Objective To explore the changes of several sero-enzyme activity including lactate dehydrogenase (LDH),aspartate aminotransferase(AST),alanine aminotransferase (ALT),creeatine phosphatase kinase (CPK) and its isoenzyme (CK-MB),?-hdroxybutyrate dehydrogenase (HBDH) in patients with chronic cor disease and its clinical significance. Methods The sera LDH,AST,ALT,CPK,CPK-MB and HBDH from 15 healthy controls and 61 patients with chronic cor disease were examined before and after treatment.CPK-MB/CPK and HBDH/LDH were calculated and simultaneously the blood gas analysis was performed. Results In experimental group all the sera enzymes contents before treatment were significantly higher than those after treatment (P

Objective To investigate the prevention and management of portal vein thrombosis following orthotopic liver transplantation.Methods Between May 1995 to September 2005,clinical data of 137 cases subject to orthotopic liver transplantation were analyzed.Among them,there were 10 cases of portal vein thrombosis(5 cases in gradeⅠ,4 cases in gradeⅡand 1 case in gradeⅢ). All patients received an eversion thromboendovenectomy(ETEV)with occlusion of the portal flow u- sing a Forgarty balloon.Ligation of the collateral circulation,especially spontaneous or surgical sple- norenal shunt,was made as approaches to improve portal flow.Heparin or low-molecule-weight hepa- rin as a prophylactic anticoagulation therapy was maintained during and after operation if prothrombin time was less than 18 s.Follow-up Doppler ultrasonography was used daily in the early postoperative period.Results After a follow-up of 2～66 months,overall incidence of portal vein thrombosis was 2.92%(4/137).Surgical thrombectomy and revascularization was carried out in 1 case.Thromboly- sis,balloon angioplasty and stent placement via hepatic artery were performed on 2 cases.No treat- ment was given in 1 patient without hepatic dysfunction and portal hypertention.Mortality related to portal vein thrombosis was 0.Conclusions Portal vein thrombosis might be avoided by performing a complete thrombectomy as often as possible,by ligation of portosystemic shunt during surgery,and by postoperative anticoagulation.Close follow-up by Doppler ultrasonography may make a prompt di- agnosis and reduce portal vein thrombosis-derived loss of grafts.

BACKGROUND: Bone tissue engineering materials/call complex has been able to live in the muscle, subcutanecus tissue, ano other heterotopic bones, or in small mammals to repair bone defect. However, there is still much practical and clinical gap, such as bone tissue engineering and technical ability to repair large bone defects in big mammals, as well as how to promote the in vivo tissue-angineerad bone revascularization process.OBJECTIVE: To observe the bone formation using beagle deep fascia pedicled flap and tissue-engineered bone.METHODS: Beagle bone marrow mesenchymal stem calls were isolated, cultured, and inoculated on poly-lactone (PCL).Bone/bone membrane defect was induced in middle tibia on the left side of beagle. Then, the defect was implanted with fascia-encapsulated bone marrow mesenchymal stem cells (BMSCs), considering as experimental group. The second defect was induced in the middle tibia on the right side of beagle and implanted with BMSCs/PCL, considering as control group. The third defect was induced in 2 additional beagles without any implantation, considering as blank control group. Gross observation, X-ray test, histology, and magnetic resonance perfusion imaging were performed on the models to observe growth and ostecblasts andvasculadzation. RESULTS AND CONCLUSION: There was no new bone formation and blood vessels growth in the blank control group, and the defect was filled by fiber scar tissues finally. After 8-16 weeks, the bone defect was gradually filled by bony tissue, and more calluses which grew in implants were observed. The broken ends of fractured bone were not intact, and pulp cavity was sclerotic.Bone formation in the experimental group was rapid than in the control group. After 6 weeks, a great quantity of calluses was observed; after 8 weeks, stant materials were completely degraded; after 12 weeks, bone defect was succassfully repaired. A greet quantity of cancallated bones was observed, the newborn cavitas medullaris was smooth, and cortical bone was successive and stable. The amount, pore diameter, and distribution of formed blood vessels in the experimental group were superior to those in the control group, suggesting that tissue-engineered bone was able to effectively and rapidly repair bone defect in some animal.Fascia flap could promote the revascularization in vivo of tissue-engineered bone.

Objective To detect the quantity of Th17 cells and expressions of related cytokines including interleukin (IL)-17 and IL-22, in peripheral blood and skin lesions of patients with psoriasis vulgaris, and to analyze their correlation with disease severity and clinical course. Methods Peripheral blood was obtained from 44 patients with progressive psoriasis vulgaris and 28 normal human controls. Three-color flow cytometry was carried out to detect the quantity of Th17 cells, and ELISA to examine the levels of serum IL-17 and -22.Skin samples were obtained from 20 patients with psoriasis vulgaris and 8 normal human controls, and a quantum dot-based double labled immumofluorescence method was used to determine the quantity of Th17 cells.Results The percentage of peripheral blood Th17 cells was higher in patients with psoriasis vulgaris than in normal human controls (4.71% ± 2.55% vs. 0.55% ± 0.39%, P ＜ 0.01 ). Elevated expressions of IL-17 and IL-22 were noted in the patients compared with the normal human controls (24.02 ± 12.31 ng/L vs. 7.16 ±4.04 ng/L, P ＜ 0.05; 18.32 ± 8.14 ng/L vs. 6.52 ± 4.15 ng/L, P ＜ 0.01 ). The percentage of peripheral blood Th17 cells and serum levels of IL-17 and IL-22 were positively correlated with psoriasis area and severity index (r= 0.53, 0.47, 0.53, respectively, all P ＜ 0.01 ), but unrelated to the clinical course of psoriasis (r = 0.09,0.03, 0.19, respectively, all P ＞ 0.05). There was an infiltrate of Th17 cells in psoriatic lesions, which was mainly distributed around the blood vessels in superficial dermis, whereas there were only a small number of CD4+ T cells in the normal control skin with the absence of Th17 cells. Conclusions Th17 cells are involved in the development of psoriasis, and Th17 cell-secreted cytokines, such as IL-17 and IL-22, may serve as a new therapeutic target for psoriasis.

Objective To explore the patterns and features of biological effects of ?-ray irradiation combined with microwave on the mouse hematopoietic system, and to provide theoretical and experimental basis for understanding the possible mechanism of the bone marrow injury caused by the combined action of microwave and ?-ray irradiation. Methods 216 healthy KM mice were randomly divided into the following four groups: normal control, microwave (S frequency range, 50mW/cm~2), ?-ray irradiation (5.5Gy), microwave combined ?-ray radiation (5.5Gy + 50mW/cm~2). They were sacrificed at 6h, 1, 3, 7, 14, 28, 90 and 180 days after radiation, respectively, then the histological and ultrastructural changes in the bone marrow and the peripheral hemogram were observed. Results Histopathological changes: the bone marrow appeared to be obviously injured either by radiation or microwave exposure, characterized by undergoing four phases, namely apoptosis-necrosis, void, regeneration and recovery phase. However, the pathological changes were more obvious and the recovery was slower in microwave combined ?-ray radiation group. Peripheral hemogram: the numbers of leucocytes, erythrocytes and platelets, and the content of hemoglobin decreased in both ?-ray irradiation group and microwave combined ?-ray radiation group, and the decrease in microwave combined radiation group was more remarkable. Ultrastructure: the bone marrow hematopoietic cells underwent obvious degeneration, apoptosis and necrosis in microwave combined ?-ray radiation group especially at 6 hours after radiation. Conclusion ?-ray combined with microwave could induce hematopoietic dysfunction and pathomorphological changes in hematopoietic organ, which were mainly caused by ?-ray, and the changes were aggravated.

Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy (TTAS) for the treatment of the peripheral stage ⅠA non small cell lung cancer(NSCLC).Methods The study involved 50 consecutive patients undergoing totally thoracoscopic anatomic segmentectomy (TTAS) from September 2010 to November 2012 in the First People's Hospital affiliatied to Nanjing Medical University.The diameter of the tumors were less than 2 cm [(mean diameter(1.35 ±0.48) cm].All lymph node sampling of N1 and N2 were neglive,All patients received symtematic lymph node dissection.The pulmonary vessels were individually ligated,and the bronchi were closed using an endoscopic stapler.The intersegmental plane was identified using the demarcation between the resected(inflated) and preserved(collapsed) lungs.Staplers were used for intersegmental dissection.Results The mean operative time and intraoperative bleeding were (191.5 ± 50.4) min and (49.2 ± 54.6) ml respectively.The chest tube drainage duration was (3 ± 1) days.The number of stapler cartridges used for intersegmental division was 3.9 ±0.8.The mean number of lymph nodes and nodal stations dissected were 12.6 ± 2.8 and 6.0 ± 1.5 respectively.No mortality and complications were observed 30 days after the surgery.Further,no local recurrence or metastases were observed during follow-up.Conclusion Totally thoracoscopic anatomic segmentectomy(TTAS) is a feasible and safe technique.With systematic lymph node dissection,TTAS can be a reasonable therapeutic option for stage ⅠA NSCLC.

Objective To explore the images and diagnostic evaluation of X-ray combined with ultrasound in paralytic intestinal obstruction caused by antipsychotic agents. Methods The data of X-ray and ultrasound of 124 cases of clinically diagnosed paralytic intestinal obstruction caused by antipsychotic agents were analyzed retrospectively, as well as their rates of confirmed diagnosis. All the 124 patients were examined by erect abdominal radiography and fluoroscopy,68 of the 124 patients by ultrasound. Results According to their typical images,the rate of X-ray confirmed diagnosis was 87.9%(109/124) with 15 missed diagnosis and the rate of missed diagnosis was 12.1%( 15/124);the rate of ultrasound confirmed diagnosis was 82.4%(56/68) with 12 missed diagnosis and the rate of missed diagnosis was 17.6%(12/68). There was no significant difference between X-ray and ultrasound (P＞ 0.05 ). Compared with X-ray or ultrasound ,X-ray combined with ultrasound in the diagnosis of paralytic intestinal obstruction could increase the rate of confirmed diagnosis (100.0% ,68/68),and decrease the rate of missed diagnosis (0),the difference was statistically significant (P＜ 0.05 ). Conclusions X-ray examination is the first choice to diagnose paralytic intestinal obstruction caused by antipsychotic agents,but ultrasound has the advantage of finding fluid in abdominal cavity. To reduce missed diagnosis, X-ray should be combined with ultrasound.

Objective To study the comprehensive therapeutic effect of interventional embolization chemotherapy in advanced cervical cancer. Methods 136 patients with advanced cervical cancer were selected as research object,and they were randomly divided into control group(radiotherapy group) 68 cases and observation group(interventional embolization chemotherapy group) 68 cases,then the total effective rate,incidence of adverse reactions,secondary operation rate and serum CA125 ,SCC and CY211 of two groups before and after the treatment were analyzed and compared. Results The total effective rate( 83. 8% vs 66. 2% ) and secondary operation rate(89.7% vs 48.5% )of observation group was higher than that of control group, incidence of adverse reactions (63.2% vs73.5 % ) was lower than that of control group,serum CA125 [(37. 89 ± 16. 78) vs(52. 36 ± 16. 98) U/ml], SCC[(0. 68 ± 0. 42) vs (1.52±0.36)μg/L]and CY211[(4.86 ±2.21)vs(8.45 ±2.85)ng/L]were all lower than those of control group. ( P ＜0.05 or P ＜0.01) , there were significant differences. Conclusion The comprehensive therapeutic effect of interventional embolization chemotherapy in advanced cervical cancer was better,and it was one of effective methods in advanced cervical cancer.

A 51-year-old man presented with multiple, disseminated dark erythematous maculopapules and nodules over the body surface for more than 1 year. Initially, the patient presented with dark erythematous macules on the trunk without discomfort. Then, lesions gradually spread over the whole body surface with the development of tenderness. Physical examination revealed multiple disseminated dark erythematous, well-demarcated maculopapules, infiltrative plaques and subcutaneous nodules on the face, neck, trunk, upper and lower limbs. Some lesions were tender on palpation. An enlarged cherry-like lymph node was detected on the right inguina. Bone marrow inspiration showed that lymphocytes amounted to 32.5%, and naive lymphocytes accounted for 10%. These lymphocytes varied in size with irregular shape, moderate amount of basophilic cytoplasm, irregular nuclei and granular chromatin. Histopathological examination revealed diffuse infiltrate of numerous medium-sized atypical blastic cells with irregular nuclei in superficial dermis and subcutaneous fat tissue. The blastic cells showed sparse fine-granular chromatin, obscure nucleoli and obvious karyokinesis. Immunophenotype examination showed that tumor cells were strongly positive for CD4, CD56 and CD43, weakly positive for CD68 and terminal deoxynucleotidyl transferase, but negative for L26, CD3, CD38, granzyme B and myeloperoxidase. The diagnosis of BPDCN is confirmed based on typical clinical features, histopathology and immunohistology findings.

Objective To investigate the prevalence and clinical characteristics of Sj?gren′s syndrome-interstitial lung disease (SS-ILD). Methods 136 patients with SS were studied. Anti-SSA and Anti-SSB antibodies were measured by Western blot. The inpatients had chest X ray, chest HRCT and pulmonary function examined. Results ①pSS-ILD patients with postive anti-SSA antibody were proned to have interstitial lung disease and the ILD were more severe. ②HRCT showed that sSS-ILD were more severe than that of pSS-ILD. ③Lung capacity of pSS-ILD decreased more frequently than sSS-ILD. sSS-ILD mainly had venti-latory function abnormalities. The lung function impairment of both were dominated by small airways dysfunction and decrease of TLCO. Conclusion SS patients should be examined by HRCT and lung function tests should be performed in the course of the disease to find out and treat ILD.