Objective To investigate the efficacy of radiofrequency ablation assisted spleen-preservation for splenic injury.Methods The clinical data of 64 patients with splenic injury who were admitted to the Suining Central Hospital from August 2010 to May 2012 were retrospectively analyzed.Radiofrequency coagulation hemostasis devices were used for stanching bleeding directly.Results Of the 64 patients,35 received radiofrequency ablation assisted splenic bleeding stemosis,and 29 received radiofrequency ablation assisted partial splenectomy.The mean operation time and volume of intraoperative blood loss were (138 ± 48)minutes and 50-400 ml,respectively.Radiofrequency ablation assisted spleen-preservation was successfully carried out in 63 patients.One patient received reoperation (splenic resection) due to hemorrhage 24 hours after operation.Transient rise of temperature was detected in all the patients,and the temperature was back to normal after conventional management.The complication rate was 6.3％ (4/63),l patient was complicated with anastomotic leakage and was cured by reoperation; 1 was complicated with left pleural effusion; 1 was complicated with pulmonary infection,and his temperature was back to normal 4 days later; 1 was complicated with effusion in the fossa of the spleen.Celiac drainage tube drainaged out 10-120 ml liquid in the first day after operation,5-25 ml on the day 2-3,and they were removed on the third day.There was no effusion around the spleens,and the texture of the spleen was even at 2 weeks after operation.The duration of hospital stay was (14 ±4)days (range,8-40 days).The results of B sonography showed that no effusion and necrotic lesions in the spleen,and immune examinations showed that the splenic function was normal.Conclusion Radiofrequency ablation assisted spleen-preservation for splenic injury is safe and easy to manipulate.

Objective To analyze effectiveness evaluation of Salbutamol combined with budesonide suspension on acute attack of bronchial asthma.Methods150 patients with acute attack of bronchial asthma in hospital from October 2015 to October 2016 were selected,patients were divided into observation group and control group,every groups with 75 cases.Control group patients were given inhalation of salbutamol,observation group patients were given salbutamol combined with budesonide treatment,two groups patients effect were analyzed.ResultsThe total effective rate of the observation group (90.7%) was significantly higher than that in control group (65.4%) (P<0.05).There was no significant difference between the two groups before treatment.The observation group was significantly better than the control group (P<0.05),cough and wheeze improvement time was significantly shorter than the control group (P<0.05).The observation group average dosage of prednisone was significantly lower than the control group (P<0.05).ConclusionWith the implementation of salbutamol combined with budesonide suspension treatment can improve the effect of the treatment of acute attack of bronchial asthma.

Objective To explore the MRI diagnostic value for pernicious placental abnormalities.Methods MRI findings of 1 5 patients with pernicious placenta previa were retrospectively analyzed after cesarean section.Results Among all cases,total placenta previa was,1 1 cases and partial placenta previa was 4 cases.The placenta located in the anterior wall in 8 cases,posterior wall in 4 cases,lateral wall in 3 cases.4 cases were diagnosed as normal placenta,6 cases as adhesion,4 cases as implanted,and 1 case as penetrating.These cases had certain special MR features.Conclusion MRI is helpful in diagnosing the location and type of the perni-cious placenta,and showing whether complicated with previa implantation and penetrating.

Purpose To study clinical pathological characteristics,margin status and its influencing factors in different type of facial basal cell carcinoma (BCC).Methods The histopathological features,margin status of the first frozen section and influencing factors was retrospectively analyzed,with review of the relevant literature.The primary outcome variable was the rate of initially positive frozen section margins.Multivariable Logistic regression was used to study histologic subtype,surgical margins,tumor size,location and other factors influence on the rate of initially positive frozen section margins.Results The pathological subtype is the major risk factor,the infiltrative (OR =4.463,95％ CI =1.919-10.380,P ＜0.05) and morpheaform (OR=5.018,95％CI=2.025-16.623,P＜0.05) had higher risk on positive surgical margin compared with the nodular.The rate of initially positive frozen section margins of nodular and superficial BCC at different margins were observed but the difference were not significant (P ＞ 0.05).Conclusion The pathological subtype is the major risk factor.Surgical excision with a 3 mm margin can achieve ideal results for nodular and superficial BCC in facial area.

Objective To evaluate endoscopic ultrasound for preoperative staging of ampullar tumors.Methods A total of 31 patients with ampullar tumors who underwent surgery from 2010 to 2015 were retrospectively reviewed.B-US,CT,MRCP and EUS were performed in all patients.The diagnostic rates of EUS and other imaging technology,and the diagnostic accuracy of preoperative staging and postoperative pathological staging were compared.Results Diagoses of 31 patients of ampullar tumors patients undergoing preoperative endoscopic ultrasonography assessment T staging were as the following:uT1,4 cases; uT2,15 cases; uT3,10 cases; uT4,2 cases.Compared with the postoperative pathological diagnosis,the T staging accuracy was 90.3％ (28/31),anong which 1 case was overestimated,2 cases were underestimated.The accuracy of endoscopic ultrasound in preoperative diagnosis of ampullar lesions was superior to other detection technology.Conclusion EUS is a valuable diagnostic tool for patients with suspected ampullar tumors.

Polo-like kinase 1(PLK1)is a serine/threonine kinase which is highly conserved, and its activity is elevated in many human tumor cell lines.Lots of reports have shown that PLK1 is critical for all stages of mitosis.The newest report finds that PLK1 is required for DNA synthesis, maintenance of DNA integrity, and prevention of cell death.PLK1 physically binds to the tumor suppressor p53 in mammalian cultured cells, and inhibits its transactivation activity as well as its function in activate checkpoint protein and its pro-apoptotic function.Also PLK1 is involved in the development of tumors, and Polo-like kinase1(PLK1)regulates IFN induction by MAVS, breakdown the innate immunity. Various of inhibitors of PLK1 show the feature of high performance and low toxicity, suggesting that PLK1 may be a feasible target for cancer therapy and immunity therapy.

Objective To clone the reconstructed Hc gene of botulinum neurotoxin type A(BoNT/AHc)and to explore the soluble expression of the reconstructed gene in E.coli.Methods The gene of Hc fragment was synthesized by replacing rare codons with frequent ones in E.coli,while the components of amino acids didn't change,and the contents of AT decreased from 76.4 % to 57.3%.The reconstructed gene was then cloned into the prokaryotic expression vector pQE-60.The recombinant plasmid pQE-60Hc was introduced into E.coli Origami(DE3)that was induced to express the protein.The soluble expression products were then detected by Western Blot.Finally the expressed product of recombination plasmid pQE-60Hc was analyzed with SDS-PAGE after purification through Ni-NTA column.Results The reconstructed Hc gene of BoNT/AHc was amplified by PCR.The expression vector pQE-60Hc was constructed successfully with BamH Ⅰ and Nco Ⅰto ingest both BoNT/AHc and vector pQE-60.Reconstructed gene could be expressed effectively in E.coli in soluble form.The molecular weight of expressed product of recombination plasmid pQE-60Hc analyzed by SDS-PAGE was 52 000,which was the same as anticipated.And the soluble expression product accounted for to 11.5 % of the total bacterial protein.Western blot assay showed that the expression product could bind to specific antibody agent BoNT/A.Conclusion The expression vector has been constructed and the reconstructed gene was expressed successfully and effectively in E.coli,which may provide a foundation for further study on antitoxin and vaccine.

Objective To analyze the MR features of atypical meningiomas,so that to improve the diagnostic accuracy of this tumor pre-surgery.Methods There were 12 cases of atypical meningiomas proved by surgery and pathology.All of these patients underwent plain and contrast-enhanced MR examinations.Results Totally 12 cases,included 2 cases of multiple meningiomas,2 cases of lateral ventriclar meningiomas,2 cases of completely calcific meningiomas,3 cases of cystic meningiomas and 3 cases of malignant meningiomas.Conclusion The external cerebral signs of the tumors are the important basis for the localizing diagnosis of atypical meningiomas.Atypical MR signs of meningiomas are of complimentary value in qualitative diagnosis.

Objective To study the applied value of diffusion weighted imaging-DWIBS(diffusion weighted imaging with background suppression) in detecting the body tumour.Methods 10 healthy volunteers and 20 patients with histologically proven tumour were examined by diffusion Weighted MR with different techniques of background/fat body signal suppression.STIR-EPI sequence and spin echo-echo planar imaging(SE-EPI) sequence with chemical shift selective(CHESS) pulse were compared in terms of their degree of fat suppression.The diffusion weighted imaging features of control group and patients with tumour were observed and the values of ADC were measured.Results Fat suppression with STIR-EPI sequence in neck,chest,spine and extremity was well and SE-EPI with CHESS pulse in chest,abdomen,pelvic was satisfying.Signal to noise ratio(SNR) wss higher in SE-EPI with CHESS than that in STIR.The glands,spleen,peripheral nerves,lymph nodes and so forth could be showed by DWIBS in control group.85% malignant lesions were well visualized and appeared as high signal intensity and lower signal intensity in similar PET imaging,but the lesions only in 3 patients are not well visualized including pancreas cancer(1 case),rectum cancer(1 case),prostate cancer(1 case).PET scan was performed in 3 patients and well corresponded with diffusion weighted imaging in 2 cases,the other one was not visualized on diffusion weighted imaging.The highest ADC of malignant tumors was(1.58?2.06)?10-3mm2/s,the lowest ADC of malignant tumors was(0.88?0.74)?10-3mm2/s,the mean values of ADC of malignant tumors was(1.34?0.79)?10-3mm2/s.Conclusion DWIBS is a new method of diffusion-weighted MR,it has high spatial resolution,high contrast to noise ratio(CNR) and high SNR. This technique can be used as a powerful screening tool for tumour and evaluating the pathological lesions by measuring the values of ADC.

Objective To explore the relationship between the classification and imageology,the dynamic changes of bronchoscopy and CT features of endobronchial tuberculosis(EBTB).Methods CT findings and bronchoscopic findings in 48 cases with EBTB proved by sputum culture , bronchoscopic biopsy and surgical pathology were analyzed.The classification,dynamic changes and CT characteristics were also evaluated.Results Bronchoscopic results showed 13 of edematous-hyperemic type, 8 of caseous nocrosis type, 5 of fibrostenotic type, 2 of tumorous type, 6 of granular type, 7 of ulcerative type and 7 of mixed type. CT manifestations in different types were intersected,including thickened bronchial wall (64.6%) , bronchial stenosis (41.7%) , aerated bronchus sign ( 37.5% ) ,intra-luminal nodules ( 25% ), bronchial structure with obstructive atelectasis ( 37.5% ) and pneumonia (25% ) .The corresponding rate between bronchoscopy and CT was 83.3% in detecting diseases.19 cases were followed-up by bronchoscopy during the initial 1~5 months of treatment,and 12 cases (3 edematous-hyperemic,4 caseation,3 ulcerative,2 mixed type) were resolved or healed without sequelae,6 cases changed into the other type,4 cases changed into the fibrostenotic type, 2 cases remained in a fibrostenotic state in spite of drug therapy.28 cases were followed-up by CT during the initial 1~5 months of treatment, and 20 cases (6 edematous-hyperemic,4 caseation,3 ulcerative, 1 granular,2 fibrostegnotic 1 tumorous,3 mixed type) were improved,6 cases changed into the other type,2 cases turned into the fibrostenotic type, 2 cases did not improve despite antituberculosis chemotherapy.CT correlated well with fibrobronchoscope(88.5%) in predicting the therapeutic outcome of EBTB.Conclusion CT as a non-invasive method has high clinical value in observing the evolution , predicting the complications and evaluating the therapeutic effect of EBTB.