Objective To investigate the relation between coagulation disorders and sepsis severity of infected patients.Methods In this retrospective study,75 patients,51 males,24 femalse,with age(55.8± 18.1),were included from January 2010 to March 2011.They were clinically diagnozed as infection,and had Thromboelastography(TEG)and routine coagulation test within 24 hours after admission to emergency department.They were divided into 3 groups based on SIRS and SOFA score within 24 hours after admission:a)infection group,patients without SIRS; b)sepsis group,patients with SIRS and SOFA score less than 5; c)severe sepsis group,patients with SOFA score greater than or equal to 5.LSD was used to compare between two groups if one-way ANOVA of three groups comparasion showed significant differences.Results In comparasion to sepsis group(n =29)and infection group(n =27),D-dimer elevated significantly in severe sepsis group(n =19)(F =3.388,P =0.004),and platelet count decreased significantly(F =3.839,P =0.026),INR and KPTT showed an increase trend without significant difference (F =2.657,P =0.077 ; F =2.782,P =0.069); TEG showed MA obviously decreased(F =5.841,P =0.004),while there were nostatistically significant differences among other data.Conclusions The extent of coagulation disorders and sepsis severity of infected patients is closely correlated to each other.

Objective To evaluate the indications,method and prognosis of emergent hepateetomy and tran-scatheter arterial embolization(TAE) for spontaneous rupture of primary liver carcinoma(PLC). Methods Clinical data of 85 cases with PLC were analyzed. Patients were divided into four groups: the group of delayed hepatectomy (group A,n=30);the group of emergent transcatheter arterial embolization (group B,n=22);the group of emer-gent hepatectomy (group C, n=18) and the group of medical treatment (group D, n=15). The hemostasis achieve-ment ratio, operative complications, perioperative morbidity, 1-year and 3-year survival rates among the four groups were compared. Results In group A and B, celiac urteriogram in 52 cases showed that extravasation of contrast media happened in 14 cases (26.9%). The hemostasis achievement ratio was 100% (30/30, 22/22, 18/18) in group A,B and C,respectively,which was remarkably higher than that in group D(40%,6/15) (P<0.05);The in-hospital fatality was 0% (0/30),3.8% (2/52) and 16.7% (3/18),which was lower than that of group D(80.0%, 12/15) (P<0.01). The 1-year survival rate was 76.7% and 3-year survival rate of group A was 53.3%, which was higher than that of group B (45.5 % and 31.8 %) and group C (44.4% and 33.3 %) (P<0.05). The cases in group D did not survive one year(P<0.01). Conclusions Emergent hepatectomy and transcatheter arterial emboli-zation are safe and feasible for spontaneous rupture of primary hepatocellular carcinoma. For those with resectable ca-ses,surgical resection is the first choice after transcatheter arterial embolization.

OBJECTIVE To investigate vascular endothelial growth factor-C (VEGF-C) and cyclooxyegense-2(COX-2) expression in nasopharyngeal carcinoma. METHODS The expression of COX-2 and VEGF-C were stained respectively in nasopharyngeal carcinoma tissues of 45 patients using immunohistochemical method,and were analyzed with clinical data. RESULTS The positive expression rates of COX-2 and VEGF-C were 68.9 % and 53.3 % respectively in nasopharyngeal carcinoma tissue. The expression of COX-2 was positively correlated with VEGF-C (r=0.334,P

In order to investigate the impact of fulvic acid (FA) on the hydroxylysyl glycosylation in collagen bio-synthesis, 40 NMRI mice were divided into two groups (n = 20 in each group, consisting 10 females and 10 males). The animal was maintained for two generations by different diets: control group with normal water and food and study group with water containing 30 mg/L FA and normal food. The second generation of the animal was slaughtered, and the biochemical parameters of collagen content and the degree of collagen hydroxylysyl glycosylation in skin, rib and tibia were detected by biochemical methods. The mean value of collagen in the study group was increased slightly, and no significant difference between study group and control group was found (P > 0.05), but the content of glucose-glactose-hydroxylysine (GGH) was significantly decreased in the study group in comparison with the control group (P<0.01). It was suggested that through the decrease of GGH 30 mg/L FA could inhibit the activity of galactosyl-hydroxylysylglucosyl-transferase and further disturb the post-translational modification of collagen intracellularly.
Benzopyrans/*pharmacology ; Bone Development ; Bone and Bones/chemistry ; Bone and Bones/*metabolism ; Collagen/*biosynthesis ; Glycosylation ; Hydroxylysine/*metabolism ; Mice, Inbred Strains ; Osteoarthritis/etiology ; Selenium/deficiency

Objective To investigate effects of problem-based learning (PBL) and traditional learning (TL) on students' long-term memory and clinical practice ability. Methods Totally 79 5-year-program undergraduates of 2006, 2007, 2008 grade in school of clinical medicine of our hospital were randomly divided into PBL group (n=38) and TL group (n=41). The teaching effects were evaluated by two exams as well as teachers' subjective impression. SPSS 17.0 statistical analysis software was used;exam results were expressed as x±s; t test and rank sum test were used to analyze the exam results and subjective impression. α=0.05 was set as inspection level. Results In the second exam after 6 months, the mean exam scores were (76.66 ±5.94) and (73.59 ±5.74) in PBL group and TL group, without significant differences between the two groups (t=1.85, P=0.068). However, at clinical intern-ship stage, PBL group outperformed TL group based on the subjective evaluation (P=0.065, 0.277). Conclusion PBL can culture students' ability of problem-solving, but it is limited in culturing long-term memory.

AIM: To study the expression and the role of ERK1/2 and JNK1/2 of MAPKs pathways in the development of neural tube defects induced by hyperthermia. METHODS: The animal models of golden hamster were produced by hyperthermia. The expression of ERK1/2 and JNK1/2, and levels of their phosphorylation were measured by Western blotting in control group and hyperthermia group. RESULTS: p-ERK1/2 steadily expressed in each control group, and the expression of p-ERK1/2 significantly decreased, which was different from that in the corresponding control group (P<0.05). The activity of p-JNK1/2 increased in hyperthermia group and the amount of p-JNK1/2 increased as compared to control group. The peak appeared at 16 h after exposed to hyperthermia (P<0.05). CONCLUSION: Hyperthermia, which induces a decrease in p-ERK1/2 expression and increases the expression of p-JNK1/2 of MAPKs pathway, results in the unbalance of cell proliferation and apoptosis, and induces neural tube defects.

Objective To analyse the breast conserving surgery feasibility in patients with advanced breast cancer after neoadjuvant chemotherapy.Methods Sixty patients with advanced breast cancer were collect-ed from June 2010 to June 2011, and were divided into breast conserving surgery after neoadjuvant chemotherapy group and modified radical mastectomy group according to the intention,30 cases in each group.They were given breast conserving surgery after neoadjuvant chemotherapy and modified radical mastectomy respectively,with fol-lowing-up for 3 years.The treatment effect and contrast analysis of two groups of breast cancer CTCs positive of the two groups were compared,two groups of late follow-up of patients with local recurrence and distant metasta-sis rate,overall survival and disease free survival rate were recorded.Results Compared with the modified radi-cal mastectomy group,CTCs detection rate in breast conserving surgery group had no statistical differences(P>0.05).Two groups of patients in clinical complete remission rate,partial remission rate,disease stability factor and local recurrence and distant metastasis rate,overall survival and disease free survival rate had no statistical significances(P>0.05).Conclusion The application of breast conserving surgery after neoadjuvant chemother-apy for patients with advanced breast cancer can achieve similar effect as modified radical mastectomy surgery treatment,and can be used as a effective treatment for advanced breast cancer.

Objective To explore the influence of G4 cyberknife treatment of large hepatocellular car-cinoma on liver function,and to evaluate its treatment safety.Methods Sixty-three large liver cancer patients treated with routine G4 cyberknife treatment were retrospectively analyzed,and then statistical analysis of the difference in liver function before and after treatment was conducted.Results After G4 cyberknife treatment of 1 2 months,the levels of ALT,ALP,TBIL,PA were respectively 23.00 U /L,1 1 1 .00 U /L,1 3.70 μmol/L, (81 .87 ±1 3.94)%.Compared with the levels before treatment [28.00 U /L,32.00 U /L,1 1 .30 μmol/L, (86.07 ±1 4.07)%],there were no signi-ficant differences found (Z =-1 .677,P =0.094;Z =-0.504, P =0.61 4;Z =-1 .945,P =0.053;t =1 .271 ,P =0.21 3).The level of ambumin was (34.84 ±4.75)g/L at 1 2 months after treatment,which decreased and the difference compared with the level before treatment [(37.45 ±4.1 4)g/L]was significant (t =3.357,P =0.002).The Child-Pugh grade was 5.80 ±1 .1 7 respectively at the time points of 1 2 months after treatment,and no significant difference was found compared with the Child-Pugh grade before treatment (5.48 ±0.81 ,t =-1 .668,P =0.1 06).Conclusion G4 cyberknife treatment does not cause liver injury.It is safe and reliable in large liver cancer treatment.So,it is worth widely clinical popularizing.

In order to investigate the impact of fulvic acid (FA) on the hydroxylysyl glycosylation in collagen bio-synthesis, 40 NMRI mice were divided into two groups (n = 20 in each group, consisting 10 females and 10 males). The animal was maintained for two generations by different diets: control group with normal water and food and study group with water containing 30 mg/L FA and normal food. The second generation of the animal was slaughtered, and the biochemical parameters of collagen content and the degree of collagen hydroxylysyl glycosylation in skin, rib and tibia were detected by biochemical methods. The mean value of collagen in the study group was increased slightly, and no significant difference between study group and control group was found (P > 0.05), but the content of glucose-glactose-hydroxylysine (GGH) was significantly decreased in the study group in comparison with the control group (P<0.01). It was suggested that through the decrease of GGH 30 mg/L FA could inhibit the activity of galactosyl-hydroxylysylglucosyl-transferase and further disturb the post-translational modification of collagen intracellularly.
Animals ; Benzopyrans ; pharmacology ; Bone Development ; Bone and Bones ; chemistry ; metabolism ; Collagen ; biosynthesis ; Female ; Glycosylation ; Hydroxylysine ; metabolism ; Male ; Mice ; Mice, Inbred Strains ; Osteoarthritis ; etiology ; Selenium ; deficiency

Purpose: This study was performed to analyze the rule of confluence of the caudate lobe bile duct (CLD) into the left hepatic duct (LHD) and to discuss the protective strategy during left hemihepatectomy. Methods: MRI of 400 patients and T-tube angiography images of 100 patients were collected, and the imaging rules of the confluence of the CLD into the LHD were summarized. The clinical data of 33 patients who underwent left hemihepatectomy using the protective strategy were analyzed. Results: MRI and T-tube angiography images showed that the length from the confluence point of the CLD into the LHD to the confluence of the left and right hepatic ducts was 1.19 ± 0.40 cm and 1.26 ± 0.39 cm, respectively. The average angle between the longitudinal axis of the 2 bile ducts was 68.27° ± 22.59° and 66.58 ± 22.88°, respectively. Coronal and cross-sectional images showed that inflow from the foot side to the cranial side was noted in 79.8% and 82.0% of patients, respectively, and inflow from the dorsal to the ventral side was observed in 84.5% and 88.0%, respectively. Based on these imaging rules, the safe transection length and plane were summarized, and the CLD was effectively protected in 33 cases of left hemihepatectomy. Conclusion In left hemihepatectomy, the LHD should be transected at least 1.5 cm away from the confluence of the left and right hepatic ducts, and the plane of transection should be oblique to the dorsal side at an angle of 45° with the LHD, these parameters represent an effective strategy to protect the CLD.