Objective To assess the efficacy of extensive esophagogastric devascularization with splenectomy for surgical treatment of portal hypertension complicating cirrhosis of liver, and to explore the pathogenesis of chronic congestive splenomegaly. Methods A retrospective analysis of clinical data of 232 patients of portal hypertension complicating cirrhosis of liver having undergone extensive esophagogastric devascularization with splenectomy was made. Pathological alterations and extracellular matrix productive cells of the congestive splenomegaly were studied both immunohistochemically and histologically. Results The functional markers including the numbers of PLT, WBC, and PTA in the peripheral blood and serum Alb were significantly improved after the operation compared with that of before the operation. Careful pre-operation preparation, replenishment of blood loss during the operation, postoperative drainage of the splenic bed, and prevention of complications were efficiently carried out. The mean volume of CCS spleens was 1 423.67?738.69cm 3. There was an obvious increase in the numbers of vimentin-, ?-SMA-positive cells in the CCS tissues, as well as CD68-positive macrophages. Conclusions The results indicated that extensive esophagogastric devascularization with splenectomy was a reasonably effective alternative therapy for patients with portal hypertension complicated by esophageal varices and congestive splenomegaly. Adequate replacement of blood lost in prevention of operation and postoperative complications were essential for satisfactory recovery of the petient. The activation of macrophagic system, with proliferation of fibroblasts and myofibroblasts, might participate in the pathogenesis of congestive splenomegaly.

Objective To search some references for estimating the time of death in some murder cases by observation the dynamic changes of organic amines derived from isolated human hepatic tissues. Method The contents of histamines, putrescines, cadaverines and undecomposed amino acids from the isolated human hepatic ussues were assayed dynamically by the method of high performance liquid chromatography (HPLC). Results The contents of the organic amines produced by the putrefaction under 8℃,15℃ , 23℃ and 32℃ were increased along with the time elapsed after death under four environmental temperatures before attaining to their peak value, While the contents of the undecomposed amino acids were decreased gradually after death. Conclusion The amount of organic amines produced by putrefaction of the isolated human hepatic tissues were directly related to the time of death. So do the environmental temperature.

Objective To compare the accuracy of cone-beam computed tomography (CBCT ) and periapical radiography in the diagnosis of simulated external apical root resorption (EARR) .Methods The study sample comprised 160 single-rooted premolars for simulating 4 degrees of EARR :no(intact teeth) ,mild(cavity of 1 .0 mm in diameter and depth in root surface) ,moderate(1 .0 mm root shortening) ,and severe(3 .0 mm root shortening) .Two sets of radiographic images were acquired with CBCT and periapi-cal radiography .The severity for all resorption lesions were evaluated blindly by one calibrated examiner .The percentages of correct classification of each degree of EARR were compared between the two imaging techniques using McNemar test .Results With CBCT method ,the percentages of correct classification of no ,mild ,moderate ,severe and all EARR were 95 .0% ,97 .5% ,42 .5% , 87 .5% and 80 .6% ,respectively ;with periapical radiography method ,the percentages were 85 .0% ,42 .5% ,70 .0% ,92 .5% and 72 .5% ,respectively .Significant differences were found between the two imaging techniques for evaluating mild ,moderate ,and all-EARR(P<0 .05) .Conclusion CBCT imaging is more reliable than periapical radiography for detecting EARR ,whereas it is not sensitive to moderate root shortening .In orthodontic practices ,CBCT could be applied to the early diagnosis of EARR ,in order to help make the decision on continuation and modification of orthodontic treatment .

Objective To compare the serum cytokines and high-sensitive C-reactive protein (hs-CRP) in the post-stroke depression(PSD) and depression patients,and further study of the pathogenesis PSD and depression.Methods The levels of serum IL-1β,IL-6 and TNF-α in the PSD group(n=30),the depression group(n=30),the post-stroke non-depression group(n=30)and normal control group(n=30)were measured with enzymatic-linked immunosorbent assay(ELISA),and the levels of serum hs-CRP were measured by scatter rate nephelometryat for these four groups.Results The levels of serum IL-1β,IL-6,TNF-α and hs-CRP in the PSD group,the depression group,the the post-stroke non-depression group and the normal control group were respectively((137.23 ±8.12) pg/ml,(34.12±3.12) pg/ml,(64.62±6.11) pg/ml,(15.36±6.25) mg/L) ; ((133.21 ±7.56) pg/ml,(33.56±2.65) pg/ml,(62.95±5.66) pg/ml,(4.02± 1.21) mg/L) ; ((43.25 ±6.23) pg/ml,(16.12±2.60) pg/ml,(32.23±7.12) pg/ml,(14.88±7.23) mg/L) ; ((42.12±5.78) pg/ml,(15.32±3.23) pg/ml,(31.55±6.70) pg/ml,(3.68± 1.11)mg/L).The levels of serum IL-1β,IL-6 and TNF-αt in the PSD group and the depression group increased significantly than those in the the post-stroke non-depression group and the normal control group(P＜0.01).The levels of serum hs-CRP:PSD group ＞ post-stroke non-depression group ＞ depression group ＞ normal control group(P＜0.05).Conclusion The PSD and depression may have the same immune mechanism.

Objective To investigate the sequences of the 3' end of genomes from enterovirus 71 isolated from pediatric patients with different symptoms in Beijing during 2008-2009.Methods Clinical specimens were collected from pediatric patients suffering from hand,foot and mouth disease(HFMD)and/or with neurological complications who visited the affiliated Children's Hospital during the epidemic seasons of 2008 and 2009 in Beijing.The samples were inoculated into the Vero cell line,and the virus isolates were further identified by nested reverse transcription-nested PCR(RT-nPCR)assay using universal enterovirus primers,type specific primers for EV71 and CA16.The 3' end of genomes(including 3D and 3' UTR regions)from 10 EV71 strains derived from various clinical presentations were amplified and sequenced.Results Analysis of the nucleotide sequences of the amplified fragments showed that the 3' end of genomes of 10 EV71 isolates include the 3D region of 1386 nucleotides(nt)encoding the 3D polymerase(3Dpol,462 amino acids),the terminator codon TGA and 3' UTR of 81 nt.Nucleotide sequence identities among 3D regions from these 10 EV71 isolates were in the range of 95.8%-99.6%,while the nucleotide sequence identities for 3' UTR were 96.3%-100%.The majority of nucleotide changes were located at the third codon positions which caused silent mutations,thus the amino acid sequence changes of 3Dpol among those 10 EV71isolates were scanty.The residues 140 and 263 which were R and 1 were substituted by K and V,respectively in 3 of 4 neurovirulent strains,whereas only 1 of 6 strains from mild cases had these 2 amino acid changes.The sequences of the 3D and 3' UTR regions of 10 EV71 isolates were compared to the representative strains of known genotypes from the GenBank.The nucleotide and amino acid sequences of 10 EV71 isolates in the 3D region exhibited highest homology to the subgenotype C4 of EV71(92.7%-94.2%and 96.8%-97.6%.respectively).However,3' UTR of 10 EV71 isolates shared the highest nucleotide identity with CA16/G10(88.9%-91.4%).The phylogenetic analysis based on the 3D regions demonstrated that 10 EV71 isolates had the closest genetic relationship with the representative isolate of CA sub-genotype of EV71 and shared more homology with CA16/G10 than other known genotypes of EV71.Conclusion Genetic analysis of the 3' end of genomes from 10 EV71 strains indicated that the 3' end of genome may play a role in the evolution of EV71.

Objective To evaluate the treatment effect of negative pressure wound therapy ( NPWT) followed by ultrasonic debridement surgical system ( UDSS) in patients with diabetic foot. Methods Forty-seven diabetic foot ulcer patients( WagnerⅡ~Ⅲ) were divided into two groups,of which 26 patients treated with UDSS combined NPWT,and 21 patients treated with traditional surgical debridement combined NPWT were control group. Cure rate, markedly effective rate and adverse reaction and complication were compared between two groups. Results Compared with control group,the experiment group had higher markedly effective rate in the first week(P<0. 05),and healing rates were higher in the 2th,4th,6th,12th weeks (P<0. 05). There were no differences in the adverse reactions and complications between the two groups. Conclusion UDSS combined with NPWT can accelerate wound cure,may play an important role for the treatment of diabetic foot ulcer.

Objective To evaluate the clinical effect and safety of percutaneous closure of patent foramen ovalein treatment of migraine.Methods We studied 23 patients with migraine who were tested positive in Contrast Transcranial Doppler (TCDc) at the Department of Neurology in Bethune First Hospital of Jilin University between 2010 May and 2011 November.Procedures of transcatheterclosure of patent foramen ovale were performed at Department of Cardiovascular Surgery.At varied time points post-surgery,the patients were re-examined by TCDc and transthoracic echocardiograph (TTE) and followed up by phone interviewed with Headache Impact Test-6 (HIT-6) questionnaire to elevate improvement of migraine.The data was analyzed statistically.Results Percutaneous closure was successful in all patients without major long-term side-effects.At follow-ups at 48-542 days ((247 ± 145) days) post-surgery,the scores of HIT-6 were reduced to 38-70 (51 ± 9),compared to the pre-operative scores of 42-76 (61 ± 8).Disability by migraine had significantly improved (t =4.80,P ＜ 0.05).In 6 patients with migraine with aura,the scores of HIT-6 were reduced to 46-56 (51 ± 3),from preoperative scores of 63-76 (69 ± 4) and their disability affected by migraine had significantly improved (t =6.80,P ＜0.05).In 17 patients with migraine without aura,the scores of HIT-6 after surgery were reduced to 36-70 (52-10) from the preoperative scores of 42-69 (60 ± 8) and disability affected by migraine in this group had significantly improved (t =3.77,P ＜0.05).Among 18 patients having MRI or CT examination before the operation,8 patients had neurological events (such as cerebral infarction,cerebral ischemia) with average age of (44 ± 7) years old.In this group,disability affected by migraine had significantly improved (the HIT-6 scores:49 ± 7 vs 58 ± 10,t =2.49,P ＜ 0.05).Conclusion Percutaneous closure of PFO showed significant improvement in migraine treatment and it is a safe procedure.

Objective To explore the predictive values of the levels of blood lipids ,liver function and estrogen for the fetal dis‐tress in intrahepatic cholestasis of pregnancy (ICP) patients .Methods The indicators of blood lipids ,liver function and estrogen of mild IPC group ,severe ICP group and control group were detected respectively ,and the results were analyzed .Results The levels of triglycerides ,total cholesterol and low‐density lipoprotein were positively related to estradiol levels .Multivariate logistic regres‐sion analysis showed that cholyglycine (OR=8 .24 ,P=0 .01) and estradiol(OR=4 .46 ,P=0 .02) were significant for prediction of fetal distress in ICP patients .Conclusion Estradiol and cholyglycine levels may be better indicators for the prediction of fetal dis‐tress in ICP patients .

Objective To evaluate the accuracy and feasibility of time-resolved immunofluorometric assay (TRI FA) for detection of HBsAg based on Abbott automated chemiluminescence immunoassay(CMIA),so as to carry out this project in primary hospitals,and provide reference for individual antiviral strategy and prediction of therapeutic effect.Methods Serum of 157 patients infected with hepatitis B virus were detected with CMIA and TRIFA,specimens with HBsAg titers exceeding the detection limit were firstly diluted,then performed quantitative analysis.HBsAg levels were divided into 4 groups:≤100 IU/mL,101-1 000 IU/mL,1 001-20 000 IU/mL,and ＞ 20 000 IU/mL,quantitative correlation between two methods was analyzed.Results The linear regression equation of two methods was Y=2.323X-896.3,correlation coefficent r=0.943,P＜0.001.CMIA was as a reference,4 groups were divided for analysis,results showed that when detected specimens was at low concentration of HBsAg,TRIFA value was low compared with CMIA method,while detected specimens was at high concentration of HB sAg,CMIA value was high,two reagents had good consistency in the detection of different concentrations of HBsAg(both P＜0.05),when concentration was at 1 001-20 000 IU/mL,consistency was the best.Conclusion The accuracy of two reagents in the quantitative detection of HBsAg is similar,and the best correlation of detection value is 1 000-20 000 IU/mL.TRIFA assay has wide application for its low-cost and easy to be operated,which is especially suitable for primary hospitals.

The elasticity of the ascending aorta in healthy volunteers and hypertension patients were examined by using quantitative tissue velocity imaging (QTVI), and the age-related change in the ascending aortic elasticity was investigated. The anterior and posterior walls of the ascending aorta were imaged with tissue Doppler method in all the subjects and QTVI was performed. Stable curves were obtained from 173 hypertension patients and 185 healthy adults. The peak early diastolic velocity (V(e)), peak late diastolic velocity (V(a)) and peak systolic velocity (V(s)) were measured. The relation of age with these measures was assessed. The results showed that the elasticity of the ascending aorta was much lower in the hypertension patients than in normal controls (P<0.05), and the elasticity was decreased with age in both groups (P<0.05). Our results suggested that QTVI, a new non-invasive ultrasonic technique, is helpful for the assessment of the aortic elasticity in hypertension patients.