Objective To investigate the clinical effect and to summarize the experience of percutaneous radiofrequency ablation (RFA) of spleen together with splenic artery balloon block in treating hypersplenism due to cirrhosis and portal hypertension. Methods Under the situation of splenic artery occlusion with balloon, RFA of the spleen was performed in 15 patients with hypersplenism caused by cirrhosis and portal hypertension. The mean duration of RFA was (46.4±5.4) min. Routine blood tests were conducted at 3 days, one week, one, 3 and 6 months after the treatment, and abdominal CT angiography was performed one month after RFA. The results were analyzed. Results One patient developed massive bloody pleural effusion at left thorax three days after RFA, which was improved after hemostasis and thoracic drainage. No severe complications occurred in other patients. Abdominal CT angiography performed one month after RFA showed that the ablated extent by RFA was accounted for about 34.3%-71.8% proportion of the spleen, with a mean of (56.20 ±13.09)%. Preoperative blood tests indicated that the count of white blood cells, red blood corpuscles and blood platelets was (3.88±1.75)×109/L, (4.06±0.37) × 1012/L and (48.14± 11.33)×109/L, respectively. One month after RFA the count of white blood cells and blood platelets increased to (5.62±1.61) ×109/L and (132.29±33.20) ×109/L respectively. When compared with the preoperative data, the differences in the count of white blood cells and blood platelets were statistically significant (P<0.05). Conclusion For the treatment of hypersplenism due to cirrhosis and portal hypertension, percutaneous radiofrequency ablation of spleen together with splenic artery balloon block is quite safe and this technique has satisfactory short-term effect.

Objective To study the chemical constituents ofPronephrium triphyllum.Methods The chemical constituents in the plant were isolated and purified with silica gel and Sephadex LH-20.Their structures were identified by analyses of spectral data and physicochemical properties.Results Six compounds were isolated and identified as shelincaoide A(1),n-butyl-13-D-fructopyranoside(2),triphyllin A(3),6,7-di-hydroxycoumarin(4),daucosterol(5),and 13-sitosterol(6),respectively.Conclusion Compound 1 is found to be a new compound.Compounds 2 and 4 are firstly isolated from the plants in Pronephrium Presl.and all compotmds except 3 are obtained from the species for the first time.

Objective To explore issues of the human tissue biobank, ranging from its establishment, collection and preservation of samples, quality control, management and application. Methods Development of standardized operational procedures, collection of such samples as fresh frozen tissues from the surgery, paraffin-embedded tissues, whole blood, serum, plasma, and cerebrospinal fluid. Specimens were classified and made aliquots according to different requirements, and then stored at room temperature, -80℃ refrigerator or in liquid nitrogen. Microsoft Access database system was used in the management of these specimens. Results From September 2004 to September 2008, a total of 11 872 samples from patients with benign and malignant diseases were collected and preserved. Among them, 4360 tubes of fresh frozen tissue samples from 2500 cases were provided within and beyond the province. These samples were also applied to DNA, RNA, protein extraction and tissue microarray, and immunohistochemistry-related research. Conclusion Human tissue biobank is highly useful in sharing human tissue resources effectively, as it can provide high quality specimens from benign and malignant diseases and normal control. In addition, it plays a very important role in exploring pathogenesis, developing new technologies for early detection of disease and new therapeutic strategies.

OBJECTIVETo investigate the clinical effect of Halo-vest head ring in the treatment of replantation of total scalp avulsion.

METHODSWe treated 11 cases of total scalp avulsion with the anastomosis of arteriovenous vessels and Halo-vest head ring from December 2006 to February 2015.

RESULTSOne patient's replanted scalp got necrosis because of serious contusion which was healed without hair growth after free skin graft and dressing. All the scalp flaps in the other 10 patients survived. After 3-96 months follow-up, the wound completely healed, the scalp and hair grew well with satisfactory appearance.

CONCLUSIONSThe use of Halo-vest head ring for replantation of total scalp avulsion can effectively improve the survival rate and survival area.

Anastomosis, Surgical ; methods ; Bandages ; Graft Survival ; Humans ; Lacerations ; surgery ; Necrosis ; etiology ; Prostheses and Implants ; Replantation ; methods ; Scalp ; injuries ; pathology ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

Objective To investigate the changes in the serum level of vascular endothelial growth factor (VEGF) in experimental Wistar rats with hepatic alveolar echinococcosis (HAE) after hepatic arterial infusion (HAI) of bevacizumab treatment, and to discuss the efficacy of HAI of bevacizumab for hepatic alveolar echinococcosis. Methods Forty Wistar rats with successfully established HAE were randomly and equally divided into two groups with 20 rats in each group: the control group and the study group. Hepatic arterial infusion of saline was performed in the rats of the control group , while hepatic arterial infusion of bevacizumab was carried out in the rats of the study group. Before and 7, 14, 21 and 28 days after the treatment peripheral blood samples were collected from the tail vein, and the serum levels of VEGF, apartate aminotransferase (AST) and alanine aminotransferase (ALT) were determined by the quantitative sandwich enzyme-linked immunosorbent assay (ELISA). All the rats were sacrificed 28 days after the treatment. HAE samples were examined to evaluate the effect of bevacizumab on HAE lesions. Results Seven days after hepatic arterial infusion of bevacizumab, serum VEGF expression level in the study group became gradually decreased, and the difference was statistically significant when compared with the preoperative level or with that in the control group (P = 0.019). Fourteen days after the treatment, the serum VEGF expression level kept going down to its lowest point, and the difference in serum VEGF expression level was statistically significant when compared with the preoperative level (P < 0.01). Twenty-one days after the treatment, serum VEGF expression level started to rise and it returned to normal level in 28 days after the treatment. In the control group no significant changes in serum VEGF expression levels was observed after hepatic arterial injection of saline (P > 0.05). Conclusion In treating hepatic alveolar echinococcosis, hepatic arterial infusion of bevacizumab has certain inhibitory effect on angiogenesis. This therapy is safe and effective.

Objective To explore the clinical efficiency and safety of radiofrequency ablation combined with Tegafur,Gimeracil and Oteracil Porassium Capsules( S-1 capsules) for hepatocellular carcinoma.Methods Sixty HCC patients included in this study were underwent initial radiofrequency ablation and then they were di-vided into RFA+S-1 group and RFA control group according to the metronomic chemotherapy either with S-1 or not.The local tumor control and disease free survival outcome between the two groups were compared.Results Follow-up observation showed that the total control rate after 9 months′treatment was 93.3%in RFA+S-1 group vs.73.4%in RFA control group(P=0.038).During the 18 months of follow up,the median time for dis-ease free survival was 16.25 months in RFA+S-1 group vs.12.25 months in RFA control group( P<0.001) . One-year progression free survival rate in RFA group was 53.3%,which was significantly lower than the RFA+S-1 group(83.3%)(P=0.012).The major complication rate was 13.3%.No procedu rerelated death or severe complications occurred.Conclusion Metronomic chemotherapy with S-1 following initial radiofrequency ablation delays tumor progression and prolongs overall survival of patients with HCC tumors.

BACKGROUND: The direct ratio is formed between the size of osseous defect around implant and the required time of complete repair. It is viewed that bone implantation is suggested if osseous defect is larger than 1 mm, which benefits the bone regeneration and early fixation of implant.OBJECTIVE: To compare the effects between coralline granules and hydroxyapatite (HA) during union after immediate implantation.DESIGN: Group observation and controlled experiment was designed.SETTING: Department of Stomatology Renmin Hospital of Wuhan University.MATERIALS: HA coated implant, HA granule, coralline granule and 3adult mongrel dogs.METHODS: The experiment was performed in Department of Stomatology, Renmin Hospital of Wuhan University from August 2002 to April 2003.Under anesthesia, 6 foramens were drilled on femurs of 3 dogs (3 foramens on each side) to result in osseous defect. Coralline granules were embedded in the osseous defect around the implant in all of proximal ends (coralline granule group, CG group), HA granules were embedded in the osseous defect around the implant in all of distal ends (HA group) and nothing was embedded in the defect around the implant in the center (the control). One dog was sacrificed under anesthesia on the 2nd, 3rd and 4th months after operation successively and the samples were collected from the implanted section in each group for X-ray examination and scanning electronic microscopic observation.MAIN OUTCOME MEASURES: X-ray examination on implanted sections and scanning electronic microscopic observation on samples in each the 4th month, it was observed that implants and osseous tissue were closely integrated in CG group and HA group and there was still partial osseous on samples in each group: on the 4th month, it was discovered that the regenerated osseous tissue was matured completely in CG group and few coralline granule residue was left. In HA group, the regenerated osseous tissue was matured completely, but there was still a large amount of HA granules left and the granules had not been absorbed obviously. In the control group, the space appeared partially in the implanted cervical region.CONCLUSION: The implantation of artificial bone is suggested if the osseous defect around immediate implant is larger than 1 mm. As the implanting materials, coralline granules and HA granules act on the most advantageous guide activity. Coralline granules can be degraded and substituted with osseous tissue,but HA granules cannot be absorbed, which affects osseous reconstruction.

The main work and achievements of clinical pathway work in China since 2009 were systematically reviewed in the paper. It analyzed the problems existing in the implementation of clinical pathway management in China, and suggested on such management in the future. The suggestions include:deeper understanding, convergence with the payment system reform, strengthened quality control, further informatization,and better performance appraisal system.

Objective:To evaluate the application value of simplified augmented reality (AR) technique in the location of puncture point before drainage of supratentorial hemorrhage in the elderly.Methods:One hundred and sixty-three senile patients with supratentorial cerebral hemorrhage (amount of bleeding: 30-60 mL) treated by hematoma drainage from February 2018 to February 2020 were chosen in our study; 85 patients (observation group) were treated with AR technique assisted drainage, and 78 patients (control group) accepted drainage assisted by virtual reality (VR) technique (3D slicer software) combined with AR technique (Sina software). The differences of preoperative location time, accuracy rate of catheter placement, sufficient drainage rate of hematoma within 72 h of surgery, postoperative pulmonary infection rate, postoperative Intensive Care Unit staying time, and favorable prognosis rate were compared between the two groups.Results:The accuracy of the catheter placement (95.3% vs. 94.9%), sufficient drainage rate of hematoma within 72 h of surgery (96.5% vs. 96.2%), postoperative pulmonary infection rate (21.2% vs. 19.2%), postoperative Intensive Care Unit staying time ([75.5±16.7] h vs. [81.5±19.5] h), favorable prognosis rate (75.3% vs. 70.5%) between the observation group and control group showed no significant differences ( P>0.05), but the preoperative location time in the observation group was significantly shorter than that in the control group ([12.2±6.5] min vs. [37.5±11.3] min, P<0.05). Conclusion:On the basis of no significant difference in the accuracy and therapeutic effect of catheter placement, drainage assisted by simplified AR technique is more convenient and faster than that by VR combined with AR technique.

Objective:To investigate the expressions of TRIM25 and RIG-Ⅰ in liver cancer tissues and their relationship with the prognosis of patients.Methods:The data of 82 patients with liver cancer who were admitted to the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University from January 2017 to January 2018 were retrospectively analyzed, and their cancer tissue and paracancerous tissue (>5 cm from the edge of the tumor) specimens were collected. The protein expressions of TRIM25 and RIG-Ⅰ in cancer tissues and paracancerous tissues were detected by immunohistochemistry. The relationship between TRIM25 and RIG-Ⅰ expressions in cancer tissues of patients and clinicopathological features was analyzed. Kaplan-Meier method was used to analyze the overall survival (OS) of patients with different TRIM25 and RIG-Ⅰ expression status.Results:The positive rate of TRIM25 in cancer tissues was higher than that in paracancerous tissues [68.29% (56/82) vs. 21.95% (18/82), P < 0.001], and the positive rate of RIG-Ⅰ in cancer tissues was lower than that in paracancerous tissues [31.71% (26/82) vs. 74.39% (61/82), P < 0.001]. The positive rate of TRIM25 in cancer tissues of poorly differentiated patients was higher than that of highly and moderately differentiated patients ( P < 0.05), and the positive rate of RIG-Ⅰ was lower than that of highly and moderately differentiated patients ( P < 0.05). The positive rate of TRIM25 in cancer tissues of patients with extrahepatic metastasis was higher than that of patients without extrahepatic metastasis ( P < 0.05), but the positive rate of RIG-Ⅰ was lower than that of patients without extrahepatic metastasis ( P < 0.05). The positive rate of TRIM25 in patients with clinical Ⅲ-Ⅳ was higher than that in patients with stage Ⅰ-Ⅱ ( P < 0.05), but the positive rate of RIG-Ⅰ was lower than that in patients with stage Ⅰ-Ⅱ ( P < 0.05). The median follow-up time was 27 months (4-48 months), 2 patients were lost to follow-up. At the end of follow-up in January 2022, the overall survival rate was 43.75% (35/80). The survival rates of patients with TRIM25-positive and TRIM25-negative cancer tissues were 33.33% (18/54) and 65.38% (17/26), respectively. The survival rates of patients with RIG-Ⅰ-positive and RIG-Ⅰ-negative cancer tissues were 64.00% (16/25) and 34.55% (19/55), respectively. Kaplan-Meier analysis showed that the OS of patients with TRIM25-negative cancer tissues was better than that of patients with TRIM25-positive cancer tissues, and the OS of patients with RIG-Ⅰ-positive cancer tissues was better than that of patients with TRIM25-negative cancer tissues, and the differences were statistically significant (both P < 0.05). Conclusions:The expression of TRIM25 is increased and the expression of RIG-Ⅰ is decreased in liver cancer tissues. The expressions of TRIM25 and RIG-Ⅰ in liver cancer tissues are associated with prognosis.