Objective To analyze the DSA manifestations of arteriovenous fistulae in hepatic cancer and to discuss the appropriate method for obstructing the fistulae in order to improve the therapeutic results for hepatic cancer associated with arteriovenous fistulae. Methods The imaging findings in 183 patients of hepatic cancer with urteriovenous fistulae, which were. selected from 637 patients with liver cancer, were retrospectively analyzed. For cases with mild arteriovenous fistulae (n = 89) the tumor-feeding arteries were embolized after iodized oil embolization procedure, while for cases with moderate and severe aneriovenous fistulae (n = 94) the abnormal shunts were obstructed before performing chemoembolization of the tumor in order to ensure that the effective infusion of the drug into the lesion and the sufficient deposit of iodized oil in the tumor could be obtained. Results The tumor-feeding arteries were successfully embolized in all 89 patients with mild arteriovenous fistulae. Of 94 cases with moderate and severe arteriovenous fistulae,excellent deposit of iodized oil was seen in 64 (68.1%), incomplete embolization in 13 (14.83%), poor oil deposit due to over-embolization in 11 (11.7%) and failure to block the fistulae as the fistulae were too large or too diffuse in 6 (6.4%). No serious complications occurred. Conclusion The arteriovenous fistulae accompanied with hepatic cancer can be effectively obstructed in most patients, with resultant clinical improvement of the patients' condition. This therapeutic technique is safe and reliable.

Objective To study the state, feature and risk factors of bacterial infection in patients with liver cirrhosis, find out the influence of infection on prognosis, and provide scientific basis for its prevention and treatment. Methods Three hundred and twenty-three patients with liver cirrhosis were analyzed. The number of the patients with infection, the location of infection, clinical feature as well as the kind of pathogenic bacteria were analyzed. Unconditional Logistic regression analysis was used to assess the risk factors of bacterial infection. Results The overall infection rate was 39.94% (129/323),of which community acquired infection rate and nosocomial infection rate were 22.60% (73/323) and 17.34%(56/323) respectively. The most common location of infection in turn were respiratory tract,gastrointestinal tract, urinary tract,biliary tract and abdominal cavity. The main pathogenic bacteria was Gram-negative bacillus, most of which had drug resistance for cefquinome and quinolones. The risk factors related with bacterial infection included liver cancer, Child-Pugh class B and C grade of liver function, gastrointestinal tract bleeding, diabetes mellitus,invasive operations and the length of staying in hospital. Conclusions The incidence rate of infection in patients with liver cirrhosis is higher. Multiple factors are likely to affect the incidence rate of infection in patients with liver cirrhosis.

Objective To investigate the protective effect of extracellular ATP on motoneurons of spinal anterior horn from spinal root avulsion induced cell injurey. Methods Thirty-six Wister rats were randomized into 2 groups: single root avulsion and root avulsion with ATP. The left C5-C8 nerve roots were avulsed, the experiment group was gioven extracellular ATP (2 mg/kg) 0.4 ml by intraperitoneal injection and control group physiological saline water was gioven 0.4ml as the same method, all one time daily, contin-ue injection ATP or saline water 2 weeks. At 2,4 and 6 week postoperatively, C5-C8 spinal cord was har-vested after the rats were executed. The change of nitric oxide synthase (NOS) and neurofilament protein (NF-200) were observed after histochemistrical examination. Results At 2、4 and 6 week postoperatively, the survival of motorneurons in the spinal anterior was 80.48%, 73.55% and 53.43% in experiment group, was 68.90%、63.58% and 37.72% in control group;compare experiment group with control group, the le-don-induced motomeurons death in the spinal anterior bern was decreased by 11.58%、9.78% and 15.71% respectively (P < 0.01) ; the activity changes of NOS expression rate was 17.85% ,40.20% and 18.03% in experiment group, was 25.53%,53.88% and 25.58% in control group, compare experiment group with con-trol group, the activity changes of NOS expression rate was decreased by 7.68% (P < 0.01), 13.68% and 7.55% (P < 0.05) respectively. The motoneurons expressed NF-200 in the experiment group was larger than the control group, there was significant difference was found between the control group and the experiment group. Conclusion ATP might play certain protective role in survival of motoneurous after spinal root avulsion.

BACKGROUND: Pedicle screw fixation is the preferred surgical treatment for clinical treatment of lumbar degenerative disease currently. The stability of pedicle screw fixation system can be evaluated from the perspective of biomechanics and finite element method is more and more popular in analyzing stress of pedicle screw fixation of vertebral body for researchers. OBJECTIVE: To analyze the stress and displacement changes of human lumbar spine in bending movement from the biomechanical point of view when unilateral and bilateral pedicle screws are fixed, providing theoretical reference for practical clinical application. METHODS: Three-dimensional models were established based on CT data of the volunteers. The volunteers signed the informed consent. This study was approved by the Hospital Ethics Committee. Abaqus software was used to simulate the actual stress conditions. Finite element analysis of lumbar spine flexion was performed during unilateral and bilateral pedicle screw fixation. The stress and displacement of lumbar vertebra, disc and pedicle screw were observed under two fixation methods. RESULTS AND CONCLUSION: (1) Under bilateral fixation, the stress on the left screw was 22.2 MPa, and the stress on the right screw was 21.14 MPa, which was far less than the stress of the screw under unilateral fixation (79.19 MPa). The stress of intervertebral disc in unilateral fixation was 87% larger than that in bilateral fixation; the stress of vertebral body in bilateral fixation was 72% smaller than that in unilateral fixation. (2) From the perspective of displacement, the displacement of screw, lumbar disc and centrum under bilateral fixation were 53%, 55% and 62% smaller than that under unilateral fixation, respectively. (3) Therefore, from the mechanical point of view, bilateral pedicle screw fixation has less stress level, which is friendlier to the human body than unilateral fixation and thus more conducive to the recovery of patients.

We describe a 58-years-old man with a primary nasopharyngeal carcinoma accompanying erythroderma. His first symptoms were systemic scattered erythema and itching for six months. Lower right cervical lymphadenectasis was found by physical examination. A neoplasm in nasopharynx could be seen with nasal endoscope. The pathology of the neoplasm was non-keratinizing carcinoma. This case illustrates that "erythroderma" could be a paraneoplastic effect of nasopharyngeal carcinoma.
Carcinoma ; Dermatitis, Exfoliative ; complications ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; complications ; Paraneoplastic Endocrine Syndromes ; complications

Objective　To study the role of TNFα in the plasm a and skin and IL-1 in the serum in the formation of secondary thrombosis after skin avulsion. Methods　After avulsive flap at size of 12 cm×4 cm was inflicted on the hind legs of pigs, skin specimens and venous blood sam ples were taken at various time points. The contents of TNFα in plasma and skin were determined with radio-immunoassay, and the activity of serum IL-1 wi th 3［H］-TdR. Results　The TNFα contents in the plasma and skin were increased significantly after avulsion（P<0.01），which were (41 5±24) ng/L and (298±18.5) ng/L respectively on the 3rd day after the injury. T he activity of IL-1 in the serum was increased (P<0.05) and was (2.59± 0.85 ) ng/L on day 3. Conclusion　The changes of TNFα contents and I L-1 activity in blood and skin play important roles in the inducetion and aggra vation of secondary tissue necrosis and early thrombosis after skin avulsion.

Objective To compare the efficacy of and adverse reactions to a fractional micro-plasma radio-frequency technology versus fractional ultrapulsed CO2 laser in the treatment of atrophic acne scars.Methods Twenty-one patients with atrophic acne scars were enrolled in this study.Half of each subject's face was treated with micro-plasma,and the other half with fractional ultrapulsed CO2 laser,for one session.Treatments were randomly administered in a split-face manner.The efficacy and adverse effects were evaluated 6 months after the treatment by using the following outcome parameters:ECCA grading scale (échelle d' évaluation clinique des cicatrices d'acné),degrees of post-treatment pain and edema,time taken for crusting and durations of inflammatory erythema,patients' subjective rating of improvement in scar by using a quartile grading scale.A non-parametric rank test was conducted to compare the efficacy and adverse effects between the two treatments.A scar model was established on both ears of a New Zealand big ear rabbit,and treated with the CO2 laser and micro-plasma respectively,immediately followed by the resection of scar tissue for the observation of histological changes.Results A decrease of ECCAscore was observed in 90.5％ (19/21) of the patients after micro-plasma treatment,and in 86.7％ (18/21) after CO2 laser treatment; no significant difference was observed in the response rate (P ＞ 0.05).In detail,ECCA score decreased by 31.5％ (from 50.71 to 34.76 ) after micro-plasma treatment,compared to 29.9％ (from 53.57 to 38.10) after CO2 laser treatmet.Mild edema was observed after micro-plasma treatment,with the duration of erythema and crusting being 13.95 days and 6.95 days,respectively,compared to 45.81 days and 10.10 days respectively,after CO2 laser treatment.Pigmentation occurred in none of the patients after micro-plasma treatment,but in 19％ after CO2 laser treatment.Animal experiment showed that microscopic ablation zones were broad and shallow after micro-plasma treatment,but narrow and deep after CO2 laser treatment.Conclusions Fractional micro-plasma and CO2 laser are both effective for the treatment of atrophic acne scars,but the former seems to have less side effects with a lower incidence of pigmentation.

Objective To evaluate the association of the size of thyroid nodules and accuracy of fineneedle aspiration cytology in diagnose of thyroid nodules.Methods 691 thyroid nodules in 630 patients pathologically confirmed were retrospectively analyzed in our hospital.All imaging data of preoperative ultrasound-guided FNAC were collected in our review.Yields of FNAC were divided into six levels according to the classification criteria of the Bethesda system(level Ⅰ,insufficient material or nondiagnosed;level Ⅱ,benign ; level Ⅲ,atypical hyperplasia; level Ⅳ,follicular neoplasm ; level Ⅴ,suspicious for malignancy; level Ⅵ,malignant),＞level Ⅳ was the malignant cytologic criteria for diagnosis of thyroid nodules.According to the maximal diameter of thyroid nodules,the nodules were divided into group A(L≤0.5 cm),group B(0.5 cm＜L＜1.0 cm) and group C(L≥1.0 cm).Postoperative pathologic results were taken as the gold standard.Results Of 691 nodules,there were 176(25.47％),298(43.13％) and 217(31.40％) in group A,group B and group C respectively.Among the three groups,accuracy of ultrasound-guided FNAC in group B (90.94 ％) was higher than in group A(80.11％) and group C(83.41 ％),with statistically significant(P ＜0.05).There was not statistically different between group A and group C(P ＞0.05).The specificity,positive predictive value and negative predictive value were not statistically different among three groups(P ＞0.05).Conclusions The size of thyroid nodules was partly associated with accuracy of ultrasound-guided FNAC.

Objective To evaluate clinical significance of ischemia grade to predict severe arrhythmia in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 225 patients with STEMI admitting to emergency department were enrolled.All enrolled patients were divided into two groups based on the QRS complex electrocardiogram on admission:grade 1Ⅱ ischemia group(135 cases) and grade Ⅲ ischemia group (90 cases).All patients received thrombolytic therapy.The incidence rate of ST segment resolution (STR) and severe arrhythmia in hospital stay was observed.Results The ST segment elevation (Σ.ST) on admission and 2 h after thrombolysis in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(0.84 ± 0.57) mV vs.(0.44 ± 0.35) mV,(0.50 ± 0.23) mV vs.(0.11 ± 0.06) mV] (P ＜ 0.01).The backing rate of ST segment ≥ 50％ 2 h after thrombolysis in grade Ⅲ ischemia group was significantly lower than that in grade Ⅱ ischemia group [56.7％ (51/90) vs.83.7％ (113/135)] (P ＜0.01).The creatine kinase MB (CK-MB) peak value in grade Ⅲ ischemia group was significantly higher than that in grade Ⅱ ischemia group [(363 ± 105) U/L vs.(212 ± 97) U/L] (P ＜ 0.01).There was no significant difference in the incidence of severe arrhythmia between two groups (P ＞ 0.05).Multiple Logistic regression analysis demonstrated that the independent predictors of severe arrhythmia were duration from symptom to thrombolysis and initial ΣST,whereas grade Ⅲ ischemia remained a strong predictor of severe arrhythmia.Conclusion Grade m ischemia on admission is associated with lower incidence of STR in patients with STEMI after thrombolysis and a strong predictor of severe arrhythmia.

Aim:To characterize the immune response to YCP, a polysaccharide (PS) isolated from marine filamentous fungus Phoma herbarum YS4108. Methods:YCP was coupled to bovine serum albumin (BSA) to construct three neoglycoproteins which are different in their degrees of substitution (DSs; ≈ 3, ≈ 6, or ≈ 10 mol of BSA carrier/mol of YCP hapten, respectively), and their immunogenicities were evaluated in mice following subcutaneous immunization,respectively. IgG subclasses against the PS and the carrier protein were measured in addition to the total IgG and IgM antibodies for YCP induced by the neoglycoproteins. Results: While unconjugated PS was weakly immunogenic, theneoglycoprotein induced vigorous primary IgM and booster IgG responses to PS and the carrier protein. Interestingly,the IgG subclass distribution was different between PS and the carrier protein; for PS, the IgG response was predominant of IgG2a subclass with approximately low levels of IgG2b and IgG1, while the response to the carrier protein was mainly of the IgG1 subclass with relatively low levels of IgG2a and IgG2b, and the lowest of IgG3. Conclusion:YCP has the potential to elicit preferentially IgG2a as the dominant isotype antibody in mice.