Objective To observe the clinical effect of Zhang point in subclavian vein puncture. Methods One hundred patients underwent deep vein catheterization were selected, ASA grade of Ⅱ- Ⅲ. The patients were divided into 2 groups according to puncture method with 50 cases each, the patients in group A used traditional puncturing method, and the patients in group B used Zhang point puncture method. The total success rate, success rate of the first trial and incidence of complication were recorded. All the patients received the bedside chest X-ray examination to observe the location of central venous catheter after surgery. Results The total success rate and success rate of the first trial in group B were significantly higher than those in group A:100%(50/50) vs. 88%(44/50) and 96%(48/50) vs. 76%(38/50), the incidence of complication was significantly lower than that in group A: 4% (2/50) vs. 20%(10/50), there were statistical differences (P<0.05). Conclusions Using of Zhang point is very simple in subclavian vein puncture catheterization, with a higher success rate and a less complication rate.

Objective:To predict the basic physicochemical properties ,structure and function ,and linear B-cell epitopes of the capsid protein VP1 of coxsackievirus A6(CVA6).Methods: The amino acid sequence of the CVA6 VP1 was analyzed using Bioedit software and various online tools including SubLoc ,TargetP and the others from ExPASy Bioinformatics Resource Portal.Results: The CVA6 VP1 protein was a hydrophilic protein with a relative molecular weight of 33.6 kD and an isoelectric point of 7.92.This protein containsed 24 phosphorylation sites , but no signal peptide , transmembrane domains and possible fatty acylation sites.Its secondary structure was characterized by the richest random coils , and 48.52 percent of its amino acid residues exposed at the solution inter-face.Epitope prediction by Bepipred showed a number of potential B cell epitopes in the protein ,the highest antigenicity index among them located in the region of amino acids residue 155-165.Conclusion:The basic physicochemical properties ,structure and function characteristics ,and potential linear B-cell epitopes of CVA 6 VP1 were successfully predicted , which laid foundations for the further study on the protein and the preparation of vaccines and immunological diagnostic reagents for CVA 6 infection.

Objective To investigate the expression pattern and possible function of Nogo-A during neuronal growth. Methods E18 rat hippocampal neurons were primarily cultured both in high-density and low-density conditions. Immunohistochemistry and Western blot were performed to detect Nogo-A expression and distributional changes. Results Nogo-A was found in hippocampal neurons, mainly located in the cytoplasm, plasma membrane and neurites. It was detected at the proximal part of all neurites before axon formation. In axons, Nogo-A was enriched in the distal segment and axonal growth cone. In mature neurons, the fiber net work displayed a large number of Nogo-A immunoreactive varicosities. Conclusion The present results indicate that the neuronal Nogo-A may be involved in the process of neurite outgrowth and axonal projection.

OBJECTIVE: To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux. METHOD: We performed a retrospective review of 4 cases. RESULT: In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence. CONCLUSION Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
2-Pyridinylmethylsulfinylbenzimidazoles ; therapeutic use ; Arytenoid Cartilage ; pathology ; Gastroesophageal Reflux ; complications ; drug therapy ; Granuloma ; etiology ; Humans ; Male ; Pantoprazole ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Treatment Outcome

Objective:To investigate the relationship between tumor necrosis factor-α (TNF-α)-308A/G gene polymorphism and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM),and their correlative risk factors thereof.Methods:Forty cases of T2DM with MCI and 80 cases of T2DM without MCI were selected for this study.The polymorphism of the TNF-α-308A/G was detected by PCR-restriction fragment length polymorphism (PCR-RFLP).According to the clinical data,such as course of disease,plasma glucose,plasma fat and body mass index(BMI),the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression.Results:The frequency of TNF-α2 allele was significantly higher in the group of T2DM with MCI than that without MCI (P＜0.01).The indexes of the statistical significant difference between the two groups were the age,course of disease,postprandial blood glucose(P2BG),glycosylated hemoglobin,body mass index,family history of T2DM,hypertension,diabetic retinopathy,diabetic peripheral neuropathy and TNF-α.The independent risk factors included TNF-α,diabetic peripheral neuropathy,diabetic retinopathy,age and P2BG.Conclusion:There is a significant relationship between TNF-α2 allele and T2DM with MCI.There is a significant relationship between the age,control of plasma glucose and microvaseular complication of T2DM with the cognitive funotion.

Objective To explore the cause,treatment and prognosis of delayed massive haemorrhage (DMH) after pancreatic resection.Method Clinical data of 1554 patients undergoing pancreatectomy in our hospital from Aug 2003 to Aug 2013 were retrospectively analyzed.Results 16 patients suffered from DMH,including 13 patients who had undergone pancreaticoduodenectomy,and 3 patients who had had resection of pancreatic body and tail.Gastrointestinal haemorrhage occurred in 6 patients,intra-abdominal haemorrhage occurred in 10 patients,respectively.Reoperations were performed in 11 patients,transcatheter arterial embolization (TAE) undertaken in 2 patients,and endoscopic treatment in 3 patients.10 patients recovered after treatment,6 patients (6/16) died.Conclusions The mortality of DMH after pancreatic surgery is high.Postoperative pancreatic leak and gastrointestinal stress ulcer are the most possible risk factors,intra-abdominal arterial haemorrhage is the main cause of death.

Objective To investigate the relationship between apolipoprotein E(Apo E) gene poly-morphism and mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM), and e-valuate the correlative risk factors. Method 40 cases of type 2 diabetes with MCI and 80 cases of type 2 diabetes without MCI were enrolled in this study. The polymorphism of the Apo E gene was detected by PCR-restriction fragment length polymorphism(PCR-RFLP). According to the clinical data such as course of disease, plasma glucose, plasma fat and body mass index (BMI), the independent risk factors of T2DM and MCI were analyzed by non-conditional logistic regression. Results The frequency of Apo E ε_4 allele in the group of type 2 diabetes with MCI was higher than that without MCI ( 25.0% vs 10. 0% ), and the difference had statistical significance( P < 0. 01 ). The indexes of the statistical significant difference be-twcen the two groups were age, course of disease, postprandial blood glucose ( P2BG), HBA1C, BMI,family history of T2DM, hypertension, diabetic retinopathy, diabetic peripheral neuropathy, Apo E gene. The independent risk factors included diabetic retinopathy ( OR = 3. 452, P < 0. 05 ), diabetic peripheral neuropathy( OR = 3. 252, P <0. 05), Ape E gene( OR = 2. 441, P < 0.01 ), HBA1C ( OR = 1. 372, P <0.05), P2BG(OR = 1. 194, P <0.05), age(OR = 1. 194, P <0.01) and course of disease(OR =1. 142, P <0. 05). Conclusion Apo E ε_4 allele has significant relationship with T2DM and MCI. The age, course of disease, control of plasma glucose, and microvascular complication of diabetes have relation-ship with the cognitive function.

Objective This study is to summarize the experience of microsurgical reconstruction for donor liver anatomical variations of hepatic arteries in orthotopic liver transplantation. Methods During the bench surgery, the anatomy of donors′ hepatic arteries was carefully examined and microsurgical techniques were used for the anomalous arteries. The graft arterial flow was checked by Doppler ultrasound daily in the first week in postoperative period and periodically thereafter. Results The arterial anatomy was anomalousin 20 out of 141 (14%) donor livers. Nine cases (6.3%) needed arterial reconstruction. In these cases, 7(4.9%) aberrant right hepatic arteries originating from superior mesenteric artery were anastomosed to gastro-duodenal arteries and another two aberrant hepatic left or right arteries were anastomosed to the stump of the donor splenic arteries. Conclusions The variations of hepatic arteries in donors are common. To obtain the ideal arterial supply of liver graft, both careful checking on the origin of donor's artery and appropriate plastic performance with refined microsurgical techniques are necessary.

Objective To evaluate the efficacy and safety of daclizumab(zenapax) in liver transplantation patients with renal insufficiency. Methods We reviewed the use of daclizumab in 50 patients with renal insufficiency or at high risk of renal insufficiency during the period of liver transplantation between March 2001 to February 2003. The control group included 62 cases with no renal insufficiency at the same period. Results Renal function was recovered in 36 of 37 patients. The administration of daclizumab caused no vital organ dysfunction. Acute rejection was 6% (3/50) vs. 29 % (18/62) (P=0.826), infection was 56% (28/50) vs. 58% (36/62)(P=0.826). Conclusion Immunoprophylaxis with daclizumab regimen is safe, effective and well tolerated, and does not lead to increased opportunistic infections, and helps in improving renal function, by reducing the dosage and postponing the application of calcineurin inhibitor.

Objective To explore the cause of and treatment for psychiatric complications developed in the early stage after liver transplantation. Method The clinical data of 125 patients who underwent liver transplantation in our hospital were analyzed retrospectively. Results There was no significant difference in gender,age,liver function and the blood cyclosporine A level between psychiatric complication (PC) patients and those without PC. The anhepatic time and the total operation time of the PC group were longer than that of the non-PC group ( P