Objective To investigate the application value of intraoperative ultrasound (IOUS) in living donor liver transplantation(LDLT). Methods In LDLT, IOUS techniques (gray scale ultrasound and color Doppler flow imaging) were adopted in 26 donors and recipients for parenchymal and vascular examinations. The abnormal sonograms were observed, and the anatomic findings of hepatic veins were recorded. All the reanastomosed blood vessels were examined by gray scale ultrasound and color Doppler flow imaging before the operations were completed. Results A hepatic parenchymatous tumor was revealed by IOUS in one donor. Besides, middle hepatic veins in 13 donors and secondary hepatic veins with diameter﹥0.5 cm in 5 donors were confirmed by IOUS. Furthermore, one operation procedure was changed and one hepatic artery stenosis was established according to IOUS findings. Conclusion IOUS is a very useful means in evaluation of parenchymal and vascular conditions of donors and recipients in LDLT, which helps to select the best cross section and provides evidence for the change of surgical procedures.

Objective To investigate the expressions and significance of p21 protein and K-ras protein in congenital biliary dilatation(CBD),and their relationship.Methods Surgical specimens of CBD were obtained during operation on 36 children from Jan.2000 to Sep.2007.Nine normal bile ducts specimens from miscarried fetus and children's corpse.The specimens were fixed in 40 g?L-1 formalin and embeded by paraffin,slice-fixed.SP immunohistochemical method was used to detect the expressions of p21 protein and K-ras protein.Results The positive rate of K-ras protein was 13.8% in CBD,which was significantly higher than that in normal bile duct tissues.The positive rate of p21 protein was 55.6% in CBD,and 100% in normal bile duct tissues.p21 protein positive expression rate in CBD was significantly lower than that in normal bile duct tissues(P

Method for measuring interleukin 1 ( IL -1 ) and effects of total glucosides of paeony(TGP) on IL -1 production were studied. The results showed that the best concentration for LPS -induced IL-1 production of M s in rats was 8mg/L, the best dilution for IL-1 of LPS-induced M s production was 1 : 90. TGP ( 0 .5 - 12 .5mg/L ) enhanced LPS-induced IL -1 production in a concentration dependent manner, but diminished in the higher concentration of TGP ( 62 .5~l25mg/L ) , the concentration-effect curve seems to be bell-shaped. The data suggested that TGP had two-sided regulatory effects on LPS -induced IL production of M s in rats.

Objective To investigate the distribution and drug resistance of pathogen in blood culture from 2014 to 2015.Meth-ods 1 260 blood specimens were incubated in our hospital,the positive samples were isolation and identification and the drug resist-ance was analyzed.Results 153 strains of bacteria were isolated from 1 260 blood specimens,and the positive rate was 12.1%. Escherichia coli and Klebsiella pneumonia were the main pathogens in gram negative bacilli,coagulase negative Staphylococci and Staphylococcus aureus were the main pathogens in gram positive cocci,Imipenem and ertapenem were the most effective antibiotics (100.0%)to Escherichia coli and Klebsiella pneumonia,the gram-positive cocci were sensitve to Vanconmycin,linezolid and tigecy-cline.Conclusion Drug resistance of isolated pathogen in blood cultures is very serious.Monitoring the change of pathogens and trends of drug resistance is very important in guiding the clinical use of drug.

Objective To evaluate the diagnostic value of serum (1-3)-β-D-glucan detection for invasive fungal infection (IFI) in neonates. Methods Eighty-seven neonates who were suspected to be IFI cases in neonatal intensive care unit from May 2008 to January 2010 were enrolled into this study. All subjects had infection symptoms, while did no react to the antibiotics treatment. The diagnosis of IFI was made according to Invasive pulmonary fungal infection diagnostic criteria of children set by Subspecialty Group of Respiratory Diseases, the Society of Pediatrics, Chinese Medical Association and Invasive fungal infection diagnostic criteria for critical patients set by the Society of Critical Care Medicine, Chinese Medical Association. Circulating (1-3)-β-D-glucan levels were determined with GKT-5M set kinetic fungus detection kit. Levels of (1-3)-Β-D-glucan in IFI group and that in the control group were compared; optimal cut-off value was established with receiver operating characteristic (ROC) curve; and the sensitivity and specificity at the cut-off value of 20.0 pg/ml and optimal cut-off value were calculated and compared. Results Among the 87 suspected cases, 59 cases were not diagnosed as IFI and 28 cases were diagnosed as IFI finally. Five patients were confirmed to be IFI; seven cases were clinically diagnosed and 16 cases were still suspected IFI. Among the five confirmed cases, four cases were blood culture positive for Candida parapsilosis, one case Candida albicans positive and two cases both cerebrospinal fluid culture and blood culture positive for Candida albicans. The median levels of (1-3)-β-D-glucan of patients diagnosed as IFI (n=28) was 131.6 pg/ml(18.6-9999.0 pg/ml), which was higher than that of the patients without IFI (8.5 pg/ml, 5.0-34.6 pg/ml)(Z=-5.064, P<0.05). Area under ROC curve was 0.806 (95% CI: 0.725-0.886, P<0.05). The sensitivity (96.43% vs 69.49%) and specificity (72.22% vs 84.21%) for (1-3)-β-D-glucan were different as 20.0 pg/ml and 53.7 pg/ml were used as the cut-off values for diagnosing IFI. Conclusions (1-3)-β-D-glucan level could be used to diagnose IFI of neonates, but further studies are needed to evaluate false-positive rates and its cut-off value in IFI diagnosis.

Effects of total glucosides of paeony ( TGP) on interleukin2 ( IL-2 ) production were studied with lL-2-dependent marine splenic lymohocytes. The results showed that IL-2 production by splenocytes was enhanced with low concentration of TGP (0.5-12.5 mg/L) , and diminished over the rang of 12.5-62.5mg/L. The concentration-effect curve seems to be bell-shaped. The data suggested that TGP hap two-sided regulatory effects on IL 2 production by splenocytes.

Objective To discussi the feasibility and indication of selective primary suture after choledo-chotomy. Methods The selected patients were intra-operatively randomized to have either primary suture or T tube drainage after choledochotomy. Comparison of the clinical effects in different groups was done. Re-sults Totally 161 cases were randomized into two groups: the primary sutures group 85 cases and the T tube drainage group 76 cases. All patient had no serious or long-term complications. The average hospital stay in primary suture group was significantly shorter (8.5±3.2) d than T-tube group(16.3±6.5) d. Conclusion Under strict indications, the primary suture after choledochotomy is feasible, and has advantages compared with the traditional method.

Objective To observe clinical results and indications of open reduction and internal fixation by bold canal titanium screws for treatment of radial head fractures. Methods From May 2003to February 2007,18 cases of radial head fractures were treated by open reduction and intemal fixation with bold canal titanium screws.There were 12 males and 6 females at age range of 15-53 years(mean 28.6 years).Of all,13 cases had Mason typeⅡ fractures,3 Mason typeⅣ and 2 Mason typeⅣ.Rehabilitation began as early as possible after operation if the internal fixation was secure;otherwise,rehabilitation began 2 weeks after operation.Postoperative plain radiography was made to observe fracture healing and complications. Results After operation,the rehabilitation was done at the first day in 15 cases and at 2 weeks in 3,with mean fracture healing time of 3 months.Function of elbows and rotation of forearnls were excellent except for 2 eases with Mason Ⅳ fractures.No deep branch of radial nerve injury occurred. Conclusion Open reduction and internal fixation with bold titanium canal screws can attain satisfactory clinical results in treatment of Mason type Ⅱ and Mason typeⅢradial head fractures.

Objective To study the clinical efficacy of recombinant human epidermal growth factor (rhEGF) in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation (WBP). Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant (P ＜ 0.05). Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.

This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
Allopurinol ; therapeutic use ; Febuxostat ; Gout ; blood ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Thiazoles ; therapeutic use ; Uric Acid ; blood