Objective To observe the hemodynamic changes during operation of piggyback liver transplantation.Methods The Swan-Ganz catheter was inserted and the parameters of hemodynamics were analyzes in 36 patients with chronic hepatic diseases following piggyback liver transplantation. The cardiac output(CO)and pulmonary arterial pressure(PAP)were measured.Results CO and PAP were decreased significantly in the anhepatic phase(P

Objective To determine the value of the apparent diffusion coefficient (ADC) of magnetic resonance diffusion-weighted imaging (MRDWI) combined with squamous cell carcinoma antigen (SCC) and carcinoembryonic antigen (CEA) in the evaluation of the efficacy and prognosis of concurrent chemoradiotherapy for cervical carcinoma.Methods A total of 80 patients with cervical squamous cell carcinoma confirmed by histology or cytology in our hospital from 2013 to 2016 were included in this study.Of the 80 patients, 39 were FIGO stage ⅡB, 7 were stage ⅢA, 26 were stage ⅢB, and 8 were stage ⅠVA.MRDWI examination and SCC and CEA measurements were first performed for the patients following group assignment, and the patients were then given extrapelvic radiotherapy (45-50 Gy)+platinum-based chemotherapy plus brachytherapy (20-25 Gy) based on their conditions.MRDWI, SCC, and CEA examinations were performed again after treatment to determine the changes in ADC, SCC, and CEA.In addition, ADC, SCC, and CEA were examined in the middle stage of treatment for 40 patients.Data were analyzed using the paired t-test or ANOVA.Results The overall response rate of the 80 patients after concurrent chemoradiotherapy was 100%.No disease progression was identified in any of the patients until the end of treatment, and the overall survival time of the patients was all above 6 months.Serum SCC and CEA were reduced after treatment (P=0.000,0.000), whereas the ADC value was increased after treatment (P=0.000).The increase in ACD following the decreases in SCC and CEA after treatment (P=0.000, 0.000) was indicative of increased efficacy of the concurrent chemotherapy and radiotherapy.Conclusions MRDWI combined with SCC and CEA is highly reliable for the evaluation of efficacy and prognosis of concurrent chemoradiotherapy for cervical cancer.

Intraperitoneal administration of timosaponin A-III (TA-III) has therapeutic effects on high-fat diet-induced metabolic dysfunction-associated steatotic liver disease (MASLD), but oral administration has no effect. This suggests that gut microbiota may affect the oral bioavailability of TA-III. Metabolic dysfunction-associated steatohepatitis (MASH) is an inflammatory subtype of MASLD. To investigate the therapeutic effect of different administration modes of TA-III on MASH and its relationship with gut microbiota metabolism. In this study, a MASH mouse model was induced by choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD). Comparing the therapeutic effect of intraperitoneal injection (10 mg·kg^-1, ip) and intragastric administration (100 mg·kg^-1, ig) of TA-III. The concentration of TA-III in serum of rats under the two administration modes was analyzed. On this basis, the metabolic effect of gut microbiota on TA-III in mice was verified by the experiment of metabolism of gut microbiota in vitro. The pharmacokinetic experiment of combined antibiotic intervention in mice further verified the metabolism of TA-III by gut microbiota in mice. Finally, the concentration of TA-III in serum of mice after the administration of TA-III by intragastric administration under different antibiotic intervention conditions was compared, and 16S rRNA sequencing analysis was combined to find the key bacteria that may participate in the metabolism of TA-III. The animal welfare and experimental procedures in this paper were in accordance with the provisions of the Animal Ethics Committee of Shanghai University of Traditional Chinese Medicine. The ethics approval number is PZSHUTCM2307030004 and PZSHUTCM2310200003. The results showed that TA-III (10 mg·kg^-1, ip) had definite therapeutic effect on MASH mice, but TA-III (100 mg·kg^-1, ig) was ineffective. The analysis showed that the prototype concentration of TA-III in serum and liver of mice in TA-III (100 mg·kg^-1, ig) was significantly lower than TA-III (10 mg·kg^-1, ip), suggesting that the oral administration of TA-III may be metabolized by gut microbiota. The concentration of TA-III in serum of streptomycin (Str) treated mice was higher than normal mice. Combined with 16S rRNA gene sequencing analysis, it was found that the abundance of Akkermansia_muciniphila (A. muciniphila) was significantly reduced in the Str group. In vitro experiments showed that A. muciniphila could metabolize TA-III. In conclusion, gut microbiota is an important factor affecting the efficacy of TA-III administration through the gastrointestinal tract, in which A. muciniphila may play an important role.

Objective To analyse the clinical and pathological characteristics of congenital adrenal hyperplasia (CAH) with adrenal myelolipoma (AML),and to improve the awareness of CAH.Methods The P450c17a gene in a pedigree with CAH and the clinical and pathological characteristics of three sisters of the pedigree with CAH and adrenal myelolipoma were studied;and the pertinent literatures reported abroad were analyzed and summarized.Results (1) A heterozygous point mutation 1178 base A to T in exon 6,and a heterozygous deletion mutation 1 457-1 465 bases TCGACTCTT of exon 8 were detected in P450c17 (CYP17) gene of three sisters of the pedigree with CAH.(2) The clinical characteristics of three sisters were hypertension,hypokalemia,primary amenorrhea,and gonadal dysgenesis.Without regular treatment after the diagnosis of CAH,the three sisters experienced many years of elevated serum ACTH levels,and developed AML.Conclusion The long-term high ACTH level plays an important role in the development of AML,although the exact mechanism of CAH with adrenal myelolipoma remains still unclear.CAH patients require long-term regular treatment.

Adenocarcinoma ; pathology ; Adenocarcinoma, Papillary ; pathology ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; Duodenal Neoplasms ; pathology ; Humans ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Neoplasms, Multiple Primary ; pathology ; Sarcoma ; pathology ; Stomach Neoplasms ; pathology

Objective To investigate the pathogens,drug resistance and outcomes of continuous ambulatory peritoneal dialysis(CAPD) patients with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers. Method Data including clinical manifestations,pathogens,treatment,outcome of 93 CAPD cases with peritoneal dialysis-related peritonitis in our peritoneal dialysis(PD) centers were retrospectively analyzed.Results Dialysate culture of 75cases was positive with a positive rate of 80.2％,including 45 cases of gram-positive cocci,21cases of gram-negative bacilli,2 cases of fungi and 5 cases of mixed infection.Coagulase-negative staphylococci were the most common gram-positive cocci.All the gram-positive cocci were sensitive to vancomycin,but the resistance rate to cefazolin was 60.0％ with an increasing tendence year by year.Resistance rate of gram-negative bacilli to ceftazidime was 46.1％.All the gram-negative bacilli were sensitive to imipenem.The withdraw rate of CAPD was 17.2％(16/93) because of peritonitis. Noobviousside-effectofperitonealadministrationofvancomycinwasfound.Conclusions Gram-positive cocci are major pathogens in CAPD-related peritonitis.Now cefasolin is not suitable for the empiric initial treatment.Peritoneal administration of vancomycin should be recommended for peritonitis caused by gram-positive cocci.

X-Ray tube is the core part of CT machines and its service life is closely tied to its quality,installation & adjustments and the status of the equipment itself.Besides,whether the operaters use the equipment correctly or not also influence the life of X-ray tubes.The author summarizes some methods for extending the life of CT tubes according to the experiences of installation,adjustment and using of the CT tubes for many years.

Objective To compare the clinical features of drug induced hepatitis caused by traditional Chinese medicines (TCM) and western medicines. Methods A total of 181 patients hospitalized with drug in-duced hepatitis between January and December 2015 were enrolled. Among the patients ,75 cases were in TCM group,66 cases in western medicine group and 40 cases in combined group(accepted both TCM and western medi-cine treatment). Liver biopsies were performed and Roussed Uclaf Causality Assessment Method (RUCAM) scores showed that all patients were with scores higher than 3. The data including gender,age,clinical manifesta-tions,physical signs,laboratory tests and image characteristics were analyzed individually. Results There was no significant difference in age,the pattern of liver injury,and the course of liver damage among the three groups (P>0.05). Anorexia was common symptom in all the three groups without any significant difference(P>0.05). Jaundice was most frequently observed in TCM group while fever was most commonly found in western medicine group,which both had significant difference(P< 0.05). The results of routine coagulation tests and serum albu-min values were normal in 3 group with increasing level of aminotransferase observed ,and there was no significant differences among 3 groups(P>0.05). Compared with western medicine group ,the patients in TCM group had a higher level of platelet counts ,serum levels of total bilirubin ,total bile acids(TBA)and serum iron(P<0.05), and less proportion of eosinophils and lower level alkaline phosphatase(P< 0.05). Conclusions The age,the pattern of liver injury,the course of liver damage and aminotransferase levels in patients with drug induced hepati-tis caused by TCM and western medicines were similar;however,western medicines were more likely to cause al-lergic responses and hyperbilirubinemia occurred more frequently in patients with drug induced hepatitis caused by TCM.

Objective To investigate the metabolic changes and the metabolites distribution of different hippocampal regions (head,body and tail)in patients with Alzheimer’s disease (AD)using 1 H-MRS for early diagnosis.Methods The hippocampal multivoxel 1H-MRS at 3.0 T was scanned in 30 patients with AD and other 30 normal cognitive elders (NC)as contrast.The data obtained were processed at a workstation.The hippocampus was divided into 3 parts (head,body and tail),and the ratios of N-acetylaspartate (NAA)/creatine (Cr),myoinositol (MI)/Cr and MI/NAA were calculated respectively.The metabolite ratios and distribution changes were compared between group AD and NC.Results Compared with the group NC,the NAA/Cr in group AD in bilateral hippocampal body and tail was decreased,whereas the MI/Cr and MI/NAA in bilateral body and tail,MI/NAA in left head were opposite (P<0.01).In group NC,the NAA/Cr was gradually decreased from the bilateral hippocampal heads to tails (P<0.01),however,the MI/NAA was opposite (P<0.01).No distribution differences in every metabolic ratios of bilateral hippocam-pus were found in AD group (P>0.05).Conclusion Metabolic changes and disappearance of the normal distribution in different hippocampal regions detected by 1 H-MRS provide helpful clues for early diagnosis of the AD.

Objective To investigate the Human papillomavirus(HPV)infection in different age groups of women in Shenyang, and explore its correlation with cervical biopsy diagnosis.Methods 7 311 women aged 13-85 did HPV test and thin-cytologic test (TCT)in the hospital.Some of them had biopsy detection under electronic colposcopy,and the pathological diagnosis was the golden standard for the diagnosis of cervical lesions.SPSS18.0 statistical software was used for all statistical analysis.Results The infection rate of <30 years old women was significantly higher than that of 30 - <40,40 - <50,≥50 years old women (P <0.05).The most prevalent high-risk HPV genotype in Shenyang were subtype 16,52,58,53,33,31 and 18,and the most prevalent low-risk HPV subtypes were 81,11 and 6.The former 4 subtypes of high-risk HPV infection accounted for 67.3% of all high-risk infection.As to the 4 subtypes with higher infection rate,the infection rate of ≥40 years old women was higher than that of <40 years old(χ2 =20.29,P =0.00).The top two low-risk HPV subtypes accounted for 74.8% of the infections.The mean age of the ICC patients were 48.3,which was statistically different from the other groups(P <0.05).Cervical lesions occured mostly in 40-49 years old,which accounted for 37.1% and was higher than the other agees(P <0.01).HPV16 infection rate increased with the severity of cervical lesions.Conclusion HPV DNA genotyping is a necessary methord for cervical cancer screen,an effective com-plement for precancerous lesions diagnosis which was missed in cytology test,and also an indispensable test for CIN treatment and follow-up after operation.