Objective To observe the effects of intervention with Simvastatin and Aspirin on carotid artery atherosclerosis(CAA).Methods 120 patients with ischemic cerebrovascular disease and complicated CAA and blood-lipid abnormality were randomly divided into the Simvastatin group,Aspirin group,Simvastatin+ Aspirin group.Each group received corresponding therapy for 6 months.The changes of serum C-reactive protein(CRP) level,blood-lipid level,the carotid artery intimal and media thickness(IMT),the plaque areas before and after treatment and the recurrence rate of cerebrovascular event among the 3 groups were compared.Results Compared with before treatment,the levels of serum CRP were significantly decreased in the 3 groups after treatment(all P

Objective To investigate the clinical-pathological feature of careinoma showing thymus-like dif- ferentiation(CASTLE) of the thyroid. Methods The clinical data, histopathologie changes and immunohistoche- mical findings were studied in 1 case of carcinoma showing thymus-like differentiation of the thyroid with review of the related literature. Results The age of the patient was 38 years old. The clinical manifestation displayed a pain- less mass in the thyroid. On ultrasound the tumor appeared hypoechoic. Histologically the tumor cells were arranged in nests and islands accompanied by desmoplasfie strorna. The architecture thus showed a superficial resemblance to the lobulation seen in thymic carcinomas. The tumor was characterized by squamoid or syheytial-appearing cells with lightly eosinophilic cytoplasm. Nuciec were oval, pale to versicular, and had small distinct nudeoli. Immunohistoche- mically the tumor cells were positive for CK, CD5, CD117 but neyative for TG, Calcitonin, SYN, NSE, TTF- 1, EBV. Conclusion CASTLE is a very rate a carcinoma thyroid with architectural resemblance to thymic epithelial tumors. The immunophenolype of CASTLE is identical with that of thymie carcinoma.

0.05). Peak force test maximal displacement evaluation and failure energy absorption measurement showed that hamstring tendon knot or bone bolt press fit implant fixation were significantly better than B-PT-B (P0.05). Conclusion Reconstruction of ACL by hamstring tendon knot or bone bolt press fit implant fixation and tibia side tendons by weaving suture to tie a knot on the bone bridge can meet daily physiological demand.

Objective To construct the ICAT gene interference lentivirus expression vector targeting and to establish stable transfected cell line HL60 .Methods The interference sequence targeted at human ICAT gene was designed and synthesized ,after annealing ,which was connected to PGLV3 interference vector and with PG‐p1‐VSVG ,PG‐p1‐REV ,PG‐p1‐RRE were co‐transfected into 293T cells The lentivirus particles were packaged and generated .The virus titer was detected .HL60 cells were transfected for establishing the stable cell line ;RT‐PCR and Western Blot techniques were used to detect ICAT gene and protein expression in sta‐ble HL60 cells ,then the results were compared with those in the control group .Results The lentivirus expression vector targeted at ICAT was successfully constructed and the virus titer was 2 × 108 U/mL .Stable transfected HL60 cell line was established .The effective interference verification revealed that shICAT could significantly reduce the mRNA and protein level of ICAT ( P<0 .001) .Conclusion The shRNA lentiviral expression vector of ICAT gene is successfully constructed and the HL 60 cell line stably interfering ICAT expression is established .

Objective To investigate the operative techniques for refractory cholelithiasis. Methods The clinical data of 521 patients with refractory cholelithiasis who had been admitted to People's Hospital of Hunan Province from January 1990 to December 2007 were retrospectively analyzed. Results All patients received surgery. After the operation, 3 patients died of liver and kidney failure, the remaining 518 patients were cured without severe complications. The results of B ultrasound and computed tomography showed residual stones in 78 patients (15.1%). Four hundred and twenty-three patients (81.7%) were followed up for 5 months to 17 years (mean, 7.5 years), and the rate of positive effect was 90.1% (381/423). Conclusions Most of the refractory cholelithiasis can be cured radically. Individualized surgical planning, fine and standard surgical procedure are key to the treatment effect.

Objective To compare the efficacies of anatomic and nonanatomic mesohepatectomy for central type hepatocellular carcinoma.Methods The clinical data of 85 patients with central type hepatocellular carcinoma undergoing hepatectomies were retrospectively analysed.36 patients underwent anatomic mesohepatectomy and the other 49 patients did nonanatomic mesohepatectomy.The operative time,intraoperative blood loss,incidence of postoperative complications,postoperative drainage volume,time to flatus and length of postoperative stay between the two groups were compared.Results There were no significant differences in the general condition,organ function,tumor size and location between the two groups before operation (P ＞ 0.05).The intraoperative blood loss,incidence of postoperative complications,drainage volume were significantly less but the operative time longer in anatomic mesohepatectomy group than nonanatomic hepatectomy group (P ＜ 0.05).No differences between the two groups were found in regard to the time for flatus and length of postoperative hospital stay (P ＞ 0.05).Tumor recurrence developed in 7 cases in group A and 20 cases in group B (P ＜ 0.05).Conclusions Anatomic mesohepatectomy has the advantages of less surgical trauma,less exudation and complications in patients with central type hepatocellular carcinoma.

BACKGROUND:Severe abdominal infection after liver transplantation is the serious perioperative complications in liver transplant recipients, and it is one of the major reasons of death or loss of liver function. OBJECTIVE:To investigate the etiology, diagnosis and treatment of severe abdominal infection after orthotopic liver transplantation. METHODS:The clinical data of 186 cases of abdominal infection that received orthotopic liver transplantation between March 2004 and November 2011 were retrospectively analyzed. RESULTS AND CONCLUSION:Among the 186 patients, 16 patients had severe abdominal infection. Among the 16 patients, five patients had the infection due to the biliary anastomotic leakage caused large effusion in the gap under liver;10 patients had infection due to the peripheral liver massive hematocele caused by liver transplant surgery wounds extensive bleeding;one patient had injection due to left subphrenic large effusion caused by lower esophagus fistula after transplantation. Twelve patients had second operation within 3 days after diagnose, and there was no death;four patients had second operation after diagnosed for 3 days, one patient dead due to multiple organ failure at 21 days after liver transplantation and 5 days after second surgery. The results show that severe abdominal infection after liver transplantation is one of the serious perioperative complications in liver transplant recipients, and active recovery, multiple organ support and removal of infected lesions with control ing surgery as wel as the adequate drainage and other comprehensive treatment measures are the key points for the treatment of severe abdominal infection after liver transplantation.

Post-stroke cognitive impairment (PSCI) is a series of syndromes caused by stroke, involving impairment of one or more cognitive functions, such as attention, language function, executive function, visuospatial cognition, episodic memory and working memory, etc. The traditional treatment methods of PSCI include drug therapy and cognitive training. The treatment modalities are limited and the maintenance effect is not good. Therefore, an auxiliary treatment method is urgently needed to improve its therapeutic effect. Transcranial direct current stimulation (tDCS) is a safe and mature non-invasive brain stimulation technique, which generates weak direct current (1-2 mA) through electrodes placed on the scalp to change the resting membrane potential of neurons, regulate the excitability of the cerebral cortex, so as to achieve the purpose of treatment. This article reviews the effect of tDCS on PSCI, and hopes to provide reference and guidance for its rehabilitation treatment.

Objective To observe the clinical effect of sling exercise therapy(S-E-T)combined with drug treatment for cervical vertigo in elderly patients.Methods Forty-nine elderly patients with cervical vertigo admitted to our hospital between January 2011 and July 2014 were randomly divided into an observation group(n=27)and a control group(n=22).The observation group was given 80 mg Ginaton(Extract of Ginkgo Biloba Leaves Tablets)produced by German Dr.Willmar Schwabe GmbH & Co.KG three times a day,combined with S-E-T,including cervical stability and stretching training for 40min,focusing on the neck global muscle and local stabilize muscle rehabilitation,once every other day.The control group was provided with the same drug treatment.During the 6-month intervention,both groups were given health education by the same therapist.Both groups were assessed using the neck disability index(NDI),visual analogue scale(VAS)and evaluation scale for cervical vertigo(ESCV) before and after the intervention,as well as at the last follow-up visit.Before the treatment and at the last follow-up visit,the cervical X-ray examination and trigger point check were also conducted for both groups.Results All the forty-nine patients were followed up for 4.83 to 6.70 months,with an average of(6.01 ± 0.49)months.Significant improvement was observed in the average ESCV score for both groups after the treatment.Compared with before the treatment,there was significant improvement in the average NDI and VAS right after the treatment and at the last follow-up visit in the observation group,but only at the last follow-up visit in the control group.From the cervical X-ray,no significant differences were found in the vertebral osteophyte formation,facet joints and uncovertebral joint degeneration between the 2 groups(P＞0.05),while significant differences were observed in the number of the neck trigger points(P＜0.05).Conclusion The sling exercise therapy combined with drug treatment can significantly improve cervical function,relieve pain and vertigo symptoms in elderly patients with cervical vertigo.The effect is better than drug treatment alone.

Objective To evaluate the feasibility of indwelling spiral nasointestinal tube through the proseal laryngeal mask airwary in critical patients. Methods According to the method of indewelling catheter, critical patients from June 2011 to August 2014 admitted in our hospital who need enteral nutrition with use of spiral nasointestinal tube were divided into PLMA group(40 cases), control group(40 cases). The effciency of insertion, blood pressure and heart rate before and after indwelling tube, complications of two groups were compared. Results The effciency of insertion, changes of vital signs and complications in PLMA group were better than those in control group (P<0.05). Conclusion Indwelling spiral nasointestinal tube through the proseal laryngeal mask airwary have higher efficiency, smaller fluctua-tions of vital signs in patients, fewer complications with respect to through mouth, that can be used in critial patients who need to implement enteral nutrition.