Objective To evaluate the value of preoperative color Doppler flow imaging findings for predicting possible difficuulties encountered during laparoscopic cholecystectomy (LC).Methods Eighty-six Datients with acute cholecystitis underwent color Doppler flow imaging examination were divided into operation difficult group(67 cases)and operation easy group(19 cases)according to the diffculty score.The parameters were measured pre-operation including the volume of gallbladder,the thickness of the gallbladder wall,the condition of arterial flow in the gallbladder wall,the conditions of gallbladder cavity and gallbladder fossa and the intra-and extra-hepatic bile duet.The relationships among imaging results,operation difficulties and operation findings were investigated.Results Gallbladder volume,gallbladder wall thickness.the presence rates of plentiful arterial flow in the gallbladder wall,adhesion of gallbladder and stone incarceration In operation difficult group were significantly different from those in operation easy group [(52.6±14.6)mm~3 vs(32.6±10.4)mm~3,(9.7±4.1)mm vs(3.8±0.9)mm,89.5%(17/19)vs 17.9%(12/67),78.9%(15/19)vs 11.9%(8/67),10.5%(2,19)vs 0(0/67)](P<0.05 or<0.01).The accurate rate was 94.2%(81/86)in predicting.Conclusion Preoperative color Doppler flow imaging is helpful in predicting difficulties of LC.

Objective Two Chinese pedigrees with congenital factor Ⅻ(FⅫ)deficiency were enrolled in the present study,and studies on the clinical manifestations,family survey,biochemical examinations and gene diagnosis of these pedigrees were performed.Methods In October 2014-2015 March,two cases of hereditary FⅫ deficiency patients were included in Xinhua hospital.Activated partial thromboplastin time(APTT),FⅫ procoagulant activity(FⅫ:C),FⅫ antigen(FⅫ:Ag)and other parameters of coagulant were detected.The FⅫ deficiency pedigree members,exons 1-14,boundary introns including the splice junctions of the F12 gene were amplified with polymerase chain reaction(PCR).Direct sequencing was exerted to purified PCR product to detect the gene mutation.If the gene mutations were found,polymorphism should be ruled out by directing sequence.One hundred and three healthy persons as normal controls.Results The two probands were manifested prolonged APTT(101 s and 143 s).They showed lower FⅫ activity and FⅫ antigen(2％and 6％,0.4％and 4％,respectively).FⅡ:C,FⅦ:C,FⅧ:C,FⅨ:C,FⅩ:C and Fg are normal in the two probands.LAC is negative.Proband 1 has c.1285C>T(p.Q429 stop)mutation.His parents and son have the heterozygous mutation in the same position.Proband 2 has c.1556T>C(p.L519P)mutation.Her two sons have the heterozygous mutation in the same position.In the promoter regions of F12 gene,there were common 46C/T and 619 G/C polymorphisms in two pedigrees.Conclusion c.1285C>T(p.Q429 stop)and c.1556T>C(p.L519P)are the cause of FⅫ deficiency.

Objective To compare the accuracy of intraocular lens(IOL)power calculations by using 6 formulas(SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ)in different axial lengths of the eye,in order to improve the accuracy of predicating IOL powers for patients after cataract surgery.Design Retrospective comparative clinical analysis.Participants 169 patients(169 eyes)with age-related cataract underwent regular phacoemulsification and posterior chamber IOL implantation.Methods 169 eyes with cataract were divided into five groups according to the axial lengths:AXL≤22mm,22mm28.4mm.The axial lengths and keratometry of the 169 eyes were measured with A-mode ultrasound before operation,and the actual postoperative refraction was measured with the methods of computer and retinoscopy optometry when patients could gain best corrected visual acuity one month after surgery or later.Inputting the axial lengths,keratometry and IOL powers into A-mode ultrasound,the predicted postoperative refraction was calculated with SRK-T,Haigis,Binkhorst-Ⅱ,Hoffer Q,Holladay-1,SRK-Ⅱ formulas,and the differences of predicted and actual postoperative refractions in different axial lengths were compared.Main Outcome Measures The absolute value with the differences of the predicted and actual postoperative refractions,i.e.absolute predicted errors.Results(1)Comparing the difference of predicted and actual postoperative refraction,there was no statistical significance between the five formulas in the groups of axial length(AXL)≤22mm,22mm28.4mm,but the average absolute predicted error of Haigis and SRK-T formulas is significantly smaller than SRK-Ⅱand Binkhorst-Ⅱ formulas.Conclusions In existing sample size,there was no obvious influence on postoperative refraction when using other five formulas except Binkhorst-Ⅱ.But in the extremely long AXL group,Haigis and SRK-T formulas have some ascendancy over the other formulas.

AIM To study the protective effects of vesnarinone on myocardial ischemia. METHODS Rat myocardial oxide nitric (NO) content, protein kinase C (PKC) activities in different groups were determined by kits. RESULTS Vesnarinone 1 mg?kg -1 or 2 mg?kg -1 iv markedly improved the NO content and PKC activity before ischemia for 30 min and reperfusion for 2 h in rats. CONCLUSION Vesnarinone possesses a protective effect against myocardial ischemia via NO induce PKC.

Objective To investigate the clinical results and related key points of surgical treatment for Hawkins Ⅲ talus neck fractures.Methods Forty-one patients with Hawkins Ⅲ talus neck fracture were treated.The fractures occurred on the left side in 21 patients and on the right side in 20 patients.All patients were performed internal fixation by internal and lateral approaches.The weight bearing should be adjusted with follow-up.The functional results were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS).Results The average duration of follow-up was (37.7 ± 8.2) months.All fractures gained union and the average union time was (4.1 ±0.5) months.The average AOFAS score after treatment was (79.3 ± 2.6) scores which was higher than that before treatment [(35.1 ± 8.0) scores],and there was significant difference (P =0.026).There were 11 cases in excellent,17 cases in good,11 cases in fair and 2 cases in poor.The excellent and good rate was 68.3％ (28/41).Traumatic arthritis occurred in 18 cases (43.9％,18/41),involved tibial astragaloid joint in 4 cases,involved subtalar joint in 6 cases,involved tibial astragaloid joint and subtalar joint in 8 cases.Avascular necrosis occurred in 7 cases (17.1％,7/41).Conclusions The effect of surgical treatment for Hawkins Ⅲ talus neck fracture via a bilateral approaches is satisfactory.Pay more attention to protect blood circulation intraoperative and perform anatomic reduction according to the characteristic of body of talus displacement.After operation,functional rehabilitation should be directed by the principle of early movement,later weighted.

BACKGROUND: Transfection is the most important beginning component of research about gene function. It is a problem to find a transfection agent with high efficiency and safety. Nanosized materials have high surface activity, are easy to be modified and easier to pass the biomembrane. Researchers are studying how to use nanosized materials as a transfection agent.OBJECTIVE: To study the transfection efficiency of different basic polymers with different molecular mass and degree of substitute, and to find the optimized transfection agent.DESIGN: Controlled study.SETTING: Institute of Genetic Engineering, Southern Medical University.METHODS: This study was performed in the Institute of Genetic Engineering, Southern Medical University from March 2006 to June 2007. Using the lipofectamine reagent as the positive control, we transfected siRNA (0.2 nmol/L), FITC-labeling targeting bcl-2, by nine nanometers (polylactic acid-polyglycolic acid, chitosan-poly-caprolactone, polyethyleneimin-macrogol) into leukemic cell K562 cultured without serum. Six hours post-transfection, 20% FBS serum was added. The cell proliferation was measured at 24, 48 and 72 hours by using the MTT method. After transfecting for 48 hours, the cells were collected to detect transfection ratio by using fluorescent microscopy, apoptosis ratio and expression of K562 and bcl-2 protein by flow cytometer (FCM). RESULTS: ① Fluorescence microscope detection showed there were significant differences of transfection efficiency between different materials (P < 0.05). Moreover there were statistical differences between different degrees of substitute, although they were the same material (P < 0.05). ② MTT method indicated the cell proliferation ratio was positively related to transfection ratio. ③ Flow cytometry results showed the suppression of expression of targeting gene and apoptosis ratio were positive correlated with transfection ratio. CONCLUSION:The nanometer poly-ethylene glycol combined with poly-ethylene imine (PEG-PEI), whose molecular mass is 1 800/2 000 and degree of substitute is 29%, has a high efficiency and low toxicity.

Objective To analyze the diagnosis and treatment of iliac pseudoaneurysms following renal transplantation.Method The data of two patients with pseudoaneurysm who underwent kidney transplantation were retrospective analysied.Result One case with pseudoaneurysm received transplant nephrectomy,and pathological examination diagnosed mucoraceae infection; the other patient received endovascular treatment and amphotericin B therapy,endly died of hemorrhagic shock.Conclusion The development of pseudoaneurysms at the kidney transplantation recipients with the same donor results in high rates of mucormycosis.They should take anti-fungus therapy and operation as early as possible.

Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group (group A) and treatment group (group B).0.3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery.Bilateral venous sonography of lower extremities were performed before and d1,d3 after operation.Blood coagulation marks PLT,PT,APTT,Fibrinogen (FIB)and D-dimer were determined at the same time.Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients:1 in group B (3％) and 6 in group A (20％) (P ＜ 0.05 ).Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient.FIB and D-dimer had no significant difference on the dl ( P ＞ 0.05 ) between two groups,but significantly lower on the d3 after surgery in group B than that in group A ( P ＜ 0.05 ).Low-molecularweight heparin reduced blood hypercoagulation state and thrombosis.Color Doppler sonography can be a valuable method for detecting asymptomatic deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.

Objective To evaluate the changes of morphology, hemodynamics and endothelial function of the dorsal artery of foot in patients with early-stage type 2 diabetic mellitus (T2DM) by high-resolution ultrasound. Methods The changes of morphology, homodynamics and endothelial function of the dorsal artery of foot were measured in 25 elderly and 35 non-elderly T2DM patients and 35 elderly and 30 non-elderly healthy persons. Results (1) The change percentage of inside diameter of foot dorsal artery under reactive hyperemia situation was obviously reduced in elderly T2DM patients compared with elderly healthy controls [(10.52±2.79)% vs. (15.43±4.69)%, P<0.01] and there was significant difference between non-elderly T2DM versus healthy persons [(12.89±4.68)% vs. (17.97±4.61)%, P<0.01],and it was lower in elderly versus non-elderly T2DM ones (P<0.05). The change percentage of inside diameter of foot dorsal artery wassignificantly lower in elderly T2DM versus healthy subjects after taning nitroglycerin [(12.40± 3.23)% vs. (16.11±5.74)% , P<0.01]. (2) Compared with control groups, the intima-medial thickness (IMT) of dorsal artery of foot was thickened significantly, and the peak reverse velocity (PRV) in early diastole, the velocity in end diastole (EDV) and pulsatility index(PI) were reduced significantly in T2DM groups (P<0.05). The peak systolic velocity (PSV) had no significant differences among all the groups (P>0. 05). (3) In T2DM groups, the PI was correlated positively with the change percentage of inside diameter of dorsal artery of foot under reactive hyperemia situation (r=0.79, P<0.01) and after having taken nitroglycerin (r=0.71, P<0.01), respectively. Conclusions The changes of morphology, hemodynamics and the injuries of endothelial function of the dorsal artery of foot can be detected in patients with early-stage T2DM byhigh-resolution ultrasound, which has clinical significance and applicable value.

34 medical college students and 26 patients with primary hypertension were served as the subjects on low sodium salt diet for 4 weeks. Before and after the experiment, serum and urinary sodium and potassium, as well as blood presure, pulse rate, and body weight were measured. During the testing period, calorie and protein were supplied sufficiently and the salt content in their common diet taken was restricted strictly. The results showed that the serum sodium decreased, potassium increased at the end of the experiment, but the changes were all within the physiological permissible limits. On the contrary, urinary sodium increased, potassium decreased and the Na/K dropped markedly, body weight increased slightly in healthy subjects and decreased by 1.0-3.0kg in patients with hypertension. The blood pressure, both systolic and diastolic, was decreased but no change in the pulse rate was observed.It was obvious that in the subjects on common salt diet, the body sodium was high and potassium low, otherwise on low sodium salt diet, such situation might be improved, and the high blood pressure could also be ameliorated in the type Ⅰ and Ⅱ of hypertension.