Objective To investigate the primary target of injury resulting from cold preservation/reperfusion after liver transplantation in rats. Methods Male SD rats were divided into three groups randomly: sham group,UW 1-h group and UW 12-h group. Orthotopic liver transplantation was performed by using the technique described by Kamada with a modification. Survival rate of rats within 168 h postoperation was observed. Liver tissue specimens and blood samples were collected at 8 time points predetermined as 1,6,12,24,48,72,96 and 168 h postoperation. Six animals were used per time-point. The liver function was evaluated by serum ALT,AST and HA levels. Morphology was observed under light microscopy and TEM. Additionally,the incidence of apoptosis (AI) in hepatocytes and sinusoidal endothelial cells (SECs) were measured separately by TUNEL method.Results The survival rate at 168 h in UW 12-h group was 50 %,significantly lower than that in UW 1-h group (F= 6.39 ,P

6, 39 cases were with 3～6, 13 cases were with the number less than 3. The diameter of stones was 0.5～1.2 cm. Five cases suffered from bile leakage, 2 cases from peritonitis and 2 cases from remnant stones in the common bile duct. Forty-one patients were followed up and doing well. Conclusions Surgical approach is choosen on the basis individually. Laparoscopic common bile duct exploration for gallstone concomittant with choledocholithiasis is safe.

Objective To assess the feasibility of hepatolithiasis treatment using laparoscopic liver resections. Methods A prospective study of laparoscopic liver resections was undertaken in selected patients with left intrahepatic stone, and these patients were operated by laparoscopic left lobectomy. Results Two cases were operated successfully. Mean blood loss was 400～600 ml. Conclusion Laparoscopic resections are feasible in selected patients with left intrahepatic stone and bring up a new method for hepatolithiasis.

Objective To investigate the value of modified loop ileostomy in laparoscopic low and superlow radical resection of the rectal cancer with reservation of anus.Methods The clinical data of 108 patients who received laparoscopic low and super-low radical resection of rectal cancer with preservation of anus at the Subei Hospital of Jiangsu Province from January 2010 to June 2012 were retrospectively analyzed.Fifty-three patients who received preventive ileostomy were in the ileostomy group,and 55 patients who did not receive preventive ileostomy were in the non-ileostomy group.The operation,incidence of complication and follow-up of the 2 groups were analyzed.All data were analyzed using the t test,chi-square text or Fisher exact test.Results The operation time and blood loss were (185 ± 14)minutes and (31 ± 26)ml in the ileostomy group,and (154 ± 12)minutes and (28 ± 19)ml in the non-ileostomy group,with no significant difference between the 2 groups (t =2.34,1.82,P ＞ 0.05).The time to first flatus,time to liquid diet intake,time to pelvic drainage tube removal,duration of hospital stay,hospital costs were (1.1 ± 0.3) days,(1.1 ± 0.2) days,(5.2 ± 1.0) days,(7.2 ± 1.4) days,(3.0 ± 0.2) ×104 yuan in the ileostomy group,and (4.2 ± 0.6) days,(4.3 ± 0.6) days,(8.4 ± 3.9) days,(12.9 ±4.4)days,(3.8 ±0.7) × 104 yuan in the non-ileostomy group,with significant differences between the 2 groups (t =7.25,28.12,15.34,34.01,7.83,P ＜ 0.05).The incidences of postoperative complications and anastomotic fistula were 5.7％ (3/53) and 0 in the ileostomy group,and 21.8％ (12/55) and 12.7％ (7/55) in the non-ileostomy group,with significant differences between the 2 groups (P ＜ 0.05).Conclusion Modified loop ileostomy in laparoscopic low and super-low radical resection of rectal cancer can effectively reduce the incidence of anastomotic fistula,and helps the recovery of patients.

Amifostine ; therapeutic use ; Animals ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Oral Health ; Radiation Injuries ; etiology ; prevention & control ; therapy ; Radiation-Protective Agents ; therapeutic use ; Radiotherapy ; adverse effects ; Radiotherapy, Conformal ; Salivary Glands ; radiation effects ; Salivation ; radiation effects ; Submandibular Gland ; surgery ; transplantation ; Xerostomia ; etiology ; prevention & control ; therapy

Objective To explore the effects of dipeptidyl peptidase ( DPP-4 ) inhibitor on proteins expression of Bcl-2 and Bax of islet β-cells through increasing the expression of islet γ amino acid butyric acid ( GABA) . Methods A total of 50 rats of clean grade were studied. Among them, ten rats were randomly selected as normal controls, the remaining forty rats were fed with high-fat diet and then intraperitoneal injection with streptozotocin, the diabetic rats models were then established. Rats were randomly divided into three groups:i. e. diabetic control group, DPP-4 inhibitor group, and antagonist group ( DPP-4 inhibitor and GABA receptor antagonist). Six weeks later, blood glucose, serum insulin, glucagon, and the proteins expression of GABA, Bcl-2, and Bax of islet β-cells were measured. Results ( 1 ) Compared with diabetic control group, serum insulin was increased(P<0.05),bloodglucoseandserumglucagonweredecreasedinDPP-4inhibitorgroup(P<0.05). (2) Compared with DPP-4 inhibitor group, serum insulin was decreased(P<0. 05), blood glucose and serum glucagon were increased(P<0. 05) in antagonist group. (3) Compared with diabetic control group, the expression of GABA was increased(P<0. 05), the expression of Bcl-2 protein was increased (P<0. 05) in pancreatic β-cells in DPP-4 inhibitor group. ( 4 ) Compared with diabetic control group, the expression of GABA in pancreatic β-cells was increased in antagonist group(P<0. 05) . Compared with DPP-4 inhibitor group, the expression of Bax protein in pancreaticβ-cells was increased in antagonist group(P<0. 05) , while the expression of Bcl-2 protein was decreased (P<0. 05). Conclusions DPP-4 inhibitor could increase the secretion of insulin, decrease the secretion of glucagon, up-regulate expression of anti-apoptosis protein Bcl-2, and down-regulate expression of apoptosis protein Bax in pancreatic β-cells through increasing the expression of GABA, inhibiting pancreatic β-cells apoptosis and protecting the damagedβ-cells in type 2 diabetic rats.

Objective To study the sonographic features of papillary thyroid carcinoma (PTC) associated with cervical lymph nodes metastasis for early diagnosis and prediction of the invaded cervical lymph nodes. Methods The sonographic features of 170 patients with pathologically confirmed PTC in First Afifliated Hospital of Harbin Medical University between 2011 and 2013 were retrospectively reviewed. There were 59 cases with neck lymph nodes metastases and 111 cases without neck lymph nodes metastases. Receiver operating characteristic (ROC) curve was aaplied to analyze the cut-off values of resistance index (RI) and peak systolic velocity (PSV) for judging the presence or absence of cercical lymph node metastasis. The Chi-square test and rank sum test were used to compare the different sonographic features between each group. The Logistic regression analysis was used to obtain the relevant factors of PTCs with cervical lymph node metastasis. Results ROC curve analysis showed that the cut-off values of RI and PSV were 0.735,13.95 cm/s. The primary tumor diameter, the existence of halo, the involvement of thyroid upper pole, the microcalciifcation, the blood suply classiifcation and the RI, PSV were statistically signiifcantly different between PTCs with and without cervical lymph node metastasis, whereas no statistical signiifcance was detected between the primary tumor echo pattern, boundary and the longitudinal/transveral ratio between the metastatic and nonmetastatic group. Logistic regression analysis showed that the PTC primary tumor diameter and PSV were independent factors coorelated with cervical lymph node metastasis. Conclusion Some sonographic features of PTC are closely correlated with lymph nodes metastasis, which are valuable in predicting the cervical lymph nodes metastasis in patients with PTC pre-operatively.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; administration & dosage ; Bronchitis ; therapy ; Bronchoscopy ; Combined Modality Therapy ; Female ; Humans ; Isoniazid ; administration & dosage ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Streptomycin ; administration & dosage ; Tuberculosis, Pulmonary ; therapy

Objective To investigate the changes of cognitive impairment with disease progression in patients with minor stroke/transient ischemic attack (TIA).Methods Consecutive patients with minor stroke/TIA were enrolled prospectively.Montreal Cognitive Assessment (MoCA) was used to conduct the cognitive function assessment within 7 d of the onset (baseline),at 1 and 3 months,respectively.Compared with the baseline,the total scores of MoCA in patients increased by ≥2 at 3 months were cognitive function improvement and increased <2 were no cognitive function improvement.Multivariate logistic regression analysis was applied to identify the independent risk factors for no cognitive improvement.ResultsA total of 112 patients with minor stroke/TIA were enrolled in the study,including 63 patients (56.2%) with TIA and 49 (43.8%) with minor stroke.At baseline,1 month,and 3 months,77 (68.8%),72 (64.3%) and 60 (53.6%) patients had cognitive impairment.At 3 months after the onset,the cognitive function of 25 patients (22.3%) were improved,in which 19 (76.0%) and 6 (24.0%) patients had TIA/minor stroke respectively;87 (77.7%) did not have any improvement.Compared with the improvement group,the level of education was significantly lower (3.29±3.48 years vs.5.63±4.26 years;t=2.814,P=0.006),the level of glycosylated hemoglobin was significantly higher (6.35%±1.26% vs.7.21%±1.26%;t=-3.088,P=0.003) in the no improvement group,and the proportions of patients with minor stroke (49.4% vs.24.0%;χ2=5.101,P=0.024),hypertension (52.9% vs.24.0%;χ2=6.509,P=0.011),hyperlipidemia (51.7% vs.24.0%;χ2=6.019,P=0.014),diabetes (41.4% vs.16.0%;χ2=5.448,P=0.020),and coronary heart disease (32.2% vs.8.0%;χ2=5.792,P=0.016) were significantly higher.Multivariate logistic regression analysis showed that the level of education (odds ratio [OR] 1.364,95% confidence interval [CI] 1.059-1.756;P=0.016),atrial fibrillation (OR 2.509,95% CI 1.020-6.167;P=0.045),and higher glycosylated hemoglobin level (OR 1.586,95% CI 1.021-2.034;P=0.030) were the independent risk factors for no cognitive function improvement at 3 months after the onset of minor stroke/TIA.As time went on,the MoCA score and visual spatial execution,memory,abstract and directional scores were increased significantly (P<0.001),while there were no significant differences in naming,attention,and language scores.Conclusion s About 2/3 patients with minor stroke/TIA had cognitive impairment,and as time went on,they were improved.The lower education level,atrial fibrillation and higher baseline glycated hemoglobin were the independent risk factors for affecting no cognitive impairment improvement after monor stroke/TIA.

The medicine for military use only is an essential material for medical support. The United States of America is one of the earliest countries which has used special medicine to protect the military personnel from injuries and diseases. The current situation of service support in the military of USA is introduced and the challenges facing the development, product, supply and use of the special medicine in USA are analyzed,for reference by our army.