ObjectiveTo explore the application of peripherally inserted central venous catheter (PICC)and central venous catheter (CVC) in the surgical parenteral nutrition.MethodThe operation time,success rate,indwelling duration,abnormal biopsy,and adverse reactions of PICC and CVC were retrospectively compared.ResultsCVC had significantly shorter operation time than PICC groups [ (28.67 ±5.13) min vs.(45.20 ±6.89)min,P =0.035 ).The mean indwelling duration was significantly longer in PICC group than in CVC group [ ( 114.85 ± 10.29) d vs.(24.78 ± 8.42) d,P =0.033 ].PICC group was superior to CVC group in terms of five complication items,while only phlebitis was more frequent/severe in CVC group.ConclusionsPICC may be more suitable for long-term ( ＞4 weeks) catheter-based nutrition.CVC has short operation time and fast flow rate,and therefore is most suitable for rescue treatment for critically ill patients.

Objective To investigate the effects of rolipram on neurofunction and the ultrastructure of the spinal cord in rats with spinal cord contusion.Methods Thirty adult,female Sprague-Dawley (SD) rats received spinal cord contusion at the T10 level.They were then randomited into an experimental group and a control group immediately after the operation.Rats in the experimental group received subcutaneous injections of 0.25mg/kg of rolipram twice daily for two weeks.Control rats received the same dosage of 0.9％ sodium chloride solution on the same schedule.The rats'functional recovery was evaluated using the open-field locomotion rating scale of Basso,Beattie and Bresnahan (BBB score),once a week within the 1st month after spinal cord injury (SCI),and once every two weeks subsequently.The morphology of the spinal cord tissue around the lesion site was observed under the light microscope with HE staining at the 8th week postoperation,and the ultrastructure of the spinal cord was observed under the transmission electron microscope at the 2nd,4th and 8th week postoperation.Results At the 2nd and 3rd week after SCI the experimental group exhibited significandy greater improvement in average BBB scores than the control group.However,the average BBB scores in the experimental and control groups were not significantly different at 8 weeks after SCI.Under the light microscope,cavities were observed in the posterior dorsal column near the SCI in both the experimental and control groups.However thick,condensed glial scars in the injured area were observed only in the control group.The density of glial cells decreased more in the experimental group than in the control group.Transmission electron microscopy revealed that,compared with the control group,inflammatory edema was attenuated and fewer axons were damaged at the 2nd week postoperation in the experimental group.That group also showed less axon degeneration as well as more angiogenesis at the 4th and 8th week.Conclusion Rolipram can reduce secondary neuron degeneration,inhibit gliosis and the formation of glial scars,and promote angiogenesis.

Objective To study the efficacy of BuShen QiangJingTang on oligoasthenozoospermia. Methods 100 patients with oligoasthenozoospermia were selected and divided into observation group (n=50) and control group (n=50) randomly, observation group were given BuShen QiangJingTang, while control group were given WuZi YanZong pills, then the efficacy was compared.Results Efficiency of observation group was 96%, which was obviously higher than control group (54%, P<0.05).Before treatment, semen parameters and symptom scores had no statistical significant differences; after treatment, semen volume, sperm survival rate, sperm density and sperm activity of observation group were significantly higher than control group, the scores of symptom (lumbar debility, fatigue weakness, nocturia) were significantly lower than control group(P<0.05).No adverse reactions were observed in two groups.Conclusion The efficacy of BuShen QiangJingTang applied to oligoasthenozoospermia is satisfying,and it can significantly improve sperm quality and activity.

ObjectiveTo explore the migration, effect on axon growth of olfactory ensheathing cells (OECs) transplanted in contused spinal cord of rats. Methods8 adult female rats were induced spinal cord contusion at T10 cord by NYU impactor (H=25 mm), and received OECs transplantation in 1 mm rostral and caudal to injury site，or injury site. Other 4 adult female rats were uncovered the spinal cord at T8-10 cord, and injected GFP+OECs at T10 cord. 1 week after transplantation, all animals were executed and the T8-11 cord (15 mm long) contained the entire injury site were observed for the migration of OECs and immunostained for neurofilament (NF) and myelin basic protein (MBP). ResultsThe OECs injected in injury site largely migrate longitudinally and laterally from the injection site, OECs injected in 1 mm rostral and caudal to injury site of contused spinal cord, migrate longitudinally and laterally from the injection site to the injury site in white and gray matter, and some along the central canal. OECs injected in normal spinal cord migrated longitudinally and laterally from injection site, too. The transplanted OECs expressed a little NF and MBP. ConclusionThe transplanted OECs are able to migrate in spinal cord and promote axon regeneration and remyelination.

Objective To assess the effect of snapshot freeze (SSF) motion correction algorithm on the image quality of coronary CT angiography (CCTA).Methods Thirty-one consecutive patients underwent coronary CTA without heart rate control.All of the CCTA images were reconstructed by the means of both standard (STD) and SSF motion correction.Image quality and interpretability of STD and SSF reconstructions were compared.CCTA images were interpreted with Likert 4-points score system by two experienced radiologists.The image qualities were assessed on per-artery and per-segment level,and interpretability was performed on per-segment,per-artery,and per-patient levels.Comparisons of variables were performed with paired Wilcoxon rank sum test and paired Chi-square test.Results SSF reconstructions showed higher interpretability than STD reconstructions on per-patient [100.0％ (31/31) vs 64.5％ (20/31),x2 =9.09,P =0.002] and per-artery [100.0％ (124/124) v s 83.9％ (104/124),x2 =18.05,P =0.001] and per-segment level [99.0％ (413/417) vs 89.2％ (372/417),x2 =35.56,P =0.001].Image qualities were higher with the use of SSF than STD reconstructions on LAD [3.3 ± 0.7 vs 2.9 ± 1.0,Z =2.70,P=0.007],LCX [3.1 ±0.8 vs 2.5 ± 1.1,Z =3.23,P =0.001] and RCA [3.3 ±0.6 vs 2.1 ±0.9,Z =4.60,P =0.001],but they were similar on LM [3.9 ± 0.4 vs 3.7 ± 0.6,Z =1.89,P =0.059].Image quality was higher with the use of SSF versus STD reconstructions on per-segment [3.5 ± 0.7 vs 3.0 ± 1.0,Z =10.31,P =0.001] level.Conclusions The use of SSF motion correction algorithm improves image quality and interpretability of coronary CTA without heart rate control.

Objective To discuss the value of volume helical shuttle(VHS) of high-definition CT(HDCT) in diagnosis and clinical path of tetralogy of Fallot(TOF).Methods 88 preschool children with TOF were examined with VHS of HDCT and echocardiography(ECHO).60 children were received surgery.Based on surgical data,the results of VHS of HDCT were compared with that of ECHO,assessing the display ability of basic deformity of TOF,the intra-cardiac lesion,extra-cardiac lesion and hemodynamics.The radiation dose(mSy) were calculated.Results The diagnostic accuracy of HDCT was 95.0％ and the ECHO was 90.0％ on the positional display.The results of HDCT were slightly smaller than ECHO on the measure of size of VSD,P ＜ 0.05,the difference was significant between the two methods.The display on right-to-left shunt of VSD using HDCT were all coincided with ECHO.One quarter of the cases showed the left-to-right shunt simultaneously.Whereas all the cases were showed slow bi-directional shunt by ECHO.There are 99 deformity in pulmonary artery stenosis,including right ventricular hypertrophy,outflow tract stenosis,pulmonary stenosis.The results of HDCT,ECHO and the operation showed no difference.All the McGoon ratio of HDCT were obviously higher than ECHO,P ＜0.01.Statistical difference was significant.The coincidence rates in aortic straddles by HDCT and ECHO both were 98.3％.Each has one case misdiagnosed.37 other intra-cardiac lesions,for example,foramen ovale and atrial septal defect.VAS has 25 misdiagnosed places and ECHO has 8.88 other extra-cardiac lesions,such as one side of pulmonary artery stenosis or atresia,collateral circulation between systemic and pulmonary circulation,coronary artery abnormal,patent ductus arteriosus(PDA) and so on.The diagnostic accuracy of HDCT was 98.8％ and the ECHO was 59.1％.Average effective dose with HDCT was(1.58 ± 0.43) mSv.Conclusion VHS of HDCT scan has obvious advantages in the diagnosis of TOF.Multiple data can reflect intra-cardiac lesion,extra-cardiac lesion accurately and intuitively.The radiation dose was in the acceptable range.Combining the HDCT VHS and the ECHO will become the clinical path of preoperative diagnosis,differential diagnosis and making the operation scheme in children with TOF.

Objective To investigate the pathogenesis of gallbladder chaotic dynamics after partial gastrec-tomy. Methods 140 cases operated by partial gastrectomy after 6 months were randomly examined, they in-cluded one group of 40 cases by Billroth type and the other 100 cases by Eiselsberg type. The ultrasonograph was applied to evaluate the function of gallbladder dynamics and radio-immunity method to determine the content of CCK at the time of having no food and 30 minutes after med. Results BV and RV of Eiselsberg group were bigger than Billroth Ⅰ obviously P<0.05. Gallbladder contraction rate displayed not well obvi-ously as too. The plasm level of CCK had no manifested distinctions in empty stomach cases of the 2 groups, but the increasing gradient plasm level of CCK in Billroth Ⅰ exceeded Eiselsberg type. Conclusions The pathogenesis of gallbladder chaotic dynamics after partial gastrectomy was correlated with the alterative type of partial gastrectomy, the reduction of CCK plasm level, the damage of anterior vagal trunk hepatic branches during the operations and so on led to the disorder of gallbladder emptying and induced cholecystolithiasis.

Objective To explore the effect of olfactory ensheathing cell (OEC) transplantation combined with walking training on neurofunction recovery in rats after spinal cord contusion. Methods Forty adult female rats aged (75 ± 1 ) days were subjected to experimental spinal cord contusion at the T10 level using a New York University impactor at a height of 25 mm. They were then divided into 4 groups: ( 1 ) an OEC transplantation combined with walking training (OEC-walking training) group, (2) an OEC transplantation (OEC) group, (3) a walking training combined with Dulbecco's modified Eagle medium injection (DMEM) (walking training-DMEM) group, and (4) aDMEM injection (SCI-DMEM) group. The OEC transplants and DMEM injections were performed 2 weeks post-injury. Walking training began at the 7th day post-injury and consisted of daily sessions (once daily, 5 days a week for 10 weeks) of quadrupedal treadmill training, starting from 15 min and gradually increasing to 30 min daily, at speeds starting from 3 m/min and gradually increasing in accordance to the condition of the rats. Locomotor function recovery of the rats' hindlimbs was evaluated weekly using the Basso, Beattie and Bresnahan (BBB) locomotor rating scale.The expression of tyrosine hydroxylase ( TH ) was detected in the injured region of the lumbar spinal cord. Results The BBB scores of rats in the OEC-walking training group and the walking training-DMEM group improved significantly from the 4th week post-injury compared to the SCI-DMEM injection group. Rats in the OEC transplantation group had a significant improvement in BBB scores at the 5th to 8th weeks post-injury. At the end of the 11th week post-injury, the average BBB scores were 13.14 ± 0.24 in the OEC-walking training group, 11. 64 ± 0.56 in the OEC transplantation group, 12.29 ±0.64 in the walking training-DMEM group and 11.07 ± 0.84 in the SCI-DMEM group.The OEC-walking training group scored significantly higher than the other 3 groups. Although the number of TH-positive neurons in the lumbar spinal cord was not significantly different among the groups, the morphology of TH-positiveneurons in the OEC-walking training group and the walking training-DMEM group was different from those in the OEC transplantation group and the SCI-DMEM group. Conclusions OEC transplantation combined with walking training can effectively promote the functional recovery of the hindlimb. The plasticity of the descending TH system and of motoneurons of the ventral horn of the lumbar spinal cord might mediate the changes.

Objective To investigate the association between arterial stiffness of the common carotid artery(CCA)and insulin resistance in hemodialysis patients. Methods Arterial stiffness index β of CCA was evaluated by an ultrasonic phase-lock Echo-tracking system in 80stable non-diabetic hemodialysis patients.Insulin resistance was detected by the homeostasis model assessment method(HOMA-IR).Plasma hemoglobin,serum albumin,total cholesterol,high density lipoprotein,low density lipoprotein,triglyceride,lipoprotein(a),ApoA1,ApoB,CRP,calcium,phosphorus and creatinine were determined by standard methods. Results The stiffness index β was 11.41±4.13 in patients with previous cardiovascular disease(CVD)and 9.75±3.63 in those without CVD(P＜0.05).The stiffness index β was positively correlated with HOMA-IR(r=0.321,P＜0.01),as well as with age(r=0.376,P＜0.01),pulse pressure(r=0.267,P＜0.05),and duration of hemodialysis(r=0.219,P＜0.05).In stepwise multiple regression analysis,HOMA-IR(β=0.228,P＜0.05)and age(β=0.308,P＜0.01)were identified as significant independent variables for stiffness index β of CCA. Conclusions Insulin resistance is associated with aaefial stiffness in nondiabetic hemodialysis patients.The increased arterial stiffness may be the link between insulin resistance and cardiovascular morbidity as well as mortality in hemodialysis patients.

OBJECTIVETo investigate the clinical factors related with liver metastasis from colorectal cancer.

METHODS1 312 colorectal cancer patients treated from 1988 to 1997 were collected to set up the database. Binary and multinomial logistic regression (SPSS 10.0 for windows) and then correlation analysis were used to evaluate the factors concerned.

RESULTSSex, disease course, gross tumor type, differentiation degree, pathological grade, infiltration depth and lymph node metastasis were related with liver metastasis by single factor analysis. Only sex, infiltration depth and lymph node metastasis were related with liver metastasis by multiple factor analysis. More male than female were observed in patients with liver metastasis from colorectal cancer (1.9:1, P = 0.006). Liver metastasis in colorectal cancer was positively related to the infiltration depth into the intestine wall (r = 0.926, P = 0.024). However, the correlation between the distance of lymph node metastasis and liver metastasis in colorectal cancer had no statistical significance (r = 0.748, P = 0.252).

CONCLUSIONSex, depth of infiltration and lymph node metastasis are the main clinical factors related with liver metastasis from colorectal cancer. Male colorectal cancer patients are apt to develop liver metastasis. The deeper the tumor infiltrates, the more the liver metastasis. Age, blood type, symptoms, course, complications, tumor size and site are not related with liver metastasis in colorectal carcinoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; Female ; Humans ; Liver Neoplasms ; secondary ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged