ObjectiveTo investigate the feasibility and effectiveness of low central venous pressure (LCVP) in the operation of major hepatic resection.MethodsFourty-eight patients underwent major hepatic resection were randomized into two groups: LCVP and control group.In the LCVP group,CVP was maintained ≤5 cm H2O during the hepatic resection and then returned to normal after resection.In the control group,CVP was maintained normal between 6 -12 cm H20.The duration of hepatectomy,volume of blood loss,volume of blood transfused and renal function were compared between the two groups.ResultsFor the LCVP and control group,the time for hepatectomy was (45 ± 8 ) and ( 35 ± 5 ) min,respectively; the volumes of blood loss were ( 850 ± 160) and (436 ±280)ml,respectively; the blood loss during operation was (490 ± 130) and (270 ± 105 ) ml respectively.The differences were statistically significant (t values were 15.53,7.69 and 17.89 separately,P ＜0.05 ).No significant difference in the renal function was observed before and after the operation ( P ＞ 0.05 ).Conclusion Using LCVP technique during liver resection significantly reduced the operation time,blood loss and blood infusion.And there wa.s no obvious adverse effect on renal function.

Objective To study the effect of Polygonum Multiflorum Thunb(PMT) on learning-memory ability in rats with Alzheimer disease(AD) and its probable mechanism. Metheds Rats were trained by Y-maze and were detected its learning-memory ability before the rats received the injection of A?1-40. The rats were treated with different dosage of PMT after the model of AD was set up. The learning-memory ability and the levels of superoxide dismutase (SOD) and malondialdehyde(MDA) were detected. Results Compared with model rats, the rats treated by middle and high-dosage of PMT, the learning-memory ability of was better,the SOD activity of was higher and the MDA concentration of was lower (P

Glucocorticoid receptor (GR),a member of the steroid receptor superfamily,can mediate the signal pathway of ligands like glucocorticoids,regulate the transcription of target genes,and exert biological activity.GR is expressed in different degrees in three major kinds of urological malignant tumors including renal cancer,bladder cancer and prostate cancer.It also affects the metabolism of tumor cells,and is closely related to the occurrence,development and prognosis of tumors.GR provides an important clue for targeted therapy and endocrine therapy of urological malignant tumors.

Objective To explore the association between gene polymorphism of interleukin(IL)-4 C590T and serum level of IL-4 and atherothrombotic cerebral infarction(ATCI).Methods The gene polymorphisms of IL-4 C590T in 159 patients with ATCI and 151 normal control subjects were carried out by polymerase chain reaction(PCR)-restriction fragment length polymorphism(RFLP).The serum level of IL-4 in normal control group was determined with enzyme linked immunosorbent assay(ELISA) method.Results In the normal control group,the serum level of IL-4 in TT genotype[(31.85?5.68) pg/ml] was higher significantly than those in TC[(28.67?6.00) pg/ml] and CC genotypes[(20.98?0.99) pg/ml],TC genotype was higher significantly than CC genotype(all P0.05).Conclusions IL-4 590T allele is associated with higher level of serum IL-4.The C590T polymorphism is not associated with the incidence of ATCI.

Objective To study the effect of intervention on blood pressure and incidence of cerebrovascular diseases. Methods In 1987, two cohorts population were selected in urban areas of Changsha . One was intervention group , another was control group. Baseline blood pressure levels were investigated and the events of stroke were collected. Results After 14 years, the cumulative stroke events were 89 in the intervention group and 128 in the control group; the mean blood pressure increased with statistical significance in each group except diastolic pressure in intervention group, but the control group increased more significantly; the analysis of Kaplan-Meier displayed that the rate of non-stroke events were higher in intervention group than that in control group and the analysis of COX regression indicated that the risk for stroke-events were 1.4 times higher in control group. Conclusions The intervention of risk factors can delay the increase of blood pressure by aging and reduce the risk of stroke-events.

Objective To analyze the clinical characteristics and prognosis of 4 rare types of non -Hodgkin lymphoma(NHL)in children,and to discuss the progress in treatment.Methods Clinical data of 1 4 patients with rare types of NHL at Shanghai Children′s Medical Center,Shanghai Jiaotong University School of Medicine between January 2004 and December 201 4 were retrospectively analyzed,and their clinical features,treatment and prognosis were dis-cussed.Results Fourteen cases were reported including 6 subcutaneous panniculitis -like T -cell lymphoma (SPTCL),3 hydroa vacciniforme -like cutaneous lymphoma(HVLL),2 pediatric follicular lymphoma(PFL)and 3 ex-tranodal NK/T -cell lymphoma,and nasal type(ENKTL).Ten patients (71 .4%)primarily presented with skin lesions and underwent a long course of illness before they were finally diagnosed (the median was 1 0 months),71 .4%(1 0 /1 4 cases)of them associated with fever and 50.0%(7 /1 4 cases)with liver and spleen enlargement,and no evidence of central nervous system (CNS)and bone marrow (BM)involvement was observed,while 28.6% patients (4 /1 4 cases) had more than two lines′abnormalities in peripheral blood examination.Since there were no standard treatment guide-lines,most patients received CHOP (Cyclophosphamide +Adriamycin +Vincristine +Prednisone)and /or mature B -cell NHL -like therapy,and 50.0%(7 /1 4 cases)of them received interferon therapy in addition,while 1 patient re-ceived allogeneic hematopoietic stem cell transplantation after recurrence.The complete remission was achieved in 71 .4%(10 /14 cases)of all the patients.Two of them died,3 lost follow -up,and 1 relapsed.The 3 -year overall survi-val and event free survival rates were 0.84 and 0.57,respectively,after a median follow -up of 26 months (range 12 -64 months).Conclusions Pediatric rare types of NHL show atypical clinical manifestation,low incidence of CNS /BMinfil-tration and long course.It is hard to make pathological diagnosis and differentiation.It is also inappropriate to apply the commonly used staging system to these rare types of NHL.No standard treatment has been found by now.SPTCL,HVLL and PFL have relatively good outcomes when treated with mature B -cell NHL -type therapy plus interferon therapy.

Objective To evaluate the outcomes of mature B-cell acute lymphoblastic leukemia(mature B-ALL) and to assess the safety and efficacy of the treatment protocol.Methods From February of 2003 to December of 2012,15 children were diagnosed as mature B-cell acute lymphoblastic leukemia/lymphoma possible (mature B-ALL/NHLp) in Shanghai Children's Medical Center(SCMC) were enrolled,and they were treated with SCMC-mature B-ALL/NHLp-2003 protocol.All of the clinical characteristics,therapeutic effects and long-term outcomes were analyzed.The statistical data were processed by SPSS 21.0.Results The median age on diagnosis was 8.7 years (1 year and 5 months to 14 years and 4 months).Among them,4 cases presented with local mass including maxillofacial tumors,neck and abdominal mass.The others had systemic manifestations such as fever and pale face.These neoplastic cells retained the expressions of surface membrane immunoglobulin M,terminal deoxynucleotidyl transferase,Cμ,CD10,CD19,cCD79 a differently.Follow-up was updated to November 30,2013.The median follow-up period was 80 months (39-128 months).Theestimated 5-year event free survival rate was (80.0 ± 10.3) ％.According to univariate analysis,increased lactate dehydrogenase level (＞ 4-times the normal value),increased serum ferritin level (＞ 2-times the normal value),no small residual disease markers were indepen-dent poor prognostic factors(x2 =5.49,4.89,5.49,all P ＜ 0.05).Conclusions SCMC-mature B-NHL/ALLp-2003 protocol is feasible and safe for children with mature B-ALL/NHLp,but more sample cases need to be investigated.

Objective To evaluate the outcomes of children with stage Ⅳ malignant extracranial germ cell tumors. Methods Twenty-five patients were enrolled in the retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method with SPSS 13.0. Results Of the 25 children, there were 13 males and 12 females. The mean age at diagnosis was 2 years old (ranged 1 to 11). Five patients receiving chemotherapy in another hospital before (n=1), or giving up treatment after confirmed diagnosis (n=1), or giving up effective treatment after received less than 2 cycles (n=3) were excluded from this analysis. Of the 20 patients, 90.0% (18/20) achieved complete remission and 5.0% (1/20) achieved partial remission after treatment. The 5-year EFS rate and 5-year OS rate were 70.0%±10.2% and 82.4%±9.2% respectively. There was no death occurred due to complications. Conclusions The effect of this treatment program is positive. The cumulative dose of the drugs is not high, compared with other schemes such as PEB, but there are more drugs involved. Whether these drugs may cause long-term adverse reactions needs further research.

BACKGROUND: Ultra-high molecular weight polyethylene (UHMWPE) is widely used as acetabulum. The hip joint will produce lots of grind particles and lead to loosening of artificial joint because of alternating load and bad lubricate condition.OBJECTIVE: To learn about the lubricate mechanism of joint, introduce the present situation on artificial hip joint of UHMWPE including wear behavior and wear resistance properties, and grope for scientific evaluate method of tribological properties in artificial joints.RETRIEVAL STRATEGY: The articles published between January 2000 and October 2007 were searched by using computer with the key terms "hip joint, ultra-high molecular weight polyethylene, tribology" in CNKI, Weipu Science and Technology Database, Wanfang Database, and its language was limited to Chinese. Meanwhile, the English articles were searched in IEEE/IEE Electronic Library and Elsevier Electronic Journal Database with the key terms "hip simulators, ultra-high molecular weight polyethylene, tribology ". Those referring to the friction and wear property of the joints were included, whereas repeated researches were deleted.LITERATURE EVALUATION: Totally 729 articles were received. After the primary screening of the titles and abstracts, 601 repeated or similar researches were excluded, and other 128 articles were adopted for further analysis, finally 22 articles in accordance with the inclusion criteria were included as references.DATA SYNTHESIS: The study about UHMWPE focused two points, one is surface modification, the other is wear and friction mechanism.①The study indicates that wear properties of UHMWPE can be improved by surface modification, such as ion implantation and nanometer padding have a remarkable elevating ability of the wear and mechanical properties.②At recent years, scholars do many basal experiences about the tribology of hip joints, and have approved that wear rate of friction pairs would reduce under biological lubricate condition using artificial joint simulators or traditional tester in various conditions.CONCLUSION: The study about hip joint in China drops behind the developed counties, this traditional method can not really reflect wear and friction properties in vivo. Therefore, the following research should include making clear the relationships of load, environmental condition and wear of artificial joint in vivo, as well as groping for a scientific evaluate method of tribological properties in hip joints.

Objective The purpose of this study was to assess the value of serial sectioning and immunohistoehemistry(IHC)for the diagnosis of senfinel lymph node(SLNs)metastases in patients with breast cancer,and to evaluate the significance of mierometastases and isolated tunlor cells(ITCs)in the SLNs. Methods Eighty pailents with clinically node-negative breast cancer underwent SLN biopsy with both99mTc-labeled sulfur colloid and iBosulfan blue dye for SLN identification.All SLNS and non-SLNs were evalnated with standard H&E stain and IHC analysis. Results SLNs were successfully identified in 78 of 80 patients(97.5%),the isotope/blue dye concordanee rate was 76.5%for all SLNs.Thirty two patients (41%)had histologically positive SLNs,and 13(40.6%)of these patients hod SLNS with micrometastatic disease.In 14(43.8%)of these patients,the SLNs were the only nodes involved.The sensitivity,specificity and accuracy of SLN biopsy in predicting axillary node stams were 96.9%,100%and 98.7%,reslaeetively.Patients with positive SLNs metastasis had a markedly higher proportion of non-SLNs metastases compared with those with only micrometastasis in the SLNS(78.9% vs 23.1%). Conclusions Serial sectioning and IHC ale sensitive methods for detecting breast cancer metastases in SLNS.The incidence of non-SLNs metastases is rather low in patients with SLNs that contain only micrometsstatic foci and ITCs.The prognostic significance and effect on surgical management of these occult disease have yet to be determined.