Objective To explore the feasibility of tubular model based segmentation method for cystic artery and three-dimensional (3D) reconstruction model of Calot's triangle.Methods A tubular model based 3D region growing algorithm was proposed for the segmentation of cystic arteries and its adjacent vessels from 13 patients' CT images in DICOM format.The data was transferred to 3D visualization workstation based on a set of CalotShow1.0 software for 3D reconstruction.Results The method could effectively segment cystic artery and obtain the 3D model of Calot's triangle.Conclusions The 3D reconstruction model based on tubular model related vessel segmentation method and CalotShow1.0 can accurately display the spatial positions and adjacent relationships of cystic artery and Calot's triangle.

Aim To determine the function of nuclear factor-κB ( NF-κB ) in immunological liver injury of rat model and its effect on CYP2E1 expression, content and metabolic activity. Methods The immunological liver injury rat model was prepared by injection of Ba-cillus Calmette Guérin ( BCG,125 mg · kg-1 ) for 14 days. The hepatic tissue injury was revealed by hema-toxylin and eosin ( HE ) method and serum concentra-tion of alanine aminotransferase( ALT) , aspartate ami-notransferase ( AST ) respectively. CYP450 total con-tent in hepatic homogenate was determined by spectro-photography. The expression of CYP2E1 protein was detected by Western blot analysis. The enzyme kinetics of CYP2 E1 probe drug chlorzoxazone was evaluated by high-performance liquid chromatography ( HPLC ) as-say. Results The results showed that BCG-pretreat-ment ( 125 mg · kg-1 ) significantly increased the weight of liver and spleen, serum levels of ALT and AST(P<0. 01) , and decreased CYP2E1 expression, content and metabolic activity ( P <0. 05 ) . Adminis-tration of ammonium pyrrolidine dithiocarbamate (PDTC) (50, 100, 200 mg·kg-1) reversed the a-bove hepatic injury stimulated by BCG in vivo. Moreo-ver, PDTC dose-dependently inhibited the down regu-lation of CYP2 E1 ( P<0. 05 ) . Conclusion Passiva-tion of NF-κB can inhibit the down regulation of CYP2 E1 in liver tissue of immunological liver injury rats;NF-κB may be involved in CYP2 E1 down-regula-tion.

Objective: To understand the Implementation of Comprehensive Evaluation of School Health (GB/T 18205-2012) and associated factors, so as to provide rationalization proposals for future revision of standards. Methods: A questionnaire survey was conducted on 436 schools, 56 health supervision agencies and 55 disease control agencies in Liaoning Province, and the main contents include the investigation of awareness rate, training, application, rationality and application of evaluation items and indicators. Results: Totally 44 supervision agencies and 29 CDCs had independent school health departments, with significant differences in faculty equipment ( t =8.53， P <0.05). The standard was trained in 100% of municipal supervision agencies, 22.50% of district and county level, 46.15% of municipal CDC ,50.00% of district county CDC; 61.54% of municipal and 45.00% of district and county supervision agencies conducted evaluations in accordance with this standard, 53.85% of the municipal CDC, 60.00% of county CDC jointly completed the standard; 30.77% of municipal and 52.50% of district and county supervisory bodies informed the educational administration of the results of the comprehensive evaluation. Conclusion The establishment of school health professional departments and the training of management objects affect the implementation of comprehensive evaluation of school health, so it is necessary to combine the actual work to modify some of the important indicators, and strengthen the application of comprehensive evaluation results.

Objective To explore the feasibility and safety of kidney transplantation for pre-sensitized infants using deceased donors and summarize the relevant literature reports .Methods A second kidney transplantation was successfully performed for an 8-month-old pre-sensitized girl in July 2017 .She had a low level of donor specific antibody (DSA ) against human leucocyte antigen (HLA ) B62 due to severe acute rejection (AR) after her first kidney transplantation .For desensitization , plasmapheresis and intravenous immunoglobulin plus anti-CD20 antibodies were offered on operative day .Clinical data and outcomes were retrospectively analyzed .Results Renal graft regained immediate function after transplantation .Preformed DSA could be detected at 1 week .However ,there was no de novo DSA .At 1 year post-transplantation ,preformed DSA turned negative .During a follow-up period of 2 years ,renal graft showed an excellent function with a serum creatinine of 31 μmol/l and eGFR of 110 ml/min/1 .73m2 .No AR episode or proteinuria occurred .DSA stayed negative .Simultaneously physical development also caught up .Her height of 93 cm tall and weight of 13 .5 kg at month 24 & 8 months corresponded to normal grow th curve of her age .Conclusions Pre-sensitized infant could tolerate desensitization therapy well and achieve satisfactory outcomes .With surgical precisions and optimized managements ,kidney transplantation provides excellent renal functions and survivals for infants with organs from deceased donors .

Objective To evaluate the efficacy of tigecycline plus prolonged high-dose meropenem infusion in the prevention and treatment of early carbapenem-resistant Klebsiella pneumoniae (CRKP) infection after renal transplantation .Methods From January 2016 to December 2018 ,clinical data were retrospectively analyzed for 13 renal transplant recipients with graft-carried CRKP .The relevant clinical data included treatments and outcomes of grafts and recipients .KPC-2 gene was the only resistance gene detectable in all isolates of CRKP . Among 13 CRKP positive recipients ,there were positive cultures of graft preservation solution ,recipient blood & urine (n=1) , positive cultures of graft preservation solution & urine (n=1) ,positive cultures of graft preservation solutions & peri-graft drainage (n=3) ,continuous positive cultures of peri-graft drainage more than twice (n= 3) and positive culture of graft preservation solution (n= 5).All patients received tigecycline plus prolonged high-dose meropenem infusion-based antibiotics .Results Five patients with CRKP positive in preservation solution were successfully prevented from infection after a treatment period of (12 .4 ± 2 .1)days .Among another 8 cases ,additional topical medications (n= 3) and surgical debridement (n= 1) were used .It took a median time of 16 (7～60) days until a negative culture and the total antibiotic treatment course was 20 (10～93) days .The average hospitalization duration was (50 ± 35) days .During a median follow-up period of 25 (6～28) months ,there was no onset of renal arterial rupture ,graft nephrectomy or death .The survival rate was 100％ for recipients and 92 .3％ for grafts .Conclusions For post-transplant infections due to graft-carried KPC-2 producing CRKP ,rapid diagnostics and tigecycline plus prolonged high-dose meropenem infusion may optimize clinical outcomes by decreasing the rate of graft nephrectomy and the recipient mortality .