Objective To investigate the clinical features with to highlight the main criteria for diagnosis of portopulmonary hypertension(POPH).Methods The clinical and laboratory data of 7 patients with POPH were retrospectively analysed.Results The patients included 2 males and 5 females with median age at diagnosis of 51 years(ranging from 26 to 73 years).The underlying diseases of portal hypertension were post-type B hepatitis cirrhosis(3 cases),autoimmune hepatitis(2 cases),immunologic deficiency disease(1 case)and portal vein thrombosis(1 case).The initial symptom of pulmonary hypertension(PH)in 5 patients was dyspnea on exertion,but 2 patients remain asymptomatic.All patients was assessed by transthoracic echocardiogram(TTE)with the pulmonary arterial systolic pressure(PASP)above 55 mmHg,1 patient accepted right heart catheterization(RHC)with mean pulmonary arterial pressure of 62 mmHg and pulmonary vascular resistance of 8.64 mN/(s?cm5).Immunologic abnormality was found in 6 patients,and the severity of liver function does not appear to correlate with the severity of the PH.Follow-up study demonstrated 3 patients died,2 of whom were due to the cardiac involvement(right heart failure and sudden death).Conclusion PH is a rare but severe complication of portal hypertension.It is the portal hypertension,not the underlying liver disease causing POPH.TTE is an important screening procedure,but the gold standard for diagnosis of POPH is hemodynamic data from RHC.

Objective To analyze the potential risk factors of sudden death at home in senile people. Methods 38 cases of cardiac arrest in a community occurring at home from 1993 to 2004 were retrospectively analyzed. The data concerning their condition of health before death, the diagnosis of the diseases confirmed, the predisposing causes of cardiac arrest, and the season and time of death were collected and analyzed. Results It was found that hypertension, CHD and diabetes were the predominant diseases in senile patients died of out-of-hospital cardiac arrest. Most of the deaths occurred in April, 73.7% of the deaths occurred during 6:00-18:00, and 81.6% cases occurred in their homes. Conclusion In senile patients, the cardiovascular diseases may be the main risk factors of out-of-hospital cardiac arrest. The patients with myocardial infarction, arrhythmia and heart failure constitute the high risk group of cardiac arrest. Usually death occurs without a portent.

Objective To study the clinical significance of end-tidal carbon dioxide partial pressure (PetCO2 ) during cardiopulmonary resuscitation (CPR) and seek the fixed value according which to decide if we should and when to give up.Methods This was a prospective,observational study.A total of 124 patients with cardiac arrest in or out-of-hospital from may 2003 to March 2009 in emergency department of our hospital were selected.All of them had definite etiological factors.Changes of PetCO2 in 124 cardiac arrest patients during CPR were tracked.Results The gender,age,rescue time in seventy-one patients with the return of spontaneous circulation (ROSC) after endotracheal intubation have a significant difference with that in fifty-three patients without ROSC (P ＜0.01 ).The PetCO2 of the survival were higher than that of patients without ROSC or with ROSC,but finally died (P ＜0.01 ).A fixed point 14.4 mmHg of PetCO2 after 20 minutes' CPR can be used as a reference value to guide CPR or predict prognosis.Conclusions Monitoring PetCO2 during CPR has a predictive value on the success of resuscitation.

Adolescent ; Child ; Female ; Humans ; Hypertension ; blood ; Insulin ; blood ; Insulin Resistance ; Male

Diagnostic Errors ; Humans ; Inflammation ; diagnosis ; etiology ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Papilloma ; surgery ; Pneumonia ; diagnosis ; Postoperative Complications ; diagnosis

Objective:To investigate surgical methods and clinical effects of tibial pseudarthrosis due to neurofibromatosis type I (NF1) in adult using Ilizarov technique combined with intramedullary nail.Methods:A total of 12 adult with tibial pseudarthrosis due to NF1 treated by Ilizarov technique combined with intramedullary nail from October 2009 to December 2017 were retrospectively included. There were 6 males and 6 females with an average age of 27±8.3 years (range 17-44). All cases presented severe anterior arch in varus or valgus deformity with shortening in an average of 10.8±3.7 cm (range 5.6-16.5 cm). The in-volved levels were at the middle and lower part of tibia. All cases suffered from more than one treatment with failed surgery. One male patient with 5 times of unsuccessful operations. There were 4 cases with severe limping gait and 8 cases with walking with the help of brace (or single crutch) preoperatively. Regarding the family history, seven cases were inherited by father and 5 cases by mother. During surgery, the part of tibial pseudarthrosis and thickened fibrous tissue surroundings like periosteal were removed. The contracture achilles tendon was elongated in open way, and intramedullary nailing cross the ankle joint was applied when the tibial medullary cavity opened. Further, iliac bone grafting and proximal tibial osteotomy were performed with Ilizarov fixator application finally. The tibia was lengthened at a rate of 0.5-1 mm/d at 7 days postoperatively. The healing rate of pseudarthrosis and the length and alignment of limb were evaluated by X-ray routinely. The lower limb function and complications were assessed by self-made table for lower limb deformity correction and functional reconstruction.Results:All patients were followed up for 31-80 months with an average of 47.6±14.7 months. Bone union of pseudarthrosis in all cases was eventually achieved. The tibia was lengthened 5-12 cm with an average of 8.4±2.5 cm. There were 9 cases underwent second surgeries to promote bone healing and to correct residual deformities. The external fixator was used for 25-37 months with an average of 31.5±3.7 months. There was no complication, including neurovascular injury, severe soft tissue or bone infection affecting the clinical effects. All intramedullary nails were not removed finally. The limb function and gait in full weight bearing in 12 patients recovered at the latest follow-up. The evaluation score was 2.4±0.3 (range 2.1-2.8), of which 9 cases were excellent 3 were good. Thus, the excellent and good rate was 100%.Conclusion:The satisfactory clinical effects, including angular deformity correction, pseudarthrosis healing and short limb lengthening, can be achieved in adult with tibial pseudarthrosis due to NF1 by using the combination method of Ilizarov technique and intramedullary nail. However, the treatment duration could be longer.

Selective salpingography and transvaginal catheter dilatation using a self- made coaxial catheter set were performed in 45 women with infertility and fallopian tube ob- struction.The successful catheterization rate was 95.5% for fallopian tubes and the recanal- ization rate proximal allogian tubes was 80%,Normal intrauterine pregnancy was achieved in total 15 women(33.3%)with in two years follow-up 50% and 17.4% pregnant rates were obtained in secondary infertility and primary infertility,respectively.The authors be- lieve that transvaginal catheter dilization is a useful method for female infertility with fallopi- an tube obstruction,especially for the secondary infertility and proximal fallopian tube ob- struction.The self-made coaxial catheter set holds the advantages of effectiveness,safety, and inexpensiveness.

Objective To study the association between three single nucleotide polymorphisms (SNP; rs2241766,rs1501299 and rs12495941) variants of the adiponectin gene (ADIPOQ) and polycystic ovary syndrome (PCOS) in PCOS family trios.Methods A total of 224 unrelated PCOS probands,their biological parents were recruited.Anthropometric variables such as waist circumference (WC),hip circumference (HC),height and weight were measured in all subjects during the first visit to the outpatient department.Body mass index (BMI) and waist-hip ratio (WHR) were calculated.Serum fasting glucose (FBG),fasting insulin (FINS),total cholesterol (TC),triglycerides (TG),low-density lipoprotein and highdensity lipoprotein cholesterol (HDL) levels were measured.PCOS patients were divided into two groups based on BMh group A (BMI＜25 kg/m2) and group B (BMI≥25 kg/m2).Parents of PCOS patients were accordingly categorized into group C,D (fathers) and group E,F (mothers).The transmission disequilibrium test (TDT) was used to analyze the association between three SNP of ADIPOQ and PCOS.Results (1) A significant positive association was detected between SNP rs1501299 and PCOS (x2=7.093,P=0.008).However we failed to find significant overtransmission of the other two SNP rs2241766 and rs12495941 from parents to PCOS offsprings (x2=1.620,P=0.203; x2=0.713,P=0.398).(2) Linkage disequilibrium (LD) was analyzed in the subjects,rs1501299 and rs2241766 were in weak LD (r2=0.063,D'=0.621).(3) The levels of WC,HC,WHR,testosterone,TG,HDL and FINS were significantly differences between obese and lean PCOS patients (P＜0.05).While in fathers we only found WC,HC,TC levels being statistically different (P＜ 0.05).Mothers of obese PCOS patients had increased levels of FINS compared with mothers of lean PCOS patients (P＜0.05).The genotype frequencies of the three SNP were not different in obese and lean PCOS patients and their parents (P＞0.05).Conclusions TDT confirms that SNP rs1501299 in the ADIPOQ is significantly associated with the risk of PCOS in the Chinese Han population.The three SNP of the ADIPOQ were not associated with the obesity of PCOS.

Objective:To study the effects of vitamin C (VC) on the injury of alveolar macrophages exposed to Ni2O3 in vitro and the expression of inducible nitric oxide synthase (iNOS). Method:The alveolar macrophages were cultured with exposure to Ni2O3 in vitro. Meanwhile,VC with different concentrations (25,50 and 100 ?mol/L) were added to the medium, respectively. The cell activity,nitric oxide(NO),reactive oxygen species (ROS), malondialdehyde (MDA) and activities of SOD, GSH-Px,CAT and iNOS were detected. iNOS mRNA expression was detected by using RT-PCR. Results:VC could decrease mortality and increase survival activity of alveolar macrophages. VC could also decrease ROS,NO and NOS activity,increase SOD,GSH-Px, CAT activities and downregulate the expression of iNOS mRNA. Conclusion:The lipid peroxidation of alveolar macrophage could be induced by Ni2O3. VC could downregulate the expression of iNOS mRNA and reduce the production of ROS and NO through increasing the activity of antioxidative enzymes and antagonize the oxidative damage induced by Ni2O3.

Biotechnology supremacy is a newly-advanced power theory. It is a superior dominance of military biotechnological application based on the microcosm of life structure within a certain period of time. The advancement of biotechnology supremacy and modern biotechnology has created the concept of bio-micro-frontier, which involves information and defense resources of all living ultra-micro-organisms with national and regional characteristics. Being feasible both in theory and practice, the implementation of bio-micro-frontier system is strategically important. This article explores the implementation of bio-micro-frontier in terms of strategy and tactics, which will add a unique dimension to future military transformation and active defense.