Objective To analyse the effect of different blood purification methods on serum cardiac troponinc T (cTnT), cardiac troponinⅠ(cTnI), β2-microglobulin (β2-MG) and interleukin-6 (IL-6) levels in patients with maintenance hemodialysis.Methods 60 uremic patients treated with maintenance hemodialysis were collected.All patients were randomly divided into conventional hemodialysis group (HD group) , hemodialysis and hemoperfusion group (HD+HP group) and hemodiafiltration group (HDF group) , 20 cases in each group.Corresponding dialysis treatment was given, then the serum levels of cTnT, cTnI,β2-MG and IL-6 were detected in all patients post-treatment.Results After treatment, the serum cTnT, cTnI,β2-MG and IL-6 levels in HD+HP group and HDF group were lower than those in HD group (P<0.05).Conclusions Different blood purification methods have different effects on serum cTnT, cTnI, β2-MG and IL-6 levels in patients with maintenance hemodialysis, HDF and HD +HP have better scavenging effect, which has the guiding significance to clinical application.

The present paper is a morphological description of the chromosomes of the mouse, Mus musculus, based on the observations of the metaphase chromosomes of both bone marrow cells and spermatogonial cells. Chromosome morphology is found to be essentially the same as those described by the previous investigators. The systematic measurements of the chromosomes have also been presented.

The iatrogenic splenic injuries occurred in 49 patients who underwent abdominal surgery from January 2005 to January 2020; including grade I injury in 40 cases and grade Ⅱ injury in 9 patients. The normal saline-soaked gauze was placed on the wound surface of the injured spleen, then the high-frequency electric coagulator was employed for hemostasis. The bleeding was successfully stopped and the spleens were preserved without postoperative complications in all cases. The results show that moist electrothermal coagulation can be effectively and safely applied in treatment of grade I and grade Ⅱ injury iatrogenic splenic injuries, and no special equipment required.

A total of 521 patients underwent laparoscopic radical gastrectomy from January 2013 to January 2020 in the First People′s Hospital of Wenling. In 242 cases the splenomental fold was severed before dissecting the left half of omentum or spleen (pretreatment group), and in 279 cases the splenomental fold was not severed priorly (routine group). For pretreatment group the introoperative splenic injury occurred in 4 cases (1.65%), including 3 cases (1.24%) with class Ⅰ injury and 1 case (0.41%) with class Ⅱ injury; while for routine group splenic injury occurred in 24 cases (8.60%), including 22 cases (7.89%) with class Ⅰ injury and 2 cases (0.72%) with class Ⅱ injury, and the rupture of splenic capsule caused by tracting splenomental fold occurred in 19 cases(6.81%). There were significant differences in total number of splenic injuries, splenic injuries with class Ⅰ and rupture of splenic capsule caused by tracting splenomental fold between two groups ( P<0.05). The operation time of 28 cases with splenic injuries was (185±89) min, which was longer than that in 493 cases without splenic injuries [(172±95) min, P<0.05]. The results show that rupture of splenic capsule by tracting splenomental fold is main cause of splenic injury in laparoscopic radical gastrectomy and most of them are class Ⅰ injuries. To sever the splenomental fold priorly can reduce the incidence of iatrogenic splenic injury.

OBJECTIVE:To investigate the clinical characteristics and gene polymorphism of oxcarbazepine (OXC)- induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). METHODS:Retrieved from CNKI,Wanfang,VIP, PubMed,EMBase,SpringerLink and other databases,case reports about OXC-induced severe ADR were summarized and ana-lyzed. RESULTS:Twelve literatures were collected,and 13 case reports about OXC-induced SJS/TEN were obtained. Male had more OXC-induced severe skin ADR than female. ADR mostly occurred during 1-14 d after medication. All patients were cured with treatment of glucocorticoid and antiallergy,without death case. Genotyping for 8 patients were performed and 6 of them showed the presence of HLA-B*1502 allele. While HLA-B alleles of 2 patients were HLA-B*1518/B*4001,which was the variation of HLA-B*1502. CONCLUSIONS:OXC-induced ADR should be monitored closely. Great importance should be attached to patient education and follow-up program. HLA-B*1502 gene detection should be performed to guide rational use of OXC and optimize clini-cal drug use plan.

Objective To explore the methods of improving diagnosis correctness between the patients with prostate cancer and benign prostatic hyperplasia.Methods Totally 87 patients with benign prostatic hyperplasia or prostate cancer which confirmed by MRI and prostate biopsy for the PSA significantly increased in our hospital from July 2013 to March 2016 were collected.By using the three methods of the PI-RADS V2 score,the T2WI+DWI/ADC+DCE-MRI+MRS and PI-RADS V2 score+MRS to diagnose,and comparing with the pathology results,the diagnostic consistency of the two physicians were analyzed.The sensitivity,accuracy and specificity of three ways were compared,and the correlation between PI-RADS V2 score and Gleason score were calculated.Results The diagnostic consistency of the two physicians:PI-RADS V2 score,K=0.951;T2WI+DWI/ADC+DCE-MRI+MRS score,K=0.838;PI-RADS V2+MRSI score,K=0.937.The correlation between PI-RADS V2 score and Gleason score,r=0.871,P=0.001 4;diagnostic sensitivity,specificity and accuracy of PI-RADS V2 score were 77.3％,74.4％,75.9％;diagnostic sensitivity,specificity and accuracy of T2WI+DWI/ADC+DCE-MRI+MRS were 88.6％,76.7％,82.8％;diagnostic sensitivity,specificity and accuracy of PI-RADS V2+MRSI score were 86.4％,81.4％,83.9％,respectively.Conclusion Compared with the traditional diagnostic methods,the combination of new prostate report and data system and MRSI can improve the diagnostic accuracy of prostate cancer and benign prostatic hyperplasia.The PI-RADS V2 score is more objective and accurate in the description of the lesion,but the low signal of benign hyperplastic nodules in transitional zone should be dialogued carefully through a variety of image parameters.

ObjectiveTo investigate the efficacy of different methods of anesthesia for laparoscopic hysterectomy.MethodsSixty ASA Ⅰ or Ⅱ patients,aged 45-60 yr,weighing 55-65 kg,scheduled for laparoscopic hysterectomy,were equally and randomly divided into 2 groups:combined intravenous-inhalational anesthesia group (group Ⅰ ) and combined spinal-epidoral anesthesia (CSEA) + general anesthesia group (group Ⅱ ).In group Ⅰ,anesthesia was maintained with inhalation of sevoflurane and infusion of remifentanil after induction of anesthesia.In group Ⅱ,CSEA was performed,after the upper level of sensory block was stable,general anesthesia was induced and maintained with inhalation of sevoflurane,and state entropy (SE) was naintained at 45-60.Arterial blood samples were taken to determine the plasma concentrations of adrenaline ( AE ),norepinephrine (NE) and dopamine (DA) after admission to the operation room,after completion of pneumoperitoneum,at 10 min after pneumopentoneum,during uterus traction,during removal of the laryngeal mask airway,and at 10 min after removal of the laryngeal mask airway (T0-5).The time for recovery of spontaneous breathing,extubation time,and time of regaining consciousness were recorded at the end of operation.The side-effects and number of patients requiring increments of analgesics were also recorded within 48 h after operation.Patient' s satisfaction was recorded at 48 h after operation.ResultsCompared with group Ⅰ,the plasma concentrations of AE and NE at T3-5 and the plasma concentrations of DA at T3,5 were significantly decreased,the time for recovery of spontaneous breathing,extubation time,and time of regaining corsciousess were significantly shortened,and the incidence of agitation and the number of patients requiring increments of analgesics were significantly decreased in group Ⅱ ( P ＜0.05).There was no significant difference in the incidence of intraoperative awareness,and nausea and vomiting after operation,and the level of patient' s satisfaction at 48 h after operation between the two groups ( P ＞ 0.05).ConctusionCSEA + general anesthesia has better efficacy than combined intravenous-inhalational anesthesia when used for laparoscopic hysterectomy.

Objective To investigate clinical significance of the changes in the peripheral blood T lymphocytes subsets in patients with diseases related to HBV infection .Methods 257 cases of inpatients and outpatients were selected from Jan .to Dec .2013 ,and were divided into hepatitis B carriers (ASC)group ,chronic hepatitis B(CHB)group ,hepatocirrhosis(LC)group and primary liver cancer(PHC)group according to types of diseases related to HBV infection .Other 50 healthy individuals conducted physical exami‐nation were enro1led in the control group .The absolute CD3+ ,CD4+ and CD8+ T‐cell count ,and CD3+ ,CD4+ and CD8+ percent‐age and CD4+ /CD8+ value were detected in all subjects by using flow cytometer .These data were compared and analyzed .Results Compared with the control group ,there were no significant differences of the absolute CD3+ ,CD4+ and CD8+ T‐cell count ,and CD3+ ,CD4+ and CD8+ percentage and CD4+ /CD8+ value in ASC group ,CHB group and LC group(P>0 .05) .Compared with the control group ,the absolute CD4+ T‐cell count ,CD4+ percentage and the CD4+ /CD8+ value were decreased in the PHC group , while the CD8+ percentage were increased in the PHC group ,there were statistical significant differences between the two groups (P<0 .05) .Conclusion The peripheral blood T lymphocyte subsets could be monitor indexes of cell immune function in diseases related to HBV infection .

Objective To define the significance of the anatomical division and features of popliteal artery in popliteal angioplasty.Methods This study involved 118 lower limbs in 113 cases of femoropoliteal occlusive disease undergoing angioplasty in our center between August 2011 and July 2013.A bent-knee angiogram was taken before recanalization of the lesion.The flexion pattern and the location of flexion points of popliteal artery were collected to study their relationship with the division of popliteal artery.A post-procedural bent-knee angiogram was taken in case of popliteal stenting to assess any change in flexion angulation and distal flow.Results There are diverse flexion patterns in popliteal artery,75.4％ of the flexion points locate in P2 segment,18.6％ in P1,and 6.0％ in P3.On post-procedural bent-knee angiogram in 73 cases of popliteal stenting,10 had a more acute distal flexion angulation,distal artery kinking was observed in another 6 cases of which 5 had compromised distal flow.Artery kinking only occurred in cross-flexion-point stenting.Conclusions A better understanding of the division and anatomical features of popliteal artery can be obtained via bent-knee angiogram.This is of value to angioplasty for lesions in different popliteal divisions.

BacKground:RectaI carcinoid is a rareIy seen neuroendocrine tumor. TiII now,there is controversiaI for the treatment modaIities of rectaI carcinoids with diameter between 1-2 cm. Aims:To study the expression of Ki-67 in rectaI carcinoids and the efficacy and safety of endoscopic resection. Methods:A totaI of 83 rectaI carcinoid patients with tumor diameter Iess than 1. 5 cm were enroIIed. AII patients were pathoIogicaIIy diagnosed and underwent endoscopic mucosaI resection from Jan. 2008 to Dec. 2013 at Chongqing Three Gorges CentraI HospitaI and Wuhan Tongji HospitaI. The medicaI records were retrospectiveIy reviewed and expression of Ki-67 in tumor tissue was assessed by immunohistochemistry. Results:AII patients underwent preoperative endoscopic uItrasonography. Tumors were Iimited to mucosa or submucosa, and no muscuIaris propria invoIvement or metastasis was seen. The mean foIIow-up duration was 38 months,and no recurrence or metastasis occurred. Ki-67 was IowIy expressed in aII rectaI carcinoids(0. 84% ± 0. 67%). When tumors were grouped by size,no significant differences in gender,age,tumor site and Ki-67 expression IeveI were seen between <1. 0 cm group and 1. 0-1. 5 cm group(P >0. 05). Furthermore,when tumors were grouped by a cutoff vaIue of mean Ki-67 index 0. 84%,differences in cIinicopathoIogicaI parameters between the two groups were not significant either( P >0. 05 ). Conclusions:Ki-67 is IowIy expressed in rectaI carcinoids Iess than 1. 5 cm in diameter enroIIed in this study,which denoted an inactive proIiferation. For rectaI carcinoids with diameter Iess than 1. 5 cm,with Iow Ki-67 expression and without muscuIaris propria invoIvement and metastasis, IocaI endoscopic excision is an effective and safe treatment modaIity.