OBJECTIVE To investigate clinical characteristics of spontaneous bacterial peritonitis(SBP) in patients with severe type of viral hepatitis.METHODS A retrospective review of 120 cases of SBP associated with severe type of viral hepatitis was performed.RESULTS Clinical manifestations were as follows:fever 85.0%,abdominal tenderness 51.6%. 63.3% of the total white blood cells count in the ascitic fluid under 0.5×109／L,85.0% of polymorphonuclear cell ratio above 0.50.The positive culture of the ascitic fluid 24.2%,whereas 42.9% of the isolated microorganisms were Escherichia coli.CONCLUSIONS Clinical manifestations in SBP may be non-specific or absent.The total white blood cells count in the ascitic fluid are often under criteria for diagnosis.E.coli was the most common culture isolate.PMN ratio is the reliable parameter for the diagnosis of SBP.

Objective To explore the relationship between plasma prothrombin activity (PTA) and histopathological lesion of the liver in patients with viral hepatitis. Methods A retrospective review of plasma PTA level and hepatohistological grading was performed in 234 patients with chronic hepatitis B (CHB) and 54 patients with severe hepatitis diagnosed both clinically and pathologically. Results PTA level was obviously negatively correlated with the hepatohistological Ishak score (P

Objective To explore the effect of preventive antibacterial treatment on spontaneous bacterial peritonitis (SBP) in the patients with severe hepatitis. Methods 120 cases of the patients with severe hepatitis were divided into two groups randomly. The patients in group A (n=62) received preventive antibacterial treatment except therapy for protecting liver. The patients in group B (n=58) only received therapy for protecting liver and served as control. Results In the group A and group B, the SBP frequency was 27.4% (17/62) and 44.8%(26/58) respectively (? 2=3.95,P

Objective Retrospective analysis of experience of distal upper limb autologous arteriovenous fistula for hemodialysis access and treatment of arteriovenous fistula occlusion was conducted.Methods To summarize the clinical data of 214 cases of initial autologous arteriovenous fistula and 22 cases of treatment of arteriovenous fistula occlusion were carried out from Aug.2007 to Mar.2011,comparing the success rate and long-term patency rate.Results Two hundred and fourteen cases of initial autologous arteriovenous fistula,in which 168 cases were cephalic vein-radial artery side-to-side anastomosis at snuffbox,46 cases were cephalic vein-radial artery end-toside anastomosis at proximal wrist,the success cases were 203 (94.8％),the failed cases were 11 (5.2％),limb edema in 82 cases and there was no steal syndrome and heart failure.The primary patency rate was 95.2％ at 1 year and 91.3％ at 2 years.There were 22 patients accepted treatment of arteriovenous fistula occlusion,in which,8 cases were embolectomy due to acute occlusion,8 cases were thrombectomy and balloon dilation because of anastomotic stricture and thrombosis and 1 failed,5 cases were proximal anastomosis again after chronic occlusion.Conclusions Autologous arteriovenous fistula of the distal upper limb,especially from the place of snuffbox which is the preferred method for autologous arteriovenous fistula.And deal with arteriovenous fistula occlusion actively can often extend the usage time of the autologous blood vessels and improve the life quality of patients.

Objective To investigate the role of IL-11 and CTGF in bone metastasis of breast cancer.Methods A total of 180 pathologically confirmed breast cancer patients in Tianjin Medical University Cancer Institute and Hospital were enrolled,90 of which had bone metastasis.Twenty healthy people who took physical examination at the same period were adopted as controls,excluding those with endocrine or metabolic disease or other chronic diseases.Peripheral blood samples were collected and ELISA was employed to detect IL-11 and CTGF expression.Forty paraffin-embedded breast cancer tissue sections from those with bone metastasis and forty tissue sectioned from those without bone metastasis were detected for IL-11 and CTGF expression with immunohistochemisty.Results Serum IL-11 level was (242.9 ±56.3) μg/L in the group with bone metastasis and (85.9 ± 35.7) μg/L in the group without bone metastasis,with a significant difference (F =43.532,P ＜0.01).Serum level of CTGF was (15.6 ±7.4) μg/L in the group with bone metastasis and (15.0 ± 7.0) μg/L in the group without bone metastasis,with no significant difference (F =3.007,P ＞ 0.05).The rate of positive immunohistochemical staining for IL-11 in the group with bone metastasis (57.5％) was significantly higher than that in the group without bone metastasis (14.3％) (x2 ＝ 36.626,P ＜ 0.01).There was no significant difference in the positive rate of CTGF expression between the group with bone metastasis (17.5％) and the group without metastasis (14.3％) (x2 =0.370,P ＞ 0.05).Conclusions IL-11 expression is correlated with bone metastasis of breast cancer.Breast cancer patients with high IL-11 expression are more prone to develop bone metastasis.

Objective To explore the misunderstanding and comprehension of hybrid operation for treating aortic dissection involving aortic arch.Methods From March 2009 to November 2013,13 patients received hybrid operation for aortic dissection involving aortic arch in the People's Hospital of Xinjiang Urgur Autonomous Region were enrolled,including male 11 and female 2,and aged 36 ～ 60 years old with a mean age (44 ± 6.8) years old.All patients were type-B aortic dissection.All of them were not suitable to be treated with endovascular exclusion monotherapy.The ascending aorta-brachiocephalic artery bypass and left carotid artery bypass was established with median sternotomy approach and neck incision in 13 patients,and 2 patients did left subclavian artery bypass additionally,then retrograde endovascular stent graft implantation was used.Computed tomography angiography (CTA) scanning at 3-month,9-month,1-year and every-year after operation showed no stent grafts translocation and bypass graft obstruction.Results The surgical operation and stent grafts implantation were completely successful.Angiography showed 1 case had end leakage and other cases no obvious displacement or end leakage of stent grafts in operation.Blood flow in true lumen of aortic dissection was recovered and all of bypass grafts were unobstructed.No death and severe complications occurred.All patients were followed-up with 3 to 56 months [(29.0 ± 10.2) months],and all patients resumed normal life.Enhanced CT scanning after operation showed 1 case had endoleak and other cases no endoleak,stent grafts translocation and bypass graft obstmction.No signs of brain and limb ischemia were observed.Conclusions To summarize misunderstanding and experience by continuous explore feature of hybrid operation for treating disease involving aortic arch,we developed a more reasonable surgical treatment options that can improve the success rate of complex aortic dissection surgery,and ultimately achieve better surgical results.

Objective To investigate the changes of perioperative right ventricular function after pulmonary resction. Methods 45 cases of pulmonary resection were divided into four groups.Group Ⅰwas wedge resection(n = 10), GroupⅡ was lobectomy(n = 19), Group Ⅲ was double lobectomy(n=7)and Group Ⅳ was pneumonectomy(n=9). The changes of CVP, PAMP, PEP/ET, Sa, VTIs, RVSP, Ea/Aa, and Tel were evaluated by traditional ultrasonic and tissue Doppler ultrasonic techniques at different time inter- vals (pre-operation, 5-7 days orland 1 month post-operation), Results Compared with the pre-operation CVP, the indexes of all groups have no significant changes post-operatively. Wedge resection didn' t obviously influence right cardiac after load and systolic function/diastolic function. No evidet changes detected in Tei pre-and post-operatively. However, the indexes (PAMP, RVSP and PEP/ET ratio) reflecting right cardiac afterload evidently increased at post-pneumonectomy or lobectomy group5- 7 days post-opera- tive. All these reflect the decrease of Tei, which was more obvious in pneumonectomy than in lobectomy group. Right cardiac after- load, systolic/diastolic function and Tel index recovered to pre-operative level 1 month post-operation in single lobectomy group. But the above indicators, especially the Tel, were still high in double lobectomy and pmeunonectomy groups 1 morth post-operation.Tei index is positively correlated with PAMP and is weakly correlated with PET/ET ratio and Ea/Aa ratio. Conclusion Pulmonary wedge resection doesn't evidently influence right cardiac function. However, right cardiac diastolic function evidently decreases temporarily at lobectomy group. The systolic function and diastolic funetions decrease after double-lobectomy and pneumonectomy and it's more evident in pneumonectomy group. Though the right cardiac afterloads of lobectomy, double lobectomy and pneumonectomy groupa all increase significantly post-operativlye, only the former recover to pre-operative level 1 month after surgery.

Objective To observe the function improvement of deep venous valve after superficial vein surgery of lower extremity by ultrasound.Methods Sixty patients(70 lower limbs)with primary deep venous insufficiency were enrolled tO accept surgical management of vein systems.All Datients were detected with color Doppler ultrasonography,their deep venous hemodynamics indices were measured and recorded before operation and 6 months after operation. Results The total improvement rate of the deep venous hemodynamics after superficial vein surgery was 65.7%.The valve function of suPerficial femoral vein and popliteal vein were improved after operation,and there was no significant difference between the two veins in effectiveness.The improvement for deep venous reflux had no significant difference between two surgical methods. Conclusions The superficial vein surgery of lower extremity can improve deep vein valve function in some extent.

ObjectiveTo observe the effect of succus entericus reinfusion with continuous enteral nutrition on the barrier function of intestinal mucosa and nutritional status in patients with stomal type fistulas. Methods Sixteen patients with stomal type fistula from July 1995 to May 2008 were enrolled in the study. A]l patients met the following conditions: gut function returned normal; abdominal infection was controlled; total enteral nutrition was provided ; and the length of small intestine for succus entericus reinfusion was more than 50 cm. Intestinal mucosa was taken at 25 to 30 cm away from stoma of fistula by endoscope 0, 7, and 14 days after reinfusior. Hematoxylineosin staining was performed to count the number of intestinal intraepithelial lymphocytes (IIELS). In addition,proliferating cell nuclear antigen (PCNA) was measured with immunohistochemical staining. Serum protein levels were determined by immunonephelometry. ResultsThe percentage of IIELS in intestinal mucosa ( 19.06％ ±4.81％ vs. 12.81％ ±2.95％, P=0.000) and the percentage of PCNA positive cells ( 12.13％ ±4.33％ vs.6.44％ ± 2.34％, P =0.000) 14 days after succus entericus reinfusion were significantly higher than those on the day of reinfusion. Serum fibronectin level increased from ( 152.80 ± 16.50 ) to ( 227.05 ± 45.36 ) mg/L ( P =0.000), and transferring protein level increased from ( 2.16 ± 0.52 ) to ( 2.62 ± 0.41 ) g/L ( P =0.017 ) 14days after succus entericus reinfusion. ConclusionSuccus entericus reinfusion is effective in protecting the intestinal mucosa in patients with stomal type fistulas.

Objective To discuss the necessity and rationality of regional pancreatoduodenectomy combined vas-cular reconstruction in the treatment of chronic pancreatitis with lump in the head. Methods Thirteen patients who suffered from pancreas with lump in the head, were operated in our department from January 2000 to March 2006. The clinical data were analyzed retrospectively,there were 10 men and 3 women with an age ranging from 37 to 71 (mean = 51 ), all the patients underwent pancreatoduodenectomy combined PV and SMV reconstruction. Results All thirteen patients were pathologically confirmed chronic pancreatitis without postoperative deaths, in which stom-ach empty disorder and pancreatic fistula occurred and were cured conservatively in one case. All the 13 patients who were followed up 19～86 months had no pain and jaundice at all after the operation. Conclusion Combined vascular reconstruction to treat the lump in the head of the pancreas that packages blood vessel and hard to separa-tion is proved to be a safe and reliable method, being capable of raising lump resection rate, which can improve quality of life of patients remarkably to avoid omit minimum cancer in lump to result in lose the curative opportunity.