Objective To investigate the diagnostic and therapeutic methods for liver injury.Methods The clinical data of 80 patients with liver injury were retrospectively analyzed.Results The liver injury was srede Ⅰ in 12 patients.grade Ⅱ in 25 patients,grade Ⅲ in 20 patients,srede Ⅳ in 14 patients,and grade V in 9 cases.16 patients were not treated with operation,24 patients were treated with hepatic artery ligation,and 3 patients were treated with plugging.75 patients were cured,and 5 patients died.Conclusion Liver injury should be clearly diagnosed as early as possible,correct therapeutic methods should be selected according to the state of the injury,and operative manner should be reasonably selected according to intraoperative conditions.The treatment of complications and postoperative protection to the function of important organs should be paid attention to.

Objective To explore the clinical effect of two-points approach vascular stenting technique (via both the femoral artery and posterior tibial artery of the affected side) in repairing blunt popliteal artery injuries.Methods The clinical data of eleven patients with blunt popliteal arterial injuries,who were treated with two-points approach vascular stenting technique during the period from March 2011 to March 2015 as single-approach stenting repair failed,were retrospectively analyzed.First,antegrade puncture of the femoral artery on the affected side with subsequent angiography was performed to evaluate the arterial injury,when the attempt to push the guide-wire to pass the injured arterial segment by twisting manipulation failed the puncture of posterior tibial artery was immediately carried out,then,a 4-French single-bend catheter together with a goose neck snare was inserted.Guide-wire capture technique was used to gasp the guide-wire in the injured artery segment,and then the guide-wire was pulled to pass through the injured artery segment.In this way,the guide-wire working circle was reliably established,and along the guide-wire the vascular stent was inserted and delivered to the right site to repair the injured artery.A 6-French guiding catheter was inserted to perform thrombus aspiration for eliminating the distal outflow obstruction caused by thrombus.Thrombolytic therapy with small dose of urokinase through a indwelling catheter was employed for the treatment of peripheral arterial thrombosis.Results The technical success rate was 100％.Angiography revealed that partial transection of artery was detected in 7 patients,and complete transection of artery in 4 patients.A total of 16 stents were implanted.No perioperative mortality or procedure-related complication occurred.All patients were followed up for 13-24 months,with a mean of (18.7±3.8) months.In-stent thrombosis occurred in 2 patients,which was treated with thrombolytic therapy and the blood flow recovered;severe in-stent stenosis (＞70％) was seen in 3 patients,in whom the blood flow returned to normal after balloon dilation therapy;mild in-stent stenosis (＜30％) was found in 6 patients,and no special treatment was given.During the follow-up period,no stent fracture,deformation,or displacement was seen,and no patient needed to have an amputation surgery.Conclusion In treating blunt popliteal artery injuries,two-points approach vascular stenting technique can effectively reduce the operation time,rapidly recover the blood flow of the injured popliteal artery,and shorten the time of limb ischemia.This technique has very satisfactory clinical shortterm effect.

Objective To study effects and other related problems of surgery for patients with cervical spine fracture and ankylosing spondylitis.Methods Twelve patients with cervical spine fracture and ankylosing spondylitis were treated with surgery from April 1986 to April 2004.All eases were studied retrospectively.They were followed up for an average of 67.5 months and their complete clinical data were kept.The neurological function was evaluated by ASIA (American Spinal Injury Association) impairment scale,and the image analyzing software (Image-Pro Plus 5.1) was used to measure the angles of superior and inferior vertebral bodies of the fusion segment at flexion and extension positions.The difference between flexion and extension angles,?,served as the parameter of interspinal movement.According to the definition of spinal fusion by FDA (Food and Drug Administration),the?≥4?was considered as nonfusion.Other related problems were discussed by descriptive study.Results The average improvement in the nine patients with neurological injury was 1.3 ASIA grades.The injured segments in 10 cases were treated with fusion,of whom nine were fused by internal fixation.The fusion rate was 100%.Three cases were scheduled to have laminoplasty,but two had to receive laminectomy instead because of intraoperative complete fracture at the hinged side.Ten patients were complicated by insufficient function of major organs preop- eratively,and endotracheal intubation was difficult to perform in eight cases.Postoperative complications occurred in three cases,but fortunately healed completely.There were no deaths or fatal complications.Conclusions The neurological function can be improved by surgery for patients with cervical spine fracture and ankylosing spondylitis. Although the cervical spine is instable for most of the patients,fusion with internal fixation is indicated and can be successful.Those who had preoperative systemic diseases are likely to suffer from postoperative complications.The difficult endotracheal intubation is a common intraoperative problem.

Objective To identify the typical imaging features of steatocystoma multiplex on mammography.Methods Mammographic findings in 9 patients with clinical and pathological diagnosis of steatocystoma multiplex were analyzed along with a review of the current literature.Results Four of the nine patients with steatocystoma multiplex had a positive family history.Nine patients showed multiple,round,thin-walled fatty,radiolucent nodules with well-defined margin.These nodules are located in the superficial layer of the axilla bilaterally.They are also seen on the skin of breast(7 cases),the anterior chest wall (4 cases) and the upper arm (3 cases).Conclusion Recognition of the characteristic mammographic features of Steatocystoma multiplex is important in the management of these patients.

BACKGROUND: Cell apoptosis and ventricle reconstitution following myocardial infarction are of mutual cause-effect, and they cause vicious cycle. How to reduce the apoptosis events following myocardial infarction is one of keys to saving heart function.OBJECTIVE: To observe the effect of umbilical cord blood mesenchymal stem cell (UCBSMC) transplantation on remaining myocardial tissue of dogs with acute myocardial infarction.DESIGN: A randomized controlled observation.SETTING: Department of Cardiothoracic Surgery, Xinhua Hospital.MATERIALS: This study was carried out in the Central Laboratory of Xinhua Hospital from October 2005 to May 2007.Thirty-six adult hybrid dogs, male and female in half, were provided by the Animal Experimental Center of Xinhua Hospital.METHODS: Thirty-six dogs were divided into cell transplantation group and control group, with 18 dogs in each according to table of random digit. Mesenchymal stem cells were isolated from the umbilical cord blood of full-term pregnant hybrid dogs, cultured and amplified. Then, they were labeled with Laz gene, in vitro induced with 5-azacytidine, and transplanted into the dogs with acute myocardial infarction in the cell transplantation group. Rats in the control group were injected with the same amount of normal saline. Each dog was euthanized by anesthesia for harvesting myocardial specimen 1,4 and 8 weeks after transplantation.MAIN OUTCOME MEASURES: ① Remaining and apoptosis index detected by TUNEL method. ② Myocardial cell volume and histomorphology detected by confocal microscopy. ③ Histological change of myocardial collagen network detected by haematoxylin-basic fuchsin-picric acid staining.RESULTS: Thirty-six involved experimental dogs all entered the stage of final analysis. ①The apoptosis index in the cell transplantation group was significantly lower than that in the control group 1, 4 and 8 weeks after cell transplantation (P ＜0.05). ② Myocardial cell volume in the cell transplantation group 1, 4 and 8 weeks after cell transplantation was significantly larger than that in the control group (P ＜ 0.05). ③ Collagen fiber in the myocardial tissue of dogs in the cell transplantation group was arranged in order and regularly, and in contrast that in the control group was not, and fibers in the control group fused partially.CONCLUSION: UCBSMC transplantation reduces the apoptosis of myocardial cells, promotes the hypertrophy of remaining myocardial cells, regulates myocardial collagen network and improves heart function.

Objective To determine the serum levels of cross-linked telopoptide of type Ⅰ collagen (ICTP),alkaline phosphatase (ALP) in patients with primary malignant bone tumor,primary benign bone tumor and malignant tumor metastasized to the bone,and to explore the clinical value of ICTP and ALP in identification and diagnosis of bone tumor.Methods Sixteen primary malignant bone tumor patients,16 primary benign bone tumor patients and 18 malignant tumor metastasized to the bone patients in 2012 were studied.Serum ALP was assayed by SFBC rate method and ICTP by enzyme linked immunosorbent assay (EIA).Results The serum levels of ICTP was not significantly different between primary benign bone tumors and normal control group (P ＞ 0.05),but the other between-groups had statistically significant difference (P ＜ 0.05).The serum levels of ALP in malignant tumor metastasized to the bone was significantly higher than the rest of the group (P ＜0.01),but the difference between the remaining groups was not statistically significant (P ＞ 0.05).The area under roc curve (AUC) of ICTP for diagnosis of primary benign bone tumors,malignant tumor metastasized to the bone,primary malignant bone tumor (0.923,0.926,0.874) was higher than the ALP (0.354,0.702,0.865).Conclusions Serum ICTP and ALP were sensitive and convenient biochemical indices which reflected metabolism of patients with bone tumor.Serum ICTP was more specific and sensitive than ALP and they have clinical importance for differential diagnosis as an index of bone tumor.

AIM:To compare the efficacy and safety of intravitreal ranibizumab to those of triamcinolone acetonide ( TA ) injection for the treatment of macular edema secondary to central retinal vein occlusion ( CRVO) .
METHODS:This retrospective study included 40 eyes of 40 patients with macular edema associated with CRVO. Twenty patients 20 eyes were treated with intravitreal injection of triamcinolone acetonide (1mg, 0. 1mL), the other 20 patients 20 eyes accepted intravitreal ranibizumab (0. 5mg, 0. 05mL). The change of best corrected visual acuity ( BCVA ) , central macular thickness ( CMT ) , and intraocular pressure ( IOP ) before treatment and at 1, 2wk, 1, 2,3,6mo post-injection in the two groups were observed.
RESULTS:BCVA was improved at 1, 2wk, 1, 2,3,6mo post-injection in the TA group (P<0.05) and ranibizumab group ( P<0. 05 ). No significant difference was found between the two groups ( P > 0. 05 ). CMT decreased significantly within each group ( P < 0. 05 ), and no significant difference between groups was found ( P >0.05). In the TA group, the IOP was significantly higher at 2wk and 4wk than before treatment (P<0. 05). In the ranibizumab group, no elevated IOP was observed at 1, 2wk, 1, 2,3,6mo (P>0. 05). However, the IOP at 1mo was significantly higher in the TA group than that in the ranibizumb group (P<0. 05).
CONCLUSION:Intravitreal ranibizumab is an effective and safe treatment method for macular edema secondary to CRVO. It can effectively improve BCVA and reduce CMT without ocular and systemic complications compared with intravitreal TA.

Objective To investigate the effects of enteral nutrition with galactooligosaccharides (GOS) on serum inflammatory cytokines in rats with severe acute pancreatitis (SAP). Methods SD rats were randomly divided into sham operation control group, SAP with enteral nutrition (EN) group and SAP with EN supplemented with GOS (GOS-EN) group, and each group was divided into 4 d and 7 d subgroups according to the time that animals were sacrificed (n=8 in each subgroup). Rat SAP models were established by injection of 38 g/L sodium taurocholate beneath the pancreatic capsule. The serum amylase, inflammatory cytokines TNF-α, IL-2 and IL-10 were detected. Results At each time point, the levels of serum amylase in all SAP groups were significantly higher than those in sham operation control group (P < 0.01), and the levels in GOS-EN group were significantly lower than those in EN group (P < 0.01). The levels of serum TNF-α and IL-10 in all SAP groups were significantly higher than those in sham operation control group (P < 0.01), while the levels of IL-2 in all SAP groups were significantly lower than those in sham operation control group. The levels of TNF-α in GOS-EN group were significantly lower than those in EN group (P <0.05), while the levels of IL-2 and IL-10 and the ratio of IL-10/TNF-α were significantly higher than those in GOS-EN group (P < 0.05). Conclusion Early EN supplemented with GOS could modulate the balance of pro- and anti-inflammatory response.

Objective To explore the efficacy of endovascular treatment for closed articular artery injuries.Methods The clinical data of 13 patients from Jan 2010 to Dec 2014 treated for closed articular artery injuries were analyzed retrospectively.The location,severity and extent of arterial injury were confirmed by intraoperative arteriography.The diameter and length of the injured arteries were measured.The guidewire was sent to the lesion site and working wire pathway was established.When the guidewire was difficult to pass through the lesion site,femoral and posterior tibial or radial artery may be used to establish working wire pathway.The stent or stent-graft was implanted through the contralateral femoral artery or distal end of ipsilateral artery.Results Intraoperative angiography confirmed intimal injury (n =2),partial transection (n =5),complete transection (n =5) and arteriovenous fistula (n =1).Eighteen stents or stent-grafts were implanted.Treatment was successful in all patients without peiropeartive death and procedure-related complications.All were followed up for 15 to 48 months and the mean follow-up was (30 ± 11) months.Three patients with stent lumen stenosis less than 50％ as showed by angiography.There was no stent fracture,displacement,or deformation.Conclusions Endovascular treatment for closed articular artery injuries is of less invasion,shorter operative time and quick postoperative recovery.

OBJECTIVETo explore the effect of Salvianolate on myosin heavy chain (MHC) in cardiomyocytes of congestive heart failure (CHF) rats.

METHODSSixty male SD rats were divided into 6 groups according to random digit table, i.e., the normal control group (NCG), the model group, the Captopril group (CAG), the low dose Salvianolate group (LSG), the high dose Salvianolate group (HSG), the Captopril and high dose Salvianolate group (CSG), 10 in each group. CHF rat model was established with peritoneal injection of adriamycin in all rats except those in the NCG. Equal volume of normal saline was peritoneally injected to rats in the NCG, once per week for 6 successive weeks. Corresponding medication was started from the 5th week of injecting adriamycin. Rats in the CAG were administered with Captopril solution at the daily dose of 10 mg/kg by gastrogavage. Rats in the LSG and the HSG were administered with Salvianolate solution at the daily dose of 24.219 mg/kg and 48.438 mg/kg respectively by gastrogavage. Salvianolate was dissolved in 2 mL 5% glucose solution and administered by peritoneal injection. Rats in the CSG were peritoneally injected with high dose Salvianolate solution and administered with Captopril solution by gastrogavage. Two mL normal saline was peritoneally injected to rats in the model group, once per day for 8 successive weeks. Eight weeks later, the cardiac function and myocardial hypertrophy indices were detected by biological signal collecting and processing system. mRNA expression levels of alpha-MHC and beta-MHC in cardiac muscle were detected by fluorescence quantitative PCR. Expressions of protein kinase C (PKC) in cardiac muscle were detected by Western blot.

RESULTSCompared with the normal control group, heart mass index (HMI) and left ventricular mass index (LVMI) obviously increased in the model group (P < 0.01). Compared with the model group, HMI and LVMI decreased in HSG, CAG, and CSG groups (P < 0.05, P < 0.01). It was more obviously lowered in the CSG group than in the CAG group (P < 0.05). Compared with the NCG, the mRNA expression level of alpha-MHC in cardiac muscle decreased, the mRNA expression level of p-MHC and the expression of PKC in cardiac muscle increased in the model group (P < 0.01). Compared with the model group, the mRNA expression level of alpha-MHC in cardiac muscle was increased, and the mRNA expression level of beta-MHC and the expression of PKC in cardiac muscle were decreased in HSG, CAG, and CSG groups (P < 0.05, P < 0.01). There was statistical difference between the CSG group and the CAG group (P < 0.05).

CONCLUSIONSSalvianolate could up-regulate the mRNA expression level of alpha-MHC, and down-regulate the mRNA expression level of beta-MHC in cardiac muscle. Its mechanism might be related to decreasing the expression of PKC.

Animals ; Captopril ; Doxorubicin ; Drugs, Chinese Herbal ; Heart Failure ; metabolism ; Male ; Myocardium ; Myocytes, Cardiac ; drug effects ; metabolism ; Myosin Heavy Chains ; metabolism ; Plant Extracts ; pharmacology ; Rats ; Rats, Sprague-Dawley