Objective To evaluate the effect of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) on S.epidermidis biofilms.Methods S.epidermidis was cultured on cover glasses,with or without thepresence of ALA at 50 mmol/L for 16 hours followed by the exposure to different doses (100,200,300 J/cm2) of red light.S.epidermidis receiving neither pretreatment nor irradiation served as the negative control.Subsequently,confocal laser scanning microscopy (CLSM) was used to observe the structure and evaluate the biological activity of S.epidermidis biofilms; colony forming units (CFUs) of S.epidermidis were counted for the evaluation of killing effect of ALA-PDT; scanning electron microscopy (SEM) was used to observe the morphological structure of the biofilms.Results The number of colony forming units per milliliter (CFU/ml) was (210 ± 7.55) × 105,(91 ± 1.53) × 105,(16 ± 1.52) × 105 for S.epidermidis pretreated with ALA followed by irradiation with red light at 100,200 and 300 J/cm2 respectively,significantly different from untreated S.epidermidis ((388 ±8.89) × 105,all P ＜ 0.01) and S.epidermidis irradiated with red light only.Increased ratio of dead to live cells was observed in ALA-pretreated S.epidermidis irradiated with red light at 100,200 and 300 J/cm2compared with untreated S.epidermidis (1.254 ± 0.096,1.301 ± 0.160 and 3.410 ± 1.140 vs.0.358 ± 0.057,all P ＜ 0.01) and S.epidermidis irradiated with red light only.SEM showed that the biofilm structure was loose and obscure in S.epidermidis treated with ALA-PDT,and even disappeared with S.epidermidis distributed in single colonies when the dose of red light was 300 mJ/cm2.Conclusion ALA-PDT shows a potential bactericidal activity against S.epidermidis in biofilms,which can not only reduce biofilm vitality,but also damage biofilm structure.

Objective To compare prognosis of esophageal cancer patients with simple radiation or chemoradiotherapy.Methods Retrospective analysis 266 cases of esophageal cancer patients from June 2005 to June 2007 of,including 128 with simple radiotherapy,138 with chemotherapy during the same period,157 cases of general radiotherapy,intensity-modulated radiotherapy,109 cases of Kaplan-Meier method for calculation of survival,Log-Rank method on the clinical factors of single factor analysis,Cox regression model with factor analysis.Two groups,clinical material and adverse reaction were compared with chi-square test.Results The median survival time of the radiation group was 25 months,chemoradiotherapy group of the median survival time was 28 months.Follow-up with 1,3,5 years were 231,106,82 cases.The 1,3,4 years OS rate were 86.8 ％ (200/231),12.8 ％ (14/106),9.0 ％ (7/82).Disease-free survival (DFS) rates were 39.8 ％ (92/231),7.9 ％ (8/106),15.8 ％ (13/82).No local relapse survival (LRFS) rates were 30.8 ％ (71/231),16.2 ％ (17/106),23.7 ％ (19/82).No distant metastasis (DMFS) survival rates were 47.0 ％ (109/231),11.3 ％ (12/106),13.9 ％ (11/82).Single factor analysis results show that age,disease length,X-ray parting,different radiation method were 5 years OS independent prognostic factors.Age,disease length were DFS independent prognostic factors.Lesion length,different radiation method were LRFS independent prognostic factors for survival,lesion length and X-ray parting were without distant metastases independent prognostic factors for survival.Multiple factors analysis results showed that age,disease length,pathological type were 5 years OS related factors,and age,disease length,different treatment methods were DFS related factors,only lesions length was DMFS related factors,lesion length,different chemotherapy method was DMFS related factors of survival.The rate of serious adverse reaction of the chemoradiotherapy group was higher than radiotherapy group,the difference had statistical significance.Conclusion The chemoradiotherapy increase DFS rate,and at the same time,the incidence of adverse reaction also increases,but 5 years OS rate doesn't increased obviously.

0.05).Conclusion The maximal slow-phase velocity induced by bithermal caloric test failed to decline with aging,implying that the functions of the horizontal semicircular didn't decline with aging.

In this paper, we propose a new active contour algorithm, i. e. hierarchical contextual active contour (HCAC), and apply it to automatic liver segmentation from three-dimensional CT (3D-CT) images. HCAC is a learning-based method and can be divided into two stages. At the first stage, i.e. the training stage, given a set of abdominal 3D-CT training images and the corresponding manual liver labels, we tried to establish a mapping between automatic segmentations (in each round) and manual reference segmentations via context features, and obtained a series of self-correcting classifiers. At the second stage, i.e. the segmentation stage, we firstly used the basic active contour to segment the image and subsequently used the contextual active contour (CAC) iteratively, which combines the image information and the current shape model, to improve the segmentation result. The current shape model is produced by the corresponding self-correcting classifier (the input is the previous automatic segmentation result). The proposed method was evaluated on the datasets of MICCAI 2007 liver segmentation challenge. The experimental results showed that we would get more and more accurate segmentation results by the iterative steps and the satisfied results would be obtained after about six rounds of iterations.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; Models, Theoretical ; Tomography, X-Ray Computed

Objective To investigate the role of AGE-RAGE system on intimal hyperplasia in autogenous vein graft of diabetic rats.Methods The experiments were performed on 40 male Sprague-Dawley rats which divided into two groups:diabetes group and control group.Autogenous vein graft model was established in all rats.Specimens were harvested 7 days and 14 days after surgery for histological examination,and RAGE,NF-?B p65 and VCAM-1mRNA were measured by semi-quantitative reverse transcription-PCR.Western Blotting and immunohistochemistry were used to detect the protein expression of RAGE,NF-?B p65 and VCAM-1.At the same time,the levels of serum AGE were tested.Results Compared with non-diabetic rats of control group,the intimal hyperplasia of vein graft in diabetic rats obviously increased(P

Objective To evaluate the effect of sevoflurane-based anesthesia on the interventricular synchronization in the patients undergoing coronary artery bypass grafting (CABG) with cardiopuhnonary bypass (CPB).Methods Twenty-four Amnerican Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 52-75 yr,with body mass index of 17-31 kg/m2,with body surface area of 1.7-2.2 m2,of New York Heart Association Ⅱ or Ⅲll,with left ventricular ejection fraction (LVEF) ≥45％,scheduled for elective CABG with CPB,were divided into 2 groups (n=12 each) using a random number table:propofol combined with remifentanil anesthesia group (group C) and sevoflurane combined with propofol and remifentanil anesthesia group (group S).After induction of general anesthesia,the patients were en-dotracheally intubated and mechanically ventilated.Anesthesia was maintained by Ⅳ infusion of propofol,remifentanil and cisatracurium,and the cerebral state index value was maintained at 40-60.In group S,the patients inhaled sevoflurane (the end-tidal concentration was 1.80％ for 50-59 yr and 1.60％ for 60-75 yr) for 60 min starting from 15 min after termination of CPB.After induction of anesthesia and before splitting of sternum,immediately before inhaling sevoflurane and at 30 and 60 min of sevoflurane inhalation,heart rate,cardiac index,LVEF,right ventricular eject fraction,QRS width and interventricular mechanical delay were recorded,and the occurrence of interventricular dyssynchrony was recorded.Results There were no significant differences between group C and group S in the heart rate,cardiac index,LVEF,right ventricular eject fraction,QRS width,interventricular mechanical delay or incidence of interventricular dyssynchrony (P＞0.05).Conclusion Sevoflurane-based anesthesia exerts no marked effect on interventricular synchronization in the patients undergoing CABG with CPB.

Objective To investigate the effect of nicardipine on the hepatic blood flow in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Twenty-six patients of both sexes,aged 30-64 yr,weighing 50-90 kg,with New York Heart Association Ⅱ or Ⅲ,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective mitral or aortic valve replacement,were randomly divided into either nicardipine group (group P,n =13) or control group (group C,n =13) using a random number table.Transesophageal echocardiography was used to measure the indexes of blood flow in the hepatic vein.Nicardipine 0.2-0.5 μg · kg-1 · min-1 was infused intravenously starting from beginning of CPB,and the infusion was stopped at termination of CPB in group P.After induction of general anesthesia,at 30 min after beginning of CPB,at 10 min before termination of CPB,and at 30 min after termination of CPB,the diameter of the right and middle hepatic veins (DR and DM),blood flow index in the right hepatic vein (QIR),blood flow index in the middle hepatic vein (QIM),and total blood flow index in the hepatic vein (QIR+M) were recorded,and the percentage of QIR+M in cardiac index (CI) (QIR+M/CI) or in QICPB (QIR+M/QICPB) was calculated.Before operation,and at 1 and 2 days after operation,blood samples were obtained from the median cubital vein for determination of total bilirubin,alanine aminotransferase,and aspartate aminotransferase (AST) levels in serum.Results Compared with group C,the serum levels of AST at 1 day after operation and serum levels of AST at 1 day after operation were significantly decreased (P＜0.05),and no significant change was found in DR,DM,QIR,QIM,QIR+M,QIR+M/CI and QIR+M/QICPB at each time point in group P (P＞0.05).Conclusion Nicardipine (0.2-0.5 μg · kg-1 · min-1) infused intravenously during CPB exerts no effect on the hepatic blood flow,and it is not related to the improvement in hepatic function in the patients undergoing cardiac valve replacement.

Objective To observe the effect of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) on S.epidermidis planktonic cells,and to determine the optimal concentration and incubation time of ALA.Methods Some S.epidermidis planktonic cells were divided into 3 groups to be incubated with ALA at 50 mmol/L for different durations (3,5,8,12,16,18,20 and 24 hours) at 37 ℃ in dark room (group 1 ),with ALA at various concentrations ( 10,20,30,40 and 50 mmol/L) for 16 hours at 37 °C in dark room (group 2),and with fresh trypticase soya broth (TSB) solution for 24 hours at 37 ℃ in dark room (group 3),respectively.Confocal laser scanning microscopy (CLSM) was used to measure the fluorescence intensity of protoporphyrin Ⅸ (PpⅨ) in bacterial suspensions at different time points.Additionally,some S.epidermidis planktonic cells in group 1 were irradiated with red light at 30,50,70,90 and 100 J/cm2 after incubation with ALA at 50 mmol/L for 16 hours,some in group 2 were irradiated with red light at 100 J/cm2 after incubation with ALA for 16 hours,those cells in group 3 received no irradiation (blank control group),and some S.epidermidis planktonic cells receiving only irradiation and no pretreatment with ALA served as the laser control group; subsequently,the bacterial suspension was inoculated onto trypticase soy agar (TSA) followed by the calculation of colony forming units (CFUs) of S.epidermidis.Results Brick red fluorescence was observed by CLSM in S.epidermidis planktonic cells in group 1 and 2,but not in those in group 3,and the fluorescence intensity was enhanced with the increase in incubation time and concentration of ALA.In detail,the fluorescence intensity was significantly higher in planktonic S.epidermidis cells after 16-,18-,20- and 24-hour incubation than in those after 3-,5-,8- and 12-hour incubation with ALA at 50 mmol/L (all P ＜ 0.05),and higher in those incubated with ALA at 50 mmol/L than in those with ALA lower than 50 mmol/L (all P ＜ 0.05).After irradiation,the number of surviving S.epidermidis planktonic cells declined with the increase in ALA concentration and red light doses,statistically lower in the group 1 and 2 than in the blank control group (both P ＜ 0.05),but similar between the blank control and laser control group (P ＞ 0.05).The growth of planktonic cells was inhibited after incubation with ALA at 50 mmol/L and irradiation with red light at 100 J/cm2.Conclusions ALA-PDT shows a marked inhibitive effect on S.epidermidis planktonic cells,with the optimal working concentration of ALA being 50 mmol/L,incubation time 16 hours,and dose of red light 100 J/cm2.

Objective To evaluate the diagnosis and treatment of pseudoaneurysm .Methods The clinical data of 17 cases of pseudoaneurysm from Jan .2007 to Dec .2011 were reviewed retrospectively ,10 cases were caused by iatrogenic ,6 cases were drug caused by injection of poison ,and 1 case was was caused by trauma .2 cases of brachial artery pseudoaneurysm ,and 15 cases of arte-ria femoralis pseudoaneurysm .1 case was treated by simple compressive therapy ,the other 16 underwent surgical treatment and the pseudoaneurysm was removed ,in which 3 cases were treated by artery patch repair ,7 were treated by bypass with prosthetic grafts , 2 were treated by bypass with saphenous vein ,4 were treated by bypass with superficial femoral vein branch .Results There was no death except 1 case died because her family gave up ,All patients with signs and symptoms were significantly alleviated ,and there was no severe ischemia limb leading to amputation in postoperative follow-up .Conclusion The revascularization of the artery in pseudoaneurysm patients can make a significant improvement in the long-term quality of life .

BACKGROUND: Anemia after kidney transplantation has a clinical incidence rate of 30%-40%, is the important risk factor for cardiovascular diseases and kidney failure after kidney transplantation and is also the independent prediction index of patient's death. OBJECTIVE: To analyze the factors related to anemia after kidney transplantation. RESULTS AND CONCLUSION: In the anemia group (n = 225, 27.2%, aged 26-65 years), the incidence rate of anemia in female and male patients was 23% and 37%, respectively (P < 0.05), 46 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 16 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 85.3% and kidney failure rate of 25.3%. In the non-anemia group (n = 601, 72.8%, 405 males, 196 females, aged 18-71 years), 35 patients had hypertension and used angiotensin-converting enzyme inhibitor or angiotensin Ⅱ receptor antagonist and 14 patients had chronic erosive gastritis or upper gastrointestinal tract ulcer, with the human survival rate of 92.1% and kidney failure rate of 12.6%. There was significant difference in above-mentioned indices between anemia and non-anemia groups (P < 0.05). These results suggest that gender, age, kidney function, digestive tract disease history, and drug application are closely related to anemia after kidney transplantation.