Objective To investigate the value of Adobe Photashop images software in the verifica-tion of radiation portal. Methods The portal and simulation films or CT reconstruction images were impor-ted into computer using a scanner. The image size, gray scale and contrast scale were adjusted with Adobe Photoshop images software, then image registration and measurement were completed. Results By the com-parison between portal image and simulation image, the set-up errors in right-left, superior-inferior and ante-rior-posterior directions were (1.11 ± 1.37) mm, (1.33 ± 1.25) mm and (0.83±0.79) mm in the head and neck;(1.44±1.03) mm,(1.6±1.52) mm and (1.34±1.17) mm in the thorax;(1.53±0.86) mm, (1.83 ± 1.19) mm and (1.67 ± 0.68)mm in the abdomen; (1.93 ± I. 83) mm, (1.59 ± 1.07)mm and (0.85 ± 0.72)mm in the pelvic cavity. Conclusions Accurate radiation portal verification and posi-tion measurement can be completed by using Adobe Photoshop, which is a simple, safe and reliable method.

The main clinical symptoms of the patients are upper gastrointestinal tract haematemesis,hypersplenotrophy and hypersplenia.Most cases can be detected by ultrasonography,digital subtraction angiography(DSA),multislice CT(MSCT) or magnetic resonance angiography(MRA).Rex surgery,Hassab surgery or combination the shunt and disconnection combined operation et al are the preferred operation,therapy for children's cavernous transformation of portal vein will be further developed.The relevant literatures were collected in recent years to review the advancement of surgical therapy for children's cavernous transformation of portal vein.

Aim To observe histopathological changes of hippocampus after acute epilepsy induced by penty-lenetetrazole (PTZ)in rats.Methods Five groups as control group,PTZ-induced 24 hours(h)group,PTZ-induced 72 hours group,PTZ-induced 1 20 hours group and PTZ-induced 1 44 hours group were designed.PTZ (64 mg·kg -1 )was administered with a single intrap-eritoneal injection for generalized tonic-clonic sei-zures in the current experiment.Control and PTZ trea-ted animals were sacrificed after specific time points. Brain was dissected out and then evaluated for neuro-pathological changes using Nissl staining and immuno-histochemical technique.Results In this study PTZ-induced hippocampal neuron status apoptosis occurred at 24 hours and was sustained for 1 44 hours after status epilepticus.Whereas,activated caspase-3 and AIF ap-peared at 24 hours and were sustained for 1 44 hours af-ter status epilepticus.Conclusion The results of this study show that the significant histopathological chan-ges of hippocampus appear in the vicinity of 1 20 hours after intraperitoneal injection of pentylenetetrazole.

Objective To discuss the value of combining superselective mesenteric angiography (SSMA)with methylene blue in-jection for localization of the Obscure Gastrointestinal Bleeding (OGIB).Methods 12 patients presenting with OGIB had preopera-tive localization of the bleeding site by SSMA.The microcatheter was remained inside the bleeding artery branch after angiography. Then the methylene blue was injected via the microcatheter for localization during exploratory laparotomy and the dyed intestine was then removed.Results The detected rate of bleeding sites by using preoperative SSMA was 100%.The lesions in total 12 patients were found quickly during the exploratory laparotomy.The length of the removed intestine was 9 -12 cm (median,10 cm).After followed up for 10-24 months (median,18 months),all patients with OGIB had no recurrence.Conclusion The method of SSMA combined with the use of methylene blue injection is a safe and effective procedure for the localization of OGIB and could be beneficial for increasing the surgical success rate of hemostasis.

Objective To observe the effect of dexmedetomidine ( Dex ) combined with oxycodone in the traditional lysis method of shoulder joint adhesions .Methods Sixty patients with shoulder joint adhesions in ASA Ⅰor Ⅱby the traditional lysis method were selected ,and they were randomly divided into control group and observation group,30 cases in each group.The control group was administered with Dex1.0μg/kg +fentanyl 1μg/kg.The observation group was administered with Dex1.0μg/kg+oxycodone 0.10mg/kg.The VAS scores and postoperative adverse reactions were compared .Results The VAS score of each group decreased with the prolong of postoperative analgesia time.The VAS scores in the observation group at postoperative 1h,4h,8h[(3.00 ±0.54)points,(1.98 ± 0.56)points,(1.55 ±0.36) points] were lower than those in the control group [(3.91 ±0.33) points,(2.88 ± 0.66)points,(2.26 ±0.77)points],the differences were statistically significant (t =3.42,4.11,2.43,all P <0.05).There was no statistically significant difference in VAS score between the two groups at postoperative 12h(P>0.05).The incidence rates of adverse reactions of respiratory depression ,tachycardia,intraoperative awareness in the control group were 26.7％(8/30),50.0％(15/30),13.3％(4/30),respectively,which in the observation group were 6.7％(2/30),20.0％(6/30),0.0(0/30),respectively,the differences were statistically significant between the two groups(χ2 =4.320,5.934,5.333,all P<0.05).Conclusion Dex combined with oxycodone can ensure good sedation and forgetting effect ,and the incidence rate of adverse reactions is low .

Objective To evaluate the cause and the treatment of the vagus nerve reflex in patients with hemoptysis during bron-chial artery embolization (BAE).Methods 1 12 patients with much hemoptysis were enrolled,9 of whom represented vagus nerve reflex in the process of interventional embolization.Results In 9 patients with mixed vagal reflex,5 occurred in the process of bron-chial artery embolization,1 in removing of sheath,1 in hemostasis by compression and 2 in returning to the ward.The intraoperative vagus reflex during BAE was related to over tension and unnormolized operation,and it improved by block of vagus nerve,raising blood pressure and fluid expansion without serious complications.Conclusion Vagus nerve reflex during BAE should be noticed, and early detection and timely intervention may improve its prognosis.

Objective To evaluate the technical success rate,effectiveness and safety of transcatheter arterial chemoembolization (TACE)via the omental branch in the treatment of hepatocellular carcinoma (HCC)with blood supply from the omental branch. Methods 45 patients with HCC fed by the omental branch who had undergone TACE were evaluated retrospectively.Results All patients had undergone several therapeutic procedures including TACE before the revelation of the blood supply from the omental branch,8 patients had a history of surgery of hepatic resection for HCC.45 patients had 48 tumors total,52 omental branches were observed angiographically,48 omental branches (9 2%)were successfully embolized.Stenosis or occlusion of the hepatic artery was observed in 37 patients(82%).The alpha fetoprotein (AFP)levels were reduced from 5.05－4 246.89 ng/mL(mean,1 748.52 ng/mL)before treatment to 3.78－1 048.32 ng/mL(mean,287.46 ng/mL)after TACE 4－6 weeks later.The tumors diminished in size in 32 patients,stabilized in 13 patients(29%),however,recurred 2－6 months (mean,3 months)after TACE.28 patients died after 6－18 months (mean,10 months),17 patients were alive for 3－32 months (mean,14 months),but tumor recurred in 8 patients.Severe complications were not observed in any patient.Conclusion TACE via the omental branch is safe,effective and had high technical success rate,it is important to embolize all the feeding arteries at the same time for reducing the recurrence rate.

Inguinal incarcerated hernia in adults is a common acute abdomen in hernia and abdominal wall surgery. If not treated in time, it is easy to progress to constrictive hernia, lead to intestinal ischemic necrosis, cellulitis of tegmental tissue outside the hernia, hernia sac empyema, intestinal fistula, and even cause toxic shock, with significantly increased mortality. The types of incarceration are different and the corresponding management methods are different. Based on the proposal of the concept of musculopubic foramen hernia repair, inguinal incarcerated hernia includes incarcerated indirect hernia, incarcerated direct hernia, incarcerated femoral hernia, etc. At present, there is no uniform standard for the comprehensive treatment of different types of inguinal incarcerated hernia, and the clinical management strategies of adult inguinal incarcerated hernia still face serious challenges.

OBJECTIVE:To study the effects of Dianxianqing granule on the interleukin(IL-6)content and glial fibrillary acid-ic protein(GFAP),ionized calcium linker molecules 1(Iba-1)expressions in hippocampus tissue of rats with kainate-induced epi-lepsy,and explore its mechanism of preventing and treating epilepsy. METHODS:Rats were randomly divided into sham operation group (distilled water),model group (distilled water),phenytoin group (0.03 g/kg,positive control) and Dianxianqing granule low-dose,medium-dose,high-dose groups(4.74,9.47,18.94 g/kg,calculated by crude drug),20 in each group. Rats were intra-gastrically administrated once a day,for 7 d. After 1 h of last administration,except for sham operation group,rats in other groups received single injection of kainite in hippocampus CA1 of left side to induce the epilepsy model. Behavioral changes and death of rats were observed. After 24 h of modeling,enzyme-linked immunosorbent method was used to detect the IL-6 content in hippocam-pus tissue of rats,Nissl staining was used to count the hippocampus neurons,and immunohistochemistry was used to detect the GFAP,Iba-1 expressions in hippocampus tissue of rats. RESULTS:Compared with sham operation group,rats in model group had obvious epilepsy symptoms after modeling,and parts of rats died;IL-6 content and number of neurons in hippocampus tissue were obviously decreased (P<0.01), while GFAP, Iba-1 expressions were obviously enhanced (P<0.01). Compared with model group,epilepsy symptoms and death in each administration group had improved,while IL-6 content in hippocampus tissue were in-creased to varying degrees,with no statistical significance (P>0.05). The numbers of neurons in phenytoin group,Dianxianqinggranule medium-dose, high-dose groups were obviously in-creased(P<0.01);GFAP expression was obviously decreased (P<0.01). Iba-1 expressions in hippocampus tissue in phenyt-oin group,Dianxianqing granule high-dose group were obvi-ously decreased (P<0.01). CONCLUSIONS:Dianxianqing granule can play the role in preventing and treating epilepsy by inhibiting GFAP,Iba-1 expressions in hippocampus tissue and in-creasing the number of neurons in hippocampus tissue.

Objective To investigate the mechanical response of Emerin, a nuclear envelope protein, and its role in apoptosis of vascular smooth muscle cells (VSMCs) during cyclic stretch, and the potential effect of transcriptional factors in this process. Methods Physiological cyclic stretch with the magnitude of 5% and frequency of 1.25 Hz was subjected to VSMCs in vitro by using FX-5000T cyclic stretch loading system. VSMCs cultured under the same conditions but without applying mechanical stretch were used as the static control. The apoptosis of VSMCs was detected by using Cleaved-caspase3 ELISA kit, and the expression of Emerin was revealed by using Western blotting. The effects of Emerin on activities of 345 kinds of transcriptional factors in VSMCs were demonstrated with Protein/DNA array after Emerin specific RNA interference (RNAi) under static condition, and the potential transcriptional factors involved in VSMC apoptosis were analyzed with Ingenurity Pathway Analysis (IPA) software. Furthermore, the binding abilities of Emerin to the motif of 2 kinds of apoptosis-related transcriptional factors were detected with chromatin immunoprecipitation (CHIP) and qPCR. ResultsCompared with the static control, the apoptosis of VSMCs was significantly decreased by 5% cyclic stretch, which suggested a protective effect of physiological cyclic stretch. The expressions of Emerin in VSMCs was remarkably increased with 5% cyclic stretch applied for 6 h, 12 h and 24 h. Specific RNAi under static condition decreased the expressions of Emerin but increased the apoptosis of VSMCs. Emerin siRNA transfection remarkably increased (more than 2 times) the activities of 10 transcriptional factors that participated in cellular apoptosis, i.e. CREB-BP1, p300, p55, MAX, NRF-1, STAT1, STAT3, TEF1, TR and BZP. CHIP-qPCR result revealed that the binding ability of Emerin to specific mofit of STAT1 or STAT3 was significantly repressed with Emerin RNAi. Conclusions Physiological cyclic stretch could increase the expression of Emerin which might modulate the binding of Emerin to motifs of apoptosis-related transcriptional factors such as STAT1 and STAT3, regulate the activities of these factors, and then subsequently repress the VSMC apoptosis. The investigation on mechanobiological mechanisms of VSMC apoptosis induced by cyclic stretch may contribute to further understanding the physiological and pathological mechanisms of vascular homeostasis and vascular remodeling.