Objective To investigate the value of soluble epithelial cadherin(sE-cad)in the differential diagnosis of pleural effusion. Methods Patients were divided into malignant pleural effusion group,infective pleural effusion group and transudation group.sE-cad in pleural fluids obtained during the first thoracocentesis was measured by enzyme-linked immunosorbent assay(ELISA).The concentration of sE-cad in all kinds of pleural effusions was compared.The cut-off value of sE-cad for the differential diagnosis of benign and malignant pleural effusion was determined by ROC curve.The diagnostic value of sE-cad was also compared with common tumor markers such as CEA,CA199,CA125 and NSE.Results The concentration of sE-cad was significant higher in the malignant pleural effusion than in the benign pleural effusion[(38.38?4.15)ng/mL vs(14.17?0.80)ng/mL,P

Objective To investigate the benefits of long-term home noninvasive positive pressure ventilation(NIPPV) for patients with stable chronic obstructive pulmonary disease(COPD). Methods From 2006 to 2007,46 patients with chronic respiratory failure due to stable COPD receiving NIPPV in Croix Rousse Hospital were retrospectively analysed.The arterial blood gas analysis of before treatment,1,3,6,12,24 and 36 months after treatment were compared,and the lung function of before treatment,6,12,24 and 36 months after treatment were also compared. Results PaCO2 of 1,3,6,12,24 and 36 months after receiving NIPPV significantly decreased(P

Objective To investigate the CT findings and guidance significance of multi-slice computed tomography(MSCT) in aortic intramural hematoma(IMH).Methods The clinical data and MSCT findings of 35 cases of aortic intramural hematomas diagnosed by MSCT with continuous volume scanning were analyzed.Results The direct signs of IMH were crescent or circular thickening of aortic wall without intimal flap and true and false lumens in all 35 patients.The indirect signs were penetrating ulcer(18 cases),calcification ingression(7 cases),atherosclerosis(16 cases)and single or bilateral pleural effusion(21 cases).The complicated signs were aneurysms(5 cases) and typical type B aortic dissection(3 case).Conclusion MSCT is a fast and noninvasive examinational technique,by which the direct,indirect and complicated signs of aortic IMH can be clearly revealed.All these signs have important guidance values for clinical diagnosis and management.

Objective To investigate the effect of ropiyacaine combined with intra-spinal epidural anesthesia by using the same volume but different injection speed on anaesthetic level.Methods 80 cases of patients of ASA～Ⅱdegree suitable to use intra-spinal epidural combined anesthesia for gynecologic operation were selected and ran- domly divided into three groups,0.75 % ropivacaine 2mg(15mg)administered,group A the speed of injection was 10 seconds,group B injection speed was 20 seconds,group C injection speed was 30 seconds,the anaesthetic level reached T_(10).The time of highest level in spinal anesthesia,30 minutes after spinal anesthesia MAP,and number of cases need to add epidural drug were all recorded.Results The best effect of anesthesia was found in group B,the block level of anesthesia was satisfactory,blood dynamic was stable,and there was no need to add epidural drug.Conclusion The speed of 0.75 % ropivacaine 2ml spinal epidural combined with anesthesia was suitable at the speed of 20 seconds.

Animals ; Berberine/pharmacology* ; Blood Glucose ; Diabetes Mellitus, Experimental/drug therapy* ; Diabetes Mellitus, Type 2 ; Insulin ; Insulin Resistance ; Rats

Objective To explore the effect of comprehensive intervention technique in neuroses nursing.Methods 48 inpatient neuroses were randomly divided into observation group(drug treatment and comprehensive intervention technique)and control group(drug treatment),using self-rating anxiety scale(SAS)and self-rating depression scale(SDS)to evaluate clinical symptoms before and after 2 months treatment.Results Before treatment.SAS and SDS scores between two patient groups had no statistic difference(P>0.05),but after 2 months treatment.the observation group had lower SAS and SDS scores than the control group,the difference were obvious(P<0.05).Conclusions Comprehensive intervention technique was useful in neuroses nursing which can ameliorate depression and anxiety emotions,improve illness recover.

Objective:To analyze the meridian and acupoint-selection patterns in acupuncture-moxibustion treatment of polycystic ovarian syndrome (PCOS) by data mining technique,for exploring acupoints that could be effective for PCOS and providing suggestion and reference in selecting acupoints for the acupuncture-moxibustion treatment of PCOS.Methods:Literatures related to the acupuncture-moxibustion treatment of PCOS published before April 2018 were collected.By a self-made data mining program developed using Microsoft Excel 2007,a database of acupuncture-moxibustion treatment of PCOS was then established.The correlation analysis was performed for the frequency of use of acupoints and acupoint groups.Cluster analysis was also conducted.Results:A total of 92 articles were recruited finally.Sanyinjiao (SP 6),Conception Vessel and chest-abdomen region ranked the top on the list of the most frequently used acupoints,meridians and regions,respectively.Correlation analysis showed that the acupoint group with the highest confidence was Sanyinjiao (SP 6) and Zusanli (ST 36),and the group with the highest support was Sanyinjiao (SP 6) and Guanyuan (CV 4).Cluster analysis revealed five effective clusters:Guanyuan (CV 4) and Sanyinjiao (SP 6);Zhongwan (CV 12) and Tianshu (ST 25);Zhongji (CV 3),Zusanli (ST 36) and Qihai (CV 6);Xuehai (SP 10),Shenshu (BL 23),Taichong (LR 3) and Guilai (ST 29);Ganshu (BL 18),Taixi (KI 3),Yinlingquan (SP 9) and Pishu (BL 20).Conclusion:According to the confidence and support report,Sanyinjiao (SP 6) and Zusanli (ST 36) or Sanyinjiao (SP 6) and Guanyuan (CV 4) are recommended in acupuncture-moxibustion treatment of PCOS,with adjunct points selected for different patterns,e.g.Zhongwan (CV 12) and Tianshu (ST 25) for tonifying spleen and expelling dampness;Zhongji (CV 3) and Qihai (CV 6) for supplementing qi and cultivating blood;Xuehai (SP 10),Shenshu (BL 23),Taichong (LR 3) and Guilai (ST 29) for tonifying kidney and dissolving stasis;Ganshu (BL 18),Taixi (KI 3),Yinlingquan (SP 9) and Pishu (BL 20) for tonifying kidney and spleen and regulating liver.

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.

Objective: To explore the effect of herb-partitioned moxibustion (HPM) on tight junctions (TJs) of intestinal epithelial cells in Crohn disease (CD) mediated by tumor necrosis factor-α (TNF-α)-nuclear factor kappa B (NF-κB)-myosin-light- chain kinase (MLCK) pathway. Methods: Forty-eight male Sprague-Dawley rats were randomly divided into a normal control (NC) group, a model control (MC) group, an HPM group and a mesalazine (MESA) group, with 12 rats in each group. Trinitrobenzene sulfonic acid (TNBS) was administered to establish CD models. When the model was confirmed a success, the HPM group rats were treated with HPM at Tianshu (ST 25) and Qihai (CV 6), while the MESA group rats were given MESA solution by lavage. When the intervention finished, the colonic epithelial tissues were separated, purified and cultured in each group to establish the intestinal epithelial barrier model in vitro, and TNF-α was added (100 ng/mL) in the culture medium and maintained for 24 h to establish an increased epithelial permeability model. Transepithelial electrical resistance (TEER) was used to examine the permeability of the barrier; Western blot was used to observe the expressions of the proteins related to TJs of intestinal epithelial cells mediated by TNF-α-NF-κB-MLCK pathway; immunofluorescence staining was used to observe the expressions and distributions of tight junction proteins in the intestinal epithelium. Results: After TNF-α induction, compared with the MC+TNF-α group, the TEER value increased significantly in the HPM+TNF-α and MESA+TNF-α groups (both P<0.001); the expressions of nuclear factor kappa B (NF-κB) p65, MLCK, myosin light chain (MLC), tumor necrosis factor receptor-associated factor 6 (TRAF6) and receptor interaction protein-1 (RIP1) decreased significantly (P<0.01 or P<0.05), and the expression of zinc finger protein A20 (A20) increased significantly (P<0.01); the expressions of occludin, claudin-1, zonula occludens protein 1 (ZO-1) and F-actin also increased significantly (all P<0.01). Compared with the MESA+TNF-α group, the expressions of MLC, occludin, claudin-1, ZO-1 and F-actin increased significantly in the HPM+TNF-α group (P<0.01 or P<0.05). Conclusion: HPM can protect or repair the damage of intestinal epithelial barrier in CD rats, which may be achieved through modulating the abnormal TJs in intestinal epithelium mediated by TNF-α-NF-κB-MLCK pathway.

BACKGROUNDLiver transplantation has become the treatment of choice for patients with end-stage acute or chronic hepatic disease. Bile duct complications are common events after liver transplantation. The aim of this study was to evaluate the blood supply of the human bile duct and identify the underlying mechanisms of bile duct complications after liver transplantation.

METHODSThe duct supply branches from gastroduodenal artery and blood supply of extrahepatic bile duct system were re-evaluated through selective hepatic angiography from 600 patients. In addition, 33 cadavers were injected with latex casting material into the common hepatic artery, then the extrahepatic bile duct and the branches from the common hepatic artery were carefully dissected to visualize the gastroduodenal artery and its branching to the extrahepatic bile duct.

RESULTSThe bile duct artery arose from the branch of the gastroduodenal artery in 8.1% (49/600). Of these 49 individuals, the bile duct artery was supplied by the gastroduodenal artery (61.22%, 30/49), the proper hepatic artery (14.29%, 7/49), or both the gastroduodenal artery and the proper hepatic artery (24.49%, 12/49). In our study of 33 cadavers, the percentage that the bile duct artery arose from the gastroduodenal artery was 27.27%. The blood supply to the bile extrahepatic bile ducts was divided into different segments and formed longitudinal and arterial network anastomosed on the walls of the duct.

CONCLUSIONSThere is a close relationship between the duct supply branches from gastroduodenal artery and the blood supplying patterns of the extrahepatic bile duct system. In liver transplant surgery, the initial part of the gastroduodenal artery is preferred to be preserved in the donor liver. It is of great significance to improve the success rate of operation and reduce complications.

Adult ; Aged ; Aged, 80 and over ; Angiography ; Bile Ducts, Extrahepatic ; diagnostic imaging ; Female ; Hepatic Artery ; diagnostic imaging ; Humans ; Liver Transplantation ; Male ; Middle Aged