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 investigate the effects of p38 mitogen-activated protein kinase (MAPK) short hair RNA (shRNA) delivered by lentiviral vectors (pGLV) on cardiac function after myocardial infarction (MI) in aldosterone overload rats and to explore the mechanism.Methods Aldosterone overload rat myocardial infarction model was obtained by ligating the left anterior descending coronary artery.The pGLV-shRNA was constructed,sequenced and injected into rats via tail vein.Rats were divided into 3 groups:pGLV-shRNA group (n=6),pGLV-shRNA-NC group (n=6,contained a nonsense shRNA) and the sham-operation group (n=6).Cardiac function was measured by cardiac ultrasound.Apoptosis was assessed by transferase (TdT)-mediated biotin-16-dUTP nick-end labelling (TUNEL).The p38 MAPK mRNA expression was analyzed by RT-PCR.The protein expressions of p38 MAPK and caspase-3 were detected by Western blot.Results Compared with the sham-operation group,cardiac systolic function was reduced and myocardial apoptosis index was significantly increased [(31.26 ± 4.45) ％ vs.(15.20 ± 2.18) ％,P ＜ 0.01] in pGLV-shRNA-NC group.The mRNA and protien expressions of p38MAPK and caspase 3 protein expression were significantly increased in pGLV-shRNA-NC group (all P＜0.01).Compared with pGLV-shRNA-NC group,cardiac function was improved,myocardial cell apoptosis index was reduced [(22.35±3.59)％ vs.(31.26±4.45)％,P＜0.05],and the mRNA and protien expressions of p38MAPK and caspase 3 protein expression were decreased in pGLV-shRNA group (all P＜0.05).Conclusions Cardiac dysfunction is associated with p38MAPK-mediated myocardial apoptosis in aldosterone overload MI rats.pGLV-shRNA may inhibit cardiomyocyte apoptosis and improve postMI cardiac function.

Objective To investigate effect and mechanism of Xuebijing administration at various concentrations on ischemia reperfusion injury (IRI) of rabbit limbs.Methods Thirty New Zealand rabbits were divided into control group (n =10),Xuebijing group Ⅰ (n =10) and Xuebijing group Ⅱ(n =10) according to random number table.Rabbit models of IRI in lower extremities were established.Each group received corresponding therapy after reperfusion:rabbits in Xuebijing group Ⅰ were firstly administered 4 ml/kg Xuebijing solution and 6 ml/kg isotonic saline; rabbits in Xuebijing group Ⅱ were administered 2 ml/kg Xuebijing solution and 8 ml/kg isotonic saline; rabbits in control group were simply administered 10 ml/kg isotonic saline.Venous blood samples were collected before reperfusion and at 1 h,2 h,4 h after reperfusion to measure coagulation parameters (APTT,Fib,INR and PT) and biochemical items (ALB,LDH and CK).Results APTT in Xuebijing group Ⅰ presented obvious improvement at 1 h and 4 h after reperfusion as compared with control group (P ＜ 0.01).PT in Xuebijing groups Ⅰ and lⅡ was significantly longer after reperfusion than that before reperfusion (P ＜0.05).Fib level in Xuebijing group Ⅰ was much higher at 4 h after reperfusion than that before reperfusion (P ＜ 0.05).ALB level at 1 hour after reperfusion showed no statistical differences from that before reperfusion in Xuebijing groups Ⅰ and Ⅱ (P ＞ 0.05).LDH and CK levels in Xuebijing group Ⅰ were much lower than those in control group after reperfusion (P ＜ 0.05).Conclusions Xuebijing injection relieves limb IRI,with better effect in Xuebijing group Ⅰ than in Xuebijing group Ⅱ.Therapeutic mechanism may be associated with its involvement in adjusting clotting function and mitigating injury of muscle tissues.

Objective To analyze the clinical and ultrasonic features of primary squamous cell carcinoma of the thyroid(PSCCT)and diagnostic value of ultrasonography (US) in PSCCT in order to improve the cognition of PSCCT.Methods The clinical data and ultrasonic characters of 5 patients with PSCCT confirmed by pathology post surgery were retrospectively reviewed.Results The average age of the 5 patients was 62 years (range from 46 to 79).All of 5 patients with PSCCT were presented with a painless neck mass in clinical palpation examination.Of them,2 patients had different degrees of difficulty in breathing and swallowing,2 patients had hoarseness.Four of 5 patients had died after surgery with average survival time of 9.5 months.On US,the size of lesions was large(a maximum diameter of 2.9-5.5 cm),all of 5 lesions appeared as single solid mixed-echogenicity mass including irregular lamellate marked hypoechoic region,with irregular margin and undefined boundary.Of them,2 lesions presented with lobulated,only 1 lesion exhibited microcalcification and another 4 lesions had no calcification,3 lesions exhibited a? sign of breakthrough thyroid envelope.Color Doppler flow imaging showed few blood flow (3/5) and moderate blood flow (2/5),a higher vascular resistance spectrum was detected in 4 lesions (RI 0.72-0.88).Three patients exhibited suspicious cervical lymph nodes.Conclusions The characteristic ultrasonic appearance combined with the clinical features enables a confident preoperative diagnosis of PSCCT.

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.