Objective To analyze the clinical manifestation, diagnosis and treatment of acute mesenteric vascular obliteration (AMVO). Methods 112 cases of AMVO were analyzed, including 20 cases admitted to our hospital from 1992 to 2004 and 92 cases reported by other hospitals. Results Abdominal pain, abdominal distension, nausea and vomiting, decrease or disappearance of bowel sound, elevation of white blood cell count were more frequent manifestations.Cardiovascular disease, portal vein stasis or hypercoagulation state were common findings in patients' history. The average misdiagnosis rate of AMVO in these 112 patients was 61.5%, with a misdiagnosis rate of 45.0% in 20 cases of our hospital. The average mortality rate of all these patients was 41.9%, with a mortality rate of 30.0% for 20 cases of our hospital. Conclusion The early clinical manifestation of AMVO lacks specificity, the misdiagnosis ratio and mortality rate are very high. Angiography should be done early to confirm the diagnosis and improve the therapeutic effect in the patients suspicions of having this ailment.

Objective To explore the clinical manifestations, pathogenic mechanisms and treatment of Mirizzi syndrome.Method 65 patients with Mirizzi syndrome were analysed retrospectively.Results According to Csendes typing, patients with Mirizzi syndrome included type Ⅰ in 18 patients(27 6%), type Ⅱ in 25 patients (38 4%), type Ⅲ in 13 patients(20 0%), type Ⅳin 9 patients(13 8%), all patients were healed by corresponding operation and perioperative management.Conclusions Good outcome of Mirizzi syndrome patients can be achieved by accurate diagnosis,exact operation and active perioperative management.

Objective To report effect on treatment tibial fracture asynthesis by external fixator combined with spongy bone implant.Methods From Februryl 999 to February 2002,11 cases of the tibial fractures asynthesis were treated with the external fixator combined with spongy bone implant.Results Follow-up was both clinically and ra-diologically performed in 1 leases.The healing rate of the fracture was 100% in this group.The average healing time was 3.2 months.Conclusion The external fixation combined with spongy bone implant is simple and effective in treatment of the tibial fracture asynthesis.

Objective To explore the value of stress dual-phase (early and delayed phases)18 FFDG myocardial PET/CT in detection of myocardial ischemia.Methods Ten swine were prepared as ischemic models and underwent 3 imaging procedures:pre-model stress (8 swine),post-model rest (8 swine)and post-model stress dual-phase imaging (10 swine).To perform stress dual-phase imaging,the tested subjects were fasted for more than 12 h and underwent early-phase PET imaging at 50 min after the intravenous injection of 18F-FDG (5 MBq/kg) for 10 mins,and followed by a dobutamine stress test,and then delayed-phase PET imaging at 50 min after the stress test for another 10 mins.The post-model rest dual-phase imaging was performed in almost the same way except that there was no dobutamine-loading.18F-FDG uptake image was qualitatively analyzed and classified into 4 levels:1 =no uptake,2 =diffuse uptake,3 =focal uptake,4=focal on diffuse uptake.Level 1 or 2 was considered as normal.If the focal uptake (level 3 or 4)was found on anterior wall or septum,ischemia was diagnosed.x2 test was used to determine the difference of the rate of ischemic myocardium between the two phases.18F-FDG uptake ratio of the anterior wall to posterior wall (K) of the left ventricle was calculated (K1 for early phase and K2 for delayed phase).Wilcoxon rank sum test was applied to determine the difference between K1 and K2.Results CAG showed LAD stenosis ＞70％ in all swine.In pre-model stress dual-phase imaging,no ischemia was detected at two phases (8/8 for level 1 or 2,0 for level 3 or 4).There was no significant difference between K1 and K2(1.08±0.10,1.11 ±0.10; Z =-1.48,P＞0.05).In post-model rest dual-phase imaging,the rate of ischemic myocardium was not significantly different between early and delayed phases (1/8,3/8 ; x2 =0.50,P＞0.05).There was no significant difference between K1 and K2(1.47±0.28,1.28±0.40; Z=-2.02,P＞0.05).In post-model stress dual-phase imaging,the rate of ischemic myocardium between the two phases was statistically different (4/10,10/10;x2=4.17,P＜0.05),and the difference between K1 and K2 was also significant (1.55±0.32,1.86±0.39; Z=-2.49,P＜0.05).Conclusion Stress dual-phase 18F-FDG myocardial PET/CT might be useful for the diagnosis of ischemia.

AIM: To investigate the role of Smad7 in the Smad2 expression induced by transforming growth factor-?_1(TGF-?_1) in rat peritoneal mesothelial cells(PMCs).METHODS: Rat PMCs were cultured at different doses of TGF-?_1 (0,1.25,2.5,10 ?g/L) for different time(0,5,15,30,60,120 min).PCDNA3-Smad7 was then transfected into cultured rat PMCs by lipofectamine,and the cells were stimulated like the above.Endogenous Smad2 and Smad7 expression was evaluated by RT-PCR and Western blotting.RESULTS: TGF-?_1 induced increase in Smad2 mRNA and protein expression at 5 min,peaked at 30 min,and declined to baseline levels at 120 min, which was in a time-dependent manner.TGF-?_1 also induced Smad7 mRNA expression at 5 min,and then declined,down to the lowest at 30 min,but at 60 min it increased again.Smad2,Smad7 mRNA and protein expression induced by TGF-?_1 were also dose-dependent.After transfection,overexpressions of Smad7 mRNA and protein in rat PMCs were observed,which did not decline with time.The expression of Smad2 mRNA significantly decreased by 33%,56%,67%,71%,63% and 57%(P

Objective To investigate the clinical roles of lysine methyltransferase 5A(KMT5A)in human hepatocellular carcinoma(HCC)and its functions in cell migration and invasion. Methods The expression levels of KMT5A of 60 cases were detected by immunohistochemistry(IHC). KMT5A siRNA was used to down-regulate the expression of KMT5A in SMMC-7721 cells. Cell migration and invasion were measured by wound healing assays and transwell assays,respectively. Immunoblotting was used to detect the expression of MMP-2 after siRNA trans-fection. miR-186 mimics were transfected into SMMC-7721 cells and the mRNA levels of KMT5A was detected by qRT-PCR after transfection. Results High expression of KMT5A was associated with large tumor diameter (>5 cm,P=0.047)and advanced TNM stage(Ⅲ+Ⅳ,P=0.035). The expression of KMT5A was knocked down by siRNA in SMMC-7721 cells. Down-regulation of KMT5A suppressed cell migration(P=0.031,P=0.006)and invasion(P=0.010),and impaired MMP-2 expression(P=0.040). Overexpression of miR-186 could significantly inhibit the expression of KMT5A(P = 0.007). Conclusions Over-expression of KMT5A in HCC tissues associ-ates with poor clinical features. KMT5A knockdown inhibits the migration and invasion on HCC cells.

Objective To explore the mediating role of coping modes between illness perception and posttraumatic growth among patients with breast cancer. Methods Totally 300 patients with breast cancer were investigated with the posttraumatic growth inventory, brief illness perception questionnaire and medical coping modes questionnaire. Results The total score of illness perception was 40. 77 ± 6. 85. The scores of confrontation coping style,avoidance coping style and resignation coping style were 19.42±3.51, 17.78±2.79,8.64±3.35. The total score of posttraumatic growth was 57.38±10.48. Illness perception was negatively correlated with posttraumatic growth ( r=-0.743) ,confrontation( r=-0.568) and avoidance ( r=-0.621),positively related with resignation( r=0.727).Posttraumatic growth was positively correlated with confrontation and avoidance ( r=0.729, r=0.657) ,but negatively correlated with resignation( r=-0.757) (P<0.01) . Coping modes had a partial mediating effect on the relationship between illness perception and postt?raumatic growth. The total mediation effect value was 0.428,and the mediation effect was 57.60%,while con?frontation and resignation mediation effect value were -0. 191 and -0. 207, and the mediation effect were 25.70% and 27. 86%. But there was no statistical significance in avoidance mediation ( effect value was-0.030 and the mediation effect was 4.04%) . Conclusion Confrontation and resignation coping modes play a role multiple mediation effects between illness perception and posttraumatic growth.

Aim To investigate the effect of intrauterine injection of rat fetal hepatocytes on homograft rejection reaction. Methods The skin graft from a male LOU/CN rat was transplanted to a female recipient CHN rat of 7 to 9 weeks after parturition, and then survival time of the graft was observed. Simultaneously, homograft rejection reaction was examined by mixture lymphocyte culture. Results As compared with control group, survival time of transplanted skin graft was obviously prolonged. Mixure lymphocyte culture demonstrated that homograft rejection reaction was inhibited markedly. Conclusion Intrauterine injection of rat fetal hepatocytes wuld obviously inhibite homograft rejection reaction, thus prolonging survival time of the graft.

Objective:To study and design measurement scale which can judge and survey sub-health state and itscharacteristic of TCM syndrome.Methods:Making use of methods of scale technique,literature research,expertise consultation et al,based on TCM theory,via conceptualization and operation of sub-health and TCM syndrome,forming structure and type of scale,establishing item pool and results,and then through item selection,assessment of validity and reliability of pre-investigation,making the measurement scale.Results:The scale is made up of 4 parts:body function state,psychological function state,social function state and particular state of TCM.The 4 parts are divided into 15 sorts,including 120 items.Conclusion:The scale contributes much to the diagnosis of sub-health state and the clari cation of clinical manifestations,features,distributions of TCM syndrome of public of sub-health,which is one of the most important methods for investigating TCM syndrome of sub-health state.

ObjectiveTo analyze the characteristics of dysphagia in children with cerebral palsy and explore the relation with the gross motor function classification.MethodsThe children with cerebral palsy in our rehabilitation center from June 2009 to June 2010 were assessed by Dysphagia Disorders Survey(DDS), Oral Motor Assessment and Gross Motor Function Classification System (GMFCS) to explore the relationship between the dysphagia disorders and different gross motor levels.ResultsOf all 105 children with cerebral palsy, 21.9% were mild dysphagia, and 34.3% were moderate to severe dysphagia, resulting in a prevalence of dysphagia of 56.2%. DDS and oral motor scores were changed by GMFCS levels. The correlation coefficient were 0.767 and -0.504 between DDS, oral motor scores and GMFCS, 0.55 and 0.27 between dysphagia, oral motor disorder and the gross motor functions, respectively(P<0.01).ConclusionDysphagia was positively related to severity of motor impairment. Children in GMFCS levels Ⅳ～Ⅴ almost with problems in the pharyngeal and esophageal phases, apparently on the DDS, should be referred for appropriate clinical evaluation of swallowing function.