Objective To summarize the clinical experiences in setting up cardiopulmonary bypass(CPB)using extracorporeal membrane oxygenation(ECMO)circuit and turning CPB to ECMO after open heart operations in 16 cases.Methods In the group of 16 cases,the annulations were via femoral vessels:by Medtronic ECMO machine and membrane oxygenator was used in all patients.All patients accepted A-V bypass.Results CPB was running smoothly during the operations,and converted to ECMO after the surgeries without complications,and the rate of ECMO withdraw was 93.75%.Mortality was 18.5%,and 81.25%of patients were discharged.Conclusion ECMO is an effective device for cardio and pulmonary support.Many patients with severe cardiac diseases and marginal cardiac function will need mechanical support after surgery.For these patients,setting up CPB using ECMO circuit during the operation and converting it to ECMO after surgery can prevent patients from additional exposure to a standard CPB circuitry.It helps decrease the inflammatory response,avoid dilution of patient's volume of cells and factors,and reduce expenses.

Objective To explore the effect of oxLDL on CXC chemokine growthregulated oncogene α (GROα) expression in human endothelial cells and the possible functional signific ance of the effect Methods LDL was isolated by sequential ultracentrifugation and oxidized to oxLDL Rever se transcriptionpolymerase chain reaction with GAPDH as internal standard was applied and CXC chemokine GROα mRNA in endothelial ECV304 cells was examined ELISA was used to determine GROα protein expression on ECV304 cell surface and in the medium With static cell adhesion assays, the physiological significa nce of elevated GROα expression was tested Results OxLDL, not LDL, treatment of ECV304 cells significantly induced the expression o f GROα mRNA that was not detectable in untreated cells Induction of expressio n was first evident at 1h, became maximal at 2h, and was substantially decre ased by 4h In a concentration and timedependent manner, oxLDL, and not L DL, induced a significant upregulation of GROα surface expression in ECV304 cel ls that was at a barely detectable level in unstimulated ECV304 cells GROα protein in the medium did not change significantly Exposure of ECV304 cells to 40μg protein /ml oxLDL for 24h resulted in a marked increase in the number of U937 cells bound to ECV304 cells and antibodies to GROα inhibited adhesion Conclusion OxLDL functionally upregulated GROα expression in endothelial cells

Objective To evaluate the feasibility of using gelatin sponge to reduce bone cement leakage in percutaneous vertebroplasty (PVP).Methods A retrospective case control study was conducted to analyze the 191 patients (191 vertebrae) with lumbar osteoporosis vertebrae compression fractures (OVCF) who were treated by PVP from October 2014 to October 2017 in Xi'an Honghui Hospital.There were 52 males and 139 females,aged 65-91 years,with an average of 75.1 years.A total of 48 patients were treated with routine PVP,and bone cement was injected directly after puncture (Group A).A total of 47 patients,49 patients and 47 patients were injected with 1/4,1/3 and 1/2 gelatin sponge before bone cement injection respectively (Group B,Group C and Group D).Postoperative routine X-ray and CT scans were used to compare the amount of bone cement injection,the leakage of bone cement,the visual analogue score (VAS),neurological symptoms and complications before and after operation.Results All patients were followed up for 1-12 months,with an average of 3.6 months.There were no significant differences in the amount of bone cement injection after operation between groups (P ＞ 0.05).There was a significant difference in the cement leakage rate among the groups after operation [Group A:42％ (20/48);Group B:40％ (19/47);Group C:14％ (7/49);Group D:13％ (6/47)] (P ＜ 0.05).The results of pairwise comparison of bone cement leakage rate were as follows:significant differences were found between Group A and Group C as well as between Group A and Group D (P ＜ 0.008 3),but no significant difference was found between Group A and Group B (P ＞ 0.008 3);significant differences were found between Group B and Group C as well as between Group B and Group D (P ＜ 0.008 3),but no significant difference was found between Group C and Group D (P ＞ 0.05).There were no significant differences in VAS among the groups (P ＞ 0.05);VAS was significantly improved after operation within each group (P ＜ 0.05).After operation,two patients had persistent lower back pain and one patient had intraspinal leakage.Wound healing was found in all patients,with no neurological symptoms.Conclusion For OVCF,use of 1/3 or 1/2 gelatin sponge in PVP can reduce bone cement leakage.

Vertebral body augmentation for spine-related diseases has the advantages of minimally invasive surgery,obvious postoperative pain relief,and quick postoperative recovery compared with open surgery.It can quickly reconstruct spinal stability,relieve pain,and improve patients' quality of life.Intraoperative injection of bone cement into the diseased vertebral body carries the risk of bone cement leakage during the process.Knowing well the complications is helpful to the timely clinical treatment so as to avoid delays,and understanding the risk factors can facilitate targeted measures to prevent leakage during surgery.Therefore,to understand the consequences of bone cement leakage,leakage incidence rate,related risks factors and preventative measures is conducive to clinical treatment and surgery safety.The authors discuss the complications and risk factors related to bone cement leakage after vertebral body augmentation,in order to deepen the understanding of bone cement leakage,provide reference for clinical work,and improve the safety of surgery.

With the widespread implementation of laparoscopic cholecystectomy in various levels of medical institutions, surgical complications have also increased. Among them, the incidence of bile duct injury remains high in complex laparoscopic cholecystectomy. The reason for this is that surgeons cannot effectively and accurately identify the relationship between the aberrant bile duct and the cystic duct and the common bile duct, resulting in the accidental injury of the bile duct, resulting in long hospital stays, increased medical costs, and decreased long-term quality of life for patients. Intraoperative cholangiography, as a real-time visual method of biliary presentation, can effectively reduce the incidence of iatrogenic bile duct injury. However, most surgeons do not fully understand the technology of intraoperative cholangiography during cholecystectomy. This article reviews the application of intraoperative cholangiography in laparoscopic cholecystectomy based on the clinical experience of the author′s team and the literature in recent years, with the aim of deepening the understanding of surgeons about intraoperative cholangiography, so as to better apply it to clinical practice and benefit patients.

Obj ective To investigate the changes of cytokeratin 1 9 fragment (CYFRA211),carcinoembryonic antigen (CEA),sugar decomposition enolase (NSE),carbohy-drate antigen 125 (CA125),carbohydrate antigen 199 (CA199)in non-small cell lung cancer pa-tients before and after chemotherapy and explore its clinical significance.Methods A total of 60 pa-tients with advanced non-small cell lung cancer were treated with 2 cycles (3 weeks per cycle)of cis-platin plus gemcitabine chemotherapy (GP).Serum CYFRA211,CEA,NSE,CA125,CA199 in patients were detected before and after chemotherapy.Results Positive rates of CYFRA211, serumCEA ,NSE ,CA 1 2 5 and CA 1 9 9 before chemotherapy in all patients were 6 1 .6 7%,5 1 .6 7%, 71.67%,53.33%,31.67%.Positive rates of serum CEA,CA125 adenocarcinoma were signifi-cantly higher than patients with squamous cell carcinomas (P<0.05 or P<0.01 ).The positive rate of NSE staging for stage IV patients was significantly higher than that in stageⅢpatients (P<0.05).After chemotherapy,5 cases had complete response,14 cases had partial response,25 cases had stable disease (SD),16 cases had progressive disease (PD).Among them,the indexes of patients with CR,PR were significantly lower than those before treatment (P<0 .05 ),SD patients with serum NSE,CA125 levels were significantly lower (P<0.05),PD patients serum CYFRA211, CEA,CA125 levels significantly increased than before treatment (P<0.05 ).Conclusion Serum CYFRA211,CEA,NSE,CA125,CA199 level can reflect Chemotherapy curative effect for patients with advanced non-small cell lung cancer.The short-term effect,tumor stage,and serum CYFRA211 levels before chemotherapy are the independent factors of prognosis.

Obj ective To investigate the changes of cytokeratin 1 9 fragment (CYFRA211),carcinoembryonic antigen (CEA),sugar decomposition enolase (NSE),carbohy-drate antigen 125 (CA125),carbohydrate antigen 199 (CA199)in non-small cell lung cancer pa-tients before and after chemotherapy and explore its clinical significance.Methods A total of 60 pa-tients with advanced non-small cell lung cancer were treated with 2 cycles (3 weeks per cycle)of cis-platin plus gemcitabine chemotherapy (GP).Serum CYFRA211,CEA,NSE,CA125,CA199 in patients were detected before and after chemotherapy.Results Positive rates of CYFRA211, serumCEA ,NSE ,CA 1 2 5 and CA 1 9 9 before chemotherapy in all patients were 6 1 .6 7%,5 1 .6 7%, 71.67%,53.33%,31.67%.Positive rates of serum CEA,CA125 adenocarcinoma were signifi-cantly higher than patients with squamous cell carcinomas (P<0.05 or P<0.01 ).The positive rate of NSE staging for stage IV patients was significantly higher than that in stageⅢpatients (P<0.05).After chemotherapy,5 cases had complete response,14 cases had partial response,25 cases had stable disease (SD),16 cases had progressive disease (PD).Among them,the indexes of patients with CR,PR were significantly lower than those before treatment (P<0 .05 ),SD patients with serum NSE,CA125 levels were significantly lower (P<0.05),PD patients serum CYFRA211, CEA,CA125 levels significantly increased than before treatment (P<0.05 ).Conclusion Serum CYFRA211,CEA,NSE,CA125,CA199 level can reflect Chemotherapy curative effect for patients with advanced non-small cell lung cancer.The short-term effect,tumor stage,and serum CYFRA211 levels before chemotherapy are the independent factors of prognosis.