Objective To investigate the feasibility of measuring liver volume with Argus methoct Methods Thirty-two healthy liver transplant donor candidates underwent liver MRI on a 3.0 T MR unit.Volume interpolated body examination(VIBE)was performed after the administration of gadobenate dimeglumine.The VIBE data was transferred to the diagnostic workstation,and then multiple planar reconstruction(MPR)images were acquired.Firstly.two observers manually drawn the liver shape and calculated three volumes:the whole liver volume and right lobes volumes include middle hepatic vein (MHV)and exclude MHV,respectively.Secondly,the same data was transferred to Argus software.calculated that three volumes.Each measurement time was recorded.Actual graft volume(the right lobe)wag measured during surgery.The correlation between right lobes volume of two measurements and actual graft volume was analyzed.The time needed for Argus and that needed for manual method were compared with paired t test.Results The right lobe volumes measured by Argus,manually and surgery method were (813±187),(807 ± 181)and(713 ± 137)mm3,respectively.Argus method and manual method showed good correlation with surgery method,and the correlation coefficients were 0.897(Argus method)and 0.884(manual method),respectively.The time for manual method and Argu8 method were(44.3 ±2.7)and(12.2.±1.0)min,respectively.There was significant difference between Argus and manual methods (t=76.39,P＜0.05).Conclusion Compared with manual method,use of the Liver volumetric measurement by Argus software not only correlated well with Actual graft volume,but also saves time.Argus has potential clinical value for volumetric measurement in living liver transplant donors.

Portal vein stricture complicated with superior mesenteric venous thrombosis is rarely seen in clinical practice. On December 26, 2009, a 51-year-old male patient who had a liver transplantation history was admitted to The General Hospital of Chinese People's Armed Police Forces with the chief complaint of intermittent abdominal pain and diarrhea.A plain and enhanced CT scan showed that the portal vein was constrictive and thrombosis had formed in the main trunk of the superior mesenteric vein, and varicose veins were seen in surrounding tissues of the esophagus. Edema was observed at the end of the ileum and cecum. The results of colonoscopy showed inflammatory changes and varicose veins of the colon. The patient received medical treatment. The thrombosis was dissolved 9 days later, and all symptoms disappeared 12 days later.

OBJECTIVEThe aim of this study is to investigate the efficiency and toxicity of the FOLFOX regimen, the combination of oxaliplatin (L-OHP), 5-fluorouracil (5-Fu) and calcium folinate (CF), for patients with locally advanced or metastatic gastric cancer.

METHODSNinety-six patients with locally advanced or metastatic gastric adenocarcinoma, including 72 males and 24 females, were treated with FOLFOX regimen: L-OHP 85 mg/m(2) iv in 2 hours on D1, CF 200 mg/m(2) iv in 2 hours on D1 and D2, 5-Fu 400 mg/m(2) iv on D1 and D2, and then continuous infusion of it at a dose of 600 mg/m(2) for 44 hours. This regimen was repeated every 2 weeks. The first evaluation was done after four cycles. The median cycle of the chemotherapy was 6 (range: 1 to 12 cycles).

RESULTSOf the 96 patients with gastric cancers, 21 underwent R0 resection and afterward received adjuvant FOLFOX chemotherapy. Ten of those were still alive, while the other 11 died of the disease, with a median disease free survival time of 24.0 months and 3-year survival rate of 51.8%. The other 75 received only palliative chemotherapy due to non-operable advanced disease. Thirty of those achieved partial response (PR), the other 20 had a stable disease (SD), but the remaining 25 experienced disease progression (PD), with an overall response rate of 40.0%. The median TTP and overall survival in those 75 patients was 5.9 and 12.0 months, respectively. All 96 patients were evaluable for toxicity according to NCI criteria. The patients of grade 3 vomiting and neural toxicity were 6 and 4, respectively.

CONCLUSIONIn terms of efficacy and safety, the FOLFOX regimen is effective and well tolerable for patients with locally advanced or metastatic gastric cancers either as adjuvant or palliative chemotherapy.

Adenocarcinoma ; drug therapy ; pathology ; secondary ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Signet Ring Cell ; drug therapy ; pathology ; secondary ; surgery ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; therapeutic use ; Follow-Up Studies ; Humans ; Leucovorin ; administration & dosage ; adverse effects ; therapeutic use ; Liver Neoplasms ; drug therapy ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neutropenia ; chemically induced ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; therapeutic use ; Palliative Care ; Remission Induction ; Stomach Neoplasms ; drug therapy ; pathology ; surgery ; Survival Rate ; Vomiting ; chemically induced

Aim To clarify the effect of circulating exosomes on hypertension, screen out miRNAs which plays a key role, and explore its function.Methods The plasma exosomes of spontaneously hypertensive rats were extracted and injected into Sprague Dawley rats.The blood pressure changes of rats were detected.Plasma exosomes and exosomal RNA of hypertensive patients and SHR were extracted.Real time PCR was used to verify the expression changes of the selected 8 miRNAs; Western blot was used to detect the expression changes of LKB1 and PTEN protein levels in human umbilical vein endothelial cells transfected with miR-17-5p mimics.Results The plasma exosomes of SHRs significantly increased the blood pressure of SD rats(P<0.05).The expression of miR-17-5p and miR-218-5p in the plasma exosomes of hypertensive patients and SHRs both significantly increased.miR-17-5p inhibitors significantly attenuated the effect of SHR-exos on raising blood pressure.miR-17-5p mimics down-regulated the expression of LKB1 and PTEN in HUVECs cultured in vitro.Conclusions The plasma exosomes of SHR can significantly increase blood pressure of Sprague Dawley rats.miR-17-5p may be the key miRNA.exo-miR-17-5p may promote the occurrence and development of hypertension by regulating the LKB1/PTEN signal.

INTRODUCTIONAcute myocardial infarction (AMI) due to unprotected left main coronary artery (ULMCA) disease is clinically catastrophic although it has a low incidence. Studies on the long-term prognosis of these patients are rare.

METHODSFrom January 1999 to September 2013, 55 patients whose infarct-related artery was the ULMCA were enrolled. Clinical, angiographic and interventional data was collected. Short-term and long-term clinical follow-up results as well as prognostic determinants during hospitalisation and follow-up were analysed.

RESULTSCardiogenic shock (CS) occurred in 30 (54.5%) patients. During hospitalisation, 22 (40.0%) patients died. Multivariate logistic regression analysis showed that CS (odds ratio [OR] 5.86; p = 0.03), collateral circulation of Grade 2 or 3 (OR 0.14; p = 0.02) and final flow of thrombolysis in myocardial infarction (TIMI) Grade 3 (OR 0.05; p = 0.03) correlated with death during hospitalisation. 33 patients survived to discharge; another seven patients died during the follow-up period of 44.6 ± 31.3 (median 60, range 0.67-117.00) months. The overall mortality rate was 52.7% (n = 29). Kaplan-Meier analysis showed that the total cumulative survival rate was 30.7%. Cox multivariate regression analysis showed that CS during hospitalisation was the only predictor of overall mortality (hazard ratio 4.07, 95% confidence interval 1.40-11.83; p = 0.01).

CONCLUSIONAMI caused by ULMCA lesions is complicated by high incidence of CS and mortality. CS, poor collateral blood flow and failure to restore final flow of TIMI Grade 3 correlated with death during hospitalisation. CS is the only predictor of long-term overall mortality.

Adult ; Aged ; Angiography ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; pathology ; therapy ; Coronary Vessels ; pathology ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction ; diagnosis ; therapy ; Odds Ratio ; Percutaneous Coronary Intervention ; Prognosis ; Proportional Hazards Models ; Regression Analysis ; Retrospective Studies ; Shock, Cardiogenic ; Young Adult

Objective: To explore the characteristics of viral infections in children with diarrhea in Beijing from 2018 to 2022. Methods: Real-time PCR and enzyme-linked immunosorbent assay were used to detect viral nucleic acid of Norovirus (NoV), Sappovirus (SaV), Astrovirus (AstV), Enteric Adenovirus (AdV) or antigen of Rotavirus (RV) in 748 stool samples collected from Beijing Capital Institute of Pediatrics from January 2018 to December 2021. Subsequently, the reverse transcription PCR or PCR method was used to amplify the target gene of the positive samples after the initial screening, followed by sequencing, genotyping and evolution analysis, so as to obtain the characteristics of these viruses. Phylogenetic analysis was performed using Mega 6.0. Results: From 2018 to 2021, the overall detection rate of the above five common viruses was 37.6%(281/748)in children under 5 years old in Beijing. NoV, Enteric AdV and RV were still the top three diarrhea-related viruses, followed by AstV and SaV, accounting for 41.6%, 29.2%, 27.8%, 8.9% and 7.5%, respectively. The detection rate of co-infections with two or three diarrhea-related viruses was 4.7% (35/748). From the perspective of annual distribution, the detection rate of Enteric AdV was the highest in 2021, while NoV was predominant in the other 4 years. From the perspective of genetic characteristics, NoV was predominant by GⅡ.4, and after the first detection of GⅡ.4[P16] in 2020, it occupied the first two gene groups together with GⅡ.4[P31]. Although the predominant RV was G9P[8], the rare epidemic strain G8P[8] was first detected in 2021. The predominant genotypes of Enteric AdV and AstV were Ad41 and HAstV-1. SaV was sporadic spread with a low detection rate. Conclusion: Among the diarrhea-related viruses infected children under 5 years of age in Beijing, the predominant strains of NoV and RV have changed and new sub-genotypes have been detected for the first time, while the predominant strains of AstV and Enteric AdV are relatively stable.
Child, Preschool ; Humans ; Infant ; Beijing/epidemiology* ; Diarrhea/epidemiology* ; Feces ; Norovirus/genetics* ; Phylogeny ; Rotavirus/genetics* ; Virus Diseases/epidemiology* ; Viruses/genetics*

Objective To assess the risk factors of the in-hospital mortality of acute type A aortic dissection after operation. Method From January 2003 to June 2008,185 patients, 144 males and 41 females, with acute type A aortic dissection operated on were enrolled. The average age of patients was (49.46 ± 11.04 ) years old.The patients' demographics, history, clinical features, and some laboratory examinations were reviewed. Univariate and multivariate analysis followed by logistic regression analysis were carried out to identify the predictors of inhospital mortality. Results The in-hospital mortality rate was 9.1%. The results of univariate and multivariate analyses as follows: pre-operation positive neurological symptom (Univariate OR = 5.084,95%CI:1.792 -14.426, P = 0.002; Multivariate OR = 5.538,95%CI: 1.834 - 16.721, P = 0.002, respectively), hypotension (Univariate OR = 6.986,95%CI:1.510- 32.323,P =0.013; multivariate OR = 1.998,95%CI:0.315-12.679,P = 0.463, respectively) and renal failure (Univariate OR = 3.594,95%CI:1.237 - 10.438,P =0.019; Multivariate OR = 3.254,95%CI:1.034- 10.242, P= 0.044, respectively). Conclusions There are two predictors, pre-operation positive neurological symptom and renal failure, of pre-hospital mortality found in current analyses. Our results may improve the regimen made by cardiac surgeons and emergency doctors so as to help patients and their relatives to make correct decision.

OBJECTIVETo study the use about balloon dilatation before incision for the patients with ureteric stricture.

METHODSSixteen patients with ureteric stricture were included in our study. The cases were reviewed retrospectively with regards to the etiological factor, the site of stricture, symptom and diagnosis. Six patients with ureteric stricture were dilated with balloon before incision using Ho YAG laser. Ten patients with ureteric stricture were dilated with rigid ureteroscope before incision using Ho YAG laser. The double "J" stent was kept for 4-6 weeks after operation. All the patients were followed up by ultrasound, BUN and creatinine. Complete success is defined as symptomatic improvement, resolution of hydronephrosis and absence of ureteric stricture 3 months after removal of the double "J" stent. If the hydronephrosis and ureteric stricture did not deteriorate, and symptom improved after stent removal, it was considered as improvement. Failure is defined as deterioration of hydronephrosis and symptoms upon removal of double "J" stent.

RESULTSThe length of stenosis was from 0.8 to 1.4 cm. Three patients failed to improve after initial dilatation with rigid ureteroscope, but were later successfully dilated using balloon. All the patients who were treated using balloon dilatation were successful. The operative time of balloon dilatation was shorter than that of dilatation by rigid ureteroscope (P < 0.05). However, the cost of balloon dilatation was higher (P < 0.05). The period of follow-up was 3-28 months. None of the patients had any complications. There were 2 cases of recurrent stricture in patients who underwent ureteroscopic dilatation.

CONCLUSIONSDespite a higher cost, balloon dilatation followed by laser incision for ureteric stricture is safe and effective. This technique may be used for selected patients.

Adult ; Catheterization ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Preoperative Care ; Retrospective Studies ; Treatment Outcome ; Ureteral Obstruction ; surgery ; therapy

Objective: To analyze the application of difficulty degree index (DDI) in predicting patients′s fertility outcome after laparoscopic myomectomy. Methods: A retrospective study was carried out on 118 patients with subserous myoma or intramural myoma undergoing laparoscopic myomectomy from January 2005 to December 2014. The rate of post-operative pregnancy, delivery outcome and disease recurrence were investigated. Logistic regression analysis was used to analyze the impact of DDI, the age of patients undergoing surgery, presence of infertility history etc, on the patients′ reproductive outcome following the surgery. Results: Follow-up for 1 to 10 years,118 cases were included in the study, the rate of post-operative pregnancy, live birth, vaginal delivery were 72.9% (86/118) , 52.5% (62/118) and 24.2% (15/62) respectively. No cases of uterine rupture and obstetric complications occurred. Univariate analysis showed that the independent variables of post-operative pregnancy rate were DDI, patient′s age at the time of surgery, presence of infertility history and myoma recurrence (all P<0.05) . In multivariate analysis, the factors of post-operative pregnancy rate were DDI (OR=3.131, 95%CI:1.012-8.894) , patient′s age at the time of surgery (OR=2.722, 95%CI:1.048-7.067) and presence of infertility history (OR=8.509, 95%CI: 2.102-34.445) . Conclusions DDI could be applied to predict post-operative pregnancy rate, with the increasing of DDI the post-operative pregnancy rate decreasing. The patients with high DDI scores, age>35 years old or presence of infertility history should get ready for pregnancy positively.

Traditional mastectomy requires the removal of nipple-areola complex(NAC),no matter whether the subsequent reconstruction or not,it can't meet the aesthetic needs of patients.With the development of breast reconstruction technology,immediate breast reconstruction with preservation of nipple-areola complex has superior aesthetic effect.More and more breast cancer patients can maintain the integrity and beauty of their body after operation.How to better protect the nipple-areola complex in breast reconstruction surgery has become one of the focuses of breast surgeons.The operator should have a strong sense of NAC protection,carefully grasp the characteristics of the posterior mammary duct and blood supply of NAC,reasonably design the surgical incision,and reduce the occurrence of postoperative nipple ischemia,necrosis and other complications as far as possible.