Bronchoarterial and left gastric arterial drug infusion therapy were carried out in 27 cases of inoperable,advanced esophageal cancer;with DMVC method on squa- mous carcinoma and FAM method on adenocarcinoma.Near future good results were ob- tained by raising the survival rate and life quality.The authors put emphysis on the discus- sion of the indications and theoratic points of interventional therapy.

Objective The influence of antiplatelet medications on prognosis after non -aneurysmal subarachnoid hemorrhage(SAH)is unknown.This study aimed to evaluate the risk of antiplatelet mdications in devel-oping SAH.Methods 420 patients who underwent catheter cerebral angiography after presenting with nontraumatic SAH were included.Outcomes were assessed by using the modified Rankin scale.Results A total of 420 patients underwent catheter angiography for evaluation of SAH.Of these,63 cases (15%)were angiogram -negative.The fraction of patients presenting with angiogram -negative SAH as well as the frequency of antiplatelet use among these patients significantly increased during the study period.Antiplatelet use was more commonly associated with angiogram-negative SAH(18 /63,28.6%)than with angiogram -positive SAH(39 /357,11%;P =0.001).At 14 days after presentation,poor outcome was significantly more frequent among patients who took antiplatelet agents (20 /63, 31.7%)than among those who did not(12 /63,20%;P =0.017).Conclusion Antiplatelet medication use is asso-ciated with poor early,but not late,outcomes after angiogram -negative SAH.More studies are needed to confirm this association.

Objective The core mechanism of renal insterstitial fibrosis (RIF) is epithelial-mesenchymal transition.This study aimed to investigate the effect of erythropoietin on high glucose-induced epithelial-mesenchymal transition ( EMT) of normal hu-man kidney proximal tubular epithelial cells (HK-2) and its possible mechanism. Mothods HK-2 cells cultured in vitro were ran-domly divided into a blank control group , a high glucose induction group , a mannitol induction group , an EPO induction group , an EPO (5, 10, and 20U/mL) inhibition group, and an Rho kinase inhibitor group.After 24 hours of intervention, the mRNA levels of RhoA and ROCK were determined by RT-PCR, those of E-cadherin and α-smooth muscle actin (α-SMA) proteins detected by immu-nofluorescence staining , and the expression of FN proteins in the supernatant measured by ELISA . Results Compared with the blank control group , the expressions of RhoA and ROCK 1 mRNA were significantly increased in the high glucose induction group (0.945 ±0.132 vs 1.400 ±0.022, 1.007 ±0.002 vs 1.913 ±0.011, P<0.05), but markedly decreased in the 5, 10, and 20U/mL EPO inhibition groups (1.400 ±0.022 vs 1.278 ±0.006, 1.400 ±0.022 vs 0.770 ±0.005, 1.400 ±0.022 vs 0.334 ±0.009, P<0.006) in comparison with the high glucose induction group , and the effects were related to the concentration of EPO .Compared with the blank control, the expression of E-cadherin protein was increased in the high glucose induction group (0.644 ±0.006 vs 0.107 ± 0.004, P<0.05), but remarkably decreased in the 5, 10, and 20 U/mL EPO inhibition groups (0.236 ±0.006, 0.433 ±0.010, 0.521 ±0.010) in comparison with the high glucose induction group (P<0.05), and the effects were also related to the concentration of EPO.Pearson correlation analysis showed a positive correlation between the mRNA expressions of RhoA and ROCK 1 in the high glu-cose induction and EPO inhibition groups . Conclusion EPO can inhibit high glucose-induced epithelial-mesenchymal transition of normal human kidney HK-2 cells and thus delay renal fibrosis , which mignt be related to the RhoA/ROCK signaling pathway .

Objective To define a suitable threshold setting for gross tumor volume (GTV)when using 18F-fluoro-deoxyglucose positron emission tomography and computed tomogram (PET/CT) for radiotherapy planning in Nasopharyngeal carcinoma(NPC).Methods Sixteen NPC patients respectively received PET/CT and MRI scan before their radiation treatment.All of the images were transferred to the radiotherapy planning system (TPS).MRI/CT-based primary GTV was defined as GTVf.Biological target volumes (BTVs) were derived from PET/CT-based GTVs of primary tumors.The BTVs were defined as the volumes when adjusting different percentage of the maximal standardized uptake value (SUVmax).GTVfs were compared with BTVs.The suitable threshold level (sTL) could be determined when BTV value and its morphology using a certain threshold level were observed to be the fittest GTVf.The suitable standardized uptake value (sSUV) was calculated as the sTL multiplied by the SUVmax.Results Our result demonstrated no single sTL or sSUV method could achieve an optimized volumetric match with the GTVf.The sTL was [20.93％±6.51％(15％-40％)],whereas the sSUV was [2.27±0.48(1.56-3.25)].The sTL was inversely correlated with the SUVmax sTL =-0.144ln(SUVmax) + 0.5548 (R2 =0.85,F =78.57,P＜0.01.The sSUV showed a linear correlation with the SUVmax sSUV =0.104(SUVmax) + 1.0398,(R2=0.75,F=41.88,P＜0.01).The sTL was not associated with the value of GTVf.Conclusions In PET/CT-based BTV for NPC,SUVmax threshold method is feasible.sTL is not a fixed value,which is correlated with the SUVmax instead of the value of tumor.

Objective To optimize supercritical extraction technique from four medicinal materials, which are the part components in the recipe of Keganliyan Oral Liquor and are extracted traditionally for essential oils. Methods Extraction ratio and menthol extraction quantity were taken as evaluated indexes. Supercritical extraction technique was researched with orthogonal tests, gas chromatography, and SAS statistic. Results Within the test levels, temperature and time showed evident effect on extraction ratio and menthol extraction quantity, while pressure did not show any evident effect on them、 The preferable technique to extraction ratio is temperature at 55 ℃, time for 120 min, and extracted pressure at 27 MPa; and the preferable technique to menthol extraction quantity is temperature at 45 ℃, time for 120 min, and extracted pressure at 22 MPa. Conclusion The optimized supercritical extraction technique for Keganliyan Oral Liquor is feasible.

Objective:To explore the value of improved sequential organ failure assessment (ISOFA) in predicting the prognosis of Klebsiella pneumoniae sepsis. Methods:The clinical data of 379 patients with Klebsiella pneumoniae sepsis admitted to the First Hospital of Jilin University from January 1, 2018 to June 30, 2019 were retrospectively analyzed.They were divided into survival group and death group according to the 28-day prognosis, and the age, gender, C-reactive protein, procalcitonin, grade of bacterial resistance, and the occurrence of septic shock of the two groups were compared.Statistical analysis was conducted by using independent sample t test, Mann-Whitney U test and chi-square test. Risk factors for the prognosis of the disease was analyzed by logistic regression analysis.The correlation between ISOFA and other scoring system including Charlson′s weighted index of comorbidities (WIC), national early warning system (NEWS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), simplified acute physiology scoreⅡ (SAPSⅡ), mortality in emergency department sepsis score (MEDS), sequential organ failure assessment (SOFA), acute gastrointestinal injury (AGI) was determined by Spearman correlation coefficient.The area under the receiver operating characteristic curve (AUROC) was used to compare the evaluation value of each scoring system for the prognosis of Klebsiella pneumoniae sepsis. The clinical significance of ISOFA risk stratification was evaluated by Kaplan-Meier survival curve. Results:Among the 379 patients with Klebsiella pneumoniae sepsis, 278 were in the survival group and 101 were in the death group.The differences of age, gender, the occurrence of septic shock, grade of bacterial resistance, C-reactive protein, procalcitonin, WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS, SOFA, AGI and ISOFA score between the two groups were all statistically significant ( t=-3.218; χ2=6.781, 24.374 and 27.208, respectively; Z=-3.689, -5.022, -4.396, -4.697, -7.438, -6.348, -6.358, -8.676, -6.680 and -11.658, respectively; all P<0.01). The calculation method of ISOFA was obtained by single factor analysis: ISOFA=SOFA+ 1.5×AGI.Multivariate logistic regression suggested that ISOFA, gender, SOFA, procalcitonin, C-reactive protein, and bacterial resistance were independent risk factors for the prognosis of the disease. The Spearman correlation coefficients of ISOFA and WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS and SOFA were 0.327, 0.371, 0.614, 0.564, 0.578 and 0.847, respectively. The AUROC and its 95% confidence interval for WIC, NEWS, MEDS, SAPSⅡ, APACHEⅡ, SOFA alone, SOFA plus AGI, and ISOFA to predict the prognosis of Klebsiella pneumoniae sepsis were 0.646 (0.584-0.708), 0.657 (0.597-0.716), 0.712 (0.654-0.771), 0.713 (0.653-0.773), 0.749 (0.693-0.806), 0.788 (0.737-0.838), 0.872 (0.826-0.917) and 0.891 (0.845-0.937), respectively.The results showed that ISOFA had the best predictive effect.The Kaplan-Meier survival curve suggested that there were statistical differences in survival rate among ISOFA low-risk level, medium-risk level, and high-risk level (all P<0.01). Conclusion:ISOFA has important clinical significance in predicting the prognosis of Klebsiella pneumoniae sepsis.

OBJECTIVE: To explore the clinical repair value of facial skin and tissue defect caused by tumour, trauma and infection with the axial flap. METHOD: The clinical data of 38 patients with facial skin and tissue defect were analyzed retrospectively. All of them were repaired by the axial flap. RESULT: The axial flap was alive in all patients, and all incision healed in the first stage. All patients had a satisfied result after the second stage of flap surgery. CONCLUSION The method of the axial flap in face can be clinically applied in the facial skin and tissue defects caused by tumour, trauma injury and infection. Because the axial flap cotained named blood vessel, the survival rate of it is high.
Dermatologic Surgical Procedures ; Face ; surgery ; Humans ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Wound Healing

ObjectiveTo evaluate totally laparoscopic Meckel's diverticulectomy in comparison with laparoscopic-assisted or open diverticulectomy.MethodsThe clinical data of 58 cases of Meckel's diverticulum admitted between January 2006 and January 2011 were analyzed.Cases were divided into three groups according to different period of time. As a result,totally laparoscopic surgery was performed in 13 cases,laparoscopic-assisted resection in 25 cases and open diverticulectomy in 20 cases. Totally laparoscopic group was compared with the other two groups in operation time,flatus defecation time,the incidence of postoperative complications and postoperative hospital stay.ResultsThe mean length of incision was ( 1.6 ± 0.4 ) cm,the mean operation time was ( 41 ± 5 ) min,flatus defecation time was (21.2 ±3.7) h,and the postoperative hospital stay was (6.3 ± 1.2) d in totally laparoscopic group.While that was (2.5 ± 1.2 ) m,( 38 ± 2 ) cm,( 23.6 ± 4.2 ) h,( 6.5 ± 2.3 ) d,respectively in laparoscopicassisted group,and the mean length of incision was (5.0 ± 2.2 ) cm,the mean operation time was (51 ± 6 )min,flatus defecation time was (32.3 ± 6.7) h,the postoperative hospital stay was (8.4 ± 3.8) d in open surgery group.Compared with conventional laparotomy,laparoscopic techniques enjoy advantages of minimal invasion,shorter operative time,fewer complications,shorter recovery period and earlier gastrointestinal recovery(P ＜ 0.05). There were nosignificant differences in operative time, recovery period and complications between totally laparoscopic group and laparoscopic-assisted group.ConclusionsTotally laparoscopic Meckel's diverticulectomy is safe,effective and miniinvasive in experienced hands.

Objective To investigate the radiosensitizing effect of knock-down the expression of miR-21 on human SHG-44 glioma cells and explore the possible mechanism. Methods Antisense oligonuleotidas of miR-21, mediated by LipofectamineTM 2000, were transfected to SHG-44 cells. Three groups were: blank control group ( mock group), negative control and antisense transfected group ( AS-miR-21 gorup). Cells of each group were irradiated with 6 MeV X-rays at the doses of 0,1,2,4,6 and 8 Gy.Dose-suvivial curve was established by colony-forming assay. The influence of AS-miR-21 on cell cycle and cell apoptosis was analyzed by flow cytometry assay after 6 Gy irradiation. Results The value of D0 and Dq of AS-miR-21 group declined obviously compared with the mock group and negative control group. Flow cytometric analysis showed that cell cycle distribution changed( G0/G1 phase arrest, S phase decreased)after transfected with AS-miR-21 (t = 8.18, -4.52,P ＜ 0.05 ). The sensitization enhancement ratios of D0 and Dq were 1.32 and 2.10 respectively. Apoptosis assay showed the early apoptosis rate was signiflcantely increased in AS-miR-21 、irradition alone and combined group than mock control group( t = 20.14,11.11,50.07, P ＜ 0.05). Conclusions AS-miR-21 can enhance the radiosensitivity of human glioma cells SHG-44 by promoting cell apoptosis and faciliating cell cycle redistribution.

BACKGROUND: The choice of suitable bone graft substitute is vital for spinal fusion treatment, which can solve some limitations caused by autogenous bone graft and other materials. OBJECTIVE: To investigate properties of different bone graft fusion materials, and to explore their application in dog spinal fusion of lumbar vertebral body. METHODS: Forty-five Chinese rural dogs were enrol ed to prepare lumbar interbody fusion models, and then were randomized into three groups transplanted with autogenous ilium, recombinant human bone morphogenetic protein-2 composite or al ograft ilium, respectively. Afterwards, effects of different materials in the lumbar interbody fusion were analyzed. RESULTS AND CONCLUSION: The fusion rate of the composite group was significantly higher than those of the other groups (P < 0.05). Oswestry dysfunction index of the composite group was significantly lower than those of the other groups after surgery (P < 0.05). Hematoxylin-eosin staining showed that dogs achieved complete bony fusion, continuous bone trabecula gradual y formed, and there was no gap between the transplanted bone and the bone surface in the composite group compared with the other groups at 12 weeks after surgery. These results demonstrate that recombinant human bone morphogenetic protein-2 composites can significantly promote the spinal fusion superior to autologous and al ogeneic bone grafts.