A common pathophysiological changes caused by liver cirrhosis indudes damage of liver function and portal hypertension,and upper gastrointestinal hemorrhage caused by portal hypertension is the main cause of death in patients with liver cirrhosis.Therefore,the main purpose of portal hypertension treatment should be prevention and control of esophagus and fundus of stomach variceal bleeding.However,upper gastrointestinal bleeding can not be completely cured no matter by medication or endoscopic treatment,devascularization or shunt.Although liver transplantation is the best treatment method for portal hypertension,the application of liver transplantation is limited by the source of donor and medical condition.Devascularization is effective to treat upper gastrointestinal hemorrhage caused by portal hypertension,while disputes exist on the surgical indications,timing and procedure selection.

Objective:To construct an adenoviral vect or carrying human tissue inhibitor of metalloproteinase-2(TIMP-2)gene in order to mediate the expression of TIMP-2 gene in vascular smooth muscle cells(SMC)i n vitro. Methods:A recombinant adenovirus(AdhTIMP-2)containging human TIM P-2 cDNA fragment was generated by homologous recombination in BJ5183 bacteria. Recombinant plasmids were screened by alteration of antibiotics.The adenovirus v ector was then packaged and amplified in 293 cells.The SMC of rat aortic were is olated and cultured in vitro and been infected with AdhTIMP-2.The expression of TIMP-2 was detected by the techniques of Western blot and RT-PCR. Results:The recombinant adenoviral vector carrying human TI MP-2 was constructed. The titer was 4?1011efu/ml after purification.The AdhTIMP-2 could infect the cultured VSMC efficiently(MOI=100,infection ra te=94%).The expression of TIMP-2 gene in those infected cells was detected by R T-PCR.After the cells were infected with AdhTIMP-2 24hours,TIMP-2 protein cou ld be detected in the conditioned medium by Western blot. Conclusion:The recombinant adenoviral vector carrying human TIMP -2 is successfully constructed and AdhTIMP-2 can efficently mediate the expres sion of TIMP-2 gene in cultured VSMC,paving the way for further application in vascular disease gene therapy.

Objective To investigate the effect of TIMP-2 gene that was transfected by adenovirus on extracellular matrix of abdominal aortic through assessing the changes of morphology and histopathology of the rat models with abdominal aortic aneurysm. Methods The rat models with abdominal aortic aneurysm were constructed by intraluminally perfusing porcine pancreatic elastase. Twenty-four SD rats with aneurysm were then randomly divided into 3 groups: AdTIMP-2 group (perfused locally with solution of TIMP-2 gene transfected by adenovirus vector to abdominal aorta), AdCMV group (transfected by non-viral vector), and PBS group. After 14 days, the concentrations of elastin and collagen that were collected from the samples of aortic wall were measured by image analysis system and the fixed aortic tissues were examined by light microscopy and some other specific staining methods. Results None of abdominal aortic aneurysm developed in TIMP-2 gene transfected group, with significantly higher rates of developed aneurysm in the other groups (P

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People′s Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients′ long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient′s short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

In order to overcome the difficulty in lung parenchymal segmentation due to the factors such as lung disease and bronchial interference, a segmentation algorithm for three-dimensional lung parenchymal is presented based on the integration of surfacelet transform and pulse coupled neural network (PCNN). First, the three-dimensional computed tomography of lungs is decomposed into surfacelet transform domain to obtain multi-scale and multi-directional sub-band information. The edge features are then enhanced by filtering sub-band coefficients using local modified Laplacian operator. Second, surfacelet inverse transform is implemented and the reconstructed image is fed back to the input of PCNN. Finally, iteration process of the PCNN is carried out to obtain final segmentation result. The proposed algorithm is validated on the samples of public dataset. The experimental results demonstrate that the proposed algorithm has superior performance over that of the three-dimensional surfacelet transform edge detection algorithm, the three-dimensional region growing algorithm, and the three-dimensional U-NET algorithm. It can effectively suppress the interference coming from lung lesions and bronchial, and obtain a complete structure of lung parenchyma.
Algorithms ; Neural Networks, Computer ; Tomography, X-Ray Computed