Objective To investigate the clinical value of the duodenum double lumen cannula suction in duodenal rupture repair.Methods According to the operation methods,60 patients with duodenal rupture undergoing duodenal repair were divided into the surgical drainage alone group(26 cases)and double sets attract tube group (34 cases).The surgery effect and complications were observed.Results The difference of traffic flow 7 days after the operation between the two groups was statistically significant(t =7.564,P <0.05).The length of stay and hospital costs of the surgical drainage alone group were more than those of the double sets attract tube group,the differences were statistically significant(t =3.567,4.123,all P <0.05).The fistula,intra -abdominal infections,wound infec-tions,pulmonary infection rates of the surgical drainage alone group were 30.77%,42.31%,46.15%,26.92%, which were higher than 2.94%,11.76%,8.82%,2.94%,5.88% of the double sets attract tube group,the differ-ences were statistically significant(χ2 =8.949,7.330,10.950,2.986,5.116,all P <0.05).Conclusion Applica-tion of the double lumen cannula duodenal suction in duodenal rupture repair can significantly reduce the incidence of postoperative complications,has certain security,it is recommended in clinical practice.

For unresectable advanced hepatocellular carcinoma (HCC),besides sorafenib,alternative drugs and treatment modalities are required.Clinical studies of hepatic arterial infusion chemotherapy (HAIC),transcatheter arterial chemoembolization (TACE),and system chemotherapy have shown favorable efficacy and tolerance in advanced HCC patients.In addition,the potential efficacy of sorafenib combined with focal treatment is also an interesting issue.As more therapies become available,decision-making for treating advanced HCC becomes increasingly complex.In our opinion,diverse treatment modalities should be utilized for the best interest of patients.Based on predictive biomarkers,we should develop a precise patient stratification system to select suitable candidates for each treatment modality in future studies,as is useful for improving prognosis of patients with advanced HCC.

Objective To evaluate the anxiety and depression status of the liver transplant recipients and to investigate the related impact factors.Method Forty-two liver transplant recipients were under survey by General Information Questionnaire (GIQ),Social Support Rating Scale (SSRS),Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and 1,6,12,24 and 36 months after operation.Result The mean anxiety scores before and 1,6,12,24 and 36 months after operation were 37.2 ± 5.3,32.2 ± 6.2,32.1 ± 6.6,31.9± 5.1,30.1 ± 4.6 and 28.5 ± 4.1,respectively.The mean depression scores at those 6 time points were 46.7 ± 7.1,37.9 ± 10.7,36.7 ±7.9,37.1 ± 6.4,34.3 ± 5.8 and 32.1 ± 5.6,respectively.Both the anxiety and depression scores showed statistically significant difference (P＜0).001) before and after operation (all time points).Also there was statistically significant difference (P＜0.001) between post-operative month 36 and other post-operative time points.The impact factors for anxiety of liver transplant recipients were subjective supports and the utilization level of the supports.The impact factors of depression of liver transplant recipients were pre-operative depression score,objective support,subjective supports and the utilization level of the supports.Conclusion Liver transplant recipients suffer less anxiety and depression after operation.The anxiety status can be further improved from 24 to 36 months postoperation.

Objective To explore the effect of fluoxetine on the brain function of bulimia nervosa (BN) patients.Methods Seven female BN patients,who met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3),accepted functional magnetic resonance imaging (fMRI) examinations before and after the antidepressant treatment (fluoxetine (20 mg/day)) for three months.Seven normal controls accepted the same fMRI examination only at baseline.fMRI imaging was block-design.Blocks of food or non-food stimulus containing pictures selected from International Affective Picture System (IAPS) which were shown by computer automatically.All subjects were evaluated by Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD17) and Likert Scale-likelihood evaluation to the same pictures in the fMRI imaging blocks.Results The average intensity and volume activated in BN before treatment were both significantly lower than that in the control (P＜0.05).But under stimulus of food pictures,bilateral prefrontal cortex and left amygdala of BN patients were significantly activated.After fluoxetine treatment,the intensity and volume activated both increased significantly (P＜0.01) and the main areas being activated were right temporal,cerebellum and bilateral prefrontal cortex.Conclusion Fluoxetine improves the bulimic symptoms of BN patients and decreases abnormal activation of prefrontal and limbic in these areas.The underline mechanism may be related to functions of serotonin system in prefrontal-limbic path.

Objective To study the diarrhea causes and nursing care after kidney transplantation from donation after cardiac death(DCD).Methods The clinical data of 91 patients undergoing kidney transplantations from DCD were retrospectively analyzed from November 2011 to May 2013 in our department,to investigate the incidence of diarrhea and the causes.Results Eighty three cases contracted diarrhea in 91 recipients,with the incidence of diarrhea 91.2%.The use of immunosuppressive agents,intestinal flora,infection and bowel movement dysfunction were all related to the diarrhea.Conclusions The incidence of diarrhea is high and the causes are complex after kidney transplantation from DCD.So nurses should take the appropriate care measures to improve the quality of nursing,avoiding complications and ensuring transplant results based on a different cause of diarrhea.

Objective To explore the depression status of the liver transplant recipients after the surgery and the impact factors.Method Forty two liver transplant recipients were assessed at 5 different time points(1 month,6 months,12 months, 24 months,36 months after the transplantation)using general information questionnaire(GIQ),social support rating scale(SSRS) and self-rating depression scale(SDS).Results After the transplantation,the longer recipients lived,the less depression they underwent.Age and post-operative objective support are the two major factors on depression status of the liver transplant recipients Conclusion The clinical and community nurses may pay attention to the mind state of the recipients after liver transplantation,and provide mental nursing in time and social support to prevent and improve the state of their depression.

Objective To analyze the incidence of BK virus (BKV) infection after kidney transplantation in our center and to evaluate the efficacy and safety of conversion treatment with Mizoribine (MZR) on BKV infection after kidney transplantation.Methods The information of recipients who received BK virus screening in hospital or outpatient during 2015-02 to 2016-12 in our center was retrospectively analyzed.The recipients positive for BKV were divided into experiment group (given conversion treatment with MZR) and control group (not given MZR conversion) according to the inclusion criteria.The negative rate of BKV,AR,hyperuricemia and the function of renal allograft during the conversion treatment with MZR were observed.Results 182 recipients accepted BKV screening during 2015-02 to 2016-12 and 68 cases were positive.The positive rate of BKV was 38.5 ％.The positive rate of peripheral blood specimens and midstream urine specimens was 7.1％ and 36.8％ respectively.Twelve recipients were positive for BKV in both peripheral blood specimens and midstream urine specimens.There were 27 recipients in experiment group and 36 cases in control group.Fourteen recipients positive for BKV became negative after MZR conversion in experiment group and the negative rate was up to 51.9％.The mean time of negative rate was 3.2 ± 2.7 (1-10) months after MZR conversion.During the conversion treatment with MZR,AR occurred in 1 case and was reversed by the impact therapy with Thymoglobulin in experiment group.The value of serum uric acid was maintained stable before and after MZR conversion under the action of uric-acidlowering drug.The renal function was kept stable in both experiment group and control group after renal transplantation.No deaths and renal allograft failure cases occurred in both groups during the research period.The 2-year survival rate for patients and kidneys was both 100％.Conclusion The incidence of BKV infection after kidney transplantation was high and the treatment scheme of MZR conversion was safe and effective.

Objective To establish a REDE-DHPLC method for detecting the EGFR and KRAS mutations in plasma DNA from tumor patients, and investigate its clinical significance. Methods Restriction endonucleases Mse Ⅰ , Msc Ⅰ , BstN Ⅰ and Bgl Ⅰ were used to digest the wild type fragments of exon 19,exon 21 of EGFR gene and coden 12, 13 of KRAS gene for enriching the mutation fragments, and REDE-DHPLC method was established to detect EGFR and KRAS mutations. The sensitivities of REDE-DHPLC and conventional DHPLC were analyzed by using a series of plasmids containing 50%, 10%, 5%, 1% and 0. 1% mutation genes. Then, Plasma samples and paraffin-embedded tissue samples of 120 NSCLC patients and 120 colorectal cancer patients were detected by REDE-DHPLC. Compared with conventional DHPLC and sequencing, the diagnostic efficiency of REDE-DHPLC method was evaluated by detecting the mutation status of 2 genes in plasma of NSCLC and colorectal cancer patients. Results The sensitivity values of REDE-DHPLC and conventional DHPLC for detecting mutations in 4 loci were 0. 1% and 1%respectively. Plasmid DNA containing 0.1% mutation gene was detected to be positive continually for 2 to 3 times by REDE-DHPLC. EGFR mutation rates of 120 plasma from NSCLC patients detected by REDE-DHPLC, conventional DHPLC and sequencing methods were 27. 5%, 16. 7% and 12.5% respectively, and KRAS mutation rates of 120 plasma from colorectal cancer patients were 38. 3%, 25. 8% and 16. 7%,respectively. The positive rates of EGFR and KRAS mutation detected by REDE-DHPLC were significantly higher than conventional DHPLC(x2 = 4. 092, 4. 301, all P ＜ 0. 05 ) and sequencing method (x2= 8. 438,14. 127,all P ＜ 0. 05 ). In comparison with conventional DHPLC, the sensitivities of REDE-DHPLC for detecting EGFR and KRAS mutation were 100% (20/20,31/31), the specificities were 87. 0% (87/100)and 83. 2% (74/89). In comparison with sequencing method, the sensitivities of REDE-DHPLC were 100%( 15/15,20/20), the specificities were 82.9% (87/105)and 74. 0% (74/100). The coincidence rate of the two methods for detecting EGFR and KRAS mutation were 89. 2% ( 107/120, Kappa = 0. 690, P ＜ 0. 05 ) and 87.5% ( 105/120, Kappa= 0. 718, P ＜ 0. 05 ). The Consistency of EGFR and KRAS mutation status in plasma and tissues detected by REDE-DHPLC were 91.7% (33/36, Kappa =0. 939,P ＜0. 05)and 90. 2 %(46/51, Kappa = 0. 914, P ＜ 0. 05 ), respectively. Conclusions The REDE-DHPLC method is highly sensitive and specific for detecting EGFR and KRAS mutations in plasma DNA from tumor patients. The results are easy to be interpreted without missing homozygous point mutation, which indicate that the detection of EGFR and KRAS mutations in plasma DNA by REDE-DHPLC could therefore extend to be usedin clinical laboratory.

Since there is a clinical need for the tissue-engineered vascular graft (TEVG), fabricating the vascular scaffold individually appears to be necessary. In this work, we have developed the traditional tubular scaffold and branch vascular scaffold utilizing low-temperature deposition manufacturing (LDM) technology. Then different tubular scaffolds were fabricated by changing the processing parameters, and the morphological properties of the scaffolds were assessed. The scaffolds reproduced the structure of 3D vascular model accurately. Wall thickness of the scaffold increased with the increase of velocity ratio (V(L)/V(s)) and nozzle temperature, and both the micropore size and wall roughness were positively correlated with the nozzle temperature. However, the porosity was barely affected by the nozzle temperature. This approach, fabricating vascular scaffold with special structure and appearance features via LDM technology, is potential for the individual fabrication of vascular scaffold.
Biocompatible Materials ; chemistry ; Blood Vessel Prosthesis ; Cold Temperature ; Computer-Aided Design ; Humans ; Lactic Acid ; chemistry ; Polyesters ; Polymers ; chemistry ; Tissue Engineering ; methods ; Tissue Scaffolds

Serious femoral damages are a common human bone disease. Rebuilding the femur and studying its mechanical properties are a continuous medical research topic, but traditional femoral prosthesis often cause some problems such as prosthesis loosening. In this work, we selected a healthy male, took his femur scanning by CT, and rebuilt high-precision femur prototypes by Mimics10.0 software, then chose the material having good biocompatibility and biodegradable, utilizing low-temperature deposition manufacturing (LDM) technology for the femoral manufacturing. This approach, fabricating the femur via LDM technology, laid a foundation for the later research on the femoral implantation in the human body.
Adult ; Biocompatible Materials ; Cold Temperature ; Computer-Aided Design ; Femur ; diagnostic imaging ; injuries ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Prostheses and Implants ; Prosthesis Design ; Software ; Tomography, X-Ray Computed