Objective To investigate the application value of intraoperative ultrasound (IOUS) in living donor liver transplantation(LDLT). Methods In LDLT, IOUS techniques (gray scale ultrasound and color Doppler flow imaging) were adopted in 26 donors and recipients for parenchymal and vascular examinations. The abnormal sonograms were observed, and the anatomic findings of hepatic veins were recorded. All the reanastomosed blood vessels were examined by gray scale ultrasound and color Doppler flow imaging before the operations were completed. Results A hepatic parenchymatous tumor was revealed by IOUS in one donor. Besides, middle hepatic veins in 13 donors and secondary hepatic veins with diameter﹥0.5 cm in 5 donors were confirmed by IOUS. Furthermore, one operation procedure was changed and one hepatic artery stenosis was established according to IOUS findings. Conclusion IOUS is a very useful means in evaluation of parenchymal and vascular conditions of donors and recipients in LDLT, which helps to select the best cross section and provides evidence for the change of surgical procedures.

Objective To investigate the expressions and significance of p21 protein and K-ras protein in congenital biliary dilatation(CBD),and their relationship.Methods Surgical specimens of CBD were obtained during operation on 36 children from Jan.2000 to Sep.2007.Nine normal bile ducts specimens from miscarried fetus and children's corpse.The specimens were fixed in 40 g?L-1 formalin and embeded by paraffin,slice-fixed.SP immunohistochemical method was used to detect the expressions of p21 protein and K-ras protein.Results The positive rate of K-ras protein was 13.8% in CBD,which was significantly higher than that in normal bile duct tissues.The positive rate of p21 protein was 55.6% in CBD,and 100% in normal bile duct tissues.p21 protein positive expression rate in CBD was significantly lower than that in normal bile duct tissues(P

Method for measuring interleukin 1 ( IL -1 ) and effects of total glucosides of paeony(TGP) on IL -1 production were studied. The results showed that the best concentration for LPS -induced IL-1 production of M s in rats was 8mg/L, the best dilution for IL-1 of LPS-induced M s production was 1 : 90. TGP ( 0 .5 - 12 .5mg/L ) enhanced LPS-induced IL -1 production in a concentration dependent manner, but diminished in the higher concentration of TGP ( 62 .5~l25mg/L ) , the concentration-effect curve seems to be bell-shaped. The data suggested that TGP had two-sided regulatory effects on LPS -induced IL production of M s in rats.

Objective To investigate the distribution and drug resistance of pathogen in blood culture from 2014 to 2015.Meth-ods 1 260 blood specimens were incubated in our hospital,the positive samples were isolation and identification and the drug resist-ance was analyzed.Results 153 strains of bacteria were isolated from 1 260 blood specimens,and the positive rate was 12.1%. Escherichia coli and Klebsiella pneumonia were the main pathogens in gram negative bacilli,coagulase negative Staphylococci and Staphylococcus aureus were the main pathogens in gram positive cocci,Imipenem and ertapenem were the most effective antibiotics (100.0%)to Escherichia coli and Klebsiella pneumonia,the gram-positive cocci were sensitve to Vanconmycin,linezolid and tigecy-cline.Conclusion Drug resistance of isolated pathogen in blood cultures is very serious.Monitoring the change of pathogens and trends of drug resistance is very important in guiding the clinical use of drug.

Objective To evaluate the diagnostic value of serum (1-3)-β-D-glucan detection for invasive fungal infection (IFI) in neonates. Methods Eighty-seven neonates who were suspected to be IFI cases in neonatal intensive care unit from May 2008 to January 2010 were enrolled into this study. All subjects had infection symptoms, while did no react to the antibiotics treatment. The diagnosis of IFI was made according to Invasive pulmonary fungal infection diagnostic criteria of children set by Subspecialty Group of Respiratory Diseases, the Society of Pediatrics, Chinese Medical Association and Invasive fungal infection diagnostic criteria for critical patients set by the Society of Critical Care Medicine, Chinese Medical Association. Circulating (1-3)-β-D-glucan levels were determined with GKT-5M set kinetic fungus detection kit. Levels of (1-3)-Β-D-glucan in IFI group and that in the control group were compared; optimal cut-off value was established with receiver operating characteristic (ROC) curve; and the sensitivity and specificity at the cut-off value of 20.0 pg/ml and optimal cut-off value were calculated and compared. Results Among the 87 suspected cases, 59 cases were not diagnosed as IFI and 28 cases were diagnosed as IFI finally. Five patients were confirmed to be IFI; seven cases were clinically diagnosed and 16 cases were still suspected IFI. Among the five confirmed cases, four cases were blood culture positive for Candida parapsilosis, one case Candida albicans positive and two cases both cerebrospinal fluid culture and blood culture positive for Candida albicans. The median levels of (1-3)-β-D-glucan of patients diagnosed as IFI (n=28) was 131.6 pg/ml(18.6-9999.0 pg/ml), which was higher than that of the patients without IFI (8.5 pg/ml, 5.0-34.6 pg/ml)(Z=-5.064, P<0.05). Area under ROC curve was 0.806 (95% CI: 0.725-0.886, P<0.05). The sensitivity (96.43% vs 69.49%) and specificity (72.22% vs 84.21%) for (1-3)-β-D-glucan were different as 20.0 pg/ml and 53.7 pg/ml were used as the cut-off values for diagnosing IFI. Conclusions (1-3)-β-D-glucan level could be used to diagnose IFI of neonates, but further studies are needed to evaluate false-positive rates and its cut-off value in IFI diagnosis.

Effects of total glucosides of paeony ( TGP) on interleukin2 ( IL-2 ) production were studied with lL-2-dependent marine splenic lymohocytes. The results showed that IL-2 production by splenocytes was enhanced with low concentration of TGP (0.5-12.5 mg/L) , and diminished over the rang of 12.5-62.5mg/L. The concentration-effect curve seems to be bell-shaped. The data suggested that TGP hap two-sided regulatory effects on IL 2 production by splenocytes.

Objective To study and compare the effects and mechanisms between the Xuebijing injection and Danshen injection on ischemic-reperfusion injury of rabbit limb .Methods 30 New Zealand rabbits were randomly divided into control group ,Xuebi-jing group and Danshen group ,with 10 in each group .The Crinnion model of ischemic-reperfusion injury of rabbit limb was used . Each group was treated correspondingly after the blood flow was restored .Xuebijing group and Danshen group were treated with 4 mL/kg Xuebijing injection 2 mL/kg Danshen injection in saline with 10 mL total volume .Control group was treated with 10 mL sa-line .Before releasing clip and 1 h ,2 h and 4 h after reperfusion ,the blood samples were collected for detecting clotting function (APTT ,FIB ,PT-INR ,PT) ,biochemistry items (ALB ,LDH ,CK) ,MDA level and SOD level .Results Compared with control group ,the APTT of Xuebijing group in 1 h and 2 h and Danshen group in 4 h after reperfusion improved significantly (P<0 .05) . The PT of Xuebijing group after reperfusion extended significantly compared with the PT before reperfusion (P<0 .05) .The FIB level of Xuebijing group and Danshen group in 4 h after reperfusion was much higher than before (P<0 .05) .The LDH and CK level of Xuebijing group after reperfusion was much lower than that of control group (P< 0 .05) .The MDA level of Xuebijing group in 2 h and Danshen group in 1 h ,2 h after reperfusion was much lower than that of control group (P<0 .05) .The SOD activ-ity of Xuebijing group in 1-4 h and Danshen group in 2 h after reperfusion was much higher than that of control group (P<0 .05) .Conclusion Xuebijing injection and Danshen injection have the relieving effect on the limb ischemic-reperfusion injury by ad-justing clotting function and decreasing free oxygen radicals .In terms of relieving the injury of muscle tissue ,the effect of Xuebijing injection might be better than Danshen .

Objective To improve the diagnosis rate and decrease misdiagnosis through analyzing the clinical and experimental features of neuroblastoma (NB) in children.Methods The clinical and experimental features associated with the misdiagnosis factors of 22 NB cases were analyzed retrospectively.Results Of the 22 cases,leg pain in 15 cases (68.18 ％),fever in 19 cases (86.36 ％),anemia in 20 cases (90.90 ％),abdominal pain and bloating in 15 cases (68.18 ％),exophthalmoses and bruises eyes in 4 cases (18.18 ％) and easily perspire in 20 cases (90.90 ％).Abdomen was the most common primary site founding in 16 cases (accounting for 72.72 ％),followed by mediastinum founding in 4 cases (accounting for 18.18 ％),other sites were 2 cases (9.09 ％).Laboratory results showed that anemia was the most common cause in 20 cases (90.90 ％),oligoleukocythemia in 2 cases (9.09 ％) and less in thrombocytopenia about 3 cases (13.63 ％).Elevated values were recorded in 77.77 ％ of patients for vanillylmandelic acid (VMA),86.36 ％ for ferritin (Fer),90.90 ％ for lactate dehydrogenase (LDH),and in 100.00 ％ for neuron specific enolase (NSE).20 cases were found metastasis when diagnosed,which accounted for 90.90 ％.16 cases (72.72 ％) were found tumour cells which determined in bone marrow and 20 cases (90.90 ％) were positive for CD56-FITC/CD81-PE/CD45-Percp by flow cytometry (FCM).12 (54.54 ％) of 22 NB cases were misdiagnosed for rheumatoid diseases (4 cases),dyspepsia (4 cases),leukemia (3 cases) and thrambocytopenia (1 case).In 22 cases,20 cases (90.90 ％) were positive for CT scan.16 cases (72.72 ％) were positive for abdominal B ultrasonography,and 14 cases (63.63 ％) were positive for radionuclide bone scan.Conclusion Bultrasonography and CT scan will contribute to find the primary focus of NB at early stage.VMA,bone marrow smear,biopsy and FCM detection could reduce misdiagnose rate.

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

Objective To investigate clinieopathologic characteristics and therapy of local advanced welldifferentiated thyroid carcinoma.Methods Data of 23 cases of advanced well-differentiated thyroid carcinoma treated from Jan.1996 to Dec.2005 were retrospectively reviewed.The data included age,pathologic type,local invasion,operative plan,postoperative complications and survival duration.Results Histology showed there were 15 cases of papillary carcinoma,6 ca8es of follicular carcinoma,and 2 cases of papiIlary follicular carcinoma.8 cases had local invasion into recurrent laryngeal nerve,12 cases had invasion into trachea,3 cases had trachea and esophagus invasion,and 8 cases had suprahyoid muscle invasion.All the 23 cases underwent resection procedure.According to surgical procedure,they were divided into radical resection group(n=6),tumor resection group(n=14)and tumor debulking group(n=3).2 cases received radiotherapy after thyroidectomy in tumor debulking group.All patients were followed up.Overall survival rate after 1 year,3 years and 5 years Was 91.3%(21/23),82.6%(19/23),and 60.8%(14/23)respectively.Prognosis of radical tumor removal group and tumor resection group was obviously better than that of tumor debulking group.Conclusions Prognosis is good for local advanced well-differentiated thyroid carcinoma patients receiving resection.Protection of local organ function Can enhance postoperative life quality.