Objective: To investigate the changes of oxygen metabolic parameters and blood glucose concentrations during perioperative period of orthotopic liver transplantation. Methods: The blood gas, cardiac index (CI), mixed venous oxygen saturation (SvO2), oxygen delivery (DO2), oxygen consumption (VO2), oxygen extraction rate (O2ER), and arterial blood glucose were measured at defined time points (before anesthesia induction, 30 min before anhepatic period, 5 min after anhepatic period, 30 min after anhepatic period, 5 min of neohepatic period, 30 min of neohepatic period, and postoperation) in 50 patients receiving liver transplantation. Results: Compared with those before anesthesia induction, no significant changes in CI, SvO2, DO2, VO2, and O2ER were found in pre-anhepatic period. CI, VO2, and DO2 decreased significantly at the early 5 min of the anhepatic period (P<0.05); VO2, DO2, and O2ER decreased significantly at the 30 min of the anhepatic stage (P<0.05). SvO2, DO2, and VO2 increased, but O2ER decreased significantly at the early 5 min of the neohepatic stage (P<0.05). DO2, VO2, and O2ER increased significantly at the 30 min of the neohepatic stage (P<0.05). During preanhepatic stage the blood glucose levels increased progressively but were lower than those during anhepatic stage. During neohepatic stage, blood glucose decreased abruptly but was still higher than the normal level (P<0.05). Conclusion: It suggests that serious imbalance of oxygen metabolism exists during liver transplantation, especially in anhepatic and early neohepatic stages. Blood glucose increases during the preanhepatic stage, reaches the peak during the anhepatic stage, and then decreases gradually.

Objective To study the methods of clinic diagnosis and treatment for chronic lumbar pain induced by lumbo-sacral compartment syndrome. Methods Thirty-three patients with chronic lumbar pain induced by lumbo-sacral compartment syndrome were diagnosed by physical, radiological examination and intra lumbo-sacral muscle compartmental pressure measurement. 33 patients consisted of 15 men and 18 women, with the mean age 42.3 years, and mean duration of chronic lumbar pain was 27 years. Lumbar erector spinae osteo-facial compartment was decompressed using mini-invasive surgery. Lumbar and abdomen muscles were rehabilitated extensively after operation. Results After operation, symptoms of low back pain were alleviated significantly, and walking distance were promoted as well. Post operative flexion and extension of lumbar spine were increased to (15??0.5?) and (7??0.7?) respectively. Intramuscular pressure in rest state, during movement and no more than 6 min after movement was (6.8?0.8), (162.3?12.35) and (7.1?0.6) mm Hg respectively [before operation was(10.4?0.9), (187.1?11.16) and (13.2?1.3) mm Hg respectively, P

Objective To compare the efficacy of postoperative noninvasive positive pressure ventilation ( NPPV ) plus standard medical therapy ( SMT) with SMT alone in patients with moderate to severe chronic obstructive pulmonary disease ( COPD )Methods Twenty-four patients, after upper abdominal or thoracic surgery, who suffered from COPD and moderate to severe respiratory insufficiency, were randomly allocated to receiving SMT alone (oxygen, aminophylline infusion, nebulized beta-2 agonists and anticholinergics, antibiotics administration and chest physiotherapy; control group ,n=12) or NPPV in addition to SMT(NPPV group ,n=12) NPPV was intermittently given with an air-cushioned face mask under the continuous positive airway pressure of 3 cmH 2O and FiO2 of 35%Results There were not significant differences in baselines between both groups 8 patients in control group ( 667%) and all patients in NPPV group recovered with initial therapy with statistically significant difference (P

Objective To explore the effect of endoscopic sinus surgery on inverted papilloma of nasal cavity and paranasal sinuses in 30 cases.Methods 30 patients with inverted papilloma of nasal cavity and paranasal sinuses were operated on by endoscopic sinus surgery.Results During a follow-up of 2～3 years,only four cases recurred, Conclusion Endoscopic sinus surgery had advantsges of clear field and little injury,and therefore it was effective for inverted papilloma of nasal cavity and paranasal sinuses.

[ ABSTRACT] AIM:To evaluate the clinical application of single nucleotide polymorphism array ( SNP array) in prenatal diagnosis for screening the abnormality of women with Down’ s syndrome ( DS) .METHODS:The amniotic fluid samples ( n=312) collected by amniocentesis for the DS screening abnormality women were tested by karyotyping and SNP array analysis, respectively.The findings of karyotyping and SNP array analysis were compared.RESULTS:Two cases of trisomy 21 were identified by karyotyping and SNP array analysis, but SNP array analysis failed to identify 6 cases of chro-mosome balanced structural rearrangement.SNP detected 176 cases copy number variants ( CNVs) in 303 cases normal karyotype were detected by SNP, including 106 benign CNVs, 61 variants of unknown significance (VOUS), 9 de novo CNVs, and none of them was pathogenic.The distribution difference of CNVs in DS screening positive group and DS screening positive plus advanced maternal age group was not statistically significant ( P>0.05) .Furthermore, we reported 14 kinds of CNVs for the first time in population.CONCLUSION:SNP array can further assure chromosome microdupli-cation/microdeletion.In normal karyotype fetus of prenatal diagnosis, SNP can detect some clinical significant CNVs.

BACKGROUND: Cervical spinal cord injury without radiographic abnormality (SCIWORA) is a special type of spinal cord injury. Because of the particularity of children in the period of growth and development on the aspects of anatomy and biomechanics, their injured mechanism and therapeutic method differ from those of adults.OBJECTIVE: To explore clinical feature and therapy of first-episode cervical SCIWORA in children.DESIGN: Retrospective analysis and self pre-and post-control observation.SETTING: Department of Spine Surgery, Second Affiliated Hospital,Harbin Medical University.PARTICIPANTS: Totally 14 patients with cervical SCIWORA, who were treated at the Departmentof Spine Surgery, Second Affiliated Hospital,Harbin Medical University between June 1997 and June 2003. Inclusive criteria: ①patients who had dysfunction of sensation, exercise and sphincter to different degree in clinic, ②patients who had no fracture dislocation after cervical vertebra X-ray plain film and MRI examination. The MRI examination showed the sign of spinal cord injury. T1WI spinal cord became thick. T2WI distributed at strip-shape high-signal region along spinal prosenchyma and spread upward and downward. There were 3 patients with complete spinal cord injury and 11 patients with incomplete spinal cord injury, among the patients with incomplete injury, there were 6 patients with central cord syndrome (CCS), 3 with Brown-Sequard syndrome and 2withfrontal spinal cord injury syndrome.METHODS: Retrospective analysis was performed in 14 children patients with cervical SCIWORA. Thirteen patients were not treated with operation and one patient was treated with cervical posterior atlantoaxial fusion. MAIN OUTCOME MEASURES: ASIA grading before and after treatment in patients.RESULTS: There were 1 dead patient and 13 cases with 3-year follow up averagely. Three patients were with insignificant amelioration, and others had recovery of limb function to different degree. According to ASIA grading standard, before treatment there were 3 cases in A grade, 5 cases in B grade, 5 cases in C grade and 1 case in D grade, and after treatment there were 1 case recovering to B grade, 2 cases to C grade, 5 cases to D grade and 2 cases to E grade.CONCLUSION: Restoration of neurofunction of children with cervical SCIWORA has closely correlation with degree of primary injury of spinal cord. Most of the patients were not treated with operation, and those with obviously instable cervical vertebra can be treated with operation.

Type 2 innate lymphoid cells ( ILC2s) are recently identified members of the innate lymphoid cell ( ILC) family. These cells are capable of producing Th2-type cytokines such as IL-5 and IL-13 in response to epithelial cell-derived cytokines IL-25 and IL-33 and play critical roles in allergic diseases such as bronchial asthma. Further investigations on ILC2s will enhance the better understanding of type 2 immune responses and may provide new strategies for the treatment of allergic asthma. In this review, we fo-cus on the origin, location and biological function of ILC2s as well as their possible roles in the pathogenesis of bronchial asthma.

OBJECTIVE:To provide reference for the construction and development of hospital modernization pharmacy in Chi-na,and to promote the application of pharmacy automation system in hospital. METHODS:By introducing the change of pharma-cy management due to the debugging and application of outpatient pharmacy automation system(rapid dispensing machine,intelli-gent access machine)in our hospital,the problems of automation system and countermeasures were put forward,and the effects of automation system in our hospital were evaluated. RESULTS:With the application of automation system,the pharmacy layout was adjusted,the drugs in the machine was debugged and optimized,the procedure on adding drugs and stocktaking drugs were im-proved,the reasonable scheduling work in outpatient pharmacy was worked,the complete management plan on validity of drugs was established;referring to the problems of automation system,the procedures of adding drugs by rapid dispensing machine and intelligent access machine were formulated as well as related working guide. The adding and delivering drug failure emergency han-dling procedure of rapid dispensing machine,intelligent access machine failure emergency handling procedure were formulated ac-cording to the possible fault of automation system. Related index evaluation showed that automation system was applied and continu-ously improved,which reduced labor intensity(step count of pharmacists adding drug decreased from 5 634.6 steps/day to 4 087.8 steps/day);the work efficiency was improved greatly(the number of prescriptions increased from 226.55 sheets/h to 311.55 sheets/h during rush hours);the work error was reduced(the number of dispensing internal error decreased from 54.75 items/week to 21.50 items/week). CONCLUSIONS:After appling the automation system in outpatient pharmacy,the drug dispensing and staff manage-ment has been standardized,and it become the hospital pharmacy development inevitable trend. But it is suggested to adjust and op-timize the automation system continuously so as to exert its maximal efficacy.

BACKGROUND:Calcaneus has its special anatomy. Moreover, it is difficult to expose the inside to the posterior side of the joint surface. Lateral calcaneal soft tissue was less. The joint surface can be clearly exposed after incision, so lateral L-shaped incision is conventionaly used in calcaneal surgery. OBJECTIVE:To analyze the suspicious factors influencing the open reduction titanium plate for calcaneal fracture and internal fixation of L-shaped wound healing during bone graft. METHODS:A total of 84 cases (94 sides) of calcaneal fractures, who were treated in the Disabled Rehabilitation Center in Liaoning Province from June 2011 to November 2014, were included in this study. They were grouped according to the source of bone graft. Alograft group contained 52 sides (44 cases). Autogenous iliac bone graft group contained 42 sides (40 cases). Operation time of calcaneus was 7-10 days after injury. L-shaped incision was made for open reduction and internal fixation with titanium plate and bone graft. The patient’s age, the type of bone graft, type of drainage and drainage time that may cause theincision complications were investigated and analyzed. RESULTS AND CONCLUSION:(1) Among 84 cases of 94 calcaneal fractures after operation, 16sides affected complications. (2) Significant differences in the incidence of complications were detected between negative pressure drainage and skin flap drainage (P< 0.05). Negative pressure drainage had a significant effect on reducing the incidence of incision complications. (3) Significant differences in the incidenceof incision complications were determined between the alograft group and autogenous iliac bone graft group (P< 0.05). Implantation of autogenous iliac bone could significantly reduce the incidence of incision complications. (4) No significant differencewas detected between the complication group and non-complication group in age and drainage time (P> 0.05). (5) These findings indicate that 7-10 days after injury, operation after the sweling subsided completely, the negative pressure drainage, and planting autogenous iliac crest can reduce the incidence of complications related to lateral calcaneal L-shaped incision.

In the past,it is always believed that routine drainage after pancreaticoduodenectomy (PD) is one of the most crucial methods to prevent and detect postoperative complications and to reduce mortality.However,in more recent years,with the development of fast track surgery,scholars in pancreatic surgery have investigated the necessity of drainage after PD together with its merits and faults.Therefore,this paper gives a brief review on this topic.