Objective To characterize the changes in the dimensions during systolic and diastolic periods in the aorta with ECG-gated multi-detector CTA scans.Methods The CT angiograms of 115 patients (78 males,mean age 55.2 ± 9.4 years;37 females,mean age 60.1 ± 8.5 years) both in systolic and diastolic periods were obtained on a 64-slice ECG-gated multi-detector CT scanner.The diameters were measured at four anatomic levels of the aorta.(Level A:1 mm proximal to the innominate artery;Level B:1 mm distal to the left common carotid artery;Level C:1 mm distal to the left subclavian artery;Level D:10cm distal to the left subclavian artery).On each level,the maximal and the minimal diameters were measured both in systolic and diastolic periods.Results The paired sample t test results showed a significant difference between the systolic and diastolic diameters in all individual subjects on every level (P ＜0.001).The mean maximum diameter changes were 1.95％ (range-2.0％ to 7.0％),2.12％ (range-3.0％ to 6.0％),1.88％(range-1.0％ to 8.0％)and2.47％(range-3.0％ to 10.0％)at level A,B,C and D,respectively.The mean minimum diameter changes were 1.43％ (range-3.0％ to 5.0％),2.67％ (range-2.0％ to 11.0％),1.75％ (range-14.0％ to 9.0％)and 2.99％ (range -2.0％ to 11.0％) at level A,B,C and D,respectively.Conclusions The differences of the aortic diameters between systolic and diastolic periods are significant.The pulsatility of aorta in Chinese population may be different from published Western literature.

Objective:To determine the derivative chromosome 9 by the method of detecting the ASS gene,and to explore the relationship between the deletion of derivative chromosome 9 and the efficacy and prognosis of the chronic myeloid leukemia (CML)patients. Methods:The materials of 34 CML patients with positive BCR-ABL fusion gene whose ASS genes were detected were retrospectively analyzed. All patients were treated with Extra-signal (ES)probe to detect the derivative chromosome 9.All patients were divided into two groups according to whether they carried the derivative chromosome 9.The blastic phase or the accelerated phase rates in two groups were compared by using Fisher exact probability. Results:All patients were detected by FISH (BCR-ABL ES probe),and all the BCR-ABL fusion signals were positive.6 of 34 patients were found the deletion of ASS gene, among them 1 case blonged to chronic phase,and 5 cases developed into blastic phase or accelerated phase. In the patients without ASS gene deletion,there were 22 cases in chronic phase,and 6 cases in plastic phase or accelerate phase,there was significant difference of blastic phase rate/accelated phase rate between them (P<0.05).A total of 26 patients were treated with tyrosine kinase inhibitors (TKI).5 of 26 patients belonged to the ASS gene deletion group,1 of 5 patients treated with TKI got molecular remission,4 of 5 patients developed into blastic phase or accelerated phase.21 of 26 patients belonged to the group without ASS gene deletion,and among them,19 cases got molecular remission,2 cases developed into plastic phase or accelerated phase after treatment of TKI,there was significant difference between them (P < 0.05 ). 6 patients were treated with traditional chemotherapy (hydroxyurea,interferon);1 of 6 patients belonged to the ASS gene deletion group,finally developed into the blastic phase or accelerated phase;5 of 6 patients belonged to the group without ASS gene deletion,2 cases got the hematological remission,and 3 patients developed into blastic phase or accelerated phase after treatment,and there was no significant difference of blastic phase rate/ accelerated phase rate between them (P > 0.05 ). Conclusion:The CML patients with derivative chromosome 9 (ASS gene deletion)prone to get disease progression, and have a higher proportion in the blastic phase or accelerated phase patients.Derivative chromosome 9 is related to the bad treatment efficacy of TKI and the poor prognosis of CML.

Objective:To investigate the effects of site specific (124 HNFTAGDLGP STIVGSAAFNMF145 ) antibody of Sodium calcium exchanger ( NCX) on calcium transient in single ventricular myocytes of normal adult rats .Methods: Isolated adult rat hearts were perfused using Langendorff method and single ventricular myocytes were then obtained .The ventricular myocytes were incubated with Fuar-2/AM and 2% bovine serum albumin for about 40 min and then,the fluorescence images were recorded when excitation wavelengths were 340 nm and 380 nm using ion imaging system.Fluorescence value F340/F380,length of cell shortening ,time to 90%restore( TR90 ) and calcium sensitivity ( ratio of F340/F380 and cell shortening ) were calculated.Results:The site specific antibody of NCX increased F340/F380 and decreased TR90 in single ventricular myocytes ,but had no more significant effect on calcium sensitivi-ty.Pretreatment with KB-R7943 or Nicardipine could significantly inhibit the TR 90 decrease or F340/F380 increase induced by the anti-body.Pretreating ventricular myocytes with combination of KB-R7943 and Nicardipine ,the antibody had no more significant effects on calcium transient.Conclusion:Site specific ( 124 HNFTAGDLGPSTIVGSAAFNMF145 ) antibody of NCX could increase calcium transient and accelerate the decrease of intracellular calcium during diastole ,which mainly related to its effects of activating L-type Ca2+channel and NCX.

Objective To investigate the risk factors of multiple recurrent bile duct stones in patients with common bile duct (CBD) stones and received endoscopic sphincterotomy (EST ) treatment . Methods From June 1st ,2007 to June 1st ,2011 ,the patients received EST treatment were followed up , the follow‐up time was three to seven years .A total of 2 738 patients were successfully followed up , including 24 patients with two or more than two times of recurrent bile stone after EST who were enrolled in multiple recurrence group .One hundred patients without recurrence were randomly selected by table of random number as control group .The clinical data of two groups were compared by t test or Chi‐square test .The factors were analyzed with multivariate Logistic regression analysis and try to find out the risk factors of multiple recurrence .Results The comparative analysis between two groups showed that the three factors of juxtapapillary duodenal diverticula [17 .0% (17/100 ) vs 41 .7% (10/24 )] ,history of biliary tract surgery [13 .0% (13/100) vs 45 .8% (11/24)] and the angle enclosed between the horizontal portion of the CBD and the horizontal plane (angleofbile duct) less than 45° [2 .0% (2/100) vs 20 .8% (5/24)] were statistically significant (χ2 = 6 .914 、13 .37 、9 .595 ,all P < 0 .01 ) . Furthermore , logistic regression analysis indicated that juxtapapillary duodenal diverticula (B = 1 .421 ,OR = 4 .142 ,P = 0 .01) , history of biliary tract surgery (B = 1 .612 ,OR = 5 .011 ,P= 0 .004) and the angle of bile ductless than 45° (B= 2 .661 ,OR= 14 .31 ,P= 0 .005) were risk factors of multiple recurrence .Conclusion Juxtapapillary duodenal diverticula , history of biliary tract surgery , and the angle of bile duct less than 45° are independent risk factors of multiple recurrence of CBD stones .

Objective·To construct C-shaped cartilage rings by rabbit auricular cartilage-derived chondrocytes combing with both electrospun gelatin/ polycaprolactone(GT/PCL) nanofibrous membranes and 3D printed supporters for repairing tracheal cartilage defects.Methods·Primary chondrocytes were isolated from rabbit auricular cartilage with methods of trypsin enzyme digestion and collagenase enzyme digestion.After proliferation in vitro,the chondrocytes of passage 2 were harvested for further experiments.Ultrafine composite fibers of GT/PCL were fabricated via electrospinning.The electrospun GT/PCL membranes were tailored into rectangle shape,the length of which is 12 cm and the width is 2.5 cm.Chondrocytes were seeded on membrane at a density of 1 × 108 cells/mL.Then the membrane were rolled onto a 3D printed supporter of poly(DL-lactide-ε-caprolactone) (PLCL) material to construct a C-shaped cartilage-like complex.After 8 weeks of subcutaneous incubation in vivo,gross inspection and paraffin section staining were applied for evaluation.Results·After 8 weeks of culture in vivo,mature cartilage-like tissue were formed with open-cylindrical bellow appearance and pecific mechanical property.C-shaped rings arranged at regular intervals on the inner surface of tissue,which were similar to the normal structure of tracheal cartilages.Histological and immunohistological staining showed a large number of typical lacunar structures and extracellular matrix secretions.Conclusion·It is feasible to construct tissue engineered C-shaped cartilage tissue by combing chondrocytes with GT/PCL membrane and 3D printed PLCL supporter for tracheal cartilage repair.

ObjectiveTo evaluate the efficacy and safety of flurbiprofen axeyil injection combined with sufentanil for postoperative patient undergoing ovarian cancer radical operation.Methods60 postoperative patients undergoing radical ovarian cancer surgery were randomly divided into three groups with 20 cases in each group, including Sufentanil 150 μg (group S) ,Flurbiprofen Axeyil injection 200 mg (group F) ,Flurbiprofen Axeyil injection 100 mg plus Sufentanil 100 μg (group FS).The drugs in each group were added with Azasetron 10 mg and diluted to 100 ml, then infused by a pump in a rate of 2 ml/h.The visual analogue scale (VAS) and Ramesays scores were used to evaluate the analgesic effect at 0.5,2,4,8,12,24 and 48 h after surgery.The incidence of side effects was recorded.ResultsAll the patients showed good pain relief with PCIA.The VAS of group F(3.3 +0.8) at 2 h after operation was slightly higher than that of group S (2.6 + 1.0) and SF (2.8 + 1.1) (P ＜ 0.05), which became similar 4 h later (P ＞0.05).In groups F (2.4 +0.8,2.3 +0.6) and FS(2.9 +0.8,2.6 ±0.4), the average Ramsay score was slightly lower than that in group S(3.8 +0.9,3.6 +0.5) (P ＜0.05).But the differences were not significant within 8 h after operation (P ＞ 0.05).The accidence rates of nausea, vomiting, itching, somnolence of group S(20％ ,15％ ,20％) were significantly higher than those in group F (5％ ,0,5％)and FS(5％,5％ ,5％) (P ＜0.05).No respiratory depression or abnormal bleeding occurred in three groups during the period of postoperative 48 hour.The amount of hydrothorax had no difference between 3 groups (P ＜0.05).ConclusionsIntravenous postoperative analgesia with Flurbiprofen Axeyil injection combined with Sufentanil had a better analgesic effect than Sufentanil or Flurbiprofen Axeyil used alone, and it could significantly reduce the dose requirement of Sufentanil as well as its associated side effects.

Myeloid-derived suppressor cells (MDSCs) play a crucial role in T cell dysfunction, which is related to poor outcome in patients with severe trauma. Cyclooxygenase-2 (Cox-2) contributes to immune disorder in trauma and infection via production of prostaglandin E2. However, the role of Cox-2 in the accumulation and function of MDSCs after traumatic stress has not been fully elucidated. In the present study, we treated murine trauma model with NS398, a selective Cox-2 inhibitor. Then the percentages of CD11b+/Gr-1+ cells, proliferation and apoptosis of CD4+ T cells were determined. Arginase activity and arginase-1 (Arg-1) protein expression of splenic CD11b+/Gr-1+ cells, and delayed-type hypersensitivity (DTH) response were analyzed. The results showed that Cox-2 blockade significantly decreased the percentages of CD11b+/Gr-1+ cells in the spleen and bone marrow 48 and 72 h after traumatic stress. NS398 inhibited arginase activity and down-regulated the Arg-1 expression of splenic CD11b+/Gr-1+ cells. Moreover, NS398 could promote proliferation and inhibit apoptosis of CD4+ T cells. It also restored DTH response of traumatic mice. Taken together, our data revealed that Cox-2 might play a pivotal role in the accumulation and function of MDSC after traumatic stress.

Objective To analyze the management of clinical pathways ( CP) in China. Methods Cross-sectional questionnaire surveys of 51 public hospitals with CPs in place in Shanghai, Hubei province and Gansu province were conducted from March to May of 2015. Results Among the 51 public hospitals with CPs, 48 ( 94. 1%) of them organized training on CPs, 48 ( 94. 1%) of them monitored CPs′implementation, and 40 (78. 4%) applied incentives for CPs′ implementation. But there were some issues and difficulties encountered in CPs′ implementation. Conclusions Comprehensive measures are necessary to improve the management of CPs at public hospitals of China.

Objective To analyze the implementation of clinical pathways ( CP) at public hospitals at different levels and in different regions in China. Methods The status of CPs′ implementation at 54 public hospitals in Shanghai, Hubei province and Gansu province was surveyed by questionnaires from March to May of 2015. Results 51 (94. 4%) of the surveyed public hospitals put in place clinical pathway(s), where the average CPs implemented were 45 and the average percentage of the cases using CPs was 52. 7%. There were great variations among these hospitals. In addition, the common diseases with definite diagnostic and treatment options were found with the highest implementation rates of CPs at such hospitals. Conclusions CPs are implemented widely at public hospitals of China, yet enhanced implementation strategies are expected to further CPs′adoption.

Objective To set up a method of stools protein extraction,analysis and identification in order to get the new nonin-vasive indicators of human digestive diseases.Methods The stools proteins,collected from healthy persons,the patients with atrophic gastritis,those who suffed from gastric carcinoma and postoperative patients with gastric carcinoma respectively, were extracted in three different ways including saline,Tris-HCl buffer and Urea buffer,the best way was selected by using SDS-PAGE,then a preliminary analysis of stools proteins was performed by 1D LC-MS/MS.Results The methods of saline and Tris-HCl buffer could get more stools proteins than the method of urea.The proteins in stools from the healthy persons, the patients with atrophic gastritis,the patients with gastric carcinoma and postoperative patients with gastric carcinoma were all abundant and more than one hundred.There was a significant difference in stools protein maps among the various populations.Alpha1-antitrypsin,a number of immunoglobulin and keratin were identified in the stools from patients with gastric carcinoma but not postoperative patients with gastric carcinoma and the healthy persons.Conclusions In this re-search,there was a significant difference in stools protein maps among the healthy persons,the patients with atrophic gastri-tis,the patients with gastric carcinoma and postoperative patients with gastric carcinoma,not only the composition of stools proteins,but also the abundance of same proteins.Therefore,using proteomics technologies to screening of the noninvasive indicators in human stools is viable.The study recommended that the noninvasive indicators in human stools should be iden-tified with quantitative differences analysis combination of quality of mass spectrometer method in the future research.