Objective To investigate the clinical efficacy of splenectomy combined with coronary-caval shunt in treatment of portal hypertension (PHT).Methods The retrospective descriptive study was conducted.The clinical data of 21 patients with PHT who underwent splenectomy combined with coronary-caval shunt at the First Affiliated Hospital of Xi'an Jiaotong University from January 2001 to December 2015 were collected.Observation indicators included (1) operation situations,changes of pre-and post-operative portal hemodynamics including operation time and volume of intraoperative blood loss,diameter and blood flow velocity of portal vein (PV),gastric coronary vein and superior mesenteric vein (SMV).(2) Clinical indexes in perioperative period (before operation,at postoperative 1 week and 1 month):① blood routine test:the counts of red blood cell (RBC),white blood cell (WBC) and platelet (PLT),② liver function:Child-Pugh score,alanine transaminase (ALT),total bilirubin (TBil),albumin (Alb),extended time of prothrombin time (PT) and international normalized ratio (INR).(3) Follow-up:postoperative 1-,3-,5-year complications [upper gastrointestinal re-bleeding,peritoneal effusion,hepatic encephalopathy,hepatic failure,portal vein thrombosis (PVT) and anastomotic stoma thrombosis].The follow-up using outpatient examination and telephone interview was regularly conducted once every 3 months within postoperative 1 year and once every 6 months after postoperative 1 year up to March 2016 or end of follow-up (death).Measurement data with normal distribution were presented as x ± s.The comparison of different time-point was analyzed by the repeated measures ANOVA and Student t test.Measurement data with sknewed distribution were presented as M (range).Results (1) Operation situations and changes of pre-and post-operative portal hemodynamics:21 patients underwent successful splenectomy combined with coronary-caval shunt,including 19 receiving splenic vein bypass combined with anastomosis of gastric coronary vein and inferior vena cava and 2 receiving anastomosis of gastric coronary vein and inferior vena cava.Operation time,volume of intraoperative blood loss were (187 ± 33)minutes and (233 ± 114)mL.Diameter and blood flow velocity of PV,gastric coronary vein and SMV were (1.39±0.20)cm,(0.66±0.15)cm,(0.74±0.32)cm,(11.2±3.4)cm/s,(6.6± 1.3)cm/s,(7.0 ±2.2)cm/s before operation and (1.36 ±0.22)cm,(0.42 ±0.11)cm,(0.81 ±0.23)cm,(10.4 ± 2.5) cm/s,(8.2 ± 2.5) cm/s,(6.9 ± 2.4) cm/s after operation,respectively,showing no statistically significant difference in the diameter and blood flow velocity of PV and SMV before and after operation (t =0.46,-0.81,0.87,0.14,P ＞ 0.05)and with statistically significant differences in the diameter and blood flow velocity of gastric coronary vein before and after operation (t =5.9 1,-2.60,P ＜ 0.05).(2) Clinical indexes in perioperative period:① routine blood test:the counts of RBC,WBC and PLT were (2.70 ± 0.50) × 1012/L,(2.6 ±2.3) × 109/L,(55 ±28) × 109/L before operation and (3.10 ±0.60) × 1012/L,(2.8 ±2.0) × 109/L,(248 ± 182) × 109/L at postoperative 1 week and (3.70 ±0.20) × 1012/L,(6.2 ± 1.9) × 109/L,(457 ± 184) × 109/L at postoperative 1 month,respectively,with statistically significant differences (F =31.91,11.03,30.74,P ＜ 0.05).There were statistically significant differences in the counts of RBC and PLT between 1 week postoperatively and before operation (t =-2.35,-4.81,P ＜ 0.05) and between 1 month postoperatively and 1 week postoperatively (t =-4.35,-5.65,-3.71,P ＜ 0.05).② Liver function:Child-Pugh score,ALT,TBil,Alb,extended time of PT and INR were 6.3 ± 1.2,(23 ± 17) U/L,(28 ± 18) μmol/L,(31.1 ± 6.8) g/L,(4.8 ±2.1) s,1.40 ± 0.20 before operation and 6.2 ± 0.9,(44 ± 24) U/L,(26 ± 11) μmol/L,(35.0 ± 7.4) g/L,(3.4 ± 2.0) s,1.30 ± 0.20 at postoperative 1 week and 6.0 ± 0.6,(36 ± 22) U/L,(23 ± 8) μmol/L,(34.2 ± 2.2) g/L,(3.7 ± 3.0) s,1.50 ± 0.30 at postoperative 1 month,respectively,showing no statistically significant difference (F =1.97,2.60,1.18,1.45,P ＞0.05).There were statistically significant differences in the ALT and extended time of PT (F =7.97,4.37,P ＜ 0.05) and in the ALT and extended time of PT between 1 week postoperatively and before operation (t =3.23,2.21,P ＜ 0.05).(3) Follow-up:21 patients were followed up for 3-168 months with a median time of 37 months.During follow-up,3 patients were dead.One,1,2 patients were complicated with upper gastrointestinal re-bleeding at postoperative 1,3,5 years and received hemostatic therapy under endoscopy,and then 2 were dead.Three,2 and 2 patients had peritoneal effusion and were improved by symptomatic treatment.One patient had hepatic encephalopathy and hepatic failure at postoperative 5 years and was dead after conservative treatment.PVT and anastomotic stoma thrombosis at postoperative 1,3,5 years were detected in 2,2,1 and 2,1,1 patients,with anticoagulant therapy,and 1 patient received vascular recanalization.Conclusion Coronary-caval shunt is a highly selective portosystemic shunt,it can significantly down regulate the regional pressure while ensure the normal blood flow of liver and decrease the rate of rebleeding,hepatic encephalopathy and thrombosis,meanwhile,it might be a potential therapy in management of PHT.

Objective To study the influence of Salvia miltiorrhiza bge. f. alba(SMA) on apoptosis and Bcl-2 expression in human umbilical vein endothelial cell (HUVEC) in vitro. Methods HUVECs were isolated using perfusion and enzyme digestion methods, and the obtained cells were identified by morphological observation and VIII = Ag immunoreactivity examination. The cells in the exponential phase of growth were treated with H2O2 and different concentrations of SM A (high dose, 0.10 g/ml, low dose, 0.01 g/ml). The cell apoptosis was determined by flow cytometric analysis and Bcl-2 expression was examined by immunofluorescence mehtod. Results SMA significantly decreased the H2O2-induced apoptosis of HUVECs (P<0.01 in high dose group and P<0.05 in low dose group), and significantly increased the expression of Bcl-2 in high dose group(P<0.01). Conclusion SMA can inhibit H2O2-induced apoptosis of HUVEC, which might be associated with the increase of Bcl-2 expression. Salvia miltiorrhiza bge. f. alba; umbilical veins; endothelial cell; apoptosis; bcl-2 genes.

OBJECTIVE To reduce the incidence of nosocomial infection by standardized packaging material and model. METHODS The packaging material and model were selected according to the different sterilizations.And the qualfication rate of sterilization and warranty period of standardized instruments were detected regularly. RESULTS The quality of sterilizations was effectively guaranteed by conducting control measures. CONCLUSIONS The nosocomial infection rate is effectively prevented by standardized packaging material and model.

Objective To analyze risk factors for grenade throwing fractures and put forward corresponding preventive measures for the fractures during the military training in recruits,so as to reduce the happen in the military training.Methods The research is case-control study.The trial group and the control group (39 patients each) were followed up and investigated.The investigation indicators included height,body mass index (BMI),whether drinking carbonated beverage frequently,literacy,osteoporosis,throwing training score,throwing posture,warm-up sufficiently,region,whether attend often physical exercise before recruitment,exercise strength,and weather factor.Results There were significant differences in the warm-up sufficiency,attending physical exercise before recruitment,exercise intensity,throwing posture,weather factor between trial group and the control group in recruits.The logistic regression analysis showed that the lack of physical exercise before recruitment,strong exercise intensity,nonstandard throwing posture were the risk factors in grenade throwing fractures in recruits.Conclusion Sufficient warm-up,avoiding exhausted exercise and assault exercise,strict training in accordance with the standard throwing posture,regular participation in physical exercise before recruitment and training in warm season are effective methods for preventing grenade throwing fractures in recruits.

Flammulin, an anti-tumor protein, was purified from the aqueous extract of basidiomes of Flammulina Velutipes. Purified flammulin emulsified with Freund's adjuvant was injected subcutaneously into New Zealand white rabbits. After several immune enhancements, these animals were bled and sera were separated. Antiserum against flammulin in Western blots were applied to determine if flammulin be present in the liquid state culture or fruiting body. The result showed that anti-flammulin serum could recognize the aqueous extract of fruiting body in SDS-PAGE gels under the reducing conditions, no flammulin was detected in mycelia of Flammulina Velutipes.

Acupuncture Therapy ; Adolescent ; Adult ; Diarrhea ; therapy ; Female ; Humans ; Irritable Bowel Syndrome ; therapy ; Male ; Middle Aged ; Mouth ; Young Adult

Child ; Dinitrobenzenes ; poisoning ; Humans

Afferent Pathways ; drug effects ; Animals ; Freund's Adjuvant ; adverse effects ; Ganglia, Sensory ; drug effects ; Hyperalgesia ; chemically induced ; Inflammation ; Male ; Morphine ; pharmacology ; Rats ; Rats, Sprague-Dawley

Objective To investigate the forearm flap personalized design method and the curative effect in repairing maxillofacial defects.Methods From March,2011 to September,2015,16 cases with oral maxillofacial tumor and facial tissue defect were treated.There were 8 males and 8 females with an age range of 41-70 years (mean,54 years).According to the shape and size of the defect after tumor resection in each patient,the forearm flap was designed to repair the defect.The effectiveness was evaluated after operation by observing the survival of the forearm flap transplantation,the patient's facial appearance,the functions of speech,swallowing.Results The incision healed by first intention in this group,16 cases of forearm flap survived.All cases were followed-up 8-36 months without tumor recurrence.The functions of speech,swallowing were basically normal.The facial appearance was satisfactory.The patients were satisfied with their appearance and functional recovery after operation.Conclusion Take personal way of forearm flap design according to maxillofacial soft tissue defect,can restore the maximum facial appearance and function of patients,improve the quality of life of patients after surgery to repair,can obtain satisfactory results.

This study was aimed to discuss possible problems in the data collection process of traditional Chinese medicine (TCM) clinical medicine and to propose appropriate solutions. Based on analysis of clinical data features and data collection demands among 20 TCM clinical research bases, reference were made on key technologies of the Electronic Medical Records' integration and sharing, to propose the solution of TCM clinical data collection. The re-sults showed that proposing the metadata and data entities synchronized intersecting strategy, analyzing key points on this strategy, and proposing appropriate solutions, found the technical processes of the TCM clinical data collec-tion. It was concluded that the analysis and solution on key points of TCM clinical data collection provided the basis and the reference to data collection issues of TCM clinical research base.