Portal hypertension is a common complication of chronic liver diseases and is responsible for most of the clinical consequences of cirrhosis.Accurate assessment of portal venous pressure is essential for the designing of treatment strategy and judging of prognosis.Measurement of hepatic venous pressure gradient (HVPG) is the gold standard for evaluating portal venous pressure, however, it is an invasive procedure and is hard to be performed routinely in clinical practice.Therefore, it is urgent to explore a noninvasive method for assessing portal venous pressure.Recent evidence highlights that biochemical parameters, transient elastography, CT, MRI and the conjoint analysis model of multiple parameters have the potential diagnostic value.This article reviewed the advances in study on noninvasive assessment of portal venous pressure.

Background: Gastrointestinal involvement of Henoch-Sch(o)nlein purpura (HSP) lacks specific clinical manifestations, which makes it difficult to be diagnosed and easy to misdiagnose.Aims: To analyze the clinical characteristics and outcome of gastrointestinal involved HSP across all ages and provide evidence for early diagnosis and treatment of the disease.Methods: A retrospective analysis was conducted on 35 gastrointestinal involved HSP patients admitted to Shanghai Changzheng Hospital from Jan.2006 to Jan.2016.The clinical outcome was followed up by phone interview.Results: Of the 35 gastrointestinal involved HSP patients, 22 were male and 13 were female, with a mean age of disease onset at 33.6 years.The frequent disease onset seasons were winter and spring, and the most frequent precipitating events were eating foreign proteins and upper respiratory tract infection shortly before disease onset.Abdominal pain was the presenting manifestation in 35 patients (57.1%) and was most frequently at periumbilical area (42.9%), and 48.6% of the pain was of paroxysmal colicky pain.The abdominal signs were mild.Laboratory tests showed 57.1% of the patients had elevated leukocyte count and 25.0% had elevated serum IgA.Stomach, duodenum, rectum and colon were frequently involved endoscopically, and the endoscopic lesions included mucosal petechia, diffuse mucosal erythema, edema and erosion.Nonspecific inflammatory cells infiltration was demonstrated by biopsy pathology.The overall prognosis was good with a recurrence rate of 21.9%.Elevated serum fibrinogen degradation product (FDP) and D-dimer were found in all the recurrent patients at admission.Conclusions: Purpura rash usually appeared later than gastrointestinal symptoms in gastrointestinal involved HSP.Typical clinical manifestations and endoscopic appearances are helpful for early diagnosis and treatment.Elevated FDP and D-dimer might be the predictor of recurrence.

OBJECTIVE: To investigate the anti-inflammatory effect and acute toxicity of standard Magnolia biondii Pamp oil (SMBO). METHODS: The anti-inflammatory effect of SMBO was evaluated in five experimental animal models, including xylene-in-duced mice ear edema, carrageenin-induced rat hind paw edema, histamine-induced rat vascular permeability, cotton pellet-induced rat granuloma formation, and guinea pig schneiderian membrane immuno-inflammation. In addition, the 7-day acute oral toxicity of SMBO was evaluated. RESULTS: Pretreatment with a single dose of SMBO produced significant dose-dependent anti-inflammatory effects on xylene-induced mice ear edema, carrageenin-induced rat hind paw edema, histamine-induced rat vascular permeability, cotton pellet-induced rat granuloma formation, and guinea pig schneiderian membrane immuno-inflammation. In addition, a single oral dose of SMBO at 2.5 g · kg-1 body weight produced no observable acute toxicity in mice within seven days. CONCLUSION: SMBO possesses potent anti-inflammatory effect and has no observable acute oral toxicity, and the mechanism may be related with the inhibition of multi-inflammatory mediators and inflammatory hyperplasia.

Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Six of 7 lesions were located in the right adrenal gland,1 in the left.The diameter of the tumors was 3.7—7.5cm,with a mean diameter of 4.6cm.The CT value of the plain scans, AP phases and PVP phases was 16.2—31.7 HU(with a mean value of 24.3 HU),20.9—36.6 HU(with a mean value of 30.2 HU),and 27.4—45.5 HU(with a mean value of 36.0 HU),respectively.The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as IV,but didn't compress or occlude them.Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious,dynamic SCT scans could suggest the diagnose.

Objective To evaluate the efficacy of MRI-detected extramural venous invasion (mrEMVI) in predicting tumor responses to preoperative chemoradiatiotherapy (pre-CRT) in patients with locally advanced rectal cancer (LARC).Methods The clinicopathological data,tumor response and mrEMVI information of 47 LARC from February 2013 to December 2014 were retrospectively collected.mrEMVI was given 0-4 score according to the degree,3-4 score were defined as mrEMVI positive;patients with mrEMVI positive were divided into three subgroups according to vascular size (large,middle and small).Association between different mrEMVI subgroup and tumor response was analyzed using Fisher exact test.Result 26 patients were mrEMVI positive.18 and 8 patients scored 3 and 4 for mrEMVI positive,respectively;16,6 and 4 patients were small,middle and larger vessels of mrEMVI positive,respectively.Patients with mrEMVI positive had less TRG 0-1 than mrEMVI negative (P =0.019).Scored 4 and larger vessel of mrEMVI positive had less TRG 0-1 than mrEMVI negative (P =0.038 and 0.017).Conclusions mrEMVI positive score 4 or larger vessel predict poor tumor response to pre-CRT in patients of locally advanced rectal cancer.

OBJECTIVETo explore the operation methods and clinical effects of transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament in treating complete acromioclavicular joint dislocation.

METHODSFrom January 2006 to June 2012,26 patients with acute complete acromioclavicular joint dislocation underwent surgery. Transfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional clavical hoot plate and Kirschner wires fixation, were performed in all the patients. Among the patients, 18 patients were male and 8 patients were female, with an average age of 36.7 years old (ranged from 25 to 51 years). The duration from injury to operation was from 3 to 12 days with an average of 5 days. According to the Rockwood classification, 4 cases were grade III and 22 cases were grade V . Clinical manifestation included local swelling, tenderness with snapping, limitation of shoulder joint motion. In preoperative bilateral shoulder joint X-rays, the injured coracoclavicular distance was (16.2 ± 5.0) mm which was significantly wider than that of uninjured sides (7.6 ± 1.0) mm. Clinical results were evaluated according to X-rays and Constant-Murley score.

RESULTSAll incisions obtained primary healing after operation without complication of infection, internal fixation breakage, redislocation. All the patients were followed up from 12 to 30 months with an average of 18 months. Kirschner wires and internal fixation plate were removed at 1 month and 8-10 months after operation, respectively. At final follow-up, the motion of shoulder joint recovered to normal and a no pain joint was obtained. According to Constant-Murley score, 24 cases got excellent results and 2 cases good. There was no significant difference after operation between the injured coracoclavicular distance and the uninjured contralateral side [(7.7 ± 1.2) mm vs (7.6 ± 1.0) mm), P > 0.05].

CONCLUSIONTransfer of the medial half of the coracoacromial ligament to reconstruct the coracoclavicular ligament, additional fixation using hook plate and Kirschner wires is the effective surgical method in treating complete acute acromioclavicular joint dislocation.

Acromioclavicular Joint ; injuries ; Adult ; Female ; Humans ; Joint Dislocations ; surgery ; Ligaments, Articular ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods

Biomedical Research ; Humans ; Mouth ; radiation effects ; Radiation Injuries ; therapy

Abstracting and Indexing as Topic ; Neoplasms ; Periodicals as Topic

Sulfate-reducing bacteria (SRB) are widespread in the environment. SRB are obligate anaerobes and capable of dissimilatory reduction of sulfate. SRB have application prospects in the control of environmental pollution due to that many pollutants can be removed by SRB. The biological characteristics and metabolic mechanisms of SRB are introduced, and the application of SRB in the treatment of environmental pollution is described in this paper. The research progress of Cr(Ⅵ ) reduction and Cr(Ⅵ ) removal from wastewater by SRB is reviewed, and future direction of research on the control of Cr(Ⅵ ) pollution by SRB is also analysed.

Objective To construct replication-deficient recombinant adenoviruses AdHNF4?that co-expresse human hepatocyte nuclear factor 4?(HNF4?) and green fluorescent protein(GFP) gene,and to evaluate the effect of HNF4?up-regulation on hepatocyte gene expression.Methods The HNF4?cDNA was obtained through RT-PCR from human hepatocyte.The recombinant adenoviral plasmid- pAdHNF4?was established using AdEasy system and packed in 293 cells.After transfection of human hepatoma cell lines HepG2 and Hep3B with AdHNF4?,the expression of HNF4?and other liver-associ- ated functional genes were evaluated by RT-PCR and Western blot.Results The recombinant plasmid pAdHNF4?was confirmed by restriction endonuclease digestion and sequencing.GFP expression was observed on the fourth day after packing the linearized pAdHNF4?in 293 cells.Stable transfection of AdHNF4?with a titer of 1?10~(10) efu/ml was obtained after repeated amplification.More than 90% of human hepatoma cells had GFP expression in 72 hours after transfection of AdHNF4?.The expression of HNF4?mRNA and protein were significantly up-regulated compared with the control group(3.4 folds in HepG2 infected with AdHNF4a and 5.2 folds in Hep3B infected with AdHNF4?).Furthermore,the transcriptional expressions of some liver-associated functional genes such as apolipoprotein,cytochrome P450 families,glutamine synthetase,phosphoenolpyruvate carboxykinase and glucose-6-phosphatase also increased after transfection of the virus,and the apoptosis ratio of the cells increased.Conclusions Up- regulating the expression of HNF4?in human hepatoma cells with AdHNF4?could enhance normal liver- specific function.Our study would provide a new idea for the researches on gene regulation of transplan- ted hepatocytes.