Arterioportal shunt often occurs in hepatocellular carcinoma of advanced stage, with obvious decrease of the survival rate. The proper management of arterioportal shunt correlates directly with patient's prognosis. This comprehansive article reviews the interventional management of arterioportal shunt for hepatic carcinoma from literatures during recent years. (J Intervent Radiol, 2006, 15: 312-314)

Objective To study the effect of gemcitabine combined with cisplatin in the treatment of non-small cell lung cancer.Methods 100 cases of non-small cell lung cancer patients who were treated in our hospital from March 2015 to August 2016 were selected as the subjects in this study.They were randomly divided into the control group and the experimental group, with 50 cases in each group.The control group were treated with gemcitabine combined with cisplatin, and routine nursing care was used.The experimental group were given psychological intervention on the basis of gemcitabine combined with cisplatin treatment, pay attention to the psychological status of patients, medical staff should strengthen communication, inform the relevant knowledge of disease, eliminate the negative emotions, improve the treatment compliance.Anxiety scores and satisfaction between the experimental group and the control group were compared.Results After the corresponding nursing, the treatment satisfaction of the control group was 72.0%, which was lower than that of the experimental group, and the satisfaction rate was 92.0%, the difference was statistically significant (P<0.05).After the intervention, the anxiety score of the experimental group(36.83±4.23)was significantly lower than that of the control group(42.12±3.41), and the difference was statistically significant (P<0.05).There was no significant difference in survival rate between the two groups after a follow-up of 1 years.Conclusion Gemcitabine Combined with cisplatin in the treatment of non-small cell lung cancer, the application of psychological intervention nursing can help patients to eliminate anxiety in a large extent, improve patient satisfaction, with further clinical promotion and application significance.

Objective To evaluate the efficacy of percutaneous vertebroplasty for treating the vertebral compression fractures and vertebral metastatic neoplasms, and to assess its clinical curative effects Methods Among 81 cases (47 men and 34 women; ages 35～84, mean age 61 2 years), 110 vertebrae with metastatic neoplasms (61 cases) or vertebral osteoporosis (20 cases) were infused with methacrylate guided by DSA Effect of the operations was observed closely after the procedures Results The procedures were successful in all the involved patients and no significant complications were noted clinically Among the 61 patients treated for malignancies, 58 showed marked pain relief and 3 moderate pain relief 20 patients with vertebral osteoporosis demonstrated complete pain relief The cement leakage observed on radiographs included slight leakage to the adjacent disc (6 of 110, 5 5%), the epidural fat (8 of 110, 7 3%), the perivertebral venous plexus (2 of 110, 1 8%), and the paravertebral soft tissues (2 of 110, 1 8%) Conclusion Percutaneous vertebroplasty can significantly relieve the pain in patients with osteoporotic fractures caused by the malignancies and the vertebral osteoporosis We suggest that slight PMM leaks, when not symptomatic, should not be considered as complications

Marginal liver donor,a way to expand the liver pool,has been maximized in the unique position due to the shortage of donors.But the definition of marginal donor liver varies from center to center and the standard is very complex.With the enhancement of organ perfusion solution,preservation methods and surgical techniques,the edge donor criteria are also gradually expanding.What decision should we make,facing such clinical controversies.This paper makes a review on the marginal liver donor in the donation after citizen deceased,so as to improve its clinical application.

BACKGROUND: There are more measurement data about knee joint at home and abroad, but few data about the northern China, especially Inner Mongolia region. Whether the posterior slope angle of tibial plateau in local area differs from that of Chinese or foreigners is rarely reported.OBJECTIVE: To measure the posterior slope angle of the medial tibial plateau in healthy Mongolia population, and to compare the differences of different measurement methods, so as to understand the anatomical characters of tibial plateau in Inner Mongolia region.METHODS: Sixty Mongolian volunteers were recruited, the 20 cm upper and under the knee joint were scanned bilaterally by GE64 row spiral CT, and the three-dimensional model of the knee was established on Mimics16.0 software, followed by processed through fairing, filling, separation and cutting. Afterwards, the angel between anterior cortical bone extension line of upper tibia (method A), tibia anatomical axis (method B), line perpendicular to the posterior cortical bone extension line of upper tibia (method C) and upper edge line of the tibial plateau was measured,respectively. The posterior slope angle of the medial tibial plateau (90°-measured angle) was obtained and compared.RESULTS AND CONCLUSION: (1) The posterior slope angle of the medial tibial plateau measured by methods A, B and C was (11.16±3.39)°, (8.60±3.29)° and (5.30±4.40)°, respectively, and the former two were similar with those reported by Wang Ye-hua and Luo Ji-wei (P > 0.05). (2) There were significant differences in the posterior slope angle of the left and right medial tibial plateau among methods (P < 0.05), but there was no significant difference between left and right sides (P > 0.05). (3) There was no significant difference in the posterior slope angle of the left and right medial tibial plateau between genders (P > 0.05). (4) These results indicate that the Mongolian population show smaller posterior slope angle of the tibial plateau, but the angle exhibits great individual difference, thereafter, an individualize scheme should be developed before osteotomy.

Objective To analyze the effects of an inhibitor of the SH3 (Src homology) domains of Grb2 on the growth and proliferation of K562 cells. Methods The peptidimer [(VPPPVPPRRR)2-K], penetratin (RQIKIWFQNRRMKWKK) and peptidimer-c [poptidimer linked to penetratin: (VPPPVPPRRR)2-K-Aha-RQIKIWFQNRRMKWKK] were synthesized by solid-phase synthesis using Fmoc chemistry, and purified by high performance liquid chromatography (HPLC) on a C18 column. Purity was evaluated by HPLC, and the identity of the peptides was checked by electrospray mass spectroscopy (MS). A pull-down assay was used to observe the specific binding of peptidimer-c to the Grb2 of K562 cell lysates. The inhibition of peptidimer-c on K562 cell proliferation was evaluated by trypan blue exclusion assay, the cytostatic effect was tested by clonogenic assay, and the cytotoxicity was examined by WST-1 method. A further experiment was performed with clonogenic assay to analyze the co-effect of peptidimer-c respectively combined with Gleevec, Hydroxyurea and Cytarabine by Jing's method. Results The HPLC analysis showed only a simple peak, which means that the peptide is in high purity. MS analysis showed the peptides were coincided with the design. The molecular weight of peptidimer-c was of 4794.0 and that of the penetratin 2246.7. Pull-down assay demonstrated that the peptidimer-c, not the penetratin, could bind to Grb2 specifically. The trypan blue assay showed that the peptidimer-c could inhibit the proliferation of K562 significantly in a dose-dependent manner, even 3～6 h after the cells were exposed to the drug, and penetratin alone did not influence the cell proliferation. Gleevec inhibited the growth of K562 not only in a dose-dependent manner, but also in a time-dependent manner. WST-1 test showed the cytotoxieity of peptidimer-c or Gleevec on K562 cells, the IC50 of peptidimer-c was (17±2) μmol/L and the IC50 of Gleevec was (0.25±0.05) μmol/L. In the methylcellulose semi-solid medium system, the colony formation of K562 was greatly decreased by peptidimer-c as compared to the penetratin, and the colony number decreased as the dose of peptidimer-c increased. The IC50 value ofpeptidimer-c on K562 colony formation was (3.9±0.9) μmol/L, IC50 of Gleevec was (0.03±0.02) μmol/L, IC50 of Hydroxyurea was (15±7) μmol/L, and that of cytarabine was (0.014±0.012) μmol/L. There were synergistic effects of peptidimer-c with Gleevec, Hydroxyurea or Cytarabine on K562 by colonogenic assay. Combination of 1.5 μmol/L peptidimer-c and 0.05 μmol/L Gleevec showed synergistic effect on K562, as well as the combination of 1.5 μmol/L peptidimer-c and 0.006 μmol/L or 0.01 μmol/L Cytarabine. Conclusion These results suggested that peptidimer-c had an inhibitory effect on K562 cells and combination of peptidimer-c with other drugs would increase the anti-cancer effects.

ObjectiveTo explore the effect of different nutritional support mdoes on humoral immunity and outcomes after esophagectomy in patients with esophageal carcinoma.MethodsForty-six patients with middle or low thoracic esophageal carcinoma underwent Ivor Lewis esophagectomy.The patients were randomized into enteral nutrition group ( EN,n =23 ) and enteral combined parenteral nutrition group ( EN + PN,n =23 ) based on the nutrition support modes.Serum levels of immunoglobulin (IgG,IgA,IgM,IgE,κ/λ light chain) and comphments (C3/C4) were assayed and compared on the 1st pre-operative day and at 18 hours as well as 3rd and 7th day after operation.The clinical outcomes including infection-related complications and hospital stay were compared between two group s.ResultsThere was no significant difference in all humoral immunity indicators between two groups at the eachpost-operative time point.In both two groups,the levels ofIgG [ (8.90 ± 1.75),(7.53 ±1.41) g/Land (8.64±2.44),(7.48±2.16) g/L],κ [ (2.14±0.46),(1.78±0.41) g/L,and (2.15 ±0.63),( 1.86 ± 0.62) g/L] and λ light chain [ ( 1.34 ± 0.45 ),( 1.11 ± 0.31 ) g/L and ( 1.20 ± 0.32),( 1.08 ± 0.35 ) g/L] were significantly lower 18 hours and 3rd day after operation than the pre-operative levels [ (12.15±2.86)and (11.11±2.96) g/L,(2.90±0.77) and (2.77±0.79) g/L,(1.79±0.57) and (1.56±0.41) g/L] (P=0.000,P=0.000,and P=0.004,P=0.000,and P=0.000,P=0.000,and P=0.011,P=0.000,and P=0.004,P=0.000,and P =0.008,P =0.000),and returned to the preoperative levels by the postoperative 7th day (P＞0.05),except for the level of κ light chain 7th day after operation in EN group [ ( 2.42 ± 0.69) g/L] ( P =0.027 ).The levels of IgA,IgE,and C3 were not significantly different during the perioperative period ( P ＞ 0.05 ).The level of IgM was not significantly different during the perioperative period in EN group (P ＞0.05),and was significantly lower on the 3rd post-operative day [ ( 1.00 ±0.53) g/L] than the pre-operative level [ ( 1.47 ±0.76) g/L] in the EN + PN group (P =0.031 ),and were not significantly different on the other time points (P ＞ 0.05 ).In the EN group,the C4 level was significantly lower at the postoperative 18 hours [ (0.24 ±0.08) g/L] than the pre-operative level [ (0.37 ±0.36) g/L] (P =0.030),and were not significantly different at the other time points ( P ＞ 0.05 ).In the EN + PN group,the C4 level was not significantly different during the perioperative period ( P ＞ 0.05 ).There was no significant difference in the infection-related complications and hospital stay between these two groups ( P =0.300,P =0.371 ).ConclusionsThe effects of EN or EN + PN on humoral immunity and outcomes after esophagectomy in patients with esophageal carcinoma are not different.Both these two nutritional support modes can not completely alleviate the harm to the humoral immunity.The EN is more cost-effective.

Objective To investigate the variation of procalcitonin(PCT)level and the significance of PCT for the diagnosis of infection during perioperative period of valve replacement for rheumatic heart disease.Methods Routine blood testing and procalcitonin(PCT)level were measured in the perioperative period of 56 patients with rheumatic heart disease receiving valve replacement.Prophylactic antibiotics management was given based on the serum procalcitonin level especialy that 3 days after operation or later.The postoperative infective complications and the duration of prophylactic antibiotics management were recorded and assessed.Results The duration of prophylactic antibiotics for all patients were 4.6 ± 2.0 days.Six patients were suffered from poor incision healing and one was suffered from pulmonary infection.There were no severe postoperative infective complications.The PCT of the patients without postoperative infection rise to peak level on the 1st day after operation and return to normal on the 3rd day.There was no significant difference in the PCT levels between the two groups.The duration for PCT descending to 0.25 mg/L was 3.7 ± 2.5 days.The PCT level of the patients suffered from pulmonary infection went up again after infection on the 5th day and return to normal on the 9th day.No severe postoperative infective complications happened after withdrawn of prophylactic antibiotics if PCT had descended tobelow 0.25 mg/L after operation.Conclusions The serum PCT level may be a good parameter for the prediction or diagnosis of infective complication in the perioperative period of patients undergoing valve replacement for rheumatic heart disease.It can be a useful marker to guide the use of prophylactic antibiotics.

ObjectiveTo study the curative effect of early intervention on selective head sub-hypothermia in full term infant with severe asphyxia.MethodsForty two full term infant with severe asphyxia were randomly divided into treatment(n =22) and control ( n =20) group,all patients were treated according to three supportive therapy and three heteropathy after resuscitation,and meanwhile the treament group combined with selective head sub-hypothermia.In the 2 groups,heart and breath oxygen saturation,blood sugar were measurded within 72 hours after treatment,and the Chinese 20-item neonate nerve behaviors were evaluated 28 days after birth.Test were conducted with the Bayley infant development scale in 2 months after birth.ResultsAfter 72 hours of treatment,the heart rate of treatment group reduced and showed significant difference from that of contol group and restored to normal.There were no significant differences in breath,blood pressure(BP),degree of blood ozygen saturation,blood sugar between the 2 groups.After 28 days of birth,scores of neonate nerve behaviors were ( 37 ± 3) in treatment group and (31 ± 3) in control group,respectively ;which showed significant difference ( P ＜ 0.01 ).In the 2nd months of birth,scores of Bayley infant development scale were (91 ± 3 ) in treatment group and ( 86 ± 4 ) in control group,respectively,which showed significant difference(P ＜ 0.05 ).ConclusionSelective head sub-hypothermia was convenient and safe,and had reliable curative effect by relieving or prenventing sequel and raising quality of life.

Objective To investigate the effects of glucocorticoid on the changes of serum cortisol and 24-hour urinary cortisol in patients undergoing rheumatic valve replacement.Methods 86 patients undergoing rheumatic valve replacement were respectively given 1000 mg methylprednisolone during extracorporeal circulation and intravenously injected 10 mg dexamethasone on the first three days after operation.The enzyme-linked immunosorbent assay (ELISA) was taken to detect the serum cortisol concentration and 24-hour urinary cortisol on the day before operation,the 1st,3rd,5th,and 7th day after surgery.The postoperative complications such as the surgical incision and pulmonary infection were observed during the recovery days.Results Serum cortisol concentrations for patients with different preoperative cardiac function classifications had no significant difference at each observation point during the perioperative period (P＞0.05).Serum cortisol concentration showed a downward trend during the first 3 days after surgery.The serum cortisol level on the 3rd day after surgery was lower compared with that before surgery (P＜0.05),whereas 3 days later the serum cortisol concentration increased gradually and got back to the preoperative levels on the 5th day after surgery.The 24-hour urinary cortisol rose to the peak level on the 1st day after surgery,then decreased to the preoperative level on the 3rd day after surgery (P＞0.05).All the patients recovered.No one died or had complications such as pulmonary infection or incisions healing problems.Conclusions The effects of corticosteroids on perioperative serum cortisol levels in patients with rheumatic heart disease were not clearly correlated with preoperative cardiac function classification.Using glucocorticoid in the first three days after surgery reveals transient inhibitory effect on serum cortisol secreting,however,the cortisol level can quickly go back to the preoperative level after stopping giving glucocorticoid.