AIM:To study the development of autologous peripheral blood stem cells in the fibrous liver after mobilizing recombinant human granulocyte colony stimulating factor and the therapeutical effect of autologous peripheral blood stem cell transplantation.METHODS:Experiments were performed at the Central Laboratory of First Affiliated Hospital,China-Japan Clinical Pathological Center and Central Laboratory of Dalian Medical University from April 2005 to April 2006.①Rat models of hepatic fibrosis were made by injecting carbon tetrachloride subcutaneously.Thirty-two successfully established rat models of hepatic fibrosis were divided into group A,group B,group C and group D with 8 in each group,male and female(half and half).②Rat models of group A were only administered with recombinant human granulocyte colony stimulating factor subcutaneously.Rat models of group B were administered with recombinant human granulocyte colony stimulating factor subcutaneously.Peripheral blood mononuclear cells containing peripheral blood stem cells were collected by density gradient centrifugation.These peripheral blood mononuclear cells were grafted in liver after labeling with PKH26-GL.Rat models of group C did not undergo any management.Serum and hepatic tissues were collected from rat models of group A,group B and group C six weeks later.Successful rat models of liver fibrosis of group D were sacrificed instantly after the last time of carbon tetrachloride administration.Serum and hepatic tissues were collected for measurement.③The alanine aminotransferase,aspartate aminotransferase,albumin and total bilirubin levels and hepatic pathological changes of rat models of all the four groups were measured.Immunofluorescent method was employed to observe the development of autologous peripheral blood stem cells in the liver.RESULTS:A total of 32 rats were involved in the result analysis.①Total bilirubin levels were lower in group A and group B than that of group C(P 0.05).②Hepatic fibrosis was significantly improved in the group A and group B as compared with the group C(P

Objective To analyze the influence of diabetes mellitus (DM) on the outcomes of percutaneous transluminal angioplasty (PTA) with stenting of femoropopliteal artery,in patients with atherosclerotic occlusive disease (ASO).Method Clinical data of inpatients who successfully received PTA with stenting procedures of femoropopliteal artery in Xuanwu Hospital from January 2006 to December 2012 were analyzed retrospectively.Patients were stratified into DM and non-DM groups.Results were compared between the two groups including primary patency (PP),assisted patency (AP),limb salvage and survival using Kaplan-Meier life table and Cox regression analyses.Result Totally 291 patients underwent 332 procedures.There were 214 DM and 118 non-DM limbs.Mean follow-up was 34 months.The 5-year PP was 23.2％,AP was 35.3％,limb salvage was 89.2％,and survival was 69.6％.DM was associated with lower 5-year PP,limb salvage,and survival than non-DM.But there were no significant difference in AP between the two groups.Females were associated with decreased PP than males on Cox multivariate analysis.Hypertension and below tibial diseases were associated with lower limb salvage rate and age is the only predictor of survival rate.Conclusions DM is a risk factor for poor outcomes after PTA with stenting procedures.

Objective To investigate the MRI features of intracranial solitary fibrous tumors/hemangiopericytomas (SFT/HPC),and to compare these findings with those of intracranial meningiomas.Methods The clinical features and MRI findings in 28 patients of intracranial SFT/HPC (SFT/HPC group)and 68 patients of meningiomas (meningiomas group) confirmed by operation and pathology were retrospectively analyzed.The indicators of two groups were compared.Results Shape of tumor,signal homogeneous,signal voids of vessel in tumor,hypointense signal nodules on T2WI and enhanded,cystic or necrosis in tumor,meningeal tail sign,changes of the nearby bone,sex,Ki-67％ level,blood lose in surgery had significant differences between SFT/HPC group and meningiomas group (all P＜0.05).Conclusion There are some differences between intracranial SFT/HPC and meningiomas.It is helpful in diagnosis and differential diagnosis through the comparative analysis of the imaging signs.

Objective To evaluate liver biopsy for the diagnosis in liver transplant patients with suspected acute rejection. Methods From Oct. 2004 to Apr. 2005, liver biopsies were performed 53 times in 39 transplant cases. Results Based on Banff schema for grading liver allograft rejection, laboratory abnormalities and result of treatment, acute rejection was diagnosed on 16 episodes, preservation injury in 12, bile duct strictures in 9, drug-induced injury in 11, chronic rejection in 3 and acute hepatic failure in 2. Conclusions Hepatocyte ballooning with necrosis features preservation injury. Drug-induced injury commonly has a combination of hepatocyte denaturalization with mild portal inflammation. Histologic features of early bile duct strictures in liver biopsy show prominent bile ductular proliferation and the canalicular cholestasis with mild hepatocyte damage which help to exclude acute rejection.

Objective To observe the outcomes of living donor liver transplantation (LDLT) for children with biliary atresia (BA) and to summarize the clinical experiences. Methods Forty-four BA patients (26 boys and 18 girls) underwent LDLT between October 2006 and December 2010. Mean (SD) and median (range) age at operation was (12.1 ± 9.0) months and 9 (6-60) months,respectively. The 44 donors were lineal relatives to the consorted recipients. Their mean (SD) and median (range) age at operation was (32. 7 ± 8. 0) months and 31 (20～54) years, respectively. All donor graft types were the left lateral segments with compatible ABO blood groups. Clinical data,including pre-operative evaluations, surgical technique, postoperative management and outcomes in all donors and recipients were retrospectively analyzed. Results All donors were followed up for (17. 5 ± 13. 3) months. No donor mortality was encountered, with a minimal morbidity and no long-term sequelae. Nine out of 44 recipients died. Three patients died of portal vein thrombosis (PVT), one of hepatic artery thrombosis (HAT), two of biliary complications, one of surgical site infections, one of abdominal bleeding and one of pulmonary infection. The overall 1-year and 2-year cumulative survival rate in recipients was 81. 2% and 76. 1 %, respectively. No re-transplantation was done. Postoperative complications included PVT, HAT, biliary leakage and refluxing cholangitis, pulmonary infections,surgical site infections and acute rejection. Conclusion LDLT has been the effective treatment for pediatric recipients with BA and provides favorable prognosis. To improve prognosis of recipients, the key points are pre-operative evaluations, surgical technique, and postoperative management

OBJECTIVE: To study the characteristic of hearing loss and the changes of the auditory brainstem response and distortion product otoacoustic emission in diabetics. METHOD: General information of 136 diabetics were investigated whether had the complication of capillary vessel and hearing loss with self-made questionnaire at random. 136 cases (272 ears) were tested with ABR and DPOAE. They were divided into A, B, C, D four groups according to the age of per ten years (30-70 years). Other 120 (240 ears) matched healthy adult were enrolled in the control group. The pure tone threshold (PTT), acoustic impedance, ABR and DPOAE results were compared between the four groups and the control group, and then made statistical analysis. RESULT: When comparing to the control group, the interpeak latency I-V and ABR response were no significant difference between patients at the stage of 30 years. Not only the threshold of wave V was elevated with aging in patients over 40 years, but the amplitude of the peak latencies of waves III and V were lessening, and the interpeak latency III-V and I-V were prolonged between patients at the stage of 60 years, which had significant difference compared with age-matched patients (P < 0.05). The inducing rate of DPOAE were 100% in the test and control group, but the amplitude of DPOAE declined ranged from 1 to 8 kHz in patients with early diabetes mellitus and were significantly reduced at 4 kHz, which had significant difference compared with age-matched patients (P < 0.05). CONCLUSION The majority of patients with diabetes mellitus had slight and moderate hearing loss gradually. The ABR and the threshold of ABR response were varied with the age and sex of patients, and whether had the complication of capillary vessel, but were not related to its type and disease course. The DPOAE can comprehend the cochlear disorder in patients with early diabetes mellitus.
Adult ; Aged ; Case-Control Studies ; Diabetes Mellitus ; physiopathology ; Evoked Potentials, Auditory, Brain Stem ; Female ; Hearing Loss ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Otoacoustic Emissions, Spontaneous

Epigenetic alterations include chromosome translocation, polycomb function and non-coding RNA abnormalities, and etc.A study on genome of childhood acute myeloid leukemia(AML)in children has shown that these abnormalities play an important role in the pathogenesis of AML, and epigenetic heterogeneity is associated with poor prognosis and relapse of AML.Presently, the overall survival(OS)for AML in children has been improved, but for the refractory/relapsed acute myeloid leukemia(r/r AML), the prognosis or curative effect remains poor.The curative effect is expected to be improved by epigenetics related therapies.A large number of studies have found that the epigenetic abnormalities of AML in children are different from those in adults.Some drugs targeting epigenetic alternations, such as DNA methyltransferase inhibitor and IDH inhibitor, have been used to treat AML in children.This paper aims to review the epigenetic regulation abnormalities in children with AML and the progress in relevant clinical applications.

Objective To analyze the clinical feasibility and effectiveness of the "G"-shaped surgical approach in robotic pancreatoduodenectomy. Methods The clinical data of 17 patients who were undergoing robotic pancreatoduodenectomy at the First Hospital of Shanxi Medical University from June 2017 to March 2018 was analyzed. Results All the 17 robotic pancreatoduodenectomy operations via the "G"-shaped surgical approach were successful. The operationtime was (499 ±146) min (350-825 min), and the blood loss was (119±38) ml (20-500 ml). All surgical margins were negative. All patients recovered well after surgeries, and the postoperative hospital stay was (21 ±6) (14-36 days). However, one patient experienced secondary surgery due to bilioenteric anastomosis fistula, fortunately the surgical process went successfully. This patient had pancreatic leakage (class B) after surgery and was discharged with tubes after a conservative treatment, another patient had gastroplegia and recovered completely after conservative treatment. Conclusion It is a safe and feasible procedure to use the robotic pancreatoduodenectomy with the"G"-shaped surgical approach.

Objective: To discuss the clinical results of three-stage functional ear reconstruction for microtia with congenital aural stenosis (CAS). Methods: From September 2007 to June 2017, 53 cases of microtia with CAS underwent all three-stage functional ear reconstruction, and 445 cases of microtia underwent two stage ear reconstruction without meatoplasty at the same periods. First-stage of three-stage functional ear reconstruction: it was similar to Nagata technique. The crus of helix could not be too long, since we needed the space for the next meatoplasty. Second-stage: it was a modified meatoplasty with endoaural-conchal incision, in which two local rotation flaps and a transposition split-thickness scalp flap were used to widen the stenotic external auditory canal (EAC) and reconstructed the tympanic membrane. Third-stage: it was a modified technique for firm elevation of the reconstructed auricle by using the retro-auricular fascial flap wrapping a porous polyethylene (Medpor) wedge or stored cartilage as the strut. If the patient showed EAC cholesteatoma or infection, we could do the meatoplasty at the first stage. If the patient had completed ear reconstruction, meatoplasty could be done at the third stage. Results: 53 cases underwent all three-stage functional ear reconstruction. There were 41 cases (77.4%) obtaining serviceable hearing. The complication rate of meatoplasty was 1.89% and the complication rate of ear reconstruction was 5.66%. Among the 445 cases of microtia treated with two stage ear reconstruction without meatoplasty, the complication rate of ear reconstruction was 9.43%. There was no significant difference between the two groups (P>0.05). Conclusions Our novel three-stage functional ear reconstruction is a feasible strategy for microtia with CAS. The patients can obtain satisfactory auricle and serviceable hearing. The results are stable and can improve the life quality in both aesthetics and hearing function.

Objective To retrospectively analyze the injury characteristics of victims and treatment strategies in the explosion accident on the 17th May 2018 in Xixia county (Xixia "May 17th" explosion accident). Methods Based on the practice featured in pre-hospital emergency of Henan province and Nanyang city Emergency Center in the explosion accident, a retrospective analysis for the Level Three medical rescue was conducted, where a total of thirteen survived victims in Xixia "May 17" explosion accident were studied retrospectively. The data included the gender, age, burned extent and depth of the patients, burns complicated by trauma, complication of burn, respiratory function maintenance, resuscitation during shock stage, skin grafting with excision and scab. Furthermore, the data of organ function and the effect of the 90-day comprehensive treatment for the burned victims wereanalyzed. Results completion the Level Three treatment on time, which was depended on the leading role played by the regional trauma centers was the main rescuing mode of the work in Xixia county, where the primary and secondary treatments were the key parts. The three-level treatment model includes: the local hospital acts as a level-one emergency medical institution, county hospitals function as secondary emergency medical institutions, and other higher medical institutions are the tertiary first aid medical institutions. The pre-hospital and in-hospital emergency procedures were initiated immediately after the large-scale explosive burn being identified, the key to the successfully rescue was to set up a comprehensive treatment team for burns and trauma. Rescue team should involve burn department and other related departments, including the departments of emergency, general surgery, orthopedic, thoracic surgery, neurosurgery, plastic surgery, intensive care unit, blood transfusion unit, anesthesiology, and interventional radiology, etc. All the thirteen burned patients were male, with inhalation injury, blast injury, hemopneumothorax, brain injury, bone fractures, and etc. Eight of them (61.54%) had multiple organ dysfunction syndrome (MODS). MODS mainly involved respiratory, circulatory, liver, gastrointestinal tract, kidney and coagulation function. With the multi-discipline treatment, the wound of 6 severely-burned patients started healing and can be discharged after keeping the patency of airway, applying resuscitation fluid and comprehensive treatments such as debridement and dressing change. Among 7 patients with extensive deep burns, one case with skull-based fracture, open craniocerebral, extensive intracranial hemorrhage and hemopneumothorax, died 9 hours later. Another case died within 24 hours after injury due to obvious exudation on the site of early incision and relaxation of wound. The escharotomy, micro-dermis and allograft skin transplantation were carried out for five cases with extensive deep burns from the 4th day after the recovery of shock. One week later, the second stage of microsphere skin transplantation was performed. But all died of sepsis or fungal infection. Conclusions MODS and infection often occur during the course especially for patients with extensive and deep burns due to the great explosion in Xixia county, most of whom were accompanied with MODS and infection. Therefore, assembling multi-discipline team for treating the group of explosively-burned patients can increase the survival rate and reduce the possibility of disability.