Objective To study the arterial portography features and the impact on surgical treatment of children′s cavernous transformation of the portal vein (CTPV). Methods Angiographic findings of the arterial portography of 6 children with CTPV and its impact on surgical treatment were retrospectively analyzed. Results Abrupt occlusion of the portal vein at the porta hepatis was revealed in 5 out of 6 cases, and a masslike network of intertwined veins around the porta hepatis and many small irregular veins radiating from the network to the liver were demonstrated. Both hepatopetal and reverse flow of collateral venous pathways were defined. Valuable information of correlative vessels for surgical treatment was obtained from all 6 angiographic findings. ConclusionChildren′s CTPV have very characteristic angiographic findings, which can be very helpful for surgical management.

Objective To evaluate the patency rate of two types of metallic biliary stent in treating malignant biliary stenosis, and to discuss the patient’s survival rate. Methods A total of 126 patients with malignant biliary stenosis were treated with percutaneous implantation of biliary stent. The clinical data were retrospectively analyzed. A total of 167 metallic biliary stents were used in 126 patients. Ninety - two metal stents of mesh type were employed in 70 cases, while 75 metal stents of laser engraving type were adopted in 56 cases. After the treatment all patients were followed up, and the stent patency time as well as the median survival time was determined. The results were analyzed and compared between the two types of stents. Results Technical success rate was 100% (126/126). The median patency rate time of mesh type and laser type was 182 days and 196 days respectively, the patient’s median survival time of mesh type group and laser type group was 179 days and 186 days respectively. No statistically significant differences in the stent patency time and in the median survival time existed between the two groups (P > 0.05). Conclusion In treating malignant biliary obstruction with stenting, the mesh type stent and the laser type stent have quite same therapeutic effect. Therefore, in clinical practice the two types of stent can be replaced with each other to a certain degree.

Objective To isolate and culture sweat gland epithelial cells in vitro,and to study the effects of acetylcholine (ACh) on intracellular flee calcium concentration ([Ca~(2+)]i) of cultured sweat gland epithelial cells.Methods Sweat glands epithelial cells were collected by enzymatic digestion.After ACh was added to the primary and first passage cells,[Ca~(2+)]i was examined using confocal laser scanning microscopy (CLSM) and the Ca~(2+) sensitive dye Fura 3/AM.Results The primary and first passage epithe- lial cells grew well.After ACh was added,opening of the calcium channel and significant [Ca~(2+)]i increase were observed when the primary and first passage cells were incubated with high concentration of calcium (2 mmol/L);no significant [Ca~(2+)]i increase was observed in those cultured without calcium.Conclusion Upon stimulation with ACh,calcium channels of cultured primary and first passage sweat gland epithelial cells would open,influx of extracellular Ca~(2+) occurred,which resulted in an increase of [Ca~(2+)]i.Extracellular bound calcium was therefore converted into intracellular free calcium.

Objectives To investigate preparation of gemcitabine albumin nanoparticles, and its property of slow-release, the cytotoxic effect on pancreatic cancer cells (PANC1) in vitro, for improving the effect of regional intra-arterial infusion chemotherapy in pancreatic cancer with new medicament in the future. Methods The gemcitabine albumin nanoparticles were prepared with bovine serum albumin and gemcitabine with the desolvation-crosslink method, the concentration of gemcitabine was detected by high performance liquid chromatography (HPLC). The cytotoxic effect on pancreatic cancer cells in vitro were detected with MTT colorimetric assay. Results The mean diameter of gemcitabine albumin nanoparticles was (156.2±2.2) nm, and Zeta potential was (-20.4±1.41)mV, drug loading was 10.8%, drug release time in virto was 3 hours respectively. Gemcitabine albumin nanoparticles (0.01～50 μg/ml) had a 31%～44% inhibitory rate on PANC1 cell, which was similar to the inhibitory rate of same concentration of gemcitabine (26%～47%). Conclusions The new preparation of gemcitabine albumin nanoparticles had obvious drug slow-release effect, which may help improve the effect of regional intra-arterial infusion chemotherapy for pancreatic cancer.

OBJECTIVE:To investigate the application of key monitoring varieties among adjuvant drugs in medical institu tions of Yunnan province,and to provide reference for the formulation of related policy and the promotion of clinical rational drug use.METHODS:The related data of key monitoring varieties in medical institutions of Yunnan province during Jan.1st-Mar.31st,2015 were investigated and analyzed statistically.RESULTS:The data with highest effective rate were reported by tertiary hospi tals,being 93.94％.Among top 10 drugs in the list of consumption sum,the number of key monitoring varieties was the highest in tertiary hospitals,being (5.50 ± 2.12) varieties averagely.The consumption sum of key monitoring varieties in tertiary hospitals took up the highest proportion in total consumption sum of hospitalization drug,being(31.94 ± 16.99)％ averagely;being(26.13 ± 11.93)％ and (22.14 ± 16.39)％ in second level hospitals and first level hospitals.Among top 10 drugs in the list of consumption sum,the consumption sum of key monitoring varieties in second level hospitals took up the highest proportion in total consumption sum of hospitalization key monitoring varieties,being (50.34 ± 26.87) ％ in average,up to 98.53 ％;being (39.13 ± 22.55) ％ and (27.38 ± 27.75)％ in tertiary hospitals and first level hospital.Among top 5 key monitoring types in the list of hospitalization con sumption sum,safflower yellow pigment and omeprazole were involved in hospitals at various levels.CONCLUSIONS:Adjuvant drug use are widespread in medical institutions of Yunnan province.Key monitoring varieties are given priority to TCM injection and proton pump inhibitors.It is necessary to take effective measures,formulate and implement the corresponding supervision sys tem so as to promote rational clinical drug use.

Background and purpose:When the patients with nasopharyngeal carcinoma (NPC) receive radiotherapy, their thyroids are inevitably involved. As a result, thyroid damage occurs. This study aimed to explore the effects of intensity modulated radiation therapy (IMRT) on dynamics of thyroid blood flow in patients with NPC.Methods:A total number of 68 patients with NPC were enrolled in the study who received primary treatment of radical radiation and chemotherapy from Jul. 2012 to Oct. 2013. And the TMN stage was fromⅡ toⅣc according to UICC 2010. The treatment method consisted of 2 cycles of TPF induction treatment, concurrent radiation therapy (IMRT) with 2 cycles of DDP and 2 cycles of adjuvant therapy sequentially. Before radiotherapy, at the end of radiotherapy, 3 and 6 months after radiotherapy, serum free triiodothyronine (FT3), free thyroxin (FT4) and thyroid-stimulating hormone (TSH) concentrations of all cases were detected by electrochemiluminescence. The highest systolic velocity, mean velocity, minimum diastolic velocity, resistance index, and the value of all thyroid diameter lines were measured by type-B ultrasound.Results:All the patients were followed up for 6 months. Hypothyroidism: the incidence of immediate clinical hypothyroidism after radiotherapy was 5.9%; 3 months later, the incidence was 13.2%; and 6 months later, the incidence was 26.5%. The difference in volume change between before radiotherapy and at the end of radiotherapy had no statistical signiifcance (P>0.05). The difference in volume change between 3 and 6 months after radiotherapy had statistical signiifcance (P<0.05). The difference in FT3, FT4 and FSH between the end of radiotherapy and before radiotherapy had no statistical signiifcance, while there was statistically signiifcant difference between at the end of radiotherapy and 3 months after radiotherapy. The thyroid volume correlated with the average dose at the end of radiotherapy, 3 and 6 months after radiotherapy as shown by the single factor correlation analysis (P<0.05). The results of sinlge factor correlation analysis also showed that the occurrence of hypothyroidism correlated with thyroid dose-volume parameter V40 at the end of radiotherapy (P<0.05). The correlation between hypothyroidism and the average dose on thyroid 6 months after radiotherapy was demonstrated by independentt test (P<0.05). Hypothyroidism had no correlation with thyroid artery systolic maximum velocity and resistance index at the end of radiotherapy, 3 and 6 months after radiotherapy (P>0.05).Conclusion:The incidence of hypothyroidism may increase with time after radiotherapy. The volume may decrease with the increased dose of radiotherapy and the follow-up time. The patients with NPC after radiotherapy should be tested for thyroid lesions routinely. The thyroid dose-volume parameter V40 may be a predictor for acute radioactive thyroid lesions. The study did not reveal temporarily that hypothyroidism was associated with thyroid ultrasound blood lfow velocity.

BACKGROUND: As a cytokine highly expressed in internal organs, visfatin could be used as a biomarker of systemic inflammation response for chronic obstructive pulmonary diseases, but few studies have reported the use of visfatin in severe pneumonia. The present study was undertaken to determine the plasma levels of visfatin in patients with severe pneumonia. METHODS: A total of 70 patients, including 40 patients with severe pneumonia (group A) and 30 patients with non severe pneumonia (group B) who had been admitted to the ICU from June 2009 to June 2010, were enrolled in this prospective study. And another 30 healthy physical examinees served as healthy controls (group C). Patients were excluded if they suffered from severe diseases of the heart, brain and kidney, cancers, autoimmune diseases, or received special treatment in the latest month. The plasma levels of visfatin, IL-6, IL-8 and TNF-α were measured by ELISA, while the level of CRP was determined by immuneturbidimetry, and the routine blood test was performed. Blood gas analysis and Acute Physiology and Chronic Health Evaluation II (APACHE II) were performed in patients with pneumonia. Comparisons between the groups were conducted by Student's t test, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson's correlation test or Spearman's rank-order correlation test. RESULTS: The plasma level of visfatin in group A was significantly higher than that in groups B and C (P<0.001), and the level of visfatin in group B was significantly higher than that in group C (P<0.001). The plasma level of visfatin was positively correlated with CRP, TNF-α, APACHE II and PMN％ in patients with severe pneumonia (rho=0.653, r=0.554, r=0.558, r=0.484, respectively, P<0.05 for all), while it was negatively correlated with PaO2 and PaO2/FiO2 (rho=?0.422, r=?0.543, respectively, P<0.05 for all). CONCLUSION: Visfatin may be involved in the systematic inflammation response in patients with severe pneumonia as a pro-inflammatory cytokine, and it is valuable in assessing the severity of pneumonia..

Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.

Gymnastics ; physiology ; Humans ; Workload

OBJECTIVE: To discuss and summarize the major characteristics, autopsy examination, and scene investigation in infant homicide cases. METHODS: From 2008 to 2013 in Suzhou, the information of seven detected infant homicide cases were collected and analyzed. RESULTS: The criminal suspects were victims' mothers with young ages and pregnancies were premarital. Infant homicide cases occurred at the same location of the delivery. The infants died of mechanical asphyxia in the majority of the cases. Most bodies were naked and their umbilical cords were not cut by iatrogenic method and didn't connect with the bodies. CONCLUSION The standardization of forensic investigation can improve the analysis and detection of infant homicide cases.
Asphyxia ; Autopsy ; China ; Criminals ; Death ; Forensic Medicine ; Homicide ; Humans ; Infant ; Retrospective Studies