Hepatic Stellate Cells ; Humans ; Liver Cirrhosis ; diagnosis ; metabolism ; Signal Transduction

Objective To determine the efficacy of Non-invasive positive pressure ventilation(NPPV)in the management of patients with respiratory failure due to an acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Forty-two patients were included in the study.Of them,21 were randomly allocated to receive NPPV plus “standard care” and 21 to “standard care”.Both groups had similar characteristics upon their admission in the hospital.Results The use of NPPV significantly decreased the PaCO_2 level and respiratory rates,but significantly increased the PaO_2 level after 2 hours of treatment(P

10.3969/j.issn.2095-4344.2013.26.005

Objective To explore the cause and the interventional treatment of restenosis after percutaneous transhepatic biliary stent.Methods 20 patients with biliary restenosis after percutaneous transhepatic biliary stent placement were collected.According to drainage volume from biliary tract and degree of amelioration of jaundice,post-operation hepatic function,blood,urine and stool routines,ultrasound,CT scan and cholangiography were performed to determine the nature and location of biliary restenosis,and then all cases underwent recanalization with intervention method by the exteriorized drainage tube approach.The China-made nickel-titanium alloy stents with diameter of 10 mm and length ranged from 40 mm to 80 mm were used.Results The biliary restenosis occurred in mid-inferior segment of common bile duct in 9 patients, common hepatic duct in 7 patients and hepatic porta in 4 patients. As regarding the causes of restenosis included tumor compression in 9 cases, angulation in upper segment of stent in 3 cases, obstruction in stent by bile, food or clot in 4 cases, cholangitic stenosis in 2 cases and granulation proliferation in 2 cases.The obstruction in all cases was relived by extraction through drainage tube, drug irrigation,dredging by wire, balloon dialtion or stent replacement, so that the total survival rate was beyond 6 months.Conclusion After percutaneous transhepatic biliary stent placement in treating the malignant biliary obstruction,the rate of biliary restenosis is still high,which should be attached importance to.

Objective To explore the epidemiology,etiology and prevention strategy of early respiratory infections (≤1 month) in lung transplantation recipients with donation after cardiac death donors.Method The clinical data of donors and recipients,particularly on early respiratory infections,were retrospectively analyzed in 17 lung transplantations.Result From Jan.2015 to Apr.2015,12 episodes of early respiratory infections (≤ 1 month) in 17 lung transplantation recipients occurred (12/17,70.6％).The organisms most frequently involved were bacteria:Pseudomonas aeruginosa (4/26,15.4％),Klebsiella pneumoniae (4/26,15.4％),Staphylococcus aureus (3/26,11.5％),and Acinetobacter baumannii (3/26,11.5％).Of 26 bacterial strains,3 were Methecillin resistant Staphlococcus aureus,3 were carbapenem resistant Acinetobacter baumanni,2 were carbapenem resistant Pseudomonas cepacia,2 were extended spectrum b-lactamase-producing Klebsiella pneumoniae,and one was carbapenem and quinolone resistant Pseudomonas aeruginosa.Conclusion The morbidity of early infections is high in lung transplantation recipients.In our experience,bacterial respiratory infections are most common in the early post-transplant period (≤ 1 month).Incidence of Aspergillus spp.and Cytomegalovirus pneumonia is lower than before lung transplantation,probably due to the spread of universal prophylaxis.

ObjectiveTo investigate the clinical efficacy of the fixation of elderly fracture of proximal humerus with locking compression plate(LCP) by mini-incision approach from lateral shoulder.Methods31 elderly patients suffered from elderly fracture of proximal humerus were treated with locking compression plate(LCP) by mini-incision approach from lateral shoulder, male 13 cases, female 18 cases; aged from 56 to 72, average 62-8 years old; fractures according to Neer classification: type Ⅱ(8 cases), type Ⅲ (19 cases), type Ⅳ (4 cases). Cause of injuries: traffic accident (9 cases), falling (20 cases), other injuries(2 cases).ResultsThe patients were followed up 6 to 36 months, an average of about 24 months. Fracture healing time was 2-2 ～ 6-4 months, on average 3-7 months; No wound infection occurred. Post-operative functional score (Neer score) revealed: excellent(18 cases), good (11 cases), fair (2 cases), the ratio of excellent(18 cases), good (11 cases) was 93-5%. ConclusionFixation of elderly fracture of proximal humerus with locking compression plate(LCP) by minimally invasive approach from lateral shoulder is a safe, reliable and minimally invasive procedure with good reduction and stable fixation. Early post-operative functional exercise may be permitted for preventing shoulder joint adhesion.

Objective To investigate diagnostic efficiency of vascular parameters in the diagnosis of BI-RADS Ⅳ breast masses using three-dimensional power Doppler ultrasound (3D-PDUS).Methods After adjusting the ultrasonic instrument under property conditions,3D-PDUS were applied to scan BI-RADS Ⅳ breast masses before surgery with QLab software,the following parameters of breast masses were obtained:total tumor volume,vascularization index (VI),flow index (FI),and vascularization flow index (VFI).According to the pathological results,the diagnostic value of vascular parameters from 3D-PDUS were assessed with receiver operating characteristic (ROC) curve,and the diagnostic efficiency were analyzed by best cut-off limits of various vascular parameters.Results The volume and vascular parameters of benign group were remarkably lower than those of malignant group (all P ＜0.001).The area under the ROC curve (AUC) of VI (0.873) ＞VFI (0.866) ＞FI (0.778).AUC of FI was significantly smaller than that of VI (P =0.016) and of VFI (P =0.039),while no statistical difference between that of VI and of VFI (P =0.294).The diagnostic accuracies of VI (cut-point:1.2,sensitivity:84.1％,specificity:83.3 ％,accuracy:83.8 ％) and of VFI (cut-point:0.5,sensitivity:82.5 ％,specificity:85.2％,accuracy:82.9％) were higher than that of FI (cut-point:35.3,sensitivity:74.6％,specificity:70.4 ％,accuracy:72.6 ％).AUC of VI (P =0.001) and of VFI (P =0.033) in small-volume group (＜2cm3) were both larger than those of large-volume group (≥2 cm3),no significant difference in AUC of FI between these two groups (P =0.09).Conclusions Vascular parameters obtained using 3D-PDUS have affirmative value in the diagnosis of BI-RADS Ⅳ breast masses,especially in masses less than 2 cm3 in volume.

Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P < 0.05), while menstrual cycle, family history of breast cancer and molecular typing showed no difference (P > 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P < 0.05), but there was no significant difference between different level of HER2 (P >0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.

Objective Precondition is an approach to myocardial protection during ischemia-reper-fusion by inhibiting myocardial cell apoptosis.The purpose of this study was to evaluate the cardioprotective effect using 99Tcm-syuaptotagmin I (Syt I)-C2A to detect myocardial cell apoptosis in the myocardial is-chemia-repedusion rat model.Methods (1) The C2A domain of Syt I was labeled with 99Tcm using 2-iminothiophene hydrochloride (IT) method.Radiochemical purity was determined with thin layer chroma-tography.The binding activity of radiolabeled protein was assessed using eamptothecin-treated Jurket cells.(2) One group of 6 rats was prepared for myocardial ischemia-reperfusion model(A group),and another group of 6 rats was prepared for myocardial ischemia precondition model(B group).99Tcm-Syt I-C2A was injected via the tail vein at a dosage of about 7.4 MBq.At 1h after injection,the rat was sacrificed,and the heart was removed to rinse with saline and dye with triphenyl tetrazolium eoride (TTC).According to the resdt of myocardial dye,theischemic myoeardium was separated from the viable myocardium and weight was measured,and then its radioactivity was determined by gamma counting.The difference of radioactive uptake in the ischemic myocardium between these two group models was compared using percentage activity of injection dose per gram of tissue(%ID/g)±standard deviation(x±s).SPSS 12.0 was used for data analy-sis,and t-test was used to compare data.Results (1) The radiochemical purity of 99Tcm-Syt I-C2A was (98.90±0.43)%,and the radioactivity in the camptothecin-treated group was (10.99±0.55) folds higher than that of non-treated viable control group.(2)In the ischemia-reperfusion model,the radioactive uptake of 99Tcm-Syt,I-C2A was(2.41±0.32)%ID/g in the ischemic myocardium,and(0.16±O.02)%ID/g in the nomud myocardiunm.However,in the myocardial ischemia precondition model,(0.46±0.05)%ID/g in the isehemic myocardium was measured,and(0.20±0.05)%ID/g in the normal myocardium.Uptake of 99Tcm-Syt I-C2A in ischemic myocrdium showed statistically significant difference (t=8.52,P

OBJECTIVETo evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.

METHODSFrom November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.

RESULTSAll patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONFluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.

Adult ; Aged ; Anesthetics, Local ; administration & dosage ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; diagnostic imaging ; drug effects ; Male ; Middle Aged ; Nerve Block ; Spinal Diseases ; diagnosis ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed