Transjugular intrahepatic portosystemic stent shunt(TIPSS)was per- formed in 30 cases of liver cirrhosis with portal hypertention.Operations were susceeded in 29 cases with only one failure.Complications happened in 7 cases,In 29 patients the average blood bilirubin was 25.12?9.80 mmol/l before TIPSS turning to 50.46?34.50 mmol/l after TIPSS;The average blood amonia was 152.33?65.30 ?g/dl before TIPSS changing to 233.33?599.96 ?g/dl after TIPSS.The contributing factors were due to liver function state and shunting channel diameter for causing hepatic encephalopathy and jaundice.Other complications such as multipule liver abscesses,pneumonia,bacteriemia were related to the accompanied diseases and operative technique.The authors introduced the principles of pre- vention and treatment of complications,together with the indications and contraindications of TIPSS.

Objective:To explore the effect and mechanism of continuous dynamic pressure stress, which is produced by Swan-like shape memory connector(SMC), on osteopontin and osteonectin mRNA expression during experimental fracture healing.Methods: Bilateral humeral diaphyses of 30 adult rabbits were osteotomized in the middle and then 1 humerus was randomly chosen for internal fixation with SMC and the contralateral side was fixed with 4-hole dynamic compression plate(DCP). Six animals were sacrificed at 2, 7, 14, 28 and 56 days after operation and samples from the fracture gaps were obtained. Histological observation and RT-PCR were employed to study the expression of osteopontin and osteonectin mRNA.Results: In terms of histology, the endochondral bone formation and callus remodelling took place earlier in fractures fixed with SMC than with DCP. Osteopontin and osteonectin mRNA expression levels peaked at 14 and 28 days after the fracture, respectively. There was a delay in the increase and decrease of osteopontin and osteonectin mRNA in DCP fixed cases. Conclusion: The persistent dynamic longitudinal pressure stress produced by SMC may promote the healing process of long bones.

Objective To observe the anesthesia effect and safety of different doses of midazolam on operation in patients with lung cancer , to explore the appropriate dose.Methods 60 cases with lung cancer were divided into observation group and control group according to the dosage of midazolam,30 cases in each group.Hemodynamic changes, recovery time, extubation time, pain score and the dosage of anesthetic drug in the two groups were observed.Results There was no significant differences in hemodynamic indexes of each time point of the two groups .Compared with control group, recovery time, extubation time, pain score, the dosage of propofol and remifentanil dosage in the observation group were significantly lower than that of the control group, the difference was statistically significant (P <0.05).Conclusion Select the 0.075 mg/kg midazolam for lung cancer operation before anesthesia induction can reduce the operation to patients stimulation, make the operation smoothly.

Antiretroviral therapy(ART)has been started in an increasingly earlier period in clinical practice.However,owing to the failure of immunological reconstitution or maintenance of latent HIV-1 reservoir in present antiviral treatment,interleukin-2(IL-2)is widely used as an adjuvant to ART with a view to intensifying immunological reconstitution and to activating latent HIV-1 infections.Some conclusions could be drawn as follows,1)IL-2 can extend the half-life of CD+4 T cells and increase the number of CD+4 T cells.2)Compared with ART alone,IL-2 and HAART combination can not reduce HIV-1 related opportunistic infection or death.IL-2 clinical usage is mainly focused on purging HIV-1 reservoir.3)IL-2 combined with ART could increase out flow rate of HIV-1 latent reservoir to reduce HIV-1 infected quiescent memory cells in peripheral circulation even to an undetectable level.4)IL-2 is supposed to be used periodically and for a long period of time.

Budd-Chiari Syndrome ; diagnosis ; diagnostic imaging ; Humans ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography

Objective Toexplore the findings of bile flow artifacts (BFA)on MR cholangiopancreatography(MRCP). MethodsEighty five patients with normal common bile duct (CBD)and 95 patients with dilated CBD who had MRCP examination were studied retrospectively. Findings of BFA on original thin images of MRCP were recorded. Date were tested by Chi-square test and Spearman ceefficient of rank correlation analysis. ResultsThe rate of BFA in CBD with normal group was 38. 8％ ( 33/85 ), in dilated group was 83.2％ (79/95), there was statistically significant difference between them( x2 ＝ 37. 512,P ＝ 0. 000). BFA was not observed when the diameter of CBD was no more than 4 mm. BFA was partly observed when the diameter of CBD was 4 mm ＜ ψ≤ 8 mm, single- string sign was predominant findings (52.6％ ,30/57 ). Three-string sign was predominant findings in CBD with slight-dilated group ( 85.7％,36/42). Multi-string sign was predominant findings in CBD with medium-dilated group (84. 6％, 22/26 ).There was statistically significant difference between each groups ( x2 ＝ 284. 561, P ＝ 0. 000 ).BFA had different manifestations with CBD of different diameter, there was relative between them ( r ＝ 0. 553, P ＝0. 000). ConclusionBFA can occur in CBD with normal diameter. CBD with dilated group has higher rate of BFA than CBD with normal diameter. Manifestations of BFA are relative with the diameter of CBD.

Objective To investigate the imaging characteristics of autoimmune pancreatitis (AIP)and its diagnostic value.Methods Imaging examinations and clinical data of 13 patients with AIP were reviewed retrospectively.Results All patients had enlargement of pancreas either diffusely ( n =11 ) or focally in pancreatic head ( n =2 ).The swollen pancreas was of homogeneous density on CT scan ( n =13 ),hypointense on T1-weighted images and mildly hyperintense on T2-weighted images in 4 patients.It was demonstrated as mild enhancement on artery phase of dynamic imaging and progressive enhancement on portal and delayed phase images.Capsule-like enhanced rim was presented around the pancreas in 9 patients.Stricture or obliteration of the common bile duct located in pancreatic head was found in 10 patients accompanied by intrahepatic bile duct dilation.Pancreatic duct was invisible on axial images in 11 cases.Among the 6 patients underwent MRCP,it was showed diffuse and irregular narrowing of the main pancreatic duct and stricture of common bile duct located in pancreatic head in 4 cases.ERCP showed diffuse and irregular narrowing of the main pancreatic duct in 7 cases.Extra-pancreatic lesion included veins around pancreas involvement in 8 cases;multiple low density renal lesions in 6 cases; retroperitoneal fibrosis in 2 cases; stricture of hilar duct,interstitial lung disease and ankylosing spondylitis in 1 case,respectively.Conclusions AIP shows some characteristic imaging features,and imaging examinations play an important role in the diagnosis of AIP.Recognition of extra-pancreatic lesions aids in the correct diagnosis of AIP.

Objective To investigate the feasibility of non-contrast-enhanced renal MR angiography (NCE-MRA) using time spatial labeling inversion pulse (Time-SLIP) technique,and to discuss the optimized inversion time (TI) and its relationship with age.Methods A total of 61 healthy volunteers were divided into two groups by age,22-50 years (n=32)and 51 80 years (n=29).All volunteers underwent 3.0T MRI examination with 6 different TIs sequences (1 200,1 300,1 400,1 600,1 600,1 700 ms).The vessel to-kidney signal ratio (VKR),grade of renal artery branches,grade of renal artery imaging quality were measured and analyzed.Results The VKR values were the highest at TI=1 500 ms in both sides ot kidneys.The scores of renal artery branches were gradually rising up but tending to be steady higher than 1 400 ms.Among all the subjects,the highest score of renal artery imaging quality was at TI=1 500 ms.In 22-50 years group,the highest score of renal artery imaging quality was at TI=1 500 ms.Meanwhile,the highest score was found at TI=1 600 ms in 51 80 years group.Moreover,the grade of renal artery imaging in the 22-50 years group acquired better scores compared to the 51 80 years group (all P＜0.05).Conclusion Time-SLIP technique is helpful to obtain renal MRA without contrast medium.The optimized TI value is 1 500 ms.Moreover,age can affect the optimized TI value.

[Objective]To evaluate the effect of continuous dynamic pressure stress on experimental humeral fracture healing and to explore the role of COX-2 /PGE2 /cAMP signaling pathway in healing promotion induced by the special biomechanical condition.[Method]A total of 120 New Zealand rabbits were divided randomly into three groups: Group A,unilateral humeral fracture was fixed with shape memory connector(SMC),producing axial continuous dynamic pressure stress on fracture gap.Group B,fixed with 4-hole DCP,and Group C,fixed with SMC and gavaged with aqueous suspensions of celecoxib(3 mg/kg/day) after fracture.COX-1 and COX-2 mRNA expressions in fracture gap were determined by real-time RT-PCR at 0,3,7,14,21,28 and 56 days after operation,as well as the contents of PGE2 and cAMP were measured by radioimmunoassay(RIA).Bone-specific alkaline phosphatase(B-ALP) activity was determined by measuring p-nitrophenol and osteocalcin concentrations were measured using enzyme-linked immunosorbent assay(ELISA) for serial collected blood samples.Callus specimens fixed by formalin were used for histopathological examination.[Result]The COX-2 mRNA levels normalized with GAPDH mRNA as well as the contents of PGE2 and cAMP showed significant difference along with the 56-day period and also between the two internal fixations.Histopathological observation and determination of serum biochemical markers of bone formation revealed that the endochondral bone formation and the callus remodelling took place earlier in Group A than in Group B.The accelerated healing process and increased serum values of the bone formation markers induced by continuous dynamic pressure stress of SMC were inhibited by celecoxib,a specific COX-2 inhibitor.[Conclusion]The persistent dynamic longitudinal pressure stress produced by SMC contributed to endochondral bone formation and callus remodelling,resulting in an acceleration of fracture healing,which was considered to be closely correlated with the COX-2/PGE2/cAMP signal transduction pathway.

Objective To evaluate superselective external carotid artery embolization before transnasal endoscopic resection in treating nasopharyngeal angiofibroma.Methods Superselective external carotid artery embolization was performed in 20 patients with nasopharyngeal angiofibroma one to three days before transnasal endoscopic resection was carried out.The clinical data,including the volume of blood loss during the surgery,the operative time and the complications,were retrospectively analyzed.Results Superselective external carotid artery embolization was successfully preformed in all 20 patients,which was followed by the transnasal endoscopic resection within 3 days.The average volume of blood loss during the surgery was 155 ml and the total time of operation was 75 minutes.Mild complications occurred in 6 patients after embolization,which were subsided after symptomatic management.No serious complications occurred after surgical resection.The mean hospitalization days of the patients were 3.5 days.Conclusion Preoperative superselective external carotid artery embolization of nasopharyngeal angiofibroma can markedly reduce the blood loss during surgical resection,apparently shorten the operative time and effectively lower the occurrence of complication after the operation.Superselective external carotid artery embolization combined with transnasal endoscopic resection should be regarded as an ideal therapy for nasopharyngeal angiofibroma.