, breakage of internal fixators and re-fracture. Hospital for Special Surgery(HSS) knee score was 90.07±4.99 at 1 year after the operation.

CONCLUSIONSThe clinical efficacy for retrograde intramedullary nailing and cannulated screw for the treatment of femoral condyles fracture was excellent. It can improve the anatomical reattachment rate and reduce the complications and promote the knee functional recovery.

Objective To explore the inhibitory effects and mechanisms of benzodiazepines on Helicobacter pylori (Hp).Methods The Hp international standard strain ATCC43504 was treated with benzodiazepines diazepam,midazolam,and remimazolam,respectively.The treatments with amoxicillin and clarithromycin were taken as the positive controls,and that with water for injection as the negative control.The inhibition zone of each drug was measured by the disk diffusion method.The minimum inhibitory concentration(MIC)and minimum bactericidal concentration(MBC)of each drug against Hp were determined.Hp suspension was configured and treated with diazepam and midazolam,respectively.The bacterial suspension without drug added was used as the control group.The concentration of K⁺ in each bacterial suspension was measured by an automatic biochemical analyzer before drug intervention(T₀)and 1(T₁),2(T₂),3(T₃),4(T₄),5(T₅),6(T₆),and 7 h(T₇)after intervention.Hp urease was extracted and treated with 1/2 MIC diazepam,1 MIC diazepam,2 MIC diazepam,1/2 MIC midazolam,1 MIC midazolam,2 MIC midazolam,1 mg/ml acetohydroxamic acid,and water for injection,respectively.The time required for the rise from pH 6.8 to pH 7.7 in each group was determined by the phenol red coloring method.Results The inhibition zones of diazepam,midazolam,remimazolam,amoxicillin,clarithromycin,and water for injection against Hp were 52.3,42.7,6.0,72.3,60.8,and 6.0 mm,respectively.Diazepam and midazolam showed the MIC of 12.5 μg/ml and 25.0 μg/ml and the MBC of 25 μg/ml and 50 μg/ml,respectively,to Hp.The concentrations of K⁺ in the diazepam,midazolam,and control groups increased during T₁-T₇ compared with those at T₀(all P<0.01).The concentration of K⁺ in diazepam and midazolam groups during T₁-T₄ was higher than that in the control group(all P<0.01).The time of inhibiting urease activity in the 1/2 MIC diazepam,1 MIC diazepam,2 MIC diazepam,1/2 MIC midazolam,1 MIC midazolam,and 2 MIC midazolam groups was(39.86±5.11),(36.52±6.65),(38.58±4.83),(39.25±6.19),(36.36±4.61),and(35.81±6.18)min,respectively,which were shorter than that in the acetohydroxamic acid group(all P<0.01)and had no significance differences from that in the water for injection group(all P>0.05).Conclusion Diazepam and midazolam exerted inhibitory effects on Hp,which may be related to the cleavage of Hp cells rather than inhibiting urease.
Midazolam ; Helicobacter pylori ; Urease ; Clarithromycin/pharmacology* ; Benzodiazepines/pharmacology* ; Diazepam/pharmacology* ; Amoxicillin ; Water ; Anti-Bacterial Agents/pharmacology*

OBJECTIVETo compare the efficacy differences between acupoint catgut-embedding combined western medicine (ACCWM) and simple western medicine (WM) for treatment of epilepsy of generalized seizures type.

METHODSFifty-two patients with epilepsy of generalized seizures type were randomly divided into an ACCWM group (n=30) and a WM group (n=22). Dazhui (GV 14), Yaoshu (GV 2), Jiuwei (CV 15), Qihai (CV 6) were selected in the ACCWM group as the main acupoints combined with routine antiepileptic drugs, Valpromide was taken orally, 2.0 g/d for adult, 50 mg/kg x d for child. The WM group was treated with routine antiepileptic drugs. The epilepsy score and the attack frequency one year before the treatment and one year during treatment were observed and the therapeutic effects in the two groups were compared.

RESULTSThe epilepsy score and the attack frequency were both decreased in the two groups (P<0.01, P<0.05), and the epilepsy score in the ACCWM group decreased significantly (6.57 +/- 3.29 vs 10.73 +/- 2.54, P<0.05). The total effective rate of 90.0% (27/30) in the ACCWM group was superior to that of 68.2% (15/22) in the WM group (P<0.05).

CONCLUSIONThe therapeutic effect of ACCWM is superior to that of simple western medicine in treating epilepsy of generalized seizures type. It can improve significantly the attack symptoms so as to enhance life quality of the patients with epilepsy.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Catgut ; Child ; Child, Preschool ; Combined Modality Therapy ; Epilepsy ; drug therapy ; therapy ; Female ; Humans ; Male ; Middle Aged ; Seizures ; drug therapy ; therapy ; Valproic Acid ; analogs & derivatives ; therapeutic use ; Young Adult

Objective To determine the values of gadoxetate disodium-enhanced MRI for quantitatively evaluating the liver function reserve.Methods Forty consecutive liver cirrhosis patients were enrolled in this retrospective study.All the patients underwent complete routine laboratory tests and the gadoxetate disodium-enhanced MR imaging with the same parameters.Liver volume and the relative enhancement index of the whole liver in hepatocellular phase were used to calculate liver relative uptake value,which is supposed to represent the total liver function reserve.And the function reserve of all liver segments was evaluated respectively by the relative enhancement index of each liver segment.One-way ANOVA was used for statistical analyses.Results The patient number in Child-Pugh A,B and C group was 23,10 and 7,respectively.Significant differences was observed in liver relative uptake value among patients in different Child-Pugh classes (F =122.05,P ＜ 0.01).Mean liver relative uptake value was highest in Child-Pugh A group(1212 ± 168),followed by B group and C group (695 ± 161,234 ±55).In Child-Pugh A group,the relative enhancement index of S1 to S8 was 1.13 ± 0.22,1.12 ± 0.50,0.81 ± 0.24,1.08 ± 0.32,1.41 ± 0.25,1.10 ± 0.30,1.16 ± 0.41 and 1.17 ± 0.23,respectively (F =5.93,P ＜ 0.01).There was no significant difference in B and C group (F =1.95,1.83 ; P ＞ 0.05).Conclusion Gadoxetate disodiumenhanced MRI can be used for evaluating whole liver function reserve quantitatively.This technique also has a potential value for evaluating of the segmental liver function reserve before partial hepatectomy.

Small bowel wall thickening is one of the presentations of small bowel diseases.Conventional diagnostic methods,such as enteroscopy, barium-contrast radiography,X-ray,capsule endoscopy,and ultrasonograhy have disadvantages of low positive rate and high misdiagnosis rate.From December 2009 to December 2011,2672 patients with small bowel wall thickening were admitted to the Southwest Hospital.The location,range,degree,attenuation,enhancement feature and associated perienteric abnormalities of thickened bowel wall were studied. Differential diagnosis of tumorous and non-tumorous small bowel wall thickening,malignant and benign tumorous small bowel wall thickening,and different diseases caused nontumorous small bowel wall thickening were carried out in the study.Etiopathogenesis of small bowel wall thickening can be inferred by computed tomography,and multi-slice computed tomography plays an important role in the differential diagnosis.

Objective To investigate changes of spontaneous brain activity in patients with type 2 diabetes mellitus (T2DM) by fractional amplitude of low-frequency fluctuations (fALFF) on subbands, and the possible relationship between these changes and cognitive impairment caused by T2DM.Methods Twenty-two T2DM patients and twenty-three healthy control subjects were involved in this study between December 2013 and June 2014 and the demographic and clinical data (fasting plasma glucose and HbA1c level) were obtained in all subjects.General cognition was assessed by MMSE in all subjects, and memory performance was assessed by Auditory Verbal Learning Test (AVLT) in T2DM group.3D-T1 structural and resting-state functional MRI data were collected by MR scanner.Then fALFF value on slow-5 (0.010-0.027 Hz) and slow-4 (0.027-0.073 Hz) were calculated respectively using DPARSF V2.3.Intra-group and inter-group t-tests were conducted by REST V1.8.Partial correlation among fALFF values extracted from significantly different brain regions, clinical data and AVLT score of T2DM patients were calculated , using age as covariate.Results Compared to the healthy controls, T2DM patients showed increased fALFF values in bilateral anterior cingulate gyrus (cluster=130, t=4.4487, P＜0.05) and partial left cerebelum areas (cluster=89, t=3.8409, P＜0.05) in frequency band slow-5.Moreover, the T2DM patients showed decreased fALFF values in bilateral middle occipital gyrus and precuneus (Left: cluster=102, t=-3.4806.Right: cluster=151, t=-5.1355.All P＜0.05) in frequency band slow-5.While in frequency band slow-4, the T2DM patients showed increased fALFF values in left inferior temporal gyrus (cluster=104, t=4.8631, P＜0.05), and decreased fALFF values in right lingual gyrus (cluster=91, t=-3.7146, P＜0.05).There was positive correlation between fALFF values of middle occipital gyrus and precuneus and AVLT immediate memory score (r=0.456, P=0.038).Conclusions T2DM patients exhibit abnormal spontaneous activity among brain regions associated with cognition, including brain regions related to default mode network on slow-5, and brain regions related to semantic cognition and visual information processing on slow-4.The abnormal regions exhibit different spatial patterns depending on the subbands of low-frequency fluctuations.

Objective To study cortical thickness of the occipital lobe in children with ametropic amblyopia by using MRI technique and the FreeSurfer software.MethOds Nine children with ametropic amblyopia were included in the amblyopic group and 8 normal children were included in the control group.All the children underwent brain MRI on the Siemens Avanto 1.5 T scanner.For the cortical thickness analysis,3-demensional MPRAGE images were collected and analyzed with FreeSurfer software package.Cortical thickness of related regions in the occipital lobe (including the cuneus,later occipital,lingual,and pericalcarine gyri) were recorded and compared. Results The cortical thickness of the lingual,pericalcarine gyri on the left hemisphere and the cuneus,lateraloccipital,lingual gyri on the right hemisphere in amblyopic group were lower than the control group (P＜0.05). Conclusion Morphological changes existed in the occipital lobe in ametropic amblyopic children.The analysis technique with the FreeSurfer package has a potential value in the clinical application.

Objective To evaluate the value of fMRI guided brain surgery for the lesions in or around Broca's area.Methods Forty-three patients with lesions in or adjacent to the Broca's area were studied.fMRI imaging was obtained by BOLD technique with the tasks of reciting.Fiber tract imaging of white matter was obtained by DTI technique.All functional imaging and anatomic imaging were transferred to neuronavigation system.The technique of direct cortical stimulation was used to validate the language cortex in fMRI.The lesions were resected in microscope.Results Broca's area activation was detected in 38 cases..The distance between the fMRI peak and direct cortical stimulation was rated as overlapping (<1 cm diatance) in 25 cases and neighbouring (<2 cm diatance) in 11 cases.Total lesion resection was achieved in 17 cases, subtotal resection in 14 cases, and partial resection in 12 cases.Postoperative neurological functions were improved in 8 cases, unchanged in 31 cases, and temporary worsen in 4 cases.Conclusions The identification of the Broca's area by reciting task in fMRI is sensitive and precise.The fMRI is helpful to decrease the side effect injury in the brain surgery for the lesions in or around the Broca's area.