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

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 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.

10.3969/j.issn.2095-4344.2013.23.018

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.

BACKGROUND: Biomechanical mechanisms are complex, and previous studiers focus on the stress conduction in the carpus. However, the stress distribution and characteristics of trabecula in the carpus are rarely reported.OBJECTIVE: To investigate the stress distribution and deformation characteristics of the normal lunate through a two-dimensional sagittal finite element model.METHODS: A normal cadaveric lunate sample was scanned with Micro-CT and the central sagittal image was chosen for further finite element analysis (FEA). The chosen image was processed and imported into the finite element analysis software (Ansys 14.0). A two-dimensional sagittal finite element model of the lunate bone was established. Axial pressure was applied to the model with the wrist held in different positions, and nine regions of interests (ROIs) were identified, for which stress and displacement nephograms were created. These included the first principal stress (S1, the maximum stress in a principal plane), the third principal stress (S3, the minimal stress in a principal plane), shear stress (SXY, the component of stress coplanar with a material cross section), von Mises stress (SEQV, yielding begins when the elastic energy of distortion reaches a critical value)and displacement of each ROI (UY, displacement on the vertical plane of the lunate) which were calculated and compared.RESULTS AND CONCLUSION: (1) The stresses on ROIs located in the proximal and volar cortices of the lunate bone were much higher than those in the distal and dorsal cortices. At the proximal lunate, S1 was less than S3; however at the distal lunate, S1 was greater than S3. The ROIs of the distal and proximal ends of the lunate bone received much higher stress than the ROIs of the middle part. As for axial trabecular displacement,both distal and proximal ROIs were compressed by axial pressure. However, the dorsal and the volar parts of the proximal lunate moved in different directions at different wrist postures. Besides, the stress values and magnitudes of displacement were elevated in wrist flexion and extension compared to neutral position.Furthermore, the stress concentration zones (the proximal volar ROI, the proximal dorsal ROI, the distal volar ROI, and the distal dorsal ROI) had different directions of shear stress and displacement in different wrist postures. (2) These results suggest that when stress is loaded on a normal lunate model, four stress concentration zones, the proximal volar ROI, the proximal dorsal ROI, the distal volar ROI, and the distal dorsal ROI are found. The wrist postures can significantly affect the value and distribution of axial stress on the sagittal lunate.

Objective:To establish the fingerprint chromatogram of anthraquinones compounds in Radix et Rhizoma Rhei. Methods: HPLC with ?Bondapak-C 18 [3.9mm?300mm,10?m] column was used, the CH 3CN-0.5% H 3PO 4 (gradient elution) as a mobile phase and detection wavelength at 430nm. Results: 12 peaks were separated on the HPLC fingerprint of anthraquinones compounds in Rhubarb. Conclusion: The method is simple and accurate with a good reproducibility and can be used for a quality control method for Radix et Rhizoma Rhei.

Objective To evaluate improved effect for deep venous valve function after superficial vein surgery of lower extremity in the intermediate stage.Methods Totally 43 patients (55 limbs) with varicose veins of lower extremity were enrolled to accept surgical management of vein systems in our department from March 2006 to October 2006.All patients were respectively followed up after 6 months and 4 years about the changes of deep venous valve function with color Doppler ultrasonography.Results Thirty-nine patients’ deep venous valve function kept well up to now,and there was no significant difference between the two results.Four patients without proximal saphenous vein ligation recurred,and there was reflux in deep venous.Conclusion Endovenous laser treatment and ablation of varicose veins of lower extremity with deep venous insufficiency could improve deep venous valve function effectively.Proximal great saphenous vein ligation is important for successful operation.