Objective:To compare the oncology effect and risk between hepatopplenectomy and conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, so as to provide guidance for clinical application.Methods:One hundred and eighteen patients with hepatic carcinoma with hypersplenism in the Private hospitals of Zhejiang Province Yiwu were studied retrospectively. Patients were divided into 2 groups according to different operation methods: combined hepatosplenectomy group and conventional hepatectomy group with 59 cases in each group. Blood routine, liver function, complication and tumor effect (local recurrence, distant metastasis and 1, 3, 5 years survival rate) was compared between two group.Results:There was no significant difference in operation time, intraoperative blood loss and hospitalization time between the two groups ( P>0.05). Compared with that of the control group, the clinical total effective rate of the combined group was significantly increased: 94.92% (56/59) vs. 79.66% (47/59), P<0.05; there was no significant difference in the incidence of complications between the two groups ( P>0.05); the two groups were followed up to August 1, 2019. The median survival time of the two groups was significantly higher than that of the open group (29 months vs 22 months) ( P<0.05); the local recurrence rate, distant metastasis rate, 1, 3 and 5-year survival rate between the two groups were statistically significant ( P<0.05). The platelet and white blood cells in the combined group were significantly higher than those in the control group after 7 days′ treatment: (264.48 ± 75.37) × 10 9/L vs. (153.53 ± 42.11) × 10 9/L, (7.86 ± 1.43) × 10 9/L vs. (3.48 ± 1.32) × 10 9/L, P<0.05. Compared with that of the control group, alanine aminotransferase and aspartate aminotransferase were significantly decreased: (49.42 ± 31.88) U/L vs. (84.22 ± 43.95) U/L, (36.50 ± 21.50) U/L vs. (49.98 ± 35.63) U/L, P<0.05. Conclusions:Compared with conventional hepatectomy for hepatocellular carcinoma patients with hypersplenism, combined hepatosplenectomy can effectively promote the increase of peripheral blood PLT and WBC and the recovery of liver function without increasing the risk of surgery, and the long-term follow-up results are more satisfactory, which has high clinical application value.

ObjectiveTo explore the effect of earlier rehabilitation on activities of daily living(ADL) of patients with spinal cord injury(SCI).Methods50 SCI patients received earlier rehabilitation and improvement of ADL of patients was evaluated.ResultsAfter two months treatment,the scores of Barthel index,functional independence measure(FIM) grade of patients increased significantly compared with that of before treatment(P<0.05) and ADL improved.ConclusionEarlier rehabilitation can improve ADL of SCI patients.

BCG Vaccine ; adverse effects ; Child ; Child, Preschool ; Genetic Diseases, X-Linked ; complications ; Granulomatous Disease, Chronic ; complications ; genetics ; Humans ; Infant ; Infant, Newborn ; Lymphadenitis ; etiology ; Male ; Membrane Glycoproteins ; genetics ; NADPH Oxidase 2 ; NADPH Oxidases ; genetics

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Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

Objective To screen for the potential protein biomarkers in serum for the diagnosis of idiopathic Parkinson's disease (PD) using proteomic fingerprint technology. Methods Proteomic fingerprint technology combining weak cation exchange (WCX) magnetic beads with MALDI-TOF-MS was used to identify and compare the serum proteins from 61 patients with idiopathic PD, 29 patients with other neurodegenerative diseases (OND) and 30 healthy blood donors. Model of biomarkers and proteomics patterns associated with PD was analyzed by Biomarker Patterns Software. The model also was validated by 40 newly recruited PD cases. Results A total of 17 discriminating M/Z peaks which were related to PD were identified ( nonparametric test, Z:-4.039--2.633, P<0.01 ). Five biomarkers with M/Z of 6121, 5234, 2961,4309 and 8170 respectively generated an excellent model of distinguishing between PD and healthy groups. The sensitivity was 98.4% and the specificity was 83.1%. Blind testing in 40 newly recruited cases demonstrated a sensitivity of 85.0% (17 of 20 PD) and a specificity of 70. 0% (14 of 20 controls). Conclusions Combination of WCX magnetic beads with MALDI-TOF-MS is a useful method in establishing proteomic patterns associated with PD. It also may be used to construct a diagnostic model with PD Biomarkers. Although this model of biomarkers fails to distinguish between PD and OND controls, it is able to differentiate PD from healthy controls.

Objective To investigate the feasibility of setting mAs in liver enhanced CT scan according to plain scan noise with fixed mA CT scanner,in order to reduce the radiation dose.Methods One hundred continuous patients underwent liver enhanced CT scan (group A) prospectively.Two hundred and fifty mAs was used in plain and enhanced CT scans.Noises of plain and venous phase CT images were measured,and the image quality was evaluated.The equation between mAs of enhanced scan and noise of plain scan image was derived.Another 100 continuous patients underwent liver enhanced CT scan (group B).Enhanced scan mAs was calculated from noise on plain scan by using the equation above.Noises on venous phase images were measured and the image quality was measured.Based on body mass index (BMI),patients in groups A and B were divided into three subgroups respectively:BMI ＜ 18.5 kg/m2,18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2 and BMI ≥ 25.0 kg/m2.Image quality score was compared with nonparametric rank sum test,CT dose index (CTDI) and effective dose (ED) were measured and compared between each subgroup with 2 independent samples t or t' test.Results The equation between enhanced scan mAs (mAsX) and plain scan noise (SDp) was as follows:mAsX =mAs1 × [(0.989 × SDp + 1.06) /SDx]2,mAs1 =250 mAs,SDx =13.In patients with BMI ＜ 18.5 kg/m2,ED of group A [(6.86 ±0.38) mSv,n =12] was significantly higher than group B [(2.66 ±0.46) mSv,n =10)] (t =18.52,P ＜0.01).In patients with 18.5 kg/m2 ≤ BMI ＜ 25.0 kg/m2,ED of group A [(7.08 ± 0.91) mSy,n =66] was significantly higher than group B [(4.50 ± 1.41) mSv,n =73] (t' =10.57,P ＜ 0.01).In patients with BMI ≥25.0 kg/m2,there was no significant difference between EDs of group A (7.54 ± 0.62 mSv,n =22) and group B [(8.19 ±3.16) mSv,n =17] (t' =0.89,P =0.39).Image quality of 5 patients in group A and none in group B did not meet the diagnostic requirement.Conclusion Setting mAs of enhanced scan according to plain scan noise could reduce the radiation dose with maintainence of image quality.

Objective To explore the effects of intraventricular administration of insulin on the expressions of Bcl-2,Bax mRNA and neuronal hippocampus apoptosis in rats after cardiopulmonary resuscitation (CPR).Methods This experiment was implemented in the animal Laboratory center of Xuanwu Hospital of Capital Medical University.Thirty male SD rats were randomly (random number)divided into three groups:control group (n=6),CPR group (n=12),insulin treated group ( n =12).CPR was performed at 6 minutes after ventricular fibrillation induced by transesophageal overdrive pacing.Resuscitation procedures lasted until restoration of spontaneous circulation (ROSC).ROSC was defined as the recovery of the supraventricular heart rates and the increase of mean arterial pressure (MAP) ＞ 60mmHg for more than 10 minutes.Ten minutes after ROSC in rats,12.5 μL ( 1 U) regular insulin was injected into the left ventricle in the insulin group,and 12.5 μL isotonic saline was injected the control and CPR groups at least 10 minutes.Real-time PCR was used to observe the expressions of Bcl-2,Bax mRNA in hippocampus CAI after reperfusion 24 h and 72 h.TUNEL staining was used to observe the neuronal apoptosis in all groups after reperfusion 7 days.Blood glucose was monitored in rats before and after CPR.Results ① The Bcl-2mRNA in insulin groups were significantly higher than those in the CPR group after 24 h and 72 h (P ＜0.01 ).The expression of Bcl-2 mRNA in 24 h insulin group were significantly higher than those in 72 h insulin group ( P ＜ 0.01 ) ; There were no significantly different in the Bax mRNA between insulin groups and the CPR and the control group after 24 h and 72 h ( P ＞ 0.05 ) ; ②After CPR 7 d,the apoptotic neurons of hippocampal CA1 area in the CPR group ( 124.75 ± 17.35 ) were significantly higher than those in the control group (5.12 ± 3.26) ( P ＜ 0.01 ) and the insulin group (92.79 ± 7.35 )(P ＜0.01 ); the apoptotic neurons in the insulin group were higher than those in the control group (P ＜0.0l ),and the differences were statistically significant.③There were no significant difference in venous blood glucose in the CPR and insulin groups (P ＞ 0.05).Conclusions Insulin may regulate Bcl-2mRNA expression in hippocampus,inhibit neuronal apoptosis and protect neurons after CPR in rats.

Objective By the method of multiple polymerase chain reaction (PCR),we intend to amplify different regions (DFR) of Yersinia pestis DNA,and to establish a multiple DFR genotyping technique for detection of Yersinia pestis.Methods According to the product size of 23 DFRs and pMT plasmid,24 primers were optimized and combined,then multiple primers in one PCR reaction system were added,and positive template DNA was amplified.Meanwhile,200 wild strain DNAs were amplified by multiple PCR and normal PCR,to verify the coincidence rate of the two methods.Results Totally 24 target segments were amplified through the positive DNA template.Through different permutation and combination,24 primers were optimized and combined into 9 groups.Totally 200 wild strain DNAs were used for verification,the coincidence rate of multiple PCR and normal PCR was 100％.Conclusions Multiple PCR is applicable and feasible for DFR genotyping of Yersinia pestis.It is an efficient,economic and high accuracy experimental method for large quantities of Yersinia pestis DFR genotyping.

Objective To explore the apoptosis effect of docetaxel combined gamma knife on hepatoma cell SMMC-7721 subcutaneous xenograft in nude mice.Methods Subcutaneous xenogyaft models were constructed and were divided into two groups:control group and experimental group.The experimental group was treated with docetaxel 60ug/0.3ml once every 3 days for 6 times and gamma irradiation once every other day for 6 times (with indoor temperature of 137Cs radiation source irradiating the tumor and of fractionated schedule 5Gy with the total dose of 10Gy every time).The control group was treated with physiological saline with the same dose of 60 ug/0.3 mL.Tumor growth was observed.Tumor samples were cut 30 days after the treatment and TUNEL was used to detect the apoptosis of tumor cells.Results Tumor growth rate in experimental group significantly slowed down.Apoptotic index in experimental groups was significantly higher than that in control group (P ＜ 0.05) Cornclusion Docetaxel combined gamma knife can inhibit the growth of hepatocellular carcinoma in nude mice.