Objective To evaluate 99tcm-DTPA nuclear dynamic imaging in distinguishing the renal occupied disease.Methods A total of 164 in-patients with renal occupied disease who underwent surgery were included.According to the pathological diagnosis,119 patients had malignant tumors,and 45 patients had benign diseases.All patients’ imaging was retrospectively analyzed.Application of 99Tcm-DTPA nuclear dynamic imaging in renal occupied disease was compared with ultrasonography (US),computed tomography (CT),magnetic resonance imaging (MRI),intravenous pyelogram (IVP),and positron emission tomography (PET)-CT.Results The accuracy rates of different imaging methods in distinguishing between renal malignant and benign disease were 99Tcm-DTPA (84 ％,45 ％),US (72 ％,64 ％),CT ( 91％,92 ％),MRI (50 ％,67 ％),IVP (50 ％, 17 ％), respectively.The diagnostic accuracy rate of PET-CT for malignant tumors was 67 ％.The accuracy rates of 99Tcm-DTPA in distinguishing different phases of renal cell carcinoma were statistically significant (x 2 =83.4, P ＜ 0.01), while the accuracy rates in distinguishing renal cyst from renal angiomyolipoma were not statistically different.With the greater diameter, the diagnostic accordance rate is higher (x 2 =16.05,P ＜ 0.05).Conclusion 99Tcm-DTPA could be used not only to evaluate the renal function quantificationally,but also be helpful to distinguish renal malignant tumor from benign disease.

Objective Imatinib mesylate (IM) is the most active agent in treating chronic myeloid leukemia (CML). 5-Aza-2-deoxycytidine (DAC) is a cytosine analogue that inhibits DNA methylation and the activity in myeloid leukemia. Therefore,we investigated combining these two drugs in human leukemia cell line K562. Methods The effects of IM and DAC was examined in K562 cells including cell viability using MTT method,cell cycle phase and cell death using flow cytometric (FCM),and the expression of bcr-abl mRNA by RT-PCR. Results Both DAC and IM resulted in time and concentration-dependent induction of cell death. DAC and IM in combination produced a greater inhibition of growth against K562 cells (F =43.947,165.580,321.193,296.101,P<0.05). The main effect and interaction between two drugs was statistically significant (F = 202.759,168.457,417.538,P <0.001) after 24 h,48 h,72 h and a greater reduction in expression of bcr-abl mRNA than either agent alone. The difference was statistically significant (F =71.981,P <0.05). The number of G1 phase cells were increased significantly when induced by single agent. 48 h incubation with IM 0.2 μmol/L alone or combined with DAC 4 μmol/L showed 6.7 %,8.4 % pre-apoptosis cells,respectively. After incubation for 48 h with DAC 4 μmol/L,the expression of mRNA were decreased by 14 %,IM 0.2 μmol/L showed 40 % reduction,and combination group were significantly depressed for the mRNA expression by 60 %. Conclusion The combination of DAC and IM showed synergistic effects on cell death in K562 cells. These data suggested that DAC used in combination with IM has clinical potential in the treatment of chronic myeloid leukemia.

ObjectiveTo probe into the clinical efficiency of reconstruction to person who had composite tissue defect of the floor of mouth and the lower part of face with the free forearm flap and free iliac bone in the same term.MethodsBefore the surgery, the surgeon should carefully evaluate the scope and shape of defects in 11 cases who had the composite tissue defects of the floor of mouth and the lower part of face, to design the individual forearm flap, so that it matches with the defect region. During surgery, the first resumption of defects using titanium plates forming the basic shape of mandible and the occlusal relationship,then used to re-sawing to take modeling of the iliac bone,transplanted free iliac bone and fixed after the inside of the titanium plate, thereby restoring the continuity of mandible missing.ResultsFree forearm flap and free iliac bone all survived in 11 cases, the success rate of 100％. The patients were followed up for 6 to 12 months, although the shape of restoration areas were different levels of fat, but eating, swallowing and other oral function had been well improved, 7/11 could enter normal diet, 4/11 to enter liquid diet, At the same time, the patients in social activities can communicate in a language daily, sensory function of skin flap and facial appearance has been satisfactory recovery.ConclusionConformal free forearm flap and free iliac bone is an ideal way to reconstruct the composite tissue defects of the floor of mouth and the lower part of face in the same period, not only safe, practical prognostic effect, and also can significantly improve the patients quality of life, which is worthy of reference and use.

Objective To discuss the relationship between human leukocyte antigen (HLA) gene heredity and morbidity of cerebral infarction by a random survey on the allele expression of HLA-A, B and DRB1 seats of patients with cerebral infarction. Methods The genotypes of HLA-A, B and DRB1 alleles in 94 patients with cerebral infarction and 122 healthy blood donors were detected by polymerase chain reaction-sequencing based typing (PCR-SBT) method. Results Sixteen alleles in HLA -A locus,32 alleles in HLA -B locus and 25 alleles in HLA -DRB1 locus expressed themselves in these patients with cerebral infarction. The gene frequency of HLA -A*1102 in patients was lower than that in healthy controls, and negative association was found between HLA -A* 1102 allele and cerebral infarction (RR=0.06,P=0.019). Conclusion The research reveals susceptibility association of HLA -A*1102 with patients having cerebral infarction, displaying close genetic immunity correlation between HLA alleles and pathogenesis of cerebral infarction. So, the research in this paper is useful in the clinical prediction of this disease.

Objective:To investigate the incidence and risk factors of AKI in intensive care unit patients .Methods :Datum of 1443 patients admitted to Intensive Care Unit (ICU) from February 2010 to December 2012 were collected and analyzed retro-spectively .AKI patients were screened according to the clinical diagnostic criteria of AKI .The etiological diseases ,laboratory indicators ,urine output ,length of ICU stay were analyzed ,and logistic regression analysis was performed to investigate the risk factors for the prognosis of AKI .Results:AKI occurred in 98 of all patients (6 .7% ) under KDIGO-AKI criteria .Among the AKI patients ,32 cases(32 .65% ) died ,and 50 cases (51 .02% ) need renal replacement therapy .The mortality rate in-creased with AKI stage and age .According to the individual etiological disease ,48 cases (48 .98% ) were septic AKI and 50 ca-ses (51 .02% ) were non-septic AKI .Septic AKI patients had longer ICU stay and hospital stay than non-septic AKI patients(t=2 .292 ,P=0 .024 ;t=2 .083 ,P=0 .040 ,respectively )as well as higher rates of renal replacement therapy (χ2 =4 .083 ,P=0 .043) .On logistic regression ,elderly ,oliguria ,shock ,metabolic acidosis ,stage 3 of AKI ,vasopressors ,infection and need of renal replacement therapy were independent predictors of mortality in AKI .Conclusions :AKI patients have high incidence and mortality in ICU .A variety of factors are related to the prognosis of AKI .Early detection and effective therapeutic meas-ures are important to reduce the mortality of AKI patients in ICU .

Objective:To explore the postoperative electrocardiogram characteristics and its clinical significance in patients who had undergone orthotopic heart transplantation with double vena cava anastomosis .Methods :The electrocardiogram results of 70 patients during postoperative follow‐up ,who underwent orthotopic heart transplantation with double vena cava anastomosis in Zhongshan Hospital ,Fudan University from 2009 to 2012 ,were retrospectively analyzed .Results:The patients’ average ventricular rate was a bit faster than normal after operation ,and the common phenomena of electrocardiogram were non‐ischemic ST‐T changes ,increasing P terminal force in lead V1(Ptfv1) and incomplete right bundle branch block(IRBBB) .The rare phenomena such as slow ventricular rate ,ischemic ST‐T changes and arrhythmia ,however ,indicated poor prognosis . Conclusions : The postoperative electrocardiogram characteristics in patients who have undergone orthotopic heart transplantation with double vena cava anastomosis are conducive to predicting the patients ’ prognosis .

Objective :To explore the safety and feasibility of the full thoracoscopic lobectomy .Methods :Forty-seven patients undergoing pulmonary lobectomy were chosen .Among them ,26 cases were given video-assisted thoracoscopic surgery (VATS group) and 21 cases were given open-thoracotomy (OT group) .The operative time ,blood loss during surgery ,thoracic duct remaining time ,duration of hospital stay and post-operative complications were compared between the two groups .Results :There was no intraoperative death in both groups .The operative time ,blood loss during surgery ,thoracic duct remaining time , duration of hospital stay and post-operative complications in the VATS group were superior to those in the OT group (P <0 .05) .Conclusions :Full thoracoscopic lobectomy has advantages such as minimal invasion ,quick recovery ,and less pain .And its safety is not inferior to that of OT .Thus it is an ideal operation method for lobectomy .

Objective To analyze the protective role of intraoperative EMG monitoring in surgical removal of tumors related to the floor of the fourth ventricle and its influencing factors.Methods Intraoperative EMG monitoring was performed during the surgical removal of 32 patients with brain tumor, admitted to our hospital from January 2007 to December 2010; among these 32patients, 11 was conformed as having medulloblastoma, 9 ependymoma, 6 brain stem cavernous hemangioma, 4 brain stem exogenous glioma and 2 hemangioblastoma of the dorsal brain stem. The influencing factors of intraoperative EMG monitoring and the possible damage of cranial nerve nuclei caused by these surgical procedures were analyzed.Results Twenty-one patients enjoyed total removal, 9 sub-total removal and 2 partial removal. Good function protection of patient's posterior cranial nerves was noted in 9 patients, mild impairment in 18 patients, and moderate dysfunction in 5 patients.The influencing factors of EMG monitoring included leaking electric current caused by bipolar coagulation, excessive use of muscle relaxant drugs, changes in depth of anesthesia, and rapid changes of patient′s temperature, saline temperature and blood pressure. Conclusion The intraoperative EMG monitoring can provide evidence about the location of the cranial motor nuclei during the surgical removal of the tumor related to the floor of the fourth ventricle and the function protection of patient’s posterior cranial nerves.