Objective To investigate the epidemiology and drug resistance associated with fungal infection during early postoperative period after liver transplantation in the purpose of prevention and treatment.Methods A total of 118 cases of liver transplantation admitted from April 2004 to January 2009 in Nanfang Hospital were studied retrospectively,and the fungal infection and drug resistance were identified.Results Fungal infections occurred in 26 cases (22.0%).Totally there were 49 fungi strains isolated,of which mainly Candida albicans (57.1%),followed by Aspergillus (18.4%),Smooth Candida (10.2%),Candida tropicalis (6.1%),Candida parapsilosis (4.1%),and Candida krusei (4.1%).The sensitive rate of voriconazole,itraconazole,amphotericin B,5-fluorouracil,fluconazole were 92.0%,90.0%,75.5%,73.5%,and 55.1% respectively.Conclusion Because of the change of fungi strains and the increase of drug resistance,it’s important to identify the fungi and drug resistance for the purpose of prophylaxis and treatments.

Ultrasound can be used to visually evaluate brain structure, estimate intracranial pressure, and identify the function of cerebrovascular autoregulation and the reactivity of cerebrovascular carbon dioxide.It can also be used in the diagnosis of cerebral vasospasm and systemic circulation evaluation.Critical care ultrasound can help clinicians identify the primary injury of neurological system, prevent and effectively manage the secondary injury through bedside, real-time, non-invasive evaluation and monitoring.It can guide the implementation and evaluate the curative effect of brain protection algorithm.

Objective To discuss the relationship between IL-13R?2 and the tumorigenesis and progression of gliomas. Methods Expression level of IL-13R?2 mRNA was studied by Reverse Transcription-Polymerase Chain Reaction(RT-PCR) in 20 cases of glioma and 5 cases of normal brain tissue. Results There was no expression of IL-13R?2 mRNA in all cases of normal brain tissue, wherea 13 of 20 gliomas expressed IL-13R?2.There were specially significant difference between them(P0.05) between low grade gliomas and high grade gliomas, there was greatly significant difference(P

Objective To investigate the diagnosis and treatment of the posterior fossa solid hemangioblastomas (PFSHs).Methods The data of 23 patients with PFSHs verified by surgery and pathology were analyzed retrospectively.Results Nineteen cases were diagnosed with PFSHs before surgery.Total tumor removal was achieved in 22 patients.No case died of operation.A follow-up time was 0.33 -9.00 (2.96 ±2.73) years,20 patients returned to work,1 patient had self-handling living,and 2 patients died.Conclusions MRI and digital subtraction angiography are major preoperatively diagnostic modalities for PFSHs.PFSHs is still a kind of challenging neoplasms.Applicating special microsurgical technique and improving the operative manipulation can improve the surgical efficacy.

Objective To investigate the effect of ultrasound-guided serratus plane block onefficacy of postoperative analgesia in patients undergoing radical mastectomy. Methods From January 2013 to December 2016, sixty-eight ASA physical statusⅠorⅡ patients scheduled for radical mastectomy under general anesthesia were randomly divided into two groups (n = 34 each): SP block group (observation group) and control group. After induction of anesthesia, ultrasound-guided homolateral SP block was performed, and 0.375% ropivacaine 20 ml was injected in observation group, while the equal volume of normal saline was used instead in control group. The patients received patient-controlled intravenous analgesia (PCIA) with sufentanil after operation in two groups. The scores of prince henry pain scale (PHPS) were evaluated at the 2nd, 4th, 8th, 12th and 24th hour (T1, T2, T3, T4, T5) after operation. The consumption of sufentanil, propofol and remifentanil was recorded.Meantime, the times of successfully delivered doses (D1) and attempts (D2) within 24 h after operation were added up, and D1/D2 was calculated. The adverse effects were also recorded. Results The scores of PHPS at T1 [(1.4 ± 0.5) scores vs. (3.1 ± 0.6) scores], T2 [(1.5 ± 0.6) scores vs. (2.9 ± 0.8) scores], T3 [(1.7 ± 0.5) scores vs. (2.8 ± 0.7) scores], and the consumption of sufentanil [(53.4 ± 16.7)μg vs. (87.8 ± 24.5)μg], remifentanil[(288.7 ± 42.1)μg vs. (376.5 ± 61.6)μg] were significantly lower in observation group than those in control group, while D1/D2 (0.89 ± 0.12 vs. 0.57 ± 0.18) was higher (P<0.05). The incidence of adverse reactions was significantly lower in observation group: 0 vs. 20.6% (7/34), P<0.05. Conclusions Ultrasound-guided SP block reduces the perioperative opioids consumption and enhances the efficacy of postoperative analgesia in patients undergoing radical mastectomy.

Objective To discuss the different contrast injection rate on the 64 -slice spiral CT scan liver arterial phase reinforced effect.Methods 60 patients who received abdominal CT scan were selected from January 2014 to April 2015.According to the different conditions,they were divided into control group (30 cases)and liver cirrhosis group (30 cases).Then each group based on packet injection rate into 2.5 mL/s (control group 1,cirrhosis group 1)and 3.5 mL/s (control group 2,cirrhosis group 2).Select Smartprep technology contrast agent tracking all patients,when the abdominal aorta CT value ≥150 HU start scanning.The departure time,CT value of each group were recorded,abdominal aortic artery,simultaneous analysis of each component of image quality comparison.Results When the contrast agent injection rate of 3.5 mL/s,excellent rate of the control group (95.5%)compared with the contrast injection rate of 2.5 mL/s (91.7%)had no significant difference (χ2 =0.021,P =0.638);The cirrhosis good rate (94.7%)compared with the contrast agent injection rate of 2.5ml/s (72.7%)had obvious advantages, the difference was statistically significant (χ2 =5.233,P =0.032).When the contrast agent injection rate of 2.5mL/s, cirrhosis abdominal aorta average peak enhancement [(187.25 ±21.00)HU]and the control group [(195.35 ± 19.00)HU]had no significant difference (t =0.826,P =0.436).The average trigger time of the control group (21.68 ±1.93)s was significantly less than the cirrhosis group (25.13 ±2.13)s,the difference was statistically significant (t =2.064,P =0.047).When the contrast agent injection rate of 3.5 mL/s,the control group,the mean abdominal aortic peak enhancement [(247.82 ±39.00)HU]was significantly greater than the cirrhosis group [(223.81 ±35.00)HU],the difference was statistically significant (t =2.652,P =0.037).The average trigger time of the control group (18.62 ±1.36)s was significantly less than the cirrhosis group (24.57 ±0.92)s,the difference was statistically significant (t =3.362,P =0.033).Conclusion The greater the contrast injection rate,arterial peak at the same time it increases the peak time come to shorten.When the contrast agent injection rate consistent with the control group,the average trigger time is short,high average peak enhancement.Cirrhosis needs higher contrast injec-tion rate.

Objective To observe the effect of FTY720 on the expressions of Bel-2 and Bax protein and explore the neuroproteetive effect of FTY720 on neuron after acute spinal cord injury in the rats.Methods A total of 75 SD rats were divided randomly into three groups,ie,the test group(treated with FTY720),the injury group(treated with normal saline)and the control group.The test and injury groups were impacted to create T10 spinal cord injury(SCI)by Allen's method.Both the mRNA and protein expressions of Bcl-2 and Bax in the injured spinal cord section were studied respectively with hematoxylin and eosin(HE)staining,immunohistochemical examination and reverse transcription polymerase chain reaction(RT-PCR)technique at different time points(at6 h,12 h,24 h,3 d and 7 d). Results The expressions of Bcl-2 and Bax in the test group and the injury group were higher than that in the control group at all time points.Meanwhile,at 12 h,24 h,3 d and 7 d,the mRNA and protein expressions of Bcl-2 in the test group were significantly higher than that in the injury group(P<0.05),while the mRNA and protein expressions of Bax in the test group were obviously lower than that in the injury group (P<0.05). Condusion Early administration of FTY720(0.5 mg/kg)after spinal cord injmy Canincrease the mRNA and protein expressions of Bcl-2,decrease the expression of Bax and inhibit neuron apoptosis in the injured spinal cord.

Objective To investigate the value of plasma miR-22 in diagnosis of idiopathic pulmonary arterial hypertension ( IPAH ),and its role of regulation mechanisms in the pathogenesis of the disease.Methods Circulating miR-22 levels of IPAH patients and healthy controls were evaluated by RTPCR.The silico analysis of targets for miR-22 was taken, and followed by eGFP reporter assay for verification of predicted target gene Myc binding protein (MYCBP). Results Compared with healthy controls,the expression of plasma miR-22 in IPAH patients was significantly decreased (P ＜ 0.01 ).The area under curve (AUC) of ROC curve was 0.744.MYCBP was a real target of miR-22 confirmed by silico analysis and eGFP reporter assay. Conclusions The expression of plasma miR-22 was significantly decreased in IPAH patients,and it could serve as a potential biomarker for diagnosis.The miR-22 might be involved in the pathogenesis of the disease through promoting its target gene MYCBP to activate the c-Myc pathway.

Objective To investigate the risk factors associated with gastroparesis syndrome after laparoscopic pancreatoduodenectomy which provide reference for clinical prevention.Methods Ninety cases of laparoscopic pancreatoduodenectomy admitted from August 2013 to December 2016 in Traditional Chinese Medicine Hospital of Guangdong Province were studied retrospectively,57 were male(63.3%),the average age was 54.6 years old.Twenty cases were diagnosed postoparative gastroparesis syndrome(22.2%).To screen out the risk factors,31 independent variables were analyzed by univariate analysis and logistic regression.Results Univariate analysis showed that malnutrition,hypoproteinemia,anemia,pylorus-preserving,extensive lymph nodes dissection,anxiety,high blood sugar before operation,delay of enteral nutrition,abdominal infection and postoperative high blood sugar were associated with postoperative gastroparesis(The value of OR were 3.143,3.587,2.852,2.889,3.231,7.071,2.889,5.359,6.000,6.263,P<0.05).Multivariate Logistic regression analysis showed that extensive lymph nodes dissection,anxiety,pylorus-preserving,abdominal infection,delay of enteral nutrition,hypoproteinemia,postoperative high blood sugar were risk factors of postoperative gastroparesis(The value of OR were 17.574,8.931,6.637,6.461,6.446,5.414,5.200;P<0.05).Conclusion Multiple risk factors can lead to gastroparesis after laparoscopic pancreatoduodenectomy,measures should be taken aimed at these risk factors during perioperative period.

Objective At present, there is no study on effect of levetiracetam(LEV) on the gray matter structure remodeling in benign epilepsy children with central temporal spikes(BECTS).The purpose of this study was to study the influence of LEV on the gray matter structure in BECTS and to evaluate the mechanism of LEV on the brain structure of BECTS through using voxel-based MRI morphological(VBM) methods.Methods From January 2014 to September 2016, twenty-four BECTS treated with LEV(LEV group), twenty-four drug-na?ve BECTS(untreated group) and twenty-four normal children(normal group) consulted in department of Neurology, Nanjing Children′s Hospital and the Nanjing Military Region, Nanjing General Hospital were continuously included to receive three-dimensional T1-weighted imaging with 3T MRI and the gray matter volume was calculated by VBM.We compared the difference of grey matter volumes of the three groups and analyzed their correlation with epilepsy duration, age of onset and medication time and other clinical index.Results Compared with the normal group, the grey matter volume of bilateral thalamus were decreased, and the volume of bilateral Rolandic areas, anterior insula/frontal operculum/frontal triangle, left supplementary motor area, paracentral lobule, precentral gyrus, superior frontal gyrus and right middle frontal gyrus were increased in the untreated group, but the grey matter volume of the bilateral Rolandic areas, frontal operculum and left supplementary motor area were decreased in the LEV group.Compared with the untreated group, the grey matter volume of bilateral supplementary motor, left paracentral lobule, precentral gyrus, bilateral anterior insula/frontal operculum/frontal triangle, left superior frontal gyrus and right middle frontal gyrus in the LEV group were decreased.The grey matter volume of left anterior insula/frontal operculum areas was negatively correlated with the medication time in LEV group(r=-0.527, P<0.01).Conclusion T The mainly representations of BECTS are thalamic gray matter damage and epileptic-related cortical area irritation structural abnormalities, but the LEV could reshape the epilepsy-related cortical area and the gray matter in the brain area associated with clinical symptoms.