0.05).[Conclusion]Composite of heterogeneous deproteinized bone+autogeneous MSCs+rhBMP2 has the same ability of autogeneous bone graft to repair big experimental segmental tibia defect,thus it can be used as a scaffold in tissue engineering and for further study of immunogenicity and ossification ability.

Budd-Chiari syndrome (BCS) is a rare disease. Because of lack of clear characteristic symptoms in the early stage, many patients are misdiagnosed or never diagnosed. Early diagnosis and prompt treatment play a key role in improving survival rates and quality of life for BCS patients. With the progress in imaging techniques, the radiological examination is playing more and more important role in the diagnosis and assessment of BCS. Ultrasound, computed tomography, magnetic resonance imaging and digital subtraction angiography are all helpful in evaluating the obstruction of hepatic vein and inferior vena cava. Thus, these imaging tests should be used rationally according to their features. On the other hand, the interventional therapy is the preferred method for the treatment of BCS. This paper intends to get a deeper understanding of BCS for clinicians, which is essential for patients to be diagnosed in time.

Objective To compare the clinical value of three-dimensional dynamic contrast enhanced magnetic resonance angiography (3D DCE MRA) and digital subtraction angiography (DSA) in diagnosing inferior vena cava diseases in suspected case of Budd-Chiari syndrome (BCS).Methods Radiological findings of 91 suspected BCS cases obtained from 3D DCE MRA and DSA in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.DSA test was considered as golden standard,which assess the capacity of 3D DCE MRA in diagnosing inferior vena cava diseases,including sensitivity,specificity and accuracy.Kappa test was utilized to compare the coincidence ratio of 3D DCE MRA and DSA in diagnosing inferior vena cava diseases.Results Among 91 suspected BCS cases with 3D DCE MRA,a total of 17 cases without inferior vena cava diseases were misdiagnosed as inferior vena cava stenosis,two patients with inferior vena caval obstruction was misdiagnosed as falsely negative.Seventy-two patients with 3D DCE MRA were confirmed via DSA in diagnosing inferior vena cava diseases,sensitivity was up to 97.7％ (58/60),false positivity 54.8％ (17/31),specificity 45.2％ (14/31),respectively.Fair coincidence ratio of 3D DCE MRA and DSA in diagnosing inferior vena cava diseases (Kappa =0.474,P ＜ 0.05).Conclusions There could be clinical value of 3D DCE MRA for its high sensitivity and low specificity in diagnosing inferior vena cava diseases,and favorable coincidence ratio was discovered between 3D DCE MRA and DSA.Comprehensive consideration is needed for suspected cases of inferior vena cava stenosis detected by 3D DCE MRA,and further analysis may figure out potential causes of misdiagnosis and decline false positive events.

Objective To explore the application value of CT perfusion imaging for predicting the tiny lymph nodes metastasis and micrometastasis of squamous cell carcinoma in cervix after neoadjuvant chemotherapy.Methods The clinical data and CT perfusion parameters of 46 patients with cervical squamous cell carcinoma who underwent neoadjuvant chemotherapy followed by surgery were enrolled in the study.Based on the surgical pathology findings and short-term follow up,the cases were divided into without tiny lymph nodes metastasis (short axle diameter of lymph nodes＜10 mm) group (n=32) and with tiny lymph nodes metastasis group (n=14).All perfusion data were analyzed retrospectively and the diagnostic value were investigated.Results Blood flow (BF),blood volume (BV) and the maximum diameter of tumor per-chemotherapy in with tiny lymph nodes metastasis group were higher than those in without tiny lymph nodes metastasis group (all P＜0.05).The differences of the maximum diameter of tumor after chemotherapy,permeability,time to peak (TTP) between two groups were not statistically significant (all P＞0.05).Multivariate Logistic regression analysis showed BF and the maximum diameter of tumor per-chemotherapy were independent predictors of the tiny lymph nodes metastasis in cervix after neoadjuvant chemotherapy.ROC showed BF (AUC=0.86,P＜0.001,95％CI [0.75,0.96]) had higher predictive value than maximum diameter of tumor per-chemotherapy (AUC=0.70,P=0.02,95 ％ CI [0.54,0.88]).Conclusion CT perfusion imaging shows the significant predictive value for the tiny lymph nodes metastasis of squamous cell carcinoma in cervix after neoadjuvant chemotherapy.

OBJECTIVE:To investigate the perioperative use of antibiotics in patients undergoing colorectal operations. METHODS:The medical records of 213 patients undergoing colorectal operations in 2006 were randomly selected from the gastrointestinal surgery department of our hospital and divided into type Ⅰ operation group and type Ⅱ operation group accord-ing to patients’ operation time and wound contamination.The kinds and medication duration of antibiotics used before,during and after operation were investigated,and the postoperative infections were analyzed.RESULTS:The preoperative preventive medication were all conducted within the first 1～3days,and the dosage schemes were unified with aminoglycosides and metronidazole topping the list.The antibiotics used during operation were all in single dose,with 3rd generation cephalosporins combined metronidazole predominantly used.Postoperative use of antibiotics was somewhat complicated:type Ⅰ operation patients were treated more often by 2 kinds of antibiotics concurrently for 3～7days and type Ⅱ operation patients were treated more often by 3 kinds of antibiotics concurrently for at least 6～7days.The incidence of postoperative infection was 3.4% in type Ⅰ operation patients as compared to 11.6% in type Ⅱ operation patients,showing significant differences between two groups.CONCLUSION:The perioperative application of antibiotics in patients undergoing colorectal operation was reasonable on the whole,with 3rd generation cephalosporins plus metronidazole predominantly used,but there were some problems in the postoperative medication.

Objective To study the clinical significance of the caudate lobe vein in patients with Budd-Chiari syndrome (BCS) by contrast-enhanced magnetic resonance imaging(MRI).Methods Contrast-enhanced MRI data of 46 patients with BCS, 30 patients with cirrhosis due to hepatitis B virus (HBV) and 49 healthy people in our institution were analyzed retrospectively.The presence and diameter of the caudate lobe vein among the three groups were measured.Among the BCS group, in which the caudate lobe vein could be seen, andpatients were divided into two groups according to disease duration and patency of inferior vena cava (IVC), respectively.And comparative study of diameter between two groups was performed.Results ①The caudate lobe vein was noted in 76.1% of patients with BCS, in 30.0% of patients with cirrhosis due to HBV,and in 36.7% of healthy subjects.The diameter of caudate lobe vein in BCS group was larger than that in both cirrhosis group and healthy group(P<0.01).There was no statistically difference between cirrhosis group and healthy group(P>0.05).②Among BCS group,the caudate vein was shown in 35 patients, with mean diameter of(4.21±1.66)mm.For 35 BCS,the diameter of caudate lobe vein in chronic group was larger than that in acute group(P<0.05).The diameter of caudate lobe vein in IVC obstruction group was larger than that in IVC open group(P<0.05).Conclusion The demonstration of the caudate lobe vein on contrast-enhanced MRI is of great significance in the diagnosis and treatment of BCS.

Objective To observe the effects of basic fibroblast growth factor on c-fos gene expression in spinal cord neurons of rats after tractive spinal cord injury. Methods The animal model of SD rats with tractive spinal cord injury was established through tracting T_ 13-L_2 spine longitudinally with a special spinal tractor that was put on parapophysis of T_ 12-L_3 vertebrae after exposing T_ 13-L_2 spinal cord via dual laminectomy, meanwhile spinal cord function was monitored by cortical somatosensory evoked potential (CSEP). Forty model rats were randomly divided into 2 groups, the bFGF treatment group (n=20) with bFGF injection into the subarachnoid cavity and the control group (n=20) with saline injection. Five SD rats without any treatment served as normal control. The c-fos gene expression was detected with immunohistochemistry and analyzed quantitatively with image system of computer. Results The c-fos gene expression in tractive spinal cord injury was higher than that in normal control group, especially increased markedly in damaged neurons. The peak value of c-fos gene appeared in 2 h after the injury, but c-fos level in the bFGF treatment group was lower evidently than that in the control group at the different sacrificed time (P

Objective To observe the effect of basic fibroblast growth factor on ChAT expression in neurons after tractive spinal cord injury in rats.Methods The animal model of tractive spinal cord injury in 36 SD rats was established.The bFGF-treated rats(n=18) received 20 ?l bFGF solution containing 20 ?g bFGF into subarachnoid cavity immediately,or at 1,2,3,4,8,12 and 24 h after animal model establishment,while the saline-treated rats(n=18) received the equal volume of normal saline at the same time.Another 6 normal SD rats underwent no treatment as normal controls.All rats were killed on postoperative day 4,7,14.The choline acetyltransferase(ChAT) were detected by immunohistochemistry preoperatively and on day 4,7,14 after spinal cord injury.Results The number of neurons positive of ChAT decreased gradually after tractive spinal cord injury.After bFGF treatment,positive neurons of ChAT increased in number,with significant difference between the bFGF-treated group and saline-treated group(P

Objective To investigate the difference of colon length between patients with intractable constipation and normal peo-ple.Methods 40 patients with intractable constipation and 35 cases of normal control group received air enema CT scan,post-pro-cessing techniques-curved planar reformation and volume rendering were used to measure the length of colon.Results Colon length of normal people and constipation patients were (1 230±33)mm and (1 605±47)mm,respectively.There was significant difference between normal people and constipation patients (t=163,P=0.015).Conclusion CT air enema technique can be used to measure the length of colon obj ectively for diagnosing and treating redundant colon.

Septic shock is a serious stage of sepsis with a hospital mortality rate of more than 40%. The pathophysiology of septic shock is vasodilation and increased permeability. Fluid resuscitation, vasopressor drugs are usually used to maintain the perfusion pressure of the main organs. However, infectious patients usually have the irresponsive vessel to catecholamines and may lead to obvious side effects using high doses of norepinephrine or dopamine. Recent studies have shown that vasopressin (AVP) improves hemodynamics, increases tissue perfusion, and synergizes with norepinephrine in patients with septic shock, showing extent application prospects in the treatment of septic shock. The practice of AVP in septic shock is reviewed in this article in order to provide a reference for clinicians.