A new anastomat for digestive tract operations, based on the magnetic compressive technique and mechanical transmission mechanism, is composed of a removable head and a reusable body. The head includes two parts: the proximal end can be fixed to the body, and the distal end could be used for performing a purse string suture. The procedure of anastomosis is similar to that of the stapler, and the anastomoses is established using a pair of magnetic rings. The instrument makes magnamosis more simple and feasible, and it would facilitate the clinical application. The body of the anastomat is reusable and the head could be replaced according to the clinical scenarios, these could reduce the medical cost. The magnetic rings would be excreted with the feces, and there is no foreign body response at last.
Anastomosis, Surgical ; instrumentation ; methods ; Gastrointestinal Tract ; surgery ; Humans ; Magnetics

The research of sleep staging is an important basis of evaluating sleep quality and diagnosing diseases. In order to achieve automatic sleep staging, we proposed a new method which combines with principal component analysis (PCA) and support vector machine (SVM) for automatic sleep staging. Firstly, we used PCA to reduce dimension of time-frequency-space domains and nonlinear dynamical characteristics of sleep EEG from 5 subjects to reduce data redundancy. Secondly, we used 1-a-1 SVM to classify sleep stages. The results showed that the correct rate can reach 89.9%, which was better than those of many other similar studies.
Electroencephalography ; Humans ; Nonlinear Dynamics ; Principal Component Analysis ; Sleep Stages ; Support Vector Machine

Objective To explore the clinical value of intra-arterial thrombolytic therapy for hepatic artery thrombosis after liver transplantation. Methods Routine color doppler imaging (CDI) was used to detect hepatic artery thrombosis (HAT) after liver transplantation in 160 cases. Suspected patients were further confirmed by immediate angiography. Four cases of HAT were diagnosed and treated by intra-arterial thrombolysis. Two cases received repeatable transcatheter hepatic arterial thrombolysis with a low dose of urokinase. Results Hepatic artery recanalization was achieved in 3 cases. Among the 3 cases, multiple HAT occurred in 1 case, intra-arterial thrombolysis was successfully completed in the end. Two cases had intra-abdominal hemorrhage, which was cured by conservative treatment. One case received retransplantation because of interventional thrombolysis failure and intra-abdominal hemorrhage. Conclusion Intra-arterial thrombolytic therapy may be a promising method in the treatment of HAT. Transcatheter hepatic arterial thrombolysis shows a significant result.

Objective To establish a rat model of sepsis induced by muramyl dipeptide (MDP) after scald burn.Methods Fifty SPF male Sprague-Dawley rats,aged 2-3 months,weighing 200-250 g,were randomly divided into 3 groups:control group (group C,n =10),scald group (group S,n =10) and MDP group (n =30).The rats were subjected to a third-degree scald burn covering 20% of total body surface area in groups S and MDP.The rats were only exposed to 20 ℃ water in group C.MDP 5 mg/kg was injected via the femoral vein at 24 h after scald bum in group MDP.Arterial blood samples were collected at 1,6 and 24 h after MDP injection in group MDP,at 24 h after scald burn in group S,or at 24 h after exposure to 20 ℃ water in group C for blood gas analysis and for measurement of white blood cell (WBC) and platelet (Plt) counts,serum aminotransferase (ALT),aspartate transferase (AST),total bilirubin (TB),creatinine (Cr) and blood urea nitrogen (BUN) levels,creatine kinase isoenzyme-MB (CK-MB) activity,and plasma tumor necrosis factor-α (TNF-α),interferon-γ(IFN-γ),interleukin-6 (IL-6),IL-10 and high mobility group box 1 protein (HMGB-1) levels.The rats were sacrificed after collecting blood samples,and heart,liver,lung,and kidney specimens were obtained for microscopic examination of pathologic changes.The activity of myeloperoxidase (MPO) in lung tissues was measured.Another 90 male Sprague-Dawley rats were randomly divided into 3 groups and treated as the method previously described for record of the survival rate within 72 h.Results Compared with C group,the plasma IL-6,IL-10,IFN-γ and HMGB1 levels,WBC count,serum ALT,AST,and BUN levels and MPO activity were significantly increased,and the survival rate within 72 h was decreased in S group,and the plasma TNF-α,IL-6,IL-10,IFN-γand HMGB-1 levels,serum ALT,AST,TB,BUN,Cr and CK-MB levels,MPO activity,PaCO2 and BE value were significantly increased,and WBC and PLT counts,pH value,PaO2 and survival rate within 72 h were decreased in MDP group (P ＜ 0.05).Compared with S group,the plasma TNF-α,IL-6,IFN-γ and HMGB-1 levels,serum ALT,AST,TB,BUN,Cr and CK-MB levels,MPO activity,PaCO2 and BE value were significantly increased,and WBC and Plt counts,pH value,PaO2 and survival rate within 72 h were decreased in MDP group (P ＜ 0.05).The pathologic changes of heart,liver,lung and kidney were obvious in S and MDP groups and severer in MDP group.Conclusion After a third-degree 20% total body surface area scald burn,MDP induces excessive production of inflammatory cytokines accompanying with multiple organ damage ; thus the model of sepsis is successfully established after scald burn in rats.

Objective To explore the evaluation methods of deodorants for patients with axillary odor. Methods Four trained judges used a blind method to evaluate 60 subjects directly or indirectly before and 6 hours and 24 hours after using deodorants. New T-shirts were provided for the subjects each time after grading. Then the judges evaluated the odor from the T-shirt as indirect axillary evaluation method. Then statistic analysis was used to compare the odor changes of axillary odor. Results The odors of axillary area were all decreased by two evaluation methods after using 3 different deodorants. But the efficacy of 3 deodorants were not completely same. Conclusion Direct axillary odor evaluation is a good method to evaluate the efficacy of deodorants.

Objective To investigate the risk factors associated with early mortality (within 30 days) of patients with spontaneously ruptured hepatocellular carcinoma (SRHCC) and assess the efficacies of different treatment regimens. Methods The clinical data of 28 patients with SRHCC who had been admitted to our hospital from January 1999 to January 2006 were retrospectively analyzed. Multiple factors that might cause early mortality were determined, and the efficacies of different treatment regimens were assessed. Results Eleven patients died within 30 days. with the mortality rate of 39%. Univariate analysis showed that shock, Child C status, hemoglobin. ALT, and volume of blood transfusion were associated with early mortality (X2=3.020, 13.741, Z=-2.059, -2.210, -4.153, P<0.05). Child C status and volume of blood transfusion were the independent risk factors. All the patients were divided into hepatectomy group (8 cases), surgical hemostasis group (7 cases), transarterial embolization group (7 cases) and conservative group (6 cases). Patients in hepatectomy group had a better 30-day and median time survival rate compared with those in the other 3 groups (X2=8.098, 8.098, 15.025, Z=-3.127, -2.840, -3.004, P<0.05). Conclusions Poor hepatic functional reserve and severe hemorrhage are closely associated with early mortality of patients with SRHCC. Hepatectomy is a better choice for SRHCC.

Objective To evaluate the effect of electro-acupunctare at Zusanli on liver injury in a rat model of sepsis after scald.Methods Fifty SPF male Sprague-Dawley rats,weighing 200-250 g,aged 2-3 months,were randomly divided into 5 groups (n =10 each) using a random number table:control group (group C); sepsis after scald group (group SS); electro-acupuncture at Zusanli group (group E); electric stimulation of non-acupoint group (group NE); electro-acupuncture at Zusanli + α-bungarotoxin (α-BGT) group (group α-BGT).The rats were subjected to a third degree scald covering 20％ of the total body surface area (TBSA) and sepsis was induced with muramyl dipeptide (MDP) 5 mg/kg injected into the femoral vein immediately after scald.Electro-stimulation (3 V,2 ms,3 Hz) of bilateral Zusanli acupoints or non-acupoints was performed for 12 min every 8 h for 2 consecutive days starting from the time point immediately after MDP was injected in group E.In group NE,electro-stimulation was performed at the points 5 mm lateral to the acupoints of bilateral Zusanli and the method was similar to those previously described in group E.In group α-BGT,α-BGT 1.0 μg/kg (in normal saline 1 ml) was injected into the femoral vein before electric stimulation,then electro-stimulation was performed and the method was similar to those previously described in group E.After 48 h of continuous stimulation,liver specimens were obtained for microscopic examination of the pathological changes.The blood samples were obtained from the abdominal aorta for determination of the levels of serum ALT and AST,tumor necrosis factor-alpha (TNF-α),and high mobility group box-1 (HMGB1) (by ELISA),and expression of Nod-like receptor 2 (NLR2) mRNA (by RTPCR) and receptor-interacting protein 2 (RIP2) in the liver tissues (by Western blot).Results The serum ALT and AST,TNF-α and HMGB-1 levels and NLR2 mRNA and RIP2 expression in liver tissues were significantly higher in SS group than in C group.Compared with SS group,the serum ALT,AST,TNF-α and HMGB1 levels were significantly decreased and NLR2 mRNA and RIP2 expression was down-regulated in E group,and no significant changes were found in the parameters mentioned above in NE group.Compared with E group,the serum ALT,AST,TNF-α and HMGB1 levels were significantly increased,and NLR2 mRNA and RIP2 expression was up-regulated in α-BGT group.The pathological changes in liver tissues were significantly reduced in group EA as compared with SS,NE and α-BGT groups.Conclusion Electro-acupuncture at Zusanli can reduce liver injury in a rat model of sepsis after scald and inhibition of NLR2/RIP2 signaling pathway and activation of cholinergic antiinflammatory pathway mediated by α7 nicotinic acetylcholine receptors in liver tissues may be involved in the mechanism.

Objective To evaluate the safety and feasibility of simple ligation and resection of the tumor involved inferior vena cava (IVC) without reconstruction during the resection of huge intraabdominal tumors.Methods From 2008 to 2011,4 cases of giant tumor encroaching on inferior vena cava underwent resection without IVC reconstruction.After resection,renal vein was not obstructed in patient 1 and 2.Tumor invaded the third patient's retrohepatic inferior vena cava,anastomosis was performed between the left hepatic vein and the opening of atrium dextrum with artificial vascular graft.The forth patient had right trisegmentectomy of the liver with retrohepatic inferior vena cava resection,anastomosis was performed between the left hepatic vein and the remaining inferior vena cava.Results All 4 patients had a successful operation without intraoperative massive bleeding and death.The postoperative complications included edema in one patient whose collateral circulation was damaged and bile leak in one.Ewin sarcoma patient died of tumor recurrence after a year,but there was no sign of poor renal function and other complications.Ligament fibroma patient had lower limb edema for a long time after the surgery,and tumor relapse for the fourth time in two years following resection.Conclusions When a giant tumor involving and invading IVC,undergoing resection,under the condition that the collateral circulations around IVC established completely,resection and ligation of the inferior vena cava along with huge tumor without IVC reconstruction is safe.This method saves operation time,increases the safety of surgery.

Objective To study the changes of the peripheral blood regulatory B cells and related cytokines in children patients with chronic idiopathic thrombocytopenic purpura (CITP),and to analyze their correlations with effective Th cells,and to discuss their roles in the pathogenesis of CITP.Methods The peripheral blood mononuclear cells (PBMC)were separated in 30 cases of CITP,then percentages of Th1 ,Th17,Th22 and Breg cells were detected by the flow cytometry(FCM).IFN-γ,IL-17,IL-22 and IL-10 levels in culture supernatant were measured by the ELISA method.Results Compared with the control group,the proportions of the peripheral blood Th1 ,Th17,Th22 subsets in CITP children were increased[(18.4±4.7)% vs.(10.82±4.4)%;(2.42±1.02 )% vs.(1 .23±0.42)%;(0.79±0.24)% vs.(0.26±0.11)%],the proportion of Breg cells was reduced significantly,the differ-ences had statistical significance[(0.83±0.21)% vs.(1 .89±0.12)%,P <0.05].In CITP children,the IFN-γ,IL-17,IL-22 levels in culture supernatant were higher than those in the control group[(278.2±121.2)pg/mL vs.(181.8 ±82.2)pg/mL;(214.8 ± 100.5)pg/mL vs.(161 .4±67.8)pg/mL;(122.16±22.2)pg/mL vs.(90.8±31.1)pg/mL],but the IL-10 level was lower than that in the healthy control group[(27.4±12.6)pg/mL vs.(46.1±16.2)pg/mL),differences between them had statistical signifi-cance(P <0.05).Besides,there was a positive correlation between the proportion of Breg cells and cytokine IL-10 level(r=0.617, P <0.05 ),however,there was a negative correlation between the proportion of Breg cells with Th1 ,Th17 and Th22 cells (P <0.05),between IL-10 level with IFN-γ,IL-17 and IL-22 levels(P <0.05).Conclusion The downregulation of Breg cells proportion may participate in the immune disorder mechanism of effective Th cells in CITP children,which can provide a new idea for the im-munoregulation therapy in CITP children.

Objective To study the characteristics of hepatic artery anatomy and master the method of arterial repair,especially the method and technology of repair of anomalous donor arteries.Methods Sixty-four(human) liver arteries were dissected and repaired,and 31 of these were used in liver transplantation.Results Twelve of 64 cases had anatomical anomaly of hepatic artery(12/64,18.75%).Five of 24 fetal(liver) donors(20.83%) had anatomical anomaly of hepatic artery,one arose from the superior mesentery(artery) as a replaced right hepatic artery,3 from accessory right hepatic artery,and in 1 case the hepatic(artery) arose from superior mesentery artery directly.Seven adults had hepatic artery anomalies:2 cases of right hepatic artery being replaced by artery derived from SMA,2 cases of left hepatic artery deriving from left gastric artery and 3 cases of accessory right hepatic artery derived from SMA.In 31 hepatic(transplantations),4 grafts with anatomical anomaly of right hepatic artery were used.Conclusions (Reconstruction) of hepatic artery plays an important role in hepatic transplantation.Avoidance of injury to(aberrant) hepatic avteries during removal of donor liver is a key to ensure successful arterial repair.During(repair) of very small accessory hepatic arteries,ligation or repair of the artery may be determined after(observation) of backflow from collateral vessels.