Objective To investigate the application of expanded p01ytetrafluoroethylene(ePTFE)grafts in upper arm to build arteriovenous aCCeSS for hemodialysis. Methods ePTFE graft vascular access was built in the upper arm in 20 uremia patients.Three operation strategies were applied according to the reference,including loop grafts connected axillary artery and axillary vein,straight graft connected axillary artery and elbow basilic vein,and bridge connected elbow brachial artery and axillary vein. Results Twenty operations were successful and after 6-8 weeks the fistula of all cases were used in hemodialysis.The blood flows were 220-300 ml/min without re-circulation found.Conclusion ePTFE graft arteriovenous vascular access in the upper arm could be an alternative for hemodialysis patients who are difficult to build native arteriovenous fistula.

Objective To enhance the clinical diagnosis efficiency and accuracy of diabetic retinopathy (DR) to facilitate its early finding and diagnosis.Methods Image segmentation method was used to process and analyze DR vessel.Clinical images by fundus fluorescein angiography (FFA) were used as the objects for the research on DR vessel segmentation and extraction.Results Image processing and analysis gained higher definition and accuracy in segmenting the normal retinal image and DR vessel when they were compared with the fundus image and FFA image.Conclusion The method proposed enhances the early diagnosis of DR by processing and analyzing the retinal vessel,and thus contributes to the increased living quality of the patient.

Objective To explore the relationship of MDR1 and its encoded product P-gp expressions with clinical efficacy of transcatheter arterial chemoembolization (TACE)in primary liver cancer and their clinical significance.Methods We selected 108 patients with primary liver cancer who came to our hospital between June 2010 and June 2013 as observation subjects.Meanwhile 50 healthy people in our hospital for liver biopsy were selected as controls.MDR1 mRNA level in observation group and control group was determined by real-time quantitative PCR.P-gp protein level was analyzed by immunohistochemistry.According to P-gp level,the 108 patients were divided into drug-resistance groups and non-resistance group;the relationship between P-gp expression level and clinical efficacy was analyzed.Results MDR1 mRNA level in liver tissues significantly enhanced in observation group compared with that in control group (P <0.05).In observation group 32 patients had the ratio of MDR1 mRNA level-normal level of more than 2 and 76 patients had the ratio of MDR1 mRNA level-normal level of less than 2. Immunohistochemistry revealed that MDR1 encoded product P-gp was brownish yellow, mainly expressed in the cell surface of liver cancer cells.There were 35 P-gp protein-negative patients (non-resistance group)and 73 positive patients (resistance group).Clinical efficacy was significantly higher in non-resistance group (74.28%)than in resistance group (43.28%)(P <0.05).The 1 year and 2-year cumulative survival rates were 54. 12% and 27.40% in resistance group and 77.14% and 42.86%% in non-resistance group.They were significantly higher in the latter group (P <0.05 ).Conclusion The overexpressed MDR1 encoded product P-gp in primary liver cancer is associated with multidrug resistance in tumor chemotherapy,suggesting that P-gp can be used as one of the guiding clinical markers of chemotherapy.

Objective To improve the clinical prognosis of patients by reviewing ten years epidemiology data of acute poisoning inpatients.Methods The epidemiology data of the acute poisoning inpatients from 2006-2015 were retrospectively analyzed.The indexes including age,gender,nationality,geographical distribution,substance of poison,seasons,diagnosis and fee-for-service were collected.Results There were 1 083 patients with acute poisoning in total,624 cases (57.6％) for gas poisoning,213 cases (19.7％) for pesticide poisoning,136 cases (12.6％) for drug poisoning,74 cases (6.8％) for food poisoning and 36 cases for others.The ration of male to female was 0.94:1.The age of 31 to 45 range accounted for the highest proportion.The incidence of poisoning in 2011-2015 was significantly higher than that in 2006-2010 (P ＜0.05).The geographical distribution was also significantly different (P ＜0.05),most of the cases were in Shihezi city,then were Manasi and Sawan counties.Among the 1 083 patients,59％ cases were cured,33.6％ cases were improved after treatment,and the mortality rate was 2.6％.Feefor-service was also significantly increased in the older patients or males,and substance of poisoning dependent.The highest treatment cost was carbon monoxide poisoning,then were pesticide,drugs and food.Conclusions The common causes of poisoning in Shihezi city were carbon monoxide,organophosphorus pesticide,botulism and drugs,more emergency medical service should prevent poisoning and treat these patients.

Objective To investigate the effects of ulinastatin on the myocardial injury in patients undergoing live donor liver transplantation.Methods Forty patients (AHA classification grade A or B),aged 40-64 yr,with a body mass index of 18-25 kg/m2,scheduled for live donor liver transplantation,were randomly divided into 2 groups ( n =20 each):control group (group C) and ulinastatin group (group U).Anesthesia was induced with midazolam,sufentanil,and cisatracurium besilate.The patients were tracheal intubated and mechanically ventilated.Ulinastatin 300 000 IU in 100 ml of normal saline was infused intravenously over 30 min after anesthesia induction and then the infusion was repeated at 4 h interval until the end of operation in group U,while the equal volume of normal saline was given in group C.Blood samples were taken from the central vein immediately before skin incision (T0,baseline),at 30 min of anhepatic phase (T1),at 30 min of neohepatic phase (T2),and at 0,4 and 24 h after operation (T3-5) for determination of the concentrations of serum cardiac troponin Ⅰ (cTnI),creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP).The changing rates of cTnI and CK-MB at T1-5 were calculated.The use of cardiovascular drugs and cardiovsscular accidents were recorded during operation.Results The serum cTnI,CK-MB and NT-proBNP concentrations were significantly higher at T2-5 than at T0 in the two groups ( P ＜ 0.05).Compared with group C,the serum cTnI,CK- MB and NT-proBNP concentrations at T2-5 were significantly deceased in group U ( P ＜ 0.05).The maximal changing rates of cTnI,CK-MB and NT-proBNP concentrations were 4.71 ± 1.62,6.85 ± 1.53 and 4.96 ± 1.23 respectively in group C,decreased to 3.26 ± 1.51,4.56 ± 1.62 and 3.67 ± 1.02 respectively in group U.There was no significant difference in the incidence of cardiovascular accidents and the use of dopamine between the two groups.Conclusion Intravenous infusion of ulinastatin can attenuate the myocardial injury to some extent in patients undergoing live donor liver transplantation.

OBJECTIVETo investigate the plasma level of extracellular histones in patients with silicosis, and to explore the role of extracellular histones in the pathogenesis of pulmonary fibrosis in silicosis.

METHODSSixty-two patients with silicosis were enrolled as the silicosis group, consisting of 23 patients with stage I silicosis, 25 with stage II silicosis, and 14 with stage III silicosis; sixty workers who had a history of occupational exposure to silica dust for more than 2 years and had not been diagnosed with silicosis were enrolled as the silica dust exposure group; sixty-five healthy workers without a history of occupational exposure to dust were enrolled as healthy controls. Enzyme-linked immunosorbent assay was applied to measure the plasma levels of plasma extracellular histone (H4) and transforming growth factor-β(TGF-β).

RESULTSCompared with healthy controls [(0.82±0.67) μg/ml], the silica dust exposure group[(4.14±2.85) μg/ml] and silicosis group[(9.50±5.04) μg/ml] had significant increases in plasma level of H4 (P<0.01). The plasma level of H4 was significantly correlated with the stage of silicosis(r=0.8955, P=0.0388). The silicosis group had a significantly higher plasma level of TGF-β than the silica dust exposure group and healthy controls(P <0.05). In the patients with silicosis, the plasma level of H4 was significantly correlated with that of TGF-β(r=0.5375, P<0.01).

CONCLUSIONThe plasma level of extracellular histones increases significantly in the pathogenesis of silicosis, and extracellular histones may play an important role in the progression of fibrosis in silicosis.

Case-Control Studies ; Disease Progression ; Dust ; Histones ; blood ; Humans ; Occupational Exposure ; Silicon Dioxide ; Silicosis ; blood ; pathology ; Transforming Growth Factor beta ; blood

Objective To investigate the effect of treatment with levothyroxine in early maternal subclinical hypothyroidism (SCH) on the neural development of the progeny. Methods 75 thyroidectomized female Wistar rats were divided randomly into groups of hypothyroidism (CH), SCH, SCH treated with levothyroxine at embryonic day 10 (E10), E13, and E17. There were 15 sham operated controls. Body weight,thyroid function, and the development of progeny by morris water maze, immunohistochemistry, and Nissl's staining of progeny were made. Results Pups from SCH or CH group had significantly lower body weight than euthyroid group ( P＜0. 05 ). Pups from E10, E13 or E17 groups had normal body weight compared to pups of control (P＞0.05). The levels of TSH and total T4( TT4 ) of all pups were normal. The mean latencies were longer in pups from CH, SCH, and E17 group than the control (P＜0.05). The mean escape latencies did not differ between the control and E10 group pups and between the control and E13 pups (P＞0.05). There were changes in the cytoarchitecture of the barrel cortex and of the hippocampus ( toluidine blue-stained sections) in CH, SCH, and E17 pups. The barrel cortex of E10 or E13 pups was similar to that of control pups. The distribution of BrdUlabeled cells was more widespread in CH, SCH, and E17 pups than in control, E10, and E13 progeny.Conclusion Maternal SCH disturbs learning and memory performances, cytoarchitecture and cell migration of the pups. Treatment with levothyroxine in early maternal SCH before E13 improves the cell migration in the developing brain of the progeny.

The report described one case of vascular paralysis syndrome during kidney transplantation to provide references for clinical practice.After intraoperative opening of kidney artery and vein, the recipient developed vascular paralysis syndrome.However, the efficacy is not obvious after dosing of norepinephrine.After an intravenous infusion of methylene blue, the recipient has a successful removal of tracheal intubation and recovered well.

Objective To determine the factors that influence the development of abnormal thyrotropin (TSH) level in an euthyroid population.Methods We conducted a follow-up study in 3 communities with different iodine status.Of the 3403 euthyroid subjects at baseline screened in 1999,80.1% ( n = 2727 ) was visited and sampled in 2004 for measuring TSH,thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb).Results Iodine status in the 3 communities were stable.Decreased TSH level( <0.3 mU/L) developed in 2.5% (n =68) of sampled subjects,while raised TSH level( > 4.8 mU/L) in 2.4% (n = 64).A logistic analysis showed that risk factors for developing decreased TSH level included positive conversion of TPOAb (OR = 5.5 ),positive TPOAb both in 1999 and in 2004 ( OR = 4.0),positive TgAb in 2004 ( OR = 3.7) and TSH < 1.0 mU/L in 1999 ( OR = 2.6).Risk factors involved in developing raised TSH level included iodine status of Zhangwu community ( OR = 4.1 ),iodine status of Huanghua community ( OR = 3.9),positive TgAb in 2004 ( OR = 3.7 ),positive TPOAb both in 1999 and 2004 (OR =3.6),positive conversion of TPOAb (OR =2.7) and TSH > 1.9 mU/L in 1999 (OR = 2.6 ).Conclusions Exposure to long-term iodine excess imposes danger of developing hypothyroidism.The risk will be even higher when exposing to iodine adequacy after correction of iodine deficiency.An interval between 1.0 and 1.9 mU/L of TSH level was optimul with the least probability of developing abnormal TSH level.

Objective: To explore the value of plasma cell-free DNA (cfDNA) in the assessment of inflammatory bowel disease (IBD) activity. Methods: From July 2014 to June 2017, 145 IBD patients from the First Affiliated Hospital of Fujian Medical University were selected. The plasma content of cfDNA was detected by picogreen-based fluorescent quantitative method. At the same period, 37 healthy individuals were enrolled as control group. The correlation between cfDNA content and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IBD activity was analyzed. The diagnostic capability of cfDNA in IBD activity was assessed by the receiver operating characteristic (ROC) curve. T-test was performed for comparison between two independent samples, and Pearson correlation coefficient test was used for correlation analysis between two variants. Results: The content of plasma cfDNA of patients with Crohn′s disease (CD) and patients with ulcerative colitis (UC) were (29.17±2.07) μg/L and (26.86±1.97) μg/L, respectively; which were both higher than those of healthy control group (21.10±1.02) μg/L, and the differences were statistically significant (t=2.609 and 2.082, both P<0.05). Moreover, the content of cfDNA of patients with active CD or UC were (35.72±3.26) μg/L and (32.37±3.42) μg/L, respectively, which were both higher than those of patients with CD or UC in remission ((21.12±1.43) μg/L and (20.82±1.02) μg/L), and the differences were statistically significant (t=3.806 and 3.116, both P<0.01). The cfDNA content of CD patients was positively correlated with CRP, ESR and disease activity (r=0.555, 0.393 and 0.400, all P<0.01). The cfDNA content of UC patients was also positively correlated with CRP, ESR and disease activity (r=0.640, 0.421 and 0.360, all P<0.01). The diagnostic capability of the combination of CRP and ESR was the highest in CD diagnosis, with the area under curve (AUC) value being 0.841, and the sensitivity and specificity being 81.4% and 74.3%, respectively. The diagnostic capability of the combination of cfDNA, CRP and ESR was the highest in UC diagnosis, with the AUC value being 0.851, and the sensitivity and specificity being 74.3% and 96.9%, respectively. Conclusions Increased cfDNA levels in IBD patients are correlated with IBD activity. Detection of cfDNA is helpful in the identification of active IBD, and the combination of ESR and CRP can improve the diagnostic efficiency of UC.