Objective To evaluate the safety and feasibility of radiofrequency ablation (RFA) for hepatic pedicle lesioning in combination with hepatic artery clamping for precise liver resection by establishing a model of precise liver resection in animals. Methods Six healthy Guangxi Bama miniature pigs were selected for this study, and S3, S5 and S6 used as target hepatic segments. The hepatic pedicles were lesioned by radioablation under ultrasound guidance. The hepatic artery was clamped temporarily at the time of radioablation. Three segments (S3, S5 and S6) were resected on each pig. The main outcome measures included the local and general tolerance, the change of blood flow parameters of each segmental arterial and portal branches, and the microscopic appearance of the segmental arterial, portal and biliary tract branches. ResultsThere was no any complication or death following RFA application, and the liver function was restored to normal 14 days after the operation in all animals. Demarcation areas were clear in all target hepatic segments. The blood flow velocity of the portal branches was 0cm/s in all the target hepatic segments after RFA. The arterial blood flow velocity was 15.1± 15.4cm/s, which was significantly lower compared with that before RFA (P>0.000). There was no difference in the flow rate of the unaffected segmental vessels following RFA. The mean ablated length of segmental portal, arterial and biliary tract branches was 1.7± 0.5cm, 1.4± 0.4cm, 1.6± 0.4cm, respectively. ConclusionsThe technique is expedient, safe and effective. Simultaneous temporary occlusion of the hepatic artery adds further benefit. The probe needs to be at least 1.5cm away from non targeted structures to avoid unintended thermal injury.

Integrative Medicine ; Medicine, Chinese Traditional

Objective To discuss the individualizing schedule of endovascular treatment for intracranial venous sinus thrombosis based on the clinical feature and the stage of the disease.Methods Forty-three patients diagnosed with intracranial venous sinus thrombosis in Xuanwu Hospital,Capital University of Medical Sciences and in Zhongshan Hospital Xiamen University during period of August 2010 to August 2011 were treated with endovascular therapy designed individually based on the clinical stage of the disease development.Of all 43 cases,22 cases with acute onset (＜ 1 week after the onset) were treated with standard anticoagulant therapy ; 11 cases who failed to respond to anticoagulant therapy and 8 cases with subacute onset (1 week to 1 month) received intravenous thrombolysis and mechanical thrombus maceration;and 13 cases with chronic course (＞ 1 month) were given mechanical thrombus maceration combined with balloon dilation vascular surgery or stent-assisted venous sinus surgery,with taking anticoagulant for 12months.The patients were followed up for 3 to 6 months (mean 4.5 months).Results Their symptoms and signs were all significantly improved,with headache relief in 29 cases(67.4％),vision improvement in 28cases (28/31,90.3％),cerebrospinal fluidpressure decrease to normal level in 32 cases(32/43,74.4％) ;no improvement in 1 case,and a complication of subdural hematoma in 1 case.Three months follow-up of 39 patients,symptoms disappeared,the pressure cerebrospinal fluid in 36 cases returned to normal (94.3％),the papilledema in 37 cases subsided (94.9％).After 6 months,16 patients were followed up with an angiography; 8 of them were found venous sinus clear,5 were found partial recanalization of venous sinus trunk,cortical veins and deep venous was partially compensation,and 3 cases with stent-assisted venous sinus surgery were found the stent not shifted or collapsed,and venous sinuses maintained patency.Conclusions Endovascular treatment for patients with intracranial venous sinus thrombosis should be treated with individually designed therapy based on their clinical features and the stage of the disease.The individualized treatment was effective and safe.

OBJECTIVE: To standardize the management on drug use in primary hospitals in Beijing Dongcheng district so as to enhance the efficiency of drug administration.METHODS: A "Drug Use Monitoring Information Platform in Primary Hospital" comprising management information system on drug use,management system on information of drug wholesalers,drug monitoring management information system was established and its problems in the try-out were analyzed.RESULTS & CONCLUSIONS: The "Drug Use Monitoring Information Platform in Primary Hospital" still faced with the problems of legal basis,psychological concern,and construction of standard basic drug information database etc.However,its operation standardized the drug purchasing channel and management on drug use in hospitals of Beijing Dongcheng district and enhanced the drug administration level and efficiency,which thus deserves to be popularized throughout the country.

This study was designed to summarize the clinical experience of harvesting the lung of a brain-death donor by international standardized methods so as to establish a set of standards and regulations that are applicable for harvesting the lung of brain-death donors in China. The patient was strictly determined according to international standardized method by two or more advanced neurologists, neurocranial surgeon, anesthetists, and ICU specialists using brain death diagnostic standards and brain death diagnostic technological specification. The family members signed a informed consent of abandoning treatment for brain death and he was a volunteer organ donor. The operation was performed on 1 brain-death donor who had endured 50 hours of mechanical ventilation to evaluate brain death and organ function. The donor was assessed by donor lung function test and international brain death standard. Then the organ was ready for lung transplantation.

Objective Although heart transplantation surgery has become more common,little is known about the psychological status of patients waiting for a heart transplant.Method Ninety-three patients registered for heart transplantation from March 2013 to March 2014 in a large general hospital in Shanghai were assessed by a psychiatrist using the Hamilton Depression Scale (17 items) and the Hamilton Anxiety Scale.Out of them 36 were preoperatively admitted to the Cardiac Surgery Department.The scales were assessed repeatedly at the 1st day,3rd day,7th day,10th day and so on until the operation took place.Result The mean scores of HAMD and HAMA of 93 patients in the waiting list were separately 13.11 ±3.81 and 14.20±4.57.Among them 18(19.4％) were classified as moderately depressed,31(33.3％) had moderately anxious symptoms,and 14(14.1％) had severe anxious symptoms.Thirty-six patients were preoperatively admitted to hospital.Their mean scores of HAMD and HAMA were separately 13.19-± 3.82 and 16.17 ± 4.35.Among them 7(19.4％) were classified as moderate depression at the time of admission,16 (44.4％) had moderately anxious symptoms and 9 (25.0％) had severe anxious symptoms.The scores of HAMD had significant difference (t =3.383,P =0.002) before and after admission.Paired t test was separately conducted to analyze the first assessment and the 3rd-day assessment of HAMA and HAMD total scores after admission of all the inpatients.The results showed the scores were statistically different (for HAMA,t =2.786,P =0.009; for HAMD,t =14.024,P =0.000).Repeated ANOVA was used to analyze the recipients who had three assessments.The results had statistical difference (for HAMA,F =4.568,P=0.020; for HAMD,F=5.626,P =0.034) and the difference of HAMD score at different time points had a linear trend (F =8.273,P =0.013).Conclusion After hospital admission,the depression symptoms will be significantly alleviated.When waiting for the transplant in the hospital,the anxiety symptoms alleviate slightly in three days and then aggravate significantly.The depression symptoms alleviate slightly continuously.

This study was designed to summarize the clinical experience of harvesting the lung of a brain-death donor by international standardized methods so as to establish a set of standards and regulations that are applicable for harvesting the lung of brain-death donors in China. The patient was strictly determined according to international standardized method by two or more advanced neurologists, neurocranial surgeon, anesthetists, and ICU specialists using brain death diagnostic standards and brain death diagnostic technological specification. The family members signed a informed consent of abandoning treatment for brain death and he was a volunteer organ donor. The operation was performed on 1 brain-death donor who had endured 50 hours of mechanical ventilation to evaluate brain death and organ function. The donor was assessed by donor lung function test and international brain death standard. Then the organ was ready for lung transplantation.

Objective To investigate the feasibility of using ultrasound‐mediated destruction of microbubbles ( US+ MB) to enhance the transplantation of endothelial progenitor cells ( EPCs) to confer chronic allograft vasculopathy (CAV) .Methods Bone marrow derived mononuclear cells were isolated and induced in vitro . The abdominal aorta transplantation was performed . Four groups were divided:control group without treatment (group A) ,injection with saline (group B) ,injection with EPCs (group C) ,group D ( US+MB+EPCs) was injected with EPCs and US was applied to MB prior to the infusion . All rats were killed during 8 weeks after transplantation to enable histological examination;SDF‐1α expression was detected by immunohistochemistry ,the expression of SDF‐1αand TNF‐αin the grafted aortas were detected with RT‐PCR . Results When 8 weeks after EPCs transplantation ,there was a significant improvement in aortic intima of Group D compared with Group B and C ,respectively ( P <0 .05) . In addition ,treatment of Group D significantly increased the expression of SDF‐1αand reduced the expression of TNF‐αin the grafted aortas . Conclusions US‐mediated MB destruction prior to EPCs transplantation into the grafted aortas can improves the effectiveness of endothelial repair and delay the progress of CAV .