Objective To investigate the ch an ges of gastric intramucosal pH (pHi) during orthotopic liver transplantation (OL T) without venovenous bypasss. Methods Twenty patients (14 males and 6 females) aged (46.7 ?4.6) years, undergoing orthotopic liver transplantation without venovenous byp asss, were included in this study. A gastric tube technique was used to draw gas tric juice 3～5 mL to determine pHi and PiCO 2 before OLT, at 20 min preanhep atic phase, 30 min anhepatic phase, 30 min new hepatic phase and at 2 h and 2 4 h after operation. The arterial blood samples collected taken for the measure ments of PaCO 2, PO 2, pH, BE and HCO 3- at the same time point s as above. pHi was calculated through Henderson-Hasselbach equation. Results The gastric intraumucosal pH (pHi) was decreased significant ly at the time points of 30 min anhepatic phase and 30 min new hepatic phase c ompared with before operation (P

Objective To explore the clinical value of cardiac magnetic resonance imaging (CMRI) in assessment of right ventricular function in patients with pulmonary arterial hypertension (PAH).Methods The PubMed/MEDLINE,Wanfang data,CNKI (from January 2001 to April 2015) were searched.The search terms were pulmonary arterial hypertension,right ventricular function,and cardiac magnetic resonance imaging.An inclusion criterion was the patients suffering from PAH,and the healthy volunteers were served as controls.The study was designed as randomized controlled trial.All the subjects investigated had received CMRI.The end of the trial included right ventricular end diastolic volume (RVEDV),right ventricular end systolic volume (RVESV) and right ventricular ejection fraction (RVEF).Meta analysis was conducted by RevMan 5.0 software provided by Cochrane Collaboration,and the publication bias was analyzed by the funnel plot analysis.Results Five papers involving 381 patients met the criteria.It was showed by Meta-analysis that compared with healthy control group,RVEDV was increase in PAH group [weighted mean difference (WMD) =33.96,95％ confidence interval (95％CI) =20.80-47.12,P ＜ 0.000 01],RVESV was increased (WMD =41.91,95％ CI =29.63-54.19,P ＜ 0.0O0 01),and RVEF was decrease (WMD =-20.09,95％CI =-22.65 to-17.52,P ＜ 0.000 01).Conclusion CMRI can be used to evaluate the right ventricular function of patients with PAH,and it has important significance in the evaluation of right ventricular function in patients with PAH.

Objective To evaluate the multi-detector CT (MDCT) on pulmonary changes in post-operative adult receptor of liver transplantation complicated with acute respiratory distress syndrome (ARDS).Methods Nineteen adult patients admitted into Tianjin First Center Hospital from January to December 2016 to perform the first time liver transplantation were enrolled in this study. Before operation, the CT showed no significant abnormality in the patients' lungs, after operation MDCT was applied to observe the pulmonary changes of ARDS post-operative complication in the adult receiver of liver transplantation, and the pulmonary changes in different gender of patients were analyzed and compared.Results MDCT showed that after liver transplantation all the 19 patients (100%) had lung pathological changes, of whom 18 cases (94.7%) manifested 2 or more than 2 kinds of pulmonary changes, including consolidation shadows (12 cases, 63.2%), patchy shadows (2 cases, 10.5%), ground glass opacity (6 cases, 31.5%) and pleural effusion (18 cases, 94.7%). In the comparisons between male and female patients with post-operative ARDS after liver transplantation, there were no significant differences in the lung pathological changes shown in MDCT (allP > 0.05) statistically.Conclusion The application of MDCT has great potential value in the evaluation of the disease situation after liver transplantation, that might providehelp to the postoperative treatment.

The aim of this study was to clarify characteristics of cardiovascular malformation in patients associated with tetralogy of Fallot (TOF) by using dual-source computed tomography (DSCT) angiography. We retrospectively analyzed DSCT angiography of 99 consecutive patients with TOF. In addition to typical CT features of TOF in all patients, the DSCT angiography showed 27 cases (27.27%) of atrial septal defect, 14 cases (14.14%) of patents ductus arteriosus, 11 cases (11.11%) of bicuspid pulmonary valve, 18 cases (18.18%) of congenital coronary artery malformation, 22 cases (22.22%) of right aortic arch, 12 cases (12.12%) of persistent left superior vena cava, 8 cases (8.08%) of retro-aortic innominate vein and 9 cases (9.09%) of pulmonary venous anomalous. DSCT is capable of displaying anatomical characteristics of cardiovascular malformation in patients with TOF.
Angiography ; Heart Defects, Congenital ; diagnosis ; Humans ; Retrospective Studies ; Tetralogy of Fallot ; diagnosis ; Tomography, X-Ray Computed

Clinical Laboratory Techniques ; Enzyme-Linked Immunosorbent Assay ; Hepatitis C ; diagnosis ; Hepatitis C Antibodies ; blood ; Humans ; RNA, Viral ; blood

Objective To investigate the therapeutic efficacy and safety of endoscopic resection of giant gastric stromal tumors without explicit evidence of metastases.Methods A total of 12 giant gastric stromal tumors with no evidence of metastases diagnosed by endoscopic ultrasound (EUS) and computed tomography (CT) scan were managed by endoscopic resection.Operation time,blood loss and the incidence rate of perforation were recorded respectively.The diagnoses of tissue specimens were made by pathological examination and immunohistochemistry.In order to assess local recurrence and distant metastases,endoscopy and endoscopic ultrasound follow-up examinations were performed routinely at 2,6 and 12 months,and the whole abdominal CT scan was also performed at 12 months after operation.Results Endoscopic resections were successfully performed in 10 of 12 cases (83.3％),among which,6 underwent endoscopic submucosal excavation (ESE) without unexpected perforation and 4 endoscopic full-thickness resection (EFR)with intentional perforation.The rate of intentional perforation was 33.3％ (4/12),and all the perforations could be sealed by endoscopic methods.The blood losses were all more than 100 ml,which could be controlled by argon plasma coagulation,electrocoagulation or hemostatic clips.In the 10 encapsulated tumors,8 could be smoothly removed from esophagus,whose long diameter of the minimum cross section was less than 3.5 cm,however,2 tumors whose diameters were larger than 3.5 cm were taken out after segmentation.In the 10 tissue samples,9 were confirmed as low risk GIST,1 larger than 5 cm was pathologically confirmed as high risk GIST.During 1-year follow-up,no local recurrence or peritoneal metastasis was found.2 tumors,larger than 5.0 cm,could not be removed by endoscopic methods due to uncontrolled bleeding.The rate of uncontrolled bleeding was 16.7％ (2/12).The patients were transferred to surgery,and pathologically confirmed as having high risk GIST.Conclusion For low-risk giant gastric stromal tumors whose diameters were less than 5cm without evidence of metastases,endoscopic resection is considered as a safe and effective procedure.Tumors with long diameter of the minimum cross section less than 3.5 cm are more suitable for endoscopic resection,which can be smoothly taken out through cardia.However,for high-risk GIST larger than 5.0 cm,the rate of uncontrolled bleeding is high,so endoscopic resection should be adopted with discretion.

Objective To assess the effectiveness of the combined treatment model for Wilms'tumor and to improve treatment results.Methods Fifty-five patients diagnosed with Wilms' tumor between July 1981 to June 2010 were analyzed retrospectively.Eighteen patients were diagnosed by preoperative ultrasound-guided fine needle biopsy,and 53 patients were confirmed by postoperative pathology results.Seven cases were in clinical stage Ⅰ,19 cases in clinical stage Ⅱ,21 cases in stage Ⅲ,six cases in stage Ⅳ and two cases in stage Ⅴ.Thirty-five cases had histopathological subtype,30 cases had the favorable type,and five cases had the unfavorable type.Among the 55 patients,kidney tumor resection was performed on 48 cases,wide edge partial nephrectomy was performed on two cases,tumor enucleation was performed on one bilateral renal tumor case,kidney tumor resection with pulmonary metastasectomy was performed on two cases,and two cases had no surgical procedures.Eighteen cases received preoperative chemotherapy,40 cases received postoperative chemotherapy,and 12 cases received postoperative radiotherapy.Patients were grouped according to age,stage,histological type,treatment model,treatment course and whether or not they had radiotherapy.The Kaplan-Meier method was used in the evaluation and comparison of over survival (OS),disease free survival (DFS) and relapse free survival (RFS) of the different groups to reveal the relationship between different grouping factors with the prognosis of Wilms' tumor. ResultsThe median of follow-up was 34 mon ( ranging from 3 to 355 mon).The 3-year OS,5-year OS and 2-year DFS were 77.6％,69.0％ and 52.4％,respectively.The differences of OS in different stages ( P =0.006 ),DFS between pure operation group and combined therapy group ( P =0.004 ) and RFS between radiotherapy group and no radiotherapy group ( P =0.03 ) were significant,P ＜ 0.05.ConclusionsThe normative multi-disciplinary treatment model for patients with Wilms' tumor can achieve good results and is well tolerated.

Objective To compare curve-tip angiography guide wire (loach guide wire) and ultrasmooth hydrophilic guide wire (zebra guide wire) in selective common bile duct (CBD) cannulation of endoscopic retrograde cholangiopancreatography (ERCP). Methods A total of 196 patients were randomly assigned to loach guide wire group to receive cannulation guided by loach guide wire first ( n = 98 ) and zebra guide wire group to use zebra guide wire first ( n =98). If cannulation was not successful after 10 minutes, a further attempt was made for an additional 10 minutes using the alternative guide wire. If still not successful after 10 minutes, other cannulation accessories would be used. The primary and overall selective cannulation time, success rate, and post-procedure abdominal pain and serum amylase were assessed. Results The primary success rate of selective CBD cannulation was higher in the loach guide wire group (93.9%) than that in zebra guide wire group (86. 7%, P ＜0. 05), while there was no significant difference in cannulation time between 2 groups (P ＞ 0. 05 ). The cannulation success rate after crossover was higher in loach guide wire group (76. 9% ) than that in zebra guide wire group (0. 0%, P ＜0. 05). There was no significant difference in post-procedure serum amylase or occurrence rate of post ERCP pancreatitis between 2 groups (P ＞ 0. 05 ).Conclusion Loach guide wire is superior to zebra guide wire in ERCP selective CBD cannulation, which can replace zebra guide wire in difficult cannulation.

The effects of combined RNA interference (RNAi) of human telomerase RNA (hTR) and human telomerase reverse transcriptase (hTERT) genes on telomerase activity in a bladder cancer cell line (BIU-87 cells) were investigated by using gene chip technology in vitro with an attempt to evaluate the role of RNAi in the gene therapy of bladder transitional cell cancer (BTCC). Three TR-specific double-stranded small interfering RNAs (siRNAs) and three TERT-specific double-stranded siRNAs were designed to target different regions of TR and TERT mRNA. The phTR-siRNA, phTERT-siRNA, and the combination of both plasmids phTR+phTERT-siRNA were transfected into BIU-87 cells. The expression of hTR and hTERT mRNA was detected by quantitative fluorescent reverse transcription-polymerase chain reaction, and a telomeric repeat amplification protocol was applied to detect telomerase activity. Growth inhibition of BIU-87 cells was measured by MTT assay. Gene chip analysis was performed to evaluate the effects of the combined RNAi of hTR+hTERT genes on telomerase activity and growth of BIU-87 cells in vitro. The results showed that the expression of hTERT and hTR mRNA was inhibited by pRNAT-hTERT-III, pRNAT-hTR-III, and pRNAT-hTR-III+hTERT-III in BIU-87 cells. The inhibition efficiency of pRNAT-hTERT-III, pRNAT-hTR-III, pRNAT-hTERT-III+pRNAT-hTR-III was 67% for TERT mRNA, 41% for TR mRNA, 57% for TR mRNA and 70% for TERT mRNA in BIU-87 cells respectively. The growth of BIU-87 cells was inhibited and telomerase activity was considerably decreased, especially in the cells treated with combined RNAi-hTR and -hTERT. Gene chip analysis revealed that 21 genes were down-regulated (ATM, BAX, BCL2, BCL2L1, BIRC5, CD44, CTNNB1, E2F1, JUN, MCAM, MTA1, MYC, NFKB1, NFKBIA, NME4, PNN, PNN, SERPINE1, THBS1, TNFRSF1A, and UCC1). The results indicated that hTR-siRNA and hTERT-siRNA, especially their combination, siRNA hTR+hTERT, specifically and effectively suppressed the expression of both hTR and hTERT mRNA and telomerase activity. Molecular biological mechanism by which combined siRNA-TR and -TERT inhibited telomerase activity and growth of BIU-87 cells in vitro may involve the down-regulation of the 21 genes.

OBJECTIVETo examine the effect of ONO-AE3-208, an EP4 antagonist, on the formation of bone metastasis from prostate cancer in mice.

METHODSThirty-four 6-week old nude mice were divided into an experimental and a control group of equal number to be treated by intraperitoneal injection of ONO-AE3-208 and double distilled water, respectively. Then PC3/LUC cells were constructed by stably transfecting luciferin to prostate cancer PC3 cells and inoculated into the left ventricle of the mice to establish an animal model of systemic bone metastasis. The time of metastasis formation, photon tumor burdens, and changes of the survival curves after modeling were compared between the two groups of mice.

RESULTSAt 30 days after modeling, bioluminescence imaging analysis showed that the photon tumor burdens were significantly increased in a time-dependent manner in the control group in comparison with those in the experimental group (P < 0.01). The rate of metastasis formation was significantly higher in the former than in the latter (93.3% vs 33.3%, P < 0.001). The median time of metastasis formation was 29 d (95% CI 26.547 - 35.262) in the experimental animals as compared with 21 d (95% CI 17.213 -24.787) in the controls (P < 0.001).

CONCLUSIONEP4 antagonist ONO-AE3-208 can inhibit the formation of bone metastasis from prostate cancer in mice.

Animals ; Bone Neoplasms ; prevention & control ; secondary ; Cell Line, Tumor ; Disease Models, Animal ; Humans ; Male ; Mice ; Mice, Nude ; Naphthalenes ; pharmacology ; Neoplasms, Experimental ; prevention & control ; Phenylbutyrates ; pharmacology ; Prostatic Neoplasms ; pathology