BACKGROUND:Biliary complications after liver transplantation can cause liver graft dysfunction. Ultrasound examination is one of important diagnostic methods of biliary complications after liver transplantation.
OBJECTIVE:To investigate the value of ultrasound in the diagnosis of biliary complications after liver transplantation.
METHODS:A total of 92 patients after liver transplantation, including 81 males, 11 females, aged 21-67 years;al ogenic orthotopic liver transplantation in 90 cases, partial living liver transplantation in 2 cases. Biliary reconstruction methods were end-to-end biliary anastomosis. Routine examination after liver transplantation and color Doppler ultrasound results were retrospectively analyzed. The inspection focused on whether common bile duct and intrahepatic bile duct had biliary leakage, biliary stenosis, biliary sludge or biliary calculus. Some patients underwent puncture and drainage under ultrasonographic guidance.
RESULTS AND CONCLUSION:In al the 92 patients, 14 cases were diagnosed ultrasonical y as biliary complications, including 5 cases of biliary leakage, 4 cases of biliary stenosis (2 cases of stomal stenosis and 2 cases of non-stomal stenosis), 4 cases of biliary sludge, and 1 case of biliary calculus. This study demonstrated that ultrasound characteristics could be easily recognized in liver transplantation patients with biliary complications. Ultrasound has very important clinical value in diagnosis of the biliary complications after liver transplantation.

Objective To determine chest ultrasound locating treatment of paraelectronic effusion by medical thoracoscopy.Methods We chose 40 Xinxiang center hospital patients in respiratory wards from June 2012 to June 2014,who was randomly divided into two teams,one was electron-assisted Thoracoscopic surgery,the other was thoracic cavity closed drainage combination of intrapleural injection of urokinase.It was 3rd reviewed by chest ultrasound,we evaluated curative effection ac cording to the drainage effect,we statisticsed two draining days and total inpatient days,and total hospital costs.The results two teams were compared between gender,age,nutritional status,effusion volume (length x width x depth),pleural effusion conventional,biochemical,lactate dehydrogenase,adenosine deaminase,carcinoembryonic antigen,the difference was not statistically significant (P ＞ 0.05).Pleural fluid culture results were negative.Medical thoracoscopy treatment group hospitalization days,drainage time was significantly shorter than the thoracic drainage combined with pleural urokinase group,The same was the cost of hospitalization.Medical thoracoscopy poor drainage treatment group was significantly lower than the thoracic drainage combined with pleural urokinase group (P ＜ 0.05).Conclusion To the middle-large number encapsulated paraelectronic effusion,chest ultrasound locating treatment by medical thoracoscopy early can reduce the formation of empyema,reduce the formation of pleural fiberboard.It is a safe,effective and worthy of promotion treatment.

Objective To explore the effect of Shen-Fu injection(SFI,参附注射液) on expressions of heme oxygenase-1(HO-1) and inducible nitric oxide synthase(iNOS) in renal failure induced by intestinal ischemia-reperfusion injury(IRI) in rats and its possible mechanism in the protection of kidney.Methods The model of intestinal IRI was induced by clamping superior mesenteric artery(SMA) for 1 hour and then releasing the arterial clamp for 6 hours.Thirty-six male Wistar rats were randomly divided into three groups: IRI model group,SFI pretreatment group and sham operation group.In the SFI pretreatment group,10 ml/kg of SFI was pumped in at constant rate 30 minutes before the ischemia,the SMA was clumped for 1 hour and then released,while in the IRI model group,an equal volume of normal saline was pumped in continuously 30 minutes before the ischemia.The serum creatinine(SCr) and blood urea nitrogen(BUN) were observed respectively.Expressions and distributions of HO-1 and iNOS in the rat kidney tissue were detected by immunohistochemitry and morphometry computer image analysis.The histological changes of kidney were observed under light microscope.Results The expressions of HO-1 and iNOS were markedly higher,and the levels of SCr and BUN were also significantly higher in intestinal IRI model group than those in the sham operation group(all P

The article mainly introduces the teaching content and teaching methods of medical ethics education for international students according to the investigation of their basic information,culture background,and learning background in Tianjin Medical University and Tianjin TCM University,and sets up a perfect teaching system with the international standard in order to realize internationalization of medical education.

BACKGROUND: At present, many problems deserve to be solved before clinical utilization of adipose tissue-derived mesenchymal stem cells (ADMSCs) such as complete differentiation from ADMSCs into cardiomyocytes and ADMSCs with or without specific function of cardiomyocytes. It is of significance to solve the problems including how to elevate the differentiation rate of ADMSCs into cardiomyocytes and how to elevate the homing and survival rate after transplantation for clinical utilization of stem cells.OBJECTIVE: To observe the differentiation of ADMSCs into cardiomyocytes after in vitro culture and induction.DESIGN: Randomized controlled observation.SETTING: Laboratory of Cardiology, General Hospital of Chinese PLA.MATERIALS: Adipose tissue was collected from abdominal operative patients at Department of General Surgery of General Hospital of Chinese PLA with the agreement of patients. Iscove's Modified Dulbecco's Medium (IMDM), type Ⅰ collagenase, 5-azacytidine (5-aza) and polyclonal antibody of specific anti-myocardial Troponin T (TnT) were purchased from Hyclon company, Gibco company, Sigma and Fujian Maixin Biotechnology Company, respectively.Monoclone antibodies of CD44, CD45, CD34, HLA2DR and factor-Ⅷ, Desmin, anti-α-striated muscle actin and anti-myosin heavy chain (MHC) were bought from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation. DAB stain, reverse transcription-polymerase chain reaction (RT-PCR) kit and atrial natriuretic peptide (ANP) radioimmunity kit were purchased from Beijing Zhongshan Golden Bridge Biotechnology Limited Corporation,Invitrogen and Radioimmunity Research Institute of Science and Technology Development Center of General Hospital of Chinese PLA, respectively.METHODS: The experiment was performed at the Laboratory of Cardiology, General Hospital of Chinese PLA from March 2005 to April 2006. ADMSCs were isolated and cultured by digestion and attachment culture method. The third generation of cells were determined by immunocytochemical method for surface molecule CD44, CD13, CD105, CD45,CD34, HLA-DR, factor Ⅷ and induced by addition of 5-aza into culture medium. On the 7th, 14th, 21st and 28th days, gene of GATA4 and Nkx2.5 were tested by reverse transcription-polymerase chain reaction (RT-PCR), and the concentration of atrial natriuretic polypeptide (ANP) were also examined by radioimmunoassay.MAIN OUTCOME MEASURES: Determination of cell surface marker, gene of GATA4 and Nkx2.5, and ANP concentration.and factor Ⅷ negative for the cultured cells. After induction for 7 days with 5-aza, no cells expressed Desmin,α-Sarcomeric Actin, Myocin heavy chain (MHC) and TnT, most cells were positive stained for CD44. After induction for 14 days, small amounts of cells displayed positive for Desmin,α-Sarcomeric Actin and MHC but still negative for TnT,while partial cells expressed positive CD44. After induction for 21 days, most cells were positive for Desmin,α-Sarcomeric after induction and no significant difference was found compared with that at the 7th day [(0.022±0.01) ng/L (P＞0.05].ANP concentration was respectively (7.92±0.21) and (8.12±0.50) ng/L at the 21st day and the 28th day (P＞0.05), but there was significant difference compared with that at the 7th day (P＜0.05).

Objective To investigate the protective effect of N-acetylcysteine(NAC) on the development of myocardial hypertrophy in diabetic rats induced by streptozotocin. Methods Male SD rats were randomly divided into normal control (NC), control treatment (NCT), diabetic (DM) and diabetes treatment (DMT) groups. NAC was administered at dose of 1.4～1.5g·kg~(-1)·d~(-1) to NCT and DMT groups in the drinking water for 8 weeks. At termination the rats were surgically prepared for hemodynamic measurement, such as systolic blood pressure, heart rate, the rate of left ventricle relaxation (-dp/dt) and the time to maximum relaxation (T). Subsequently, the hearts were removed to assay relative ratio of left ventricle weight versus body weight (LVW/BW) and cardiomyocyte cross sectional areas.Plasma glucose, insulin, 15-F_(2t)-isoprostane(15-F_(2t)-Isop) concentration and superoxide dismutase (SOD) activity were analyzed. Results The LVW/BW ratio and cardiomyocyte areas were significantly attenuated by NAC treatment as compared to DM group (P＜ 0.05). Increases in -dp/dt and SOD activity and the decreases in glucose, 15-F_(2t)-Isop T (P＜ 0.05) were found at the same time. Conclusions NAC can effectively prevent the development of myocardial hypertrophy and improve diastolic function in diabetic rats, which may be related to its antioxidant capacity.

Immunohisto-chemical S-P method was used to examine the expression of E-cadherin,Vimentin and TGF-β1 in 54 cases oral carcinoma and 10 cases of normal oral mucosa.The positive rates of the expression of E-cadherin,Vimentin and TGF-β1 were 55.6%, 33.33% and 59.3%,respectively in oral carcinoma group(vs normal oral mucosa,P <0.05).The expression of TGF-β1 was correlated with lymph node metastasis,and showed significant positive correlation with Vimentin.Epithelial-mesenchymal transition may promote inva-sion and metastasis of oral carcinoma,and TGF-β1 promotes EMT.

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

ObjectiveTo explore the characteristics of left ventricular myocardial function after percutaneous coronary intervention (PCI) in patients with angina pectoris of single-vessel and.multiple-vessel coronary artery disease with two-dimensional strain (2DS).MethodsTotally 63 patients with angina pectoris were divided to single-vessel coronary artery group (n=33) and multiple-vessel coronary artery group (n= 30) based on coronary angiography,and 30 healthy volunteers were enrolled as control group.The two-dimensional images were obtained before and 3 months after PCI,and two-dimensional radial strain was analyzed on GE Echo PAC system.Peak radial strain values of left ventricular basal plane,papillary muscle plane and apical plane during systole were measured.ResultsCompared to control group,left ventricular peak systolic radial strain values decreased in many segments in patients with single-vessel coronary artery group and multiple-vessel coronary artery group before and 3 months after PCI (P＜0.05).Totally 136 and 158 left ventricular ischemic segments attained to normal 3 months after PCI in single-vessel coronary artery group (136/185,73.51％) and multiplevessel coronary artery group (158/292,54.11％),respectively (P＜0.01).ConclusionThe improvements of peak systolic radial strain are significantly different between angina pectoris patients with single-vessel and multiple-vessels coronary artery disease after PCI.

BACKGROUND: Reperfusion injury and inadequate perfusion exist,causing the injury of intestinal mucosa during shock / resuscitation.OBJECTIVE: To investigate protective effect of shenfu injection (SFI) in equal dosage for human effect on intestinal mucosal pH (PHi) of sigmoid colon, the contents of nitric oxide (NO), malonialdehyde(MDA) and Ca2+ of intestinal mucosa, activity of serum diamine oxidase(DAO of rabbits during shock/resuscitation.DESIGN:A randomized controlled trial with experimental animals as the subjects.SETTING: DepartmentofAnesthesiology, Renmin Hospital of Wuhan University MATERIALS: The experiment was performed in the Research Institute of Anesthesiology, Renmin Hospital of Wuhan University from August to October in 2003. Twenty-four adult healthy white rabbits were randomly divided into 3 groups with 8 animals for each: Shenfu injection group (SFI group), shock/resuscitation group and control group .INTERVENTIONS: Hemorrhagic shock was induced by blood withdrawal from femoral artery at a rate of 2 mL/kg per minute until MAP dropped to 40 mmHg. MAP was maintained at this level for 60 minutes,then the collected auto-blood and the same volume of balanced salt solution was transfused to the animal for preparing shock/resuscitation model. In SFI group: the animals were given 2.1 mL/kg SFI together with the auto-blood transfusion and followed by a continuous infusion of 5mL/kg SFI per hour.MAIN OUTCOME MEASURES: Intestinal mucosal pH (PHi) of sigmoid colon, NO, MDA and Ca2+ contents of intestinal mucosa, activity of serum DAO were detected before shock (So), 1 hour after shock (S1), 1 hour (R1) and 3 hour (R3) following resuscitation.the R1 reperfusion (7.171±0.102) , and R3 reperfusion (7.194±0.106) of the SFI group were higher than those of the shock/ resuscitation group (6.920±0.155,6.971±0.165,P ＜ 0.05,P ＜ 0.01) and those of the contents of the reperfusion R1 (35.090±1.184) μkat/L and R3 (32.440±2.884) μkat/L of the SFI groups were significantly higher than those of the shock/resuscitation group [(50.994±2.684),(52.377±1.217) μkat/L,P＜ 0.01] and of the control group [(15.970±1.734), (16.620±0.767)μkat/L,Pgroup were significantly lower than those in the shock/resuscitation group [ (61.8±5.3,72.2±5.8 ) μmol/g , (68.2±4.9,96.9±8.5) μmol/L ,P＜ 0.05]. Ca2+ content of intestinal mucosa at reperfusion 3 hours in the SFI group [(2.43±0.27)μmol/L] was lower than that in the shock/resuscitation group [(2.93±0.34)μmol/L,P ＜ 0.05] and higher than that in the control group [(2.26±0.31 )μmol/L, (P ＜ 0.05)].CONCLUSION: SFI in equal dosage for human effect could protect intestinal mucosa from shock/resuscitation injury through improving perfusion and oxygenation, inhibit the activity of NO, reduce oxygen free radical and calcium overload, with a good protective effect on intestinal mucosa during shock/resuscitation.