Objective To investigate an effective method of autologous arteriovenous fistula formation for the elderly uremic patients with diabetic nephropathy.Methods The nest in the elbow above the median cubital vein at the curved incision 1-2 cm,inline high Fistula,namely arm cephalic vein and brachial artery bifurcation of the upper portion of the distal radioulnar side anastomosis in 20 cases over 75 years elderly uremic patients with diabetic nephropathy.And compared the effect of 16 cases of patients with similar conventional fistula.Results Twenty cases over 75 years elderly uremic patients with diabetic nephropathy were successful in all high dynamic fistula intravenous,blood flow was (1 007±131) ml/m,the immediate opening rate of 16 patients similar to conventional instant fistula was 12.5％,and a year after the opening rate was 6.25％ Conclusion High fistula are more easy to shape conventional,easy mature,full blood flow characteristics comparing with commom fistula,so elderly uremic patients with diabetic nephropathy fistula making difficult situation has been effectively improved.

Objective To investigate the changes of clinical symptoms and liver or lung functions after inferior vena cava stent implantation in Budd Chiari syndrome patients. Methods 35 cases of Budd Chiari syndrome patients were enrolled and retrospective analysized, such as ascites, edema of lower limbs, abdomen wall of varicose veins and serum total bilirubin, serum albumin, prothrombin time, FVC, MVV, PEF, FEV1.0, FEV1.0/FVC and other pulmonary functional changes were analyzed before and 1 months after inferior vena cava stent implantation. Results Ascites, edema of lower limbs, abdominal varicose veins and other clinical symptoms were significantly reduced or disappeared, the total serum bilirubin significantly decreased, serum albumin significantly increased, and prothrombin time significantly reduced 1 month after surgery in patients with Budd Chiari syndrome, (t = 1.95, 2.31, 2.07, P < 0.01). FVC, MVV, PEF, FEV1, the indexes of FEV1/FVC improved obviously after surgery (t = 1.83, 2.69, 1.47, 1.69, 1, 97, P = 0.041, 0.029,0.046, 0.043, 0.043, 0.038). Conclusion Inferior vena cava stent implantation could effectively improve the clinical symptoms of patients with Budd Chiari syndrome.

Objective To study the significance of protein tyrosine phosphatase (SHP2)expression in bac-terial meningitis.Methods 90 rats were divided into meningitis group (72)and healthy controls (18)two groups based on the random number table,The SHP2 expression in rat brain tissue at different time points of meningitis group and healthy control group were tested by reverse transcription (RT)a PCR,Western blotting,immunohistochemical methods,then the relationship between SHP2 protein expression and tumor necrosis factor-α(TNF-α),white blood cell (WBC)counts were observed and analyzed.Results The cortical SHP2 mRNA expression of meningitis rat in-cluding (0.035 ±0.020),(0.200 ±0.049),(0.129 ±0.032)and (0.057 ±0.039),were significantly higher than those of the healthy control group (0.031 ±0.028)(F=12.74,P<0.05);the third periventricular SHP2 positive cells were significantly more than those of the healthy control group (χ2 =5.02,P<0.05);the correlation coefficient of cortical SHP2 protein expression and concentration of CSF TNF -α,the correlation coefficient of cortical SHP2 protein expression and WBC counts were respectively 0.08(P>0.05)and 0.77 (t=4.303,P<0.05).Conclusion SHP2 participates in pathophysiology of bacterial meningitis,the main role may be in suppressing inflammation and repairing inflammatory response,it can be used as a reference indicator of condition changes.

Objectives: To study the treatment outcome of mucoepidermoid carcinoma(MEC).Methods:128 cases of MEC with definite pathologic diagnosis treated in our hospital during the past 15 years were investigated. The relationship between the effects of the therapy and the prognosis was analysed.Result:Treatment with surgical operation only was used in 99 cases,radiotherapy after operation was applied in 26 cases and follow-up was carried out in 76 cases. 5-year survival rate was 90.7%.5 patients who died within 5 years after operation were all with the diagnosis of MEC in clinical stage Ⅳand poor differentiaton.Conclusion:The local extensive excision for the well differentiated MEC,the radiotherapy after operation for poorly differentiated or that of clinical stage Ⅳ,especially in maxilla,may increase 5-year survival rate.Since there were cases of recurrences of MEC 13 years after surgical treatment,long-term follow-up is necessary.

Objective To construct short-hairpin RNA (shRNA) eukaryotic express vectors targeting of insulin like growth factor-1 receptor (IGF1R) gene, and to explore the changes of adhesion, invasion and FAK protein expression of MHCC-97 H hepatocellular carcinoma cells with RNA interference. Methods The shRNA oligonucleotide fragments were designed and synthesized based on the sequence of IGF1R mRNA. Double strands were formed after annealing and inserted into pGCsi-U6-Neo-GFP vector. The recombinant was transformed into Stable 3, then plasmids were extracted and identified by restriction enzyme and sequencing analysis. The most effective vectors were selected by RT-PCR and Western blotting after transfecting 293T cells. The best one was used to transform MHCC-97H cells which were selected with G418 to obtain positive colons. The changes of adhesion, invasion and FAK protein expression in MHCC-97H cells were studied. Results The restriction enzyme analysis and sequencing analysis demonstrated that shRNA had been inserted into vectors, and their sequences were the same as the design. It was indicated by RT-PCR and Western blotting that the silencing efficacy of IGF1R was 88%. The ability of adhesion and invasion significantly decreased after IGF1R silencing in MHCC-97H cells, and so was the expression of FAK protein. Conclusion IGF1R pGCsi-U6-Neo-GFP shRNA can significantly decrease the abilities of adhesion and invasion in MHCC-97H cells, and inhibit the expression of FAK protein.

Objective To improve the accuracy of diagnosis of the greater omentum blunt trauma(GOBT)by analyzing the MSCT findings and pathological features.Methods The MSCT appearances of 5 1 cases of GOBT with operation and (or)pathological con-firmed were analyzed retrospectively.All patients were underwent MSCT plain scan in whole abdomen.Two experienced radiolo-gists blinded to the clinical diagnosis,reached a diagnosis from the MSCT findings by two ways of plain and plain joint post-process-ing MSCT images.The detection rates of GOBT were compared by two-related-samples Fisher exact probability chi-square test.Re-sults Fifty-one cases of GOBT were distributed over the intestine,in the superior abdominal cavity,the left and the right abdominal cavity,those cases were 27,18,3 and 3 respectively.The MSCT findings of GOBT mainly consist of greater omentum(GO)streak-ing,GO hematoma and fluid around GO.Those detectable rates were 80.3%,68.6%and 90.2 % respectively.The accuracy in di-agnosis of GOBT with MSCT was 94.1%(48/51)in our study.The detection rate of GOBT by two ways was significant (P=0.04).The detection rate of GOBT was increased obviously by the way of plain joint post-processing MSCT images.Conclusion MSCT manifestations of GOBT has some characteristics.A more accurate diagnosis of GOBT could be made according to the MSCT findings by plain joint post-processing MSCT images.

ObjectiveTo explore adrenal insufficiency in the preterm infants who had critical lung diseases and the relationship between adrenal insufifciency and long-term or short-term prognosis.Methods The basal cortisol and ACTH of iffty preterm infants enrolled were tested. The peak cortisol at 30 minutes after low dose ACTH stimulation was tested. The adrenal insufifciency was deifned as the concentration of the basal cortisol less than 15 μg/dl or the increment of cortisol concentration after low dose ACTH stimulation less than 9 μg/dl. The pretern infants with adrenal insufifciency were the AI group and others were the adrenal normality, AN group.Results Thirty-one cases were adrenal insufifciency in 50 preterm infants with critical lung disease. The incidence was 62%. The concentrations of the basal and peak cortisol in AI group were lower than those in AN group (P<0.01). The increment of cortisol concentration after low dose ACTH stimulation had not signiifcant difference between two groups. The concentration of ACTH in AI group was lower than that in AN group (P<0.01). The mean arterial blood pressure in AI group was lower than that in AN group (P<0.01). The blood sugar, potassium and sodium had no signiifcant difference between two groups (P>0.05). There was no signiifcant difference in the mortality and the incidence of BPD between two groups (P>0.05).Conclusions The incidence of adrenal insufifciency was high in the preterm infants with critical lung diseases, which may be due to insufifcient production of endogenous ACTH. When the adrenal insufifciency was happened, the blood pressure is relatively low in preterm infants with critical lung diseases, but it was not related to the mortality and the incidence of BPD.

objective: To develop injectable tissue engineered bone through injection of osteoblasts/alginate composite in rabbits. Methods: Bone marrow cells isolated from iliac bone of New Zealand rabbits were cultured and induced to differentiate into osteoblasts.The osteoblasts were mixed with 25 g/L sodium alginate solution to generate osteoblasts/alginate composite with final cellular density of 5?10 6/ml. 0.17 g of sterilized CaSO 4 powder was then added to 2 ml osteoblasts/alginate. The mixture was injected into the dorsal subcutaneous tissue at left side of 6 New Zealand rabbits. The alginate composite without osteoblasts was injected into the right side as the control. 4 and 8 weeks after implantation, the bone formation was evaluated by means of gross, X ray and histological observation. Results: 4 weeks after implantation, cartilage formation was observed and 8 weeks after implantation,new mature bone was observed in the osteoblasts/alginate composites. No new bone formation was observed in all of the control specimens. Conclusion: Calcium alginate can be used as a carrier in injectable bone tissue engineering, and new bone can be created through injection of osteoblasts/alginate composites in immune animals.

Objective To evaluate the efficacy and safety of interventional occlsu ion operait no by analyizn g thes urgical data of 23 csa es of infants with patent ductusa rteriosus complicated with middle and severe pulmo an ry arterial hypertension.Methods Teh 23 cases of infants wiht patne t ductus arteriosus com-plicated with middlea nd severe pulmonary arterial hypertensionw ere collected in the hospital from January 2011 to December2014 .These infatn s rce eived transcateh ter occlusion with intravenuo s anesthesia after the preoperative examination.The operation procse s included:right ventriculography and pulmonary atr ery pressure tested,then lateral angiogar phy of descending aorta was performed to observe the type and size of patent ud ctus atr eriosus and measure ascending aorta,descending aortic pressure,and recorded the pressure re-spectively.1 ml blood sample of ascending aorta,pulmonary artery and inef rior vena vein respectively was used for gas analysis.All these data was used to calculate pulmonary vascular resistance.After tried to plug-ging effectiveyl we can release the occluder.In the postoperative 24 h,1 month,3 months,the infants should be measured with Doppler echocardiography,chest X ray and electrocardiogram examination.Results The clinical symptoms disappeared and the short-term follow-up was not associated with the complications of interventional therapy.Th e comparison of the pressure changes before and after the operation were performed as following, aortic per ssure decreased [ preoperation ( 68.3 ±17.5 )/( 21.4 ±3.7 ) mmHg, postoperation (52.4 ±8.7)/(15.6 ±3.5) mmHg,1 mmHg=0.133 kPa],ascending aorta pressure increased(preoperation (83.5 ±5.9)/(51.3 ±3.6) mmHg,postoperation(88.2 ±5.1)/(52.4 ±2.7) mmHg),and descending aorta pressure increased ( preoperation ( 81.4 ±3.3 )/( 48.2 ±2.7 ) mmHg, postoperation ( 86.5 ±4.7 )/(51.5 ±3.2) mmHg), the differences were statistically significant before and after surgery ( t =5.455/3.945 ,P<0.01;t=-2.696/-1.193 , P<0.05; t=-4.167/-3.745 , P<0.01 ) .Conclusion Under conditions of mastering the appropriate operation time and strengthening the management of the perioperative management,transcatheter measurement is safe and effective for infants with patent ductus arteriosus compli-cated with middle and severe pulmonary arterial hypertension.

Background and purpose:There is growing evidence that metformin,a commonly used drug in the treatment of type Ⅱ diabetes,may impede the growth of human tumors.However in a recent study it was found that metformin treatment might result in promotion of the angiogenic phenotype and increase tumorigenic progression.In this study we investigated the effects of metformin on the migration and invasion abilities of human lung adenocarcinoma cell line A549 in vitro and explored the possible underlying mechanisms.Methods:A549 cells were treated with 0.5,2 and 8 mmol/L metformin for 72 hrs.The laterad-migration and invasion abilities of the cells in vitro were measured by scratch assay and Boyden-Chamber assay,respectively.Expressions of MMP2 and MMP9 mRNA of the cells before and after metformin treatment were measured by Real-time PCR.Results:The migration rate of A549 cells was increased after treated by metformin at the concentration of 8 mmol/L.The invasion ability was also signifi cantly increased by 8 mmol/L metformin treatment from 37.4?4.6 to 59.8?7.2(P