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 explore the clinical significance of serum ProGRP in diagnosis of SCLC.Methods Serum ProGRP were detected in twenty-three SCLC patients,forty NSCLC patients and forty-three patients with benign pulmonary disease whose were definite diagnosis collected from April 15,2016 to July 19,2016,and a contemporary cohort of 40 healthy controls were while recruited.Results The levels of ProGRP in SCLC group were significantly higher than those in NSCLC group,benign pulmonary disease group and healthy control group(P <0.05).The levels of ProGRP in extensive disease group were significantly higher than those in 1imited disease group(P <0.05).There was no significant difference in the positive rates of ProGRP between the sex group and age group (P > 0.05 ).The boundary value of diagnosis of SCLC through ProGRP identified through ROC curve was 65.66 ng/L.The sensitivity and specificity of the ProGRP for the diagnosis of SCLC were respectively 90.9% and 89.9%.Conclu-sion Serum ProGRP can be use as a sensitive and specific index for diagnosis of SCLC,and the level of ProGRP can also be used for the clinical staging of SCLC.

AIM: To study the expression of laminin and survivin in primary gallbladder carcinoma(PGC),and their correlation with clinicopathologic characteristics of PGC.METHODS: Forty-nine specimens with PGC,21 with cholecystoadenoma and 13 with chronic cholecystitis were included in this study.Laminin and survivin expression in gallbladder tissues were detected by immunohistochemistry.The relationship between laminin or survivin expression and clinico-pathologic data were also analyzed.RESULTS: An intact basement membrane(BM) with well-delineated,smooth and continuous line-like laminin staining was identified in the tissues from chronic cholecystitis,adenoma of gallbladder and gallbladder carcinoma in situ.Submucosal BM,which was interrupted in PGC specimens in NevinⅡstage,was almost lost in tumor tissues in Nevin Ⅲ,Ⅳ and Ⅴ stage.Meanwhile,a distinguishing feature of the tumor tissue was broken or discontinuous line-like laminin staining in the matrix to tumor cells.These lines were detected to be weak,or even entirely absent in some neoplastic tissue sections.Sometimes,a faint cytoplasmic staining of laminin was also found in tumor tissues as classified to Nevin Ⅲ,Ⅳ and Ⅴ stage.Expression of survivin in PGC tissues was significantly higher than that in adenoma of gallbladder and chronic cholecystitis.However,survivin expressions had no specificity and positive predictive value for cell differentiation and grade as well as clinic stage of PGC by using statistical analyses.Furthermore,no correlation was confirmed between the staining features of laminin and survivin expression.CONCLUSION: Laminin expression is strongly associated with the malignancy and invasiveness of PGC,and survivin might play an important synergistic role in the development of PGC.

OBJECTIVE To analyze the reasons of misdiagnosis and surgical complications of primary lymphoma of thyroid gland(PLT). METHODS The clinical data of 10 patients with PLT in our hospital from 1992 to 2006 were retrospectively analyzed. RESULTS All of 10 patients were misdiagnosed,the major surgical complication was hoarseness. CONCLUSION The misdiagnosis of PLT is often encountered. Mastering the clinical features,using fine-needle biopsy,rapid biopsy combining immunocytochemical method can diagnose the primary lymphoma of thyroid gland.

BACKGROUND:It is unclear whether serial cel passage in vitro influences the differentiation of bone marrow mesenchymal stem cel s into neural stem cel s.
OBJECTIVE:To investigate the effect of cel passage on the differentiation of bone marrow mesenchymal stem cel s into neural stem cel s.
METHODS:Rat bone marrow mesenchymal stem cel s were isolated and cultured by the whole bone marrow adherence method. Bone marrow mesenchymal stem cel s at passages 3, 6, 9, 12 were incubated in serum-free medium. After culture for 7 and 14 days, cel biological characterization was observed and differenitaiton ability into neural stem cel s was observed by detecting Nestin expression in cel s using flow cytometry. Then, the cel s were further induced to differentiate and cel multipotential differentiation capacity was detected by measurement of nerve enolase and glial acidic protein expression.
RESULTS AND CONCLUSION:Under induction, bone marrow mesenchymal stem cel s at different passages were al differentiated into Nestin-positive neural stem cel s. However, there was a significant difference in differentiation proportion of cel s at different passages (P<0.05). Strongest differentiation ability was found in the passage 6 cel s, with the Nestin expression up to (93.7±2.3)%at 7 days of induction and (96.2±1.8)%at 14 days of induction. The proportion of differentiated cel s at passages 6 and 9 was signfi cantly higher than that at passages 3 and 12. Moreover, adherent cel s were positive for nerve enolase and glial acidic protein. Al these findings indicate that the differentiation of bone marrow mesenchymal stem cel s into neural stem cel s is correlated with cel passage. Cel s at lower or higher passages are both detrimental to cel differentiation.