Objective To investigate prophylaxis and therapy of early complications following relatives' partial live small bowel transplantation.Methods Four relatives' partial live small bowel transplantations were carried out.Among the 4 patients,there were 3 cases of short intestine syn- drome and one case of non-function of small bowel caused by the absence of nerve ganglion of small in- testine.More than 4 antigens of HLA were completely matched between donators and receptors.In- testines of donators were got from terminal ileum with the length of (150?10) cm.After operations, tacrolimus (FK506),mycophenolate mofetil (MMF),and methylprednisolone were used to prevent rejections.Measures such as use of anticoagulation,improving microcirculation and albumin infusion, aimed at regulating the function of blood coagulation and preventing bleeding and formation of thrombus at anastomotic stoma;famotidine and omeprazole were used to prevent irritable ulcer;use of the third generation of cephalosporins antibiotics,ganciclovir and fluconazol could prevent bacteria,vi- rus and eumycete infections;disinfection and care of easily-infected organs were emphasized;receptors were encouraged to get out of their beds to move frequently;glutamine and enteral nutrition were used early to promote recovery of intestinal function.Results Three days after operation,one patient's lung was infected with baumanii,and the infection had been under control after being treated with the third generation cephalosporins antibiotics;five days after operation,haematoma was detected on an- other patient and was cleared through the second operations growth of eumycete was found in 2 pa- tients' excretion and secretion from enteron,and their situations were improved with fluconazol;acute rejections of the 4 patients were detected 20 days after operation and reversed by the increased use of FK506 combined with methylprednisolone.Among the 4 patients,2 of them have survived for a long time,and the first patient has survived for 6 years and 8 months till now and the other one for 3 years and 2 months;furthermore,other 2 patients respectively died of infections 5 months and 35 days after the operations.Conclusion Because of special constitution of intestine,early complications of rela- tives' partial live small intestine transplantation are frequent and complicated.Therefore,prophylaxis and therapy of early complications are crucial to the success of the transplantation.

Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.

Objective To evaluate the feasibility of catheter ablation of Para-Hisian Atrial Tachycardia guide by CARTO. Method Catheter ablation guided by CARTO was performed after activation map in three patients with Para-Hisian Atrial Tachycardia. Result Successful ablation was got at right atrial in two patients and at non-coronary in one patient. Conclusion Catheter ablation guided by CARTO is safe and efficient for Para-Hisian Atrial Tachycardia.

Objective To explore the clinical characteristics of patients with autoimmune glial fibrillary acidic protein(GFAP) astrocytosis with central nervous system inflammation as the main manifestation.Methods Twenty-one patients with autoimmune GFAP astrocytosis with positive cerebrospinal fluid GFAP antibody were collected from January 2017 to April 2020.The clinical data of 14 patients with cerebrospinal fluid GFAP antibody positive were retrospectively analyzed.Results Among the 14 patients,4 were female and 10 were male.The age of onset was(42±16) years old.The main clinical manifestations of the patients were headache(13/14),fever(13/14),disturbance of consciousness(11/14),mental symptoms(10/14),epilepsy(4/10),defecation disorder(8/14),hypoxemia(6/14),limb paralysis(2/14),etc.MRI showed abnormal enhancement of intracranial meninges in 13 cases(13/14) and spinal cord involvement in 5 cases(5/14).Conclusion There are more males than females with autoimmune GFAP astrocytosis with cerebrospinal meningitis and other central system inflammation.MRI manifestations are complex.Intracranial and spinal cord can be involved at the same time.Intracranial lesions mainly involve meninges,which can be combined with cerebral cortex damage.In myelopathy,both the spinal cord and the spinal cord are involved,and the spinal cord membrane is mainly involved.

OBJECTIVETo investigate the administration of far lateral craniocervical approach in the jugular foramen (JF) tumors.

METHODSA retrospective analysis was performed in 14 cases of JF tumors (9 neurilemmomas, 3 meningiomas, 1 glomus jugulare tumor, and 1 adenoid cystic carcinoma) surgically treated between January 2009 and January 2012, with focus on the surgical approach. Six patients (6/14) showed hydrocephalus. The tumor type was composed of 5 intracranial and intraforamen tumors with patent or occluded jugular bulb, 1 intracranial tumor with extension into the upper cervical canal, 4 extracranial and intra foramen tumors, 4 intra- and extracranial dumbbell-shaped communicating tumors involving the parapharyngeal space above C2 or extending caudally below C3. Far lateral postcondylar approach (FLPC) was carried out in 2 cases, far lateral tansjugular process approach (FLTJP) in 3 cases, combined FLPC + C1-2 semi-laminectomy approach in 1 case, combined FLTJP + trans-C1 transverse process approach in 7 cases, and combined FLTJP + neck approach with dissection of carotid sheath to the skull base in 1 case. Endovascular embolotherapy prior to surgical resection was performed in 1 glomus jugulare tumor.

RESULTSTotal tumor removal was achieved in 12 patients and subtotal removal in 2 patients, with no cerebrospinal fluid leakage or operative mortality. New cranial nerve paresis occurred after surgery in 1 case of facial nerve and 1 case of lower cranial nerve. Transient worsening of preoperative lower cranial nerve deficits was noted in 3 patients. Long-term follow-up study ranging from 5 to 32 months (average 13.7 months) showed 7 patients with lower cranial nerve deficits (6 preexisting and 1 new), with exception of one preoperative lower cranial nerve dysfunction due to the infiltration of an adenoid cystic carcinoma, experienced favorable improvement with recovery of adequate swallowing function, but voice disturbance remained in 4 cases. One patient with new facial nerve deficit presented with partial improvement and the hydrocephalus in 6 patients all spontaneously regressed. There was no tumor recurrence in patients receiving total removal and no tumor progression in patients undergoing subtotal removal.

CONCLUSIONSFLTJP is a basic approach for JF tumors. The combined cranial and cervical approach should be considered in those tumors extending into the upper cervical canal and parapharyngeal space. The associated hydrocephalus seldom requires additional surgical management.

Adult ; Aged ; Brain Neoplasms ; surgery ; Female ; Follow-Up Studies ; Glomus Jugulare Tumor ; surgery ; Humans ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Skull Base ; surgery

OBJECTIVETo investigate the risk factors for the prognosis in patients with gastric cancer undergoing surgery.

METHODSClinical data of 1031 cases who underwent gastric cancer resection from January 2003 to December 2007 were studied using univariable analysis and multivariable regression analysis.

RESULTSIn 1031 cases,95 (9.2%) cases were early-stage gastric cancer. The other 936 (90.8%) cases were advanced gastric cancer. The tumor was resectable in 980 (95.1%) cases, of which 874 (84.8%) were curative resection,106 (10.3%) were palliative, and 51 (4.9%) were bypass procedures or laparotomy alone. The stage-specific 5-year survival rates were 93.2% (stage IA), 65.1%(stage IB), 52.3% (stage II), 41.4% (stage IIIA), 16.6% (stage IIIB) and 10.6% (stage IV), respectively. The 1-, 3- and 5-year survival rates were 80.2%, 58.0% and 48.2%, respectively. The independent risk factors associated with the prognosis of these patients were tumor size, serum albumin, curative resection, TNM staging and multidisciplinary treatment in both univariable and multivariable analyses.

CONCLUSIONSEarly curative resection is the most important treatment for the patients with gastric cancer. Individualized surgical procedure combined with multidisciplinary treatment can improve the outcome. Tumor size, serum albumin level and TNM staging are important predictors of survival in patients with gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Causality ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; epidemiology ; mortality ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo analyze the expression level of candidate tumor suppressor gene N-Myc downstream-regulated gene 2 (NDRG2) in human colon cancer.

METHODSThirty samples of colon cancer tissues with matched normal colon tissues were collected. The NDRG2 mRNA level was detected by semi-quantitive RT-PCR and the NDRG2 protein level was examined by Western blot and immunohistochemistry.

RESULTSTwelve samples of colon cancer tissues had low NDRG2 mRNA level and low protein level. The positive rates of NDRG2 in normal tissues and the tumorous colon tissues were 90.0%(27/30) and 53.3%(16/30) by immunohistochemistry respectively. There was a significant difference between two groups (P<0.05). The NDRG2 expression was not correlated with age, sex, metastasis of lymph node, depth of infiltration, as well as the Dukes staging(P>0.05), while it was correlated to the histology grading. The positive rate of NDRG2 in the well- and moderate-differentiation group was higher than that in the poor-differentiation group(P<0.05).

CONCLUSIONThe expression of NDRG2 is low in some colon cancer tissues, which indicates that the low level of NDRG2 expression may be engaged in the development of colon cancer.

Blotting, Western ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Suppressor Proteins ; genetics ; metabolism

Obstructive nephropathy ultimately leads to end-stage renal failure. Renovascular lesions are involved in various nephropathies, and most renal diseases have an ischemic component that underlies the resulting renal fibrosis. The aim of this study was to investigate whether morphological changes occur in the renal vasculature in hydronephrosis and the possible mechanisms involved. A model of complete unilateral ureteral obstruction (CUUO) was used. Experimental animals were divided into five groups: a normal control group (N) and groups of animals at 1st week (O1), 2nd week (O2), 4th week (O4) and 8th week (O8) after CUUO. Blood pressure was measured, renal arterial trees and glomeruli were assessed quantitatively, and renovascular three-dimensional reconstruction was performed on all groups. Glomerular ultrastructural changes were examined by transmission electron microscopy. The results showed that the systolic blood pressure was significantly increased in the obstructed groups (O1, O2, O4 and O8). Three-dimensional reconstruction showed sparse arterial trees in the O8 group, and a tortuous and sometimes ruptured glomerular basement membrane was found in the O4 and O8 groups. Furthermore, epithelial media thickness and media/lumen ratio were increased, lumen diameters were decreased, and the cross-sectional area of the media was unaltered in the segmental renal artery, interlobar artery and afferent arterioles, respectively. In conclusion, renal arterial trees and glomeruli were dramatically altered following CUUO and the changes may be partially ascribed to vascular remodeling. Elucidation of the molecular mechanisms of renovascular morphological alterations will enable the development of potential therapeutic approaches for hydronephrosis.

Objective:To observe the effect of acupuncture on the expression of mitochondrial proteome in hippocampus of senescence-accelerated mouse prone g (SAMPg) mice models with Alzheimer disease (AD),and to explore the possible protective mechanism of acupuncture on mitochondria.Methods:Sixty 6-month-old male SAMP8 mice were randomly divided into an acupuncture at acupoint group,an acupuncture at non-acupoint group and a model group,20 mice in each group.The 20 male senescence-accelerated mouse/resistance 1 (SAMR1) mice of the same age were used as a normal control group.Shenshu (BL 23),Baihui (GV 20),Xuehai (SP 10) and Geshu (BL 17) were selected for acupuncture intervention in acupuncture at acupoint group.After an 8-week intervention,mitochondrial tissues were extracted from the hippocampus.Differentially expressed proteins were identified by subcellular organelle proteomics.Western blot was used to verify the expressions of some related proteins in hippocampal mitochondria.Results:Compared with the model group,there were 13 differentially expressed protein spots in the acupuncture at acupoint group,of which,9 were up-regulated,including neurofilament light polypeptide (NFL),actin (cytoplasmic 1,database ID:ACTB),tubulin beta-2A chain (TBB2A),tropomodulin-2 (TMOD2),pyruvate dehydrogenase E1 component subunit beta (PDHE1-β),NADH-ubiquinone oxidoreductase 75 kDa subunit (database ID:NDUS1),heat shock cognate 71 kDa protein (HSC71),pyruvate dehydrogenase E1 component subunit alpha (PDHE1-α) and ATP synthase beta subunit (ATP-β);4 were down-regulated,including glial fibrillary acidic protein (GFAP),pyruvate dehydrogenase phosphatase 1 (PDP1),mitochondrial-processing peptidase subunit alpha (MMP-α) and adenosine kinase (ADK).According to the information provided in the protein database,most of the differentially expressed proteins involve the regulation of mitochondrial function and structure.The expression levels of NFL and TBB2A in the normal control group and the acupuncture at acupoint group were significantly higher than those in the acupuncture at non-acupoint group (P＜0.05).ATP-β and NDUS1 expression levels were significantly higher in the acupuncture at acupoint group than those in the acupuncture at non-acupoint group (P＜0.05);there was no significant difference between the acupuncture at non-acupoint group and the model group (P＞0.05).Conclusion:Acupuncture may achieve the potential therapeutic effect on AD by regulating the structure and functional proteins of hippocampal mitochondria.

AIM: To study the influence of intravitreal injection of bevacizumab combined with photon dynamic treatment ( PDT ) in the treatment of central serous choroiretinopathy (CSC). METHODS:We selected 82 CSC patients treated in the hospital between February 2012 and April 2015, who were diagnosed by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) and all got the disease monocularly, and divided them into two groups called control group (n=35) and research group (n=47) by different methods, the patients of control group were treated by PDT method, while the patients of research group were treated by vitreous bevacizumab injection combined with PDT. Then compare the number of treatment times, the rate of flat pigment epithelial detachment(PED), macular subretinal fluid absorption, OCT indexes such as volume of the macular central hub, average thickness of central macular with diameter of 6mm and thickness of central macular region below 1mm range, the difference of corrected vision and clinical efficacy of two groups before and after the treatment. RESULTS:There were 32 eyes which were treated once, and 3 eyes which were treated twice in the control group, the average treatment times was 1.25士0.20; however, there were 9 eyes which were treated three times,10 eyes twice,28 eyes once, the average treatment number was 1.48士0.22, the treatment times of two groups had no statistical difference (t= 1.209, P>0.05). On the other hand,13 eyes' PED (37%) was flat in the control group,22 eyes (63%) which macular retinal subepithelial serous absorption;30 eyes' PED (64%) was flat in the research group,17 eyes (36%) which macular retinal subepithelial serous absorption. The rate of flat PED and macular retinal subepithelial serous absorption of two groups had obvious statistical difference (P<0.05). The OCT indexes such as volume of the macular central hub, average thickness of central macular with diameter of 6mm and thickness of central macular region bellow 1mm of two groups had no statistical difference before the treatment (P>0.05), in contrast these OCT indexes were all much lower than control group after the treatment, and the results had obvious statistical difference (P < 0. 05). Besides,these OCT indexes after treatment were all much lower than that of two groups before treatment respectively,and it also had obvious statistical difference (P< 0. 05). After 1 - month's treatment, the LogMAR corrected vision of two groups had no statistical difference (P>0.05). While the LogMAR corrected vision of research groups had statistical difference with control group after 3mo and 6mo (P<0.05). There were 6 invalid cases, 15 improvement cases, 8 excellence cases and 6 healing cases in the control group; the total effective rate of control group was 83%. While there were 3 invalid cases, 8 improvement cases, 20 excellence cases, 16 healing cases in the research group, the total effective rate of research group was 94%. The effective rate of two groups had obvious statistical difference (P<0.05). CONCLUSION: In the treatment of chronic CSC with PED patients, the method of vitreous bevacizumab injection combined with low dose PDT has better effect on PED flat, promoting macular subretinal serous absorption, reducing macular thickness and improving visual acuity.