Objective To evaluate the value of 320 row CT upper abdominal computed tomography angiography (CTA) in the follow up of transjugular intrahepatic portosystemic shunt(TIPSS) .Methods 21 cases after TIPSS therapy underwent upper ab-dominal CTA .Post-processing images ,including MPR ,VR ,MIP ,and CPR ,were used to determine the position and patency of the stent .The best images of the portal veins were obtained .Results Among the 21 cases ,CPR image clearly demonstrated endovascu-lar stent thrombosis in 3 cases(14 .29% ) with stent occlusion and 1 case(4 .76% ) with stent stenosis ;there were no stent stenosis or occlusion in 17 cases(80 .95% ) ,their CPR image showed the contrast agent was filled completely in the stent and no low-density thrombosis was found .The best phase of the portal vein was 45 s .Conclusion 320 row CT upper abdominal CTA can clearly dis-play the stent position and patency situation in patients ,therefore ,should be regarded as the first choice for the follow-up of patients after TIPSS therapy .

BACKGROUND:Genetic factors, environment, chronic infection, and autoimmune disorders are considered to be involved in the pathogenesis of ankylosing spondylitis. Genetic factors play an important role in the pathogenesis of the disease. Ethnic and regional diversity of differentialy expressed genes has become research hotspot because of family aggregation and ethnic diversity of ankylosing spondylitis.
OBJECTIVE:To screen differentialy expressed genes in Xinjiang Uygur and Han patients with ankylosing spondylitis by microarray screening and compare differences in gene expressions.
METHODS: Uygur and Han patients with active ankylosing spondylitis in department of rheumatology of our hospital were randomly colected with five patients for each. In addition, three healthy volunteers were selected as controls. RNA from peripheral blood was extracted and used for microarray hybridization after probe preparation to screen differentialy expressed genes in ankylosing spondylitis samples and the microarray results were verified by semi-quantitative RT-PCR analysis.
RESULTS AND CONCLUSION: Twenty differentialy expressed miRNAs were screened in Uygur and Han patients with active ankylosing spondylitis (P < 0.05). From relationship analysis of target genes and miRNAs, 15 target genes corresponding to the 79 miRNAs involved in human leucocyte antigens and interleukins which linked to human immunity system were found. These findings suggest that differentialy expressed genes can be screened from Uygur and Han patients with ankylosing spondylitis.

Background and purpose:Reasonable proportion with blood less than half of the surgical system, cancer patients during surgery prone to acute massive blood loss, this study aimed to investigate blood transfusion in the patients who diagnosed with cancer during operation in the Afifliated Tumor Hospital of Xinjiang Medical University, and in order to improve the intraoperative blood transfusion and make it more scientiifc and more reasonable.Methods:The patients who were taken selective operations and heterogenous blood transfusions in the Afifliated Tumor Hospital of Xinjiang Medical University from Oct. 2012 to Dec. 2013 were enrolled, and the clinical data were retrospectively surveyed and investigated.The intraoperative use of blood components and reasonableness in each department were analyzed.Results:The medical records of 299 blood transfusion receipts proportions of reasonable transfusion of RBC from department of gastrointestinal surgery, gynecology, orthopedics, hepatobiliary surgery, neurosurgery, urological surgery and thoracic surgery were 88.9%, 91.8%, 94.3%, 96.3%, 91.6%, 100%, 81.3%,respectively. And the proportions of reasonable transfusion of plasma were 86.2%, 71.8%, 96.4%, 78.4%, 100%, 100%, 87.5%, respectively. The proportions of low-volume blood transfusion and the combined transfusion of RBC and plasma were 62.5% and 43.2% in unreasonable blood transfusion.Conclusion:Except for the unreasonableness in very few departments, the intraoperative blood component transfusion is carried on fairly well. The medical staff still should be further trained in the appropriate use of blood and strengthened the knowledge on blood transfusion.

Objective To appraise the postoperative anti-reflux function of vertical esophagogastic valve-plasty anastomosis for cardiac cancer.Methods Forty patients with cardiac cancer were randomly divided into study group and surgery control group,with 20 patients in each group.The study group underwent vertical esopagogastric valve-plasty anastomosis,while the surgery control group underwent conventional esophagogastrostomy.Ten healthy volunteers were recruited as normal control group.A 24-hour esophageal pH monitoring and endoscopy check-up was carried out in all experimental subjects at 90 days postoperatively.Results All of the pH monitoring indexes in study and surgery control groups were higher than those in normal control group(P

Objective:To fabricate and to study the surface morphology and biological safety of a novel coating on microarc-oxidized titanium.Methods:The novel functional coating was fabricated by cross-linking the double-layer nanoparticles loading rhBMP-2 and SDF-1 with gelatin on microarc-oxidation coating on titanium implant surface.The surface topography was observed and optimized,and the biological safety of the novel coating was primarily evaluated by cell toxicity test,oral mucosa stimulation test and hemolysis test in vitro.Results:The novel functional coating possesses excellent morphology.The coating showed the cytotoxicity of score 1 and no mucous membrane irritation,the hemolytic rate of the coating was 4.6％.Conclusion:The coating possesses good morphology and biological safety.

Objective To evaluate risk factors of in-hospital mortality during extracorporeal membrane oxygenation(ECMO) support for those with refractory cardiogenic shock after aortic surgery.Methods Retrospective analyses were conducted for 35 patients using ECMO after aortic surgery at Beijing Anzhen Hospital,Capital Medical University from September 2009 to March 2016.Demographic characteristics,diagnosis,ECMO related data,including ECMO indication,operation,clinical parameters before and 24 hours during ECMO were collected to set up a database.The patients were divided into survival group and non-survival group according to the prognosis.The risk factors of mortality in hospital after ECMO were analyzed by multivariate logistic regression analysis regression.Results There were 35 adult patients who had received ECMO support with 32 male and 3female.All patients received veno-arterial ECMO (V-A ECMO).ECMO was successfully weaned in 22 patients (62.9％),and 18 patients(51.4％) survived.Multivariate logistic regression analysis revealed that high lactic acid levels at 12 hours after ECMO(OR =1.445;95％ CI:1.026-2.034) and multiple organ dysfunction syndrome(MODS,OR =10.412;95％ CI:2.246-70.798)(P ＜ 0.05) were independent risk factors of in-hospital mortality in adult patients undergoing ECMO after aortic surgery.Conclusion High lactic acid levels at 12 hours after ECMO and MODS were very important factors of patients undergoing ECMO after aortic surgery.The proper identification and management shall improve the prognosis of patients.

Background and purpose:Histological grade of DCIS is an important factor in the prognosis, high nuclear grade have higher inifltration trend and recurrence rate. This study aimed to evaluate the dynamic and morphological MRI charactristics of ductal carcinoma in situ (DCIS) of the breast, then analyze its relations with nuclear grade. Methods:Of the 94 patients, 97 lesions were proved DCIS by pathology. The morphology, maximum size, time-intensity curve of lesion were recorded or measured. Statistic was performed to identify MR imaging features that optimally discriminated HNG from non-HNG DCIS. Results:There were 49 non mass-like enhancement lesions, and 48 masses enhancement lesions. Among 49 non mass-like lesions, 29 were segmental enhancement (59.18%). Dynamic enhanced performance:50 exhibited plateau curves and 27 were washout curves. BI-RADS categories:22 BI-RADS 4A, 19 BI-RADS 4B, 29 BI-RADS 4C, and 27 BI-RADS 5. HNG lesions exhibited larger mean maximum lesion size (non-mass-like enhancement: P=0.01; mass: P=0.03), time- intensity curve was variable to approach signiifcance (P=0.01), and BI-RADS can help to discriminate the nuclear grade (P=0.02). There were no differences in lesion morphology (P>0.05). Conclusion:The preliminary ifndings suggest that DCE MR imaging features may aid in identifying patients with high risk DCIS.

Objective To detect the effect and mechanism of Cyr61 on the apoptosis of renal tissue caused by early stage of ischemic acute kidney injury (AKI). Methods 30 SD rats were randomized into 5 groups, including control group, AKI group, AKI+bicarbonate group, AKI+blank virus group, and AKI+over?expression Cyr61 virus group. After animal models were created for 2h, serum and renal tissue were collected from sacrificed animals. Expression level of TNF?α was determined by ELISA. HE staining was used to observe the histologic changes of renal tissues. The levels of NF?κB p65 and TNFR1 were measured by immunohistochemical method. RT?PCR and Western blotting assay were adopted to detect the mRNA and protein expression levels of NF?κB p65, TNFR1 and Caspase3. Results Compared with control group, AKI group, AKI+bicarbonate group, AKI+blank virus group, AKI+over?expression Cyr61 virus group had obvious kidney injury. The levels of TNF?α, the mRNA and protein expression levels of NF?κB p65, TNFR1 and caspase3 were markedly up?regulated. Over?expression of Cyr61 significantly attenuated the degree of pathological injury, numbers of apoptotic renal tubular epithelial cells and increased the degree of Scr. Although compared with other groups, the level of TNF?α in kidney tissue had no difference, there was obvious decreased protein level of NF?κB p65, while the increase of TNFR1 and Caspase3 protein was moderate. Conclusions During the early stage of AKI, over expression of Cyr61 could inhibit apoptosis, which may be related to the suppression of TNFR1 transcriptional expression and interference of TNF?αpathway. Its underlying mechanism therefore deserves further research.

Objective To assess the renal protective effects of triptolide treatment in type 2 diabetic rats and its possible mechanisms.Methods Wistar rats were randomized to receive following approach control (n=7),dia- betic model without treatment (n=7) and diabetic group treated with triptolide[200 ?g/(kg?d),n=7].Plasma glucose (PG),serum creatinine (Scr),total cholesterin (TC),triglyeride (TG),kidney mass (KM),index number of kidney hypertrophy (KM/body mass,KM/BM),and 24 hours urinary albumin (24 h UAL) were determined. The protein expression of monocyte chemoattractant protein-1 (MCP-1),osteopontin (OPN) and ED-1 in renal tissue were determined by immunohistochemical technique.The mRNA expressions of MCP-1 and OPN in kidney tissue were assessed by reverse transcription-polymerase chain reaction (RT-PCR).Results Elevated 24 h UAL was markedly attenuated by triptolide treatment [24 h UAL,triptolide:2.32?0.29 vs diabetic model group:3.89? 0.51 mg/mgCr,P

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.