Objective To investigate whether the spleen diameter,serum albumin and periphefial blood cells might be as non-invasive predictive indicators for the presence of esophageal varices(EV)in patients with liver cirrhosis.The predictive values of these parameters to the large esophageal varices were evaluated.Methods OBe hundred and sixty-seven patients with liver cirrhosis underwent endoscopic examination.Among them,127 patients(mild in 41,medium in 38,severe in 48)were found with EV and 40 patients without(NEV).The diameters of portal vein and spleen vein,the sizes of spleen and the ratio of platelet count/spleen size were examined by Doppler ultrasound.The platelet count and the level of albumin were calculated.Results The average of age,diameter of portal vein and spleen vein,and sizes of spleen were higher in EV group than those in NEV group,while the platelet count,the level of albumin and the ratio of platelet count/spleen size in EV groups were lower than those in NEV group.Multifactor analysis revealed that the index related to serious EV were the blood platelet count(＜70×109/L),the ratio of platelet count/spleen size(＜1.0)and albumin level (＜35 g/L).Conclusions The degree of EV in patients with liver cirrhosis were paralleled with the degree of portal hypertension.The patients who present with platelet count＜70×109/L,or platelet count/spleen size＜1.0 or albumin＜35 g/L should be considered as EV,and endoscopic examination is needed.

Objective To compare the rates of clearance of different solutes during continuous veno-venous haemodiafiltration (CVVHDF) between pre-dilution and post-dilution.Methods A study in vitro was carried out using model CRRT system with AN69 filter used,which was applied to perform CVVHDF for solutes clearance.The removed amounts of different solutes including potassium ion (K +),creatinine (Cr),vancomycin,insulin,and interleukin-6 (IL-6) were determined in the groups of control (without dilution),pre-dilution and post-dilution during CVVHDF at the same substitution fluid amount.Each group was repeated 4 times (n =4).Results Post-dilution mode increased K +,Cr,vancomycin and insulin clearances significantly.There was no difference in clearance of IL-6 between the pre-and post-dilution groups.In the control group,insulin and IL-6 levels were decreased extremely.Conclusions In general,the rate of clearance using post-dilution of CVVHDF is higher than that using pre-dilution.Among high molecular weight solutes,the difference in clearance is not significant.The control group demonstrates insulin and IL-6 adsorbed by the filter.

Objective To study the distribution of hemodynamics in carotid artery under the fluid-solid interaction at the typical point of time during a single cardiac cycle, and to explore the mechanism of the formation and development of carotid atherosclerotic plaque. Methods Numerical analysis the blood flow characteristics within a cardiac cycle in carotid artery was analyzed by using computational method of fluid dynamics. Based on the hemodynamic parameters, the influences of the cardiac systole and diastole on the blood flow distribution were analyzed. Results The distribution of blood flow in the carotid artery within a typical cardiac cycle was obtained. Compared with the findings in cardiac diastole, a larger area of blood stasis at the entrance of external carotid artery was observed. In this area, the flow velocity, the wall pressure and the wall shear stress were all lower, while the arterial wall deformation and von Mises equivalent stress were larger. Conclusion Under fluid-solid interaction, the low blood flow in carotid artery causes blood reflux, resulting in the deposition of lipid, fiber and other large molecular materials. The low wall pressure produced“negative pressure” effect, thus the normal blood flow is changed, the flow velocity becomes slow, and the blood supply of the brain becomes insufficient. The low wall shear stress destroys the blood flow near the wall, causing the increase of platelet activity and intimal hyperplasia. The larger arterial wall deformation variable and von Mises equivalent stress can cause stress concentration and increase vascular rupture risk.

Twenty adult male rats, weighing 200～300 g were divided into 3 groups: (1) Six. animals were stimulated through two electrodes fixed on the tail to produce somatic pain.(2) Six animals were stimulated by increasing pressure in the stomach through an air balloon to cause visceral pain. And 8 animals served as control.All the animals were sacrificed and their neurohypophysis were fixed in 4％ glutaraldehyde and 1％ OsO_4 successively. Their section were cut with an LKB microtome and observed under H 500 electron microscope.The experimental results summarized as follows:1. The bodies of pituicytes under the pain stimulation were hypertrophied. The rough endoplasmic reticulum, polyribosomes and mitochondria were increased. The Golgi complex was well developed. There were numerous elliptical vesicles appearing in the cytoplasm of pituicytes.2. The number of large lipid masses was increased while the processes of pituicytes engulfed the degenerative neurosecretory terminal into them and the pituicyte digted it finally.3. Neurosecretory granules were decreased but the synaptic small vesicles were increased in the dilated parts of neurosecretory fibers after the pain stimulation.4. The continuous network of perivascular space and interstitial space between the dilated parts of neurosecretory fibers were widened.

Pain just tolerable was caused intermittently by electric stimulation on rat's tail or by distented baloon in stomach for 30 min. The changes of intermediate lobe are summarized as follows: (1) The cell body, nucleus or nucleolus was hypertrophied. The number of rough endoplasmic reticulum, particularly of its vesicular cisternae was increased. Golgi complex enlarged. The ribosome multiplied. All of these change indicated that the activity of cells was increased and the rate of synthesis enhanced. (2) Both the secretory granules shifted to the periphery of cell body and some of them showed pale density. These changes were interpreted as increase of seretory activity. (3) The mitochondria became enlarged and the crsitae in them were changed into tubular form. This suggested an acceleration of cell metabolism, which might provide a large amount of energy. (4) There was no degenerative change. (5) The cytological changes caused by visceral pain were simillar with, but more striking than, those caused by somatic pain. (6) The secretions were increased, among which ?-endorphin and ACTH etc were known to be closely related to analgesia.

Our experiments were designed to observe the cytological changes of the anterior lobes in rats pituitary at electron microscopic level after electric pain-stimulation. obvious changes were founded in the ACTH, GH and PRL cells and slight changes in the FSH and TSH cells. However, the LH cells remained to resemble the normal cells. In the experiment group of the somatic painful stimulation the results were as follows: The ACTH cells were irregularly shaped, with extended thin and long plasmatic processes which interdigitated with GH cells. The processes filled with secretory granules. Some of the Secretory granules aligning along the plasmatic membrane showed pale density. The flat cisternae of rough endoplasmic reticulum (RER) appeared to be slightly dilated. The sizes of the bodies of GH and PRL cells increased. In the GH cells there were numera media cisternae in RER, their Golgi complex was well developed, and the secretory granules were distributed to the periphery of the cell bodies. All these phenomenous showed the secretory activity of these cells was enhanced. The PRL cells contained well developed Golgi complex and abundant RER. In the experiment group of the visceral painful stimulation the results were as follows: There were more striking changes of parenchymal cells of anterior lobes in rats pituitary than those of the experimental group of the somatic painful stimulation. The cell bodies of ACTH, GH and PRL cells showed hypertrophy, the nucleus enlarged and nucleolus were relatively prominent. The dense granules decreased in number and the pale or empty visicles almost situated near the plasmic membrane in ACTH cells. In the GH cells large vacuoles were distributed throughout the cytoplasma. The number and density of the secretory granules decreased. In PRL cells the Golgi complex were extended, the dictyosomes increased, in addition, RER, polyribosomes and mitochandria were more aboundant than that in these normal cells. These cytological changes suggested secretory and synthetic activity of these cells were enhanced. At last, pain in relation to several hormones such as ?-endorphin, ?-LPH, ACTH and ?-MSH etc. were discussed by the author.

The purpose of this research work is to study the influence of experimentally produced pain on the uhrastructural changes of the nerve endings of the neurosecretory fibers from hypothalamus to neurohypophysis.Twenty adult male rats, weighing 200～300 g were divided into 3 groups: (1) Six animals were stimulated through two electrodes fixed on the tail to produce somatic pain. (2) Six animals were stimulated by increasing pressure in the stomach through an air balloon to cause visceral pain. And 8 animals served as control.All the animals were sacrificed and their neurohypophysis were fixed in 40％ glutaraldehyde and 1％ OsO_4 successively. Sections were cut with an LKB microtome and observed under H500 electron microscope.The following conclusions were drawn from the observed results:1. The neurosecretory granules in the fibers from hypothalamus to neurohypophysis grew up to maturity by increasing in size gradually as they passing down from hypothalamus to neurohypophysis.2. Basing on the morphological exhibition of the neurosecretory granules, we get the impression that the neurosecretion might be released either by molecular dispersion or by exocytosis.3. There were a great number of discrete smooth vesicles grouped in cluster in the dilated parts of neurosecretory fibers. These vesicles had been called as "synaptic" or "synaptoid" vesicles. They might be really synaptic vesicles and containing acetylcholine. Other vesicles with irregular profile and varying in size, collapsing vesicles and vacuoles might be the residues of the neurosecretory granules after discharging their content.4. Many synaptic vesicles were concentrated at the axolemma of the dilated parts of neurosecretory fibers and the membranes were thickened and leaving a synaptic cleft.5. In the exprimental groups after pain stimulation the neurosecretory granules decreased in number and the synaptoid vesicles increased in number and the neurosecretory granules showed a wide pale halo. The number of irregular vesicles and ghost of granules were increased. This phenomenon might show that the excretion of neurosecretory material and neurotransmitters was enhanced.6. Neurohemal zones were the barrier for the neurosecretory material entering into blood. Acetylcholine, endogenous opiatelike substances and gamma-aminobutyric acid (GABA) might play a control role for neurosecretion at this site.7. This experimental results supported the action mechanism of endogenous opaitelike substance and morphine could produce an important role directly in neurohypophysis.

Objective To study the two-phase flow dynamics distribution and red blood cell distribution under the fluid-solid coupling interaction in left coronary artery at the typical time point within one cardiac cycle,and to investigate the formation and development mechanisms of left coronary artery atherosclerotic plaque Methods The blood was regarded as a two-phase fluid.Based on fluid-solid interaction between blood and vascular wall,the computational fluid dynamics method was used to make the transient numerical simulation of two-phase flow in the left coronary artery under fluid-solid interaction;the distribution of blood flow in the left coronary artery at the typical time point within one cardiac cycle was studied,the relationship between hemodynamic parameters and the formation of atherosclerotic plaque was analyzed.Results A lowspeed eddy zone existed in an area between the distal segment of circumferential branch and the proximal outside of blunt-edge branch of the left coronary artery,where both internal wall shear stress and red blood cell volume fraction were very small and the blood flow pattern was very complicated.Conclusion At the lowspeed eddy zone that carries small wall shear stress,the lipid concentration polarization and macromolecular material deposition are easy to be produced.The area that has less red blood cells is liable to develop hypoxia,resulting in increased vascular wall permeability and intimal injury,which will activate the immune system,causing lipid accumulation in vascular wall and intimal hyperplasia and,thus,to induce the formation of atherosclerotic plaque.(J Intervent Radiol,2017,26:253-257)

Objective To study the protective mechanism of adenosine on intestinal barrier function in acute hemorragic necrotizing pancreatitis (AHNP) pigs; Methods Twelve small pigs were equally devided into two groups randomly after the AHNP model sitted up: (1) AHNP controll group (group A) and adenosine treated group (group B). The intestinal blood flow, intestinal permeability, bacterial culture and endotoxin in portal blood were compared between the two groups in pre and post AHNP. Results (1)The intestinal blood flow was dramatically decreased in group A, and much higher in group B than that in group A at the 8 h, 24 hour and day 7 after ANHP model was setted up (P0.001,P

Objective To evaluate the short-term efficacy of lamivudine versus entecavir for patients with HBeAg-negative acute-on-chronic liver failure (ACLF) with different pretreatment liver failure degrees.MethodsA total of patients with HBeAg-negative ACLF were enrolled into this retrospective study.Seventy-two cases were treated with lamivudine 100 mg daily,while 93 cases were treated with entecavir 0.5 mg daily.Biochemical items,model for end-stage liver disease (MELD)score,hepatitis B virus (HBV) DNA level and mortality were observed.The efficacies of the two drugs were analyzed in patients with different degrees of liver failure.The comparison of rates was done using chi-square test and the measurement data were compared by t test.ResultsAmong the patients with pretreatment MELD scores above 30,the post-treatment HBV DNA levels in lamivudine group and entecavir group were (3.6 ± 1.1) lg copy/mL and (3.7 ± 1.4) lg copy/mL,respectively (t=0.181,P=0.859) and the mortalities were 92.0％ and 91.8％,respectively (χ2 =0.002,P=0.680).For the patients with pretreatment MELD scores from 23 to 30,the post-treatment HBV DNA levels in two groups were (3.2± 1.1) lg copy/mL and (3.2±2.3) lg copy/mL,respectively (t=0.760,P=0.455) and the mortalities were 42.9％,54.1％,respectively (χ2 =0.799,P=0.455).In patients with pretreatment MELD scores below 23,the post-treatment HBV DNA levels in two groups were (3.1±1.0) lg copy/mL and (2.8±1.5) lg copy/mL,respectively (t=-0.740,P=0.464) and the mortalities were 3/19 and 6.3％,respectively (χ2=1.227,P=0.455).In lamivudine group,the mortalities were significantly different among patients with three different ranges of pretreatment MELD scores (χ2 =26.967,P =0.000).The similar differences were also found in entecavir group (χ2 =41.260,P=0.000).ConclusionsAmong treatment na?ve patients with HBeAg-negative ACLF,the short-term efficacy of lamivudine versus entecavir is equal if the degree of pretreatment liver failure is similar.Meanwhile,the degrees of pretreatment liver failure significantly affects the outcome of the treatment.