Objective To evaluate the clinical value of endoscopic retrograde cholangiopancreatography(ERCP) in the diagnosis and treatment of biliary complications after orthotroptic liver transplangtation.Methods We retrospectively reviewed the clinical data of 139 patients with biliary complications after orthotropic liver transplangtation,and summarized 10 categories of biliary complications.The location of biliary complications included donor liver,anastomotic stoma,receptor biliary duct,duodenal papilla,and so on.Common complications were biliary duct or anastomotic strictures(102/139,73.4%),cholangitis(94/139,67.6%),common bile duct or intrahepatic cholelithiasis(75/139,54.0%),dysfunction of the duodenal papilla(20/139,14.4%),bile leakage(17/139,12.2%),and complications related to T-tube(4/139,2.9%).Infrequent complications involved duodenal papillary stenosis(1/139,0.7%),complications related to PTC(2/139,1.4%),biliary bleeding(3/139,2.2%),and too long and twisted bile duct(4/139,2.9%).The treatment methods included EST(112/139,80.6%),dilatable bougie or balloon dilatation(157/250,62.8%),plastic stent placement(139/250,55.6%),ENBD and irrigation(87/250,34.8%),and gallstone removal(27/250,10.8%).Results A total of 250 times of ERCP was performed in the 139 patients,the success rate of intubation being 99.2%(248/250).The total cure rate reached 70.5%(98/139) and the improvement rate was 18.7%(26/139),with a total effective rate of 89.2%(124/139).There were 9 patients with conversions to open surgery(9/139,6.5%),4 patients with no improvement(4/139,2.9%),and 2 patients with spontaneous quitting treatment or loss of follow-up.The postoperative complications included cholangitis in 37 patients,the dislodgement of ENBD tube in 26 patients,and biliary sludge or stone in 18 patients.Conclusions ERCP is an effective way to diagnose and treat the biliary complications after orthotroptic liver transplantation.

Purpose:To study the feasibility of 1 H-magnetic resonance spectroscopy ( 1 H-MRS) in the chemical induced rat hepatocellular carcinoma(HCC) model by a new 1.5T MR set and endeavor to have an initial understanding of the characteristics of its cancer development. Methods:Diethylnitrosamine (DEN) induced rat HCC models(n=30) were established. At different intervals rats were randomly scanned before being killed on the following day. Their livers were dissected for histopathologic study. Results:Three rats died unexpectedly. 27 rats (90%) developed liver lesions and were investigated according to the plan. T 1 WI is good for demonstration of anatomic structure and T 2 WI at showing the lesions in detail. The scanning methods have been improved gradually. 1 H-MRS results were satisfactory for 64% of the single-voxel and 50% of the multi-voxel respectively. Conclusions:DEN induced rat HCC model is suitable for the Medical Imaging studies and liver 1 H-MRS scan is practical with this new 1.5T unit.

Objective To investigate the effect of propofol on N-methyl-D-aspartate (NMDA) receptor-mediated currents. Methods Hippocampal neurons were prepared from newborn Wistar rats and cultured for 8-12 days. Whole cell currents were recorded using patch-clamp technique and cells were voltaged-clamped at - 80 mV. 100 ?mol?L-1 NMDA and 3 or 48 ?g?ml-1 propofol were applied with a multi-pipe ejection system. GABAA receptor was then blocked with 100 ?mol?L-1 bicuculline to investigate the effect of propofol on NMDA receptor without the influence of GABAA receptor.Results Run-down of INMDA induced by 100 ?mol?L-1 NMDA applied to neurons which were cultured for 8-12 days was 15%?8%. Propofol 3 or 48 ?g?ml-1 significantly inhibited spontaneous excitatory postsynaptic currents and elicited a Cl- -mediated response by direct activation of GABAA receptor in the absence of GABA. therefore produced a reversible inhibition of whole cell currents activated by NMDA. After the GABAA receptor was blocked by 100 ?mol?L-1 bicuculine propofol still inhibited NMDA currents slightly. Conclusion Propofol inhibits the NMDA subtype of glutamate receptor mainly through activation of GABAA receptor. It can also directly suppress the NMDA receptor slightly.

BACKGROUND:Cervical single-door laminoplasty for chronic compressive myelopathy has obtained exact effects. To reduce the occurrence of related complications, different doctors have proposed different improvement programs, and have achieved a certain effect, but the effect on postoperative complications is not very wel. OBJECTIVE:To evaluate the effect of modified open-door laminoplasty with steel implantation and preservation of bilateral semispinalis. METHODS: We retrospectively analyzed the data of 30 cases of multilevel cervical spondyiotic myelopathy who underwent modified open-door laminoplasty from October 2013 to March 2014. Internal fixation material was Centerpiece titanium plate fixation system. Visual Analogue Scale score, Japanese Orthopaedic Association score (17-score method), neck disability index, range of motion of cervical vertebra, and cervical curvature were compared before treatment and during folow-up. Axial symptom severity was assessed after treatment. RESULTS AND CONCLUSION:The patients were followed up for 12-24 months. No complications appeared during repair, including postoperative spinal cord injury, cerebrospinal fluid leakage, infection or C5 nerve root palsy. Only one patient suffered from axial pain, but there was no need for oral medication. The improvement rate of Japanese Orthopaedic Association score was (76.96±17.61)%. Neck disability index decreased from 12.29±3.82 preoperatively to 8.24±2.86 in final follow-up. Range of motion of cervical vertebra (47.41±17.33)° in final follow-up, accounting for (93.0±4.2)% of preoperative data. Cervical curvature decreased from (13.47±10.54)° preoperatively to (12.88±8.56)° in final follow-up. These findings confirm that modified open-door laminoplasty with preservation of bilateral semispinalis can reserve cervical rear structure to maximum extent, is conducive to early functional exercise after rehabilitation, and reduces the incidence of axial symptoms and loss of cervical curvature.

BACKGROUND: At present, more and more scholars pay attention to the influence of spine and pelvis sagittal balance on the quality of life of patients. Postoperative changes in spine imaging parameters fol owing corrective osteotomy for lumbar degenerative kyphosis have not been reported. OBJECTIVE: To evaluate postoperative changes in sagittal balance fol owing corrective osteotomy for lumbar degenerative kyphosis. METHODS: We retrospectively analyzed 35 consecutive lumbar degenerative kyphosis patients treated with posterior osteotomy fixation in the First Affiliated Hospital of Xinjiang Medical University from February 2012 to December 2014. Imaging parameters were measured before fixation, immediately after fixation and during final fol ow-up. RESULTS AND CONCLUSION: (1) There were significant differences between preoperative and postoperative parameters except for pelvic incidence angle (P < 0.05). (2) There were significant differences between postoperative and last fol ow-up parameters except for Cobb angle, pelvic incidence angle, thoracic kyphosis angle and the thoracolumbar kyphosis (P < 0.05). (3) Pelvic tilt angle was negatively correlated with lumbar lordosis after fixation (r=-0.610, P < 0.001). Thoracic kyphosis was positively correlated with lumbar lordosis (r=0.598, P < 0.001). (4) Results suggested that lumbar sagittal contour can be significantly improved by corrective osteotomy for lumbar degenerative kyphosis. Simultaneously, reciprocal changes in the adjacent areas such as thoracic spine and pelvis occur to adapt to the new sagittal balance.

Objective Through comparative study of the rate and influence factors of intraoperative and postoperative complications of cervical cancer after laparoscopic radical hysterectomy which to guide the clinical practice of this kind of surgery in the future. Methods The clinical data of 314 patients undergoing laparoscopic radical hysterectomy from January 2013 to December 2015, the complication rate was observed, and the inlfuencing factors were analyzed by the method of multiple factor analysis. Result The number of intraoperative complications were 20 cases, accounting for 6.37%, the number of postoperative complications were 80 cases, accounting for 25.48%. Intraoperative complications influence factors including FIGO, surgery time, doctors surgery experience [OR^ =2.00, 95%CI (1.00~4.25)] which have the highest value. postoperative complications inlfuence factors including age, body mass index (BMI), lymph node metastasis, FIGO, doctors surgery experience, operative time [O^R=4.69, 95%CI (1.05~2.84)] which have the highest value. Conclusions Complications are dififcult to avoid completely, but we can reduce it by age, BMI, lymph node metastasis, FIGO, operation time, doctor’s operation experience and so on.

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Objective:To explore the predictive factors of intestinal necrosis in acute mesenteric ischemia.Methods:This retrospective study enrolled 81 patients diagnosed as acute mesenteric vascular occlusive diseases in Zhongshan Hospital, Fudan University between Nov 2012 to May 2017. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis.Results:In univariate analysis, the predictive factors of intestinal necrosis were peritoneal irritation sign ( P<0.001), white blood cell count ( P<0.001), serum albumin ( P=0.028), blood creatinine ( P=0.025), serum lactic acid ( P=0.008), D-dimer ( P=0.037), intestinal pneumatosis ( P=0.017), decreased or disappeared enhanced bowel wall ( P<0.001) and bowel loop dilation>2.5 cm ( P=0.01) on CT scan. According to multivariate logistic regression analysis, white blood cells ( OR=3.60, 95% CI: 1.51-5.47, P=0.007), lactic acid ( OR=4.80, 95% CI: 1.36-9.89, P=0.032), reduced or disappeared enhanced bowel wall ( OR=10.57, 95% CI: 1.82-61.10, P=0.008) were independent predictive factors of intestinal necrosis in patients with acute mesenteric ischemia. Conclusions:The predicted risk factors for intestinal necrosis in mesenteric ischemic diseases are increased white blood cells, elevated serum lactate levels, and reduced or disappeared enhanced bowel wall on CT scan.

AIM To investigate the protective effects and mechanism of propofol on cultured rat hippocampal neurons subjected to anoxia injury METHODS Hippocampal neurons of neonatal rats, which had been cultured in vitro for 10 days, were allocated to control groups and propofol treating groups In propofol treated groups,the culture medium were loaded with propofol at the concentrations of 3, 6, 12, 24, 48 mg?L -1 respectively, and then the neurons were exposed to oxygen glucose deprivation for 24 h, to 40 ?mol?L -1 H 2O 2 for 24 h or to 100 ?mol?L -1 glutamate for 50 min The cell survival rate in each group was evaluated by MTT colorimetry. Using a laser scanning confocal microscope (LSCM), the effects of propofol on neuronal calcium overload and on the reduction of mitochondrial membrane potential (△?m) evoked by anoxia were observed with fluo 3 and rhodamine 123 for real time changes of [Ca 2+ ] i and △?m. The electron spin resonance (ESR) was used to measure the scavenging effects of propofol on hydroxyl radical and superoxide anion RESULTS Propofol at the concentrations of 6～48 mg?L -1 attenuated the anoxic injury ( P

As the real-time and dynamic ultrasound images play an important role in the distance education of ultrasound medicine, the learning system is more dependent on the technology of modern net-work information. By using the DGX protocol, we have constructed an ultrasonic distance education system composed of 5 main operating terminals, which has ensured the reliable and adaptive window transmission, and has realized the optimization of the coding and decoding technology. At the same time, we have used the system to carry out ultrasonic distance education to medical students, the staff of our ultrasound department and the ultrasound doctors in other hospitals, and have achieved good results in practical application.