Objective　To evaluate the results of radical resection for the treatment of Budd-Chiari syndrome (BCS) caused by short segmental lesions in inferior vena cava (IVC), and major hepatic veins (MHV).　Methods　In this series, resection of IVC occlusive segment and orthotopic artificial vascular graft transplantation were performed in 42 patients. Resection of major hepatic vein, hepatic venous plasty and orthotopic transplantation with artificial vascular graft were performed in 10 patients. Resection of major hepatic vein, anastomosis between hepatic vein and right artrium in 3 cases. Percutaneous transhepatic angioplasty in 10 cases.　Results　One patient died of complication. 58 cases were followed up for an average of 30 months. 3 cases in interventional group suffered recurrence and one in surgical group had recurrence.　Conclusions　The treatment of BCS by resecting inflicted segment of IVC or hepatic veins and orthotopic artificial vascular graft transplantation effect a radical cure in most cases.

Objective [WT5”BZ]To evaluate the results of radical resection for the treatment of Budd Chiari syndrome (BCS) caused by short segmental lesions in inferior vena cava (IVC), and major hepatic veins (MHV).[WT5”HZ]Methods [WT5”BZ]In this series, resection of IVC occlusive segment and orthotopic artificial vascular graft transplantation were performed in 42 patients. Resection of major hepatic vein, hepatic venous plasty and orthotopic transplantation with artificial vascular graft were performed in 10 patients. Resection of major hepatic vein, anastomosis between hepatic vein and right artrium in 3 cases. Percutaneous transhepatic angioplasty in 10 cases.[WT5”HZ]Results [WT5”BZ]One patient died of complication. 58 cases were followed up for an average of 30 months. 3 cases in interventional group suffered recurrence and one in surgical group had recurrence.[WT5”HZ]Conclusions [WT5”BZ]The treatment of BCS by resecting inflicted segment of IVC or hepatic veins and orthotopic artificial vascular graft transplantation effect a radical cure in most cases.

Objective To investigate the changes in plasma very long chain fatty acids (VLCFAs),and to explore its relationship with obesity-related index in obese children.Methods One hundred and sixty-six obese children aged 7 to 12 years old were investigated and 148 health children matched with age and sex were selected as control group.Their height,weight,and waist circumference (WC) were measured.The percentage of body fat (PBF) was tested by dual-energy X-ray absorptiometry.Fasting blood triglycerides (TG),total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),low density lipoprotein-cholesterol (LDL-C) levels,fasting plasma glucose,and fasting insulin (FINS) were determined.The body mass index (BMI),BMI-Z score,waist to height ratio (WHtR),and homeostasis model assessment for insulin resistance (HOMA-IR) were calculated.The plasma VLCFAs were analyzed by gas chromatography-mass spectrometry.Results (1) Compared with normal control children,body weight,BMI,BMI-Z score,WC,WHtR,PBF,TG,TC,LDL-C,FINS,and HOMA-IR in obese children were increased (all P ＜ 0.05),and the level of HDL-C was decreased (P ＜ 0.05).(2) The plasma levels of docosamonoenoic acid (C22 ∶ 1 n-9) and arachidonic acid (C20 ∶ 4n-6) were decreased while the levels of arachicacid (C20 ∶ 0) and eicosapentaenoic acid (C20 ∶ 5n-3) increased in obese children compared to non-obese children.(3) The linear correlation analysis showed that PBF was positively correlated with C20 ∶ 0 and C20 ∶ 5n-3,and negatively correlated with C20 ∶ 4n-6.WHtR was negatively correlated with C22 ∶ 1 n-9 and positively correlated with C20 ∶ 0 (4) The multiple stepwise regression analysis showed that C20 ∶ 0 was the main factor for PBF,and C22 ∶ 1 n-9 and C20 ∶ 0 were the main factors for WHtR.Conclusion The metabolic abnormality of plasma very long chain fatty acids exists in obese children.The changes in C20 ∶ 0,C22 ∶ 1 n-9,and C20 ∶ 5n-3 may be associated with obesity in children.

Objective To evaluate the clinical efficacy of arthroscopic treatment of tibial intercondylar eminence avulsion fracture in pediatric patients without epiphyseal interference.Methods From February 2010 to February 2014,18 children patients with avulsion fracture of tibial eminence were admitted.They were 12 boys and 6 girls,from 7 to 14 years of age (average,10.4 years).Four cases were complicated with meniscus injury and 2 with medial collateral ligament injury.The mean time from injury to surgery was 4.5 days (range,from 2 to 7 days).According to Meyers-McKeever classification,13 children were type Ⅱ and 5 type Ⅲ.They were treated with Ultrabraid sutures arthroscopically.After reposition,the bone fragments were fixated to the distal epiphysis of tibial tubercle through the inferior of transverse ligament of knee to avoid epiphyseal injury.Anterior drawer test,Lanchman test,pivot shift test and Lysholm knee scoring were conducted at all clinical follow-up visits to assess functional recovery.Results All children were followed up from 10 to 24 months (average,15 months).The X-ray examination demonstrated bone union in all cases.At the end of follow-up,all children achieved satisfactory recovery of range of motion without complications like joint stiffness,joint relaxation,dysfunction or epiphyseal injury.The anterior drawer test,Lanchman test and pivot shift test were all negative at the last follow-up.The mean Lysholm knee scores improved significantly from preoperative 45.6 ± 7.4 to 92.4 ± 5.8 at the final follow-up (t =-25.403,P ＜ 0.01).Conclusions Bone reposition under arthroscopy with suture fixation is reliable and minimally invasive in the treatment of avulsion fractures of tibial intercondylar eminence in pediatric patients.

Objective To study the accuracy and practical value in the clinical diagnosis of Budd-Chiari syndrome by B ultrasonography and postcaval vein contrast examination.Methods 42 patients received B ultrasonographic scanning of the postcaval vein and the liver before the use of angiography.Angiography included Seldinger single-direction postcaval intubation(14 cases) and double-direction intubation(28 cases),and quick photographic observation.Results B ultrasonography showed that 18 cases had postcaval segmental or membranous obstruction 24 cases had postcaval stricture at its opening,and 20 cases complicated with single right hepatic stricture,8 cases with left vein stricture and 12 cases with central hepatic caval stricture.Communicating branched vessels were formed among 16 cases between hepatic vessels were formed among 8 cases between hepatic left-middle,and middle-right hepatic veins each.Reticular communicating vessels were formed in 8 cases between left middle and right.5 cases had slight postcaval stricture and their blood flowed non-obstructedly postcaval veinography showed 12 cases had postcaval stricture at proximal end,28 cases total segmental or membranous obstruction.There were 8 cases respectively for hepatic central vein and right hepatic vein development each.The remaining 26 cases had no hepatic venous development.There were 30 cases who had obvious branched circulaltion formation,and even their branched circular vessels had tumous-like expansion.Conclusion B ultrasonography,as a way of easy,and no-trauma examination,is the first-choice means to screen the patients.Postcaval angiography is a means to diagnose Budd-Chiari syndrome,which is neccessary for the cases with total segmental or membranous obstruction to have double-direction postcaval angiography,especially for the cases to have interventive therapy.

Objective To explore the mechanism of melanoma differentiation associated gene-7(mda-7) in combination with adriamycin(ADM) killing the HCC HepG2 cells and reversing their multidrug resistance (MDR). Methods The experiment was conducted in three groups including the combined group, ADM group and mda-7 group. MTT assay and FCM were used to determine the differences among the 3 groups and clarify the reversing effect of combined treatment on multidrug resistance of the tumor cells. Expression levels of MDR-1, STAT-3, BCL-2, BAXmRNA were determined with real-time PCR. Western blotting was performed to observe the changes of proteins gp-l70, stat3,P-stat3, PKB, bcl-2,bax in all 3 groups. Result After transfection with 100VP/cell Ad. mda-7,the growth suppression rate of HepG2 treated by ADM (1.5 mg/L) rose from 17.46% to 79. 5%.According to the changes, killed HepG2 cells were increased by a factor of 4.55. times. MDR-1 mRNA was decreased from (16.49 ± 0. 11) to (5.48±0.05) and STAT-3 mRNA increased from (13.17±0. 08) to (21. 57±0. 11)(P＜0.05). Western blotting also showed that P-170 and PKB was decreased and the phosphorylation-stat-3 increased after the combined treatment. Conclusion Ad.mda-7 can reverse the multidrug resistance HepG2 cells. It inhibits the expression of MDR-1 mRNA,then arrests PKB protein and the signaling pathway of active stat-3 to induce apoptosis of HCC cells.

Objective:To explore the predictive value of stroke-related early tracheotomy score (SET) for tracheotomy in neurocritical patients.Methods:A retrospective analysis of the clinical data of neurocritical patients admitted to the department of intensive care unit (ICU) of the Xindu District People's Hospital of Chengdu from January 1st to December 31st, 2019. Patients were divided into tracheostomy group and non-tracheostomy group according to whether they underwent tracheotomy during hospitalization; according to SET score, patients were divided into groups with SET score < 10 points and SET score ≥ 10 points. The differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), Glasgow coma score (GCS), SET score, the length of ICU stay and mechanical ventilation time were compared between the two groups. The receiver operator characteristic curve (ROC curve) was used to analyze the predictive value of SET score for the length of ICU stay > 10 days, mechanical ventilation time > 5 days, and tracheotomy treatment, and the predictive value of APACHEⅡ score for tracheotomy treatment.Results:Among 66 patients, 35 cases underwent a tracheotomy, 31 cases did not; SET score < 10 points in 19 cases, while SET score ≥ 10 points in 47 cases. Compared with the non-tracheostomy group, there were more male patients in the tracheostomy group (cases: 27 vs. 13), the GCS score was lower (7.00±2.41 vs. 11.52±2.00), the APACHEⅡ score and the SET score were higher (22.43±4.45 vs. 19.58±5.86, 16.11±3.67 vs. 8.61±4.27), and the length of ICU stay and mechanical ventilation time was longer [days: 27.54±18.82 vs. 7.45±5.30, 13 (9, 19) vs. 0 (0, 2)], and all differences were statistically significant (all P < 0.05). Compared with SET score < 10 points group, the proportion of traumatic brain injury and tracheotomy in the SET score ≥ 10 points group was higher (44.68% vs. 15.79%, 70.21% vs. 5.26%), the GCS score was lower (8.00±2.87 vs. 11.89±1.97), APACHEⅡ score was higher (22.30±4.80 vs. 18.11±5.49), and the length of ICU stay and mechanical ventilation time was longer [days: 22.38±18.74 vs. 7.53±4.60, 9 (4, 16) vs. 0 (0, 2)], and the differences were statistically significant (all P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of SET score predicting the length of ICU stay > 10 days of neurocritical patients was 0.877, and the 95% confidence interval (95% CI) was 0.790-0.964 ( P = 0.000), and its cut-off value was 13.50, the sensitivity was 80.0%, and the specificity was 87.1%. The SET score predicts the AUC for mechanical ventilation time > 5 days was 0.915, the 95% CI was 0.851-0.979 ( P = 0.000), the cut-off value was 13.50, the sensitivity was 78.4%, and the specificity was 89.7%. SET score predicts the AUC of tracheotomy treatment was 0.919, 95% CI was 0.853-0.985 ( P = 0.000), its cut-off value was 13.50, the sensitivity was 82.9%, and the specificity was 90.3%, which was significantly better than that of APACHEⅡ score in predicting the value of tracheotomy (AUC was 0.647, 95% CI was 0.512-0.783, P = 0.040, its cut-off value was 17.50, the sensitivity was 91.4%, and the specificity was 41.9%). Conclusion:SET score has a good predictive value for the length of ICU stay, mechanical ventilation time and tracheotomy in neurocritical patients.

Objective:To explore the effect of dual antiplatelet combined with calf serum deproteinized injection in the treatment of mild ischemic stroke after intravenous thrombolysis.Methods:From October 2017 to December 2018, 82 patients with mild ischemic stroke who were diagnosed in the People's Hospital of Ruian were selected.The patients were divided into control group (41 cases) and observation group (41 cases) according to random number table method.The control group was treated with aspirin after intravenous thrombolysis.On this basis, the observation group was treated with dual antiplatelet combined with calf serum deproteinized injection.The course of treatment was 3 months in both two groups.The total effective rate, the changes of hemorheological indicators, the improvement of neurological deficit, the ability of daily living and the ability of returning to society were compared between the two groups before and after treatment.The complications and prognosis were recorded.Results:The total effective rate of the observation group was 95.12% (39/41), which was higher than 78.05% (32/41) of the control group (χ 2=5.145, P<0.05). After treatment, the National Institutes of Health Stroke Score Scale (NIHSS) score, Modified Rankin Score (mRS), Barthel index (BI) score of the observation group were (0.34±0.18)points, (92.15±6.73)points, (0.87±0.36)points, respectively, which of the control group were (0.92±0.35)points, (76.05±4.86)points, (1.64±0.52)points, respectively, there were statistically significant differences between the two groups ( t=8.592, 11.308, 7.099, all P<0.05). The whole blood viscosity, plasma viscosity and platelet aggregation rate of the observation group were (4.13±0.36)mPa/s, (1.39±0.31)mPa/s, (32.35±2.61)%, respectively, which were lower than those of the control group [(8.65±0.72)mPa/s, (1.62±0.47)mPa/s, (39.07±3.25)%] ( t=32.740, 2.382, 9.400, all P<0.05). There were no cases of cerebral hemorrhage and death in the two groups, and there was no statistically significant difference in recurrence rate between the two groups (χ 2=2.565, P>0.05). Conclusion:After intravenous thrombolytic therapy for patients with mild ischemic stroke, dual antiplatelet therapy combined with calf serum deproteinized injection can improve the neurological function, life ability and hemorheological indicators of patients, with good prognosis, it is safe and effective.

Although the tumor suppressor P53 is known to regulate a broad network of signaling pathways, it is still unclear how certain drugs influence these P53 signaling networks. Here, we used a comprehensive single-cell multiomics view of the effects of ginsenosides on cancer cells. Transcriptome and proteome profiling revealed that the antitumor activity of ginsenosides is closely associated with P53 protein. A miRNA-proteome interaction network revealed that P53 controlled the transcription of at least 38 proteins, and proteome-metabolome profiling analysis revealed that P53 regulated proteins involved in nucleotide metabolism, amino acid metabolism and "Warburg effect". The results of integrative multiomics analysis revealed P53 protein as a potential key target that influences the anti-tumor activity of ginsenosides. Furthermore, by applying affinity mass spectrometry (MS) screening and surface plasmon resonance fragment library screening, we confirmed that 20()-protopanaxatriol directly targeted adjacent regions of the P53 DNA-binding pocket and promoted the stability of P53-DNA interactions, which further induced a series of omics changes.