0 05). The blood loss in group I (160?40ml)was significantly less than that in group II(190?60ml)(P

Objective To investigate the significance of an accessory hepatic vein (AHV) in the interventional treatment of Budd-Chiari syndrome (BCS).Methods From Mar.2011 to Jun.2013,35 patients with BCS who also had an AHV were included into this study.The patients were divided into two groups according to whether the AHV was obstructive:21 patients had obstruction to the inferior vena cava (IVC) and to the 3 hepatic veins (HV),but the AHV was open; 14 patients had obstruction to the AHV and the 3 HVs.In 13 of these patients the IVC was open,but 1 patient had obstruction to the IVC.During treatment,the patients in the AHV open group underwent balloon dilation or stent insertion of IVC ; patients in the AHV obstruction group underwent balloon dilation or stent insertion of AHV.The patient with obstruction to the IVC underwent balloon dilation of IVC first.Results All patients were successfully treated without any procedure-related complications.In the AHV open group,the average pressure of the AHV decreased from (28.81 ± 6.23) cmH2 O (1 cmH2O =0.098 kPa) before treatment to (18.62 ± 5.06) cmH2O after treatment (P ＜ 0.01) ; the average serum TBIL decreased from (23.24 ± 6.41) μmol/L before treatment to (19.52 ± 4.31) μmol/L after treatment (P ＜ 0.01) ; the average serum albumin changed from (33.76 ± 3.74) g/L before treatment to (34.05 ± 3.62) g/L after treatment (P =0.485).In the AHV obstruction group,the average pressure of the AHV decreased from (36.29 ± 11.65) cmH2O before treatment to (22.07 ± 7.67) cmH2O after treatment (P ＜ 0.01) ; the average serum TBIL decreased from (31.24 ± 9.54) μmol/L before treatment to (20.93 ±7.26) μmol/L after treatment (P ＜0.01) ; the average serum albumin changed from (32.14 ± 4.55) g/L before treatment to (32.11 ± 4.47) g/L after treatment (P =0.861).During follow-up,no patients experienced recurrence of symptoms in the AHV open group; one patient experienced recurrence of symptoms 5 months after treatment in the AHV obstruction group.This patient received a second balloon dilation of the AHV.Conclusions For patients with BCS with IVC and the 3 HVs obstruction,if the AHV was open,we could only treat the IVC.For patients with BCS with AHV and the 3 HVs obstruction,AHV dilation followed by recanalization of AHV was also effective.

Subtilis bacillus spores for novel vaccine delivery has attracted significant interest of more and more researchers by their unique biological characteristics. In this review,the structure and immunogenicity of spores were briefly discussed, then special emphasis placed on the use of recombinant spores as vaccine delivery vehicles,some ideas for further studies on surface display of recombinant vaccines on Subtilis bacillus spores were also proposed

Objective To investigate the effect of PBL combined with EBM applied in the teaching of fever of unknown origin. Methods PBL combined with EBM teaching was applied in fever of unknown origin course for 30 clinical medicine specialty(eight years) students of Tongji class of grade 2009(experiment group), while PBL teaching was applied in fever of unknown origin course for 30 clinical medicine specialty (eight years) students of Tongji class of grade 2008 (control group). After teaching, the theory examination for both basic knowledge and case analysis was organized for all students of both groups. At the same time the questionnaire survey was conducted to 30 students of grade 2009 to evaluate the teaching effect. The results were assessed by using SPSS 18.0 statistical software for the T-test of the experimental group and the control group.Inspection level was α=0.05. Results The theory test score of students in the experimental group was (93.5±3.2) point, signifi-cantly higher than that of the students in the control group(84.7±2.8). There was statistically signifi-cant difference between the scores of the two groups of students (P=0.00). Survey results showed 19 students ( 63 . 33%) thought that the development of PBL teaching combined with evidence-based medicine teaching had its necessity, and 16 students(53.33%) thought that the teaching method im-proved their clinical thinking ability of logical reasoning. Conclusion The concept of PBL combined with EBM has achieved significant resultsinthe teaching offever of unknown origin, and it is necessary to carry out this teaching mode in medical colleges with certain teaching strength.

Using metabolic flux balance model , the metabolic flux balance of L- v aline synthesis was established in this paper by material balances and linear p rogramming method. The analysis results indicate that 62.8% metabolic flux ent er ed EMP pathway and 38.2% metabolic flux entered the HMP pathway. And only 9.2 % c arbon entered the TCA cycle. But comparing to the optimal flux distributions of 92.31, the production of L-valine should be improved from the genetic manipula ti on and fermentation control through reducing byproduct of amino acid and decreas ing the metabolic flux.

Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation(SKPT) with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine(PE).Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage.The clinical data,operative techbuque,and the prevention of non-technical complications were summarized.Results This procedure was successfully applied in the 5 patients.Three patients recovered excellently;but 2 died perioperatively,one died of sepsis due to pancreatic leakage,and one of FK506 toxicity.On postoperative day 3,in the 3 survivors,blood creatinine and urea nitrogen levels returned to normal;insulin administration was discontinued on 7d postoperatively,and the endogenous and exogenous secretory functions of the graft were normal.Conclusions SKPT with PE is a resonable procedure,because of its potential physiologic,metabolic,and immunologic advantages.PE drainage may become the prefer technique of pancreas transplantation.Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.

Objective:To explore the role of lectin-like oxidized low density lipoprotein (ox-LDL) receptor(LOX1) in ox-LDL stimulating endothelial nitric oxide(NO) production. Methods: LOX1 mRNA expression was detected by reverse transcription-polymerase chain reaction(RT-PCR). The quantity of NO was detected by Enzyme-method. Results: Incubation of ox-LDL increased endothelial NO production and LOX1 mRNA expression. When HUVECs were incubated with ox-LDL as well as the inhibitor of LOX1, polyinosinic acid,the increase of NO production and LOX1mRNA expression were attenuated. Conclusion: Ox-LDL enhanced endothelial NO production in a concentration-dependent manner, and the effect of ox-LDL on endothelial NO was mediated by LOX1.

Objective To explore the spiral computed tomography (CT) imaging feature of post-intubation tracheal stenosis (PITS) and to discuss its clinical significance. Methods The clinical data and CT imaging findings of 27 patients with PITS were retrospectively analyzed. The location, degree and shape of PITS were analyzed, and the imaging features were summarized. Based on the imaging features the etiology of PITS was suggested, and the role of imaging feature in assessing PITS condition and in planning clinical management was evaluated. Results A total of 35 tracheal strictures were detected in the 27 patients. The location of the strictures included trachea incision site (n=10), balloon level (n=5) and distal end of tube (n = 20). In all patients the degree of stenosis was > 30%. Localized stenosis was seen in 15 cases, which presented as “hourglass”or “girdle”shape. Segmental stenosis was found in 4 cases, which was characterized by a “ribbon” or “dumbbell” stricture on CT scans. Complex stenosis was found in 8 cases. With the help of imaging findings, all patients got timely, proper and individualized treatment. Conclusion PITS has typical imaging characteristics. Spiral CT scanning should be regarded as the imaging examination of first choice. Based on the different imaging characteristics, the relevant departments can evaluate patient’s condition and make individualized treatment plan. The imaging finding is very helpful for anesthesiologists and other clinicians in recognizing and in managing the post-intubation tracheal stenosis.

Objective To establish a stable,repeatable and long-lasting rat model of myocardial infarction,and to evaluate the feasibility of monitoring electrophysiological changes and left ventricular function after myocardial infarction by electrocardiography (ECG) and ultrasonic cardiography(UCG). Methods Wistar rats were ligated on the left anterior descending coronary artery after anaesthesia with 10% chloral hydrate and machinery assisted respiration. Then they were monitored by ECG and UCG afer 4,8 and 12 weeks,and were sacrificed and pathologically examined at 12 weeks after operation. Results The rat model of myocardial infarction was established with a survival rate of 83.3% at 72 hours after the operation and 73.3% at 12 weeks after the operation. In the myocardial infarction group,the PR,QRS,QT and QTc intervals were statistically significantly longer than that in the sham operation group. UCG showed that the left ventricular internal diameter at end-diastole (LVIDd) and the left ventricular internal diameter at end-systole (LVIDs) were statiscally significantly higher in the infarction group,and the ejection fraction (EF) and fractional shortening (FS) significantly lower than those in the sham operation group. Long-lasting pathological changes can be seen in the tissues at 12 weeks after operation. Conclusions The method used in the present study is an simple,less injurious and highly successful technique,and the changes in electrophysiology and left ventricular function can be well monitored by ECG and UCG at different times during this period.

OBJECTIVETo investigate the prognostic factors for non-small cell lung cancer(NSCLC)in patients under 40 years of age.

METHODSThe clinicopathological data of 148 young patients with NSCLC were retrospectively analyzed. Kaplan-Meier and Cox regression analyses were used to analyze the relationship between prognostic factors and survival time.

RESULTSThe patients were followed-up for 6 - 148 months, and the follow-up rate was 100%. In the whole group, 122 patients died and 26 cases were surviving. The 1-, 3- and 5-year survival rates were 54.7%, 10.4% and 5.6%, respectively. The median survival time (MST) was 14.7 months. Kaplan-Meier analysis showed that Karnofsky performance status (KPS), clinical stage, treatment modality and serum CEA were related with prognosis (P < 0.05). Multivariate analysis indicated that KPS, clinical stage, treatment modality and serum CEA were independent prognostic factors (P < 0.05).

CONCLUSIONSKPS, CEA, clinical stage and treatment modalities are independent prognostic factors in young NSCLC patients.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoembryonic Antigen ; blood ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; pathology ; radiotherapy ; surgery ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Karnofsky Performance Status ; Lung Neoplasms ; blood ; drug therapy ; pathology ; radiotherapy ; surgery ; Male ; Neoplasm Staging ; Pneumonectomy ; methods ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Young Adult