Objective To investigate whether pulse pressure variation (△PP) reflect the effects of PEEP and fluid resuscitation (FR) on hemodynamic effects.Methods Twenty critical patients with acute lung injury was ventilated with volume control (VT =8 mL/kg,Ti/Te = 1: 2) ,and PaCO2 was kept at 35 to 45 mm Hg.PEEP was setted as 5 cm H2O and 15 cm H2O in randomized order.Hemodynamic parameters including cardiac index, pulse pressure, central venous pressure, etc.were monitered by PiCCO system.Measurements were performed after the application of 5 cm H2O PEEP (PEEPs group)and 15 cm H2O PEEP (PEEP15 group) respectively.When the PEEP-induced decrease in cardiac index (CI) was > 10%, measurements were also performed after fluid resuscitation.Results Compared with PEEPs group, CI was decreased significantly in PEEP15 group(P < 0.05), and APP was increased significantly (P < 0.05).In 14 patients whose PEEP-induced decrease in CI was > 10%, fluid resuscitation increased CI from (3.01±0.57)L · min-1· m-1to (3.62±0.68)L · min-1 · m-2(P<0.01),and decreased △PP from (17±3)% to (10±2) % (P < 0.01).PEEP15-induced decrease in CI was correlated negatively with APP on PEEP5 (r =-0.91,P < 0.01) and with the PEEP15-induced increase in △PP (r =-0.79, P < 0.01).FR-induced changes in CI correlated with APP before FR (r = 0.96, P < 0.01) and with the FR-induced decrease in APP (r =-0.95, P < 0.01).Conclusions In ventilated patients with ALI, △PP may be a simple and useful parameter in predicting and assessing the hemodynamic effects of PEEP and FR.

Objective To compare the lymph node dissection of left chest single incision and neck-right chest-abdomen incision in esophageal cancer surgery,and to explore the reasonable range of lymph node dissection in esophageal cancer surgery.Methods We retrospectively analyzed the clinical data of 72 patients with esophageal cancer radical surgery.According to the surgical approach,the patients were divided into left chest single-incision group (32 cases) and three-incision group (40 cases).The surgery time,number of lymph node resected,drainage tube time,length of hospital stay,lymph node dissection status and incidence of postoperative complications were analyzed.Results In left chest single-incision group and three-incision group,the operative time [(225.44 ± 11.98) min vs (265.42 + 13.15) min],lymph node dissection number[(8.031 ± 1.153) vs (11.821 ± 1.138)],length of stay [(13.212 ± 1.294) d vs(15.691 ± 1.404) d] and other aspects had statistically significant differences (t =24.201,25.302,14.010,all P ＜ 0.05).There were no significant differences between two groups in the chest tube indwelling time and the incidence of postoperative complications (P ＞ 0.05).Conclusion Both surgical radical resection of esophageal cancer have their own characteristics in terms of surgical difficulty,risks,efficacy and complications.In clinical,these must be carefully evaluated in patients with lesions and body affordability flexibility to choose the surgical approach in order to achieve the best therapeutic effect.

Objective To evaluate the medial longitudinal arch of the foot with and without hallux valgus in order to establish the relationship between hallux valgus and the arch. Methods 34 feet of 24 cases with hallux valgus and 34 normal feet of 18 cases were investigated by roentgenography. On the dorsal plantar view while weight-bearing standing, the hallux valgus angle (HVA), the first intermetatarsal angle, and the position of the tibial sesamoid relative to the first metatarsus were measured respectively. On the lateral view while weight-bearing standing, the top angle of the medial longitudinal arch, the anterior angle of the medial longitudinal arch (also named as the first metatarsal inclination angle) and the relative height of the talus, which are similar to measurement of the height of the medial longitudinal arch, were measured respectively. The characteristics of the medial longitudinal arch of the feet with and without hallux valgus were compared, and the correlation between the height of the medial longitudinal arch and the severity of the hallux valgus, which were manifested by the hallux valgus angle, first intermatatarsal angle, the relative position of the tibial sesamoid, was analyzed. Results The top angle of medial longitudinal arch was 136.9??7.6? in hallux valgus feet and 126.7??2.1? in normal feet; the anterior angle of medial longitudinal arch was 10.8??2.6? in hullux valgus feet and 16.6??1.6? in normal feet; the relative ratio of height of talus was 0.159?0.03 in hallux valgus feet and 0.199?0.01 in normal feet , there was significant difference between two groups. While with the increase of the lateral displacement of tibial sesamoid, the angle of hullxus valgus and the first intermetatarsal angle, the top angle of medial longitudinal arch became larger, the anterior angle of arch became smaller, and the relative height of talus became lower. The medial longitudinal arch of the foot with hallux valgus was collapsed, and there was moderate to high relationship between the height of the medial longitudinal arch and the severity of the hallux valgus. Conclusion Hallux valgus is a three dimensional deformity, which will disturb the normal biomechanics of the foot.

Objective To assess the practical value of ultrasound-guided percutaneous pericardium centesis in patients with pericardial effusion.Methods Twenty-eight patients with pericardial effusion were treated with ultrasound-guided percutaneous pericardium centesis from May 2004 to May 2009.Results Operations were successfully done in all 28 patients.The puncture needle,guide wire and drainage catheter could be clearly visualized under ultrasound.Complications included ache,bleeding and drainage catheter obstruction or prolapsus.Conclusion Able to be used bedside,ultrasoundguided percutaneous pericardium centesis is a real time,exact,safe and convenient method for the diagnosis and treatment of pericardial effusion.

Objective To investigate the effect and mechanism of S100A16 in the course of 3T3-L1 preadipocytes differentiation.MethodsA recombinant virus vector overexpressing S100A16 ( PLJM1-S100A16-GFP) was constructed and transfected into 3T3-L1 preadipocytes.The expression of S100A16 in the course of 3T3-L1 preadipocytes differentiated into adipocytes was detected by Western blot.The lipid droplets were observed by oil-red O staining and triglycercide (TG) content was measured by the TG measure kit.Levels of adipogenesis-associated genes such as PPARγ,CCAAT/enhancer binding protein ( C/EBP-α),lipoprotein lipase ( LPL),fatty acid synthase ( FAS),adipocyte fatty acid binding protein( aP2 ) were measured by realtime PCR and Western blot.The interaction between S100A16 and p53 was detected by immunoprecipitation.Results3T3-L1 cell line overexpressing S100A16was successfully contructed.It was found that the expression of S100A16 was increased during 3T3-L1 adipocytes differentiation.Overexpression of S100A16 stimulated 3T3-L1 preadipocytes differentiation and increased the accumulation of triglycerides in adipocytes (P＜ 0.01 ),along with the up-regulation of adipocyte differentiationassociated gene expressions including PPARγ,C/EBP-α,LPL,aP2,and FAS ( P ＜ 0.05 or P ＜ 0.01 ).Immunoprecipitation analysis revealed that S100A16 interacted with tumor suppressor protein p53,also a known inhibitor of adipogenesis.ConclusionS100A16 stimulates 3T3-LI preadipocytes differentiation via inhibiting p53activity.

3D medical image segmentation is a fundamental technique for computer assisted surgery and therapy. There exist various segmentation algorithms, but still we hope to have a more efficient and intuitive evaluation method for validation. In this paper, after reviewing the existing validation methods, we propose a new approach for 3D image segmentation validation. The details of the method are introduced in two parts: local error validation and global accuracy validation. Then, we apply it to validate three typical segmentation algorithms and a user proposed hybrid segmentation method in our experiment. The hybrid approach is also briefly introduced. The experimental results reveal that the proposed validation method can evaluate the employed segmentation methods more accurately and intuitionally.
Algorithms ; Diagnostic Imaging ; instrumentation ; methods ; Humans ; Image Enhancement ; methods ; Image Interpretation, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; methods

Objective To assess the relationship between the polymorphisms of heme oxygenase-1 gene and blood pressure level.Methods With the whole-gene based tagging SNP approach,3 tag SNPs of heme oxygenase-1 gene were selected for study.These tag SNPs were genotyped in 503 essential hypertension cases Blood pressure lev-els among different genotypes of each SNP were compared with ANOVA.The haplo.stats program wa8 employed to test haplotype frequency with blood pressure level.Results Subjects with rs2071749 A allele had the lower blood pressure levels than subjects with GG genotypes(SBP:159.5 mm Hg vs.168.5 mm Hg and DBP:97.6 mm Hg vs.101.3 mm Hg respectively.P<0.05).In the haplotype analyses.Haplotype T-T-A which carried the rs2071749 A allele was found significantly associated with SBP and DBP after adjustment for age,gender,body mass index.8n10k.illg and drinking·Conclusion The genetic variants of heine oxygenase.1 gene misht be associated with blood pres-sure levels.

Objectives:Dose-response effect of nicorandil cardioplegia at various concentrations was studied to optimize its myocardial protective effect.Methods:Forty-eight isolated working rat hearts were divided into 6 groups randomly.They were group A:control (depolarized cardiac arrest with St.Thomas solution No.2),group B,C,E,F and G:hyperpolarized cardiac arrest (nicorandil concentration were 25,50,100,125 and 150μmol/L respectively).The hearts underwent a 120-minute hypothermic arrest (15±1)℃ with cardioplegia (40 ml/kg) and reinfused with cardioplegia (40 ml/kg) at interval of 30 minutes.Mechanical arrest time,cardiac functional recoveries,myocardial content of malondialdehyde (MDA) and ultrastructure were measured.Results:The protective effect of nicorandil cardioplegia was dose-related.Conclusions:The optimal concentration of nicorandil in cardiplegia may be 100μmol/L for myocardial protection.

Objective To evaluate the efficacy of minimally invasive percutaneous intervertebral disc approach for treatment of sympathetic cervical spondylosis. Methods Fifty?six patients diagnosed as having sympathetic cervical spondylosis from January 2009 to August 2014, aged 22-64 yr, with the dis?ease course ranged from 6 months to 15 yr and a follow?up period of 6 months, were enrolled in the study. The related minimally invasive approach was selected according to the height of the diseased intervertebral space. When the ratio of the height of diseased intervertebral space∕normal intervertebral space≤1∕3, per?cutaneous radiofrequency ablation was used ( groupⅠ, n=19); when the ratio within the range of 1∕3-2∕3, percutaneous laser disk decompression was used ( groupⅡ, n=12); when the ratio≥2∕3, low?tem?perature plasma radiofrequency ablation was used ( group Ⅲ, n=25) . Before operation, at 2 weeks after operation, and at 1, 3 and 6 months after operation, the sympathetic symptoms were evaluated using the 20?point score. At 2 weeks and 6 months after operation, the patients′ subjective satisfaction was assessed and graded ( excellent, good, medium and poor ) . Results All the patients were followed up for 6 months. The sympathetic symptom scores were significantly lower at each time point after operation in Ⅰand Ⅲ groups and at 2 weeks and 3 and 6 months after operation in group Ⅱ than those before operation
( P<0.05) . The excellent and good rate of patients′subjective satisfaction was 67.9% at 2 weeks after op?eration, and 76.8% in the last follow?up period at 6 months after operation. Conclusion The minimally invasive percutaneous intervertebral disc approach has a marked short?term effect on sympathetic cervical spondylosis.

Objective To investigate the clinical value of echocardiography combined with genetic testing in the fetal cardiac rhabdomyoma. Methods Thirty-three fetal cardiac rhabdomyoma cases diagnosed by fetal echocardiogram in Beijing Anzhen Hospital from Jan. 2011 to Oct. 2015 were enrolled in a retrospective analysis. The results of other examination and pregnancy outcomes of them were followed up, the genetic characteristics of cardiac rhabdomyoma were summarized on the basis of pathology and genetics examination results. Results The pregnancy outcomes:24 cases were terminated pregnancy, 4 cases were born and 5 cases were lost. The results of ultrasound, pathology and genetic examination were detailed in 8 cases. Pathological examination: the typical characteristics of cardiac rhabdomyoma were found in the 8 cases with cardiac rhabdomyoma. The tumor tissue was composed of irregular and swelling shape of cardiomyocytes, and the cytoplasm was vacuole like, which was characteristic of“spider like cells”through microscopic observation. The geneticdetection results: 7 cases had tuberous sclerosis complex (TSC) gene mutation, TSC gene abnormalities were not detected in 1 case. Among the 7 cases with TSC gene mutations, 6 cases were with TSC2 gene mutation and the other 1 case was with TSC1 gene mutation. The family gene was investigated in the 5 cases, which including 3 cases of TSC gene mutation in mother passed on to the fetus (1 case with family of three generations of genetic) and 2 cases of spontaneous TSC gene mutation in the fetus. Conclusions Prenatal echocardiography combined with genetic detection have important clinical significance, which not only can clear if cardiac rhabdomyomas were associated with TSC, but also can clear the TSC gene mutation source. So as to further guide the perinatal management.